Metformin is commonly used oral hypoglycaemic agent in the treatment of type-2 Diabetes Mellitus (DM). One of the important side effect of long term metformin therapy is malabsorption of vitamin B 12 which could lead to megaloblastic anemia and peripheral neuropathy. Therefore annual screening of serum vitamin B 12 level or serum methylmalonic acid (MMA)/serum homocysteine level should be done in cases taking metformin for more than four to five years with average dose of >1g per day, even in the absence of haematological or neurological abnormalities. However, as the incidence of type-2 DM is increasing, cost of annual measurement of vitamin B 12 level also increases. Considering cost factor for annual screening, vitamin B 12 supplementation appears to be more cost effective approach rather than annual screening for routine prophylaxis. Routine vitamin preparations available in the market may contain less amount of B 12 and hence are not of much therapeutic use in treatment of B 12 deficiency due to Metformin. Hence there is a need to look for higher doses of approximately 500-2000μg/day.

Objective: The purpose of this study is to identify the patterns, presentations of ocular trauma, todetermine the groups at risk, types of injuries, analyze visual outcomes of ocular trauma in patients presenting at our hospital. Method –It is a prospective hospital based study done over a period of one year on ocular trauma patientsbetween Jan 2020 – Dec 2020.All consecutive, consenting patients with ocular trauma were interviewed with the aid of a questionnaire and underwent a detailed eye examination. Results: The study included 100 patients .Males were affected in 82%cases. The highest incidence of trauma was seen in the age group of 21-30 years( 29%).Children below 10 years were found in 12 % cases.Blunt trauma was found in 49% whereas penetrating injuries were found in 44 %. The most common site of injury was the cornea(30.58%). Keywords: ocular trauma, eye injuries, penetrating eye injuries, hyphaema

Background: Accurate knowledge of gestational age of the foetus is essential for planning a timely and uneventful outcome. Biparietal diameter, head circumference, abdominal circumference and femur length reliably predict gestational age. The humerus length is not widely used as biometric parameter for determining the GA so the present study was done to estimate foetal gestational age by measuring humerus length between 18 to 36 weeks of normal singleton pregnancies and to compare humerus length with routine parameters.Methods: This was a hospital based descriptive cross-sectional study, 200 women with viable singleton pregnancy, with known LMP, between 18 weeks to 36 weeks of gestation were included. Various foetal measurements such as biparietal diameter, head circumference, abdominal circumference, femur length and humerus length were measured using electronic calipers on ultrasound. Data were statistically analyzed.Results: The mean humerus length at 18 weeks was 25.27±1.16 mm and at 36 weeks of gestation was 57.11±1.58 mm. Simple linear regression analysis shows a strongly significant linear relationship between humerus length and gestational age. Where, gestational age (weeks) Y= 0.5213 x humerus length (X) + 4.905; with high degree of correlation coefficient (R2 =0.9785 and P≤0.0001). When Compared with BPD, HC, AC and FL, humerus length also shows a linear correlation.Conclusions: The measurement of the humerus length can be an important additional parameter for estimating gestational age along with other parameters and can be used to predict the gestational age of fetuses in special circumstances.

Pharmacovigilance (PV) plays a vital role in the healthcare system through assessment, monitoring and discovery of interactions amongst drugs and their effects in human. Medicines do come with their respective adverse effects.  Therefore it is imperative to do Adverse Drug Reaction (ADR) monitoring while they are being marketed. PV is a part of the second MBBS curriculum, but often given less importance by the students. If this Knowledge Attitude & Practice of PV can be made effective during the MBBS course itself, it may make the students better aware about ADR monitoring. Aims & Objective: Our purpose was to find out the knowledge, attitude & practices amongst the second year medical students in a tertiary care hospital in North Maharashtra. Methods: This was an observational based study which had predesigned questions. After seeking the approval from the Institutional Ethics Committee, questionnaire was given to second year students of a tertiary care hospital in north Maharashtra. MS Excel was used for data analysis. Results:  The overall response rate was 76%. 30% answered knowledge question correctly whereas 70% answered the attitude questions correctly. Only 4 % had reported an ADR and majority felt that busy duty hours and fear of legal action was the reason for underreporting. Conclusion: Our study revealed that in spite of PV being part of 2nd year MBBS, it still needs more emphasis and attention. The   student feedback regarding ADR after they visit wards may help in improving the general awareness. Keywords: Pharmacovigilance, Knowledge, Attitude, ADR.

In the beginning of 20 th century vitamin D was classified as a vitamin but later considered as a prohormone ("conditional" vitamin) which influences the expression of more than 200 genes in the human body. Worldwide vitamin D insufficiency affects about 50% of the population and in India about 80% of population has vitamin D level less than normal. In India sunshine is abundant but still Indians are deprived of this sunshine vitamin. Minimal exposure to direct sunlight, staying indoors, use of sunscreen lotions, pollution, clothing, dietary and cooking habits are most important factors for vitamin D deficiency in the Indian population. Serum 25 hydroxyvitamin D level is the initial diagnostic test in patients at risk for deficiency. Treatment with either vitamin D 2 or vitamin D 3 is recommended for patients having deficiency, keeping hypervitaminosis in mind. deficiency. However nobody recognized the vital role of diet or exposure to sunlight in the prevention of this disease. Around 200 years later in 1840 a Polish physician Sniadecki found that rickets occurred in children living in the industrial centre of Warsaw but did not affect children living outside Warsaw. He found that lack of exposure to sunlight in the crowded streets of the city where sunlight is not abundant and there was considerable pollution due to the burning of coal and wood, caused the disease.In 1918 Sir Edward Mellan by discovered that beagles, which are exclusively placed inside house away from natural sunlight and fed a diet of oatmeal, developed rickets but after the addition of cod liver oil to the food cure the disease successfully. In 1921 he demonstrate "The action of fats in rickets is due to a vitamin or a specific food factor which they contain, probably the fat-soluble vitamin.In MetabolismVitamin D 3 is cholecalciferol and vitamin D 2 is ergocalciferol. On exposure to sunlight Vitamin D 3 is produced in the skin. It is derived from 7-dehydrocholesterol by ultraviolet irradiation of the skin. After ingestion vitamin D both D 2 or D 3 , incorporated into chylomicrons which get absorbed into the lymphatic system and enter the venous blood. Vitamin D that comes from the skin or diet is biologically inert and requires its first hydroxylation in the liver and second one in kidneys to form the biologically active form of vitaminD1, 25(OH)2D, 1,25(OH)2D may be responsible for regulating up to 200 genes which may facilitate many of the health benefits 2 . SourcesVitamin D perhaps the one of the vitamin that gets synthesized in the body in the skin with the help of sunlight. Vitamin D 3 is found in animal food e.g., fatty fish (e.g., mackerel, salmon and tuna), cod liver oil, milk. Vitamin D 2 is found in vegetal sources like sun-exposed yeast and mushrooms Causes of Vitamin D Deficiency 2• Inadequate exposure to sunlight -as major source of vitamin D is exposure to natural sunlight.• Skin tone-Dark skin people are more prone for deficiency than white tone as dark skin provide natural sun protection.• Use of sunscreens-reduce...