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Background: Millets are a group of small-seeded grasses that are cultivated as food crops around the world especially in Africa and Asia. Millets have high fibre content which helps in better digestion and relief from constipation, high antioxidant activities and also helps to lower cholesterol. United Nations declared the year 2023 as International Year of Millets (IYoM-2023). Limited studies have been conducted on the Knowledge, Attitude and Practices (KAP) on acceptance to use millets in diet in our country. Consumption of millets was higher in the states of Gujarat, Karnataka, Maharashtra but negligible in the states of Kerala, Orissa, West Bengal and Tamil Nadu where rice is the most consumed cereal as opined by National Nutrition Monitoring Bureau. The objective of the study was to assess the acceptance of millets in diet among housewives residing in a Military garrison in West Bengal. Methods: A cross-sectional study was carried out from 01 Aug 2023 and 15 Aug 2023 among housewives residing in a Military garrison in West Bengal. Results: A total of 209 respondents participated in the study of which, 33% of the respondents belonged to 25-29 yrs age group. 52% of them were either graduates or post graduates. There is a significant (p<0.05) association between level of education and knowledge of health benefits of millets. Conclusions: The Armed Forces have been the front runners in incorporating millets in their ration scale as clearly observed from our present study. Sustained efforts are required to create awareness and improve acceptance of use of millets amongst general population.
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Background: To increase community participation in tuberculosis (TB) elimination efforts, the government of India has launched ‘Pradhan Mantri TB Mukt Bharath Abhiyan’ (PMTBMBA) under the national TB elimination programme. The scheme allows interested parties (Ni-kshay mitras) to offer nutritional support to TB patients. This study aims to understand the impact of such a support in improving weight and body mass index (BMI) among TB patients as most available evidence comes from research settings. Methods: This is a retrospective cross-sectional study carried out in Ramgarh district of Jharkhand, India, for the period first quarter 2023. Relevant data was extracted from Ni-kshay web portal and TB treatment cards. The data is analyzed using excel 365. Results: Of the 114 participants, 69 received nutritional support during the entire duration of treatment and 45 received support partially. Single factor ANOVA on weight and BMI gain revealed statistically significant difference in mean weight/BMI between the two groups with F (1, 110)=35.4660, p=3.16×10-08 and F (1, 110)=22.9994, p=5.12×10-06. Correlation analysis showed a moderate correlation between the number of nutritional kits received and the weight/BMI gain with correlation coefficients r=0.5, p=1.07×10-07 and r=0.4, p=1.65×10-05 respectively. Conclusions: The study concludes that the impact of nutritional supplementation in programmatic setting is comparable with that of implementation research study settings.
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Background: Type 2 diabetes mellitus (T2DM) development involves various interrelated risk factors, including age, gender, obesity, and inactivity. However, research lacks insights into the risk factors within the minor ethnic Bishnupriya Manipuri community in Bangladesh. This study aimed to identify T2DM risk factors within this community. Methods: This survey-based prospective observational study was conducted in different villages of Kamalgonj Upazila under the Moulvibazar district in Bangladesh from March 2023 to June 2023 enrolled 280 individuals using purposive sampling. Data collection involved a questionnaire, verbal agreement, and diagnostic documentation. Analysis utilized Microsoft Office and the student抯 t-test. Results: Participants exhibited a 1:1.2 male-female ratio, with 64% aged 36-65. 43% were housewives, 55% engaged in moderate work, 15% smoked, and 41% had a family history of diabetes. Diabetic cases accounted for 39%, with an average age of 57.39�.99 years, significantly higher than non-diabetic cases (46.79�.93 years). Diabetic cases also showed significantly higher waist circumference (94.11�63 cm versus 84.71�.76 cm) and body mass index (BMI) (26.12�61 kg/m2 versus 21.44�97 kg/m2). Conclusions: T2DM predominantly affects older individuals in the Bishnupriya Manipuri community. Increased waist circumference, overweight, and obesity emerged as significant risk factors for T2DM within this population.
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Bowel obstruction is a common complication in advanced ovarian cancer with a reported obstruction rate between 5�%, which is treated with resection and anastomosis. Post-operative complications (PPCs) generally occur due to immobility, decreased chest expansion, reduced thoracic mobility, weakness of respiratory muscles, severe pain at the suture site, and bandaging, making it difficult for the patient to cough. Thick and sticky mucus and depressed mucociliary clearance as an effect of anesthesia, cause accumulation of secretions in the lungs and can lead to PPCs. All this leads to prolonged hospital stays for the patient and delays recovery. Hence, our study aims to study the effects of chest physiotherapy and cognitive behavioral therapy in preventing post-operative complications in a patient who has undergone double barrel ileostomy. A 47-year-old female presented with the chief complaint of pain in the abdomen, for 2 months, which was dull aching and did not relieve with medication. She underwent double barrel ileostomy surgery. Following surgery, a 1- week exercise program was designed for the patient, which included the combination of chest PT and cognitive behavioral therapy with pre- and post-assessment of 3 scales, HAM-A, MGS-2, and POP DST, which showed remarkable differences in the pre and post values of the patient. Our present study concluded that post-operative physiotherapy intervention of chest PT and cognitive behavioral therapy was effective in preventing post-operative complications in the patient and promoted her early discharge from the hospital.
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Visible light (VL) radiation poses potential risks to the skin, including solar urticaria, chronic actinic dermatitis (CAD), cutaneous porphyrias, and others. Photodermatoses, another skin condition, can be worsened by exposure to light. Involves the production of reactive oxygen and nitrogen species (ROS and RNS, respectively), which harms proteins, lipids, and DNA results in an inflammatory reaction and increased skin pigmentation. Studies show that plant-derived antioxidants can shield VIS-exposed skin from oxidative damage brought on by ROS. Both API (Active pharmaceutical ingredients) and BTC (Bis trichloromethyl carbonate) give protection against harm caused by VL and useful topical antioxidants that can be added to sunscreens in terms of sun protection techniques, whereas, vitamins A, C, and E are antioxidants that reduce the aging process by preventing free radicals from oxidizing sensitive biological components. With an emphasis on either VL blocking (tinted sunscreens) or production of reactive species and radical quenching (antioxidant sunscreens), availability of photoprotection products that contain VL protection is expanding. Promising advancements have been made in incorporating antioxidants and radical scavengers into sunscreen formulations to address the induction of ROS/RNS by visible light. Topical application of an antioxidant blend containing varying concentrations of a singlet oxygen quencher along with fixed concentrations of vitamin E (0.25%) and vitamin C (0.01%) has shown ability to inhibit erythema and reduce pigmentation in certain skin types. Recent advancements in understanding VL's ability to induce reactive species have paved the way for antioxidant-based formulations, which offer promising alternatives for photoprotection across all skin types.
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Many neurological and cardiovascular complications have been discovered post-COVID 19 infections. Long-term pulmonary complications like pneumonia, respiratory failure, ARDS, and lung abscess are described in different studies. To overcome these complications respiratory chest physiotherapy plays an important role for an individual. Respiratory chest physiotherapy has been shown to improve gas exchange, reverse pathological progression, and reduce or avoid the need for artificial ventilation when it is provided very early in other respiratory conditions. This case study highlights the combined effects of positioning with conventional Respiratory chest physiotherapy in post-COVID 19 respiratory complications in a 26-year-old young individual, presenting with complaints like dyspnoea. Changes in modified medical research council (MMRC) score and chest X-ray were seen by end of discharge of the patient.
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Background: With an estimated 600 million cases of foodborne illnesses annually, unsafe food is a threat to human health and economies globally. World Health Organization (WHO) emphasizes that the future of food safety is to transform knowledge into action for people and communities. Hence, this study was undertaken to evaluate the effectiveness of an educational intervention package on Knowledge, Attitude and Practice (KAP) of food handlers and to evaluate the barriers to implementation of food safety. Methods: This was an educational intervention before and after comparison study. All food handlers employed in food establishments located in the premises of a tertiary care hospital were included in the study. The educational intervention comprised of interactive lectures and documentaries. The responses of the participants were recorded on pre-validated questionnaires and KAP scores were calculated before and after the educational intervention. Chi square test and paired t-test were used to assess statistical significance. Results: The mean age of food handlers was 38+2 years. Majority were educated up to 12th standard. There was a significant improvement in the KAP scores pre- and post- intervention. Among the barriers recognised in ensuring food safety, the most common were manpower management and absence of basic amenities for hand washing. Conclusions: The study concludes that while educational intervention has a significant role in improving the KAP of food handlers, a holistic approach in prevention of food borne illnesses should include active participation from the stakeholders and clientele besides providing periodic training to the food handlers.
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Background: Carcinoma of the uterine cervix is a major health problem faced by the Indian women. Every year approximately 120000 women develop this disease. India accounts for 15.2% percent of the total cervical cancer deaths globally. Objective to assess the sociodemographic factors and knowledge regarding cervical cancer and associated risk factors among women of age group 20-60 years. Methods: A community-based cross-sectional study was conducted among women aged 20-60 years residing in the urban field practice area attached to the department of community medicine of a tertiary care centre from June 2018 to May 2019 that is for a span of 12 months. The survey included demographic data such as age, education level, occupation, religion, socioeconomic status, parity, age of marriage, age at birth of first child. Results: In the present study about 60% of the female had knowledge that menstrual abnormality is also a risk factor for cancer cervix. Only 60% of the female in our study reported that early marriage is also a risk factor for cancer cervix. A lower (30%) percent of the female in our study had knowledge that vaginal discharge is also a risk factor for cancer cervix. Conclusions: The present study aimed to assess the socio-demographic factors and knowledge regarding cervical cancer among women of age group 20-60 years residing in an urban slum of Patna district. With prior knowledge of risk factors, cervical cancer can be identified. Identification of high?risk populations and starting early screening was found to be effective in early recognition of cervical cancer.
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Background: Street children constitute a marginalized group in most societies. These children experience social and behavioural problems resulting from their environmental influences, school and peer interactions, home and family settings, or any combination of these. Keeping in view the prevalence of psychosocial distress among street children, this study was undertaken to assess the levels of psychosocial distress and problems faced by orphan and vulnerable children (OVC) living in Kolkata city. Methods: This was a cross sectional analytical study. A total of 127 children were interviewed with the help of pre-validated semi-structured questionnaire. GHQ-12 scale was used to measure the symptoms of the psychosocial distress. Bivariate analysis with the help of Chi-square test was done to determine variations in the psychosocial distress experienced by OVC by age, gender, duration of stay on streets, education. Results: The mean age of the study participants was 15±2 years. About one third of the children showed symptoms of severe psycho-social distress with 30% of children showing signs of intentional self-harm. Age, education and duration of living on the streets were some of the factors that showed significant correlation with the levels of psychosocial distress. Conclusions: The study concludes that although institutional care and support from NGOs takes care of basic amenities such as shelter, food and education, there is a need to address the psychological needs of the children through teacher sensitization programmes. A well-informed caregiver would be able to address the needs of children under his supervision and care.
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Background: Polycystic ovary syndrome (PCOS) is a common disorder in women of reproductive age. Although PCOS patients have a high prevalence of obstructive sleep apnea (OSA), there is limited data on sleep quality and abnormalities in sleep architecture among this patient population. We conducted a study to assess the frequency of OSA and poor sleep quality in women with PCOS and to assess any association between these sleep disorders and metabolic abnormalities. Materials and methods: An observational study of adults with PCOS (by revised Rotterdam criteria) from May 2015 to June 2017 was conducted. Patients with thyroid disorders, pre-existing depression, current pregnancy, and recent drug use (benzodiazepines, antidiabetics, antiepileptics, steroids, and androgens) were excluded. The evaluations included the following: overnight polysomnography (PSG), lipid profile, testosterone, fasting insulin, fasting glucose levels, free androgen index (FAI), and homeostatic model assessment for insulin resistance (HOMA-IR); sleep quality [Pittsburgh Sleep Quality Index (PSQI), Jenkins Sleep Scale (JSS)], daytime sleepiness and possible depression were assessed by standard questionnaires. Descriptive statistics, t-test/Mann朩hitney test, Chi-squared test/Fischer's test were used as appropriate; p <0.05 was considered statistically significant. Results: A total of 65 patients, mean age 24.3 � 4.0 years; mean body mass index (BMI) 26.4 � 5.3 kg/m2 were included. Frequencies of sleep disorders were evaluated as follows: Obstructive sleep apnea 10.9% (7/64) [95% confidence interval (CI): 5.4�.9%], poor sleep quality 35.0% (21/60) (95% CI: 24.2�.6%) by JSS, 54.2% (32/59) (95% CI: 41.6�.3%) by PSQI. The PSG indicators of sleep quality were abnormal in arousal index, 96.8% (62); %wake time, 62.5% (40); sleep latency, 40.6% (26); and sleep efficiency, 12.5% (8). Anthropometric indicators of obesity were higher in OSA vs non-OSA patients (p <0.05). The OSA patients had lower total sleep time and %N2 stage, and higher desaturation index than non-OSA patients. When patients with good and poor sleep quality were compared, poor sleepers (by JSS and PSQI) had higher depression scores; poor sleepers by JSS had a lower waist杊ip ratio (p <0.05). Daytime sleepiness scores were similar in OSA and non-OSA patients, and in good and poor sleepers. Conclusion: Sleep disorders, particularly poor sleep quality, are frequent in women with PCOS. Patients should be screened for these disorders using specific questionnaires. Further research into the metabolic consequences of these sleep disorders is mandated.
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Finger millet is an important crop in Maharashtra, Orissa, and Tamil Nadu. Millet production and consumption have been on the decline for some years. Finger millet samples were gathered from regional locations in Nashik and Kolhapur, Maharashtra. These were also taken as samples for chemical composition and proximate analysis. Standard analytical procedures were used to determine the results. The result of the chemical composition, Nashik (sample one) was found to be Ca mg (6.19), Mg (0.52), Fe (1.09), Zn (1.74± 0.96), Cu (0.10), P (8.90) These findings suggest that finger millet is a good source of calcium and phosphorus. These can be utilised as calcium supplement foods, and their composite flours can be used to preserve a variety of nutrient-dense recipes that can be employed as part of a supplement feeding regimen.
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Background: There is minimal information about the association of head growth at different stages of childhood with cognitive ability. Objective: To determine the relationship of newborn head size and head growth during infancy, childhood and adolescence with attained education, a proxy for cognitive ability. Study design: Prospective birth cohort study. Setting: Married women living in South Delhi between 1969 and 1973. Participants: The New Delhi Birth Cohort study followed up 8030 newborns born in 1969-1973 with head circumference, weight and height measurements at birth and 6-12 monthly until adulthood. Of these, 1526 men and women were followed up at the age of 26-32 years. Outcomes: Association between years of schooling, as an indicator of cognitive ability, and newborn head circumference and conditional measures of head growth during infancy, childhood and adolescence. Results: In unadjusted analyses, newborn head size was positively associated with years of education [(? (95% CI)=0.30 (0.14 to 0.47) years per SD head circumference], as was head growth from birth to 6 months [? (95% CI)=0.44 (0.28 to 0.60) years per SD conditional head growth], 6 months to 2 years [? (95% CI)=0.31 (0.15 to 0.47) years per SD conditional head growth] and 2 to 11 years [? (95% CI)=0.20 (0.03 to 0.36) years per SD conditional head growth]. There were similar findings for height and body mass index (BMI). In the adjusted model containing all growth measures, gestational age, and socioeconomic status (SES) at birth as predictors, only SES was positively associated with educational attainment. Conclusion: Educational attainment in this population is positively associated with socioeconomic status and its influence on inter-related early life (fetal, infant and childhood) factors like nutritional status and brain growth.
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Background: Neuronal studies on diabetes mellitus (DM) were previously based on peripheral and autonomic nerves. With the advent of Brainstem Auditory Evoked Potential (BAEPs), studies on sensory pathways in the central nervous system become easier and more productive. BAEPs is a non-invasive electrophysiological tool to detect retro-cochlear lesion. Hence, it is helpful to detect early Impairment of the auditory nerve and brainstem function. Aim and Objective: DM Type 2 (T2DM) is a known cause of neuropathy and in earlier course, it involves sensory nerves. T2DM runs in families and it has a genetic predisposition. BAEP is one of the methods to find out problems related to hearing by analyzing latencies of waveforms and inter-peak latencies. Hence, BAEPs in apparently healthy subjects with and without family history of T2DM is assessed. Materials and methods: This is a cross-sectional, casecontrol study. We have taken 110 volunteers from MBBS students of IMS, BHU of 17–23 years of age. Those with co-morbid conditions (eg. diabetes and hypertension), neurodegenerative diseases, neuropathy, schizophrenia, and those on ototoxic and neurotoxic drugs are excluded from the study. After taking consent and conducting a preliminary physical examination, BAEPs are recorded using a proper BAEP recording device. Statistical analysis is done using SPSS 2016 software trial version with Chi-square test. Results: The subjects with positive family history of T2DM in paternal grandfather showed deviation in latencies of BAEPs wave I (P < 0.001), wave III (P = 0.019), wave V (P = 0.033), and inter-peak latency between wave I and wave V (P = 0.019) from the normal values in the left ear. The subjects with positive family history of T2DM in paternal grandmother showed deviation from the normal in case of V/I % in the right ear (P = 0.016). Conclusion: The presence of T2DM in families can affect the wave latencies and inter-peak latencies of BAEPs.
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Background: Worldwide, Chronic obstructive pulmonary disease (COPD) is the one of the leading cause of chronic morbidity and mortality. COPD is one of the diseases in which smoking is the common and important risk factor when it is associated with Metabolic syndrome (MetS). The individual components of MetS, i.e., obesity, dyslipidemia, fasting hyperglycaemia, and hypertension were independently associated with impairment of lung function too. The objective of this study is to find out the prevalence of metabolic syndrome among COPD patients.Methods: This was a cross-sectional study conducted in department of Respiratory Diseases and a total of 70 COPD patients were included in the study, which were enrolled for treatment from July 2016 to July 2017. The severity level in patients with COPD were determined according to GOLD (Global Initiative for Chronic Obstructive Lung Disease), 2015 guideline. International Diabetes Federation (IDF) guideline; (2005) was used in diagnosis of metabolic syndrome.Results: Seventy patients with COPD were enrolled during the study period. There were 45 males (64.2%) and 25(35.7%) females. Mean age of male patients was 58.67±9.87 years, while mean age of female patients was 57.23±10.4 years (35-87 years). Mean BMI of male was 24.33±6.64 kg/m2, while in case of female it was 30.07±6.95 kg/m2 and overall mean BMI of study population was 26.22±7.22 kg/m2. The mean waist circumference of male was 86.91±13.31 cm while in female it was 87.18±14.51 cm. The Overall prevalence of metabolic syndrome was 31.34% and most common in GOLD stage-3 (47.06%), followed by stage-2 (40%), followed by stage-4 (25.71%) and 7.4 % in GOLD stage -1.Conclusions: The presence of metabolic syndrome is common in patients with COPD and, all COPD patients should be considered for screening for it.
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Background: Rotator cuff tendinopathy (RCT) is a significantsource of disability and loss of work. As commonly usedsubacromial corticosteroid injection for treatment of chronicrotator cuff tendinopathy has adverse effects especially inelderly people, new treatment options such as Platelet-RichPlasma (PRP) can be considered for managing of thispathology. The aim of the present study was conducted toevaluate the effectiveness of autologous platelet rich plasmainjection in the treatment of rotator cuff tendinopathy.Materials and Methods: The present study was conductedamong adults of age 30-70 years over the period of 1 year fromFeb 2018 to Jan 2019. The primary outcome measure for allparticipants was a score on a 0–10 visual analog scale (VAS)assessing current resting pain at baseline and at 8, 12, and 52weeks. Demographics and information about duration of RCTpain and prior therapies for RCT were collected. Eachparticipant underwent a single injection of PRP. In-personassessment occurred at 2, 8, and 12 weeks and by phone at52 weeks. Statistical analysis was done using SPSS 21software. P values less than .05 were considered statisticallysignificant for main and interaction effects.Results: In the present study total sample size was 46 inwhich 32 were males and 14 were females. VAS score wasevaluated for the treatment of Rotator cuff Tendinopathy atbaseline, 8 week, 12 week, 52 weeks after the injection ofautologous platelet rich plasma. The result shows that VASscore was less after 8 weeks and after 12 weeks and 52 weeksit was almost same.Conclusion: Our study concluded that pain was less in thepatients of Rotator cuff Tendinopathy after the injection ofautologous platelet rich plasma.
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Purpose: To study the utility and predictive ability of newer macular hole (MH) indices for closure following surgery. Methods: In this retrospective study, pre- and post-operative optical coherence tomography images of 49 eyes with idiopathic full-thickness MH were reviewed and analysed. Various quantitative parameters of MH like maximum outer diameter (OD), minimum diameter between edges, height, nasal and temporal arm lengths, macular hole angle were noted. Indices including hole form factor, Macular Hole Index, (MHI), Diameter Hole Index (DHI) and Tractional Hole Index (THI) were calculated. Newer area indices like macular hole area index (MAI), cystoid space area index (MCSAI) and tissue area index (MTAI) were calculated using Image J (Ver. 1.51). Receiver operating characteristic (ROC) curves and cut-off values were derived for indices predicting type 1 or type 2 closure. Stepwise regression analysis and binary logistic regression analysis were carried out to predict the chances of hole closure. Results: ROC curve analysis showed indices like MHI, THI and MCSAI were capable of successfully predicting type 1 closure while OD, DHI and MAI predicted type 2 closure. On stepwise regression analysis, MAI was identified as the most important index in predicting the type of hole closure. Using the binary logistic regression analysis, the predictive ability of the model to identify success or failure following MH surgery was 89.7% and 80% respectively. Conclusion: MAI measurement could be used as a single important index in predicting hole closure in idiopathic MH. Further research is required to study this area index in detail.
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We present a case of a 37-year-old gentleman with a rare diagnosis of Torpedo maculopathy (TM). We describe the multimodal imaging features of torpedo maculopathy using adaptive optics, visual fields, OCT and multifocal ERG, and understand the clinical and structural-functional correlation in TM. According to us, this is the first case report to describe the adaptive optics imaging findings in Torpedo maculopathy in English Medical literature.
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The incidence of carbapenem-resistant Enterobacteriaceae has been steadily rising. The morbidity, mortality and financial implications of such patients are significant. We did a retrospective analysis of the case records of 11 patients who had culture report positive for pan drug-resistant (PDR) organisms. There were total 15 isolates of PDR organisms in 11 patients. These were associated with catheter-associated urinary tract infections (7), tracheitis (4), bacteraemia (2), meningitis (1) and soft-tissue infection (1). Average APACHE II score was 23.72 (range 7-36) indicating patients with multiple co-morbidities and organ dysfunction. The average length of hospital stay was 60.72 (25-123) days. The overall mortality rate was 81.81 per cent, while PDR infection-related mortality was 18.18 per cent. Strict implementation of antibiotic stewardship programme is essential to limit use and prevent abuse of colistin.
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Background & objectives: Diabetes mellitus (DM) is an important risk factor for tuberculosis and has received increasing emphasis. However, the reverse association of tuberculosis impacting blood sugar levels has not been well studied. The present study was conducted to evaluate the prevalence of hyperglycemia in patients with tuberculosis and assess its resolution following successful treatment of tuberculosis. Methods: In this prospective study, a total of 582 patients with tuberculosis were evaluated for hyperglycaemia [DM or impaired glucose tolerance (IGT)] with random blood sugar (RBS) and all patients with RBS >100 mg/dl were subjected to a 75 g oral glucose tolerance test (OGTT). All patients received thrice weekly intermittent Directly Observed Treatment Short Course (DOTS) for tuberculosis. Patients with hyperglycaemia were re-evaluated at the end of anti-tuberculosis treatment with an OGTT and glycated hemoglobin (HbA1c) levels to assess for glycaemic status. Results: In the present study, 41 of the 582 patients were found to have DM [7%, 95% confidence interval (CI) (5.2, 9.4)] while 26 patients were found to have IGT [4.5%, 95% CI (3, 6.5)]. Three patients were lost to follow up. Of the 26 patients with IGT, 17 [65.4%, 95% CI (46.1, 80.7)] reverted to euglycaemic status following successful treatment of tuberculosis, while the blood sugar levels improved in all patients with DM following treatment of tuberculosis. Interpretation & conclusions: Our study results show that tuberculosis adversely impacts glycaemic status with improvement in blood sugar levels at the end of successful treatment of tuberculosis. Longitudinal studies with large sample size are required to confirm these findings.