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Background: Diabetes is a most prevalent chronic disease and has reached to alarming stage in almost all developed and developing countries. Worldwide approximately four hundred millions of people are living with diabetes and it is a leading cause of death. Aims and objectives is to study effectiveness of addition of drug Teneligliptin to Metformin, Glimepiride, Pioglitazone combination in type II Diabetic patients.Methods: This was a cross sectional study carried out in the department of Medicine of a tertiary health care centre during the one year period i.e. January 2017 to January 2018 in the type II diabetic patients. Out of all type II diabetic patients 40 patients who were on the treatment for hypoglycemia with drugs Metformin, Glimepiride, Pioglitazone were selected out of these randomly 20 patients were continued on the previous treatment (Group B) and remaining 20 were given additional drug Teneligliptin (Group A). The statistical analysis was done by unpaired t-test and chi-square test analyzed by SPSS 19 version of software.Results: In this study Authors have seen that the average age in both the groups was comparable i.e. 36.78±6.74 and 38.92±5.87 (p>0.05, t=1.24, df=38), the sex ration was also similar in both the group (p>0.43, χ2=0.43, df=1) and the HbA1C was comparable at 1st Wk. 10±4.56 - 9.87±3.42 (p>0.05, t=1.023, df=38) and 4th Wk. 8±5.23 - 9.67±4.52 (p>0.05, t=1.0804, df=38) but significantly differed at 8th Wk. 7.12±2.34 - 9.92±3.56 (p<0.01, t=3.82, df=38), 12th Wk. 5.98±1.98 - 9.24±2.79 (p<0.001, t=4.26, df=38) respectively in Group A and B.Conclusions: It can be concluded from this study that the addition of Teneligliptin significantly reduced the HbA1c level at the end of 4th wk. and hence superior to conventional Metformin, Glimepiride, Pioglitazone only combination treatment.

Background: Laboratory biomarkers/radiological ndings are less expensive, faster and easier to obtain. As such, they have been the preferred modality to monitor and predict outcomes and prognosis of COVID 19. Present study was aimed to study laboratory bio markers, CT severity in patients, had mortality due to COVID19 at tertiary care hospital. Material and Methods: Present study was single-center, retrospective, case record based study, conducted among case records of patients of age ≥15 yrs, with COVID RT-PCR positive (oropharyngeal or nasopharyngeal swab) or HRCT-CHESTsuggestive of COVID 19. Results:Among 100 patients, died due to COVID 19 related complications. majority of patients were elderly, from > 64 years age group (55 %), male gender (68 %) had pre-existing morbidity such as Diabetes (53 %), Cardiovascular disease/ Hypertension (25 %), Chronic lung disease (11%). Complications such as Acute Respiratory Distress Syndrome (81 %), Septic shock (65 %), Disseminated Intravascular Coagulation (47 %), Acute Kidney Injury (17 %), Myocardial infarction (17 %) & Liver failure (11 %) were noted among non-survivor patients. Mortality was noted more in 06-10 days (37 %), followed by 11-15 days (26 %), 15-25 days (24 %), ≤ 5 days (9 %) & least was among admitted >25 days (4 %). In patients not survived in COVID 19 infection, raised levels of white blood cell count, neutrophils count, PT, aPTT, serum potassium, direct bilirubin, indirect bilirubin, total bilirubin, AST, ALT, LDH, CRP, D-dimer & procalcitonin while reduced levels of platelets, PaO2 (mmHg), SpO2 (%) were noted. Conclusion: Raised levels of white blood cell count, neutrophils count, PT, aPTT, serum potassium, direct bilirubin, indirect bilirubin, total bilirubin, AST, ALT, LDH, CRP, D-dimer & procalcitonin. while reduced levels of platelets, PaO2 (mmHg), SpO2 were major laboratory bio markers/CTseverity in patients who had mortality due to COVID19

BACKGROUND Real-time reverse transcription polymerase chain reaction (rRTPCR) test is the gold standard assay to diagnose Covid-19 in-spite of few concerns. The disease is suspected in patients presenting with clinical features suggestive of Covid-19 supported by laboratory markers and imaging studies. We describe a case series of ten patients suspected to have SARS CoV-2 infection but RTPCR negative. METHODS We carried out a retrospective observational study of patients who presented with clinical features suggestive of Covid-19 but were RTPCR negative. As dedicated Covid hospitals, RTPCR negative patients were not admitted because of overload. We admitted such patients in isolation ward in non Covid hospitals, evaluated them further with laboratory biomarkers, and imaging studies. All patients were categorised in disease severity and were managed according to guidelines of Ministry of Health and Family Welfare (MoHFW) India. RESULTS Our case series included ten patients with a mean age of 55.1 years and the male to female ratio was 1.5:1. All patients (100 %) were suspected to have SARS CoV2 infection. Commonest symptom was fever in all (100 %) and least common was diarrhoea in 30 % patients. Mean SpO2 was 92.5 % on pulse oximeter (range 91 to 94 %). The laboratory findings showed (median): white blood cell count 9400 / cumm, N / L ratio 3.78, C-reactive protein (CRP) 46.21 mg / L, D-dimer 465 ng / mL, lactate dehydrogenase 499.59 U / L, serum ferritin 160.55 ng / mL, interleukin 6 31.6 pg / mL. Chest radiograph showed patchy non homogenous opacities in lungs in 6 (60 %) out of 10 patients, high resolution computed tomography (HRCT) chest revealed peripheral ground glass opacities (GGOs) in 10 (100 %) patients, Coronavirus Disease 2019 Reporting and Data System (CORADS) score was 5 in 8 (80 %) patients and less than 5 in 2 (20 %) patients. CONCLUSIONS In current pandemic, patients presenting with clinical features suggestive of Covid19, but RT-PCR negative should be suspected to have SARS CoV-2 infection, further evaluation with laboratory markers and imaging study help in diagnosis. Managing and monitoring according to MoHFW guidelines show good clinical recovery. KEYWORDS Corona Virus Disease (Covid-19), Real-Time Reverse Transcription Polymerase Chain Reaction (RT-PCR), High Resolution Computed Tomography (HRCT), Chest X-Ray (CXR)

BACKGROUND Global epidemic of obesity has highlighted the magnitude of the risk associated with this disease. Obesity is associated with risk of not only type 2 diabetes mellitus but other non-communicable diseases. Obesity is well documented and modifiable risk factor. Other diseases e.g. hypertension, diabetes etc., in presence of obesity have overall increased mortality. Both central and general obesity are associated with type 2 diabetes, central obesity being more commonly associated with T2DM. India is facing rapid surge of diabetes and obesity correlating with rapid economic growth in last few decades. Better glycaemic control is achieved with appropriate weight management. Non-expensive tool like body mass index and waist circumference are used to identify obesity. Detecting and addressing it will reduce morbidity and mortality along with reduction of socioeconomic burden of society. MATERIALS AND METHODS Prospective study was carried out in diabetes clinic in Karad Tahasil from Maharashtra. Patients attending from February 2015 to October 2018 were enrolled. There anthropometric measurements as height, weight, waist circumference were taken after their informed consent. Body mass index was used to decide general and waist circumference central obesity. Data analysis was done with t-test and Chi-square. RESULTS The results showed 48.5% males and 56.5% females were having general obesity (p=0.067), and 60.7% males and 82.3% females were having central obesity. Surprisingly our study shows 24.9% (25.8% males, 23.8% females) were diabetic in spite of normal BMI. Females outnumber males to have both general and central obesity. CONCLUSION Both general and central obesity are strongly associated with type 2 diabetes mellitus, females outnumbering males in both. Timely management of obesity will help for better glycaemic control, and reduction in mortality. Appropriate weight management in our health care is need of the hour.