Asian Journal of Medical Research

Study of Serum Amylase Levels in Patients with Type 2 Diabetes Mellitus in a Tertiary Care Hospital

Anil Kumar — 2022-04-15

Background: Diabetes mellitus is an endocrine disorder of the pancreas, due to inadequate synthesis of insulin and /or resistance to the action of it. There is a close anatomical and functional relationship between its endocrine and exocrine portions both directly and in directly. So we are studying the Serum amylase in Type2 Diabetes mellitus (DM). The aims and objective is to study the Serum Amylase levels in patients of Type-2 Diabetes Mellitus and to correlate Serum Amylase level with the HbA1c level in patients with type-2 DM. Subjects and Methods: Patients with Type-2 Diabetes Mellitus aged more than 30 years were taken for the study. After obtaining consent from patient, a detailed history was taken and a proper clinical examination was done. Relevant clinical investigations were done. Serum Amylase was measured. Then Serum Amylase level was compared with the HbA1c level. Results: In this study, serum amylase level was statistically significantly lower in Type 2 DM group compared to non diabetics group with p value <0.01. Conclusion: The study revealed that patients with Type 2 DM the exocrine functions of pancreas are also affected. Patients of Type 2 DM have low serum amylase levels. Serum amylase levels was negatively correlated with HbA1c levels in patients with type 2 DM, indicating the exocrine dysfunction which needs further evaluation to rule out chronic exocrine pancreatic insufficiency in type 2 DM patients .

Clinical Proﬁle of Diabetic Nephropathy and Diabetic Retinopathy in a Tertiary Care Hospital

T. L Chetan — 2022-04-15

Background: Diabetic nephropathy is one of the leading causes of chronic renal failure in India contributing to over 30% of cases. In the last 50 years, blood urea and serum estimation have become the most commonly used serum markers of renal function. The aim is to assessment on Clinical Profile of Diabetic nephropathy and diabetic in a tertiary care hospital. Subjects and Methods: Study was conducted in KIMS on patients with type 2 diabetes and total of 137 patients were included in the study based on inclusion and exclusion criteria. Patients were divided two groups based on their UAC ratio, group A with patients and group b with patients. Statistical analysis were conducted and results were drawn. Results: Mean age of subjects in Group A was 55.24 ± 5.9 years and in Group B was 54.77 ± 5.4 years. Male predominance was observed in the study among both the groups. Mean Hba1C in group A is 7.18 ±0.28 and in group B is 7.68 ±0.27. Mean duration from the onset of diabetes in group A is 5.68 ± 2.37 and in group B is 6.48 ± 1.95. Mean RBS on admission in group A was 183.67 ± 38.3 and in group B was 206.71 ± 38.6. In group A, 22 members were found to have diabetic in group B 42 members were found to have diabetes . Mean Urine albumin in Group A was 13.30 ± 2.22 micro/ml and in Group B was 123.87 ± 46.67 micro/ml. There was significant difference in urine albumin between two groups. Mean Urine in Group A was 48.38 ± 6.64 mg/ and in Group B was 101.44 ± 20.93 mg/. There was significant difference in Urine between two groups. Conclusion: It can be concluded that serum C is elevated much earlier than UACR rises and appears and hence a better predictor of nephropathy among type 2 DM subjects.

Evaluating the Eﬀects of Topical Timolol 0.5% (Ophthalmic Solution) Over the Scalp in Case of Infantile Hemangioma

Niraj — 2022-04-15

Background: Infantile hemangioma (IH) is the most common tumour reported during infancy. These lesions are mostly proliferate during the first year of life after that involutions naturally happen within 7 years of age. We studied 15 patients out of whom seven completed all follow ups who were treated for IH on the scalp with topical application of 0.5% timolol maleate ophthalmic solution. The aims & objectives is to evaluate the effects and adverse effects of 0.5% topical timolol maleate solution in infantile hemangioma on the scalp. Subjects and Methods: Up to six month old children were included and treated with the drops of 0.5% timolol maleate ophthalmic solution twice daily on the lesions for 6 months. At the end of the study, patients were assessed about the acceptable outcome like, cosmetically acceptance, functional improvement, adverse reactions, especially alopecia. Results: Out of fifteen, seven children treated and followed up with timolol topical application. After six months treatment with 0.5% timolol maleate ophthalmic solution, the ratio of lesions which had complete improvement was 28.57% (2/7), substantial change in 14.28% (1/7), moderate change in 14.28% (1/7), fair change in 14.28% (1/7), minimal change in 14.28% (1/7), and only 1/7 cases (14.28%) did not change and the lesion increased in size. There were no adverse effects observed. Conclusion: Timolol maleate 0.5% ophthalmic solution has showed promising and safe results for the treatment of infantile hemangioma of scalp after 6 months of treatment without any significant side effect.

Lichen Planus: A Clinical and Epidemiological Study

Niraj — 2022-04-15

Background: Lichen planus is a common pruritic inflammatory disease that affects the skin, mucous membrane, nails and hair. The initial description of LP was given by Hebra and later, Erasmus Wilson (1869) has given it this name. Endogenous- genetic and exogenous- environmental components like drugs or infection may interact to elicit the disease. The familial form of the disease is common among human leukocyte antigen (HLA) haplotypes —B7,-Aw19,-B18 and —Cw8. Subjects and Methods: After getting ethical committee approval patients were selected from the out patients department of Skin & VD Varun Arjun Medical College and Rohilkhand Hospital. A total of 180 cases of Lichen planus were screened, examined and recruited. A detailed history was taken and through examination carried out after proper consent and counseling. Result: Majority (20.00%) of the patients belonged to 11-20 year age group. Male: female ratio was 0.64:1. 124 (68.89%) patients came from urban area and 56 (31.11%) from rural areas. Conclusion: The majority of the patients presenting were in the second decade.The majority of cases had disease duration of 2-5 years. Family history was present in a subset of patients and maximum cases with positive family history had guttate type of Lichen planus. Pterygium was the most common nail finding among various nail changes.

Analgesic Eﬀect of Intra Peritoneal and Port Site Instillation of Bupivacaine in Post Laparoscopic Cholecystectomy

Rakshit Ahuja — 2022-04-15

Background: Pain in cases of laparoscopy is a distressing side effect mainly in initial post-operative period. This randomized control study is done to evaluate the local effect of Bupivacaine instillation intraperitoneally and at port site. Subjects and Methods: Our study is a randomized controlled study of 90 cases of symptomatic cholelithiasis admitted and operated upon during the period of 24 months in the department of general surgery of our institute. The patients were randomly divided into 3 groups, Group A received intraperitoneal instillation of 20 ml of 0.5% Bupivacaine on gall bladder fossa and subdiaphragmatic region. Group B received 10 ml of 0.5%. bupivacaine on gall bladder fossa subdiaphragmatic and 10ml at the port site. Group C was the Control group who has not received any local analgesia. Postoperative pain and shoulder tip pain were then compared using Visual Analogue Scale (VAS) and Verbal Rating Scale (VRS). Results : At 2 and 4 hours pain score significantly more in Group C compared to Group B and A. After 8 hours there was no difference in pain score in all 3 groups. Time to receive first analgesia is significantly longer in group B compared to other groups. No difference in the shoulder pain in any of the groups. Conclusion: The instillation of Bupivacaine at the port site and intra-peritoneally (at the gallbladder fossa and sub-diaphragmatically), significantly decreases the pain in initial post-operative period in laparoscopic cholecystectomy.

Antibody Response Against Covid-19 Among Vaccinated Health Care Workers – A Cross-Sectional Serosurveillance Study

Rayvathy Balasubramanian — 2022-04-15

Background: The vaccination drive against COVID-19 in India began on January 16^th, 2021, with two approved vaccines - Covishield^TM and Covaxin^TM. Despite hurdles in the production and supply of vaccines, the vaccination rollout envisaged the successful vaccination of the entire adult population of the country by the end of this year. The humoral response against COVID-19 induced by the administration of two doses of any one of the two available vaccines was estimated among health care workers (HCW). Subjects and Methods: Semiquantitative estimation of SARS-CoV-2 IgG antibody against S1 domain of spike protein was done in the serum obtained from 89 HCWs using ELISA. The antibody response was correlated with age, sex, body mass index (BMI), and co-morbid conditions. A comparison of antibody response was done among the infection naïve and naturally infected study population. The common adverse effects following vaccination were identified. Results: The seropositivity rate of this study was 86.5%. Covishield recipients reported higher seropositivity (89%). There was no significant correlation of antibody response with age, sex, BMI, and co-morbid conditions. The antibody response was significantly higher in participants who had previous COVID infection when compared with the infection naïve group. Conclusion: Vaccination is essential for containing the current pandemic. Significant antibody titer is present in vaccinated individuals. The immune response of participants who had been previously infected is significantly improved with vaccination.

Bronchoscopy Characteristics and Outcome in Severe COVID-19 Patients: A Single Centre Study from North India

Deepak Kumar — 2022-04-15

Background: Bronchoscopy may be required in patients with severe COVID-19 to manage complications such as atelectasis or haemoptysis. Bronchoscopy in COVID-19, on the other hand, is not without risks and there are various guidelines to reduce clinical practise variability, but the supporting scientific evidence is scarce so, the present study was conducted with an aim to describe the bronchoscopy findings including BAL results and its association with patient outcome. Subjects and Methods: The present cross-sectional observational study was conducted among 120 critically ill patients requiring invasive mechanical ventilation for severe COVID-19 pneumonia admitted at tertiary care hospital during April 2020 to SEP 2021. Bronchoscopy procedure were performed under usual intravenous sedation and with pressure-controlled ventilation mode. After taking informed consent from relatives a pretested proforma was used to record the relevant details. The data was coded and entered into Microsoft Excel spreadsheet. Analysis was done using SPSS version 20. Level of significance was set at P 0.05. Results: The mean age of the subjects in the present study was 51.3 17.1 years. Around two third of subjects were males (65.8%). In this study, 27.0 % of BAL samples were positive for bacterial cultures or CB-NAAT, whereas 12.2 % of BAL samples revealed fungi on culture or spores on KOH mount. Thick mucus secretion was observed more frequently (p<0.05) among dead patients (64.5%) as compared to discharged patients (38.2%). Conclusion: In conclusion, haematic secretions and thick mucus secretion in the respiratory tract, as well as an absence of diffuse mucosal hyperaemia, are poor prognostic factors.