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Background. Celiac disease is frequently associated with type 1 diabetes mellitus, but is usually ill-defined and not usually suspected until the disease becomes advanced. Objective. To study the prevalence and clinical profile of celiac disease among patients with type 1 diabetes mellitus in a tertiary care referral centre in north India. Methodology. Two hundred and fifty six patients were screened (149 males and 107 females) during the study period of two years, patients were evaluated for the clinical signs, biochemical investigations and family history of celiac disease in tertiary care health center in western Uttar Pradesh. Results. Twenty four (9.37%) patients were diagnosed to have celiac disease; the mean age at diagnosis of diabetes was 9.34 ± 7.3 years. Only 1/24 patients with celiac disease had been diagnosed before detection of diabetes mellitus. The common manifestations were normocytic normochromic anemia (66.6%) followed by diarrhoea (62.5%), abdominal pain/bloating sensation (58.3%) and short stature (58.3%). Some uncommon manifestations were also observed in small number of patients: rickets (20.8%), recurrent hypoglycemia (16.6%), carpopedal spasm (8.3%), and night blindness (8.3%). Conclusion. Celiac disease was found in about 10% of patients with type 1 diabetes, almost 10-20 times higher than that observed in general pediatric population. Atypical manifestations (rickets, recurrent hypoglycemia, carpopedal spasm and night blindness) were found to be common in patients with type 1 diabetes as compared to the general population. Unexplained anemia, diarrhoea, short stature and rickets should raise suspicion for the possibility of undiagnosed celiac disease in type 1 diabetes mellitus.

Objective: The objective was to determine the role of various components of metabolic syndrome (MetS) as independent risk factor for erectile dysfunction (ED). Materials and Methods: A total of 113 subjects of MetS, as recommended by recent IDF and AHA/NHLBI joint interim statement were selected for study who presented for ED. After doing Anthropometric examination, fasting laboratory assay for fasting plasma glucose (FPG), fasting insulin, hemoglobin A1c, triglyceride (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), and 2 h oral glucose tolerance test (OGTT) was done. Erectile function was assessed by completing questions one through five of the International Index of Erectile Function (IIEF-5). A multiple linear regression analysis was carried out on 66 subjects with IIEF-5 score as dependent variable and components of MetS FPG, 2 h OGTT, TG, HDL, and waist circumference as independent variables. Results: Using a multiple linear regression analysis, we observed that presence of the various components of MetS was associated with ED and a decrease IIEF-5 score and this effect was greater than the effect associated with any of the individual components. Of the individual components of the MetS, HDL (B = 0.136; P = 0.004) and FPG (B = −0.069; P = 0.007) conferred the strongest effect on IIEF-5 score. However, overall age had most significant effect on IIEF-5 score. Conclusion: It is crucial to formulate strategies and implement them to prevent or control the epidemic of the MetS and its consequences. The early identification and treatment of risk factors might be helpful to prevent ED and secondary cardiovascular disease, including diet and lifestyle interventions.

Background: Sepsis is the leading cause of mortality in the critically ill. Recently, it has been found in many studies that many trace elements and nutrients do have an effect on human body and if supplemented can improve the prognosis in patients with sepsis. Aim and Objectives: Primary objective: Whether low Vitamin D is associated with mortality. Secondary objective: To find out association of low Vitamin D levels and morbidity in terms of length of hospital and Intensive Care Unit (ICU) stay. Subjects and Methods: Following ethical approval, consent will be sought from either the patient or assent from a near relative. Successive patients admitted to the medical emergency and ICU at tertiary care health center who fulfill the following criteria for sepsis, within a 24 h time window, were included in the study. Results: Among 88 patients evaluated in our study 15 patients (18.2%) were found to have adequate Vitamin D levels and seven patients (8%) were found insufficient and rest 52 patients (73.9%) were found deficient in Vitamin D. Age of the patients ranged between 18 and 82 years with mean (±standard deviation) 45.02 ± 17.69 years. Mean Vitamin D level was found significantly higher among patients with positive outcome than those with unfavorable outcome (expiry) ( t = 2.075, P = 0.04). On comparison of the length of hospital stay (morbidity) with Vitamin D levels, we found statistically significant inverse relation between Vitamin D levels and length of hospital stay. Conclusion: Vitamin D deficiency leads to increased risk of mortality in the critically ill along with prolonged hospital stay.

Drugs raise blood glucose concentrations via two broad mechanisms: By reducing insulin biosynthesis or secretion, or by reducing tissue sensitivity to insulin. Until date, there have been very few reported cases of isoniazid induced diabetes. We are presenting a case report of 6-year-old child with isoniazid induced diabetes who was misdiagnosed initially as a case of type 1 diabetes mellitus. We hereby stress that before diagnosing a patient with diabetes-type 1 or 2, a detailed history of drug intake for any such drugs, which can cause hyperglycemia has to be taken. Clear cut knowledge/cognizance of all such culprit drugs is therefore required.

Background and aim. We planned this prospective cohort study in term newborn babies, with the objective to determine the incidence of vitamin D deficiency in infancy and to determine the level of vitamin D which triggers the physiological PTH axis of the body so as to differentiate truly deficient from sufficient vitamin D status.Methods. 96 participants at birth were enrolled and followed up till 9 months of age. Serum25OHD was estimated in cord blood at birth and at 14 ± 1 weeks of life. 77 participants were followed up at 9 months for estimation of serum 25OHD, PTH, Alkaline phosphatase (ALP), calcium and phosphorus. Vitamin D deficiency was defined as serum 25OHD

Skeletal muscles express and elaborate a number of cytokines and other substances for modulating various metabolic processes which function locally and also target distant organs are known as myokines. Irisin is one of the most recently discovered myokines and is found to modulate effect of exercise on adipocytes through browning of white adipose tissue. Besides this, irisin is considered to be one of the future targets for therapies for metabolic disorders.

Gingival hypertrophy is a common manifestation of any pathology affecting gingival and periodontal regions. It commonly follows inflammatory disorders, Vitamin C deficiency, leukemia and due to drugs such as anticonvulsants, immunosuppressants, and calcium channel blockers. Amlodipine is a third generation dihydropyridine derived calcium channel blocker commonly used to treat hypertension. Here, we describe the case of a 45-year-old hypertensive woman who was on amlodipine for 1 year and subsequently developed one of its rarest adverse effects, i.e., gingival hypertrophy.