European Journal of Molecular & Clinical Medicine

Cerebrovascular accident or stroke is one among the three leading causes of death, surpassed only by ischemic heart disease and malignancy. Stroke is also a common cause of physical disability, which imposes a substantial burden to the community in the foreseeable future. It is estimated that the incidence of stroke is likely to increase by about 20% in the next 20 years. Aim & Objective: 1. To study clinical profile and risk factors in cerebrovascular accident.2. study CT scan finding among cerebrovascular accident patients. Methods: Study design: Prospective Observational Study. Study setting: Medicine ward of tertiary care center. Study duration: 2017 to 2019
Study population: The study population included all the cases with stroke admitted at a tertiary care center. Sample size: 91. Results: The maximum incidence of stroke in this study was observed in the age group of above 60 yrs total -36, that is [18(19.78%)] each for 61-70 and >70 years of age. the male to female ratio in this study was 1.68:1. Most common risk factor was HTN 57.14%, DM 26.37, smoking 45.05%, Alcohol consumption 32.97%, Heart disease 20.88% and Hypercholesterolemia 10.99%. coronary artery disease was present in 12 patients (63.17%), rheumatic heart disease in 7 patients (36.83 %). CT Scan showed ischemic stroke in 86.81% and haemorrhage in 13.19%. 13 out of the 79 ischemic stroke patients and 09 out of the 12 haemorrhagic stroke patients were expired. Conclusion: Cerebrovascular accident cases were having male predominance with most common presentation among age group of 61-70years & more than 70 years. Hypertension was the commonest risk factor and other common factors were diabetes mellitus, cardiac disease, smoking. Ischaemic stroke constituted larger percentage of stroke and mortality was highest in haemorrhagic stroke. MCA territory was most commonly involved. CT scan was important for diagnosis of stroke as rational management depends on accurate diagnosis.

Aim: The purpose of the present research was to assess the prevalence of cardiac risk factors in case of diabetic patients.
Methodology: We conducted a cross-sectional study that included 800 patients with type 2 DM. We classified the participants into three groups according to the hemoglobin A1c (HbA1c) levels. We assessed the prevalence of other cardiovascular risk factors and their association with HbA1c levels through a detailed history, full clinical examination, and laboratory tests.
Results: We found that 75% of the participants were males, 25.5% elderly, 60.25% had hypertension, 60.75% had dyslipidemia, 33.25% were overweight or obese, 19.75% had a family history of coronary artery disease (CAD), 55.75% had established CVD, 42.5% were smokers, and only 12.25% were physically inactive. We found that 84% of the participants had ≥ two cardiovascular risk factors other than DM. HbA1c level was ≥ 7% in 77% of patients. After multivariate regression analysis, we found a significant association of higher systolic blood pressure (BP), more elevated diastolic BP, higher body mass index (BMI), increased waist circumference, old age, long duration of DM, and an increase in the number of clustered CV risk factors with a higher HbA1c level. At the same time, insulin therapy was significantly associated with a lower HbA1c level.
Conclusion: All type 2 diabetic patients in Upper Egypt villages have other associated CV risk factors. The clustering of cardiovascular risk factors showed a significant association with higher HbA1c levels. These findings require the thought of associated CV risk factors in choosing medical treatments to optimize glycemic control and multifactorial intervention to improve CV risk

Introduction:  
Diabetes mellitus (DM) is a growing problem in our country and we have observed that many patients are associated with thyroid dysfunction later in their life. Hence, the prevalence of thyroid dysfunction in diabetes mellitus patients should be evaluated. 
Objectives:  
To evaluate spectrum of thyroid disorders in diabetic patients and To access  altered thyroid function in patients with diabetes mellitus regarding age, sex, duration of  diabetes, family history, regularity of treatment and BMI.  
Materials and Methods:  
In this cross sectional study, after taking permission from ethical committee, data of 280 DM patients who attended the OPD clinic of sir  takhtasinhji hospital, Bhavnagar over period of 9 month, and whose thyroid stimulating  hormone (TSH), free T3, free T4 level were investigated, were included. The inclusion criteria were known cases of DM. Exclusion criteria were patients with previous history of thyroid disorder and those on drugs affecting the thyroid profile, chronic renal failure and Diabetic nephropathy, acute illness, hepatic dysfunction, psychiatric illness, Pregnancy.  
 
Results:  
Out of 280 DM patients 158 were males and 122 were females, 195 (69.64%) were euthyroid, 37 (13.22%) had subclinical hypothyroidism, 23 (8.21%) had overt hypothyroidism, 14 (5%) had subclinical hyperthyroidism and 11 (3.9%) were overt hyperthyroidism cases.  Female sex (P < 0.0091) and patient with irregular treatment (P < 0.001) were at increased risk of having hypothyroidism.  
Conclusion:  
 
Prevalence of thyroid dysfunction was high in DM patients with female sex and patients with irregular treatment.  
Introduction:  
Diabetes mellitus (DM) is a growing problem in our country and we have observed that many patients are associated with thyroid dysfunction later in their life. Hence, the prevalence of thyroid dysfunction in diabetes mellitus patients should be evaluated. 
 
 
 
Objectives:  
To evaluate spectrum of thyroid disorders in diabetic patients and To access  altered thyroid function in patients with diabetes mellitus regarding age, sex, duration of  diabetes, family history, regularity of treatment and BMI.  
 
Materials and Methods:  
In this cross sectional study, after taking permission from ethical committee, data of 280 DM patients who attended the OPD clinic of sir  takhtasinhji hospital, Bhavnagar over period of 9 month, and whose thyroid stimulating  hormone (TSH), free T3, free T4 level were investigated, were included. The inclusion criteria were known cases of DM. Exclusion criteria were patients with previous history of thyroid disorder and those on drugs affecting the thyroid profile, chronic renal failure and Diabetic nephropathy, acute illness, hepatic dysfunction, psychiatric illness, Pregnancy.  
 
Results:  
Out of 280 DM patients 158 were males and 122 were females, 195 (69.64%) were euthyroid, 37 (13.22%) had subclinical hypothyroidism, 23 (8.21%) had overt hypothyroidism, 14 (5%) had subclinical hyperthyroidism and 11 (3.9%) were overt hyperthyroidism cases.  Female sex (P < 0.0091) and patient with irregular treatment (P < 0.001) were at increased risk of having hypothyroidism.  
 
Conclusion:  
Prevalence of thyroid dysfunction was high in DM patients with female sex and patients with irregular treatment.  
 

Aim: To correlate between the severity of diabetic peripheral polyneuropathy and glycosylated hemoglobin (HbA1C) levels.
Material and method: The present prospective observational study was conducted to evaluate the type 2 DM with peripheral neuropathy patients from December 2020 to August 2022. 100 subjects having age > 18 Years, patients diagnosed for DPN by clinically (DNS >=1)/ by electro diagnostic testing (in selected cases) were included in the study. HbA1c levels were assayed using Biochemical method. Severity of DPN Categorized By Neuropathy Disability Score (NDS).
Results: Hypertension and cardiovascular disease was revealed in 14.17% and 6.67% of the subjects respectively. NDS score viz. mild, moderate and severe deficits was found among 13%, 68% and 19% of the subjects respectively. Mean HbA1c level increases along with increase in NDS score i.e., higher the deficits, more is the HbA1c.
Conclusion: It can be concluded that increased HbA1c level indicative of chronic hyperglycemia, could significantly increase the risk and quantitatively reflect the severity of polyneuropathy in diabetic patients

CAD and stroke are the predominant causes and are responsible for >80% of CVD deaths. The Global
Burden of Disease study estimate of age-standardized CVD death rate of 272 per 100000 populations
in India is higher than the global average of 235 per 100000 populations. In India of particular concern
is its accelerated buildup, the early age of disease onset in the population and the high case fatality rate.
After getting approval from institutional ethics committee, study was carried out in all patients
fulfilling the inclusion and exclusion criteria during the study period. Patient diagnosed or known case
of CAD either from history, investigations were included in the study after obtaining written valid
informed consent. 2D Echo of patient diagnosed or known CAD was routinely done in our institution
mainly to know the ventricular function. The number of patients having DM was comparable in the two
groups (p value-0.644). The percentage of DM patients in group A and group B being 40% and 35%
respectively. The time taken for intubation in two groups was comparable, with the mean duration
being 19.5s in group A and 19.4s in group.

Background: To analyze the etiology, clinical presentation and outcome of oculomotor nerve paralysis.
Materials and Methods: It is a prospective study. All cases for the study is collected from the patients presenting themselves directly to Department of Ophthalmology, some cases are referred from Department of Neurology and Neurosurgery, NRI Medical College and General Hospital, Chinakakani from 2017 to 2019.
Results: Most of the patients belong to 51- 60 yrs age group (9) followed by age group 41-50 yrs (7). Among 30 patients right eye was involved in 13 patients, and the left eye was involved in 17 patients. No patients had bilateral palsy. The most common cause of isolated oculomotor cranial nerve paralysis is DM and HTN (microvascular ischemia) in 19 patients. In the present study, out of 9 hypertensives patients with third cranial nerve paralysis eight not recovered and one recovered, out of 21 patients, ten recovered and 11 not recovered. 18 had pupil sparing oculomotor nerve paralysis and 12 had pupil involving paralysis among 30 patients .Patients with pupil sparing oculomotor cranial nerve paralysis recovered completely within six months.
Conclusion: Finally we concluded that microvascular ischemia i.e. diabetes and hypertension, incomplete paresis and pupil sparing paralysis has high chances of complete recovery.

There are several reports that many co morbidities can both accelerate TB disease and complicate TB treatment. It is therefore important to identify these co morbidities in people diagnosed with TB in order to ensure early diagnosis and improve co-management. When these conditions are highly prevalent in the general populations they can be important contributors to the TB burden. The research students attended ward rounds on a daily basis and collected the cases which are mentioned under the inclusion criteria. All the required parameters were analyzed thoroughly and data was pooled and analyzed. Identified adverse drug reactions and drug interactions were reported to the consultant physician on time and on daily basis. Among 250 patients, majority 182(72.8%) of the patients were found to be without any comorbidities & 68(27.2%) were with co morbidities. Patients with co morbidities were 68, out of which male patients 62(91.2%) were more in number compared to female patients 6(8.82%). There were 55 (80.88%) DM patients followed by COPD-7 (10.29%) and HIV-6 (8.83%).