Diabetes mellitus is the most common metabolic disorder in the world. In India, the prevalence rates of diabetes has increased dramatically since the first national survey was undertaken (1971)

BACKGROUNDAcute Pancreatitis (AP) is a common disorder with substantial burden on the healthcare system. The clinical course of AP is usually mild and often resolves without sequelae. Early, quick and accurate risk stratification of AP patients would permit evidence-based early initiation of intensive care therapy for patients with Severe AP (SAP) to prevent adverse outcomes and allow treatment of mild AP. Therefore, a reliable risk stratification tool to predict the severity and prognoses of AP is of great clinical importance for the management of this disease.The aim of the present study is designed to compare the accuracy of BISAP to the traditional multifactorial scoring systems-APACHE II and CTSI in predicting disease severity, PNec and mortality. MATERIALS AND METHODSThe present prospective observational study is carried out for a period of 2 years. 100 consecutive patients with acute pancreatitis according to inclusion and exclusion criteria were taken and were fully explained regarding the study and written informed consent was taken. Detailed case history and clinical examination was done. Vitals and GCS score were recorded. Necessary laboratory investigations were done. CECT of abdomen was done. RESULTSIn the present study, among 100 patients, 60% are males and 40% are female patients. Mean age group of patients in present study is 37.82±10.73 years. The commonest aetiology alcohol accounted for 61% cases followed by idiopathic in 20% and gallstones in 16% cases. Severe acute pancreatitis developed in 20% of patients. Pancreatic necrosis developed in 14% of patients. In the present study, mortality is 6%. All the scoring systems are found to be comparable and good in the prediction of severe acute pancreatitis (AUC for BISAP -0.80, APACHE II -0.81, CTSI -0.79). CTSI is more accurate (AUC -0.96) in predicting PNec when compared to BISAP (AUC -0.91) and APACHE II (AUC -0.84). APACHE II is excellent (AUC -1.00) in predicting mortality. CONCLUSIONThe present study concluded that all the scoring systems were found to be comparable and good in the prediction of SAP, whereas CTSI is more accurate in predicting PNec and APACHE II was excellent in predicting mortality.

Introduction: Urosepsis is a serious, life-threatening consequence of a complicated Urinary Tract Infection (UTI). It is caused by bacterial infection of the urinary tract or prostate that spreads into the bloodstream. Since urosepsis is associated with a very high mortality rate (20-40%), an early diagnosis and identification of the causative bacteria is important so as to facilitate a prompt treatment with appropriate antibiotics. Nearly 50% cases of urosepsis are caused by the Gram Negative Bacterial (GNB) pathogen, Escherichia coli(E. coli). Aim: To determine the bacteriological profile, antimicrobial susceptibility pattern, phenotypic resistance of the organisms associated with urosepsis and to correlate the levels of proinflammatory markers with the clinical outcome of the patient associated with urosepsis. Materials and Methods: This was a prospective observational study including all patients with simultaneously positive urine and blood cultures, with identical bacterial isolate(s). The details of clinical presentation, antibiotic therapy and other relevant information such as C-Reactive Protein (CRP) and Procalcitonin (PCT) values were recorded and analysed using Microsoft office excel 2013. Results:E. coli was the commonest isolate (43/53, 81.1%). Of the total 43 E. coli isolates, 4/43 (9.3%) were Extended Spectrum Beta Lactamase (ESBL) producers and 23/43 (53.49%) were Carbapenemase producers. Significant rise of the proinflammatory markers (PCT>10 ng/mL) and (CRP>100 mg/l) were associated with high mortality (49%). Out of the 53 patients, 43.4% (23/53) patients had more than one risk factor associated with severe sepsis and poor prognosis. conclusion: Early recognition of symptoms followed by accurate diagnosis and early goal directed therapy is essential to decrease morbidity and mortality from urosepsis.

Introduction: Post-operative pain and discomfort are unavoidable after orthopaedic surgeries. Effective pain management is an essential component of post-operative care. Aromatherapy is one of the popular complementary therapies used with pain management in various medical conditions. Methods: A quantitative research approach with the true experimental study with pre-test post-test control group design was adopted with sixty patients (Control -30, Experimental-30) who were selected using a simple random sampling technique. The data was collected using the baseline and clinical variables, numerical pain scale, and discomfort intensity scale. Results: In the experimental group, the mean and S.D of pain on the 1st day was 7.97+1.38 and in the post-test was 6.13+ 1.74. And the 3rd-day pre-test was 2.70+1.51 and the post-test was 1.53+1.14. And the mean and S.D of discomfort on the 1st day was 19.7+4.7 and in the post-test was 14.07+3.93. And 3rd-day pre-test was 2.70+1.51 and post-test was 1.53+1.14 in the experimental group. The repeated measures of ANOVA indicated that there was within the group difference of pain (F=314.7, p=0.001), and discomfort (F=23.21, p=0.001) scores were decreased over time (pre day1-post day3) in the experimental group. Conclusion: This present study showed a significant positive effect of aromatherapy in the reduction of pain and discomfort among orthopaedic surgical patients.

Background: Asthma is a chronic life-threatening disease as the airways in the lungs often swollen or inflamed, which makes the airways very sensitive. So, the exposure to the environment in day-to-day life triggers asthma. Asthma can affect at any age group. This study mainly focuses on comparing the effects of Buteyko breathing technique and Pranayama on improving Pulmonary Function in subjects with Bronchial Asthma. Method: Total of 79subjects selected, out of those 66 subjects were included after obtaining the consent document. Subjects are divided into two groups by lottery method, in which 6 subjects dropped. So, the study was completed with 60 subjects. Both groups performed intervention for 1 hour a day 5 days week for 4 weeks. The outcomes of the study were FEV1, FVC & FEV1/FVC ratio. Results: Paired t test was used to assess statically significance between pre and post test scores with in the groups, independent t test was used to access statistical significance of post-test mean score between the groups, statistical analysis of the data revealed that Buteyko Breathing technique group has more difference when compare to Pranayama group. Conclusion: The results had shown that both Group-A (Buteyko Breathing Group) and Group-B (Pranayama Group) has improved significantly on pre and post-test values within the groups but when compared between the groups statistical significance is noted in Group-A. So, this study concludes that Group-A showed significant improvement on Pulmonary Function in subjects with Bronchial Asthma. Keywords: Buteyko Breathing technique, Nadishuddhi Pranayama, FEV1/FVC, Bronchial Asthma.