Journal of the Indian Medical Association
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Comparative Study
Glycaemic control in type 2 diabetes mellitus patients undergoing major surgery: comparison of three subcutaneous insulin regimens.
Pre-operative glucose control with subcutaneous insulin in non-urgent situations is logical and well accepted. But the best regimen amongst the many available ones of insulin administration during peroperative period during major surgery is uncertain. We compared three subcutaneous insulin regimens for pre-operative glucose control in type 2 diabetes mellitus (T2DM) patients. ⋯ Incidence of infection (10.53 versus 18.52 and 15.00%, p > 0.05), renal complications (10.53 versus 11.11 and 15.00%, p > 0.05) and mortality (5.26 versus 14.81 and 15.00%, p > 0.05) were lower with this regimen, but the difference was not statistically significant. Premix 30/70 and R + NPH regimens were comparable for most parameters but hypoglycaemia and severe hyperglycaemia were more frequent respectively with premix 30/70 and R + NPH regimens. In contrast to the popular perception about the risk of hypoglycaemia with long acting insulins, insulin analogue glargine was found to be better than NPH insulin in basal bolus regimens in achieving better glycaemic control with fewer incidence of hypoglycaemia.
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Tuberculosis is considered to be 100% curable if adequate drug regimen is followed, still in developing countries it is becoming leading cause of death. The Revised National Tuberculosis Control Programme (RNTCP) came into existence by formulating and adopting the DOTS (direct observation treatment--short course). By March 2006 the whole country was covered by RNTCP. ⋯ The Government of India is planning to implement DOTS plus by 2010 all over the country and by 2012 access under RNTCP for laboratory based quality assured MDR-TB diagnosis and treatment. Tuberculosis along with HIV and MDR/XDR TB is further worsening the scenario. To counter this menace, every medical practitioner's co-operation is important.
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Historical Article
Percutaneous coronary interventions: past, present and future.