Background: With a rise in the elderly population worldwide, falls have been seen to cause a substantial increase in mortality and morbidity in this age group. Multiple factors have been held responsible for resulting in falls, which can be broadly classified as intrinsic causes and extrinsic causes. Diabetes along with hypertension has been considered to be one of the major intrinsic causes leading to increase in incidence of fall. Materials and methods: The objective of the study was to find out estimation of fall risk among diabetic elderly with history of fall in last 6 months and evaluation of its recurrence over the next 1 year. This prospective observational cohort study was conducted at Outpatient Department of General Medicine Department of RG Kar Medical College, Kolkata, West Bengal, India, from July 2017 to September 2018. Data were collected from 116 elderly patients. Results: Our study demonstrated that patients on insulin along with oral hypoglycemics (OHA) had increased number of falls through the next year. Diabetes was also found to be significantly associated with intrinsic fall. Number of falls through next year was significantly associated with taking patients insulin. Conclusion: This study reveals that diabetes along with use of antidiabetics in elderly population increased risk of fall in this population. With the elderly population increasing in West Bengal, larger studies will help to explain the increased incidence of fall in all diabetic elderly population further.
The current coronavirus-19 (COVID-19) pandemic has diverted the world\'s attention to the burning problem of infectious diseases and their management. Clinicians are increasingly realizing that the management of diseases like COVID-19 requires not only antimicrobial drugs but also drugs or strategies to tackle the various comorbidities occurring or aggravating due to the disease. Hypoglycemia is one of the important adverse effects of hydroxychloroquine, used frequently in COVID-19. The known diabetics affected with COVID-19 are therefore at a greater risk of hypoglycemia. In this review article, we describe the management strategy for the known diabetics infected with COVID-19 and admitted in inpatient settings, including the dose calculations for insulin infusion and subcutaneous administration of insulin.
Coronavirus disease-2019 (COVID-19) has emerged as a pandemic affecting millions of people worldwide. It is characterized by multisystem involvement. The endocrine organs are also expected to be affected in COVID-19 as the interplay between the virus, severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2), and the endocrine system occurs at multiple organ levels with a swarm of clinical manifestations. In addition to other organ systems, COVID-19 also affects persons with known endocrine disorders, thereby making them susceptible to an increased risk of disease severity, worse prognosis, and increased mortality. However, the virus being a novel one, its possible effect on the endocrine system is not yet entirely understood with limited clinical data to date and remains an emerging area of further research. In this review, the variety of endocrine manifestations that have been reported in both SARS-CoV-1 and SARS-CoV-2 to date have been highlighted. Besides, the possible mechanisms by which SARS-CoV-2 may affect various endocrine organs have been explored.
Never in the history of mankind has the global scientific and medical community been subjected to such a testing time as in the coronavirus-2019 (COVID-19) pandemic triggered off by the novel RNA severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) virus of 125 nm size. Despite the concerted efforts of the entire world, we do not seem to be making progress in being able to confidently recommend evidence-based pharmacological interventions in affected patients or advise governments on immunological interventions to avoid mass fatalities that are already in very significant numbers throughout the developed and the developing world including unfortunately in India. This has been a wake-up call for researchers, virologists, and immunologists to undertake more critical research into the deficiencies of our knowledge base that has been exposed by the current pandemic. The shift of recent research since the last HIV scare in the early 1980s has been toward noncommunicable diseases and drug development has also followed the same trend. There has been considerable progress on antibiotic resistance although antiviral therapies have not made progress in line with potential emergence of novel viruses as has been cruelly demonstrated in this current pandemic. The immunological responses that have been so varied to the current pathogen in individuals are again a matter of further research and understanding of human immunology and its complex response to cancers, autoimmune diseases, and external pathogens—further research is necessary here. The long-term impact of COVID-19 illness spectrum remains to be seen as clinicians and basic scientists put their heads together to evaluate the clinical profile of the illness spectrum from case records of recovered patients and those who succumbed and evidence-based treatment approaches need to be available instead of the best guess treatments that we are practicing presently to save lives. Immunologists, virologists, clinical trial experts, and pharmacologists are now tasked to develop evidence-based pharmacological therapies and efficient vaccines to rebuild the confidence of the population and governments globally who have always relied upon and respected healthcare stakeholders to protect global health. We live in uncertain times filled with anxiety and disruption of normal human lifestyle habits. Never has the tolerance, patience, and fortitude of the global village, we live in and of the economic fallouts arising been tested to the hilt as much as we have seen in these last six months. Hopefully, we should be able to see the light at the end of the “COVID-19” tunnel soon. Going forward, we hope we emerge as a stronger human civilization being able to collaborate, cooperate, and cohabit this beautiful planet and together we become masters of our destiny so that future generations will be grateful to us for having taken responsible decisions during times of crisis that threatened our civilization and brought all of us proverbially to our knees.
We present the case of a 40-year-old woman presenting with bilateral asymmetric pedal swelling and abdominal lump. Investigations revealed a retroperitoneal necrotic mass encasing the large vessels along with deep venous thrombosis of bilateral femoral, popliteal, and saphenous veins. There were erosion of lumber vertebra and encroachment of paravertebral muscles. The extensive spread, vascular involvement, and necrosis on imaging pointed provisionally to a retroperitoneal sarcoma though we lost the patient before histological confirmation could be done.