Neuromedin U (NmU), a multifunctional neuropeptide, belongs to a family of neuropeptides, the neuromedins. It is ubiquitously distributed with highest levels found in the gastrointestinal tract and pituitary. The conservation of structural elements of NmU across species, the widespread distribution of NmU and its receptors throughout the body point to a fundamental role in key physiological processes. Two G protein coupled receptors for NmU have been cloned NmU R1 and NmU R2. NmU R1 is expressed pre-dominantly in the periphery especially the gastrointestinal tract whereas NmU R2 is expressed pre-dominantly in the central nervous system. Current evidence suggests a role of NmU in pain, in regulation of feeding and energy homeostasis, stress, cancer, immune mediated inflammatory diseases like asthma, inflammatory diseases, maintaining the biological clock, in the regulation of smooth muscle contraction in the gastrointestinal and genitourinary tract, and in the control of blood flow and blood pressure. With the development of drugs selectively acting on receptors and knockout animal models, exact pathophysiological roles of NmU will become clearer.

Background & Objectives: Information on hepatitis C virus (HCV) infection, Hepatitis B Virus (HBV) and Human immunodeficiency virus in pregnant women in India is not much. This study was carried out to investigate the prevalence of HIV, HBV and HCV infection within an obstetric population in north India.Methods: It was a retrospective study which was conducted by analyzing the data of pregnant patients who delivered at Labour room of Obstetrics & Gynecology department of PGIMS, Rohtak over one year period i.e.01.01.2015 to 31.12.2015. All the pregnant patients who delivered were screened for HBsAg, Anti HIV antibodies and Anti HCV antibodies. A total number of 10,000 pregnant patients delivered in this one year time. Results:It was observed that 84 tested positive for HIV (0. 84%), 36 were positive for HBsAg (0.36%), 30 were positive for HCV (0.30%). The mean age and parity of these delivered patients was 22.50±8.8 yrs. Conclusion:With a prevalence of the HCV infection equivalent to elsewhere in the world but with no significantly associated risk factor, identification of HCV infection here poses a greater public health problem. In this situation, the modules based on selective screening for high risk factor analysis will fail to identify over half of the infected patients. Therefore, targeted screening is not appropriate and universal screening would present cost constraints especially in resource-poor countries. Further research is necessary to understand the causes and implications of this observation and to give future directions.

Introduction: The prevalence of chronic hepatitis C virus (HCV) infection has been estimated at between 1.2% and 1.7% in the adult global population whereas estimated figure in India is around 1% but there are no discrete studies for the same. The high cost and long waitlist in developed countries causes unnecessary delay but situation is totally reverse in Haryana, India where with efforts of government, treatment is free of cost to every resident and that too without any waiting period. Review of Literature: HCV, a single stranded RNA can go into chronic phase in 85% of patients and rest can clear this virus on its own. The patients who develop Chronic hepatitis C, after a prolonged period of ten to twenty years can develop cirrhosis in 5-20 % of patients. Few years back, the treatment was given with simple Interferon, followed by Pegylated Interferon & Ribavarin for 24 -48 weeks but after availability of Directly acting antiviral agents (DAA'S), interferon free era of treatment has started since December, 2015 in India. Summary and Conclusions: The main hindrance in treatment of chronic hepatitis C in developed countries is long waiting list and cost of therapy whereas in India, Haryana with help of Jeevan rekha Model, acts of commission has been removed and purchasing is done through open transparent tenders, thus free treatment to every resident has been made available to needy patients for controlling hepatitis C.

Background: Celiac disease (CD), is a chronic immune-mediated disorder of small intestine that occurs in genetically predisposed populations. It is characterized by permanent intolerance to wheat gliadins and other cereal prolamins. The epidemiology of CD has iceberg characteristics with more undiagnosed cases. The diagnosis of CD is currently based on both typical small bowel biopsy findings with clinical and serological parameters. Anemia secondary to iron, folic acid and vitamin B12 malabsorption is a common complication of celiac disease. Patients can also present with thrombocytosis, thrombocytopenia, leukopenia, venous thromboembolism, hyposplenism and IgA deficiency. Aims: This study conducted with aims to study presenting complaints of suspected cases of celiac disease and further correlate endoscopic duodenal biopsies with various clinical and serological parameters. Materials and Methods: The detailed clinical history and physical examination was done and then duodenum biopsies in hundred cases of suspected CD (on the basis of clinical and serological profile) were taken. Histopathological diagnosis was established on routine hematoxylin and eosin stained sections. The histopathological grading was performed as per modified Marsh grading. Representative section was also subjected for immunohistochemically staining with antihuman CD3 antibody for evaluating intraepithelial lymphocytes. Comparison of these grades with the serological (anti tTG levels) and other clinical parameters (symptoms, weight, endoscopy and hemoglobin levels) were done. These data were subsequently analyzed using SPSS 20.0 software. Chi square test and other relevant statistics were used to assess the relationship between two variables. P-value less than 0.05 was accepted as statistically significant. Results and Conclusions: Majority of patients presented with typical gastrointestinal symptoms and anemia and significantly correlated with higher Marsh grades (p=0.0326) but atypical symptoms can be the primary presentation of the disease. Patients with higher serum anti-tTG levels, have a high-degree probability of duodenal damage. Anti-tTG levels have conclusively been proven to correlate with increasing histological grades (p=0.005).

Case report: We present a young female of fourteen years who was admitted to the hospital with short duration of Icterus, malaise, vomiting and diagnosed to be having acute hepatitis B. She went into acute liver failure as evidenced by development of hepatic encephalopathy and coagulopathy. She was managed on lines of hepatic encephalopathy along with oral antiviral treatment. She recovered successfully and was discharged after two weeks in heamodynamically stable condition. After a gap of six months, she became Hepatitis B surface (HbsAg) & hepatitis B e-antigen (HbeAg) negative and Hepatitis B Virus DNA (HBV DNA) was undetectable with normal liver function tests. She is on regular follow up for last one year and is absolutely normal. Conclusion: Acute hepatitis B can go into acute liver failure in 1% of cases, treatment for which includes liver transplantation and oral antiviral treatment which is especially helpful in cases who cannot afford liver transplantation, as was in our case.