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Background: Poorly controlled diabetes mellitus as indicated by elevated glycated haemoglobin (HbA1c) levels is associated with increased cardiovascular risk. C–reactive protein (CRP), an important cardiovascular risk factor, is elevated in diabetics with poor glycaemic control than those with good control. The present study assessed the correlation between HbA1c and CRP levels.Methods: A prospective study was conducted in thirty type 2 diabetic patients irrespective of the disease duration and treatment; those with established target organ damage were excluded. HbA1c and hsCRP levels were measured at baseline; sugars were monitored monthly and medications optimised; at the end of six months HbA1c and hsCRP levels were measured.Results: Mean age of the study subjects was 58.7±8.6 years; At the baseline, all had poor glycaemic control (HbA1c >7%); 15 had hsCRP >3 mg/L. At the end of 6 months, 5 achieved good glycaemic control (HbA1c <7%); 10 had hsCRP >3 mg/L. Baseline median hsCRP was 3.33 mg/L (0.68, 15.9) and at the end of 6 months it was 2.08 mg/L (0.48, 9.12). Mean HbA1c at baseline and end line was 10.6±1.55% and 8.43±1.84% respectively. There was significant reduction in both the mean HbA1c and median hsCRP at the end of 6 months (p <0.001). Positive correlation was observed between HbA1c and CRP at baseline (r=0.32, p=0.10). However, this was not observed at the end of 6 months.Conclusions: There is positive correlation between the level of glycaemic control (HbA1c) and CRP levels; Better glycaemic control results in significant reduction in the hsCRP levels.

Introduction:: Stroke is a global health problem. Studies have shown that serum albumin level is an independent predictor of ischemic stroke outcome. In the present study we compared the serum albumin and the volume of infarct with the clinical outcome.

IntroductionMeningitis is a clinical syndrome characterised by infl ammation of the meninges surrounding the brain and the spinal cord. The classic triad of meningitis consists of fever, headache and neck stiffness. 1 Meningitis can be of infective or noninfective aetiology, occurring in any age group, with extremes of age being the most severely affected. The immune-compromised state also has high mortality and morbidity. The overall case fatality rate of bacterial meningitis in adult patients is around 30%. [2][3][4] Although encephalitis by definition involves the brain parenchyma, it may also involve the meninges as well, which is termed as 'meningoencephalitis'. From an epidemiologic and pathophysiologic perspective, encephalitis is distinct from meningitis, though on clinical evaluation both can coexist. The clinical presentation is encephalopathy with diffuse or focal neurological symptoms, including behavioural and personality changes, decreased level of consciousness, neck pain/ stiffness, photophobia, lethargy, generalised or focal seizures, acute confusion or amnesic states, and fl accid paralysis. 5 Organisms responsible for bacterial meningitis are Streptococcus pneumoniae, Neisseria meningitis, Group B streptococci, Listeria monocytogens and Haemophilus infl uenza type b. Most patients recover completely if appropriate antibiotic therapy is instituted promptly. Mycobacterium tuberculosis is another major cause, especially in developing countries. Tuberculous meningitis is a critical disease in terms of fatal outcome and permanent sequelae, requiring rapid diagnosis and treatment. 6 The term aseptic meningitis is used for all types of infl ammation of the brain meninges not caused by pusproducing bacteria. It is usually a benign syndrome. Viral and aseptic meningitis are terms used interchangeably as, not only viruses are a major cause, other noninfective causes are equally attributable to the development of meningitis. Worldwide causes of viral meningitis include enterovirus, herpes, mumps, measles and HIV, with enterovirus being the most common cause of viral meningitis.In the emergency setting differentiating bacterial meningitis from other causes, such as fungal, tuberculous, viral, Background Although there are numerous studies on meningitis and encephalitis separately, literature on meningoencephalitis is sparse. In this study we analysed the clinical pro le of meningoencephalitis and its clinical outcome.Methods Fifty adults diagnosed with meningoencephalitis from July 2014 to July 2015 in a tertiary care hospital in South India were studied prospectively and their clinical presentation, aetiology and outcome were analysed.Results Among 50 patients, 33 (66%) were male; 39 (78%) were <50 years of age. Fever was the most common presenting symptom in 41 out of 50 patients (82%), followed by headache (74%) and altered sensorium (62%); only 18 patients (36%) had all three classical symptoms. Twenty-eight out of 50 patients (56%) did not have neck stiffness. A majority of patients had acute-to-subac...

Introduction: Diabetes mellitus and depression are mutually aggravating conditions. Here we present a study on the prevalence of depression and their association with the control of the Type 2 diabetes patients above 40 years of age in a tertiary care center.

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Introduction: Diabetes is the leading cause of adult blindness due to retinopathy, end stage renal disease due to nephropathy and foot ulcers and lower limb amputation due to neuropathy. Serum uric acid levels independently predict the development of micro vascular complications. In this study, we analyse the association of serum uric acid with the micro vascular complications of diabetes. Material and methods: In this hospital based observational study, hundred diabetic patients were included; of which fifty had micro vascular complications, the remaining fifty had no complications. Blood investigations including fasting(FBS) and post prandial blood sugars(PPBS), glycosylated haemoglobin (HbA1C), and serum creatinine and serum uric acid were done in all patients. All the parameters were compared between the two groups. Results: Females presented with significantly higher complications as compared to males. The mean age of the patients presented with and without complications was 56.4 ± 9.3 and 59.9 ± 10.3 respectively. HbA1C had a positive correlation with the serum uric acid (SUA) (r=0.327, P = 0.001). Mean uric acid levels were higher among patients with complications (5.96 ± 2.16) compared to patients without complications (4.95 ± 2.04) which was statistically significant (P value =0.021). Patients with nephropathy and neuropathy had significant elevation in serum uric acid levels than those without; however this significance was not noted in those with retinopathy. Conclusion: Patients with micro vascular complications had higher levels of serum uric acid compared to those without complications. Also there was positive correlation between HbA1C and serum uric acid levels.

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