Research Article
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Diabetes mellitus is a chronic and non-communicable disease which is also termed as “sugar” emerged as one of the leading causes of global health deterioration. It is associated with decreased physiological and psychological functioning. Age is a significant predictor to evolve diabetes mellitus. Cognitive changes due to diabetes and psychosocial distress are prominent among the population and the risk is high with increasing age range. The aim of the present study is to find out any association between age and cognitive and psychological functioning of patients with diabetes. In the present study, age range of the sample was selected as 40–60 years. A total of 60 individuals of both genders were selected; 30 individuals with diagnosis of diabetes mellitus and equal number of normal controls were included. The cognitive functioning was measured by neuropsychological tools and the psychological functioning was measured by Psychological General Well-being Index. The results indicate that in case of diabetes patients, age was found to be mostly significant and negatively correlated with cognitive and psychological functioning in comparison to normal controls. Findings from the present study suggest that age could be a predictor in changed cognitive and psychological functioning of patients with diabetes and increased age showed poorer cognitive and psychological functioning.
Research Article
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Background: With the advancement of diagnostic modalities, there is an increase in the number of individuals detected with thyroid nodules. There are multiple treatment options for the management of nontoxic benign nodular goiter. Radioactive iodine results in effective goiter size reduction which can be administered as out-patient basis and is an appropriate alternative for patients with higher risk for surgery. Our group have shown the effectiveness of 131Iodine therapy for nodular nontoxic goiters. We aim to determine the long-term effectiveness of radioactive iodine therapy among patients with nodular nontoxic goiter.
Methods: This is a retrospective cohort study of patients with nontoxic benign nodular goiter, negative for malignancy on biopsy who underwent radioactive therapy with a follow-up of ≥36months using ultrasound studies. Thyroid size, number of nodules and size of nodules pre-treatment and ≥36months post-treatment were compared.
Results: 63 patients were included with an average follow-up of 73.14 ± 34.87 months. Mean age during radioactive therapy and last follow-up was 41 ± 14 and 47 ± 14 respectively. Significant thyroid size reduction was noted in 92.06% of patients (right thyroid lobe: 47.54 ± 31.25%, left thyroid lobe 47.44 ± 31.82%) while significant reduction in number and size of nodules were noted in 96.82% and 98.41% of patients respectively. No increase in the number of nodules and no development of new nodules were noted among all patients.
Conclusion: Radioactive iodine therapy for nontoxic benign nodular goiter produces a sustained reduction in thyroid size, number and size of nodules even after a long follow-up period. Hence, it is a viable alternative to surgical removal of the thyroid offering a lower risk for complication especially among patients who refuse surgery or has a contraindication to surgical management.
Mini-Review
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Background: Many cases of newly diagnosed diabetes were reported in association with coronavirus 2019 (COVID-19) caused by the severe acute respiratory syndrome-associated coronavirus-2 (SARS-CoV-2).
Objective: To clarify whether COVID-19 triggers new diabetes or unmask pre-existing undiagnosed diabetes.
Methods: PubMed search of literature up to February 3, 2021. Search terms included diabetes, COVID-19, diagnosis, hemoglobin A1c (HbA1c), diabetic ketoacidosis, diabetes ketoacidosis, pancreatitis. Case reports, case series, retrospective studies, reviews, and pertinent in-vitro investigations were reviewed.
Results: Retrospective studies and case series suggest that COVID-19 can worsen diabetes control and precipitate hyperglycemic crises in patients admitted to the hospital. Majority of these patients had pre-existing undiagnosed type 2 diabetes as reflected by elevated HbA1c levels on admission. Many patients presenting with hyperglycemia and normal HbA1c levels may have transient stress hyperglycemia. This group of patients are misclassified as new-onset diabetes despite lack of patient follow-up after discharge. Only one case report of possible new-onset diabetes described a patient with pre-diabetes who progressed to severe diabetes 6 weeks following COVID-19 pneumonia. Mechanisms of worsening glycemic control by COVID-19 infection include increased release of cytokines and insulin counter-regulatory hormones. Binding of SARS-CoV-2 to pancreatic β-cells and their subsequent destruction by the virus as another mechanism requires further studies.
Conclusion: COVID-19 infection commonly unmasks pre-existing diabetes. Follow-up of patients presenting with new-onset hyperglycemia after hospital discharge is essential to distinguish between stress hyperglycemia and new-onset diabetes.
Research Article
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Supplementary File
Diabetes is a group of diseases characterized by high levels of blood sugar for an extended period. Despite newer and effective therapy, current treatment is riddled with fundamental challenges. To overcome the adverse effects of existing drugs, regenerative medicine has emerged as an essential treatment, for which tissue engineering may serve as a foundation for the repair of pancreatic cells secreting insulin. Different polymeric scaffolds have been explored for pancreatic tissue engineering. In the current study, a continuation of our preceding work we attempt to test the role of previously synthesized agarose-chitosan coated silver nanocomposite scaffold (AG-CHNp) for the long-term growth of pancreatic cells. Pancreatic cells were isolated from BALB/c mice and were characterized by dithizone (DTZ) staining, real time polymerase chain reaction (RT-PCR), western blotting, and flow cytometry for characteristic pancreatic markers. The isolated population of cells was grown on scaffolds and its effectiveness towards insulin secretion was studied. The isolated population was found to be positive for glucagon, PDX-1 and Pax-4, while a 200-fold change transcript level of insulin was observed. The cells upon seeding on the scaffolds exhibited sustained growth and insulin secretion as confirmed by western blotting. Overall, the study demonstrates the suitability and application of AG-CHNp for pancreatic tissue engineering.