Background: Diabetes mellitus is one of the commonest disease worldwide ranking next to cardiovascular disorder. The estimated prevalence of diabetes among adults is expected to rise about 100% in future. Cardiac involvement in diabetes commonly manifests as CAD and less commonly as dilated (diabetic) cardiomyopathy and autonomic cardiovascular neuropathy. The risk of CAD among diabetic patients is directly related to the levels of blood pressure, cigarette smoking and total cholesterol. Methods: The present study was undertaken at Chandulal Chandrakar memorial hospital, Bhilai, Chhattisgarh (India) between the periods of September 2010-2012 (2 years). 120 cases of CAD were studied, out of which 60 cases are diabetic CAD and 60 cases are non-diabetic CAD. Sample is drawn by simple random technique. Ethical approval was obtained from institutional ethical committee. Total Cases-120, Diabetic CAD [group -1]-60 and Non-diabetic CAD [group -2] -60. On recruiting the subjects into Group 1 and Group 2 following protocol is followed-history, clinical examination, pt. stabilization, anthropometric measurement, routine investigations, specific investigations including echocardiography. Procedures, definitions and criteria were used in the study as per standard protocol. In the present study values are expressed as mean ±1 SD. Demographic characteristics of patient with or without diabetes and other unpaired variables were compared. Results: Mean age in diabetic group was (55.7 ± 9.5) years while in non-diabetic group (55.6 ± 9.32) years. Diabetic group consists of 42 males and 18 females. Non Diabetic Group consists of 38 males and 22 females. Most of the patients in diabetic group presented with chest pain with sweating and with symptoms of sympathetic stimulation (vomiting/ apprehension 83.33%). A small fraction of diabetic patients presented with breathlessness -20%, syncope (3.33%) and palpitation (8.3%). In diabetic group 55% of patients were hypertensive, pre-HTN was seen in 18.33% and 26.66% had optimal blood pressure. Non-diabetics have higher ideal body weight 58.33% than diabetic (36.66%). Among the diabetic group and non-diabetic group maximum number of cases belonged to low risk category with total cholesterol, triglycerides and LDL cholesterol, but with borderline risk with HDL cholesterol. Diabetics are more vulnerable to mortality than non-diabetics (p<0.05). Conclusions: Diabetics had considerably higher percent of typical and atypical presentation. Hence, CAD should be considered as one of the differential diagnoses in diabetics who have presented with chest pain, however less severe it may be.

Brunner’s gland hyperplasia (BGH) or adenoma is an uncommon benign lesion which mimics malignancy in the duodenum. In the present study, five cases of BGH were reported, out of which one case was presented with large size measuring 5.54×4.05 cm, which has not been yet reported. Computed tomography demonstrated a large obstructing polypoidal mass, on esophagogastroduodenoscopy demonstrated polypoidal growth, and histologic examination revealed brunner’s gland adenoma. Most of the cases presented with gastric outlet obstruction and upper gastrointestinal bleeding with other non-specific symptoms. BGH is an uncommon benign condition of the duodenum, patients were usually asymptomatic or may present with non-specific symptoms or present as an incidental finding on endoscopy. Endoscopic and/or surgical resection represents the ideal approach. Brunner’s gland described by the Swiss anatomist Johann Conrad Brunner in 1688, predominantly present within the submucosa, begin just distal to the gastroduodenal junction, and gradually decrease in size and number distally and are often used as a histological marker of the duodenum. A Brunner’s gland adenoma (BGA), also known as BGH or hamartoma, is an uncommonbenign lesion in the duodenum.

Peripheral nerve sheath tumors (PNST) are one of the most common neoplasms, with classical morphology and histopathological features, but they can be diagnostically challenging at times. Albeit well defined subtypes of PNST have been described in literature, but controversies regarding reporting and typing of these tumors persists. Malignant PNSTs represent a diagnostically challenging group. Although the diagnosis and classification of most PNST are relatively straightforward, borderline grey zone neoplasms continue to be a diagnostic difficulty. In our case series, we attempt in providing some useful information for the oncopathologist to help navigate these persistent and challenging problems. In the present study, we found 26 cases of PNST, out of which the most common was schwannoma (n=18), followed by neurofibroma (n=7) and one case of malignant type, that is, malignant PNST. The cases involving all age from 12 to 65 years, showing slight male preponderance.

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