Background: Acute falciparum Malaria infected patients show wide ranges of metabolic derangement including changes in serum lipid profiles. The exact mechanisms of this derangement in serum lipid profiles are still poorly understood. Objective was to study the lipid profiles among acute plasmodium falciparum infected patients.Methods: It was a Prospective observational comparative study. A total of 100 patients were consecutively taken in the study. Fifty Non- malaria febrile cases and 50 healthy volunteers were taken as control group. Baseline lipid profiles were estimated in all cases at the time of admission and at the end of one week. Data were collected and analyzed.Results: There were 100 diagnosed cases of falciparum malaria and 50 non malarial febrile and 50 healthy volunteers taken as control group. Complications was present in 50 and 50 were uncomplicated. Serum total cholesterol, HDL and LDL levels were significantly low in falciparum malaria patients, and serum TG and VLDL levels were higher than control. There were no significant changes in mean serum lipids profiles in survived and deaths cases.Conclusions: The derangement in lipid profiles in falciparum malaria was characteristic and specific for the disease. Characteristic changes were lower HDL, LDL and total cholesterol levels and higher TG and VLDL levels in comparison to control groups. Changes are more pronounced in complicated falciparum Malaria and persisting till the end of the week. These findings may be of diagnostic and prognostic value.

Background: Intracerebral hemorrhage (ICH) and Ischemic strokes (ISCHS) can occurs along with many metabolic abnormalities in acute stage. Electrolyte disturbances can occurs in acute stage of strokes due to many causes. The aim of the present study is to observe the clinical profiles, electrolytes status in acute stage of strokes and their outcome.Methods: One hundred stroke patients diagnosed clinically and confirmed by CT or MRI within 24 hours of onset were consecutively selected for the study after fulfillment of inclusion criteria in the indoor department of medicine, VSSIMSAR, Burla, Odisha (India), from Nov 2015 to Nov 2017. Baseline Glasgow Coma Scale (GCS), serum electrolytes were estimated along with other biochemical tests as needed. Glasgow Outcome Scale (GOS) was determined after 5th day of strokes.  Data were collected and analyzed.  Results: Hyponatraemia present in 13 (36.11%) of ICH and 6 (2.38%) ISCHS. Hypokalaemia was present in 7 (9.44%) of ICH and 11(17.19%) ISCHS. Hypocalcaemia was present in 3 (8.33%) of ICH and 18(28.12%) ISCHS. (P 0.0001). Hypomagnesaemia in 2(5.56%) ICH and 21 (32.81%) ISCHS. (P 0.0001). Minor GCS in 38 (62.29%), moderate 15 (24.59%) and severe 8(13.12%) patients with dyselectrolytemia versus 31 (79.48%), 5 (12.82%) and 3 (7.7%) with normal electrolytes respectively. GOS was good in 30 (49.18%), poor 18 (29.51%) and GOS 1 (Deaths) 13 (21.31%) versus 32(82.05%), 5(12.82%) and 1(1.3%) in patients with normal electrolytes status. (P 0.03).Conclusions: E Hyponatraemia and hypoklaemia was very often present in ICH and hypocalcaemia and hypomagnesaemia in ISCHS, Higher rates of morbidity and mortalities was associated with dyselectrolytemia.

BACKGROUNDDiabetes mellitus has primarily centered around the insulin deficiency owing to pancreatic beta-cell dysfunction or loss and associated insulin resistance. Recently, numerous findings indicate that defect of glucagon secreting alpha-cell get involved with development and exacerbation of hyperglycaemia in both type 1 and type 2 DM. Aberrant α-cell responses exhibit both fasting and postprandial hyperglucagonaemia contributes to fasting and postprandial hyperglycaemia caused by inappropriate hepatic glucose production owing to blunted α-cell suppression. Thus, blockade of glucagon receptor or suppression of glucagon secretion from α-cell would be novel therapeutic target for control of hyperglycaemia. There have not been remarkable advances in developing new class of drugs, currently glucagon-like peptide-1 and dipeptidyl peptidase-4 inhibitors and amylin agonist are available targeting alpha-cell dysfunction for the treatment of diabetes mellitus.

Background: The first important step is to decide whether the pleural effusion is transudate or exudates by Light’s criteria. Light’s criteria can misclassify 25% of pleural transudates as exudates. Pleural fluid cholesterol level can differentiate transudates from exudates as a single parameter instead of multiple parameters used in Light’s criteria. Measurement of pleural fluid cholesterol levels to differentiate transudative effusions from exudative effusions.Methods: Consecutive 60 cases of pleural effusion were taken in the study. Pleural fluid analysis was done for parameters of Light’s criteria along with pleural fluid cholesterol levels. First exudative and transudative effusion was classified by Light’s criteria. Other  clinical and relevant  biochemical tests were done to arrive in  the final etiological diagnosis  and data were collected and analysed .Pleural fluid cholesterol levels was  correlated to Light’s criteria.Results: Total 60 cases of pleural effusion were there in the study. There were 43 exudative and 17 transudative effusions. Mean cholesterol level was 64.2± 7.5mg/dl in exudative effusions and 26.05±8.01 mg/dl in transudates. Pleural fluid cholesterol was ≥55mg /dl in 43 cases of exudates and <55mg/dl in 17 cases of transudates.Conclusions: Pleural fluid cholesterol level of ≥ 55mg/dl had similar sensitivity and specificity to Light’s criteria and as a single important parameter to differentiate exudative from transudative pleural effusion

Background: Type 2 diabetes mellitus (T2DM) have multiple pathophysiologic defects contributing to hyperglycemia. T2DM patients have insulin resistance with progressive β-cell failure and progressive insulin secretion defect. Dipeptidyl peptidase-4 (DPP-4) inhibitors target the incretin system. saxagliptin is a DPP-4 inhibitor slowing the degradation of Glucagon-like peptide-1 (GLP-1) and Glucose-dependent insulinotropic peptide (GIP) sustain the incretin effects. Aim was to know the add-on effects of saxagliptin among uncontrolled T2DM.Methods: A total of 71 uncontrolled T2DM patients on various antidiabetic therapies except incretin mimetic were consecutively selected for the study. Baseline fasting plasma glucose (FPG), 2hour postprandial glucose (PPG) and glycated hemoglobin (HbA1c) was measured. Saxagliptin orally 5mg/day was given after approval of ethical committee and FPG, 2hour PPG and HbA1c was measured at 12 weeks and 24 weeks. Data were collected and analyzed by ‘t’ test using SPSS software version 25.Results: Baseline FPG, 2hour PPG and HbA1c was 158.4±13.9mg%, 252.6±24.4mg% and 8.6±1.3% respectively. Percentage of patients achieved HbA1c of <7% at 12 weeks was 16.9% and 43.6% at 24 weeks (P <0.05). Adjusted mean difference in HbA1c was 0.73% at 12 weeks and 1.2 % at 24 weeks (P <0.05). Reduction of mean FPG, 2hour PPG and HbA1c was 154.48±13.8mg%, 240.31±26.8mg% and 7.93±1.1% at 12 weeks and 151.15±13.7mg%, 231.7±27mg% and 7.38±1% at 24 weeks respectively (P <0.05). Patients on insulin were better responded.Conclusions: Add-on saxagliptin improves all parameter of glycemic status in uncontrolled type 2 DM patients.