Arup Bandyopadhyay

Appraisal of cognitive function of diabetics in a rural healthcare teaching institute

Context (Background): Cognitive dysfunctions as the unexplored complications in diabetics need to be systematically studied. Aims: To assess the correlation between type 2 diabetes mellitus (DM) and associated cognitive dysfunctions with varying age groups and duration. Settings and Design: A hospital-based cross-sectional study was conducted in a tertiary care teaching institute in eastern India. Materials and Methods: In this study the participants were allocated into five groups according to duration of diabetes, for example, less than 3 months, 3 months-5 years, 6-10 years, 11-20 years, and more than 20 years. Each of these groups was then classified into following six subgroups according to age: group A (20 years or less), group B (21-30 years), group C (31-40 years), group D (41-50 years), group E (51-60 years), and group F (more than 60 years). A predesigned, pretested, semi-structured questionnaire was used to find the cognitive functions based on the Global Deterioration Scale (GDS) in diabetics and age-matched nondiabetic participants. Statistical Analysis Used: Statistical analysis using Statistical Package for the Social Sciences (SPSS) version 11.0 to calculate proportions and significance test were done in this study. Results: There was noticeable attenuation of cognitive functions in diabetics in all age groups irrespective of duration of the morbidity. Further, a distinct pattern of incremental cognitive dysfunctions was also noticed as the age progressed in diabetics and in healthy controls. Conclusion: Diabetics are more at risk of cognitive dysfunctions than age-matched controls, which needs more elaborative studies.

Comparison of lower limit of normal values with a fixed ratio assessed by spirometry in obstructive and restrictive lung diseases in Indian population

Background and Aim: Spirometric parameters are approximated by the normal distribution and using lower limit of normal (LLN) minimize the misclassification with fixed-ratio protocol in interpretation of spirometry results. This study investigates prevalence and characterization of obstructive and restrictive lung function impairments, and dissimilarities between two guidelines interpreting spirometry. Methods: This study was conducted to assess the lung function in students and patients (n = 74) of MGM Medical College, Kishanganj, Bihar, between September 2012 and May 2014, using computerized Spirometer. Results: Forced vital capacity (FVC), forced expiratory volume in the 1st s (FEV1)/FVC, forced expiratory flow25-75% (FEF25-75%), peak expiratory flow rate (PEFR) were normally distributed with inflection at their mean ± standard deviation. FEF25-75%, and PEFR were higher in normal individuals compared to individuals with respiratory disease. FEV1/FVC were lower, and FVC were higher in obstructive disease while the reverse results were obtained in restrictive disease category. Restrictive disease by fixed-ratio was found with 55% negative predictive value (NPV) and 5% positive predictive value (PPV), while the normal cases by fixed-ratio criteria was found with 91% NPV and 15% PPV versus LLN criteria. There were 58 individuals with normal spirometries under the LLN method but a discrepant of only 12 fixed-ratio normal results. Concordance analysis by kappa statistics yielded a κ = 0.017. Conclusion: Older adults are more pulmonary susceptible. The performance of LLN criteria in differentiating respiratory diseases is better than the fixed-ratio criteria. Poor agreement exist between the fixed-ratio and LLN protocols in interpreting spirometric results. There is the difference between the LLN and fixed-ratio criteria which need to be redressed with population-specific reference values.