No abstract

Highly Active Antiretroviral Therapy (HAART) has been a major leap in the treatment of HIV. HAART has improved both morbidity and mortality in HIV patients. Of late, the cases of gynaecomastia are increasing secondary to initiation of ART. Efavirenz-induced gynaecomastia still remains underreported. CASE PRESENTATION We hereby report two cases of Efavirenz-induced Gynaecomastia in young males with median duration of 12 months on Efavirenz after valid written consent. CONCLUSION Efavirenz is being used as a first line regimen drug for ART initiation and also when patient has tuberculosis as opportunistic infection. Hence, the side effects of Efavirenz should be addressed and proper guidelines should be framed to manage the same.

BACKGROUND To investigate relationship between glycated haemoglobin (HbA1c) level and coronary artery disease (CAD) severity. METHODS This cross sectional observational study was conducted over a period of six months, and 100 participants were enrolled and baseline characteristics were collected. Clinical presentations in terms of unstable angina, NSTEMI or acute myocardial infarction were diagnosed. Coronary angiography was performed on all participants to figure out the numbers of coronary artery stenosis in terms of non-significant stenosis (<50% stenosis), single or multiple vessels stenosis (≥50% stenosis). All participants were divided into subgroups according to two categories in terms of severity of clinical presentation (unstable angina, NSTEMI or acute myocardial infarction) and the number of coronary artery stenoses (single, and multiple vessels). Primary endpoint was to evaluate relationship between baseline HbA1c value and CAD severity. RESULTS Consistent to previous studies, participants with CAD had more risk factors such as age, smoking, low HDL-C. Notably, HbA1c level was more prominent in CAD group than that without CAD. As compared to unstable angina subgroup, HbA1c levels were gradually increased in NSTEMI and acute myocardial infarction groups. Similar trend was identified in another category in terms of higher HbA1c level corresponding to multivessel stenosis. Multivariate regression analyses showed that after adjusting for traditional risk factors as well as fasting blood glucose, HbA1c remained strongly associated with the severity of CAD. CONCLUSION HbA1c may be a useful indicator for CAD risk evaluation.

BACKGROUND Bartter syndrome is a group of channelopathies with different genetic origins and molecular pathophysiologies, but sharing common feature of decreased tubular transport of sodium chloride in thick ascending loop of Henle (TAL), 1 although more common in antenatal group. Classic adult variant of Bartter syndrome is a rare entity. We hereby present a rare adult variant of classic Bartter syndrome.

BACKGROUNDDiabetes has now become the most common single cause of end-stage renal disease. Diabetic Kidney Disease (DKD) is a lifethreatening and irreversible microvascular complication characterised by presence of persistent proteinuria, hypertension and progressive decline in renal function. Early detection and risk reduction measures can prevent diabetic nephropathy. Screening for microalbuminuria will allow early identification of patients with nephropathy provide an opportunity for early treatment, which has been shown to preserve renal function and thus prevent morbidity and mortality from diabetic nephropathy.The aim of the study is to study the relation between duration of diabetes and nephropathy.