| Popis: |
Insulin Resistance is a major factor among patients with critical illness due to various causes. Severe falciparum malaria with MODS diagnosed as per the criteria of MSS and admitted to the Medical ward of our hospital were assessed for IR and β cell function by using homeostasis model assessment. 75 consecutive patients of SFM admitted to the Medical ward of our hospital were included in this study. Malaria was diagnosed as per criteria of WHO and organ dysfunction was diagnosed as per Malaria Severity Score. Insulin Resistance and β cell function was assessed by using homeostasis model assessment on Day-1 and Day-7. Out of 75 patients of severe falciparum malaria with MODS 2, 3, 4, and 5 organ dysfunctions constituted 16 (21.3%), 34 (45.3%), 16 (21.3%), and 9 (12.0%) patients, respectively.Hepatic failure was the most common organ system failure (n=58; 77.3%), followed by neurological (n=50;66.6%) ,renal (n=40;53.3%), hematological (n=30; 40.0%), and, respiratory failure ( n=15; 20.0%). Hyperglycemia was present in 25 (33.3%) cases where as normoglycemia was present in 50 (66.6%) cases. The values of FBS, Tg, insulin, IR, and β cell function decreased on Day-7 compared to Day-1 after recovery from critically ill state. The patients who died had a high insulin value, IR, but low β cell dysfunction compared to the survivors. This study showed that IR and β cell dysfunction were associated with severe malaria with MODS with increased mortality. |
