Background: Type 2 Diabetes Mellitus (T2DM) is the most prevalent metabolic disorder in the world. Recent evidence however suggests that T2DM is not only a disease of metabolism, but also an inflammatory disorder and that inflammation also plays an important role in the pathogenesis of Diabetic complications. Our aim was to study the level of interleukin-17 (IL 17) in Indian populations with T2DM as an inflammatory marker and analyze its role in different diabetic complications. Methods: A total of consecutive 67 patients of T2DM were evaluated for clinical parameters fasting blood glucose (FBG), 2hr-post-prandial blood glucose (PPBG), lipid profile, HbA1c and plasma IL 17. They were divided into three groups-Patients of T2DM without any complications (group A; n = 24), T2DM with acute complications (group B; n = 20), T2DM with chronic complications (group C; n = 23) and compared with 23 healthy controls (group D). Results: Diabetic patients had a higher level of IL 17 as compared to the healthy controls. The level of IL 17 in complicated diabetics was higher than the patients with T2DM without complications. Multiple logistic regression analysis showed positive correlation of IL 17 with Diabetic Retinopathy and Diabetic Neuropathy. IL 17 also showed a positive Pearsons correlation with systolic blood pressure (SBP), diastolic blood pressure (DBP), serum triglycerides (TG), serum total cholesterol (TC), very low density lipoproteins (VLDL), low density lipoproteins (LDL), HbA1c and a negative correlation with HDL. Conclusion: Indian subjects with T2DM with or without complications had higher values of IL 17 as compared to healthy controls. Also diabetic neuropathy and diabetic retinopathy were positively correlated to levels of IL 17.

Detection of paroxysmal atrial fibrillation requires continuous cardiovascular monitoring due to its episodic nature. Such monitoring is impractical with electrocardiogram Holter monitors, which are the currently employed for ambulatory cardiovascular monitoring, but are cumbersome for prolonged use. This thesis studies monitoring using photoplethysmography (PPG) devices, which may be embedded into wristband devices which can be easily worn continuously. However, the quality of wrist-based PPG is highly variable, and is subject to artifacts from motion and other interferences.The goal of this thesis is to evaluate the signal quality obtained from wrist-based PPG when used in an ambulatory setting. Ambulatory data is collected over a 24-hour period for 10 elderly, and 16 non-elderly participants. Visual assessment is used as the gold standard for PPG signal quality, with Fleiss's Kappa being used to evaluate the agreement between raters. With this gold standard, 5 classifiers are evaluated using a modified 13-fold cross-validation approach. Based on this evaluation, a Random Forest quality classification algorithm is selected, with an accuracy of 74.5%. The algorithm is used to evaluate the ambulatory use of wrist-based PPG over a 24-hour period. Overall, it is found that data quality is high at night, and low during the day.

BACKGROUND: Oral anti-diabetic drugs (OADs) are often advised for initial treatment for patients with Type 2 Diabetes Mellitus (T2DM). Their effects on glycemic control, lipid profile, insulin resistance and beta cell function has not been systematically studied in India. The objective of this study was to evaluate the effect of lifestyle modification and OADs on metabolic parameters in recently diagnosed uncomplicated T2DM patients. MATERIAL METHODS: A total of consecutive sixty four (64) cases of recently diagnosed uncomplicated T2DM in the age group of 30 -60 years were studied. They were evaluated for weight, body mass index (BMI), fasting plasma glucose (FPG), 2hr post glucose plasma glucose (2hrPGPG), HbA1c, lipid profile, serum fasting insulin, c-peptide, HOMA-IR and HOMA-β. They were divided into four groups according to increasing order of HbA1c values (6.5% -6.9%, 7% -7.5%, 7.6% -8.5%, 8.6% -8.9%). These four groups were subjected to lifestyle modification (LSM), monotherapy with metformin (1 g) and LSM, dual drug therapy i.e. metformin (1 g), glimepiride (1 mg) and LSM, triple drug therapy i.e. metformin (1 g), glimepiride 1 mg, sitagliptin 100 mg) and LSM respectively. These patients were followed up after three months of therapy. They were evaluated for the same metabolic parameters and compared with their baseline value. Fourteen (14) patients were lost to follow up. RESULTS: We found 91%, 92.8%, 53.3% and 60% of our patients from above four different groups achieved target glycemic control (HbA1c ≤ 6.5%). In all