Background: Dengue is a common vector-borne disease in India with significant morbidity & mortality. Thrombocytopenia is a common complication in dengue. Bleeding manifestations in dengue put an immense pressure on both patients and treating physicians. There are no clear guidelines for transfusion of platelets in bleeding patients and role of Platelet transfusion in this condition is a bit controversial.Methods: It was an observational study done at Sree Rajarajeswari medical college and hospital between 1st May and 31st July 2016. Total of 100 dengue-positive cases were studied with respect to clinical features, laboratory parameters and requirement of platelet transfusion.Results: Majority of patients were males and in the age group 21-30 years. Fever was present in all cases, with a mean of 3-6 days duration. Epistaxis was the most common bleeding manifestation (43%), Malena being the least (3%). Leucopenia was observed in 52% patients. Thrombocytopenia was seen in 89% of admitted patients and 38% among them had raised aPTT. 53%of patients in our study received platelet transfusion.Conclusions: Bleeding manifestations have no significant association with severity of platelet count. Severe leucopenia is associated with thrombocytopenia. There is no need of platelet-transfusion in all patients with thrombocytopenia with minor bleeds.

Background: Diabetes Mellitus (DM) is a major emerging health issue and the risk factors are varied in women making them susceptible to it. Metformin is most preferred and widely used drug worldwide due to various reasons. Vitamin B12 deficiency in DM caused by Metformin is least known side effect. Objective: This study was taken up to assess the correlation between deficiency and duration and dose of metformin treatment. Methods: This being a hospital based observational study, 650 Diabetic women were evaluated by detailed questionnaire, general physical examination, fasting blood glucose (FBS), post prandial blood glucose (PPBS), serum Vitamin B12 levels, CBC and NCS. Results: The mean age of the cases was 51.98±5.17years. 164/408 cases (on metformin therapy for >3 months) had low vitamin B12 as against 22/242 controls (never on metformin therapy). Mean Serum vitamin B12 was low in cases with less duration of DM when compared to cases with longer duration. Vitamin B12 deficiency was correlated with anemia and neuropathy. Conclusions: Metformin treatment in cases is associated with higher prevalence of Vitamin B12 deficiency which increases with duration of DM and dose of metformin. Deficiency correlated with development of macrocytic anemia and worsening of neuropathy. In some, symptoms of deficiency are difficult to diagnose and can be irreversible if left untreated (like neuropathy). Routine screening of Vitamin B12 levels, CBC, NCS should be done in all diabetic women at the beginning of metformin therapy, and yearly thereafter. Treatment and prevention of deficiency is easy, cheap, safe, and effective

: Diabetes Mellitus (DM) is a chronic disease, requiring long term medications and frequent monitoring of blood sugars. Education is one of the key components in ensuring better treatment and control of diabetes. Good glycaemic control with frequent monitoring of blood glucose, healthy diet, and adequate physical activity can go a long way in prolonging longevity of patients with DM and also in preventing morbidity. This study was taken up to assess the knowledge and attitude of people in Rural India towards DM. This being a hospital based descriptive cross sectional study, 550 Diabetics were evaluated by detailed questionnaire.: The mean age observed was 49.6±8.6 years, 73% of patients were illiterates. Majority of patients were farmers who indulged in heavy work (55%). (11%) was aware about diabetic diet while only 5%actually followed it. Majority (86.2%) were adherent to medications, while only 15.3% were actually aware regarding consequences and complications of missing medications dosage. None of patients were having facilities for home monitoring of glucose and only 9% got their sugars checked regularly. Only, 62.5% of patients used footwear regularly. Only 21.6% patients were aware regarding importance of foot examination, while only 7.4% performed it regularly.75% did not come to hospital for regular glycemic monitoring as there was no one to accompany them. Spreading knowledge regarding diabetes and its management in the form strict adherence to prescribed medications, diabetic diet, and regular physical activity will motivate individuals with diabetes to visit hospitals regularly. This is an important step in preventing diabetes-related complications. Awareness methodology specific for rural populations needs to be adopted