In long-standing Diabetes Mellitus (DM) of both types, a wide variety of lesions develop in many organs, which are important causes of morbidity and mortality.

Insulin is the major hormone regulating blood glucose level. Insulin is synthesized by β cells of pancreas as preproinsulin, which is rapidly converted to proinsulin. Proinsulin is a single chain polypeptide. In the Golgi apparatus, proinsulin is broken down into 2 units- insulin (51 amino acids) and C (connecting)-polypeptide (31 amino acids) (Figure 1192.1).

Diabetes mellitus (DM) is a metabolic group of disorders characterized by persistent hyperglycemia due to deficiency and/or diminished effectiveness of insulin. There are derangements of carbohydrate, protein, and fat metabolism due to failure of insulin action on target cells.

Detection of a fake or adulterated urine sample is necessary before going to the further process of urine testing in the laboratory. Urine adulteration causes false-positive and false-negative results. However, most attempts of a fake or adulteration in a urine sample can be detected either by a trained collection site personnel or by a laboratory technician during the testing process. Coordination and cooperation between the collection site and the testing laboratory provide effective and reliable test results. There are some methods by which fake or adulterated urine can easily identify.

Electrocardiogram (ECG / EKG) test is important for the diagnosis of myocardial infarction. ECG reading is obtained rapidly from ECG machine. ECG scan is useful for diagnosis, prognosis, and monitoring of myocardial infarction.

Good dental hygiene and regular visits to the dentist will always lead to healthy teeth and gums. So, here are the most important tips to help you look after your teeth.

The peritoneal cavity is a potential space in the abdomen lined by mesothelial cells and normally containing about 30-50 ml of serous fluid. The fluid is an ultrafiltrate of plasma and its formation is dependent upon hydrostatic pressure, plasma oncotic pressure, and capillary permeability.

Excessive gas and bloating can sometimes indicate an underlying health problem, they often occur due to the foods that people eat. Knowing which foods trigger gas and bloating can help a person reduce flatulence.

Heartburn and gas can occur together. Although one does not cause the other, they may make each other worse. Certain underlying conditions can possibly cause some pyrosis and gas. In these cases, treating the underlying condition will help relieve some the gas and pyrosis.

Gastropassage reflux unwellness normally causes pyrosis, as well as metabolism and digestive symptoms. Doctors often recommend that people with this common unwellness avoid drinking caffein. Nevertheless, the scientific evidence is not so clear.

For the first time, researchers have managed to create a human esophagus in the laboratory. This may pave the way for new, recistronrative treatments.

Palpitations are irregular heartbeat generation that can occur periodically or often. Although palpitations have galore direct causes, internal organ reflux illness (GERD), the long-run and frequent occurrence of acid reflux, is unlikely to be one of them. Nevertheless, acid reflux shares some of the same triggers as palpitations and may besides lead to them indirectly.

Bulimia nervosa, or bulimia, is a feeding disorder that leads to bingeing, purging, and other symptoms. The adverse physical side personal effects of bulimia may not be noticeable at first, but over time they can take their toll on the body.

The exercise tolerance test (ETT) is also known as an exercise electrocardiogram (ECG). This test is done to assess the severity of coronary heart disease. In such condition, the blood vessels are narrowed due to the blockage causing irritation for free-flowing blood supply to the heart. Exercise tolerance test (ETT) assess the response of the heart to raised workload and demand of blood. This is obtained by recording the ECG whilst the patient start walking on a treadmill machine.

Once the patient starts walking on the treadmill, heart rate, blood pressure, general condition and ECG will be monitored continuously. After every 3 minutes, the speed and incline of the treadmill will be increased. The patient will be encouraged to exercise for as long as he/she can and the test will be continued until the patient reaches to the desired heart rate and/or cannot exercise anymore (usually 10 to 15 minutes). After the test, the patient will be asked to rest while his/her ECG and blood pressure are recorded and until his/her recordings reach the normal baseline heart rate. All the recordings will be analyzed by a cardiologist (a doctor with special training to treat heart-related diseases).

What is an electrocardiogram (ECG)?

An electrocardiogram (ECG) test is done by an ECG machine. It records the electrical activity of the heart. The heart produces micro electrical impulses which spread through the heart muscle to make the heart contract. The micro electrical impulses are detected by an ECG machine. The ECG machine amplifies the micro electrical impulses that occur at each heartbeat and records them on to a paper or computer.

An ECG recording is harmless since it records the electrical impulses coming from your body and it does not put any electricity into your body.

What is an exercise tolerance test (ETT)?

An exercise tolerance test (ETT) records the electrical impulses of your heart whilst you exercise. This test is very useful for a patient experiencing chest pain when they exert themselves. This test is also very useful for the detection of rhythm abnormalities.

Some decades ago this was the routine test of choice to investigate a patient for the presence of narrowing of the arteries to the heart. Nowadays it is common for scans of the heart to be done rather than an ETT. The scans that can be done for the heart include:

  • Computerised tomography (CT) coronary scan/CT coronary angiography
  • Cardiac magnetic resonance imaging (MRI) scan of the heart
  • Myocardial perfusion scan

How is an exercise tolerance test (ETT) done?

Small electrodes are stuck on to the patient's chest. Wires from the electrodes are connected to the ECG machine. The patient is asked to walk on a treadmill and the heart rate, blood pressure, general condition and ECG is monitored continuously. After every 3 minutes, the speed and incline of the treadmill are increased. The patient is encouraged to exercise for as long as he/she can and the test is continued until the patient reaches to the desired heart rate and/or cannot exercise anymore (usually 10 to 15 minutes). After the test, the patient is asked to rest while his/her ECG and blood pressure are recorded and until his/her recordings reach the normal baseline heart rate. All the records are analyzed by a cardiologist. The whole process ends in 15-20 minutes.

Are there any risks when doing an exercise tolerance test (ETT)?

An exercise tolerance test (ETT), normally do not cause any complications since, in this procedure, micro electrical pulses are recorded produced by the heart contraction. For this purpose, ECG machine is used which does not input electricity into your body.

If you do not have coronary heart disease (CHD) then complications are rare. However, serious complications occur in a small number of people who have coronary heart disease and there are reports of, very rarely, some people who have died during an ETT.


A wart is a viral infection of the surface layers of the skin. The incubation period varies from a few weeks to several months. Warts can be spread by direct or indirect contact with a wart to damaged skin.


A corn is a small, hardened area of skin which often looks yellow compared to the surrounding skin. It is typically round or corn-shaped, pointing down into the skin. Corns most often form on the feet and sometimes on the hands and are caused by constant or repeated friction or pressure.


A callus is rough, thickened skin spread over a wide area. Like a corn, it caused by constant or repeated friction or pressure, but unlike corns, calluses are flat and have normal skin markings.

It is a clear, colorless fluid formed in the ventricles of the brain mainly by choroid plexus (an interlaced structure or meshwork of tiny small blood vessels in the lateral third and fourth ventricles). It is mainly an ultrafiltrate of plasma.

Waste products excreted from the digestive tract are composed of water (up to 75%), indigestible residue, undigested food, food which is digested but not absorbed, bile, epithelial cells, secretions from the digestive tract, inorganic material, and bacteria. The normal amount of feces in an adult is 100-200 grams per day. Examination of feces is helpful in the investigation of diseases of the gastrointestinal tract.

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