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Introduction:Diabetic nephropathy (DN) is a microvascular complication of diabetes. DN is clinically manifested as an increase in urine albumin excretion. Total white blood cell count is a crude but sensitive indicator of inflammation and studied in many cardiac and noncardiac diseases as an inflammatory marker such as acute myocardial infarction, stroke, and heart failure. In this study, the association of neutrophil-lymphocyte ratio (NLR) with DN is studied.Patients and Methods:It is an observational cross-sectional study. Totally 115 diagnosed type 2 diabetes mellitus patients were registered in this study. NLR was calculated by analyzing differential leukocyte count in complete blood picture. Albuminuria was tested by MICRAL-II TEST strips by dipstick method.Results:Totally 115 diabetic patients were registered. About 56 patients had DN and 59 had normal urine albumin. Mean NLR for a normal group is 1.94 ± 0.65 and in DN group is 2.83 ± 0.85 which was highly significant (P < 0.001). Estimated glomerular filtration rate (P = 0.047) and serum glutamate pyruvate transaminase (P < 0.001) were also significant.Conclusion:The results of our study show that there was a significant relation between NLR and DN. Therefore, NLR may be considered as a novel surrogate marker of DN in early stages.

Background:The informational continuity for a diabetic patient is of paramount importance. This study on a pilot basis explores the process utility of structured educational modular sessions grounded on the principle of near-peer mentoring.Methodology:Visual modules were prepared for diabetic patients. These modules were instituted to 25 diabetic patients in logical sequences. In the next phase, 4 persons of these 25 patients were designated as diabetic-diabetes ongoing sustainable care and treatment (DOST). Each diabetic-DOST was clubbed with two patients for modular session and informational deliverance during the next 7 days. Process analysis was performed with “proxy-indicators,” namely, monthly glycemic status, knowledge assessment scores, and quality of life. Data were analyzed by interval estimates and through nonparametric analysis.Results:Nonparametric analysis indicated a significant improvement in glycemic status in terms with fasting blood sugar (W = 78 z = 3.04, P = 0.002), 2 h-postprandial blood sugar (W = 54, z = 2.01, P = 0.035), and in knowledge score (χ2 = 19.53, df = 3; P = 0.0002). Quality of life score showed significant improvement in 2 out of 7 domains, namely, satisfaction with treatment ([difference in mean score = 1.40 [1.94 to 0.85]) and symptom botherness (difference in mean score = 0.98 [1.3–0.65]).Conclusion:Because of inherent methodological limitations and innate biases, at this juncture no conclusive statement can be drawn. Although, primitive process evidences indicate the promising role of the diabetic-DOST strategy.

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Introduction: Diabetes mellitus is one of the leading cause of mortality and morbidity worldwide. Type 2 DM is a complex group of disorders characterized by different levels of insulin resistance, impaired secretion of insulin , and increased production of glucose. The complications of diabetes mellitus are inuenced by the average level of blood glucose along with glycosylated hemoglobin. Serum ferritin is an indicator of iron store. Iron stores are associated with decrease in insulin sensitivity, insulin secretion and hence type 2 diabetes. Methods: This study was done in Department of Biochemistry in collaboration with Medicine Department of Gandhi medical college Bhopal. 160 previously diagnosed type 2 diabetes subjects (mean age 55.59±7.74 years) with mean BMI 30.14±3.48kg/m2 were taken and their Serum ferritin, Fasting Blood Sugar and Glycosylated Hemoglobin were measured. Results: It was found that serum ferritin was signicantly high in diabetic patients and serum ferritin had a positive correlation with increasing glycosylated hemoglobin and Fasting blood sugar. Conclusion:It was concluded that serum ferritin level can be used as an indicator of control of glycaemia in type 2 diabetes mellitus patients. HbA1C and Serum ferritin level can also be used as a marker to prevent complications of the disease.

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Acute kidney injury is one of the major conditions complicating the outcome of hospital admitted patients. Early detection and treatment of AKI can help reduce the mortality to a signicant level. The most common conditions succumbing to AKI are hypovolemia, sepsis, drug induced kidney injury, cardiac conditions (reduced cardiac output). Common co-morbid conditions associated are hypertension, diabetes, chronic debilitating conditions like CVA and CAD. OBJECTIVE- The study aimed at evaluating the etiological factors and co-morbid conditions associated with acute kidney injury in medical intensive care unit in tertiary care setting in central India. MATERIAL AND MATERIAL AND METHODS- Total 200 patients admitted in medical ICU were selected based on AKIN criteria. pre-exiting conditions like hypertension, diabetes, CAD, CVA were noted. Increase in serum creatinine >1.5 times or >0.3mg/dl and decrease in urine output <0.5ml/kg/h for 6-12 hrs were the criteria for selection. Patients were observed till the time of discharge or death. Data collected was analysed statistically. RESULTS-Out of the 200 enrolled in the study,81 patients were female and 119 males. Majority of the patients were found to be under the age group of 35-54 years with a total number of 101. Hypertension was found to be the major co-morbid condition with a patient load of 62, followed by diabetes, CVA, CAD with a patient load of 30,24and 5 respectively. Sepsis and shock were found to complicating majority of the illnesses and contributing 87.6% and 67.6% to the total mortality. Infective conditions like acute gastroenteritis and UTI were the most common causes with a total load of 76 and 15 respectively. Chronic liver disease and hemolytic conditions like malaria were found to contributing a lower patient load but higher mortality. Other causes found to be associated with AKI were found to be post natal cases, snake bite and poisoning. CONCLUSION- pre- renal causes were found to be the most common causes of AKI. Early recognition and vigorous management is the key to reduce mortality and long term complications