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Filariasis is a major parasitic infection, which continues to be a public health problem in India with most infections being caused by Wuchereria bancrofti. The area of lymphatic involvement and duration of infection usually determines the clinical presentation. It frequently presents as lymphadenopathy limited to inguinal region or as filarial lymphoedema of lower limbs. Unilateral mass is an extremely rare presentation of this condition. We report a case of filariasis presenting as axillary mass without peripheral eosinophilia, lymphadenopathy and microfilaremia.

Background: Immunization coverage remains very low among adults. Vaccine preventable diseases (VPDs) may have an unpredictable course in diabetes mellitus (DM) owing to their altered immune functions. The objective of the study was to analyse the knowledge, attitude, practices and behaviour of the healthcare professionals (HCPs) regarding the pneumococcal, influenza and hepatitis B vaccination in patients of type-2 DM.Methods: This was a community based, cross-sectional study focusing on HCPs who were involved in diabetic care and were aware about recommended guidelines of adult immunization program. 100 HCPs completed this survey which embraced various parameters involved in vaccine uptake.Results: Females constituted 34% of the participating HCPs. The HCPs with qualification of MBBS and MD were 51% and 49% respectively. MD HCPs were routinely vaccinating DM patient more than MBBS ones which was statistically significant. Difficulty in identifying patients eligible for vaccination was perceived by 53% of HCPs. Vaccination was believed to be more important in children than adults by 63% HCPs and 93% agreed that vaccination provided protection against VPDs. Perceived as barriers for vaccination were: urgent concerns of the patients (79%), lack of time for explaining (49%), vaccine safety (60%), cost of vaccine (58%), lack of records (65%), lack of recall system (62%), lack of educational material for patients (83%), lack of training for HCPs (75%) and lack of ‘standing orders’ (84%).Conclusions: Despite recommendations for adult immunization, there are many substantial lacunae in knowledge and practice among HCPs resulting in low immunization coverage. A structured approach encompassing education and training, identification and elimination of potential barriers and improving infrastructure and leadership is the need to curb the mortality and morbidity associated with VPDs in diabetics.

Background: The mortality and morbidity associated with acute pancreatitis (AP) demands timely management and prediction of disease progression and clinical outcome. Multifactorial scoring systems shall facilitate risk stratification and prognostic assessment in AP. Aims and Objectives: The aim of the study was (i) to assess C-reactive protein (CRP) levels and modified computed tomography severity index (mCTSI) in AP patients and their association with the clinical outcome and (ii) to determine the correlation between CRP levels and mCTSI scores in AP. Materials and Methods: This cross-sectional, hospital-based study comprised 90 patients diagnosed with AP. Data collection included sociodemographic information, clinical presentation, and CRP estimation. The mCTSI score was estimated by axial slices contrast-enhanced computed tomography of abdomen and was used to assess the severity of AP. Categorical data were analyzed by Chi-square test and Pearson’s coefficient was estimated to determine the correlation between CRP levels and mCTSI score. P<0.05 was adopted as level of significance. Results: The study comprised 81 males (90%) and 9 females (10%). The mean age of the patients was 36.94±9.19 years, with majority in age group of 31–40 years (40%). Alcohol consumption (>50 g/day) was the commonest risk factor in 82.22% (n=74) patients, followed by hypertriglyceridemia in 13.33% (n=12) patients. Pain in abdomen was the most common presentation in 96.67% (n=87) patients, followed by vomiting 57.78% (n=52) patients. Majority of patients [82.22% (n=74)] had CRP levels of 10–21 mg/dL. Mild, moderate, and severe mCTSI scores were obtained in 17.78%, 66.67%, and 15.55% patients, respectively. There is a significant positive correlation between CRP values and mCTSI scores with r=0.3008 (P=0.003). Conclusion: CRP level had significant positive correlation with mCTSI scores in AP. Higher values of CRP and severe mCTSI scores had worse clinical outcome in AP.