Introduction:Diabetes mellitus is present in as many as 30% of patients hospitalized with acute coronary syndromes. It has been recognized for some time that diabetics experience a greater mortality during the acute phase of myocardial infarction and a higher morbidity in the postinfarction period. The main contributory factors for these complications are uncontrolled diabetes mellitus and dyslipedemia. HBA1C level is gold standard in knowing control of diabetes mellitus and its complications. The lipid abnormalities in uncontrolled diabetes mellitus contribute to cardiovascular and peripheral vascular complication morbidity and mortality. Aims: To study the level of HbA1C and Lipid profile in patients with Acute Myocardial infarction and correlate the findings with existing literatures. Material and methods: Present prospective observational study was conducted on 100 patients admitted to the hospital with acute myocardial infarction with or without diabetes mellitus. After a detailed history and physical examination, HbA1c, lipid profile, cardiac enzymes, ECG were performed in all patients. The patients were then divided into two groups based on the HbA1c levels i.e. good glycemic control (HbA1c< 7%) and poor glycemic control (HbA1c>/= 7%). Pearson's correlation coefficient was used to examine the association between various parameters; the linear regression graph was used. Results: Poor glycemic control was seen in 60% patients. HbA1C showed a direct correlation with triglycerides, total cholesterol, low density lipoproteins levels and indirect correlation with high density lipoproteins levels. Conclusion: HbA1C provides valuable supplementary information about the extent of circulating lipids besides its primary role in monitoring long-term glycaemic control.

BACKGROUND Pyogenic meningitis is one of the most common infectious disease emergencies involving the central nervous system with higher incidence in developing countries than developed nations. Despite the large number of pathogens that have been reported to cause acute pyogenic meningitis, certain microorganisms are isolated with higher frequency depending on patient's age, immune status and geography. Present study was aimed to determine the trends in aetiology and spectrum of the bacteriological profile in adult patients with suspected pyogenic meningitis in NorthEast India. MATERIALS 50 CSF samples from as many patients of Acute Bacterial Meningitis over a period of one year were processed for cell counts, biochemical analysis, gram staining, culture, antigen detection by latex agglutination test and antibiotic susceptibility tests, as per standard techniques. OBSERVATION CSF cell counts showed neutrophilic predominance in all cases along with high protein and low sugar levels. 44% of the cases were culture positive and latex agglutination test was positive in 46.4% of the cases where culture was negative. S. pneumonia was the predominant pathogen identified in the present study in 12(24%) cases, followed by Pseudomonas and E. coli in 5(10%) cases each. Gram stain indicated the causative organisms in 68.2% of the culture positive cases. Among the culture negative patients gram stain indicated the causative organism in 3(10.7%) cases and these three cases were positive by LAT also. CONCLUSION Simple, rapid, inexpensive tests like gram staining remain significant means for diagnosis of acute pyogenic meningitis in developing countries. LAT goes a long way in identifying the organisms where the cultures are negative. This study thus paves the way for larger studies in this region for better recognition of the predominant organisms and the empirical antibiotic regimens.

BACKGROUNDOrganophosphorus (OP) pesticides are arguably one of the most common cause of morbidity and mortality due to poisoning worldwide especially in developing countries like India, where agriculture is the backbone of the economy. Organophosphorus pesticides poisoning can result from intentional, occupational or accidental exposure. The primary toxicity from these compounds is derived from excessive stimulation of muscarinic and nicotinic cholinergic receptors by accumulated acetylcholine in central and autonomic nervous systems as well as in skeletal neuromuscular junction. Patients with acute Organophosphorus poisoning are usually monitored by using serum acetylcholinesterase level which are expected to fall. It is not specific and does not correlate with the severity of poisoning and cannot be used as a prognostic indicator. Estimation of Creatine Phosphokinase is economical, and levels are increased both in acute as well as in intermediate syndrome and can be used as a low budget, easily available prognostic marker for acute organophosphorus poisoning.The aim and objective of the study is to assess serum Creatine Phosphokinase (CPK) level in acute organophosphorus poisoning and to find out the correlation of serum Creatine Phosphokinase (CPK) level with the severity of organophosphorus poisoning.

BACKGROUND Cardiovascular disease is commonly seen in patients with Chronic Obstructive Pulmonary Disease (COPD). Brain Natriuretic Peptide (BNP) is a marker of ventricular dysfunction and troponin T of myocardial necrosis. Elevations of these markers have been found in many disorders, COPD being one of them. The aim of the study is to assess the association of elevated cardiac biomarkers with the 6-month mortality in patients with Acute Exacerbation of COPD (AECOPD). MATERIALS AND METHODS 86 patients admitted with acute exacerbation of COPD were included in this prospective study. Cardiac Biomarkers-BNP and troponin-T were measured on admission. Patients were followed up for the next 6 months and mortality over this duration was recorded and analysed. Statistical Analysis-Pearson X 2 testing was used.

Background: Minimal Hepatic Encephalopathy (MHE) is now increasingly described in patients with cirrhosis without any overt abnormalities on clinical examination. The diagnosis of MHE is based on multiple tests including a combination of paper and pencil tests, computerised tests and neurophysiological tests. Aim of the study: To study the alpha wave patterns in patients with MHE as this has been sparsely reported in the literature. Methods: The study included 70 diagnosed cases of cirrhosis and an equal number of age and sex matched control who were subjected to two paper and pencil tests-NCT-A and DST along with EEG. Results and observations: Of the 70 patients included in the study, 56 (80%) was in CPC-A class. MHE was present in 52 (74.28%) cases of which 38 belonged to CPC-A class. In patients with MHE, alpha wave frequency (10.82 ±0.41Hz) was significantly lower than those in controls (11.52 ± 0.64 Hz) (p< 0.05). Alpha wave amplitude was lower in MHE patients (35 ± 2.78 µV) than in controls (48.18 ± 3.59 µV) (p < 0.05). The frequency and amplitude decreased with higher grades of CPC and higher NCT-A. No difference was noted in the pattern of other wave forms in EEG between patients with MHE and controls. Conclusion: A lower frequency and amplitude of alpha wave along with abnormal NCT-A can be predictive of MHE in cirrhosis.