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BACKGROUND: Intensive medical care units (IMCUs) usually admit patients who are in critical medical need and require the utmost attention of healthcare professionals, along with the best treatment options available. These patients are prone to infections and require various antibiotics for the treatment. Varying costs of antibiotics, variable dosage forms, and antibiotic resistance cause an economic burden on patients Methodology: This study was designed and conducted prospectively to evaluate the prescribing pattern of antibiotics at the IMCU in a tertiary care hospital. A total of 102 patients were included in the study based on the exclusion and inclusion criteria, and the collected data was tabulated in an Excel sheet and analyzed using Prism GraphPad software. Data were presented as numbers and percentages. RESULTS: Most of the patients were in the age group of 41-50 years. The number of male patients was slightly more than that of female patients. The majority of the patients admitted to the IMCU had acute pulmonary edema and cerebrovascular accidents. Most antibiotics were prescribed empirically and administered parenterally, of which Amoxicillin + Potassium clavulanate was the most commonly used antibiotic. Tigecycline had the highest daily defined dose per 100 bed days value, and injection Sulbactam + Cefoperazone was the costliest of all antibiotic therapy. CONCLUSION: Antibiotic therapy used in the IMCU consisting of Sulbactam + Cefoperazone was found to be costlier, and Amoxicillin + Potassium clavulanate were the commonly prescribed antibiotics among the other prescribed antibiotics. The average cost of antibiotics was found to be higher, which increased the economic healthcare burden for patients and their families.
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INTRODUCTION: Diabetes mellitus type 2 (T2DM) is a metabolic disorder, and its prevalence is rising worldwide. The objective of the study was to investigate the association between mean platelet volume (MPV) and red cell distribution width (RDW) and the glycemic control marker HbA1c. So MPV and RDW could be used as prognostic indicators of deterioration of gluco-regulation in diabetes mellitus type 2 and the associated microvascular complications. METHODOLOGY: A cross-sectional study was conducted on 216 type 2 diabetic patients, who were divided into two groups based on HbA1c values (<7% and >7%). Red blood cell distribution width, mean platelet volume, plasma glucose estimation, fasting lipid profile, spot urine albumin creatinine ratio (ACR), direct ophthalmoscopic examination, and nerve conduction study were tested in all the patients. RESULTS: Of the 216 individuals diagnosed with type 2 diabetes mellitus, 210 exhibited inadequate glycemic control, establishing a statistically significant correlation with triglyceride levels, mean platelet volume, and blood sugar levels. The study revealed a significant association between MPV and RDW and HbA1c levels. Additionally, microvascular complications such as retinopathy, proteinuria, and neuropathy exhibited strong correlations in this patient cohort, emphasizing the interconnectedness of glycemic control and various health indicators in individuals with T2DM. CONCLUSION: This study provides significant results that mean platelet volume and red cell distribution can be used as markers in the diagnosis of microvascular complications in type 2 diabetes mellitus.
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Background Diabetes mellitus (DM) refers to a group of metabolic disorders that share the phenotype of hyperglycemia. "Diabetic nephropathy (DN)" is a microvascular complication of DM, and it is the leading cause of end-stage renal failure. Increased urinary albumin excretion (UAE) and a decrease in glomerular filtration rate (GFR) are associated with DN along with elevated blood pressure and end-stage renal disease (ESRD). The purpose of this study is to analyze the prognostic significance of the monocyte-to-high-density lipoprotein (HDL) cholesterol ratio (MHR) in DN patients. Materials and methods This prospective observational study was carried out over a period of 1.5 years, with patients being followed up for three months. One hundred twenty participants were enrolled and allotted into groups based on the measure of urine albumin-to-creatinine ratio (UACR). The participants were categorized into healthy individuals, normoalbuminuric diabetic patients, microalbuminuric diabetic patients, and macroalbuminuric diabetic patients group. The MHR, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) were estimated and compared between the baseline measurements. Conclusion The MHR, NLR, and PLR showed a positive correlation with UACR levels which could serve as an inflammatory marker and be used as an inexpensive and accessible prognostic marker in DN patients.
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BACKGROUND: Early diagnosis of atherosclerosis is exigent in patients with known cardiovascular disease (CVD) risk factors. During the initial phases of atherosclerosis, appearance of plaques can be detected by the ultrasonic phased tracking method which measures the arterial wall elasticity. However, reliable and easily available biochemical markers are not evaluated in the diagnosis of early-stage atherosclerosis. So the current study was carried out to assess the serum cystatin C level as an atherosclerotic marker, by evaluating its association with carotid arterial elastic modulus using the phased tracking method. MATERIALS AND METHODS: A cross-sectional study was conducted on 115 patients having risk factors for atherosclerosis but not meeting carotid intima-media thickness (IMT) criteria. The early-stage atherosclerosis was detected by using the ultrasonic phased tracking method and the patients were divided based on low and high carotid elastic modulus. Serum levels of cystatin-C were measured in association with IMT, and elastic modulus was calculated using a novel method. This study also put forth the evaluation of the sensitivity and specificity of cystatin C for early diagnosis of atherosclerosis. RESULTS: Cystatin C was strongly related to carotid elasticity (r=0.650). Based on multi-linear regression analysis, cystatin C showed significant association with carotid elasticity (ß=0.509; p<0.001). It also displayed significant positive association with high carotid elastic modulus (ß=0.511; p=0.02). Cystatin C showed a sensitivity of 85% in the prediction of high carotid elastic modulus. CONCLUSION: For patients who are at risk to evolve atherosclerosis but are not evident with arterial plaques, cystatin C exhibits a significant association with carotid wall elastic modulus, which eases the detection of atherosclerosis. Thus, cystatin C is a potential biochemical marker for early diagnosis of atherosclerosis.