The Journal of the Association of Physicians of India
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J Assoc Physicians India · Jul 2012
Prevalence of peripheral arterial disease in type 2 diabetes mellitus and its correlation with coronary artery disease and its risk factors.
Peripheral arterial disease (PAD) is one of the macrovascular complications of type 2 diabetes mellitus. Unlike other complications, it has received little attention in the Indian medical literature. There is significant difference in the reported prevalence of PAD and its associated risk factors between Indian and Western studies. In order to assess PAD in diabetics, its associated risk factors and its relationship with coronary artery disease, we conducted a hospital-based, cross-sectional study. ⋯ Using ankle brachial index, we found evidence of PAD in 14.3% of type 2 diabetics. Risk factors significantly associated with PAD were--higher age, longer duration of diabetes, higher systolic and diastolic blood pressure, smoking, higher HbA1c levels and CAD. The prevalence of CAD was higher in patients with PAD (52.38% vs. 24% in those without PAD; p=0.007). Thus the presence of PAD should alert the clinician to a high probability of underlying CAD.
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J Assoc Physicians India · Jun 2012
Case ReportsDisseminated melioidosis presenting as septic arthritis.
Melioidosis is an infection caused by Burkholderia pseudomallei. The disease is known as a remarkable imitator due to the wide and variable clinical spectrum of its manifestations. ⋯ We report a case of melioidosis in a 52 year male with uncontrolled diabetes mellitus (DM) presenting with a rare combination of septic arthritis and abscesses in the chest wall, liver and subcutaneous tissue. The patient responded to prolonged treatment of intravenous ceftazidime followed by oral co-trimoxazole.
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J Assoc Physicians India · May 2012
Case ReportsWernicke's encephalopathy with visual loss in a patient with hyperemesis gravidarum.
We describe a case of Wernicke's encephalopathy associated with visual loss that was caused by hyperemesis gravidarum. ⋯ Wernicke's Encephalopathy can occur in many hitherto under-recognised clinical scenarios associated with inadequate oral intake like hyperemesis gravidarum, after gastric bypass surgeries and those on total parenteral nutrition. Visual loss is increasingly being recognized as the additional, reversible feature of Wernicke's Encephalopathy. The changes that occur on MRI brain, especially on the diffusion weighted images, are characteristic and considered diagnostic of Wernicke's Encephalopathy.
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J Assoc Physicians India · May 2012
Randomized Controlled TrialPentoxifylline in severe alcoholic hepatitis: a prospective, randomised trial.
Role of corticosteroids in treatment of severe alcoholic hepatitis (SAH) is controversial. Pentoxifylline (PTX), an inhibitor of TNF, has also been shown to decrease short term mortality in SAH. Aim of this study was to evaluate the effect of PTX on short term mortality, renal and hepatic functions in patients with SAH. ⋯ In patients with SAH, PTX leads to a significant improvement in renal and hepatic functions, and a trend towards decreased short term mortality.