Articles

How Decreased Level of Plasma Tryptophan Play Role in Diabetic Patients?

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Tryptophan is an essential amino acid found in many protein-based foods and dietary proteins including meats, dairy, fruits, and seeds. High-glycaemic index and -glycaemic load meals also increase the availability of tryptophan. The main objective of the study is to find the role of tryptophan in diabetic patients. Tryptophan metabolism has been reported highly associated with insulin resistance and diabetes risk. The activity of rate-limiting enzyme of tryptophan-kynurenine, indoleamine-2,3-dioxygenase (IDO), was enhanced significantly in T2D patients, thus downstream metabolites such as kynurenine, kynurenic acid, xanthurenic acid and hydroxykynurenine, were higher in T2D than in non-diabetic subjects, although inconsistent observations of tryptophan levels. Returning to the question posed at the beginning of the review, these studies have shown that decreased level of tryptophan plays an important role in diabetic patients. decrease in plasma TRP levels in diabetic patients regardless of their gender and these patients also exhibited a greater incidence of memory dysfunction compared to the controls.

Clinical Audit on Hypoglycemic Symptoms in Type 2 Diabetic Patients

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: Hypoglycaemia is an important complication in the treatment of type 2 diabetes mellitus, because it   causes   recurrent   physical   and   psycho-social morbidity, and is sometimes fatal. The main objective of the study is to clinically audit the hypoglycaemic symptoms in type 2 diabetic patients in Jinnah Hospital, Lahore. This cross sectional clinical audit was done in Jinnah Hospital, Lahore during May 2020. The data was collected with the permission of ethical committee of hospital. The data was collected from type 2 diabetic patients who were enrolled during last 6 months in the hospital. We critically analyse the hypoglycemic symptoms of type 2 diabetic patients. The data was collected from 150 patients of Nishtar hospital, Multan for audit analysis. There were 70 males and 80 females. The age range was 40 to 70 years and the mean age was 58.95±5.67 for hypoglycaemic symptoms patients and 55.15±10.67 for without symptoms patients. It is concluded that hypoglycaemic symptoms are a common complication   of   diabetic   treatment,   and   efforts should be focused especially on insulin-treated patients    to    prevent    hypoglycaemia,    including education    on    hypoglycaemia    awareness,    self-monitoring of blood glucose and dietary advice.

Role of Aminotransferase in Patients of Type 2 Diabetes Mellitus

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Introduction: Diabetes mellitus is a heterogeneous group of disorders characterized by persistent hyperglycemia with carbohydrate, lipid, and protein metabolism resulting from defects in insulin secretion and/or insulin action.

Objectives: The main objective of the study is to find the role of aminotransferase in patients of type 2 diabetes mellitus. Methodology of the study: This cross sectional study was conducted in BVH, Bahawalpur during 2021. The data was collected from 100 patients of both genders. Patients whose fasting plasma glucose (FPG) ≥126 mg/dl on 2 occasion were included in the study. Patients with any concomitant diseases which can alter liver function and patient with hepatitis, alcoholic and taking any medicine were excluded from the study.

Results: The data was collected from 100 patients with a mean age of 53.72 ± 9.82 years old and mean duration of disease of 7.41 ± 6.01 years were included in the final analysis. There were no significant difference in the levels of Fas, AST, Cl, K, Ca, BUN, creatinine and uric acid in type II diabetics compared to the non-diabetic healthy control group.

Conclusion: Serum alanine aminotransferases are frequently high in patients of type 2 diabetes mellitus. However, there was no association with gender, body mass index, or duration of diabetes.

Frequency of Stroke Acquired Pneumonia in Patients Admitted In Intensive Care Unit with Stroke

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Stroke is a highly morbid entity and it can be fatal directly due to neurological damage and affecting the respiratory system or can add to over all morbidity and mortality due to its associated complications like stroke associated pneumonia (SAP).

Objective: To determine the frequency of stroke acquired pneumonia in ICU patients.

Study Design: Descriptive case series.

Settings: Department of Medicine, THQ Hospital, Sargodha.

Period: Six months from October, 2020 to April, 2021

Material & Methods: In this study, the cases of either gender and age 30 to 70 years suffering from stroke within 12 hours were included. SAP was labelled on the basis of fever, cough and non homogenous opacities on chest X-ray.

Results: In the present study, 160 cases of stroke were included and out of these 82 (51.25%) were males and 78 (48.75%) females. The mean age of the subjects was 54.24±7.15 years and mean duration of stroke was 7.05±2.54 hours. There were 35 (21.88%) cases that had DM, 28 (17.50%) had HTN and 30 (18.75%) of cases had history of smoking. Stroke acquired pneumonia (SAP) was seen in 20 (12.50%) of the cases. SAP was seen in 12 (15.38%) female cases as compared to 8 (9.75%) males with p= 0.34. SAP was more seen in cases with DM where this was observed in 7 (20%) of the cases as compared to 13 (10.4%) with no DM with p= 0.15. SAP was seen in 5 (17.85%) cases with HTN and 4 (13.33%) cases with history of smoking with p values of 0.35 and 1.0 respectively. SAP was seen in 15 (14.42%) cases with duration of stroke 6-12 hours in contrast to 5 (8.92%) cases with duration less than this with p= 0.45.

Conclusion: Stroke acquired pneumonia is not uncommon and is seen in more than 1 out of every 10 cases and it is more seen in females and those with history of DM, HTN and duration of stroke 6 to 12 hours; though none of this variable was found statistically significant.