Uncontrolled Blood Sugar Research Articles

Pengaruh Edukasi Gizi Terhadap Pengetahuan, Pola Makan Dan Kadar Glukosa Darah Pasien Diabetes Melitus Tipe 2 RSU Kota Mataram Dengan Provinsi NTB

The phenomenon of diabetes mellitus from year to year an increasing number. One major factor is the lack of knowledge in conducting therapy in patients with diabetes mellitus diit so may lead to increased blood sugar levels. The aim of this study was to determine the effect of nutrition education to increase the knowledge, dietary compliance and uncontrolled blood sugar levels Type 2 Diabetes Mellitus Outpatient in Kota Mataram Dg Provinsi NTB Public Hospital Jeneponto. The design of this research was experimental studies with pre experimental designs One Group Pretest And Postest Design. Sampling was conducted using purposive sampling technique with a sample of 30 people. Data was collected by the secondary data and primary data. The dietary pattern data was collected by 24 hours recall questionnaire, blood glucose level of patients were measured by blood glucose meter. While the knowledge of patients were collected by interview using questionnaire.given before and after the education. Height and weight of patients were measured by scale and microtoice. The secondary data are the description of hospital and laboratory result data obtained from the hospital. Data analysis was performed by Mc Nemar test.The results showed, after education, knowledge of patients categorized sufficiently increased (p = 0.031), from 33.3% to 53.3%, as well as the diet of patients (p = 0.003), from 23.3% to 60 , 0% categorized fairly, as well as the patient's blood sugar levels were controlled (p = 0.000), from 3.3% to 46.7%. It is recommended to patients to better manage diet to control blood sugar levels with the help of physical activity and obedient in taking the drug.

Diabetic Foot Ulcer Identification: A Review

Diabetes is a chronic condition caused by an uncontrolled blood sugar levels in the human body. Its early diagnosis may prevent severe complications such as diabetic foot ulcers (DFUs). A DFU is a critical condition that can lead to the amputation of a diabetic patient’s lower limb. The diagnosis of DFU is very complicated for the medical professional as it often goes through several costly and time-consuming clinical procedures. In the age of data deluge, the application of deep learning, machine learning, and computer vision techniques have provided various solutions for assisting clinicians in making more reliable and faster diagnostic decisions. Therefore, the automatic identification of DFU has recently received more attention from the research community. The wound characteristics and visual perceptions with respect to computer vision and deep learning, especially convolutional neural network (CNN) approaches, have provided potential solutions for DFU diagnosis. These approaches have the potential to be quite helpful in current medical practices. Therefore, a detailed comprehensive study of such existing approaches was required. The article aimed to provide researchers with a detailed current status of automatic DFU identification tasks. Multiple observations have been made from existing works, such as the use of traditional ML and advanced DL techniques being necessary to help clinicians make faster and more reliable diagnostic decisions. In traditional ML approaches, image features provide signification information about DFU wounds and help with accurate identification. However, advanced DL approaches have proven to be more promising than ML approaches. The CNN-based solutions proposed by various authors have dominated the problem domain. An interested researcher will successfully be able identify the overall idea in the DFU identification task, and this article will help them finalize the future research goal.

Socio-Demographic, Clinical and Diabetes Status of Foot Ulcer Patients

Background: Foot ulcers are considered as a serious complication, especially for patients with diabetes. People with diabetes and people with peripheral vascular disease are more likely to develop foot ulcers. If an infection occurs in an ulcer and is not treated in the proper way, it can develop into cellulitis, osteomyelitis, or gangrene that may require some part of the toe, foot, or lower leg to be amputated. The aim of this study was to find the socio-demographic, clinical, and diabetes status of foot ulcer patients. Material & Methods: This prospective observational study was conducted in the Department of Surgery, Rajshahi Medical College Hospital, Rajshahi, Bangladesh, during the period from March 2012 to August 2012. In total 100 patients with foot ulcers in the different surgical units of the mentioned hospital were enrolled in this study as study subjects. Data from the study regarding age, sex, occupation, smoking habit, and socio-demographic condition were recorded in the prescribed questionnaire. The purposive sampling technique was used for this study. All data were processed, analyzed, and disseminated using MS Excel and SPSS version 23 programs as necessary. Results: In this study, the male-female ratio of the participants was 2:1. The maximum number of patients (42%) were from the age of 51-60 years and the highest number of patients were housewives (28%), followed by farmers (22%). Among the total male patients, 87.88% were smokers. Low HDL was found in 51% of patients and 68% of patients had been suffering from diabetes mellitus,18% from Buerger’s disease and 6% from atherosclerosis, and 8% from malignant foot ulcer. Most of the diabetic patients (95.59%) were hyperglycemic on admission and 55.88% had diabetes for 6-10 years. On admission, 3 patients (4.41%) had controlled blood sugar and 65 patients (95.59%) had uncontrolled blood sugar. Conclusion: The frequency of foot ulcers among the male population was higher than that in females. Concerning occupation of the patients, housewives and farmers were the most prevalent. Smokers were most affected groups among the study population. Pre-diagnosed diabetes mellitus for a long period was one of the major clinical issues in most of the patients. Uncontrolled blood sugar was also seen in majority of the patients regarding clinical background.

Fiber Intake and Vegan Lifestyle Behaviour on Blood Glucose Control in Type 2 Diabetes Mellitus Patients: A Case-Control Study.

The study aims to determine the relationship between blood glucose level control with a vegetarian diet and vegan lifestyle behavior in patients with T2DM. Diabetes prevalence escalates each year. Nutritional therapy is one of its management, by choosing a suitable diet to maintain nutrient intake. This was a case-control study including 46 patients with T2DM divided into 24 people for the case group and 22 people for the control group selected using purposive sampling method. Data was obtained using a general questionnaire; food intake with the SQFFQ; the 8-item Morisky Scale questionnaire, to assess medication adherence; the IPAQ, to assess physical activity. Blood sugar measurements were observed by measuring the respondents' fasting blood sugar in the last six months. The data was then analyzed using Chi-square statistical test and logistic regression. The results indicate a relationship between a vegetarian diet and a vegan lifestyle behavior that control blood sugar levels in patients with T2DM (P = 0.004). Diabetic patients on a nonvegetarian diet had a six times greater risk of having uncontrolled blood sugar (OR = 6.476). A significant relationship was found between a vegetarian diet and fasting blood sugar control based on bivariate analysis. In multivariate analysis, fiber intake was most significant to blood glucose control (OR=18.824; 95% CI 2.795-126.795). Vegetarian diet affects blood sugar control in T2DM patients. The type of nutritional intake needs to be more considered rather than the vegetarian diet in general, so that nutritional therapy in diabetics can be started by increasing fiber intake.

Case Report of Type-1 Diabetes Mellitus with Uncontrolled Blood Sugar Improved by Complex Korean Medicine Treatment

Objective: This study reported the effectiveness of Korean medicine for a patient with Type-1 diabetes mellitus after pancreatectomy with a compression fracture of the thoracic spine.Methods: A patient diagnosed with Type-1 diabetes mellitus after a pancreatectomy was treated with acupuncture, pharmacopuncture, <i>Gami-hwanggigyejiomul-tang</i> (modified Huangqi Guizhi Wuwu decotion), Jindang-won, etc. The conventional treatment was maintained using an insulin pump and insulin injection.Results: Blood glucose (FBS/PP2hrs), ESR and CRP decreased after one month of treatment.Conclusion: <i>Gami-hwanggigyejiomul-tang</i> and <i>Jindang-won</i> may be effective treatments for Type-1 diabetes mellitus. Further studies are needed to confirm the findings of this case.

Diabetes Mellitus Health Counseling in Jetis Village, Bondowoso

An increase in the prevalence of diabetes mellitus (DM) sufferers has occurred throughout the world, where Indonesia ranks 4th for the number of DM sufferers worldwide. This is certainly a phenomenon that needs serious attention from the government and society. Diabetes mellitus is a chronic disease characterized by uncontrolled blood sugar levels that can cause permanent damage to organs such as the eyes, heart, kidneys, and blood vessels. Diabetes mellitus is possible for everyone to suffer from, both those with a hereditary history of suffering from DM and those who do not have a hereditary history. Activities carried out in preparation, implementation, and evaluation. The activity method used is a lecture equipped with leaflet media where a discussion then follows the activity. The activity results showed that the implementation of counseling went smoothly, with an explanation of the material regarding definitions, patient criteria, risk factors, ways to prevent management, and the introduction of blood sugar measuring devices. The very high enthusiasm of the participants in asking questions was obtained by 90% of the participants asking questions, with each questioner asking one to four questions. Participants proposed to carry out the follow-up of diabetes mellitus counseling in the form of blood sugar checks which would be carried out at the next study meeting. The conclusion is that education in the form of counseling has formed positive perceptions related to awareness of the importance of preventing and controlling diabetes mellitus.

Epidemiological profile and diabetes control of Type 1 Diabetes Mellitus patients in Karbala Governorate, Iraq.

Background: Type1 Diabetes Mellitus is a common chronic diseases among children, and associated with morbidity, mortality, and enormous healthcare expenditures. Objectives; to estimate the prevalence, incidence, and describe the epidemiological characteristics of Type 1 Diabetes Mellitus among children in Karbala governorate. Methods: A cross-sectional study was conducted among all children who attended the main DM center in Karbala Teaching Hospital for Children, Public Clinics, and Primary Health Care centers. Data was collected by structured questionnaire and biochemical and anthropometric measurements. The statistical analysis data entry was conducted using Statistical Package for Social Sciences. Results: Total number of Type 1 Diabetes Mellitus patients aged 0-15 years in Karbala in 2015 was 199; making 44.66/100 5. Fifty-four patients were newly diagnosed patients making an incidence of 12.11/100 5. There was nearly equal distribution among both sexes. Most of the cases were from urban areas and most of the patients had a Family history of Type 2 Diabetes Mellitus. Diabetic ketoacidosis was reported in 16.8% of the patients. Only 31.6% of patients had HbA1c < 7%. Half of the patients had a history of admission to the hospital for diabetes. Logistic regression analysis revealed that the only independent variables significantly correlated with poor glycemic control were lack of Self-Monitoring Blood Glucose, irregular visits to the Diabetic Center, and positive family history of diabetes. Conclusion: Only one-third of T1DM children in Karbala city had controlled blood sugar. Lack of regular blood glucose monitoring and irregular contact with health care providers were the main determinants of uncontrolled blood sugar.

Prevalence of Karapada daha-suptata in Madhumeha with reference to diabetic peripheral neuropathy in type 2 diabetes mellitus patients.

Background: Diabetes mellitus is a major health issue in today's world. Main threat is not the disease itself but its complications like nephropathy, retinopathy and neuropathy etc. Diabetic peripheral neurropathy is the leading cause of foot ulcers, their complications like limb amputation and cost associated with it. Madhumeha which has been described as 'Maharogas' i.e. difficult to treat disease has many similarities with Diabetes mellitus can be understood and studied as same disease. Ayurveda has mentioned the causes, pathophysiology and symptoms of Diabetic Peripheral Neuropathy as 'karapada daha -suptata' in purvarupa lakshanas and upadrava lakshanas but inscattered form. It needs depth study to understand the concept of Karapada daha- suptata (DPN).&#x0D; Objective: To study prevalence of Karapada daha-suptata (Diabetic peripheral neuropathy) and the relation of Karapada daha- suptata (DPN) with age, gender, duration of disease Madhumeha, blood sugar level, alcohol and smoking habit etc in Madhumeha patients.&#x0D; Method :A cross sectional study was carried out in Tribhuvan University Ayurveda Teaching Hospital,. Madhumeha patients (Type 2 diabetes mellitus) patients were recruited for the study. MNSI (Michigan Neuropathy Screening Instrument) was used to diagnose Karapada daha- suptata (Diabetic peripheral neuropathy).&#x0D; Result: Among 100 patients 31% patient had Karapada daha- suptata (DPN). Our study showed that the prevalence of Karapada daha-suptata(DPN) increased with increasing age of the study population. Similarly prevalence of Karapada daha -suptata in patients with disease duration of Madhumeha (DM2) for more than 5 years was 61.29% where as patients having Diabetes for less than 5 year was 38.71%. Prevalence of Karapada daha-suptata (DPN) was very high (43.13%) among uncontrolled fasting blood sugar level (&gt;126mg/dl) and (47.5%) among uncontrolled post prandial blood sugar level (&gt;200mg/dl). In this study mean Fasting blood sugar level was 177.0323 mg/dl in the patients with Karapada daha-suptata(DPN) and mean post prandial blood sugar level in patients with diabetic peripheral neuropathy was 239.1613mg/dl.&#x0D; Conclusion: Our study showed Karapada daha-suptata/DPN is highly prevalent and increasing as the duration of disease Madhumeha increses but its not uncommon in newly disagnosed disease too. This study showed significant relation of Karapada daha suptata with disease duration of Madhumeha, level of blood sugar, and increasing age of the patients.Study showed no significant differences in the prevalence of Kara pada daha- suptata in male and female patients and with the smoking habit of the patients.

Factors associated with severity and anatomical distribution of diabetic foot ulcer in Uganda: a multicenter cross-sectional study

BackgroundDiabetic foot ulcer (DFU) is a devastating complication of diabetes mellitus (DM) that is associated with increased mortality, morbidity, amputation rate and economic burden. This study aimed at identifying the anatomical distribution and factors associated with severity of DFU in Uganda.MethodologyThis was a multicenter cross-sectional study conducted in seven selected referral hospitals in Uganda. A total of 117 patients with DFU were enrolled in this study between November 2021 and January 2022. Descriptive analysis and modified Poisson regression analysis were performed at 95% confidence interval; factors with p-value < 0.2 at bivariate analysis were considered for multivariate analysis.ResultsThe right foot was affected in 47.9% (n = 56) of patients, 44.4% (n = 52) had the DFU on the plantar region of the foot and 47.9% (n = 56) had an ulcer of > 5 cm in diameter. The majority (50.4%, n = 59) of patients had one ulcer. 59.8% (n = 69) had severe DFU, 61.5% (n = 72) were female and 76.9% had uncontrolled blood sugar. The mean age in years was 57.5 (standard deviation 15.2 years). Primary (p = 0.011) and secondary (p < 0.001) school educational levels, moderate (p = 0.003) and severe visual loss (p = 0.011), 2 ulcers on one foot (p = 0.011), and eating vegetables regularly were protective against developing severe DFU (p = 0.03). Severity of DFU was 3.4 and 2.7 times more prevalent in patients with mild and moderate neuropathies (p < 0.01), respectively. Also, severity was 1.5 and 2.5 higher in patients with DFU of 5–10 cm (p = 0.047) and in those with > 10 cm diameter (p = 0.002), respectively.ConclusionMost DFU were located on the right foot and on the plantar region of the foot. The anatomical location was not associated with DFU severity. Neuropathies and ulcers of > 5 cm diameter were associated with severe DFU but primary and secondary school education level and eating vegetables were protective. Early management of the precipitating factors is important to reduce the burden of DFU.

A STUDY OF SERUM PHOSPHORUS LEVEL IN PATIENTS WITH DIABETES MELLITUS

Introduction: Diabetes mellitus is one of the most common chronic metabolic diseases in children and adolescents, which changes the cellular metabolism. Phosphorus is an essentialelement for metabolism. Early in the progression of diabetes, a paradoxical metabolic imbalance in inorganic phosphate (Pi) occurs that may lead to reduced high energy phosphate and tissue hypoxia. While low and high uncontrolled blood sugars can be easily recognized by clinical symptoms, low and high plasma inorganic phosphate remain unrecognizable. Therefore, we aimed to assess the association between hemoglobin A1c (HbA1c) with serum inorganic phosphate in diabetes. Aim: To study the changes in serum phosphorus levels with severity of DM as adjudged by HbAlc by investigating the following parameters in serum. 1. Blood glucose level (FBS &amp; PPBS) 2. Glycated HbA1c 3. Serum Phosphorus. Materials And Methods: The present study involved 50 healthy controls and 50 clinically diagnoseddiabetic cases.Blood samples were collected under aseptic precautions from controls andcases. Relevant investigations were carried out and results interpreted for statistical evaluation. Results: The levels of serum phosphorus decreased in diabetic cases compared to healthy controls . Blood urea and serum creatinine levels were withinnormal limits in both controls and cases which are statistically not significant. Conclusion: It is concluded that decrease in serum phosphorus level is negativelycorrelated with glycated HbAlc , indicates that as the severity of diabetes increasesthere is a significant decrease in serum phosphorus level. Thereforediabeticstreatedwith insulin should be monitored to prevent morbidity and mortalityfromhypophosphatemia.

Prevalence and Associated Clinical Features of Type 1 Diabetes Mellitus Among Children Presented to a Tertiary Health Care Center of Himalayan Foothills.

Introduction Diabetes Mellitus (DM) is a complex metabolic disorder characterized by chronic hyperglycemia. Knowing its prevalence, associated clinical features, and complications is essential for diagnosing children having diabetes-like clinical features. Since there is a limited study from India and no similar study from this geographical part, the present study was carried out. Material and method It is a cross-sectional study, which includes children aged 1-18 years presented to the pediatric outpatient department (OPD), inpatient department (IPD), and emergency with clinical features of Type 1 Diabetes Mellitus (T1DM). The enrolled cases were assessed for confirmation of T1DM, and clinical features and associated complications were recorded in the case record form. Result A total of 218 children with clinical features of T1DM were enrolled, out of which 32 (14.7%) had T1DM. Among the 32 T1DM patients, 31 (96.9%) of the participants presented with polyuria, 29 (90.6%) had polydipsia, and 13 (40.6%) had polyphagia. Out of 32 children, 3 (9.38%) had diabetic neuropathy, and 1 (3.1%) had diabetic retinopathy. Conclusion We found that many children with diabetes have clinical features of T1DM and uncontrolled blood sugar. This emphasizes the need for early detection and treatment to prevent long-term complications.

Spotlight on the Mucormycosis Outbreak: A Deadly Fungal Infection That Followed the COVID-19 Pandemic.

The COVID-19 pandemic along with its treatment has brought myriad potential complications including the heightened risk of secondary fungal infections like mucormycosis. Mucormycosis is a rare angioinvasive fungal infection that has traditionally been highly fatal despite surgical intervention and antifungal medications. To re-evaluate the risk factors, epidemiology, and possible COVID-19-associated conditions on a larger sample size than the existing data. We studied the possible risk factors, clinical presentations, treatment, and outcome of 203 patients with mucormycosis in a single-center retrospective-prospective observational study for three months at a tertiary care hospital after obtaining due permission from the institutional ethics committee. The mean age of patients was 52 ± 11.5 years, and 92.61% had a history of COVID-19 infection. Around 86.7% of patients were suffering from diabetes mellitus with 50% being already known cases whereas the other 50% developed post-COVID-19 infection; 65.02% of patients were administered corticosteroids during their COVID-19 treatment. About 51.72% of patients required hospital admission and among them, 16.25% of patients required ICU support. The mean oxygen saturation (SpO2) levels on admission were 84.61 ± 12.96%, and 38.92% of patients required mechanical respiratory support. The mean duration between COVID-19 infection and the onset of mucormycosis was 18.80 ± 16.61 days. The most common clinical presentations were facial pain and swelling (26.6%) and ophthalmic symptoms including eye swelling, pain, and ptosis (25.12%). Antifungal treatment was given to all the patients and 89.36% of the patients underwent surgical debridement of fungal mass. At the end of three months,60.59% of the 188 patients survived with improvement, 13.30% had no improvement and/or deterioration of health, and 18.72% succumbed to mucormycosis. Intracranial involvement and leukocytosis were positively associated with mortality whereas surgical intervention was significant forpositive outcomes at the end of three months in patients with mucormycosis(p<0.05). The sudden rise of mucormycosis during the second wave of COVID-19 can be attributed to uncontrolled blood sugar levels along with high corticosteroid usage as well as various nosocomial factors during the COVID-19 treatment. Early and aggressive treatment with surgical intervention and antifungal drugs can improve disease outcomes.

Management of Diabetic Macular Edema Through Ayurveda: A Single Case Study

Diabetic macular edema is one of the leading causes of visual acuity loss in people with diabetes. It produces blurry vision, particularly in the centre of the vision field, floaters and black spots in front of the eyes etc. The treatment recommended by modern science is laser photocoagulation and anti-VEGF injection, which is pricey and does not ensure visual reversal in the patient. In Ayurveda text, diabetic retinopathy and diabetic macular edema are not directly described but etiopathogenesis of eye diseases and Prameha gives an idea of possible correlation between these two diseases. So, DME resembles Timira (Pramehajanya). In Ayurveda, Timira has been explained in detail by our Acharyas. Clinical manifestations of Timira are Vihwal Drishti (blurred vision), Makshika Mashaka Kesha Jaala Pashyati (floaters), Tamasa Darshanam (Scotoma- black spots in front of eyes) and Nasa Akshi Yuktani Vipritani Vikshate (Metamorphopsia or distorted vision) which has similarity with features of DME. Material &amp; Methods: In the present study, a female patient aged 51 years, visited the Shalakya Tantra OPD of National Institute of Ayurveda, Jaipur, with complaining of Blurriness of vision since 6 months and uncontrolled blood sugar level. Result: Blood sugar level was controlled and saw reduction in subjective and objective parameters. Discussion: Following an Ayurvedic drugs and routine will assist to slow the advancement of the condition, prevent further diabetes complications, and improve quality of life.

IMPACT OF DIABETES MELLITUS ON CLINICAL PROFILE AND OUTCOME OF COVID-19 PATIENTS IN A TERTIARY CARE HOSPITAL

Objective: A novel coronavirus infection (SARS-CoV-2) pneumonia (COVID-19) has been quickly spreading throughout China and the rest of the world since December 2019. Respiratory tract infections are frequently linked to diabetes mellitus (DM), a different risk factor. This study has reported the clinical presentation and therapeutic outcomes of COVID-19 with diabetes. Methods: From medical records and histories provided by 72 Covid-19-infected patients with diabetes admitted to the KMCH institute of health sciences and research, Coimbatore, data on demographics, clinical, laboratory, and radiological characteristics as well as treatment outcomes were collected using data collection forms. Real-time reverse transcription polymerase chain reaction (RT-PCR) assay of 2019-CoV RNA was used to screen patients with Covid-19. Results: 72 diabetes patients who tested positive for Covid-19 were admitted for this study. SPSS software version 26 was used to evaluate the data that had been collected. Clinical profiles and outcomes of patients with and without diabetes underwent descriptive analysis. Controlled diabetics had a mean plasma glucose of 112.22±11.41, while uncontrolled diabetics had a mean plasma glucose of 154.2±23.22. Fever was the most prevalent symptom in both managed and uncontrolled diabetes patients (94% and 100%), followed by sore throat (84% and 88%). In patients with uncontrolled diabetes compared to those with controlled diabetes, breathlessness is considerably higher (p&lt;0.05). In the CORADS scoring, 11 of the 34 diabetics with uncontrolled blood sugar levels had CORADS 6 (32.35%), compared to just 2 of the 38 diabetics with regulated blood sugar levels (5.26%), which is considerably higher (p&lt;0.01). In uncontrolled diabetics, the length of hospital stay is much longer (p&lt;0.001). Compared to diabetics with controlled blood sugar, uncontrolled patients SPO2 dramatically dropped (p&lt;0.001). Those with uncontrolled diabetes are more likely to be admitted to the ICU than patients with controlled diabetes (p&lt;0.05). In uncontrolled diabetes compared to controlled patients, the severity was considerably higher (p&lt;0.05). One person who had uncontrolled diabetes died, although no one who had controlled diabetes died. Conclusion: Covid 19, persons with uncontrolled diabetes appear to be more likely to sustain lung damage, necessitating admission to the ICU, an extended stay in the hospital, and oxygen assistance throughout the duration of the illness.

Successful treatment of a case of Congenital Lipodystrophy with 1 mg subcutanous Semaglutide

Abstract 25-year-old female presented to the endocrine clinic suffering from uncontrolled blood sugar and irregular period, she was diagnosed with type 1 diabetes since she was 15 and treated with premixed insulin, on the other hand she was diagnosed with polycystic ovary syndrome and treated with oral contraceptive pills, on examination; there is acanthosis nigricans in the axilla and forearm, android lean body habitus and acromegalic face, hirsutism and prominent veins. Labs revealed high triglyceride (more than 1000 mg/dL), high fasting insulin, high total testosterone 0.9 ng/mL, HbA1c 14,5%, high ALT, albuminuria, she is using very high doses of insulin yet uncontrolled, we diagnosed her as generalized lipodystrophy, the drug of choice is metroleptin which is not available, so I started pioglitazone 45 mg with semaglutide 1mg, gradually weaned off insulin. After 3 months of treatment her HbA1c declined to 7 without insulin, triglyceride to 422 mg/dL, proteinuria declined but was not normalized. We postulate the hypothesis that the insulin sensitizing properties of GLP1 agonist in the treatment of insulin resistance syndromes can be implemented particularly in countries with middle and low socioeconomic status that don't have access to the expensive drugs. Figure 1. Patient footage oral consent taken. Table 1.Results of biochemical parameters before and after treatment.

The Analisis Faktor Risiko Leukosituria Pada Pasien Diabetes Di Desa Uteun Kot Kota Lhokseumawe

Diabetes mellitus (DM) is a chronic disease that is still a problem in Indonesia. DM occurs when there is an increase in the level of glucose in the blood (hyperglycemia), in which the body cannot produce enough insulin or use insulin effectively. It is important for DM patients to comply with a series of examinations such as controlling blood sugar so that subjective complaints do not occur that lead to complications. DM patients are at risk for chronic macrovascular complications in the form of infections, ranging from simple to complex infections. This study aims to determine and analyze risk factors for leukocyturia in DM patients in Uteun Kot Village. The research designs used were a laboratory examination and a survey using a questionnaire with a cross-section approach. Laboratory examinations were carried out on the urine of patients with diabetes mellitus (DM) to determine the incidence of leukocyturia and blood sugar levels to determine the blood sugar values of DM patients. The number of samples used in this study was 85 samples that met the criteria determined by using the Slovin formula. sampling using the sequential random sampling method. The variables used in this study were leukocyturia as the dependent variable and gender, duration of illness, and blood sugar levels as independent variables. Leukocyturia laboratory examination by urinalysis and microscopic examinationThe data analysis method used univariate analysis and bivariate analysis. The results showed that 68.2% of DM patients in Uteun Kot Village had leukocyturia, 63.5% of DM patients had high KGDS, and 71.8% had suffered from DM for more than 5 years. The variable duration of suffering from DM has a significant relationship with leukocyturia, where respondents with long suffering from DM above 10 years have a positive probability of leukocyturia 3.72 times compared to those suffering from DM under 10 years. Similarly, DM patients with uncontrolled blood sugar levels have a positive probability of leukocyturia 2.51 times compared to DM patients with controlled blood sugar levels.

Factors Affecting Controlled Blood Sugar Levels in Patients with Type 2 Diabetes Mellitus at the Internal Medicine Polyclinic at the Regional General Hospital of West Nusa Tenggara Province

Indonesia is ranked seventh out of countries that contributed to the highest number of DM in the world in 2019 and estimate that in 2045 it could reach 16.6 million cases. West Nusa Tenggara Province is one of the provinces with a fairly high DM rate reaching 21,308 with various complications due to uncontrolled blood sugar levels. High blood sugar levels in DM patients are caused by several uncontrolled factors in DM patients. This study aims to determine the factors associated with uncontrolled blood sugar levels in type 2 DM patients at the NTB Provincial Hospital. This research is a observational with a cross sectional study. The sample selection using the consecutive sampling obtained from the medical records of type 2 DM patients who were treated at the Internal Medicine Polyclinic of the NTB Provincial Hospital. The study sample size were 100 people with univariate and bivariate data analysis using the Chi-square test. The subjects in this study were dominated by patient age &gt; 45 years (75.6%), female (51.2%), using non-insulin therapy (52.4%), and duration of type 2 diabetes &lt; 10 years. (67.07%) with uncontrolled blood sugar status (52.4%). Bivariate analysis using the Chi-square showed that there were a statistically significant relationship between controlled blood sugar levels and patient age (p=0.021), controlled blood sugar levels with gender (p=0.008), controlled blood sugar levels and the type of therapy (p=0.008). = 0.004), and controlled blood sugar levels with duration of diabetes (0.023).

Cough, with a sac of marbles in the chest.

A 48-year-old male patient presented with productive cough, dyspnea and abdominal pain of 2 months duration. He was diagnosed with diabetes mellitus 6 months ago and had not been regular with his medications. Clinical examination revealed a respiratory rate of 18 per min with room air saturation of 95%, and a paucity of movements with bronchial breath sounds identified on inspection and auscultation, respectively, over the right hemithorax. Chest skiagram and computed tomography images of his thorax are shown below [Figure 1].Figure 1: (a) shows chest skiagram and (b–d) shows high-resolution computed tomography images of the chest. A description of the images is in the accompanying textQuestion: What is the diagnosis? Answer: Pulmonary and hepatic hydatid disease. DISCUSSION The chest skiagram [Figure 1a] revealed a well-defined round radio-opacity in the right mid zone with a crescentic hyperlucent medial margin, called the crescent sign (white arrow). Figure 1b is a coronal view of high-resolution computed tomography (HRCT) scan of the chest lung window, which shows a large cyst in the right lung, with multiple small rounded opacities with fluid attenuation, some of which appear to be floating within it, appearing like a sac of marbles. This is consistent with a diagnosis of a hydatid cyst with multiple daughter cysts within it. There are pockets of air seen between the outer pericyst and inner endocyst, aptly named ‘air-crescent sign’ (blue arrow) and ‘signet ring sign’ (red arrow), which suggest a ruptured or complicated hydatid cyst. Figure 1c, the sagittal section of the HRCT scan of the chest lung window at the level of the aortic outflow tract, shows the ruptured hydatid cyst in the right lung. The daughter cysts have collected in the dependent area of the larger cyst, with some appearing to ‘rise’ over the rest, or the ‘rising-sun sign’ (blue arrow). Also seen is a small air pocket inferiorly (red arrow) between the pericyst and endocyst, called the ‘air-bubble sign’. The presence of air on either side of the endocyst (red arrowheads) gives the appearance of an ‘onion-peel sign’, or the ‘cumbo sign’. Figure 1d shows a large well-defined homogenous cyst in the right lobe of the liver.[1] Blood investigations revealed uncontrolled blood sugar levels. Armed with the characteristic radiology above, and supplemented by a positive serum latex agglutination test for Echinococcus antigen, he was diagnosed with pulmonary and hepatic hydatid disease. He was started on oral albendazole and subsequently underwent pericystectomy of lung cyst along with partial pericystectomy of cyst in the liver. Post-surgery, he is at present asymptomatic and is on regular follow-up. Hydatid disease is a zoonosis, commonly caused by the accidental ingestion of ova of the tapeworm Echinococcusgranulosus, which subsequently develop into larvae in the host intestine and migrate to other parts of the body where they develop into embryos, with the liver and lung being the most commonly involved organs.[1] Characteristic thoracic radiology should lead clinicians to suspect pulmonary hydatid disease, especially when dealing with patients with non-resolving pneumonia or lung mass. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.

Wound Healing in Diabetic Patients

Introduction: Diabetes mellitus (DM) is a very common disease that results from the body’s inability to maintain blood glucose level within normal limits. Blood glucose levels are either too high or too low. One study shows that up-to 30% people with DM experience skin problems. If blood sugar levels are well controlled, the rate of wound healing and developing a severe infection is significantly less. Regarding management of wound in diabetic patients, keep wounds dry with meticulous dressing, limb elevation, protect the surgical fixation in splint or braces for an extended period of time and patient education to keep in touch wither consultant and promptly report any unusual discomfort, pain, wound discharge, soaking of dressing and systemic symptoms. Objectives: the objective of this study is to identify the risk of wound infection and rate of healing in diabetic patient. Materials and Methods: The study was conducted at orthopedic department of Gulab Devi hospital. It was a Cross sectional study. The data was collected from September 2021 to February 2022. Non–Probability purposive sampling technique was used. The data was collected from indoor of Gulab Devi Chest Hospital Lahore and informed consent was taken from all the patients. The target populations were those who have diabetes mellitus and treated in orthopedic ward at Gulab Devi hospital Lahore. Diabetic patients enrolled in the presented study n=60. Results: our patient population was 28 to 55 year old with mean age 40years. 83% were in 35 to 40 age group. Wound problems were frequently encountered in patients with uncontrolled diabetes and 50% (n=30) of these patients had at least one wound complication after operation. And 71% (n=43) patients had increased pain and delayed recovery of their surgical wounds. When it comes to the relationship between bone health and diabetes, 63% (n=38) patients had history of previous bone fracture and 61% (n=37) patients had deformity of bone. Due to diabetic neuropathy 68% (n=41) patient were weight bearing on fracture site without concern. And the risk of diabetes include slow wound healing 75%. Practical implication; we aim to raise awareness among treating surgeons and physicians of patients presenting with diabetes and planning to undergo surgical intervention. Meticulous wound care and strict control of blood sugar levels are paramount to successful outcome. Conclusion: Diabetes mellitus is a systemic disease associated with uncontrolled blood sugar levels with systemic manifestations. Our study has proved an association of high wound complication with DM patients. Strict diabetic control as well as extra vigilance and meticulous techniques are needed to prevent complications in this group of patients. Keywords: Diabetes mellitus, infected wound, diabetes complications, wound healing

A Rare Case Study to Understand the Path of Post Dengue Mucormycosis

Mucormycosis is a rare form of opportunistic and third most common fungal infection which is aggressive in nature and frequently fatal. The infection is chronic, persisting for years, attributed by immunocompromised status of the patients with poor oral and nasal hygiene. A case study attempted to understand the path of Mucormycosis in a case of post dengue infection admitted at the tertiary care hospital. Interview with the case and caretaker and the case file review was done to collect the data. This is the case of rhino- orbital Mucormycosis attributed by uncontrolled blood sugar during treatment of dengue infection, the disease progression has been triggered by ignorance from the health care personnel’s &amp; the patient’s unhygienic practices. Unsafe and infected environment of the hospital made her immunocompromised and vulnerable due to dengue and gave the chance of disease progression.