Study of plasma fibrinogen level and its relation to glycemic control in type-2 diabetes mellitus patients attending diabetes clinic at a tertiary care teaching hospital in Madhya Pradesh, India

Background: Diabetes mellitus comprises a group of common metabolic disorders where increased fibrinogen levels can act as a thrombogenic factor. Diabetic patients have higher cardiovascular morbidity than non-diabetic subjects. Several studies have shown that haemostatic factor especially hyperfibrinogenemia is implicated as a source of atherosclerosis and its complications.Methods: A comparative observational study was conducted to compare fibrinogen levels between type 2 diabetes patients and healthy controls. Their fibrinogen levels were compared and co-related with glycemic status and other risk factors and parameters like glycosylated haemoglobin, age, sex, smoking, body mass index (kg/m2), hypertension and ischemic heart disease.Results: It was seen that in the diabetic subset, the plasma fibrinogen levels are significantly higher than the non-diabetic subset (386.04±132.87 vs. 314.38±97.42; p<0.001). Our study re-established correlation between HbA1c and fibrinogen levels of the diabetic patient is positive i.e., poorer the glycemic status, higher the fibrinogen levels (r=0.24).Conclusions: It can be concluded from the study that fibrinogen levels are in­creased in type 2 diabetic subjects with and without CHD. Plasma fibrinogen levels usually increased in type 2 diabetes, thus suggesting that hyperfibrinogenemia could contribute to the excess cardiovascular morbidity and mortality in this disease

Study of altered platelet morphology with changes in glycaemic status

Background: Diabetes is a pandemic causing very high morbidity and mortality due to its complications which are a result of micro and macro angiopathy. Platelets play a key role in the vascular complications. These complications are attributed to platelet activation which can be recognised by an increase in platelet volume indices (PVI) including mean platelet volume (MPV) and platelet distribution width (PDW). Platelet indices can be potentially useful surrogate markers for the early diagnosis of thromboembolic and cardiovascular complications in diabetes.Methods: This is a cross-sectional study conducted for 2 years with total 930 subjects. The patients were segregated in 03 groups on basis of HbA1C as (a) Diabetic, (b) Non-Diabetic and (c) FG. Samples for HbA1C and platelet indices were collected using EDTA (ethylene diamine tetracetic acid) as anticoagulant and were processed on autoanalysers.Results: The study revealed a stepwise increase in the PVI from non-diabetics to IFG to diabetics. MPV and PDW were increased in the IFG cases as compared to the non-diabetic and were markedly increased in the diabetic patients. MPV and PDW of diabetics, IFG and non-diabetics were 17.60±2.04, 11.76±0.73, 9.93±0.64 and 19.17±1.48, 15.49±0.67, 10.59±0.67 respectively with a significant p value 0.00. Significant positive correlation between PVI with glycaemic levels and duration of diabetes across the groups (MPV-HbA1c r = 0.951; PDW-HbA1c r = 0.875). However, the total platelet count was found to decrease with the increasing glycaemic levels with a p value <0.001. A significant negative correlation was found between glycaemic levels and total platelet count (PC- HbA1c r = -0.164).Conclusions: This study showed that platelet morphology is altered with increasing glycaemic levels. These changes can be known by measurements of PVI which is an important simple and effortless tool can be used more extensively to predict the acute vascular events and thereby help curb morbidity and mortality.

Spectrum of ovarian tumours- a five year study

Background: Ovarian tumor is the seventh most common cause of cancer related deaths in female. The aim of this study is to find the, morphological and clinicopathological correlation, gross, histological pattern, and incidence of age distribution of ovarian tumors.Materials and Methods: This retrospective and prospective study was carried out from January 2011 to December 2015. The diagnosis was confirmed by histopathological examination using hematoxylin and eosin stain. Special stains and immunohistochemistry were carried out whenever needed.Results: Out of total 158 cases, 62.65% were benign, 3.79% were borderline, and 33.55% were malignant. Histologically, surface epithelial tumors were the most common (74.06%) followed by germ cell tumours(15.82%) and sex cord–stromal tumors (10.12%).Benign tumors were mostly seen in age group of 20–40 years, borderline 21–40 years, and malignant 50–80 years.Conclusion: Tumors originating from surface epithelium are the most common and their malignant counterparts are more frequent in the elderly age group.</p

Cardiopulmonary Outcomes in Covid-19 Patients Discharged From a Tertiary Care Center: A Prospective Study

To determine the cardiopulmonary changes in the survivors of acute COVID-19 infection at 3-6 month and 6-12 month. We followed up 53 patients out of which 28 (52%) had mild COVID-19 and 25 (48%) had severe COVID-19. The first follow-up was between 3 month after diagnosis up to 6 month and second follow-up between 6 and 12 month from the date of diagnosis of acute COVID-19. They were monitored using vital parameters, pulmonary function tests, echocardiography and a chest computed tomography (CT) scan. We found improvement in diffusing capacity for carbon monoxide (DLCO) with a median of 52% of predicted and 80% of predicted at the first and second follow-up, respectively. There was improvement in the CTSS in severe group from 22 (18-24) to 12 (10-18; p-0.001). Multivariable logistic regression revealed increased odds of past severe disease with higher CTSS at follow-up (OR-1.7 [CI 1.14-2.77]

ROLE OF HEMATOLOGICAL PARAMETERS IN COVID-19 PATIENT IN INDEX MEDICAL COLLEGE, INDORE

AIM: Study to evulate the pattern of the hematolofical parameters of covid-19 patients along with their clinical course in the Indian scenario.&#x0D; Material&amp; method: A prospective study of 100 patients with laboratory-confirmed covid-19 admitted to index medical college indore from April to june were enrolled for the study. Patients were divided into asymptomatic (mild) patients, and symptomatic (moderate).&#x0D; The demographic date, the clinical status of the patients during admission, and follow up and hematological finding were recorded. The semples for complete blood count and peripheral smears for microscopy examination were collected on the day of admission .the sample were tested for complete blood count on 5-part hematology analyzer, and values were recorded. peripheral smears were stained by gimsa stains, and findings were noted.&#x0D; Results: All the paediatric cases under study were stable and asymptomatic, with only supportive treatment. Adults patients included in the study were given supportive treatment, and only one case showed clinical deteriotion over a period of 90 day of admission.&#x0D; Conclusion: The study of 100 covid-19 cases of Indian population shows that majority of the patients are younger, have asymptomatic to mild clinical presentation, and a higher incidence in the female population. The majority of pediatric cases have mild symptomology with a stable clinical corse. Baseline CBC finding of all the cases show. mild neutrophilia, mild lymphopenia, eosinophilia, mild monocytosis, and a normal to mild thromobocytopenia. a significance statistical trend of increase in CBC PARAMETER, NLR, was noted in follow up cases with persistent symptoms, however, a larger follow up cohort is needed to arrive at a statistical significances.&#x0D; Keywords: hematological, covid-19 &amp; neutrophilia.</jats:p