Burn injuries, generally have continued to attract the attention of researchers all over the world. Burn injuries rank among the most severe types of injuries suffered by the human body with an attendant high mortality and morbidity rate.1 Developing countries have a high incidence of burn injuries, creating a formidable public health problem. High population density, illiteracy, and poverty are the main demographic factors associated with a high risk of burn injury. The exact number of burn injury is diffi cult to determine. Judicious extrapolation suggests that in India, with a population of over 1 billion, 700 000 to

Background:The term "THYROID DIABETES" was coined in early literature to depict the influence of thyroid hormone excess in deterioration of glucose control. Although autoimmune thyroid disease is more prevalent in Type1 Diabetes mellitus as a result of their common origin, the prevalence of hypothyroidism and hyperthyroidism is supposed to be similar to that of general population in patient with type2 DM. The purpose of the study was to evaluate the prevalence of thyroid dysfunction in patients with type2 diabetes mellitus and to correlate thyroid abnormalities with insulin resistance and serum markers for autoimmune thyroiditis. Methods: 120 cases of type2 diabetes mellitus patients satisfying WHO criteria without pre-existing thyroid disease were included in the study. Thyroid function test, fasting serum insulin was done.HOMA-IR & HOMA-B (HOMA-Homeostatic model assessment) was calculated. Serum antithyroid peroxidase anibody (anti-TPO) and antithyroglobulin antibodies (anti-TG) and ANA were done. Results: Prevalence of thyroid dysfunction in type2 diabetes mellitus was 28.33% according to our study, which included overt hypothyroidism (15%), subclinical hypothyroidism (8.33%), secondary hypothyroidism (0.83%), overt hyperthyroidism (1.67%) and subclinical hyperthyroidism (2.5%). Anti TPO and anti TG antibodies were elevated in 62.07% cases of hypothyroidism, 40% cases of hyperthyroidism and 6.9% euthyroid cases of type2 DM. Anti TPO and antiTG antibodies were significantly raised in type2DM patient with hypothroidism than that of euthyroid (p value<0.0001).Compared to euthyroid diabetics, hypothyroid cases had lower values of insulin resistance markers like fasting insulin, HOMA-IR and HOMA-B. Hyperthyoid cases had higher values. Conclusion: Hyperthyroid diabetics have higher insulin resistance as fasting insulin, HOMA-IR, HOMA-B showed negative correlation with TSH. (p value<0.05).

A chronic anal fissure is a non-healing linear tear in the distal anal mucosa below the dentate line and is a painful entity. A fissure is defined as chronic when it fails to heal within Keywords-Lateral internal sphincterotomy, 2 % Diltiazem ointment, chronic anal fissure. I.INTRODUCTION A chronic anal fissure is a crack in the distal anal mucosa which often does not heal after an acute attack. Apart from it being a painful condition it has different modes of presentation such as bleeding per rectum, pain during defecation and pain during defecation with constipation. There are several factors for the development of chronic anal fissure like internal sphincter hypertonia, trauma due to passage of hard stools or diarrhoea episodes, paucity of blood supply, especially the posterior commissure, by the compression of inferior rectal artery. The paucity of blood flow prevents healing of anal fissure until the cycle of internal sphincter hypertonia and decreased blood flow is broken by muscle relaxants or surgery. There are different non-surgical treatments for chronic anal fissure including 2 % Diltiazem ointment topical application and also there are different surgical interventions including lateral internal sphincterotomy. The study was designed to compare the effect of medical management with topical 2 % Diltiazem ointment and surgical treatment by lateral internal sphincterotomy in case of chronic anal fissure with regards to ulcer healing, pain reduction, cessation of bleeding per rectum and incontinence.

Abstract

Maintenance of normal fluid-electrolyte balance is desirable for maintenance of homeostasis.Much is now known about the metabolism of sodium and potassium and their effects on the body when these electrolytes are deficient.