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Thirty patients with non-insulin-dependent diabetes mellitus were selected for the study. 15 age-matched healthy volunteers served as controls. Serum malonaldehyde, total glutathione, and vitamin E levels were estimated before and after glycemic control and after 4 weeks of vitamin E supplementation. Both total glutathione and vitamin E levels increased after glycemic control and showed an increase after vitamin E supplementation. Malonaldehyde levels lowered after glycemic control, but remained higher than controls. Since vitamin E supplementation significantly decreased oxidative stress in the present study, it may play a role in reducing free-radical-induced oxidant injury in diabetes mellitus.

Objective:We evaluated the thyroid function tests in individuals with metabolic syndrome to explore the possibility of thyroid receptor resistance.Materials and Methods:The study was a cross-sectional study. It included 40 patients (group I) and 20 healthy individuals served as controls (group II). Patients in group I fulfilled the three or more of the NCEP ATP III (National Cholesterol Education Programme – Adult Treatment Panel III) criterion to define the metabolic syndrome. Blood sugar and serum insulin levels were measured in both the groups. All the patients (group I) had insulin resistance as per the HOMA IR (the homeostasis model for insulin resistance) model. The HOMA IR value obtained in group II individuals served as a reference mark to define insulin resistance. T3, T4, TSH levels were measured as indicators of thyroid functions. There was an increase in TSH levels with normal T3 and T4 in group I indicating that increased TSH probably due to thyroid receptor resistance may be a part of metabolic syndrome rather than a state of hypothyroidism.Results:T3 and T4 levels were comparable in patients and controls. There was a significant increase in TSH levels in patients as compared to the controls.Conclusion:Raised TSH in patients with metabolic syndrome independent of lowered T3 and T4 suggest it to be a part and parcel of this syndrome.

Background:Surgical management of posttraumatic elbow stiffness has been reported with poor outcome following treatment. Sequential release in earlier stages of stiffness yielded much better results. The goal of our study was to assess the outcome in improvement of the range of motion of the elbow after surgical release and to analyze a tailor-made approach according to individual needs to yield good result.Materials and Methods:A prospective study was conducted in 47 cases of elbow stiffness due to various types of injuries. All the cases were treated with sequential release if there was no progress after adequate supervised conservative management except in unreduced dislocations. All the cases were followed up for a minimum period of 24 months. Overall outcome was rated with the functional scoring system by Mayo Clinic Performance Index.Results:Twenty-five (44.68%) out of 47 patients had excellent results with a mean preoperative range of motion of 33.9° and postoperative range of motion of 105° with net gain in range of motion of 71.1° (‘t’ test value is 19.27, P < 0.01). None of the patients had elbow instability. Patients not having heterotopic ossification, who underwent surgery from three to six months post injury had a mean gain of 73.5°. In patients who waited for more than six months had mean gain of 66.8°. However, the results in cases having heterotopic ossification followed a slightly different pattern. In cases where release was performed from three months to six months had mean gain of 77.5°. Cases in which release was performed after six months had gain of 57.1°.Conclusions:In cases of posttraumatic elbow stiffness after a failed initial conservative treatment, early arthrolysis with sequential surgical soft tissue release yields good result than delayed surgery.

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