Background:Depression is found to be common among patients with diabetes and it is associated with poor outcomes in disease control. This study was carried out to find out the proportion and determinants associated with depression among patients with established type 2 diabetes mellitus (T2DM) in various tertiary care hospitals in Mangalore city of south India.Materials and Methods:This study was conducted in one government and three private tertiary care hospitals in Mangalore in December 2010. All consenting patients with confirmed diagnosis of T2DM were interviewed and screened for depression by administering the 9-item PRIME-MD Patient Health Questionnaire (PHQ-9).Results:Of the 230 T2DM patients, 119 (51.7%) were males. The mean age of all participants was 53.61 ± 10.7 years. The median duration of T2DM was found to be 12.1 ± 7.35 years. Among the participants, 71 (30.9%) met the criteria for moderate depression, 33 (14.3%) for severe depression, and the remaining 126 (54.8%) had no clinically significant depression. Only 26 (11.3%) patients were already aware that they were depressed, of whom just 3 had taken medical consultation. Among the risk factors, depression was found to be significantly associated with older age, female gender, low socioeconomic status, unskilled and retired employment status, having complications due to T2DM or comorbidities like hypertension and coronary artery disease, being overweight and being on insulin syringe injections.Conclusion:This study found a high proportion of depression among patients with T2DM. Therefore the care of individuals with diabetes mellitus (DM) should include the screening and possible treatment of depression in order to achieve and sustain treatment goals.
Sudden unwitnessed, unexpected deaths when the bodies are found in public places require a complete and meticulous medicolegal autopsy to ascertain the cause and manner of death to avoid further unnecessary investigations by the legal authorities. Such deaths attributed to gastrointestinal causes at autopsy are relatively uncommon. We report a case of sudden unexpected death due to strangulated inguinal hernia in a 60-year-old man. The body was discovered in a public area near a place of worship. The present case illustrates a potentially preventable sudden unexpected death due to a surgically correctable gastrointestinal condition. In the present case, the individual feared being hospitalised for treatment of his scrotal swelling with potential surgery and the eventual loss of daily income. In our opinion, such apprehensions may have delayed the potentially life-saving hospital surgical intervention in the individual.
Cut-throats can be of homicidal, suicidal or accidental origin. In cases of death from a cut-throat, distinguishing the cause is one of the important functions in crime investigation. The features that differentiate suicidal and homicidal cut-throat injuries are the presence of hesitation cuts, depth of wound, signs of struggle, edges of the wound, etc. In the case of a suicidal cut-throat, it is not uncommon to find hesitation cuts but in a homicidal cut-throat, it is uncommon. We present a case of a homicidal cut-throat injury but with hesitation cuts and tailing over the neck, unlike the classical description of homicidal cut-throat injury. This resulted from a curved, sharp and moderately heavy weapon.
Colchicine, a natural pseudo-alkaloid found in plants such as the Colchicum autumnale and Gloriosa superba has tremendous medicinal properties, but if misused by an unqualified person can result in fatal consequences. We report a case of colchicine poisoning in an adult man as a result of consumption of the herb G. superba by a 50-year-old man and review the literature.
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