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Background Diabetes mellitus (DM) is a chronic endocrine disease characterized by impaired glucose metabolism. Type 2 DM (T2DM) is an age-related disease that usually affects middle and older-aged people who suffer from increased blood glucose activities. Several complications are associated with uncontrolled diabetes that include abnormal lipid levels/dyslipidemia. This may predispose T2DM patients to life-threatening cardiovascular diseases. Therefore, it is essential to evaluate the activities of lipids among T2DM patients. Methodology A case-control study involving 300 participants was conducted in the outpatient department of medicine attached to Mahavir Institute of Medical Sciences, Vikarabad, Telangana, India. The study included 150 T2DM patients and the same number of age-matched controls. In this study, 5 mL of fasting blood sugar (FBS) was collected from each participant for the estimation of lipids (total cholesterol (TC), triacylglyceride (TAG), low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein-cholesterol (HDL-C), and very low-density lipoprotein-cholesterol (VLDL-C)) and glucose. Results The FBS levels among T2DM patients (211.6 ± 60.97 mg/dL) and non-diabetic individuals (87.34 ± 13.06 mg/dL) were significantly (p < 0001) different. Analysis of lipid chemistry that included TC (174.8 ± 38.28 mg/dL vs. 157.22 ± 30.34 mg/dL), TAG (173.14 ± 83.48 mg/dL vs. 133.94 ± 39.69 mg/dL), HDL-C (37.28 ± 7.84 mg/dL vs. 43.4 ± 10.82 mg/dL), LDL-C (113.44 ± 28.79 mg/dL vs. 96.72 ± 21.53 mg/dL), and VLDL-C (34.58 ± 19.02 mg/dL vs. 26.7 ± 8.61 mg/dL) revealed significant variations among T2DM and non-diabetic individuals. There was a 14.10% decrease in the activities of HDL-C among T2DM patients along with an increase in the activities of TC (11.18%), TAG (29.27%), LDL-C (17.29%), and VLDL-C (30%). Conclusions T2DM patients have demonstrated abnormal lipid activities/dyslipidemia compared to non-diabetic patients. Patients with dyslipidemia may be predisposed to cardiovascular diseases. Therefore, regular monitoring of such patients for dyslipidemia is extremely vital to minimize the long-term complications associated with T2DM.
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De Barsy syndrome (DBS) is an exceedingly rare autosomal recessively inherited genetic disorder that manifests as premature aging with progeroid features. Typically, the skin loses its elasticity, causing laxity, wrinkling, and sagging. Other characteristics include ophthalmological, orthopedic, and neurological abnormalities. As of 2011, only 27 DBS cases had been recorded. This paper reports the case of a two-day-old female infant who was referred to the pediatrics department with complaints of lax skin, a progeroid appearance, a short stature, hazy corneas, and bilateral claw-like hands with thin overlapping fingers. She also had features of pectus excavatum and visible veins over her chest and abdomen. There was a history of third-degree consanguineous parents in this patient. This patient was diagnosed with De Barsy syndrome due to findings on the Verhoeff Van Gieson staining, which demonstrated a marked decrease in elastic tissue fibers. Palliative care was recommended for this infant. We report this case considering its extreme rarity.
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Introduction The indoor air in hospitals could play a significant role in the transmission of a wide array of infections, especially in respiratory intensive care units, pulmonary outpatient departments, and other areas. Unprotected coughing and sneezing may facilitate the release of aerosols and contaminate the indoor environment. The majority of infections transmitted through these modes include viral diseases, including tuberculosis (TB), influenza, and measles, among several others. Moreover, the possibility of direct and indirect transmission of microbes by air has been underestimated in hospital settings, especially in developing countries. This study therefore was carried out to assess the burden of microbes in the air of selected wards in a tertiary care hospital and evaluate the occupational risk of some infections among healthcare workers (HCWs). Methods This study was carried out between September 2019 and February 2021 at a tertiary care teaching hospital in South India. A total of 30 symptomatic healthcare workers (HCWs) were included in the study and were screened for present and past tuberculosis (TB) as well as other lower respiratory tract infections. A tuberculin skin test, chest X-ray, and sputum acid-fast staining were performed on all the HCWs who were negative for other bacterial infections and were symptomatic. The study was conducted in coordination with the pulmonology department. Active monitoring of air was performed by microbiological air sampler in the respiratory intensive care unit (RICU) and other high-risk areas including the pulmonology outpatient department (OPD), the radiology OPD, and the microbiology department. Results Sputum for tuberculous bacteria was positive in four (16.6%) HCWs. The chest X-ray showed radiological findings suggestive of TB in five (20.8%) HCWs. Three (12.5%) HCWs who were screened for extrapulmonary TB revealed one (33.3%) was positive for TB of the hip joint. Among the HCWs, eight (33%) returned positive tuberculin tests. Assessment of the hospital air in the RICU revealed the bacterial count (288 CFU/m3) exceeded the normal limit (≤50 CFU/m3). The COVID-19 isolation ward showed the lowest bacterial count (06 CFU/m3) and no fungi. The predominant bacterial isolates were gram-positive cocci in clusters (Methicillin-sensitive Staphylococcus aureus). After proper disinfection and correction of ventilation techniques, the resampling results noted microbial colonies under normal limits. Conclusion A high burden of TB was noted among the HCWs. The airborne infection control strategies are essential to minimize the risk of nosocomial infections and occupational TB risk to HCWs. Most microbes are transmitted through the airborne route and therefore it is extremely important to take measures to control the transmission of such pathogens in hospital settings.
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Aim The purpose of this study was to determine the relationship between biochemical markers such as serum calcium (Ca), phosphorus (P), intact parathyroid hormone (iPTH), 25(OH) vitamin D, and fibroblast growth factor 23 (FGF23) in our study group, as well as to correlate dual-energy X-ray absorptiometry (DEXA) findings with these biochemical markers. Methodology An eligible group of 50 chronic hemodialysis (HD) patients, age 18 and older, who have undergone HD two times a week for at least six months participated in this retrospective cross-sectional study. We compared serum FGF23, intact parathyroid hormone (iPTH), 25(OH) vitamin D, calcium, phosphorus, and dual-energy X-ray absorptiometry scan showing bone mineral density disorder (BMD) around the femoral neck, distal radius, and lumbar spine. Human FGF23 Enzyme Linked Immuno Sorbent Assay (ELISA) Kit PicoKine® (Catalog # EK0759; Boster Biological Technology, Pleasanton, CA) was used in the optimum moisture content (OMC) lab to measure FGF23 levels. For the analysis of associations with various studied variables, the levels of FGF23 were split into two groups, which were high (group 1, FGF23 50 to 500 pg/ml), that is, up to 10 times the normal levels and extremely high (group 2, FGF23 > 500 pg/ml) FGF23 levels. All the tests were conducted for routine examination where the data obtained was analyzed in this research project. Results The mean age of patients was 39.18 ±12.84 years, of whom 35 (70%) were males and 15 (30%) were females. For the entire cohort, serum PTH levels were consistently high, and vitamin D levels were low. FGF23 levels were high in the whole cohort. The average iPTH concentration was 304.20 ± 113.18 pg/ml, while the average 25(OH) vitamin D concentration was 19.68±7.49 ng/ml. The mean FGF23 levels were 1877.36±1378.67 pg./ml. The mean calcium value was 8.23±1.05 mg /dl and the mean phosphate of 6.56±2.28 mg /dl. In the whole cohort, FGF23 showed a negative correlation with vitamin D and a positive correlation with PTH, but not statistically significant. Extremely high FGF23 levels were associated with lower bone density compared to high FGF23 values. Considering that in the whole cohort of patients, only nine had high FGF-23 and the rest of 41 patients had extremely high FGF23, we could not ascertain differences in PTH, calcium, phosphorus, and 25(OH) vitamin D levels between the two groups. The average length of time on dialysis was eight months, and there was no link between FGF-23 levels and the length of time on dialysis. Conclusion Bone demineralization and biochemical abnormalities are a hallmark in chronic kidney disease (CKD) patients. Abnormalities in serum phosphate, parathyroid hormone, calcium, and 25(OH) vitamin D play critical roles in the development of BMD in CKD patients. With the discovery of FGF-23 as a biomarker that is increased early in CKD patients, new questions arise about the effects and actions of FGF-23 in controlling bone demineralization and other biochemical markers. Our study found no statistically significant correlation to suggest an effect of FGF-23 on these parameters. But the findings need to be looked at more in prospective, controlled research, especially to find out if therapies that successfully target FGF-23 can make a big difference in how people with CKD feel about their health.
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People with gynecologic neoplasms have the highest risk of having an ischemic stroke. A 76-year-old woman came into the stroke unit of our hospital complaining of anosmia and acutely developing dysarthria. She was ultimately determined to have ovarian cancer after extensive testing. Ovarian carcinoma is one of the neoplasms that cause ischemic stroke and is most commonly documented in case studies. Identifying the underlying neoplastic condition in female ischemic stroke patients who are otherwise "healthy" is crucial as an early surgical intervention on cancer offers therapeutic treatment for both malignancy and thromboembolism.
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Introduction Infants depend exclusively on mothers' milk for nutrition in their early months of life. However, some infants are given cow/buffalo milk during insufficiency. After six months, the children are supplemented with complementary food, including solid food, to meet the nutritional requirements of a growing infant, a process known as weaning. Therefore, it is important for mothers to have a clear understanding of the nature of food, and the nutritional requirements of the children. This study aimed to understand the knowledge, awareness, and practice of breastfeeding, weaning, and complementary feeding among women. Methods A cross-sectional questionnaire-based observational study was carried out between May and June 2021. The study included 150 women attending the outpatient department of pediatrics attached to Mahavir Institute of Medical Sciences (MIMS), Vikarabad, Telangana, India. After taking the informed consent, the researcher filled out a pre-validated questionnaire based on the subjects' responses. The data regarding socio-demographic details and information regarding knowledge, timing, practices of weaning, knowledge of nutritional requirements, and child feeding practices were collected as a pre-test. An educational briefing of the essentials of child feeding practices, weaning, and dietary requirements was undertaken using chalk and board and audio-visual aids, among others. In the post-test, the knowledge of mothers regarding weaning practices, the importance of weaning, and understanding of the nutritional requirements and their inclusion in a child's diet was assessed. The quantitative data were represented as percentages. The Chi-square test was applied to find out the statistical significance of the results obtained from the study. Results Of the 150 women who participated in the study, the majority belonged to the age group of 18-23 years (66.7%). Most women were illiterate (34%) and only 12% were graduates. More than 70% of the participants belonged to the middle and lower middle class. The majority of participants (96.7%) had carried out exclusive breastfeeding for the first six months, and 63.35% of mothers had initiated weaning their child between the age of 6-12 months. Only 37.4% of mothers started breastfeeding within hours after the delivery. A combination of all foods (36%), rice/wheat (29%), processed food (18.8%), fruits and vegetables (9.2%), and pulses (6.7%) were chosen for weaning. Many felt that eggs and meat supplementation can be done between 12-18 months. Conclusion The knowledge of breastfeeding and best practices of weaning and complementary feeding habits significantly affects the child's growth and overall health. The women in this study had a moderate level of understanding regarding the aspects of breastfeeding, weaning practices, and complementary dietary requirements during weaning.