Background: Megaloblastic anemia is one of the frequently occurring diseases in a developing country such as India. Megaloblastic anemia occurs mainly because of vitamin B12 and folate deficiency, but in some cases, it may occur owing to the causes affecting the metabolism of vitamins or the defect in DNA synthesis. Very few studies have been conducted to study the prevalence of megaloblastic anemia in the general population. Objective: To find out the age-wise pattern with its clinical profile and response to the treatment. Materials and Methods: A cross-sectional, observational study was carried out at LG Hospital, a tertiary-care teaching hospital. The study was carried out during the period from August 2006 to May 2008. The patients who presented with clinical features of anemia in medical outpatient department between August 2006 and May 2008 were evaluated with complete blood count with RBC indices. Result: Incidence on megaloblastic anemia was the highest in the subjects aged between 40 and 49 years. Weakness and abnormal bowel habits were the common presenting symptoms. Pallor and glossitis were the most common clinical signs. About 94% of the patients presented with moderate to severe anemia. Almost all the patients showed a dramatic response in Hb level, mean corpuscular volume, and reticulocyte count. Conclusion: Vitamin B12 deficiency is not uncommon in India. This study will definitely help clinicians for the diagnosis and treatment of megaloblastic anemia.

Background: The spectrum of clinical picture of malaria ranges from the most benign febrile illness, which is completely curable with a simple course of chloroquine tablets to the most serious and life-threatening illness, even with very drastic therapeutic measures. That is the reason that has led to the studies from different parts the world to find out the clinical and laboratory parameters that may show a prognostic significance in this very common and frequently encountered condition. Objective: (1) To identify the various clinical and laboratory parameters showing prognostic significance in severe and complicated malaria; (2) to study the relationship of these factors with mortality and morbidity; and (3) to find out the therapeutic outcome with various antimalarial drugs in such severe and complicated malaria cases. Materials and Methods: A cross-sectional, observational study was carried out in LG Hospital, Ahmedabad. Adult patients of both the sexes admitted that clinical history suggestive of severe and/or complicated illness were included in the study. Result: In this study, 100 adult male and female patients were studied. The male to female ratio was 3:2. The maximum number of patients was in the age range of 31-40 years. The overall mortality in this study was 10%, with more number (25%) of older patients showing fatal outcome with severe and complicated malaria. Anemia (35%) was the most common complication but with less mortality. Only one patient with Plasmodium vivax lead to fatal outcome, but he also showed very high parasitemia (grade IV), and the cause of death was acute respiratory distress syndrome. Conclusion: Mortality is higher with Plasmodium facliparum malaria. Organ dysfunction is associated with higher mortality and is a sign of poor prognosis. Anemia, hypoglycemia, coma, convulsion, organ dysfunction, lactic acidosis hyperparasitemia, and leucocytosis are the prognostic factors in severe and complicated malaria as defined by the WHO. They are easily detectable and treatable and, hence, signify the importance of an early detection of these complications to decrease the morbidity and mortality owing to severe and complicated malaria.

Cardiovascular (CV) deaths are the most common cause of mortality in diabetes mellitus and India is one of the leading countries with one of the highest number of patients with diabetes mellitus. Patients with diabetes mellitus who have been identified with peripheral arterial disease (PAD) are more prone to the sudden ischemia of arterial thrombosis. [2] Diabetes mellitus is associated with high risk of cardiovascular diseases and PAD when compared to those without diabetes mellitus. Hence, physicians should aggressively manage all CV risk factors in people with diabetes mellitus. [3] Dyslipidemia is one of the most important risk factor for PAD that co-occurs with type 2 diabetes mellitus in more than 70% patients and the typical pattern of dyslipidemia is known as diabetic dyslipidemia. PAD is a common complication of both type 1 and type 2 diabetes mellitus. PAD occurs earlier in individuals with diabetes mellitus than in those without it, which is often more severe and diffuse. [4] Background: Diabetes mellitus is rapidly rising. Majority of patients with diabetes mellitus also have dyslipidemia [diabetic dyslipidemia (DD)]. DD has been found to be associated with increased risk of peripheral arterial disease (PAD). Objective: To use ankle-brachial index (ABI) to evaluate the prevalence of PAD and to identify the associated risk factors and their level of control in patients with diabetes mellitus. Materials and Methods: This cross-sectional study was carried out in tertiary-care teaching hospital of Gujarat. People attending diabetes clinics were screened for PAD by measuring their ABI. In addition, their medical records were reviewed for PAD risk factors, including age, smoking, blood pressure, glycated hemoglobin, and lipid profile. Association between serum lipid profile and PAD was analyzed. Result: Total 50 patients were enrolled in this observational study. Of these, 16 were (32%) women and 34 (68%) were men aged 25-72 years. Of total 50 patients, 19 (38%) had positive history of smoking and 1 (2%) had history of alcohol consumption. More than two-thirds of the participants had HbA1c >10%. On analysis of PAD, 41 patients were found to have ABI > 1, and their total cholesterol, triglyceride, and low-density lipoprotein (LDL) were noted to be higher than those for patients having ABI < 1, which was statistically significant (P < 0.05). Conclusion: The study showed that PAD is highly prevalent among people with diabetes mellitus. Increased level of total cholesterol, triglyceride, and LDL was positively associated with the development of PAD.

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