Background: Chronic obstructive pulmonary disease (COPD), the fourth leading cause of death in the world.Acute exacerbation of COPD has 10% mortality rate at admission and 1/3rd die within a year of hospitalization. Eosinopenia typically accompanies the response to acute inflammation or infection. The objective of this study was to know whether eosinopenia is an economical marker in predicting the outcome in patients hospitalized due to acute exacerbation of COPD.Methods: This is a prospective study conducted on 121 patients presenting with AECOPD satisfying inclusion and exclusion criteria admitted in hospitals attached to Bangalore Medical College and Research Institute. All necessary investigations were done. Patients with AECOPD were divided in two groups: One with eosinopenia and other without eosinopenia. Duration of hospitalization, need for mechanical ventilation and in-hospital mortality was assessed in both the groups.  Results: Among 121 patients with AECOPD, 56 were eosinopenic and 65 patients were non-eosinopenic. Majority of patients belonged to age group of 51-60 years with mean age was 62.06±10.783 years. Duration of hospitalization of patients with eosinopenia was 9.04±5.18 days and that of patients without eosinopenia was 6.15±2.89 (p value<0.001). Among them, 41 (73.2%) patients with eosinopenia and 21 (32.3%) patients without eosinopenia needed mechanical ventilation (p≤0.001). In-hospital mortality rates among eosinopenic and non-eosinopenic patients were 53.6% and 15.4% respectively.  Conclusions: There is a significant relationship between eosinopenia and outcomes of patients with AECOPD. Thus, eosinopenia is a useful, easy-to-measure, inexpensive biomarker for predicting the prognosis and outcome in patients with AECOPD.

Cryptococcosis is an important opportunistic fungal infection and also cause of death due to central nervous system disease among patients with human immunodeficiency virus worldwide. Most of the cases occur in immunocompromised patients like HIV infected people, people with organ transplants and on immunosuppressants. Nowdays there is increase in cases of cryptoccal meningitis among diabetic patients. Current case series includes cryptococcal meningitis among diabetic patients after ruling out of other immunocompromised states.

Background: Anaemia is one of the world’s most common preventable condition yet it is often overlooked especially in people with Diabetes Mellitus. Anaemia is a common finding in patients with diabetes. Anaemia in patients with diabetes mellitus might contribute to the pathogenesis and progression of cardiovascular disease and aggravate diabetic nephropathy and retinopathy. This aims to study the correlation between HbA1c and blood glucose levels in anaemic diabetics in order to assess the influence of anaemia on HbA1c and the effect of severity and type of anaemia on HbA1c.Methods: It’s a case control study, 200 Diabetic subjects were divided into two groups of 100 each based on their HbA1c levels group A, with good glycaemic control (HbA1c<7) and group B with poor glycaemic control (HbA1c>7), incidence of anaemia was measured and compared among them and also with 100 age and sex matched healthy non Diabetic controls. Results: In this study, it was found that high incidence of anaemia was found significantly higher in diabetics group with poor glycaemic control. Anemia was detected in 55% of patients among diabetic patients. Anaemia was seen in 71% of patients in group B with poor glycaemic control as compared to group A with good glycaemic control, in which only 39% of patients had anaemia. Mean haemoglobin was significantly lower that is, 10.81±3.0 in group with poor glycaemic control as compared to group with good glycaemic control i.e. 13.04±2.02. There was a statistically significant negative correllation between Haemoglobin percentage and HbA1c.Conclusion: Anaemia is a common finding in patients with diabetes. Diabetes related chronic hyperglycaemia can lead to a hypoxic environment in the renal interstitium which results in impaired production of erythropoietin by the peritubular fibroblasts and subsequently anaemia occurs. Anaemia in patients with diabetes mellitus might contribute to pathogenesis and progression of cardiovascular disease and aggravate diabetic nephropathy and retinopathy. However, an emphasis on regular screening for anaemia, alongside that for other diabetes related complications, might help to delay the progression of vascular complication in these patients.

Background: Diabetes mellitus (DM) refers to a group of common metabolic disorders that share the phenotype of hyperglycemia. The deficiency of C-peptide in type 1 DM or its excess in type 2 DM leads to the development of disorders which includes the cardiovascular, nervous, excretory and other systems. The present study is done to assess the serum C-peptide levels in newly detected diabetic patients and its significance in classification of diabetes and deciding about management.Methods: This cross sectional study was conducted within the hospitals attached to Bangalore medical college and research institute. 65 newly detected diabetes patients who gave consent for study and satisfy the inclusion criteria were included in the study. Data was collected using semi structured questionnaire, clinical examination and relevant investigations. Statistical analysis was performed using SPSS software. A p value of <0.05 was considered significant.Results: C-peptide levels showed that 34 (52.3%) subjects had C-peptide levels >2 followed by 10 (15.4%) subjects having 0.1 to 0.6, 9 (13.8%) subjects having 1 to 2, 6 (9.2%) subjects each having 0.6 to 1 and <0.1.Conclusions: Serum C-peptide levels are useful as an index of endogenous insulin production. Low C-peptide levels need insulin treatment due to poor insulin reserve. Majority of the subjects, who had low serum C-peptide levels also had low BMI suggesting a positive correlation between C-peptide levels and BMI.

The prognosis of HIV infection has significantly changed following the introduction of highly active anti-retroviral therapy by reducing AIDS related morbidity and mortality. At the same time, HAART is documented for its side effects. Gynaecomastia is a less documented side effect of a commonly used ART drug efavirenz. There are only few case reports of HAART-induced gynaecomastia in resource limited settings. Initially gynaecomastia related to HAART in HIV patients was thought due to lipodystrophy and was termed as pseudogynaecomastia. Later, few case reports of efavirenz related gynaecomastia were published after ruling out other causes of gynaecomastia. All other causes of gynaecomastia were ruled out in our patients too. The incidence of gynaecomastia is increasing in men with HIV on HAART therapy, proper identification and management will promote better drug adherence. The present study presented a series of two cases that developed ultrasound confirmed gynaecomastia following efavirenz containing HAART.

Congenital heart defects and skeletal malformation syndrome is very rare syndrome. Most of the patients had germline mutations in ABL1 gene. A 30-year-old gentleman presented with history of congenital heart disease (ventricular septal defect) and skeletal malformations which are typical of CHDSKM. Patient also had congenital hemiplegia which is rare in CHDSKMS. Patient also had lactose intolerance since childhood. Patients were evaluated thoroughly to rule out other causes. Current report is one of the rare case reports of CHDSKMS, only few case reports have been published till now.