Much has been published on the characteristics of type 2 diabetes mellitus and its association with the epidemic of obesity. But relatively little is known about the incidence of lean diabetes, progression of disease and fate of the patients with low-normal body mass index (< 25). Studies in developing countries have shown that the clinical characteristics of these patients include history of childhood malnutrition, poor socioeconomic status, relatively early age of onset and absence of ketosis on withdrawal of insulin. In the United States, recent studies showed that the lean, normal weight diabetes is not rare especially among minority populations. They showed that these patients are mainly males, have higher prevalence of insulin use indicating rapid beta cell failure. They might have increased total, cardiovascular and non cardiovascular mortality when compared to obese diabetic patients. In this review, the epidemiologic and clinical features of lean diabetes are presented. The potential causal mechanisms of this emerging diabetes type that may include genetic, autoimmune, acquired and behavioral factors are discussed. The need for studies to further elucidate the causation as well as specific prevention and treatment of lean diabetes is emphasized.

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<p class="abstract"><strong>Background:</strong> Prior knowledge about temporal bone anatomy and extent of cholesteatoma may help the ENT surgeon to plan the surgery and avoid impending complications. This study aims to evaluate the role of pre-operative high resolution computed tomography (HRCT) in cholesteatoma and to compare HRCT findings with intra-operative findings.</p><p class="abstract"><strong>Methods:</strong> A diagnostic evaluation study was performed among 30 atticoantral cholesteatoma cases presenting in the ENT outpatient department of MES Medical College in Malappuram, Kerala over a period of one and half years. The intraoperative findings were considered as the gold standard to which the radiological features were compared and the sensitivity, specificity and predictive value of HRCT were determined.  </p><p class="abstract"><strong>Results:</strong> High sensitivity of HRCT was noted in detecting soft tissue in mesotympanum 94.4% and aditus ad antrum 94.1%. Low sensitivity 59% was noted in detecting stapes erosion when compared to malleus and incus erosions. Except in conditions of soft tissue in epitympanum, dural plate dehiscence and sclerotic mastoid, a high specificity of 100% was noted in all other findings.</p><p><strong>Conclusions:</strong> This study reaffirms the usefulness of HRCT in pre-operative evaluation of cholesteatoma-atticoantral type. </p>

Macrophage activation syndrome (MAS) is a systemic disorder with a high mortality, commonly associated with rheumatological conditions, but which can also occur as a complication of several infections. Here we present a case of MAS following Acinetobacter baumannii sepsis. Early institution of therapy with prednisolone, cyclosporine, colistin, and polymyxin resulted in a prompt clinical recovery. There are very few reported cases of Acinetobacter-related MAS that have been successfully treated.

Conclusion: Exploring and addressing barriers to potentially curative treatment options may help to improve survival in MPNs. Our population was significant for being primarily white and highly educated, limiting the generalizability. However, we identified many concerns patients have regarding transplant. These results can be validated and explored further in other settings such as focus groups.

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<p class="abstract"><strong>Background:</strong> Peritonsillar abscess is a life threatening infection which requires immediate attention and care. If not treated immediately it may lead to several complications. But the culture and sensitivity results can be obtained after a minimum of 72 hours and hence empirical antibiotic therapy is needed. The objective of the study was to study the microbiological profile of peritonsillar abscess and the antibiotic sensitivity pattern of peritonsillar abscess.</p><p class="abstract"><strong>Methods:</strong> This cross sectional study was carried out on 47 quinsy patients who attended the ENT OPD of a tertiary care hospital. Abscess was drained and the pus was sent for culture and sensitivity.  </p><p class="abstract"><strong>Results:</strong> 65.95% of the study population were males. prevalence of peritonsillar abscess was high in the age group of 21-30 (42.55%). Only one patient had bilateral abscess. Group-A beta hemolytic streptococcus was the common organism isolated followed by <em>Staphyloccus aureus</em>. Fluroquinolones and cefotaxime had a better sensitivity to nearly all the organisms.</p><p class="abstract"><strong>Conclusions:</strong> <em>Staphylococcu</em>s and <em>Streptococcus</em> were the highly prevalent organisms. Immediate empirical antibiotic therapy must be advocated after draining the collection.</p>