European Journal of Molecular & Clinical Medicine

To assess prevalance of hearing loss and tinnitus among Diabetes mellitus type 2 patients in the cross-sectional study.
Materials and Methods: 120 patients were divided into groups based on their age, gender, the duration of their diabetes mellitus (10 years), and the types of diabetic medications they were using. In a soundproof room, thorough otoscopy examinations of their ears were performed, along with the tuning fork test, PTA, and other tests. A questionnaire was used to assess tinnitus.
Results: The total no.of diabetic patients considered for this study are 120. Out of which, 76 patients were identified with sensorineural hearing loss (SNHL). In these SHNL patients,48 were identified with mild SNHL(63.15%), 22 patients with moderate SNHL(28.94%), 2 with moderate severe SNHL(2.63%) and 4 patients with severe SNHL (5.26%).Tinnitus is seen in 35 patients (29.16%).The association of age (p=0.21) and sex (p=0.58) with Hearing loss (HL) and tinnitus were not statistically significant. Nevertheless, the duration of diabetes mellitus in relation to these ailments were statistically significant (p=0.07).
Conclusion: The patients with Diabetic mellitus were having higher degree of hearing threshold with B/L mild to moderate SNHL. Age and Gender of diabetic mellitus patients had no major correlation with HL and tinnitus. While the duration had major correlation with HL and tinnitus. These results infer that there is more prevalence of hearing impairment and tinnitus and develop at an earlier age in type 2 diabetes patients

India is emerging as diabetic capital of world as 2nd most affected country in the world. Common microvascular complications are neuropathy, nephropathy and retinopathy. It is most common cause of preventable blindness all over the world. Hence has been included in VISION 2020. Global prevalence of DR was found to be 22.27%. In India the incidence and prevalence of diabetes and thereby DR is increasing exponentially in urban as well as rural population and involves population from all socioeconomic strata. The present study was undertaken to study the clinical profile of DR in known diabetics. It aimed to know the various factors affecting progression and pathogenesis of DR, to grade the DR, to know the complications and visual morbidity due to DR in our institution

To determine whether shoulder pain is common and whether it affects individuals with uncontrolled diabetes mellitus' ability to do daily activities (DM).
Methods: All patients with uncontrolled DM (HbA1c > 9) who visited the diabetes clinic throughout the study period were included in this cross-sectional study, which was carried out over a period of four months from October 2021 to January 2022. A doctor from the Family Medicine Department conducted telephone interviews using the American Shoulder and Elbow Surgeons Assessment Form, a previously validated questionnaire.
Results: The study involved 285 patients in all; 156 (54.7%) of them were women, and 129 (45.3%) were men. Most of the patients (51.1%) were in the 45-64 age range. 41.1% of the patients had type I DM, while 58.9% of the patients had type II DM. 10.56 was the mean HbA1c value. 42.5% of the patients (109; 38.2%) who reported shoulder pain were between the ages of 45 and 64, and 44.1% were between the ages of 65 and 96. In contrast to the 176 (61.8%) participants who reported no pain at all, 70% of men and 54% of women had no shoulder pain (p 0.001). According to various age groups, the average shoulder pain intensity for all patients was 5.81 (SD=3.21), ranging from 4.71 (SD=3.15) to 6.13 (SD=3.29) and showed a significant correlation (p<0.05).
Conclusions: Physicians are becoming more concerned about early identification and treatment of shoulder dysfunction due to its rising prevalence. In order to enhance the patients' daily lives, it should be obligatory for diabetes care programmes to include screening, preventive, and rehabilitation measures for shoulder dysfunction

To evaluate sensorineural hearing loss among diabetic subjects.
Materials & methods: A total of 20 cases with diabetes were enrolled. 20 control groups were included. The age of subjects was between 20- 60 years. Complete history was taken and ENT examination was done. Laboratory investigations were done. Random blood sugar concentration was noted. Chi square test was used to compare the categorical data. Significance level was fixed at p < 0.05.
Results: 20 were diabetic subjects and 20 were the control group. 15 (75%) cases had sensorineural hearing loss and 5 (25%) cases had normal hearing. Only 4 (20%) controls had sensorineural hearing loss and 16 (80%) controls had normal hearing.
Conclusion: Duration of diabetes plays a significant role in hearing loss

Diabetes mellitus type 2 usually occur in adults, which occurs when the body becomes resistant to insulin or doesn't make enough insulin. Various micro as well as macrovascular complications associated with chronic DM type 2.This study aimed to determine  magnitude of one of the significant macrovascular complication i.e silent myocardial ischemia in selected asymptomatic DM outpatients by exercise tread mill test.
Material and Methods: ThisCross sectional observational study was conducted at a tertiary care centre of Western India. Study population comprised of 125 asymptomatic type 2 Diabetes Mellitus patients, without any clinical evidence of Coronary Artery Disease, with normal resting ECG. Patients with Previous history of MI, heart failure, Evidence of angina pectoris, any additional chronic illness were excluded from the study. Silent Myocardial Infarction was identified using Treadmill test (TMT), conducted according to ‘Bruce protocol’ by CASE/T2100 sr number GE MAC.
Results: Proportion of Silent MI (Positive TMT) among Diabetics was 12.8%. TMT positivity was significantly associated with older age (p=0.002), duration of Diabetes for >10 years (p<0.001), dyslipidemia (p<0.001) and HbA1c >10% (p<0.001). Total cholesterol, LDL and Triglycerides were found to be significantly higher in TMT positive patients as compared to TMT negative patients. HDL level was significantly lower in TMT positive patients as compared to TMT negative patients.
Conclusion: A significant proportion of patients with type 2 Diabetes mellitus had silent myocardial infarction or asymptomatic Coronary artery disease. Diabetics with older age, obesity, dyslipidemia, high HbAIC had higher risk of silent MI. TMT could be used as a simple, non-invasive tool for early identification of Silent MI.

Aim: The COVID-19 global pandemic had resulted in a rise in a spike of Mucormycosis (black fungus) in COVID-19 individuals and diabetes is a standalone risk factor for both severe COVID-19 and black fungus, especially in India. We sought to find out how often CAM (Covid 19-associated Mucormycosis) was among both diabetes and non-diabetic individuals.
Method: The data was gathered from Kaushik pathology Lab, Barara, Ambala, Haryana. The study includes 300 patients divided into 2 groups. Both the groups comprise of 150 patients each. Group 1 consist of patients with diabetes whereas group 2 comprise of non-diabetic patients. Prevalence of CAM was then noted in both the groups.
Result: The study showed that in group 1, 74.4% cases were reported as CAM and 25.6% cases were identified as non-CAM whereas in group 2, only 38.4% CAM cases were reported in non-diabetic patients and majority of them (61.6%) were evaluated as non-CAM. A significant difference was also observed between the prevalence rate of both the groups (P < 0.05).
Conclusion: A significant difference in the CAM cases of both the groups was observed. Interestingly diabetic patients were found to be more prevalent to be infected with CAM. Further, it was concluded that New-onset diabetes was the predominant risk factor for CAM in our study. COVID-19 being other important ones for Mucormycosis in COVID-19 patients.

Background: India is the world's largest TB epidemic country, with approximately 2-3 million new cases of TB. Diabetes mellitus (DM) is an emerging chronic health condition of developed and developing countries. It increases the risk of developing active TB by a factor of 2–3 compared with normal population. Materials And Methods: Patients with sputum smear positive pulmonary tuberculosis with diabetes mellitus were enrolled for a prospective observational study at GMC Jammu in India. Diagnosis of Diabetes Mellitus was based on the following criteria: Blood Sugar Fasting > 126 mg/dl, Blood Sugar (after 2 hrs during OGTT) > 200mg/dl and HbA1C > 6.5%. Results: Persons with diabetes mellitus (DM) have a 3-fold increased risk of developing tuberculosis. The median age of the Diabetic patients was significantly higher than the non-diabetics. Magee et al reported that TB–DM patients were significantly more likely to be older. After 2 months of treatment, the sputum positivity decreased in both the groups. There were significantly more Diabetics (28%) as compared to non- diabetics for AFB (P<0.05).  Conclusion: After anti-TB treatment, the sputum positivity decreased in both the diabetics and non-diabetics. However, decrease was less in diabetic patients at 2 months of treatment. Increasing age was an independent risk factor of increased risk of symptoms. Patients having both tuberculosis and DM should be screened for TB in early stages.

Diabetes mellitus is a global epidemic, and India being the major epicenter of it. However, many synthetic drugs are available in the market. But produce specific side effects or residual effects. The concept of plant-based inhibitors has come up to overcome the adverse effects of synthetic drugs. Plant-derived inhibitors are less toxic, have minimal side effects, and are easily adaptable by the human body. Sequential solvent extraction of Premna herbacea leaves was carried out to evaluate the in-vitro and in-vivo anti-diabetic properties against streptozotocin (STZ) induced Wister albino diabetic rats. Among all the extracts, methanol showed the highest inhibitory potential of α-amylase (IC₅₀ 68.62  ± 2.11) and α-glucosidase (IC₅₀ 75.01 ± 2.40) significantly in comparison to standard acarbose. The toxicity, carbohydrate tolerance, and biochemical parameters among the experimental animal groups were performed using the methanol extract. The methanol extract showed no toxicity and side effects. It had significant tolerance against glucose, maltose, and starch compared to the diabetic control and standard groups. The methanol extract has shown effective results in controlling body weight loss, decreased blood glucose level, and other biochemical parameters like cholesterol, triglycerides, and glycosylated hemoglobin. The in-vitro and in-vivo results suggested that the methanolic Premna herbacea leaves extract is a dose-dependent inhibitor of α-amylase and α-glucosidase in managing type 2 diabetes mellitus. Furthermore, the GC-MS analysis validates the hypoglycemic property of Premna herbacea by reporting the presence of major active anti-diabetic compounds like Beta-Sitosterol, Octadecenoic Acid, Triacontanoic Acid, Phytol, Methyl Eicosatetraenoate, Stigmasterol, Thymol, and D-Mannitol.

Introduction: Obesity has become the leading global health problem. In numerous large population-based studies-Higher BMI associated with presence and development of low estimated GFR and many other renal diseases.
Objective: To study the renal functions in obese adults of rural area.
To do comparative analysis of renal functions with age and sex matched non obese adults.
Material and Methods: The present cross-sectional study was carried out in the General Medicine OPD of BPS GMC for Women, Khanpur Kalan, Sonipat, Haryana. A sample of convenient 100 obese patients were taken. A total of 200 patients attending General Medicine OPD were taken, out of which 100 were obese and 100 were non obese.
Results: Statistically significant P values were obtained for Blood Urea, Serum Creatinine, Serum Calcium, Serum Phosphorus, and urine albumin among obese and non-obese adults. Study shows no significant gender differences between obese and non-obese. Statistical analysis shows some age-related differences among obese and non-obese large population studies-showing positive association of BMI with chronic kidney disease.

Type 2 Diabetes mellitus (T2DM) is a chronic metabolic disorder characterized by hyperglycemia. It affects millions of people worldwide and is the fourth leading cause of death in India. One of the most important and effective treatment to achieve glycemic control in diabetic patients are various oral hypoglycemic agents with adequate lifestyle modifications and physical activities. Sodium glucose cotransporter 2 inhibitors are one such emerging oral hypoglycemic agents that achieve the desired goal with some complimentary benefits. This prospective observational study using four different SGLT2 inhibitors amongst 68 patients with Type II diabetes namely Canagliflozin 100 mg, Dapagliflozin 10 mg, Empagliflozin 25 mg, Remogliflozin 100mg has shown promising results in managing glycemic control along with complimentary benefits including weight loss

Background: Covid-19 infection time and again has been causing major morbidities and mortalities. Increased vulnerability of Covid-19 recovered patients was seen towards mucormycosis infection. Mucormycosisis is an aggressive, angioinvasive fungal disease caued by fungi of order Mucorales. This increase in cases may be attributed to a weakened immune system, pre-existing comorbidities such as diabetes, overzealous use of steroids. We conducted a study on 25 cases admitted in mucor ward in a tertiary care setting to highlight this association and focusing on possible causes so that we can be prepared to handle any such catastrophe in future in a better way.
 Methods and results: We did a retrospective study on 25 cases admitted in a tertiary care center catering to large population of Covid -19 patients with varying severity.Covid-19 associated mucormycosis(CAM) was found to be more common in males(76%).Diabetes mellitus was the most common underlying condition(72%).68% patients had received steroids and antibiotics , 28% patients had history of receiving Oxygen. In CAM predominant presentation was rhino-orbital mucormycosis. Unilateral orbit involvement was seen in (88%) cases.
Conclusion: As severe acute respiratory syndrome coronavirus-2 is highly susceptible to mutations and is causingseries of waves, its association with opportunistic fungal infection is a serious concern. Incidences of mucormycosis were increased in Covid-19 patients due to immune modulation and coexistence of immunosuppressive conditions  such as diabetes. Concurrent glucocorticoid therapy further heightens the risk. Early diagnosis and prompt intervention can help improve outcome.

Red cell distribution width (RDW) have been found to be altered in uncontrolled diabetic patients because of consistent increase in HbA1c values that are known to induce functional and structural changes in Hb and an alteration in its cytoplasmic environment. Alteration in RDW may have a role in the diagnosis and monitoring of glycemic status along with its complications.
Objective: Present study aims towards analysis of correlation of red cell distribution width with HbA1c in T2DM patients.
Methodology: Present study was a case control study in which total 50 cases and 50 controls were recruited. Controls were the healthy non-diabetic patients and cases involved patients with diabetes. Patients were categorized as diabetic and non-diabetic as per American Diabetes Association Diagnostic Criteria. 3ml blood sample was obtained to analyze the RDW and HbA1c.
Results: The mean age of patients was 59.54±10.78 in the cases and was 55.40±15.63 in control group. The mean HbA1c was 10.79±2.45 was significantly high in cases compared to 5.59±0.31 in controls. The mean RDW was 13.69±1.31 in cases and 13.40±1.17 in controls which do not differ significantly. In diabetes patients, a non-significant positive correlation was observed between the HbA1c and RDW with the correlation coeffect of 0.027.
Conclusion: In present study, a non- significant correlation was observed between the RDW and HbA1c in diabetes patients. A multicentric study with a large sample size is required to establish diagnostic significance of RDW in diabetes patients.

It determined the frequency, dimensions, treatment, and results of the COVID-19 pandemic in children who had endocrine problems and diabetes.
Methods: A worldwide network of endocrine societies was sent an internet survey in the form of a cross-sectional questionnaire. The professional and practice characteristics of respondents, the size of their clinics, the nation in which they practiced medicine, and the influence that COVID-19 had on endocrine illnesses were explored.
Results: The study was completed by respondents from 134 pediatric endocrine institutions located in 51 different countries and across all seven continents. The majority of pediatric endocrinology clinics have made adjustments to their standard checkups as well as their educational programming. More than twenty percent of clinics reported experiencing a lack of availability of crucial supplies or drugs. Patients diagnosed with diabetes and COVID-19 needed therapy in an intensive care unit. It has been clearly stated that pediatric patients with endocrine abnormalities have alterations in their biopsychosocial functioning as well as their behaviors.
Conclusions: This extensive worldwide study was carried out during the COVID-19 pandemic, and its findings underscore the fact that diabetes is more difficult to control than any other juvenile endocrine illness, and it also carries a higher risk of morbidity. It is necessary to acknowledge and treat the psychological anguish that has been caused by COVID-19. Every patient ought to have easy access to medical supplies, and it is essential that they maintain frequent interaction with the medical staff who are responsible for their treatment

Background: Obstructive sleep apnea (OSA) is being recognized as an important public health problem worldwide. The timely diagnosis and treatment of OSA with underlying etiology leads to decreased symptoms and increases quality of life among OSA patients. Present study was aimed to study clinical profile of patients with obstructive sleep apnea attending tertiary care hospital. Material and Methods: Present study was single-center, prospective, observational study, conducted in patients more than 18 years of age, had symptoms suggestive of Sleep Disordered Breathing such as, excessive daytime somnolence, disruptive snoring, fragmented sleep, choking and gasping, un-refreshing sleep, morning headache, personality changes and Impaired concentration, insomnia, daytime headache. Sleep study parameters collected from polysomnography were Apnea–Hypopnea Index (AHI). Results: During study period, total 66 patients underwent evaluation. Mean age was 47.9 ± 14.2 years. Majority were male (62.12 %) as compared to female (37.88 %). Mean body measurements such as mean height was 1.59 ± 0.14 meters, mean weight 91.2 ± 23.3 kgs, mean Body Mass Index was 30.4 ± 6.1 kg/m², mean neck circumference was 35.2 ± 4.2 cms & lowest saturation % in sleep study was 82.2 ± 9.6 %. Common co-morbidities noted were hypertension (57.58 %), overweight (48.48 %), smoking (31.82 %), obesity (30.3 %), diabetes mellites (25.76 %), asthma (13.64 %) & COPD (10.61 %) In present study, majority patients had Severe OSA (56.06 %) followed by moderate OSA (28.79 %), mild OSA (9.09 %) while 4 patients had no OSA (6.06 %). Conclusion: Obesity, Hypertension and diabetes were common associations in patients with significant obstructive sleep apnea. Polysomnography is a useful investigation which helps in diagnosis of OSA.

The globe today faces as epidemic of non-communicable diseases (NCD), which will soon surpass communicable diseases. Indian Diabetes Risk score developed by Madras Diabetes Research Foundation and Ramachandran A et al⁸ can be used as simple tool to screen the population in an area. Aim and objectives: Screening of diabetes mellitus in a rural area by using IDRS. Material and Methods: The cross sectional study was done in field practice area of rural health and training centre associated with a medical college. From the survey proforma four important factors like, age, abdominal obesity, family history of diabetes and physical activity were taken to calculate Indian diabetes Risk score- IDRS. The study tool which we have used in this study was IDRS - Indian Diabetes Risk Score - A simplified form of score for screening undiagnosed Diabetics. Results: Our study included 610 study participants in which majority 64.26% males, 73.77% belonging to nuclear family and majority were from lower and lower middle class of socioeconomic status. Risk factors calculated for IDRS show 29.18 % of participants were above 50 years and abdominal obesity measured in terms of waist circumference show higher level in males that is 43.11% males were having WC from 91-99 and 24.59% males were having above 100 waist circumference .as physical activity was assessed it shows majority that is 43% were doing moderate activity, 21.48 were doing mild physical activity and 13.44% were sedentary population.

Background: To assess prevalence of diabetic retinopathy in non- insulin dependent diabetes mellitus (NIDDM) patients.
Materials and Methods: One hundred thirty non- insulin dependent diabetes mellitus (NIDDM) patients of both genders were enrolled and the prevalence of DR was recorded. Retinopathy was classified as mild non-proliferative retinopathy, moderate non-proliferative retinopathy and severe retinopathy.
Results: Out of 130 patients, males were 70 (53.8%) and females were 60 (46.2%). Out of 70 males, 42 (60%) males and out of 60 females, 28 (46.6%) females had diabetic retinopathy. The difference was significant (P< 0.05). Out of 70 diabetic retinopathy patients, mild non-proliferative retinopathy was seen in 14 males and 8 females, moderate non-proliferative retinopathy was seen in 18 males and 12 females, severe non-proliferative retinopathy was seen in 10 males and 8 females. The difference was significant (P< 0.05). Duration of diabetes was <5 years was seen in 14, 5-10 years in 26 and >10 years in 30. In 45 patients with DR, family history was positive. DR was present in patients with BMI <24.9 in 13, 25-29.9 in 15 and >30 in 42. Hypertension was seen in 48. The difference was significant (P< 0.05).
Conclusion: Results showed that maximum cases of diabetic retinopathy were seen in patients with BMI >30, hypertension and with 5-10 years of diabetes and with positive family history of diabetes.

Background: Diabetes is a major cause of morbidity and mortality worldwide and it contributes substantially to healthcare costs. The present study was conducted to assess cardiovascular risk factors in diabetes patients.
Materials & Methods: 86 type II diabetic patients of both genders. In all the patients, biochemical and hematological profile was obtained. Various cardiovascular risk factors were recorded.
Results: Out of 86 patients, males were 56 and females were 30. Common risk factors in diabetes patients were coronary heart disease in 12, peripheral heart disease in 5, stroke in 4 patients, retinopathy in 2 and nephropathy in 3 patients. The difference was significant (P< 0.05).
Conclusion: Common risk factors in diabetes patients were coronary heart disease, peripheral heart disease, stroke, retinopathy and nephropathy.

Background: The prevalence of type 2 diabetes mellitus (T2DM) is increasing worldwide and so are the disease-associated complications. The present study evaluated correlation of glycosylated hemoglobin (HbA1c) with microalbuminuria among diabetics.
Materials & Methods: 58 type II diabetics of both genders were enrolled. Blood pressure, smoking habit, family history of diabetes, renal disease and hypertension was recorded. Blood samples were analyzed for HbA1c, fasting blood glucose, postprandial blood glucose, serum urea and serum creatinine. Urine sample was analyzed for microalbuminuria.
Results: Out of 58 patients, males were 38 and females were 20. Duration of diabetes was 1-5 years in 27, 6-10 years in 20 and 10-15 years in 11 patients. Family history was positive in 23. Fasting blood glucose level was 182.4 mg/dl, PPBS level was 240.6 mg/dl and HbA1C was 9.15%. The difference was significant (P< 0.05). Microalbuminuria and glycemic control have shown a significant linear correlation with duration of diabetes (p<0.05). Also micro albuminuria has a significant negative correlation with increase in level of glycosylated haemoglobin.
Conclusion: The prevalence of microalbuminuria in diabetic patients was found to be high. Microalbuminuria has a significant negative correlation with increase in level of glycosylated haemoglobin.

Background: The estimated prevalence of fatty liver in the general population averages around 14-25 % with rising prevalence in the presence of risk factors. Liver biopsy continues to be the ultimate and specific investigation for assessing the nature and severity of a spectrum of liver diseases. Present study was aimed to study clinical & histological profile of patients with nonalcoholic fatty liver disease.
Material and Methods: This study was retrospective and prospective, observational study, conducted in patients with increased echo texture of liver on routine ultra-sound scan, suggestive of fatty liver disease, prior to performing percutaneous liver biopsy, the proper preparation of a patient is important, with attention to a detailed knowledge of the procedure, a complete history and physical evaluation, medication use, and fresh clotting parameters.
Results: In present study, among 60 patients, 36 (60%) were females and 24(40%) were males. Majority were from the age group of 41- 50 years (36.66%), followed by 51-60 years (30 %).  Commonest symptom was fatigability and malaise (66.66%), followed by right upper abdominal discomfort (46.66%), Jaundice (10%), ascites (10%), UGI Bleed (8.3%) patients and 20 (33.33%) patients were asymptomatic at the time of diagnosis. The commonest clinical sign was of hepatomegaly or palpable liver (90%), edema (35 %), abdominal distension (18.33 %), splenomegaly (16.67 %) & icterus (13.33 %). Various risk factors noted were dyslipidemia (61.67 %), diabetes mellites (58.33 %), hypertension (53.33 %), overweight (50 %), obese (46.67 %) & coronary artery disease (40 %). 7 patients underwent biopsy. Of these 4.28% patient showed steatohepatitis, 42.86% patients showed simple fatty change and 14.28% patient had cirrhosis. Other 28.57% had no specific changes.
Conclusion: Our findings were consistent with the earlier concept that non-alcoholic steatohepatitis was prevalent in obese females with diabetes and hyperlipidemia.

The global prevalence of diabetes is increasing exponentially and expected to reach 783 million by the end of year 2045. The burden of complications of diabetes can be mitigated if the disease is diagnosed early and treated adequately. A cross-sectional pilot study from July 2021 to October 2021 on 52 participants from diverse areas of Bareilly (Northern India) was conducted. Only 38.46% of participants found to have good knowledge (knowledge score ≥ 19). Characters like ‘level of education’, ‘close relative with diabetes’, ‘income’ and ‘education in the medical field’ were having significant association with good knowledge score (p<0.05). Around 67.28% population showed positive attitude towards diabetes. Although ‘the education related to medical field’ and ‘level of education’ were found significantly associated with positive attitude (p < 0.05) and binary logistic regression showed both the variable as the predictor of positive attitude. The mean knowledge score of participants possessing positive practices in relation to ‘doing regular exercise’ was higher compared with who do not do regular exercise (p<0.001). Conclusively, the current study can be considered as a baseline for nationwide diabetes awareness programs to revamp the knowledge of population towards diabetes emphasizing the development of attitude & practices.

Background: Dry socket lesions occur in about 1%-5% of all extractions and in up to 38% of mandibular third molar extractions. The present study assessed risk factors of dry socket after tooth extraction.
Materials & Methods: 190 patients who underwent extraction of both genders were included. Smoking status, systemic diseases, use of oral contraceptives, antibiotic consumption before extraction, number of carpules used for anesthesia etc. recorded. The incidence of dry socket was recorded.
Results: Out of 190 patients, males were 85 and females were 105.Common risk factors were <2 carpules seen in 8 and >2 carpules in 4, use of pre-anaesthetic antibiotic consumption in 2, use of field block in 7 and regional block in 5 patients with dry sockets. The smoking was seen in 10, diabetes seen in 11 and systemic diseases in 6 patients of dry sockets. The difference was significant (P< 0.05). Out of 190 teeth, 12 (6.3%) had dry sockets.
Conclusion: Common risk factors for dry sockets was use of less than 2 carpules, non- use of pre-anaesthetic antibiotic consumption, field block anaesthetic technique, smoking, systemic disease and diabetes.

Background:Acute myocardial infarction (AMI) is one of the leading causes of all acute emergencies and is becoming an important public health problem in the developing countries. The present study was conducted to assess complications and mortality in ST-segment elevation acute myocardial infarction in diabetic and non-diabetic patients.
Materials & Methods: 80 consecutive patients of diabetic (group I) and non-diabetic (group II) having acute ST-segment elevation myocardial infarction (STEMI) of both genders were included. Different treatment was given to all patients.
Results: Age group <40 years had 12 diabetic and 14 non- diabetic, 40-55 years had 25 diabetic and 22 non- diabetic, 55-70 years had 15 diabetics and 18 non- diabetics and >70 years had 28 diabetics and 26 non- diabetics. The difference was non- significant (P> 0.05). Site of AMI was anterior in 30 and 20, inferior in 20 and 40, inferior+ right ventricular in 20 and 10 and lateral in 10 and 5 in group I and II respectively. Mortality was seen in those in which streptokinase was given in 6 and 3 and streptokinase not given in 14 and 8 in group I and group II respectively (P< 0.05). Type of treatment given was beta- blockers in 82, ACE inhibitors in 105, streptokinase in 96, aspirin in 154, statins in 128 and diuretics in 44 patients. The difference was significant (P< 0.05).
Conclusion: In diabetic and in non- diabetic, reduction in mortality rate was seen with the streptokinase administration. However, diabetics not on streptokinase had higher mortality as compared to non- diabetics

Introduction: In addition to having a small carbon footprint and the capacity to endure high temperatures with little water, millets are recognised to be very nutrient-dense foods. Millets are well known for helping to treat diabetes because of their low Glycaemic Index (GI). All of the evidence was compiled in this meta-analysis across all millets and cooking/processing methods.
Methods: 39 papers with 111 observations were chosen from the 65 research that were gathered globally to examine GI outcomes. In a meta-analysis, results from 56 trials were examined for fasting, post-prandial glucose level, insulin index, and HbA1c levels. The descriptive statistics make it clear that millets have a mean GI that is 36% lower than that of popular staples like refined wheat and milled rice.
Results: The descriptive, meta, and regression results demonstrated that the millets with the lowest mean GI were Job's tears, fonio, foxtail, barnyard, and teff. A meta-analysis revealed that all millets, with the exception of small millet, which had contradictory data, had considerably lower GI than white rice, refined wheat, conventional glucose, or white wheat bread. In diabetic patients, long-term millet eating significantly decreased fasting and post-prandial blood glucose levels by 12 and 15%, respectively. A significant decrease in HbA1c level was observed in pre-diabetic patients who consumed millets over an extended period of time. Compared to milled rice and refined wheat, less processed millets were 30% more successful at lowering the GI of a meal.
Conclusion: As a result, millets may be utilised to create appropriate meals for diabetic and pre-diabetic patients as well as for persons without diabetes as a preventive measure. Millets can also be helpful in treating and reducing the risk of acquiring diabetes.

Background: Diabetes is the commonest endocrine disease affecting mankind. The present study was conducted to assess ECG abnormalities and treadmill test findings in patients with type 2 diabetes mellitus.
Materials & Methods: 80 diabetic and 50 non-diabetic subjects of both genders were enrolled. All the subjects underwent fasting and postprandial blood sugar, glycosylated haemoglobin (HbA1c), lipid profile (fasting and post-prandial), electrocardiography (ECG), and treadmill test (TMT) monitoring.
Results: Group I had 50 males and 30 females and group II had 20 males and 30 females. Out of 80 diabetes patients, ST depression & T wave inversion was found in 24, 10 had  Left atrial enlargement(LAE), 6 had left ventricular hypertrophy(LVH), 4 had Right bundle branch block (RBBB) and 2 had left bundle branch block (LBBB). The difference was significant (P< 0.05). 52% had abnormal triglyceride (TG), 54% abnormal total cholesterol(TC), 55% abnormal high-density lipids (HDL), and 56% abnormal low-density lipids (LDL) having positive TMT test. The difference was significant (P< 0.05).
Conclusion: Patients with T2DM had a higher prevalence of ECG abnormality. T2DM patients are also found to be more TMT-positive.

Background: The most noticeable part of human body is face. The obvious boundaries on the skin known as Pigmentary Demarcation Lines (PDL) found over face and have clear borders of abrupt transition between more hyper-pigmented skin and areas of normal skin pigmentation due to differences in melanocyte distribution that may be influenced by multiple factors. Facial pigmentary demarcation lines (PDL) directly reflect on patient’s physical appearance and self-image as they may contribute to dysmorphism and even central to depressive illness in susceptible individuals posing cosmetic concern for the patient and a challenge for dermatologist. Therefore, it is important for early identification and management of facial skin disorders. Until now, nine different types of PDLs have been described which are designated as Type A to I of which Type F to H PDLs are most common on the face. Etiology involving the whole spectrum of PDL continues to be an enigma and needs further research among Indian population.
Materials and Methods: Total 304 patients between 15 to 75 years of age range were included in study lead between May 2018 to May 2020 after thorough examination for inclusion and exclusion criteria, informed consent and Ethics committee approval. Statistical analysis was done using descriptive and inferential statistical approach using Chi-square test and Fisher’s exact test and p value was calculated and considered to be significant if <0.05.
Results: Out of 304 study subjects the frequency of facial PDL type H (50.65%) was most common than type G (29.60%) and type F (19.73%) with male predisposition (79.60%) with agricultural occupations (59.86%) than females and with significant family history from father (41.44%). Most of the present study subjects were of Fitzpatrick skin type IV (50.01%) with hyper-pigmented macules (12.5%) and shown unilateral PDL symmetry (58.22%) with sharp PDL line margins (81.25%). The most common aggravating factor was prolonged exposure to sun light (56.90%) and most of (25.98%) the subjects experienced periorbital melanosis at different times. Diabetes (38.15%) and hypertension (29.60%) were the most common co morbidities observed in study subjects. Using Fishers exact test, p value was calculated and it was found to be highly significant (p=0.003).
Conclusion: Present study pronounces the incidence of facial PDL (types F-H) are sharply common especially amongst the males who are in agricultural occupations with prolonged sun exposure and with other co morbidities like diabetes, hypertension and tuberculosis. In females the prevalent type was Type H PDL during and after pregnancy. The agricultural occupations with prolonged sun exposure, diabetes, hypertension, tuberculosis and positive paternal family history were shown strong correlation with facial PDL among Indian population irrespective of gender and it was found to be highly significant (p=0.003).

Objectives: To study the awareness about the disease related complications in the diabetic patients who are, as yet, not suffering from any long-term complication.
Methods: A cross-sectional observational study was conducted involving 389 patients of type 2 diabetes for a period of two years, from March 2018 to March 2020 in a tertiary care centre. The patients having disease diagnosed with in last five years and not suffering from any diabetic related complication were included in the study. The questions pertaining to the knowledge about complications related to eyes, kidneys, nerves, brain and heart were asked and recorded. The data was entered in MS EXCEL spreadsheet and analysis was done using Statistical Package for Social Sciences (SPSS) version 21.0.
Results: The most common complication known was retinopathy (45.48%), followed by nephropathy (38,69%), peripheral neuropathy (33.42); cardiac complications (26.13%) and stroke (37.19%). The factors associated with good knowledge and awareness were advanced age, higher socioeconomic status, male gender and presence of positive family history of diabetes.
Conclusion: There is a wide gap in the knowledge of Diabetes and its related complications among the patients which may prevent them from taking good care about their glycaemic levels. It demands a bidirectional approach by the treating doctor and the patient himself to update the knowledge about the chronic debilitating nature of the disease to better the outcomes of the patients in terms of associated morbidity and mortality.

Background::Hypertension is a major public health problem among India. It is a important area of research due to its high prevalence and being major risk factor for cardiovascular diseases and other complications.

Background:Diabetes Mellitus is the most common metabolic disease and is posing as a major public health problem in the world, developing countries like India in particular. India has the second highest number of diabetics worldwide after China. Diabetes Mellitus is characterized by chronic hyperglycemia due to defective insulin secretion and / or insulin resistance. Non-insulin dependent diabetes mellitus (NIDDM) or type 2 diabetes mellitus accounts for more than 85% of the all the diabetics. It can occur at any age but is most common between 40 to 80 years of age. Macro minerals (calcium, magnesium, chloride, sulphur and phosphorus) play an important role in intermediary metabolism and cellular function, including enzyme activities and electrical gradients. The present study of these parameters is essential in clinically diagnosed patients of type 2 diabetes mellitus to show their role in the pathogenesis and to ascertain their role as possible biochemical markers of the disease progress.
Materials and Methods: Observational cross-sectional study was done. STUDY SUBJECT AND SIZEA total of one hundred patients aged between 30 years to 60 years, both male and female patients were selected from King George Hospital attached to Andhra Medical College, Visakhapatnam. Fifty patients diagnosed with type 2 diabetes mellitus attending OP at Department of Endocrinology and fifty healthy non-diabetic subjects were selected. The subjects are divided into two groups, fulfilling the inclusion and exclusion criteria. Group A (Cases): consisting of 50, type 2 diabetes mellitus diagnosed patients Group B (Controls): consisting of 50 healthy non diabetic subjects. Study Period: This study was conducted between December 2020 to November 2021 in the Department of Biochemistry, King George Hospital, Visakhapatnam. Sample Collection: After 12 hours of fasting, 5ml of venous blood is collected from the antecubital vein from each subject under aseptic conditions. Blood was collected in a clot activator vacutainer (red cap tubes) and allowed to clot spontaneously in the tube, and then centrifuged for about 10 minutes at 3000rpm. In case of delay, the sample was stored at -20 degree Celsius for further analysis on the next working day. Carewas taken to prevent hemolysis.The findings were recorded and then tabulated in excel sheets, statistically analyzed using SPSS software. Unpaired t-test was done and expressed in terms of mean and standard deviation. A p-value of < 0.05 is considered as statistically significant.
Results: The (mean±SD) serum triglyceride levels in T2DM cases were 228±116.03 mg/dl and in healthy controls 103±18.23 mg/dl. The (Mean±SD) serum total cholesterol levels in T2DM cases were 208.26±48.14 mg/dl and in controls 164.18±12.71 mg/dl. The (mean±SD) serum HDL-C levels in T2DM cases were 33.82±7.89 mg/dl and in controls 45.16±3.35 mg/dl. The (mean±SD) serumLDL-C levels in T2DM cases were 128.36±44.80 mg/dl and in controls 99.74±9.23 mg/dl. The (mean±SD) serum VLDL-C levels in T2DM cases were 45.68±23.20 mg/dl and in controls 20.47±3.31 mg/dl. The (mean±SD) serum calcium levels in T2DM cases were 9.12±0.79 mg/dl and in controls 9.83±0.53 mg/dl. The (mean±SD) serum magnesium levels in T2DM cases were 1.87±0.35 mg/dl and in controls 2.30±0.36 mg/dl. The (mean±SD) serum phosphoruslevels in T2DM cases were 2.92±0.64 mg/dl and in controls 3.06±0.70 mg/dl. There is no statistical significance in the serum phosphorus levels in between the two groups.
Conclusion: in this present study. The serum triglyceride (TG) levels, serum total cholesterol levels, serum LDL-C Levels,VLDL-C Levels were significantly increased in the T2DM cases compared to the controls. The serum HDL-C levels were significantly decreased in the T2DM cases when compared to the controls. The serum calcium levels, Serum magnesium levels and serum phosphorous levels were significantly decreased in the T2DM cases when compared to the controls.
 

Introduction: Psoriasis is a chronic inflammatory disease of skin and joint associated with cardiovascular morbidity.Previous studies have shown higher prevalence of metabolic syndrome in psoriasis patients.
Material & Methods: In this study 60 adult patients from each group with psoriasis and chronic eczemawere included for assessment of metabolic syndrome.Metabolic syndrome was diagnosed based on the presence of three or more criteria of the National Cholesterol Education Program, Adult Panel III (ATP III) with Asian modification for waist circumference.
Results: Metabolic syndrome was significantly more common in psoriatic patients than in eczema patients ((23)38.3% VS (13) 21.6%) P=0.046. Psoriatic patients had a higher prevalence of triglyceridemia, low HDL levels and elevated blood sugaras compared to those findings in chronic eczema group of patients.
Conclusion: In view of our study showing strong association between metabolic syndrome and psoriasis, it is recommended that all psoriasis patients should be screened for early detection of metabolic syndrome so as to prevent mortality and morbidity related to metabolic syndrome. In eczema, the prevalence of metabolic syndrome is comparable to that observed in normal population of this region.

Background & Objectives: Chronic kidney disease (CKD) is a commonly seen clinical condition resulting from different etiologies, diabetes and hypertension contributing to majority of CKD. Hyperhomocysteinemia is observed in CKD, which contributes to increased cardiovascular morbidity and mortalities according to many studies. Reduction of homocysteine level may help to decrease the cardiovascular morbidity and mortality which are leading cause of death in CKD patients.
Material and Methods: 90 patients with diabetes and/or hypertension, diagnosed as CKD with eGFR <90ml/min visiting the hospitals attached to BMCRI were chosen and their fasting plasma homocysteine level were measured. Patients less than 18 years age and had history of cerebral vascular disease, coagulopathy, Alzheimer’s disease were excluded from the study. The data was summarized using mean, standard deviation for parametric data and median, interquartile range for non-parametric data and chi-square test was used for analyzing categorical variables.
Results: Hyperhomocysteinemia was observed in 63.33% of patients with CKD, majority of patients (26.3%) belonged to 50-59 years age group with a significant male (73.7%) preponderance in CKD with hyperhomocysteinemia group. Prevalence of Diabetes and Hypertension in CKD with hyperhomocysteinemia were 73.7% and 82.5% respectively and with a mean duration of Diabetes and Hypertension of 9.82 ± 7.073 years and 7.3 ± 6.545 years respectively. 12.3% patients in CKD with hyperhomocysteinemia were found to have underlying causes for CKD, among them around 57.1% of them had Chronic Interstitial Nephritis. Prevalence of hyperhomocysteinemia was more in end stages of CKD i.e. stage 3B (8.8%), stage 4 (15.8%) & stage 5 (75.4%). Homocysteine elevation was found in both CKD without dialysis and with intermittent hemodialysis.
Conclusion: Serum homocysteine levels appear to be closely associated with CKD and serum homocysteine levels are negatively associated with GFR. Thereby, serum homocysteine levels can be used as a marker of renal dysfunction in patients with diabetes and hypertension.

Background and Aims: The significant and rising incidence of type 2 diabetes and the associated vascular complications have been a growing concern. Cardiovascular complications are neglected and are the leading causes of deaths in the diabetic population. Autonomic Imbalance (AI) is a bother complication of the diabetes mellitus, related to aggravated risk of morbidity as well as mortality. Nevertheless, there are not many studies assessing this relationship and there are no studies especially of rural setting, hence we have undertaken this study for assessing the need of this association from an Indian rural setting.
Methods: A detailed questionnaire including the socio-demographic details, anthropometric data, history, clinical examination, investigations performed, and treatment undergoing was gathered from each patient. Special attention was extended for identifying the cardiovascular risk factors like hypertension, alcohol intake or smoking, family history of cardiovascular disease (CVD), Heart rate, etc.
Results: Autonomic Imbalance have been studied among the 158 diabetic patients, of which the mean age was 58 years, with male preponderance of around 58%. Good Glycaemic control was observed in one-fourth (40 patients) and 102 out of 158 of the study participants (type 2 diabetics) were hypertensives.The prevalence of autonomic imbalance identified using tests for autonomic function ranges from 50-70%, where the diagnosis of autonomic imbalance is achieved based on the outcomes of multiple autonomic tests with various components instead of a single test. The prevalence of autonomic neuropathy was on the rise as people got older.
Conclusions: Screening for autonomic function and the patient education could be the key factors among the patients with autonomic imbalance in order to prevent devastating events further.

Background:Diabetes mellitus (DM) referred as a group of metabolic disorders
characterized by high blood sugar levels over an extended period. The present study
was conducted to assess fasting and postprandial lipid profile in diabetic patient.
Materials & Methods:60type II diabetes patients of both genders were enrolled in group
I and 60 control in group II. Parameters such as HbA1c, FBS, PBS, total cholesterol
(TC), triglycerides (TG), high density lipoprotein – cholesterol (HDL-C), very-lowdensity
lipoprotein cholesterol (VLDL) and low-density lipoprotein cholesterol (LDL)
were assessed.
Results: Group I had 35 males and 25 females and group II had 28 males and 32
females. In group I and group II, mean PBS was 145.2 and 131.4, HbA1c was 9.4% and
4.5%, TG (mg/dl) was 184.2 and 150.3, TC (mg/dl) was 215.8 and 178.4, HDL- C (mg/dl)
was 44.2 and 58.2, VLDL (mg/dl) was 36.3 and 30.6 and LDL (mg/dl) was 170.4 and
85.2. The difference was significant (P< 0.05). The mean fasting and postprandial TG
value was 215.2 and 240.6, TC was 183.2 and 190.1, HDL- C was 44.2 and 37.3, VLDL
was 37.5 and 38.2 and LDL was 170.5 and 176.2 respectively. The difference was
significant (P< 0.05).
Conclusion: Postprandial lipid profile significantly increased when compared to fasting
lipid profile among type 2 DM patients.

Objective: To find out the sensitivity of Indian diabetes risk score as a screening test tool of diabetes mellitus among adult population by comparing the result of IDRS with ADA diabetes diagnostic criteria (fasting blood glucose/postprandial blood glucose).As adult population is at risk for developing diabetes mellitus. Early diagnosis and treatment may reduce the morbidity and mortality.
Methodology: The study was conducted on 600 patients of Dr. Sampurnanand Medical College and Associated Hospital, Jodhpur included all individuals > 20 years of age, a verbal consent taken from all individuals entering in to the study. IDRS will be applied to all individuals, then all subjects will tested for fasting (8 hours fasting) blood glucose level and, or 2 hours postprandial blood glucose level population attending the outdoor clinics, indoor wards and general population (attendants, accompanying peoples) using venous blood sample in fluoride vial.
Conclusion: In our study it can be concluded that IDRS can be applied as a screening test in our country regardless of the demographic variation in the prevalence of diabetes. Thus IDRS is a simple, reliable and easy to use tool for mass screening of the high risk individual of Diabetes mellitus.

Aim: To compare staplers vs simple interrupted vs sub-cuticular method of skin closure of
surgical wounds.
Material and method:The present randomized prospective study was conducted in the
Department of Surgery at Rohilkhand Medical College and Hospital, Bareilly from January
2020 to October 2021 among 150 subjects who underwent surgical procedures. Equal number
of patients was allotted to 3 groups by random envelope allocation method i.e. Group
A(Stapled skin closure), Group B(Interrupted skin closure) and Group C(Sub cuticular skin
closure). Following the completion of closure, an antiseptic medicated cream was applied
followed with a protective dressing for the first 24–72 h. Subcutaneous Drains were placed in
selective cases according to infection and were kept till the drain content was minimal. All
patients were given IV antibiotics for 5–7 days postoperatively. The closures were removed
after an interval of 10–14 days, first removing the alternate sutures and then the remaining
sutures after few days and pain on removal was recorded using VAS.
Results: Postoperative pain score at discharge was least in sub-cuticular group followed by
stapled and interrupted skin closure group, though statistically there was no difference.
Conclusion: In this we found that time required for skin closure (in seconds) was least in
stapled skin closure group while pain and POSAS score was minimum in sub-cuticular skin
closure group. Wound infection was present maximum and minimum among sub-cuticular
and interrupted skin closure group respectively

Background
Cardiorenal syndrome (CRS) is not a newly discovered syndrome. The adverse outcomes of
the renal impairment in patients with Heart failure were known since long. Our aim in this
study was to evaluate the occurrence of AKI, to determine the outcome (morbidity and
mortality) in patients suffering with AKI.
Methods
The present observational prospective study was conducted for a duration of 1 yearamong
100 patients (age 18 years or more) admitted to hospital with acute decompensated heart
failure.A written informed consent taken from each patient and were then screened for
cardiac dysfunction by a detailed history, clinical examination and
echocardiography.Univariate logistic regression was used to find out association of various
outcomes with AKI. A p value of <0.05 was considered statistically significant.
Results
The mean age of the study population was 58.98 ± 17.16 years. The mean Boston criteria for
the population was 9.87 ± 1.36. Baseline S. creatinine, eGFR and even B. Urea were strongly
associated with the occurrence of AKI. Presence of diastolic dysfunction was associated with
AKI. Mortality and readmission were significantly higher in AKI group as compared to non-
AKI group.The predictive value of AKI was maximum with the baseline S. creatinine.
Conclusion
Cardio-renal syndrome is a commonly seen in patients admitted in hospital. AKI can lead to
poor cardiac output or pre-renal failure as a result of overuse of diuretics. The mechanism
involved is complex. AKI in patients admitted with ADHF has poor prognosis with increased
mortality and longer duration of hospital stay.

Background: Diabetes mellitus is a chronic, multi-system metabolic disorder which gives
rise to ernestful ocular complications. Cataract is believed to be the second most common
of these complications, next to diabetic retinopathy, and it poses special challenges to the
surgeon both in terms of management and post-operative outcomes. Materials and
methods: This was a comparative, prospective, interventional study to assess and compare
preoperative and postoperative central macular thickness at weeks 1 and 12 after
uncomplicated cataract surgery among 50 well-controlled diabetic subjects with no
evidence of diabetic retinopathy and 50 non-diabetic subjects, using Optical Coherence
Tomography (OCT).Results: Majority patients of the diabetic group (42%) belonged to the
age-group of 51 to 60 years, while the majority in the control group (36%) belonged to the
age-group of 61 to 70 years. 54% of the patients had duration of diabetes between 5 to 10
years, while 44% of the patients had duration of diabetes less than 5 years. Significant
increase in central macular thickness (CMT) from baseline was seen postoperatively at
weeks 1 and 12 in both the groups, but while making inter-group comparison, the changes
in macular thickness were not found to be significant. Also, the incidence of post-operative
complications was observed to be higher in the diabetic group in comparison to the control
group.Conclusion: Uncomplicated cataract surgery in diabetics with well-controlled
glycaemic profile and without any evidence of diabetic retinopathy yielded similar
outcomes as non-diabetics in terms of rise in post-operative macular thickness. However,
in terms of post-operative complications, diabetic group showed a slightly higher incidence.

Background: Urinary Tract Infection (UTI) is one of the common infections affecting people, both from the community and hospital. The causative pathogens for UTI and their drug sensitivity patterns vary from region to region. Changes in their genetic constituents with time might be the reason.
Aim: In this study, we aimed investigate the profile of common uropathogens and assess their antibiotic sensitivity patterns with commonly used drugs for UTI patients.
Materials and methods: In this study, 153 urine samples were analyzed with routine microscopy, culture and sensitivity for a period of six months at Institute of Medical Science and SUM Hospital, Bhubaneswar, Odisha. Both bacteria and fungi were used for drug sensitivity test.
Result: A total no. of 54Gram positive bacteria and 40 Gram Negative bacteria were isolated. S. aureus was the most common GPC isolated and P. aeruginosa was the most common GNB. E. coli was the second most GNB which showed resistance to Cephalosporins and Aminocoumarin group. 4 Candida species were isolated, to which Clotrimazole was the most susceptible antifungal agent. Staphylococcus sp. showed resistance to β-lactams and Macrolides group of antibiotics. Shigella sp. showed resistance to β-lactams. C. albicans was found to be the common Fungi isolated, followed by C. krusei.
Conclusion: Since the drug sensitivity pattern changes from place to place and varies from time to time. The culture sensitivity therapy should be practiced before empirical administration of antibiotics.

Background: Anaemia is a common diabetes mellitus (DM) consequence that has a
negative impact on the progression and development of other diabetes-related
problems. Despite this, little is known about the prevalence of anaemia and its
associated variables in type 2 diabetes mellitus (T2DM) patients. As a result, the
purpose of this study was to look at the prevalence of anaemia and its associated
variables in T2DM patients.
Methods: A hospital-based cross-sectional study was carried out on 249 T2DM patients
who were chosen by a systematic random sample procedure. Face-to-face interviews,
anthropometric measurements, and laboratory testing such as haemoglobin
measurements, red blood indices, and serum creatinine analysis were used to collect
data. The data were coded and entered into Epi-data management version 4.4.1.0 before
being analysed using SPSS version 22. Bivariate and multivariate logistic regression
analysis were used to discover the determinants of anaemia. P-values less than 0.05 were
considered statistically significant.
Results: According to the findings of the study, 20.1 percent of the individuals were
anaemic. Age >60 years (AOR=3.06, 95 percent CI: 1.32–7.11), poor glycemic control
(AOR=2.95, 95 percent CI: 1.22–7.15), eGFR 60–89.9 mL/min/1.73m2 (AOR=2.91, 95
percent CI: 1.15–7.37), eGFR 10 years (AOR=2.75, 95 percent CI: 1.17–6.48), and
experiencing diabetic complications (AOR=3.81, 95% CI: 1.65–8.81) were significantly
associated with anaemia.

The availability of different vaccines plays a crucial role in bringing the COVID-19 pandemic to a standstill. All the vaccines with two initial and a booster dose have reduced the mortality rate and do not elicit serious symptoms or illness. However, the clinical trials on different vulnerable populations are still not reliable. In particular, COVID-19 patients belonging to the diabetic population exhibited higher morbidity and mortality. Therefore, the prioritization of vaccination for these populations may reduce further complications. Yet, the hesitancy toward vaccines hinders the process of vaccination campaigns. Hence, this review focuses on the availability of different vaccines against COVID-19 and their role in eradicating previous epidemics. The effect of this vaccination on the diabetic group and the management of chronic illness have been emphasized.

Introduction: Vitamin D belongs to a group of fat-soluble secosteroids which helps in increasing intestinal absorption of calcium, iron, magnesium, phosphate, and zinc. In humans, vitamin D3 (also known as cholecalciferol) and vitamin D2 (ergocalciferol) are important compounds. Cholecalciferol and ergocalciferol can be ingested from the diet and from supplements.
Materials and Methods: This was a prospective observational study of postmenopausal women attending gynaec OPD department of Obstetrics and Gynecology, Kakatiya Medical College and MGM hospital, Warangal from1^st October 2021 to 30^th September 2022 (1 year). Apparently healthy postmenopausal women without any prolonged medical illness like diabetes, thyroid, hepato-renal disease, malignancy, or without any surgical illness were selected. Besides patients on HRT, steroids, bisphosphonates or any drugs affecting bone metabolism, smokers and alcoholics were excluded.
Results: Out of total 206 postmenopausal women attending gynaec OPD during the study period, only 122 women were found eligible for study after satisfying inclusion-exclusion criteria. We divided these postmenopausal women according to their age into five years age-groups, starting from 50 years to 70 years of age. Most common age-group was 55-60 years accounting for 49% followed by 50-55 years age-group making 41%, thus together adding up to 90% of study population. This shows the authenticity of study population. Mean age of study group was 56.9 years.
Conclusion: There is high prevalence of vitamin D deficiency among Indian postmenopausal women, but our study shows no correlation between hypovitaminosis D and fasting blood sugar. Besides, the cut-off level for vitamin D deficiency should be reviewed in Indian population looking at the scenario of adequate sunlight exposure, to prevent it from overtreatment and also for dietary modification. The role of bioavailable 25(OH) vitamin D should be ascertained.

Background: It has been reported in many studies that nail growth is affected in Diabetes. A recent study was done in India which has postulated that the nail growth in Diabetes was more when compared to the normal subjects. This study puts in an effort to find the answers.
Aims and Objectives: To determine the nail growth rate in diabetics.
Materials and Methods: This study was started in Feb 2019 to Jan 2022 Mata Guruji Memorial Medical College and Hospital, Kishanganj, Bihar and Hind Institute of Medical Sciences, Mau, Ataria, Sitapur. Chitrapati Shahu Ji Maharaj University, Kanpur.
Total of 211 patients were studied and have been reported.
This study is a cross sectional study.
Two hundred eleven patients were studied. Out of this 100 were from Mata Guruji Memorial Medical College and Hospital, Kishanganj, Bihar and the rest of them were from Hind Institute of Medical Sciences, Mau, Ataria, Sitapur. Chitrapati Shahu Ji Maharaj University, Kanpur.
Results: The rates of the nail growth were found to be less when compared with normal rates of growth that has been given in the textbooks.
Conclusion: This can be considered as a useful tool in the hands of paramedical workers especially in the underprivileged areas.

Aim: To analyse the role of amino acids among subjects with type 2 diabetes having foot
ulcer.
Material and method: The present study was conducted in the Department of Surgery,
Rohilkhand Medical College and Hospital, Bareilly from February 2020 to March 2021. The
study comprised of 60 patients, aged 18 years and above, suffering from diabetic foot ulcer.
Patients were divided into two groups i.e. group A and B. Patients of group A continued to
take diabetic diet as they were taking before while patients of group B were given IV amino
acid (200ml) on alternate day till 15th day in addition to the diet they were taking before.
Ulcers of all patients were properly cleaned and dressed under aseptic condition with normal
saline and povidone iodine everyday, wound debridement was done as required. Ulcers were
assessed on day 0, 5, 10 and 15.
Results: Mean cholesterol increased in group A while it decreased in group B at different
intervals with statistically insignificant difference as p>0.05. At the end of study, normal
healing was found among 26.67% and 66.67% of the subjects in group A and B respectively.
Major haematoma was reported only in group A and that among 10% of subjects. Hence
healing was observed better among group B subjects.
Conclusion: It can be concluded from the results that among subjects with diabetic foot
ulcers, amino acid administration leads to better healing and satisfaction among the patients.
Therefore, amino acids supplement should be given to diabetic foot ulcer subjects

Background: Diabetes Mellitus is a worldwide epidemic, affecting over 346 million people globally, with India ranking second with 65.1 million diabetic patients. Foot ulceration is the most common consequence of diabetes mellitus.It affects about 15% of diabetic individuals over the course of their lives and is quite frequent.To a considerable extent, it is preventable if the risk factors are identified early. The aim of present study is to evaluate the association of risk factorswith diabetic foot ulcer and to estimate prevalence of diabetic foot ulcer (DFU).
Material and Methods: A systematic random sample of 500 diabetic patients was selected from patients attending the outpatient department of General Surgery, National Capital Region Institute of Medical Sciences, Meerut. A standardized form was used to record data obtained from reviewing the medical records, interviewing, and examining the patients.
Results:The sample had a male-to-female ratio of 48 percent. The average age of the participants was 55 years, and they had diabetes for an average of 8.9 years. The prevalence of diabetic foot ulcers was 4.8%, sensory neuropathy was 15.3%, lower limb ischemia was 8.2%,and amputation was 2%. Ulceration was linked to male gender, neuropathy, and having diabetes for a longer period of time.
Conclusion:Future efforts should focus on educating both healthcare professionals and patients about proper foot care. To ascertain the true prevalence of diabetic foot problems, community-based research is also required.

Aims: To compare HbA1c levels with inflammatory markers that include a neutrophilto-
lymphocyte ratio (NLR) and monocyteto-lymphocyte ratio (MLR) in controlled and
uncontrolled diabetics.
Materials and methods: Two hundred type 2 diabetes mellitus (T2DM) patients were
separated into two groups of managed (HbA1c 7%) diabetics. HbA1c (glycated
haemoglobin) levels, leukocyte count (WBC), haemoglobin (Hb), hematocrit (Hct), red
blood cell distribution width (RDW), neutrophils, lymphocytes, and monocytes were all
measured using recent laboratory data. The laboratory results were used to determine
the NLR and MLR.
Results:Controlled diabetics had a mean age of 58.30 years, while uncontrolled diabetics
had a mean age of 55.62 years. The mean NLR in diabetics with and without diabetes
was 2.61 and 4.88, respectively. The distinction was discovered to be statistically
significant (p < 0.05). The mean MLR in diabetics with and without diabetes was 0.2
and 0.24, respectively, however the difference was not statistically significant (p > 0.05).
The data showed a modest positive connection between HbA1c levels and the
haematological indices, but it was statistically insignificant.
Conclusion: The study found a substantial difference in NLR between diabetics who
were well-controlled and those who were not. Although only a slight positive connection
was detected between glycated Hb levels and the haematological indices, the results
revealed a substantial difference in NLR between the two groups. This demonstrates
that these ratios have the potential to be used as inflammatory indicators in T2DM.

Background & objectives: The quantity of diabetes in India is expanding at a disturbing
rate. The impacts of active work as obstruction preparing or oxygen-consuming
activities on type 2 diabetes have not been examined in the Indian populace. The goal of
this study was to break down the impacts of about two months of Physical Readiness
Tests (PRT) contrasted and aerobic exercise (AE) on glycaemic control, metabolic
profile, cardiovascular wellness boundaries and general prosperity in grown-ups with
type 2 diabetes.
Methods: Thirty grown-ups (14 females and 16 males mean; age 53.8 ± 8.8 years) with
type 2 diabetes were arbitrarily allotted to an 8-week regulated PRT (n=10) or AE
(n=10) or control group (n=10). Glycosylated haemoglobin (HbA1c), lipid profile, blood
pressure, pulse, body mass index (BMI) and general prosperity were estimated before
preparing (for example 0 weeks) and after 8 weeks of preparing period.
Results: Plasma glycosylated haemoglobin levels diminished altogether (P<0.05) both in
the PRT group (7.57 ± 2.4% to 6.23 ± 0.8%) and in the AE group (8.11±0.9% to 6.66 ±
0.9%). Total cholesterol levels diminished essentially (P<0.05) by 13.3 percent in the
PRT group and by 6.1 percent in the AE group. Both exercise groups showed an
essentially decrease in systolic circulatory strain (P<0.05). General prosperity
improvement was significantly more in PRT (8.6%) when contrasted with the AE group
(2.7%).
Conclusions: Our discoveries showed that both PRT and AE were successful in working
on the metabolic profile of grown-ups with type 2 diabetes however the rate
improvement in fatty oils, complete cholesterol levels and general prosperity with PRT
was more contrasted with AE. Further investigations on a bigger example should be
done to affirm these discoveries.

Background: Diabetes mellitus is a metabolic disorder due to absolute or relative insulin deficiency. Polyuria in type 2 DM leads to loss of important water soluble nutrients in urine. In view of widespread deficiency of vitamin B12 in our country and increasing prevalence of diabetes mellitus type 2, it is considered worthwhile to assess vitamin B12 status of patients with diabetes mellitus type 2.
Material and methods: Present study comprises of 60 subjects of both sexes whom 30 are healthy controls and 30 are clinically confirmed cases of diabetes mellitus, age group ranges from 40-70 yrs. Serum separated from plain vial after centrifugation was used for estimation of serum vitamin B12 by ELISA, Plasma glucose estimation by GOD-POD Method, End Point, Glycated hemoglobin by Boronate Affinity chromatography (NycoCard).
Result: In our study it was found that serum vitamin B12 (218.24 ± 68.31 pg/ml) was significantly lower in type2 diabetes mellitus patients compared to serum vitamin B12 (254.20 ± 64.89 pg/ml) of controls. Serum vitamin B12 level (190.20 ± 19.44 pg/ml) is significantly lower in diabetes mellitus patients who were suffering from the disease for more than 3.5 years as compared to serum vitamin B12 level (257.18 ± 88.74 pg/ml) of diabetes mellitus patients who were suffering from the disease for less than 3.5 years.
Conclusion: Thus, it can be concluded that there is significant vitamin B12 deficiency in type 2 diabetes mellitus patients.

Background: To assess the correlation between obesity and glycated haemoglobin in type 2 diabetic patients.
Materials & methods: 50 patients were enrolled. The categorisation of patients was done based on BMI. Blood samples were obtained and sent to the laboratory where HbA1c values were assessed. Further evaluation of the correlation between obesity and glycated haemoglobin in type 2 diabetic patients was done.
Results: Mean HbA1c among diabetic subjects with normal BMI, overweight and obese status was 7.2%, 8.9% and 10.1% respectively. Significant results were obtained while correlating obesity and glycated haemoglobin in type 2 diabetic patients.
Conclusion: There exists a significant correlation between obesity and glycated haemoglobin in type 2 diabetic patients.  

Background:Dyslipidemia was defined as a combination of high serum triglyceride ≥ 1.7
mmol/L, high serum LDL cholesterol ≥ 2.6 mmol/L and low serum HDL cholesterol <
1mmol/L for men and < 1.30 mmol/L for women. Non-HDL cholesterol ≥ 3.37mmol/Land
atherogenic index ≥ 0.11, were also considered abnormalType II diabetes mellitus (T2DM),
characterized by chronic hyperglycemia, and impaired insulin secretion and insulin
resistance. The objective of the present study was to study the lipid profile among type 2
diabetes mellitus patients.
Materials & Methods: The present study was conducted in the department of general
medicine. It comprised of 62 T2DM patients of both genders. Fasting blood sugar and lipid
profile such as serum cholesterol, serum triglycerides, HDL, LDL and VLDL was assessed.
Results and Observations:There were 31 males and females each. The mean serum
cholesterol level was 228.76 mg/dl, serum TG level was 202.6 mg/dl, HDL level was 39.8
mg/dl, LDL was 142.64 mg/dl and VLDL level was 43.5 mg/dl.
Conclusion: The diabetes has a significant role in alteration of lipoprotein levels. There is
significant alteration in lipid profile levels.

Background: Diabetes mellitus is a non-communicable chronic metabolic disorder. The
association between sensorineural hearing loss and diabetes has become an important subject
of research. Correlation of hearing loss with genders is not still clear so we have aimed our
study to explore the same.
Objective: To examine the gender-specific association between diabetes and hearing loss.
Methods: This study was conducted on a total number of 150 (78 male & 72 female) selected
diabetic patients from November 2018 to December 2020. The correlation of hearing loss
between male and female diabetic patients was compared by getting a pure tone audiogram.
Results: Out of a total of 150 patients, only 42 patients (28%) were suffered from hearing
loss. Sensorineural hearing loss was present 25.6% in males and 30.5% in females which was
not significantly different (p >0.05).
Conclusion: We concluded that hearing loss has no significant association with genders in
diabetic patients, but early diagnosis and screening of diabetic paints for hearing loss help in a
better quality of life.

Background:Type 2 diabetes mellitus (T2DM) is a complex metabolic disorder
characterized by persistent hyperglycaemia due to relative insulin deficiency, insulin
resistance. This study assessed efficacy of Saroglitazar in patients with diabetic
dyslipidemia
Materials & Methods:120 patients with type 2 diabetes mellitus of both genders were
assessed for serum fasting plasma glucose, post prandial glucose, glycated hemoglobin
(HbA1c), blood urea, serum creatinine, S.G.O.T, S.G.P.T and lipid profile. Patients were
treated with Saroglitazar 4 mg once daily and the follow-up data were available for 12
months.
Results: Out of 120 patients, males were 80 and females were 40. The mean triglyceride
level was 610.4, 208.4 and 224.4, total cholesterol was 312.2, 244.7 and 172.1, non- HDLC
was 274.8, 199.6 and 126.3, LDL- C was 165.6, 116.8 and 104.17, HDL- C was 41.4, 42.1
and 42.5, HbA1C was 8.02, 7.8 and 7.1, FPG was 156.2, 130.5 and 120.4, PPG was
234.6, 172.1 and 160.5, SGOT was 46.6, 42.3 and 40.3, SGPT was 34.2, 38.4 and 37.4, S.
Creatinine was 0.7 and CPK was 74.3, 71.6 and 68.3 at baseline, 12 wees and 52 weeks
respectively. The difference was significant (P<0.05).
Conclusion: Saroglitazar is a very effective therapeutic option in diabetic dyslipidemia with
very high triglycerides level.

Background:Dry socket (DS), also referred to as alveolar or fibrinolytic osteitis, is a major
complication that follows extraction of tooth/teeth in oral surgery. The present study was
conducted to assess the risk factors for Dry socket.
Materials & Methods: 340 patients requiring extraction of mandibular third molars of both
genders were included. Risk factors such as smoking status, indication of exodontia and
systemic diseases etc. were recorded.
Results: Out of 340 patients, males were 210 and females were 130. Out of 210 males, 20
developed DS and out of 130 females, 24 had DS. The difference was significant (P< 0.05).
Diabetes was seen in 32, smoking in 14, pericoronitis in 22 and systemic disease in 35. The
difference was significant (P< 0.05).
Conclusion: Risk factors for dry socket were systemic disease, diabetes and smoking.

Background: Diabetes is a universal problem and is becoming a major concern at old age
especially in obese people and in people with sedentary life style. The present study was
conducted to assess complications and mortality in ST-segment elevation acute myocardial
infarction in diabetic and non-diabetic patients.
Materials & Methods:160 consecutive patients of diabetic (group I) and non-diabetic
(group II) having acute ST-segment elevation myocardial infarction (STEMI) of both
genders were included. Treatment was given to all patients.
Results: Age group <44 years had 15 diabetic and 10 non- diabetic, 45-54 years had 25
diabetic and 12 non- diabetic, 55-64 years had 10 diabetic and 20 non- diabetic and >65
years had 40 diabetic and 28 non- diabetics. The site was anterior in 26 and 20, inferior in
38 and 40, inferior+ right ventricular in 20 and 10 and lateral in 6. Mortality was seen in
those in which streptokinase was given in 7 and 3 and streptokinase not given in 15 and 10
in group I and group II respectively (P< 0.05).
Conclusion: With streptokinase administration there was reduction in mortality in diabetic
as well as in non- diabetic. However, diabetics not on streptokinase had higher mortality as
compared to non- diabetics.

 Burst Abdomen is a preventable condition in which many risk factors play their role and lead to life threatening complications. The aim of the present study is to identify the different risk factors and high risk patients for burst abdomen for decreasing the rate of burst abdomen post operatively. Patients and methods: An observational analytical study included 110 patients and carried out in General Surgery Department, Faculty of Medicine, Zagazig University Hospitals. The patients were divided into 2 main groups: post-midline laparotomy burst abdomen patients and postmidline non complicated laparotomy with burst abdomen patients. Evaluation of different risk factors between the two groups was performed. Results: There is statistically significant relation between occurrence of burst abdomen and both smoking and obesity. There is statistically significant relation between occurrence of burst abdomen and all of direct trauma, diabetes, intraabdominal infection and jaundice. There is non-significant relation between occurrence of burst abdomen and other risk factors. There is statistically significant relation between occurrence of burst abdomen and postoperative ileus, pulmonary complications and wound infection. Diabetes, wound infection, smoking and direct trauma increased risk of burst abdomen by 47.205, 58.547, 40.559 and 39.874 folds respectively. Conclusion: Intra-abdominal infection is the most important factor in predicting burst abdomen. Patient factors like anemia, diabetes, smoking, peritonitis due to bowel perforation act as determinant for wound dehiscence. Postoperatively abdominal burst can be prevented by improving the nutritional status of the patient, early mobilization of the patient and simple investigations like Hemogram, RBS, RFT, LFT, chest x-ray may help to detect predisposing factors

 
Background: Hypertension is a growing concern in the Indian population with urbanization and developments in work culture and treatment methods.
Aim and objective: To evaluate the influence of serum magnesium levels in gradations of primary hypertension and evaluate its impact on co-morbid conditions.
Methods: Hypertensive patients were screened and included in the study by categorizing them in to grade I and II based on blood pressure levels. Socio-demographic, physical and systemic examination details were recorded with pre-designed questionnaire; electrolyte levels, fasting blood sugar, status of retina and heart were assessed and analyzed using t-test and logistic regression.
Results:Total 100 patients in the study, mean age was 59.3±14.79 years; male predominance (61%); normal retina (83%) and presence of pre-diabetic conditions (67%) was observed, with normal serum magnesium levels in majority (76%). Serum magnesium levels were significantly associated with grade I (P = 0.0173) patients; influencing systolic and diastolic blood pressure values (r = -0.3552, P = 0.003; r = -0.2160, P = 0.0309, respectively).
Conclusion:The optimal values can be further established by evaluation of large sample size, quality of life during treatment, and influence of co-morbidities/complications of hypertension, among others.
 

Objective: Stress is a feeling of emotional or physical tension. It has now become a part of modern lifestyle. At some point in life, everyone must have encountered with some degrees of stress. It has negative impact of life and certain complications associated which includes increased risk of cardiovascular disease, elevating certain medical conditions like asthma, diabetes, hypertension, etc. Considering the increasing prevalence of stress and anxiety through multiple factors, there is a great need to find a solution to the existing problem. The current research depicts the safety and efficacy of HFSM-02 in reducing stress and anxiety in subjects with chronic medical condition and perceived stress. Material and methods: 120 subjects were enrolled in the study. Subjects were undergoing clinical examination. Vitals were recorded. Blood samples were collected for biochemical tests like change in serum cortisol levels. Subjective questionnaire scores evaluation were performed like POMS-2, and GHQ-28, questionnaire. Changes in symptoms severity were noted like disturbed sleep, and day time mood swings.

Background:Diabetic kidney disease (DKD) is defined as kidney disease attributed
to diabetes. Diabetic nephropathy (DN) is a common micro vascular complication
of diabetes .DN develops in 15-20% of subjects with T1DM and in similar or higher
percentage of T2DM patients, causing increased morbidity and premature
mortality. American Diabetes Association (ADA) recommends screening for
nephropathy 5 years after diagnosis for type 1 diabetes and at diagnosis for type 2
diabetes.Aim: To estimate the occurrence of diabetic nephropathy in children and
adolescent diagnosed with diabetes Method: A case control study was carried on
one hundred and fifty of children went to pediatrics clinics of zagazig university
hospital. They were classified in to 75 diabetic children who were type 1DM for
more than 4 years and their age less than 18 years old and 75 non diabetic children
of the same gender and age. Both groups under go full history, clinical and
laboratory investigations during the period from December 2018 to November 2019.
Result: frequency of persistent microalbuminuria and hypertension among diabetic
patients were 293 per 1000 and 160 per 1000patient respectively.Conclusion: Type1
diabetic children and adolescent are liable for the occurrence of early diabetic
nephropathy so intensive diabetes therapy is needed, regular screening for MA and
measurement and interpretation of BP and GFR

Background: Diabetes mellitus (DM) is a chronic systemic metabolic disease characterized by abnormally high blood glucose levels. The present study was conducted to assess cases of type I diabetes mellitus and oral health status in children. Materials & Methods: 82 children age ranged 8-16 years of both genders were selected. Diagnosis of dental caries decayed, missing, and filled surfaces/decayed and filled surfaces was done. Blood samples were collected and HbA1c values measured. Results: There were 14 controlled diabetics and 68 uncontrolled diabetics. The mean dfs score in diabetics was 0.612 and in uncontrolled diabetics was 0.431, mean plaque score was 0.71 and 0.89 in controlled and uncontrolled diabetics and mean gingival score was 0.056 and 0.215 in controlled and uncontrolled diabetics. The difference was non- significant (P> 0.05). Conclusion: No difference in dfs score, plaque score and gingival score in controlled and uncontrolled diabetics was observed.

Renal Failure (RF) is devastating pathology with several causative factors, resulting in dialysis or kidney transplantation needed by end-stage renal disease (ESRD. The progression of RF is closely related to systemic oxidative stress, which causes various complications such as hypertension and diabetic mellitus . The current study was focusing on the oxidative effects of NLRP3 and CYP2E1 gene expression in the pathological development of renal failure disease with hypertension and diabetic mellitus as complications associated diseases. This study involved 100 patients diagnosed clinically and seriologicaly with renal failure 52 males and 48 females, their age from 17 to 80 years . Also the study comprise (18 males and 12 females) healthy volunteers as control group. RNA extracted from blood samples and converted to cDNA which subjected to real-time PCR for detection gene expression . The results detected that Hypertension and diabetic mellitus are the important risk factors that causes and advances renal failure disease . NLRP3 and CYP2E1 have significantly overexpression (1.60 folds and 5.37 folds ) respectively in RF patients compared with healthy group ( p <0.05). However, the expression of NLRP3 and CYP2E1 increase in diabetic mellitus (2.16 and 1.58 ) respectively than hypertension in RF patients with and control group (p<0.05). Diabetic mellitus generate free radical consequently causes ROS, hence elevated expression in oxidative NLRP3 and CYP2E1 genes in diabetic RF patients .

Background:Theriskfactorsforimplantareduetosurgicalprocedureandpatientcharacteristics.
The present study was conducted to assess effect of diabetes and smokingonprognosis of
dentalimplants.
Materials & Methods: 120 patients who received dental implants in last 2 years
weredivided into 4 groups of 30 each. Group I were smokers and non- diabetic, group II
werediabetic and non- smokers, group III were smokers and diabetics and group IV
werecontrols.Success rate of dental implants wereassessed.
Results: There were 18 males and 12 females in group I, 14 males and 16 females in
groupII, 13 males and 17 females in group III and 15 males and 15 females in group IV.
Therewere 24 successful implants in group I, 23 in group II, 23 in group III and 28 in
group IV.Thedifferencewas significant (P< 0.05).
Conclusion:Successratewashighestamonghealthyascomparedtodiabeticsandsmokers

Background: The diabetic neuropathy, including the cardiovascular autonomic neuropathy
(CAN), is a common complication of type 1 and 2 diabetes that leads to high mortality and
morbidity. The present study was conducted to determine CAN in type II DM patients.
Materials & Methods: 168 type II DM patients of both genders were recruited. Resting
heart rate, blood pressure, and body mass index (BMI), systolic blood pressure (SBP) ≥140
mmHg or diastolic blood pressure (DBP) ≥90 mmHg, fasting lipid profile (low-density
lipoprotein/LDL, high-density lipoprotein/HDL, triglycerides/TG) and cardiac autonomic
function was evaluated with the CAN system analyzer as early, definite and advanced
CAN.
Results: CAN was seen in 66 patients. The mean age (years) was 45.2 and 44.5, duration of
diabetes (years) was 6.1 and 12.3, SBP (mm Hg) was 130.4 and 134.5, DBP (mm Hg) was
86.2 and 87.6, resting heart rate (beats/min) was 76.3 and 87.4, LDL (mg/dl) was 102.4 and
98.6, HDL (mg/dl) was 40.5 and 38.1 and TG (mg/dl) was 165.2 and 184.6 in CAN- and
CAN+ patients. The difference was non- significant (P> 0.05). Severity of CAN found to be
early in 20%, definitive in 45% and advanced in 35%. The difference was significant (P<
0.05).
Conclusion: Type II diabetes patients had high prevalence of cardiac autonomic
neuropathy.

In Deep learning methods such as automatic encoder, long-term short-term memory (LSTM) and repetitive neural network (RNN), in mixed group of population, fasting blood glucose level (FBGL) was used to detect the BG level. The Indian population is healthy and sick. The appearance of high FBGL from the electrochemical parameters of human saliva, redox potential, pH, concentration of sodium, and calcium ions was evaluated. Samples were taken from 175 randomly particular persons, half of healthy patients and half of those with diabetes. Models were trained with 70% of all data and tested in the remaining set. In every algorithm, the data points were randomly crossed three times before the model was implemented. The effectiveness of machine learning techniques is presented in terms of the four parameters that are statistically significant, the accuracy, the sensitivity, and the F1 score. The proposed analysis shows that the RNN-based deep learning method yields better results. This deep learning technique to measure blood glucose level non-invasively using electrochemical saliva will helps the society to control the diabetes effectively.

There is a wide variation in the prevalence of Trichomonas vaginalis in Iraqi women. There are no data on prevalence in Iraq women with diabetes, a known risk factor for increased genital infection. We wished to ascertain the prevalence of Trichomonas vaginalis infection in diabetic women with vaginal discharge in Thi-Qar, Iraq. A cross-sectional study was performed at one specialized polyclinic between November 2019 and December 2020. One hundred and ten pregnant and non-pregnant diabetic women aged 17-52 years who complain of vaginal discharge were interviewed and high vaginal swabs were taken and tested with wet mount and culture to detect Trichomonas vaginalis, candida and bacteria. Random blood glucose levels and VDRL tests were also done for all patients. Twenty seven out of 110 vaginal swabs (24.5%) were positive for Trichomonas vaginalis. The age of the patient, color and smell of the vaginal discharge significantly concurred with the Trichomonas vaginalis infection status. Highest rate of infection (50%) observed in diabetic women over 40 years of age. Non-pregnant diabetic women had a slightly higher prevalence (27.7%) than pregnant diabetic women (22.2 %). Eighteen of all vaginal discharge (16.4%) were positive for Candida albicans. Bacterial vaginosis was mostly due to Staphylococcus spp (100%). Additionally, 4 patients (3.6%) had a positive VDRL test.
Conclusion: Nearly quarter of women with type 2 diabetes mellitus presenting with vaginal discharge in Thi-Qar had Trichomonas vaginalis infection. This is markedly higher than previously reported rates in the general female population of the city.

In the US, dietary recommendations in >50 y centered on reducing saturated and total fat intakes. During this time, however, obesity and diabetes rates have dramatically increased, with potentially devastating consequences for public and economic health. Ketogenic diets have recently gained extensive media interest and nutrition studies. During this time, however, obesity and diabetes rates have dramatically increased, with potentially devastating consequences for public and economic health. Ketogenic diets have recently gained extensive media interest and nutrition studies. In addition to decreases in blood glucose and insulin, which can be accomplished by reducing carbohydrates, persistent ketosis could convey specific metabolic advantages that are important for cancer, neurodegenerative disorders and other insulin resistance conditions. Based on existing data, a well-formulated ketogenic diet does not seem to have significant public safety issues and should be seen as a key solution to obesity and diabetes. Medical studies of good consistency.

Abstract: Background: Diabetic Ketoacidosis (DKA) is an critical and menacing problem
of Type 1 as well as type 2 diabetes mellitus (T2DM). DKA is associated with high amount
of risk of mortality and morbidity (hospital stay). The prognostic factors of DKA are
important factors affecting the outcome of the patients (as treated or death). S. Albumin is
one of the prognostic factor less studied up till now.
Objectives: To determine Clinical profile of DKA patients: aetiologies, precipitating
factors, biochemical parameters and other complications of T2DM patients and to corelate
serum albumin level with mortality, duration of stay among DKA patients.
Methodology: This cross sectional study will be conducted among 100 diabetic patients
with and without ketoacidosis from May 2019 to May 2021. Biochemical parameters:
glycated Haemoglobin, urine ketones and serum albumin will be gathered to determine the
prognosis. Controls will be adult diabetic patients without ketoacidosis. Data from Cases
and controls will be statistically analysed and then compared accordingly.
Expected Results: It is expected that decreased Sr. albumin will be associated with poor
prognosis in DKA patients. Sr. Albumin might be an indirect prognostic marker of diabetes
control due anabolic effect of Insulin, which affects both ketosis possibility and glucose
levels.

Diabetic complications, such as, retinopathy, nephropathy lead to blindness and end stage renal failure respectively, various neuropathies, and ultimately increased mortality. While the exact mechanisms that lie behind the pathological changes associated with diabetes remain obscure, however, it is widely believed that chronic or intermittent hyperglycemia may alter various metabolic pathways at the tissue level, for instance, increased flux through the polyol and the hexosamine pathways as well as a persistent activation of protein kinase C (PKC). Reducing sugars such as glucose and fructose may react non-enzymatically through their carbonyl groups with free amino groups of proteins (commonly the Ɛ amino group of lysine) to form a Schiff base intermediate which then rearranges to a more stable structure known as Amadori product. The Amadori products generated by the aforementioned Maillard reaction may then undergo further reactions, including dehydration, oxidation and rearrangement resulting in the irreversible formation of heterogeneous advanced glycation end products (AGEs)

Background: Stroke is the second leading cause of death in the world in the last two decades. The present study was conducted to evaluate HbA1C as a valid tool for risk assessment in ischemic stroke and TIA.
Materials & Methods: 50 patients who were diagnosed with acute ischemic stroke or TIA, were included. Diagnosis of acute ischemic stroke was made on CT/MRI scan. Estimation of HbA1C was done by photometric test using ion exchange resin. Estimation of blood glucose level was done by glucose oxidase method.
Results: Group I was non- diabetic having 10, group II was pre- diabetic having 8 and group III was diabetic having 22 patients. There were 30 (60%) males and 20 (40%) females. In group A there were 6 males and 4 females, group B had 10 males and 8 females while in group C there were 14 males and 8 females. The sex distribution amongst the three groups did not reveal any statistical difference, and hence all the three groups were comparable.
Conclusion: HbA1C is a novel marker for determining the glycaemic status of a person. In cases of acute ischemic stroke and TIA, HbA1C should be used as a screening tool in determining the previous glycaemic status, prevalence of prediabetes and differentiate it from stress hyperglycaemia.

Diabetes mellitus regardless of the type, its associated complications and the tendency to inherit the condition due to genetic reasons have affected world wide and is increasing at a rapid pace. Although there are effective ways to manage this condition, none of them stops the progressive decline of the beta cell functioning. The existing treatment modalities only delays the complications. Pancreatic islet transplantation have been promising with patients being insulin independent for initial few years post transplant, but over the period of time they restart their daily insulin injections. Even though stem cell therapy for diabetes is currently being investigated, its recent progress has been assuring one. Stem cell therapy does not face risk like graft rejection requiring immunosuppression or complications associated with the procedure and post transplant unlike the pancreatic islet transplantation, since they can withdrawn from the diabetic patient and injected back, thus eliminating issues like lack of donors. This review shows the potential of hematopoeitic stem cell and mesenchymal stem cell therapy as a good alternative approach in treating diabetes.

Background: Stroke is the second leading cause of death in the world in the last two decades. The present study was conducted to evaluate correlation of HbA1C with lipid profile in patients of ischemic stroke or TIA.
Materials & Methods: 50 patients of acute ischemic stroke or TIA, were assessed for glycosylated blood glucose and lipid profile level.
Results: There were 10 patients in age group of <50years, 6 patients in age group of 50-60 years, 16 patients in age group 60-70 years, 11 patient in age group of 70-80 years and 7 patients in age group >80 years. The mean FBS (mg/dl) in group I was 96.6, in group II was 116 and in (%) group III was 163, RBS (mg/dl) was 132.1, 157 and 205.6 in group I, II and III respectively, HbA1C (%) was 5.3, 6.15 and 8.43, mean cholesterol level (mg/dl) was 148.6, 151.1 and 220.5, LDL (mg/dl) was 91.6, 97.5 and 154.21, HDL (mg/dl) was 41, 39.8 and 37.6, TG (mg/dl) was 106.9, 192.2 and 175.5 in group I, II and III respectively. The difference was significant (P< 0.05).
Conclusion: HbA1C can be helpful in the management and outcome of patients of ischemic stroke and TIA.

Diabetic wounds are a popular health problem affecting 15% of diabetic individuals. Traditional treatment depends on understanding the relationship between diabetes and wound healing mechanisms. Recent studies tend to use natural products that possess active components for treatments. Luteolin is the most common flavonoids found in many medicinal plants. The study has also highlighted the recent advances in the therapeutic effect of luteolin, particularly, on diabetic wounds healing. Luteolin has demonstrated its anti-inflammatory effect through its impact on fibroblast cell proliferation and migration. Further studies are highly recommended to focus on luteolin as an anti-inflammatory agent in human diabetic wounds healing.

Diabetes mellitus is one of the major non-communicable diseases which have great impact on human life today. A huge amount of data is generated including a wide variety of the Electronic Medical Record (EMR), pharmacy reports, and laboratory reports, among other data related to patients. Big data analytics can be applied to this data to generate useful patterns and relation between different factors which affects diabetes. The results obtained from this analysis shows relation between different attributes which can be used to improve healthcare system. In this paper the analysis of the diabetes dataset is done using Hadoop framework, which is a distributive framework and can be used to analysis large amount of data. The dataset is taken from PIMA Indian Database, which includes different factors that affect diabetes like age, blood pressure, BMI (Body-Mass Index), skin thickness etc. Results produced by the analysis of data are projects on Power BI.

Background: Nishamalaki or Nisha Amalaki representing various combination formulations of Turmeric and Indian gooseberry is recommended in Ayurveda, proven efficacious and widely practiced in the management and prevention of complications of Madhumeha (Diabetes).
Aims: To assess the effectiveness of scaling and root planing on the glycemic status and gingival crevicular fluid (GCF) levels of Malondialdehyde, Superoxide Dismutase, Catalase and Osteocalcin in Type II diabetes patients with chronic periodontitis under systemic administration of Nishamalaki, an ayurvedic hypoglycemic formulation.
Material and methods: The study included 90 newly diagnosed Type II diabetic patients in the age group between 30 to 50 years with mild to moderate chronic periodontitis and was randomly divided into 45 patients of two groups each. Group A were Type II diabetic patients with mild to moderate chronic periodontitis taking supplements of Nishamalaki 1 gram twice daily for 3 months and Group B were Type II diabetic patients with mild to moderate chronic periodontitis undergoing scaling and root planing and receiving supplements of Nishamalaki 1 gram twice daily for 3 months.
Results: Independent t-test has been applied to compare the two groups. It has been observed there is no significant difference exists between the two groups. However administration of Nishamalaki and scaling has been all effective in group B parameters.
Conclusion: Nishamalaki showed protective effect and appeared to be useful in reducing the glycemic status, levels of superoxide dismutase, catalase, lipid peroxidase and osteocalcin in GCF in type-2 diabetes patients with chronic periodontitis.

Approximately 422 million people across the world have diabetes, particularly in countries where the average income is in the middle and lower end of the economic spectrum. Statistics reveal that every year, about 1.6 million deaths are recorded which can be directly attributed to diabetes. The graph suggests that number of cases as well as the prevalence of diabetes have been steadily incrementing over the past few decades. Through this new implementation of the Bayesian Classifier, raw medical data is analyzed and the risk of diabetes diagnosis based on each patient’s medical information can be calculated. The raw data is converted into class labels and the likelihood of a positive potential diabetes case is derived, as a probability (≤1). This can not only be used by healthcare professionals but also by common users, and can be useful in detecting the risk and preventing it in time without taking any medical tests. This classifier uses very basic information that would be known to each patient or can easily be obtained.

Pharmacogenomics (PGx), likewise perceived as pharmacogenetics, is a branch about pharmacologyor genomics. It is an ongoing abstention that examination the results about genomic, yet hereditary variety about the assimilation, digestion, working effectiveness, antagonistic responses of pills between the ethnic body, in this way the improvement of advance medications have been incorporated. The PGx thought has been proposed since 1950s, alongside the primary reason for distinguishing significant hereditary forms up to desire to fix ailment between people. As of now PGx is the former decision as a result of coordinating genomic records into clinical practice and offering therapeutic choice help. PGx inquire about indicated amazing accomplishments for different sickness. Among them, Diabetes is a most plentifully influenced by quality inconstancies. Diabetes is infection characterized dependent on hyperglycemia. There are monogenics of diabetes where characterizing the hereditary reason dramatically affects treatment with patients having the option to move from insulin to sulfonylureas. Be that as it may, most of diabetes is type-2 diabetes. Until this point in time, clinically significant pharmacogenomics has to a great extent been restricted to extreme eccentric antagonistic medication responses, to variety in sedate digestion, and to treatment result in malignant growth chemotherapeutics where the physical transformations drive the decision of focused intercession. In this review article, we concentrate on pharmacogenomics in type-2 diabetes and utilize this not exclusively to layout the ongoing advances in the field however to address the difficulties that are confronted while thinking about hereditary qualities of treatment adequacy and symptoms in like manner complex illness status of diabetes.

Depression occurrence is found to be three times higher in people with diabetes mellitus. Sometimes the majority of the cases with depression are under diagnosed. According to the International diabetes federation, diabetes is the largest global health emergency of the 21st century. A questionnaire was created with a set of ten questions related to diabetic patients and depression. 100 random participants of the age 25- 50 years took the survey and a random sampling method was done. More than half the participants are well aware that depression is common in adults with diabetes (57.5%). 71.3% think that diabetic patients are more anxious than a normal person, 54.5% are aware that using antidepressants in diabetic adults can be risky, 51% think that diabetes can be under diagnosed during treatment and 70% are aware that glucose metabolism will be altered if the doabetic patient is under depression or stress. Awareness about diabetic patients who could possibly be dealing with stress and depression was created.

Saliva is a unique fluid which plays an important role in maintaining the normal oral health of an individual. Diabetes is the major factor that leads to the changes in the salivary pH, salivary flow and dental caries. 32 articles were collected from the pubmed website and were included as citations in our present review. Salivary glucose and blood glucose level are directly proportional to each other. Normal level of salivary glucose is 0.5-1.00 mg/ml. Salivary hypofunction in diabetic individuals is observed. Diabetes leads to the reduction of salivary pPH and salivary flow. It also helps in multiplication of harmful microorganisms in the oral cavity.

Analysis of the assessment of attitudes towards their health among the unorganized population. With the important role of timely and adequate detection of various diseases and pathological conditions by doctors of the health facility, the adequacy of assessing patients health is of particular importance. An adequate assessment of the patient's own health is an important help in the timely referral to the doctor and the conduct of the preventive measures. In this regard, the frequency of the main components of the metabolic syndrome among people who differ in assessing their health was analyzed.
Among the unorganized population of Bukhara there is an inadequate assessment of the state of health among patients with arterial hypertension, with body mass index and obesity and a violation of carbohydrate metabolism.

Denture Stomatitis( DS) is one of the common denture related complications in patients wearing dentures after years of denture use. There have been various studies on its prevalence despite the fact that its exact etiology is still unknown. Removable dentures have served as an important prosthesis in dentistry, whereby it helps in regaining the phonetics and masticatory functions as well as esthetics in edentulous patients. The aim of this study was to determine the prevalence and risk factors that can cause denture stomatitis in denture wearers. This study was designed as a retrospective clinical study. All the patients with removable dentures (Complete dentures , Removable Partial dentures , Cast partial denture ) were taken into account and the data was retrieved. The data was analysed and results were recorded.Out of the 1415 subjects wearing dentures (complete or partial ) , 80 were found to have denture stomatitis in which 57.4% were women and 42.6% were men. The majority of the DS patients were in the age group range of 51-80 years. Temporary partial dentures (50%) were the most prevalent type of prosthesis in patients with denture stomatitis. When the medical history was reviewed most of the patients did not have any underlying systemic diseases(61.1%) did not have any medical condition, (18.5%) were diabetic, (11.1 %) were hypertensive. When all the diabetic patients(2577) were evaluated , 9.32% had denture stomatitis .In the study, it was observed that denture stomatitis was prevalent in elderly patients with slight female predilection. Diabetes was the most prevalent systemic illness associated with denture stomatitis

Background: It is estimated that 30% of patients with diabetes mellitus will experience a skin problem at some stage throughout the course of their disease. Several skin disorders are more common in diabetic patients, particularly those due to infection such as candida and impetigo. Patients with type 2 diabetes also have twice the risk of developing the common scaly disease, psoriasis, as non-diabetics. This study is a sincere effort to study the skin lesions in Diabetes Mellitus.
Aims and Objectives: To study the skin lesions in Diabetes Mellitus.
Methods: Three hundred seventy seven patients were included for the study.
Results: A surprising 54.64 percent of the patients complained of some skin manifestations and the fungal infections were seen in majority of the cases.
Conclusion: Skin lesions in diabetics are fairly common and utmost care has to be taken to immediately identify and treat accordingly.