Superior Mesenteric Artery Syndrome (SMAS) is a rare clinical entity presenting as acute or chronic upper gastrointestinal obstruction. It occurs due to compression of third part of duodenum between abdominal aorta and overlying superior mesenteric artery caused by a decrease in angle between the two vessels. Rapid loss of retroperitoneal fat, in conditions leading to severe weight loss is the main factor responsible for this disorder. Superior mesenteric artery syndrome in association with abdominal tuberculosis has not been reported earlier to the best of our knowledge. Therefore, an unknown cause (SMAS) of upper gastrointestinal obstruction in a patient of abdominal tuberculosis is being presented for the first time through this case report. An imaging diagnosis of SMAS was made on contrast enhanced CT abdomen which also confirmed the clinical suspicion of abdominal tuberculosis in the patient. The patient was managed conservatively and recovered without requiring any surgical intervention for the obstructive symptoms.

BACKGROUND: Sleep disturbances are common in individuals with diabetes. Patients with diabetes have higher rates of insomnia, excessive daytime sleepiness and increased incidence of restless leg syndrome. The purpose of our study was to investigate the prevalence and determine the predictors of sleep dysfunction in patients with type 2 diabetes in a southeast Asian Indian population. METHODS: We enrolled 120 patients with type 2 diabetes who attended an endocrinology clinic in a tertiary-care hospital. After we collected their demographic data, we recorded their anthropometric measurements. Fasting, postprandial blood glucose values and glycosylated hemoglobin (HbA1c) values were then obtained. Quality of sleep was evaluated in all the patients through the Pittsburgh Sleep Quality Index (PSQI), which is a questionnaire that assesses sleep quality and disturbances over a monthlong period. A Global Sleep Quality score > or =5 discriminates between good and poor sleepers. RESULTS: The mean global PSQI score was 7.08 (standard deviation, 3.89), which suggested poor sleep quality in this population. Sixty-nine percent of patients had a global PSQI score > or =5, indicating that they were "poor sleepers." The global PSQI score positively correlated with the duration of diabetes and was also independent of other variables such as age, gender, body mass index, HbA1c, or medications. CONCLUSION: We found a high prevalence of sleep dysfunction in patients with type 2 diabetes. We also found a significant correlation between duration of diabetes and quality of sleep, independent of other variables. It is important for physicians to address the quality and duration of sleep in patients with type 2 diabetes.
Asian Continental Ancestry Group ; Blood Glucose ; Body Mass Index ; Diabetes Mellitus, Type 2 ; Endocrinology ; Fasting ; Hemoglobin A, Glycosylated ; Humans ; Incidence ; Leg ; Prevalence ; Sleep Initiation and Maintenance Disorders ; Surveys and Questionnaires