Background: Diastolic dysfunction in patients suffering from diabetes mellitus represents an earlier stage in the natural history of cardiomyopathy. This study was done to assess the left ventricular diastolic dysfunction in recently diagnosed (<5yr) Type 2 Diabetes Mellitus by Echocardiography and also to determine association of glycemic status (by HBA1c levels) with left ventricular diastolic dysfunction (LVDD).Methods: An observational descriptive study involving 100 diabetic patients, taken on first come first serve basis after applying inclusion and exclusion criteria. In all the subjects, other than routine investigations, HbA1c was estimated and echocardiography was done to evaluate LVDD.Results: Mean value of HbA1c in the study was 8.31+ 1.408 %. 63 out of 100 subjects had LVDD. There was significant positive correlation between HbA1c and LVDD (p value <0.001). As HbA1c increased, severity of LVDD increased. In this study, as BMI increased, HbA1c and LVDD increased & both findings were statistically significant (p value =0.001).Conclusion: Our study indicates that myocardial damage in patients with diabetes affects diastolic function before systolic function &higher HbA1C level is strongly associated with presence of LVDD. Patients should be advised strict control of diabetes in order to reduce the risk for developing LVDD which is a precursor for more advanced disease.Keywords: Diabetes mellitus, Diastolic dysfunction, BMI, HbA1c

Influenza A (H1N1)pdm09 infection during pregnancy causes more severe illness. Early recognition and timely administration of antiviral therapy can improve outcomes. The role of influenza vaccination in this high-risk population cannot be overemphasized.

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Neonicotinoids are a new class of insecticides widely applied for crop protection. Information on human exposures to neonicotinoids is limited. The most common routes of exposure were ingestion (51%), dermal (44%), and ocular (11%). These insecticides act as agonists at nicotinic acetylcholine receptors, which cause insect paralysis and death the high specificity for receptors in insects was considered to possess highly selective toxicity to insects and relative sparing of mammals. However, an increasing number of cases of acute neonicotinoid poisoning have been reported in recent years. Present study report three cases presented to us with acute neonicotinoid poisoning with different manifestations including acute myocardial infarction, central nervous system (CNS) depression, and acute kidney injury, who recovered subsequently with supportive care. A detailed literature review found that respiratory, cardiovascular and certain neurological presentations are warning signs of severe neonicotinoid intoxication. Supportive treatment and decontamination are the practical methods for the management of all neonicotinoid-poisoned patients.

Dengue virus infection is showing upsurge with rapid urbanization and climate change in India. The spectrum of disease varies from mild illness to severe disease such as dengue hemorrhagic syndrome, dengue shock, multi-organ failure, and death therefore prompt recognition of severe form is crucial to improve the survival in severe dengue. Currently there are no tests available to predict the course of the illness therefore it is imperative to develop an early reliable and feasible biomarker to predict the severity of dengue illness which can aid in vigorous monitoring and early intervention. In this study we tried to establish a correlation between serum ferritin and severity of dengue illness and analyzed whether serum ferritin can be used to predict the severity at an earlier stage. Methods: This was a Cross sectional study conducted at tertiary care hospital. 350 patients above 18 years with fever of duration less than 2 weeks with thrombocytopenia were enrolled. Serum ferritin levels were measured and results were analyzed. Results: Out of 350 patients Dengue was diagnosed in 210 patients. Mean Ferritn levels were highest in dengue patients (2898.18±2097.72 μg/l) and Severe dengue patients had significantly higher median ferritin levels (3985 μg/l) compared to non-severe dengue group with median 1936 μg/l (p value <0.001). Conclusion: Serum ferritin can serve as a surrogate marker of dengue fever. Serum ferritin is an inexpensive and easily accessible biomarker that can be used as a prognostic marker to predict severity of disease.