INTRODUCTION:Chronic kidney disease is a worldwide public health problem. Chronic renal failure is defined by the National Kidney Foundation as either damage or a glomerular filtration rate less than 60ml/minute/1.73m 2 of body surface area for more than 3 months. The primary cause of anemia in patients with chronic renal failure is insufficient production of erythropoietin by the diseased kidneys. As there is paucity of data regarding the haematological changes in chronic renal failure in this region, the present study was aimed to achieve the following objectives. AIMS AND OBJECTIVES: 1. To assess the various hematological changes in chronic renal failure. 2. To assess the correlation between hematological and biochemical parameters. MATERIALS AND METHODS:The present study was conducted in the department of Medicine, in a tertiary care hospital, Assam for one year. STUDY DESIGN: Hospital based, single centred observational study. All patients with features of chronic renal failure, who were admitted in medicine wards, were taken randomly for the study. RESULTS: The series included 100 cases of which the highest number 37% were in the age group of 51-60 years. Male preponderance was observed with males being 65% and females 35%. Generalized weakness and swelling were the commonest symptoms observed in 76% and 74% cases and pallor, hypertension, pedal edema, ascites and acidotic breathing on examination were found in 85%, 70%, 57%, 17% and 17% cases respectively. 72% patients had serum creatinine between 5.1 to 10 mg/dl. A negative co-relationship was observed between serum creatinine and hemoglogin.All cases had anemia of which 52% had hemoglobin between 7 to 10 gm/dl, 61% had normocytic normochronic anemia and 20% had absolute iron deficiency. Diabetes was the commonest etiology in 42%, followed by hypertension 35%, undiagnosed 12%, chronic glomerulonephritis 7%, polycystic kidney and obstructive nephropathy in 2% each respectively. CONCLUSION: Anemia is the commonest haematological manifestation with normocytic normochromic anemia being the commonest morphological type. Absolute iron deficiency was significantly associated with chronic renal failure. Diabetes and hypertension were the commonest etiological factors. The concentration of haemoglobin showed negative correlationship with serum creatinine which was statistically significant.

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Hyponatremia is the most common electrolyte disorder in hospitalized patients in various clinical settings. Water intake and circulating Arginine Vasopressin constitute the two key effectors in the defense of serum osmolality; defects in one or both of these defense mechanisms cause most cases of hyponatremia. Hyponatremia and stroke are associated with poor outcome but outcome of hyponatremia in acute stroke is not well established and very few studies have been conducted in this regard and according to which the mortality ranges from 14%-44%. OBJECTIVE: This study aims to provide more data regarding impact of hyponatremia in acute stroke mortality. MATERIALS AND METHODS: The present study is a hospital based prospective, single Centre, observational study which was conducted in the

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BACKGROUND The worldwide prevalence of diabetes has risen dramatically over the past two decades from 30 million cases in 1985 to 382 million in 2013. Infections are of particular concern in diabetics. Benign prostatic hyperplasia and benign prostatic enlargement are the most common diseases in aging men which can lead to lower urinary tract symptoms. AIMS AND OBJECTIVE The objective of this study. 1. To study various risk factors associated with Urinary tract infections in Diabetes with prostatomegaly. 2. To study causative microorganisms and their drug susceptibility in diabetics with Urinary tract infections having prostatomegaly. MATERIALS & METHODS: STUDY SETTING A hospital based prospective observational study conducted for a period of 1 year. 50 indoor cases meeting inclusion criteria were selected. INCLUSION CRITERIA Diabetics having prostatomegaly presenting with urinary tract infection or positive urine culture were included. RESULTS Out of 50 patients 46% had bacteriuria, 82% were above 50 years. Longer duration of diabetes >6years were associated with bacteriuria in 59.37% in contrast to <6 years in 22.22% of cases. Significant higher bacteriuria was seen in group noncompliant to treatment than those of compliant group, 64% vs 28%. Association of bacteriuria were lower in patients with HbA1C <7% whereas no difference was observed in relation to fasting and postprandial blood sugar levels. Bacteriuric patients also had significantly high post voidal residue >150 ml in contrast to those with <150ml (56.75% vs. 38%) and greater size of prostate volume >40cc in comparison with volume <40 (57.57% vs 23.53%). E. coli was the commonest organism followed by klebsiella in 56.52% and 17.39% respectively and were sensitive to imipenem, cefepime, aminoglycoside, fluoroquinolones and nitrofurantoin. CONCLUSION Urinary tract infection is frequently encountered in diabetics with prostatomegaly. Elderly patients aged >50 years, longer duration of diabetes, non-adherence to treatment, insulin therapy and prostate volume >40cc could be considered as significant risk for bacteriuric urinary infection. Uncontrolled blood glucose with HbA1 C>7%, post void residue >150 ml and prostate volume >40 cc are associated with bacteriuria. E. coli is the commonest organism and imipenem, cefepime, aminoglycosides, fluoroquinolones and nitrofurantoin showed favourable response.