Online ISSN: 2515-8260

Keywords : corticosteroid


Significant endoscopic findings and the probable associated factors in dyspeptic patients: A cross-sectional study conducted in a tertiary care hospital, rural Mandya

Dr. Yamuna VS, Dr. Sachin K, Dr. Selva Rani, Dr. Veena Ghanteppagol, Dr. Ullas Mahesh

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 5, Pages 382-390

Introduction: Dyspepsia is the most common gastrointestinal problem. Majority of dyspepsia is functional dyspepsia. Due to the high prevalence of dyspepsia, inappropriate use of upper GI Endoscopy can lead to unnecessary costs, risk of complications, and associated with reduced diagnostic yield.
Objectives:

To determine the prevalence of significant endoscopic finding (SEF) and H.Pylori in dyspeptic patients.
To determine the response of dyspeptic patients to PPIs and H.pylori eradication therapy.
To assess the factors predicting SEF in dyspeptic patients.

Materials and Methods: This was a cross-sectional study conducted for a period of 18 months among 100 patients with dyspepsia at department of general surgery of a tertiary care hospital. Data was collected using a semi-structured questionnaire by interview technique. The study subjects were subjected to upper gastro-intestinal endoscopy during which biopsies were taken and sent for routine histopathology examination. Descriptive and inferential statistics has been carried out in the present study. A P value < 0.05 was considered statistically significant.
Results: The mean age of the study subjects was 45.13±14.06 years. Pain abdomen was the commonest (82.0%) alarm symptom of dyspepsia and 64.0% of those with dyspepsia were smokers and 61.0% were alcoholics. Overall prevalence of significant endoscopic finding (SEF) was 36.0% and duodenal ulcer (22.0%) was the commonest of all. 71.0% revealed H.pylori infection and at least 90.0% responded well to proton pump inhibitors (PPIs) and triple drug therapy. Among the different factors, bloating or belching was found to be significantly associated with the SEF.
Conclusion: The prevalence of SEF was 36.0% and H.pylori was 71.0%. Most of them i.e. 90.0% responded both clinically and microbiologically to the treatment and bloating or belching was a significant alarm symptom associated with SEF. A trial of proton pump inhibitors (PPIs) and triple drug therapy can be considered before subjecting the patients to the invasive procedure of endoscopy.

CLINICAL CHARACTERISTICS OF NON-DIABETIC HYPERGLYCEMIA PATIENTS TREATED IN INTENSIVE CARE

Amaliah .; Satriawan Abadi; Andi Makbul Aman; Syakib Bakri; Hasyim Kasim; Khalid Saleh; Himawan Sanusi; Fabiola.M.S. Adam; Arifin Seweng

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 2644-2657

Background of study: Hyperglycemia often occurs in critically ill patients even without a history of diabetes. Hyperglycemia, in hospital, according to the American Diabetes Association (ADA) is defined as a condition in which blood glucose levels are ≥140 mg/dl and HbA1c ≤6.5, without any prior diabetes history. Hyperglycemia results from an endocrine and metabolic response to stress. Studies and literature regarding hyperglycemia in non-diabetic patients in Indonesia are deemed limited, especially case studies of non-diabetic hyperglycemia in intensive care and the prevalence of hyperglycemia related to age, sex, metabolic risk (obesity, hypertension, dyslipidemia), history of parenteral nutrition, history of corticosteroids use, and disease diagnosis.
Methods: The present study is a retrospective descriptive study using medical record data of patients at the HCU, ICU, Brain Center, and CVCU PJT Wahidin Sudirohusodo Hospital in August 2020 - October 2020. This study involved 90 non-diabetic subjects in intensive care. The inclusion criteria were based on the ADA criteria for non-diabetic hyperglycemia in the hospital.
Results: This study involved 44 non-diabetic hyperglycemic patients and 46 non-diabetic patients without hyperglycemia with a mean age of 53.5 years in non-diabetic hyperglycemic subjects and 57.7 years old in subjects without hyperglycemia. Non-diabetic hyperglycemia subjects with obesity (34.1%), hypertension (61.5%), and dyslipidemia (46.9%). Subjects with hyperglycemia with a history of corticosteroid use (95%). Based on the diagnosis of the disease when the subject was in intensive care, the subject with a diagnosis of CHD had hyperglycemia (36.8%), stroke with hyperglycemia (58.8%), and other diagnoses (infection, tumor, postoperative, and trauma) accompanied by hyperglycemia (57, 1%).