A clinical study on autonomic nervous system manifestations in diabetes mellitus.
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Biomedical subjects
Publications and source records attributed to S Singla.
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AIMS AND OBJECTIVE: Ultrasonographic determination of gallbladder volume in diabetics [both type I and type 2], it's comparison with a control group, and correlation of gallbladder volume in diabetics with parameters such as age, sex, body mass index, parity, hyperlipidaemia, and autonomic neuropathy. MATERIALS AND METHOD: Ninety one cases of diabetes mellitus and 40 healthy controls were recruited for the study. A detailed history and physical examination were recorded. Laboratory investigations done were--fasting and postprandial blood sugar, glycosylated haemoglobin, microalbuminuria, and serum lipid profile. Autonomic neuropathy was determined by using simple non-invasive bedside tests. Fasting gallbladder volume was measured by ultrasonography (calculated by ellipsoid formula). RESULTS: The mean fasting gallbladder volume was 18.20 +/- 2.54 ml in type I diabetics and 25.87 +/- 13.90 ml in type 2 diabetics, with a minimum value of 9.30 ml and maximum value of 88 ml. When type 2 diabetics were subgrouped according to the presence of autonomic neuropathy, higher gallbladder volumes were seen in patients with autonomic neuropathy. CONCLUSIONS: Cholecystomegaly, to a significant degree, was found in type 2 diabetics in the present study. It was significantly correlated with age, body mass index, and the severity of autonomic neuropathy. In male type 2 diabetics, gallbladder volume was significantly correlated with LDL cholesterol levels. In female type 2 diabetics, gallbladder volume was significantly correlated with waist-hip ratio. Gallbladder volume also had significant correlation with proliferative diabetic retinopathy, but not with glycaemic control, microalbuminuria, hypertension, or the duration of diabetes.
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Unripe Banana (Plantain) is used in South India as a bland diet for peptic ulcer patients. Flour made of plantain is quite often prescribed in dyspepsia in this part of the country. This has led to the belief that ripe banana may also be a bland fruit. However, it was observed by the Senior Author that ripe banana does produce symptoms of hyperacidity. Hence a study was undertaken to assess whether ripe banana is a bland food or not. A total of 115 patients entered the study. 89 individuals had no GIT symptoms, 15 patients had proved peptic ulcer while 11 patients had non-ulcer acid dyspepsia. The gastric residue was emptied by a nasogastric tube after a night fast. Patients were then given 80 gms. of banana or porridge on two different days. Then consecutive 15 minute samples of gastric juice were collected and submitted for estimation of acid output in mEq/l. It was observed that gastric acid values were higher following banana as compared to porridge and the difference was statistically significant (p < 0.001). It was was thus concluded that ripe banana is not a bland food. It should not be recommended as a part of bland diet for patients of acid peptic disease.
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Since hapten inhibition of precipitation is relatively time consuming, we have developed a hapten inhibition of adsorption assay to explore the sugar binding specificity of the Sophora japonica lectin. Adsorbents were prepared with Sephadex and p-aminophenyl beta-D-galactopyranoside using the CNBr procedure. The ability of simple saccharides to inhibit the binding of lectin to the adsorbent was performed employing a fixed amount of adsorption with respect to the logarithm of micromoles of inhibitor yielded sigmoid shaped curves. The quantities of various saccharides required to cause 50% inhibition of the lectin--adsorbent interaction relative to D-galactose were within+/-5% of the relative inhibiting potencies of the sugars in