One of the complications of brucellosis is infective endocarditis, which carries a high mortality rate if undiagnosed or misdiagnosed. We report a case of Brucella infective endocarditis, which was diagnosed serologically and by polymerase chain reaction. After Brucella specific treatment, patient showed dramatic improvement clinically, as evident by echocardiogram findings and other investigations.

BACKGROUND AND OBJECTIVES: Earlier diabetes mellitus (DM) was the disease thought to be the disease of elderly but at present there has been a trend towards shift in the mean age of onset of type 2 diabetes to a much younger age. This rise in prevalence has been attributed to changes towards a western lifestyle, obesity and family history. The Indian diabetic risk score (IDRS) is simple and easily applicable for screening of DM. This study was undertaken to evaluate the risk of DM among medical students likely versus not likely to develop Type 2 DM. METHODOLOGY: The present one year cross-sectional study was carried out in the Department of Medicine of a tertiary care centre situated in South India from January 2014 to December 2014 on 200 medical students aged >18 years. Assessment of diabetes risk was based on IDRS a simple questionnaire consisting of four simple parameters i.e. age, obesity status, exercise status, and family history of type 2 DM. RESULTS:The fasting blood sugars level were found to be between 100 to 125mg/dL in 24.5% of the students and 16.5% of the students had HbA1c between 5.5 to 6.4 while one student had HbA1c >6.5 suggesting diabetes mellitus. The risk of developing DM was low in 82.5%, moderate in 16.5% and high risk in 1% of the students. There was positive association between diabetes risk based on IDRS score and FBS, HbA1c and body mass index. Among the 35 students with moderate and high risk of DM, 31.43% had raised LDL, 68.57% had abnormal HDL while triglycerides and total cholesterol were raised in 11.43% and 8.57% respectively. CONCLUSION: Individuals above 18 years should be screened for the presence of risk factors including physical activity, obesity and family history of diabetes mellitus using IDRS which will not only help to predict the risk of developing DM but also helps in prevention.

A 40-year-old farmer from the district of North Karnataka who had received treatment for high fever of 8 days duration was admitted with fever, dyspnea, and poor general condition. Ultrasonography and echocardiogram revealed multiple splenic abscesses, vegetation on atrioventricular valve, aortic regurgitation (Grade I–II), and mitral valve regurgitation (Grade II–III), respectively. Brucella melitensis was detected in blood culture, and high titers of IgM and IgG anti-Brucella antibodies were observed in Brucella specific serological tests. The patient developed fulminant septicemia and succumbed due to multi-organ failure.

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OBJECTIVE: To assess the insulin resistance in offspring's of type 2 diabetes mellitus patients, with off springs of non-diabetic patients. METHODOLOGY: The study included offspring's of 30 diabetic and 30 non-diabetic patients with a proper clinical examination according to predesigned and pretested proforma. Mean age, insulin levels, Homeostasis model assessment-insulin resistance (HOMA-IR) and BMI of the two groups were compared using unpaired't' test. Chi-square test and Kruskal Wallis test were used to test the association between two or more variables in case of frequency distribution. RESULTS: It was observed that the offspring's in case group had higher insulin levels compared to control group. Insulin resistance was found to be 48.5% in case group and 19.4% in control group which was considered is statistically significant (p=0.009). Insulin resistance was seen in 47.05% offspring's whose fathers were a diabetic, 41.6% offspring's whose mother were a diabetic and 66.6% offspring's had history of both parents being diabetic. However, the p value was not statistically significant (p=0.597).