European Journal of Molecular & Clinical Medicine

Background:  A persistent metabolic syndrome is diabetes mellitus marked mostly by chronic hyperglycemia. Recently,it is considered as state of prothrombosis,characterized by abnormalities in platelet function which has been recognized as a component of the metabolic syndrome. Aims are made to discover and demonstrate the utility of various blood tests, including platelet indices for the early diagnosis of diabetic problems.  Increased platelet activity  has a role in development of diabetic complications, thus platelet volume indices are considered as potential biomarkers in diabetics who have vascular issues.
Methods :  356 people with diabetes and 201 non-diabetics participated in the study. To perform a complete hemogram, a Sysmex KX-21 automatic blood counter and a Benesphera H51 coulter were used. From the records of the Central Clinical Laboratory, the HbA1c level was assessed using the immunoturbidometric inhibition technique. The statistical analysis was carried out using SPSS version 17 (Statistical Package for the Social Sciences) (Chicago, IL). Student's t-test was used to determine if there was a significant difference in HbA1c, PC, MPV and  PDW. Statistics were judged significant at P 0.05.
Results :  In our study, MPV and PDW was statistically significant in diabetic patients with complications (P<0.0001 and P=0.0001respectively). A positive correlation was seen between MPV and HbA1c. While  MPV was statistically significant in diabetic retinopathy, nephropathy, and diabetic foot, PDW was statistically significant in diabetic retinopathy and nephropathy.
Conclusion : An effective predictor of diabetic cardiovascular issues would be MPV. Additionally, we found a direct correlation between an increase in MPV and a rise in HbA1c levels. Therefore, we propose that MPV can be used as a simple and low-cost method to monitor the onset and control of Diabetes Mellitus and its cardio-vascular effects.

Introduction: Diabetes is a common disease of the current population and its most common complication is recurrent urinary tract infection. Recurrent infections are treated with recurrent antibiotic therapy which leads to emergence of resistant strains of bacteria like ESBL, which can prove to be fatal.
Materials and Methods: Patients with confirmed cases of diabetes were selected based o inclusion and exclusion criteria. The urine samples of all patients were analyzed for bacterial isolates and further analyzed for ESBL producing organisms. ESBL producing strains were tested for their antibiotic sensitivity   
Results: A total of 164 patients comprising of 82 males patients and 82 female patients of both genders in the age groups of 30-60yrs were selected. Out of this 58 females and 32 males had recurrent UTI. 45.73% urine samples showed gram negative isolates and among them 25.33% were found to be positive for ESBL isolates using combination disc method. The predominant micro organism was found to be E coli (33%) in urine samples of both genders. E coli was the largest producer of EBSL (57.9%) followed by K pneumoniae (21.1%). We found a strong association between increasing years of diabetes with ESBL production. 
Conclusion: We found that recurrent UTI in diabetics was most common in sixth decade of life and was noted to be more in female population. E coli and K pneumoniae were the most common GNB isolates as well as ESBL producers respectively. They were resistant to 3rd generation cephalosporin but were highly sensitive to amaikacin and nitrofurantoin.

Background: Diabetic patients have an increased risk of developing micro- vascular and macro vascular disease, and platelets may be involved as a causative agent with respect to altered platelet morphology and function. Aim of our study was to determine if platelets were activated in diabetes and to see if there was a difference in MPV in diabetics and non-diabetics.
Methodology: A cross sectional study had been conducted to study the impact of HBA1C on mean platelet volume in Type 2 diabetic patients in western Rajasthanattending the Medicine Outdoor and indoor at M.D.M. Hospital Jodhpur.
Conclusion: Platelets in Diabetes Mellitus become more reactive and agreeable and their Mean Platelet Volume (MPV) is increased. Increase in platelet size may be the one factor responsible for microvascular complication in Diabetes Mellitus. Hence, MPV could be a useful prognostic marker of micro vascular complications.

Background: Diabetic patients have an increased risk of developing micro- vascular and macro vascular disease, and platelets may be involved as a causative agent with respect to altered platelet morphology and function. Aim of our study was to determine if platelets were activated in diabetes and to see if there was a difference in MPV in diabetics and non-diabetics.
Methodology: A cross sectional study had been conducted to study the impact of HBA1C on mean platelet volume in Type 2 diabetic patientsand to find out association of mean platelet volume and development of microvascular complication (neuropathy, nephropathy andretinopathy) in diabetics in western Rajasthanattending the Medicine Outdoor and indoor at M.D.M. Hospital Jodhpur.
Conclusion: Platelets in Diabetes Mellitus become more reactive and agreeable and their Mean Platelet Volume (MPV) is increased. Increase in HbA1c concentration is directly proportional to increased MPV, thus poor glycemic control causes increase in MPV which result in more chance of developing microvascular complication. However, the increased MPV as the cause or the end result of microvascular complications needs to be further explored. Hence, we propose that MPV can be used as simple and cost effective tool to monitor the progression and control of Diabetes Mellitus and its associated microvascular complications.

According to WHO, Osteoporosis is second only to cardiovascular disease as a global
healthcare problem. International Osteoporosis Foundation (IOF) estimates that the annual
direct cost of treating osteoporosis fractures of people in the workplace in the USA, Canada
and Europe alone is approximately USD48 billion. The present study comprises of clinically,
diagnostically confirmed cases of Postmenopausal Osteoporosis both Diabetics and Non-
Diabetics and attending the orthopaedic unit of KLES Dr. Prabhakar Kore Hospital and
Medical Research Centre, Belagavi. All the cases were evaluated and selected by simple
random technique after fulfilling the selection criteria. The cases of Osteoporosis reported to
the Department of Orthopaedics unit of KLES Hospital and Medical Research Center were
screened. After finding the suitability as per selection criteria they were requested to
participate in the study and briefed about the nature of the study and interventions used. The
mean serum calcium for diabetics was 8.22±1.13 mg/dL and for non-diabetics was 8.4 ± 1.27
mg/Dl. The mean serum calcium levels were lower in Diabetics but was not statistically
significant (p=0.5564 for calcium).

Background: Hypomagnesaemia and hypermagnesuria was reported to be associated with diabetes complications. Thus, magnesium has drawn considerable attention for its potential role in improving insulin sensitivity and preventing DM. Zinc, another important trace element, acting as a cofactor for several biochemical processes has a major role in health status. There is substantiating evidence indicating the importance of zinc in DM. Impaired zinc metabolism, decreased plasma zinc and hyperzincuria has been reported as a consequential effect of glucose absorption. But limited studies have been conducted in this part of the world. This study puts in an effort to find the answers.
Aims and Objectives: To study the association of serum magnesium and zinc levels in diabetics.
Materials and Methods: This study was done in the Department of General Medicine, SSPM’S Medical College and Lifetime Hospital, Padve.
This study was done from Jan 2019 to Dec 2020.
Ninety and an equal age and sex matched control were used for the study.
Results: There is a strong association between the serum magnesium and zinc levels in diabetics when compared to normal individuals.
Conclusion: More number of studies have to come up in different geographical locations so as to be helpful to the practicing physicians.

Background: Mucormycosis is a rare disease of immunocompromised adults largely
restricted to the diabetic community with uncontrolled hyperglycaemia. In the second
wave of Covid, in multiple cities over the Indian Peninsula, this much dreaded “black
fungus” has afflicted many individuals who suffered from covid or were recovering
from it.
Aim: To establish the risk factors, clinical presentation, diagnostic sensitivities,
radiological survey of different types of mucormycosis in SARS Cov 2 patients.
Methods: Seventeen patients with covid infection admitted in tertiary care hospital with
diagnosed mucormycosis between Nov 2020 to June 2021 via histopathological or
culture confirmation. This is a cross-sectional observational study where detailed
assessment of clinical profile, biochemical markers and sensitivities of diagnostic
procedures was done. The data then collected and was made into a master chart and
subjected to statistical analysis. Fischer exact test was used for statistical anaylsis.
Result:In total of 17 patients,mean blood glucose levels were compared at the onset of
symptoms of covid and mucormycosis werestatistically significant with (P=0.001). Out
of 17 patients, 11 were rhino-orbital mucormycosis, four had rhino-orbito-cerebral
mucormycosis and 2 had pulmonary mucormycosis.HbA1c >8 had significant
correlation(P=0.009) with rhino-orbital and rhino-orbito-cerebral mucormycosis
whilehigher total dosage of steroids was associated with pulmonary mucormycosis (P=
0.015. Sensitivity of culture was 64.7% in our study while histopathology was
considered gold standard.
Conclusion: Our study shows strong correlation between the long term as well as short
term glycaemic control with the onset of rhino-orbital mucormycosis while dosage and
duration of steroids with pulmonary mucormycosis.

Background:Hearing is an essential part of how we communicate with others and become
aware of sounds that happen in our immediate environment. The present study was
conducted to assess sensorineural hearing loss in diabetes and hypertensive patients.
Materials & Methods: 120 subjects of both genders were divided into 3 groups. Group I
had diabetics, group II had hypertensive and group II had control subjects. General ear
examination was done using otoscopy. Hearing function, degree, form, and configuration
of any hearing loss, were determined through a general ear examination and Pure Tone
Audiometry.
Results: Group I had 22 males and 18 females, group II had 16 males and 24 females and
group III had 15 males and 25 females. Normal hearing loss was observed in 25% in group
I, 26% in group II and 85% in group III, mild hearing loss was observed in 75% in group
I, 50% in group II and 15% in group III and moderate hearing loss was observed in 24%
in group II. The difference was significant (P< 0.05).
Conclusion: There was more hearing loss in diabetics and hypertensive subjects as
compared to healthy individuals.

Background: The present study was conducted to compare peri implant soft tissue and crystal bone status of dental implant placed in pre diabetic, diabetic and non diabetic individuals.
Materials & Methods: 60 patients were divided into 3 groups. Group I were pre diabetic (HbA1c 5.5 to 6.4%), group II were patients with poorly controlled type 2 DM (HbA1c ≥ 6.5%) and group III were healthy individuals (HbA1c < 5.7%). In all patients, peri-implant GI, PD and plaque index (PI) were measured.
Results: In group I, there were 12 males and 8 females, in group II were 10 males and 10 females and in group III, 9 males and 11 females. The mean plaque index in group I was 2.7 in group II was 3.1 and in group III was 0.5, gingival index was 2.9 in group I, 3.4 in group II and 0.6 in group III, probing depth was 4.1 in group I, 4.8 in group II and 1.2 in group III, crestal bone loss on mesial side was 3.6 mm in group I, 4.2 mm in group II and 0.7 mm in group III and crestal bone loss on distal side was 3.7 mm in group I, 4.0 mm in group II and 0.8 mm in group III. The difference was significant (P< 0.05).
Conclusion: Chronic hyperglycemia increases the risk of peri-implant diseases, there a good glycaemic control is necessary to prevent it.

Background:- Alkaline phosphatase is the group of hydrolytic enzymes that are involved in the cellular metabolism. Alkaline phosphatase in saliva is used as an indicator of gingival inflammation, bone metabolism and other oral lesions like premalignancies and oral cancer.
Aim and objective: To estimate the levels of Salivary Alkaline Phosphatase (S-ALP) in smokers and tobacco chewers associated with diabetes and diabetics without any habits.
Materials and Methods: The study includes 30 cases and 10 control. 30 cases divided in group A, B and C and control group D: (1) Group A - 10 smokers who are diabetic. (2) Group B - 10 tobacco chewers who are diabetic. (3) Group C - 10 nonsmokers and non-tobacco chewers who are diabetic. (4) Group D - 10 nonsmokers, non-tobacco chewers and nondiabetic as control. Saliva was collected from the subjects of the above mentioned groups and the levels of S-ALP were estimated using a semi auto- analyzer and comparison was made.
Results: The result reveals increase in the alkaline phosphatase levels in saliva of smokers and tobacco chewers with diabetes group (Group A, B). Non-smokers and non-tobacco chewers with diabetes group (Group C) had higher level compared to the control group (Group D).
Conclusion: Salivary alkaline phosphatase is a clinical biomarker that is used to determine the oral diseases due to adverse habits and diabetes at its early stage.

Diabetes mellitus and thyroid gland abnormalities are interlinked and coexist with influencing each other. Current study was planned and conducted to evaluate thyroid status in patients with type-2 diabetics. The main aim of the study was to understand the relationship between diabetes mellitus and thyroid abnormalities. Total 100 known diabetic patients were studied, out of them 37 were males with the mean age 59.81 ± 12.8 years, and 63 females with average age of 55.31 ±11.10 years. 50 non-diabetic healthy subjects included 13 males and 37 female of mean age 48.86 ± 12.9 and 48.86 ± 17.94 years respectively selected as a control. All the patients were evaluated for thyroid profile (TSH, FT3, and FT4) and diabetic profile (RBS and HbA1c) by using Cobas C-311 and Cobas E-411 fully automated immunoassay analyzer. The observations were recorded. The result showed that, out of 100 diabetic subjects 41.03% male and 58.97% female were faced with euthyroid and the remaining 22% had thyroid dysfunctions. Hypothyroidism was more common in females (78.97%) as compared to men (21.05%). The mean values for TSH, FT3 and FT4 at (p> 0.05%) probability level shows statistically no significant difference. The relationship between diabetes and thyroid abnormalities was significantly difference, interdependency of these two conditions and evaluation of thyroid hormones status with the diabetic profile in the early days of diabetes is recommended. This will induce the management strategies of diabetes and can delay and avoid the progression of the secondary complications in diabetic patients with uncontrolled diabetes.

Background: The present study was conducted to compare peri implant soft tissue and crystal bone status of dental implant placed in pre diabetic, diabetic and non diabetic individuals.
Materials & Methods: 60 patients were divided into 3 groups. Group I were pre diabetic (HbA1c 5.5 to 6.4%), group II were patients with poorly controlled type 2 DM (HbA1c ≥ 6.5%) and group III were healthy individuals (HbA1c < 5.7%). In all patients, peri-implant GI, PD and plaque index (PI) were measured.
Results: In group I, there were 12 males and 8 females, in group II were 10 males and 10 females and in group III, 9 males and 11 females. The mean plaque index in group I was 2.7 in group II was 3.1 and in group III was 0.5, gingival index was 2.9 in group I, 3.4 in group II and 0.6 in group III, probing depth was 4.1 in group I, 4.8 in group II and 1.2 in group III, crestal bone loss on mesial side was 3.6 mm in group I, 4.2 mm in group II and 0.7 mm in group III and crestal bone loss on distal side was 3.7 mm in group I, 4.0 mm in group II and 0.8 mm in group III. The difference was significant (P< 0.05).
Conclusion: Chronic hyperglycemia increases the risk of peri-implant diseases, there a good glycaemic control is necessary to prevent it.