International Journal of Medical Research and Review

In Hospital Outcome of Acute Anterior Myocardial Infarction in Diabetic and Non-Diabetic Patients

2023-10-10T05:29:59+00:00

Background: Patients with acute anterior myocardial infarction and diabetes have a poor prognosis. Objectives: To see the in-hospital outcome of acute anterior myocardial infarction in diabetic and non-diabetic patients. Methodology: This cross-sectional observational study was conducted in the Department of Cardiology, Sylhet MAG Osmani Medical College Hospital, Sylhet over a period of two years from July 2015 to June 2017. A total of 100 acute anterior MI patients (50 diabetic and 50 non diabetic) were included in this study. Acute anterior MI patients admitted after 6 hours of symptom onset or who did not receive streptokinase were excluded. Results: Male predominance was obvious in both groups [40 (80%) versus 42 (84%); p>0.05] in diabetic and non-diabetic group respectively. Mean age was 53.34 ± 11.32 and 54.84 ± 14.12 years in diabetic and non-diabetic groups respectively. Dyslipidemia [6 (12%) versus 6 (12%); p >0.05], Smoking [32 (64%) versus 34 (68%); p >0.05] and Family history of cardiovascular disease [6 (12%) versus 4 (8%); p >0.05] were similar among diabetic and non-diabetic respectively. Hypertension was found more among non-diabetic [27 (54%) versus 19 (38%); p>0.05] but difference was not statistically significant. Diabetic group had more Apical Anterior MI [22 (44%) versus 19 (38%); p<0.05] and Extensive Anterior MI [20 (40%) versus 11 (22%); p<0.05] while non-diabetic group had more Septal MI [10 (20%) versus 3 (6%); p<0.05] and Mid Anterior MI [10 (20%) versus 4 (8%); p<0.05]. LV ejection fraction was found significantly low in diabetic patients [43.96 ± 5.95 versus 53.68 ± 6.36; p<0.01]. Killip Class III was more in diabetic [24 (48%) versus 9 (18%); p<0.01] and Killip Class I was more in non-diabetic group [18 (36%) versus 3 (6%); p<0.01] according to Killip classification of HF which was statistically significant between the two groups. Atrial Fibrillation was more in diabetics [6 (12%) versus 1 (2%); p<0.05] while sinus tachycardia was more among non-diabetics [20 (40%) versus 5 (10%); p<0.05] which are statistically significant. Diabetic group had more acute MR [2 (4%) versus 0 (0%); p>0.05] but was not significant. Death was more in diabetic group than that of non-diabetic group [7 (14%) versus 3 (6%); p>0.05] but it was statistically not significant. Conclusion: It is concluded from the present study that in hospital outcomes of acute anterior myocardial infarction are worse in diabetic patients than in non-diabetic patients.

A Cross-Sectional Study of Socio-Demographic and Clinical Features of Indian Subjects with Type 2 Diabetes Mellitus in a Tertiary Diabetes Hospital

2023-11-09T20:15:55+00:00

Introduction: Diabetes mellitus is a group of heterogeneous diseases with varied clinical presentation and disease progression. Understanding the socio-demographic factors in subjects with diabetes is an important step for planning diabetes care. Objectives: The objective of the study was to assess the socio-demographic and clinical features of subjects with diabetes and impact of these factors on their glycemic control. Materials and Methods: A cross-sectional observational study was conducted in the outpatient department of Karnataka Institute of Endocrinology and research, Bangalore. 200 subjects with diabetes were recruited for the study, between January to August 2019. Results: In the study, mean age at diagnosis was 43.73 ± 8.705 years. Majority of subjects were in the age group >56 years (53%). 59.5% of the subjects were males and 83.5% of the subjects were from urban area. Majority of them were diagnosed during routine check-up (52.5%). Most common symptom was polyuria (21%). 12.5% of the subjects were incidentally detected during hospital admission. 46.5% had family history of Diabetes. 77.5% of the subjects were overweight and obese. Only 18.5% of the subjects had HbA1c <7. 39% of the subjects had dyslipidemia, 54.5% had hypertension and 19% had hypothyroidism. 29% of the subjects had retinopathy, 20% had neuropathy, 7% had nephropathy and 3.5% had PAD. 79% of the subjects were on OHA, 6% were on insulin and 12.5% were on both OHA and insulin. Amongst the subjects on oral drugs, only 6.3% were on monotherapy and the rest were on multiple drugs. Amongst subjects on insulin, 96.5% were on premixed insulin. Age, gender, education, OHA and combination of insulin and OHA for treatment were the factors associated significantly with glycemic control. Good control was highest in young age group (66.7%) and lowest in old age group (16%). Females had highest level of poor control compared to males. Graduates had higher percentage of good control compared to lower educational status. Subjects on OHA had higher percentage of good control. Conclusions: The study revealed that poor glycemic control, comorbidities like HTN, obesity and dyslipidemia and chronic complications were commonly prevalent in subjects with T2DM. Emphasis should be given to periodic evaluation of glycemic status, comorbidities, and diabetes complications.

Dr Namrata TRUE TALES OF TEN T-PLL OVER A DECADE

2023-11-20T19:19:55+00:00

Background

T- prolymphocytic leukemia(T-PLL) ,are aggressive lymphoid malignancies with unique morphologic, cytogenetic, immunophenotypic, and molecular features^. T-PLL is a mature T-cell leukemia typically presenting at stages of exponentially rising lymphocyte counts in peripheral blood,accompanied by splenomegaly and bone marrow involvement. They are extremely rare ,comprising of <2% of mature T –leukemias and inherently aggressive and notoriously refractory to therapeutics.Extensive search for Indian literature on T-PLL and Immunophenotypic characterization of this entity did not yield any results. We analysed the characteristics, prognostic factors, outcomes and treatments of 10 patients with T-PLL . To our knowledge this is the largest series of T-PLL from India , this study reviews clinical, cytogentic and flow cytometric immunophenotyping findings, and differential diagnosis of patients with T-cell prolymphocytic leukemia from January 2012 to January 2022.Methods: Our laboratory received 4500 clinically suspected chronic leukemias, during a period of 10 years ,at kidwai memorial institute of oncology ,which is state cancer institute , where diagnostic flow cytometric analysis was done and leukemias were classified based on WHO 2008 criterias. Results: out of 4500 cases of Chronic lympho proliferative disorders sent for flow cytometric immunophenotyping, only 10 cases were diagnosed as T-PLL .Study period January 2012 to January 2022.Conclusions: Evaluation of immunophenotype of this rare entity by flow cytometry is a critical part of diagnosis and is a indespensible tool in distinguishing T-PLL from other mature T-cell lymphoid neoplasms.Awareness of this rare entity aids in work up .