An uncommon cause of fever in a patient with hyperthyroidism.

Fever as an indicator of disease has always been and remains a clinical symptom of great importance. It may be a manifestation of any inflammatory process of the thyroid and also may be presenting feature of thyroid storm. Melioidosis, is an infection caused by the gram negative bacterium Burkholderia pseudomallei and the commonest co-morbidity observed in India is diabetes mellitus. Here we present a case of Graves disease (hyperthyroidism) who was referred by primary care physician with history of prolonged fever of more than one month duration and later diagnosed to have melioidosis. It is important in primary care setting as family physicians need to be aware of this infection as it can affect many organs and early diagnosis and treatment will result in cure of this condition.

Demographic details, clinical features, and nutritional characteristics of young adults with Type 1 diabetes mellitus - A South Indian tertiary center experience.

CONTEXT: Type 1 diabetes mellitus (T1DM) accounts for 5-10% of all diagnosed diabetes and the highest incidence is found in India. AIMS: The main objectives were to study the demographic, clinical, and nutritional characteristics of young adults with T1DM and its effect glycosylated hemoglobin levels. SUBJECTS AND METHODS: This cross-sectional study was conducted among young adults with T1DM (18-45 years of age) in a tertiary hospital in South India. Data were obtained from updated medical records. The dietary data were assessed from food diaries and 24 h recall method. Anthropometry was determined. RESULTS: The analysis revealed that socio-economic variables did not affect the glycosylated hemoglobin levels. The mean glycosylated hemoglobin value was 8.81 ± 2.38%. Nearly, half the patients were malnourished. The overall dietary intake was inadequate. The multivariate regression model, adjusted for confounding factors such as gender, age, and body mass index, revealed that only duration of diabetes and protein intake were significant predictors of glycosylated hemoglobin status (P < 0.005). CONCLUSION: Integrated care provided at subsidized cost has been pivotal in effective diabetes management. However, there is an urgent need to educate our patients on nutrition therapy. T1DM patients need specialized advice to ensure appropriately balanced nutrition that has a significant impact on their long-term glycemic control.