Objective: To compare the efficacy and safety of azithromycin with ofloxacin in patients with uncomplicated typhoid fever.

Background: Diabetes mellitus is known for its complications such as retinopathy, neuropathy and nephropathy. Diabetic neuropathy is one of the devastating complication associated with diabetes mellitus. The objective of this study was to detect sensory motor neuropathy in type 2 Diabetes mellitus by clinical examination and nerve conduction study and to correlate clinical features of peripheral neuropathy with nerve conduction study in Type 2 Diabetes mellitus. Methods: This study was undertaken to study types of neuropathy in type 2 diabetes and to correlate clinical features of peripheral neuropathy with nerve conduction study in type 2 diabetes mellitus.100 patients with diabetes whose onset of diabetes mellitus after age of 30 years and duration of diabetes 5 years or more visiting SGRDIMSR, Vallah, Amritsar were subjected to nerve conduction study to find out peripheral neuropathy. Results: Eight four percentage patients were found to have neuropathy on NCS whereas only 61% of patients were found to have neuropathy on clinical examination and detection rate with NCS was statistically significant (p <0.001) as compared to clinical examination. Conclusions: NCS helps in early detection of neuropathy and most common form of diabetic neuropathy is distal symmetrical polyneuropathy.

Background: Diabetes mellitus (DM) is on the increase globally. Cardiovascular complications, such as left ventricular dysfunction is a major cause of death in patients with type II DM. Prior to the development of symptomatic heart failure, subclinical left ventricular dysfunction (systolic and diastolic) may exist for some time. Aim of this study is to find out abnormalities in left ventricular function in patients of type 2 diabetes mellitus with help of 2D Colour Doppler Echocardiography. To find its correlation with glycemic control on the basis of glycosylated haemoglobin (Hba1c).Methods: Total 100 Patients of type 2 Diabetes Mellitus of duration more than 10 years of both sexes were included in the cross-sectional study conducted from Jan 2018 to Aug 2019.All the patients were assessed through clinical examination and 2-D echocardiography and control of diabetes determined on the basis of HbA1c.Results: Study consisted of 100 patients with type 2 DM, 55(55%) were females and 45(45%) males. Majority of patients were in the age group of 4th to 6th decade of life.  Diastolic dysfunction was present in 81(81%) patients. systolic dysfunction was present in 14(14%) patients. There was a linear increase in prevalence of diastolic dysfunction with increasing age, increased FPG, increased BMI. There was also significant correlation between LV diastolic dysfunction (LVDD) and LA size. While no statistical correlation found between gender, duration of diabetes, HbA1c with diastolic and systolic dysfunction.Conclusions: LV diastolic dysfunction is an early manifestation of diabetic cardiomyopathy. LVDD contributes significantly to morbidity of congestive heart failure in diabetic patients. Echocardiography is a very useful non-invasive tool in detecting LVDD and systolic dysfunction in type 2 DM patients.

Background: Hepatorenal syndrome (HRS) is functional renal failure occurring in advanced stage liver disease associated with poor prognosis. The best treatment is liver transplantation. Terlipressin is effective in treatment of HRS but noradrenaline has been suggested as cheaper and readily available alternative and we aimed to compare the efficacy of noradrenaline and terlipressin in patients with HRS.Methods: 30 patients were allocated to each group and group A received infusion of noradrenaline at dose of 0.5 mg/hr (maximum 3 mg/hr) and group B received terlipressin at dose 1 mg intravenously 6 hourly until reversal of HRS or completion of 7 days of therapy. Intravenous albumin (20 g/day) was given to both groups. Decrease in serum creatinine and increase in daily urine output and mean arterial pressure (MAP) helped us in comparison.Results: Out of 60 cirrhotics screened, 51 were randomised into group A (N=22) or group B (N=29). Baseline characteristics of both groups were similar. In group A, 0% showed complete response while 31.8% showed partial response but majority (68.2%) showed no response. In group B, 89.7% showed complete response and 6.9% showed partial response. Decrease in serum creatinine in both groups (group A- 3.91±1.58 mg/dl to 3.07±1.68 mg/dl; group B- 3.21±1.24 mg/dl to 1.36±0.87 mg/dl). Both groups showed an increase in MAP (group A- 76.93±6.18 mmHg to 89.49±6.93 mmHg; group B- 75.54±5.51 mmHg to 89.92±5.07 mmHg).Conclusions: Noradrenaline was not as effective as terlipressin in treatment of HRS.

Background: Dengue fever is an acute febrile illness characterized by frontal headache, retro ocular pain, muscle and joint pain, nausea, vomiting and rash. Frequent sonographic findings in a case of dengue include thickened gall bladder with pericholecystitic fluid, ascites, spleenomegaly and pleural effusion which is commonly right sided.Methods: 540 patients of confirmed dengue fever were subjected to ultrasonography abdomen to find the incidence of acalculous cholecystitis for diagnostic and prognostic significance.Results: Acalculous cholecystitis was detected in 210 patients (38.88%) of confirmed dengue fever. Patients developing acalculous cholecystitis recovered with conservative treatment only though the hospital stay was prolonged in these patients.Conclusions: In dengue fever patients, acute acalculous cholecystitis is not uncommon and is usually self-limiting and resolves with conservative management only. Role of ultrasonography has a supporting role in dengue fever for prognostic and diagnostic significance.