Abstract Background: There is paucity of data on triple drug combination containing low dose (7.5 mg) pioglitazone in Indian type 2 diabetes patients (T2DM). Objective: Comparative evaluation of efficacy and safety of glimepiride, metformin (GM) plus low dose pioglitazone fixed dose combination (FDC) in T2DM. Material and methods: In this open label study, 75 insulin naïve T2DM subjects inadequately controlled on GM oral therapy were randomized into Group A: FDC of G 1mg + M 500 mg SR + Pioglitazone 7.5 mg; Group B: FDC of G 2mg + M 500 mg SR + Pioglitazone 7.5 mg or Group C: Insulin 70/30 Mix + M 500mg SR. The primary outcome measure was reduction in HbA1c at 180 days. The secondary end points included reduction in fasting plasma glucose (FPG), postprandial plasma glucose (PPG) and change in lipid parameters and weight. Results: At baseline mean age, weight, HbA1c, body weight, FPG, PPG, C peptide level, LDL-C, triglyceride and HDL-C were similar in three groups. All treatments resulted in significant reduction in mean HbA1c. At the end of 180 days, reduction in HbA1c was 1.49%, 1.51% and 1.11% in Group A, B and C respectively. The difference in HbA1c reduction between groups was not statistically significant. At the end of 180 days, the mean reduction in FPG was -66.72+27.12 mg/dl, -79.68+23.87 mg/dl and -69.60+25.34 mg/dl in Group A, B and C respectively. The difference in the reduction of FPG and PPG was not significant between the groups at day 30, 90 and 180. Significant reduction in LDL-C, TG and increase in HDL-C was observed in all groups without significant difference between the groups. No hypoglycemic episodes requiring hospitalization were observed in any group. Change in weight was comparable between groups. Conclusion: Metformin, glimepiride plus low dose pioglitazone FDC is equally efficacious and well tolerated compared to insulin plus metformin in uncontrolled T2DM. This combination may help in postponing insulin therapy.
Abstract : Background;Malaria is of immense importance among tropical diseases in India. Pathophysiology of complicated malaria is multifactorial in origin involving tissue hypoxia, liver dysfunction, and impaired renal handling of bicarbonate. Acidosis is an important contributor to death from severe falciparum malaria. Metabolic acidosis results from abnormal microcirculatory perfusion and anaerobic glycolysis as a result of sequestration of parasitized erythrocytes and, also, cellular dysfunction consequent on release of host and parasite-derived toxic mediators.Material and methods:The study was conducted at Victoria and Bowring & lady Curzon hospitals, attached to Bangalore medical college & research institute, Bangalore. A total of 40 patients with complicated malaria with respect to serum lactate levels measured serially every 24hours were studied.Results:During our study, 24 out of 40 patients had lactate levels >19.8mg/dl. Out of these 24 patients,10 were given blood transfusion,3 were given platelet transfusion,9 were given inotropic support and 2 were dialysed as compared to patients with normal lactate levels who were 4,1,2 and 0 respectively; implying the fact that the incidence of complications are high in patients with hyperlactatemia. Also, 3 patients died during the study; all of them were from increasing levels of lactate levels on day 3 when compared to levels at the time of admission.
Background: The metabolic syndrome consists of constellation of central obesity, hyperglycemia, hypertension, hypertriglyceridemia and low HDL cholesterol. Elevated serum Complement C3 levels independently predicted incident type 2 diabetes and increased cardiovascular risk in prospective studies in apparently healthy men and women.
ABSTRACT Background: Diabetic nephropathy is the single most frequent cause of end stage renal disease. GFR is the best index of renal function in health and disease. Its direct measurement with inulin or EDTA requires specialized technical personnel. Properties of an ideal endogenous blood substance to estimate GFR should include release into blood stream at constant rate and free filtration by glomerulus. Serum Creatinine is the most commonly used filtration marker in clinical practice but its accuracy is significantly hampered by the confounding influence of diet, age, gender and muscle mass. Microalbuminuria is first detectable functional abnormality, but there is 40% day to day variability. Several factors can increase urinary albumin like exercise, UTI, CCF. Cystatin C is s 13kDa protein expressed in all nucleated cells and produced at constant rate. It is freely filtered by glomerulus. It does not return to blood stream and is not secreted by renal tubules. It has been suggested to be “ideal” endogenous marker.
ABSTRACT : Aims: This study was undertaken to describe the common metastases to different groups of lymph nodes and to underline the importance of FNA as a diagnostic tool in malignant disease of lymph nodesSettings and Design: The study was conducted in the department of pathology, Assam Medical College over a period of one year. Study design : Cross sectional studyMethods and Material: A one year retrospective study was carried out on all malignant lymph node aspirates. Inadequate smears were excluded from the study.Statistical analysis used: Rates and proportions using percentageResults: A total of 151 cases showed evidence of malignant disease with a male female ratio of 2.6:1 and age range of 15 yrs to 85 yrs. 10.6% of the cases were lymphomas and 89.4% were metastatic malignancy . Cervical group (102 cases) was most commonly involved followed by supraclavicular nodes (21 cases). Axillary nodes(10 cases), submandibular (9 cases),inguinal (4 cases), pre auricular(2 cases) , abdominal nodes (2 cases) and pre tracheal (1 case) constituted the rest. The most common type of lymphoma was non Hodgkin’s lymphoma whereas the most common type of metastasis was squamous cell carcinoma(80 cases) followed by adenocarcinoma (21 cases).