Autonomic nervous system abnormalities are major causes of morbidity and mortality in patients with chronic renal failure (CRF) on hemodialysis and are generally considered a part of polyneuropathy. Postural hypotension, impotency, gastrointestinal disturbance, gastrointestinal motility, and sweating abnormalities are common symptoms. The most frequent complication in patients with CRF on hemodialysis is intradialytic hypotension, and it has been suggested that intradialytic hypotension is mostly related to autonomic neuropathy. The pathogenesis of autonomic neuropathy is unclear, but a reduced response to norepinephrine by the end organ and the toxic effect of metabolic toxins are considered to be some of the causes. Five cardiovascular reflex tests are generally used to determine autonomic neuropathy: the heart rate reaction to the Valsalva Maneuver, the heart rate variability during deep breathing, the heart rate response to standing up, the blood pressure response to standing up, and the blood pressure response to hand grip exercise.

Background: Currently, the importance of non alcoholic fatty liver disease (NAFLD) and its relationship with coronary artery disease (CAD) is being increasingly recognized and this has stimulated an interest in the possible role of NAFLD in the development of atherosclerosis. Recent studies have reported the association of NAFLD with multiple classical and non-classical risk factors for cardiovascular disease (CVD). Non-alcoholic fatty liver disease (NAFLD) is a distinct hepatic condition characterized by abnormal fat accumulation in liver cells; histologically resembling alcohol induced liver damage. The overall prevalence of NAFLD in western countries varies from 15-40% and in Asian countries from 9-40%. In the present study, we shall determine the occurrence of Non-Alcoholic Fatty Liver Disease in patients with Coronary Artery Disease and to establish any clinical correlation between the two. Methods: The study was conducted over a period of 18 months. Patients coming to the NIMS hospital OPD/IPD with clinical history and physical examination- suggestive of CAD and confirmed by ECG, ECHO, Cardiac Biomarkers and wherever possible with Coronary Angiography. Diagnosis of NAFLD was done using ultrasonography. Results: Our study exhibited that patients having NAFLD presented with increased severity of clinical symptoms and the prevalence of NAFLD is more in CAD patients. Conclusions: The results from this study demonstrate the prevalence of NAFLD in patients of CAD and their clinical correlation. This study will help clinicians in devising treatment and designing preventive strategies for the aforementioned diseases.

Aims & Objectives: To study the profile of Autosomal Dominant Polycystic Kidney Disease (ADPKD) in low lying areas of NorthIndia. This is a 2 year observation study of patients attending Nephrology department in National Institute of Medical Sciences, Shobha Nagar, Jaipur, Rajasthan, India. Material & Methods: This is a 2 year prospective study done in National Institute of Medical Sciences- a tertiary hospital in rural area close to Jaipur. All ADPKD patients attending Nephrology department were studied to know their complete profile. Results: A total of 54 ADPKD patients attended Nephrology department between Jan 2014-Jan 2016, Out of which 34 patients presented with pain abdomen, 22 patients with hypertension, 8 patients with chronic renal failure kept on medical management, 8 with Chronic Kidney Disease CKD-ESRD (End Stage Renal Disease) on maintenance hemodialysis(MHD). Out of these 8 CKD-ESRD, there were 4 incidents of AV fistula thrombosis and 1 died recently whereas 20 patients remained completely asymptomatic. Conclusion: Timely diagnosis, proper understanding of disease by patients will provide good quality of life in these patients. Low salt diet, good control of hypertension (<130/80 mm of hg) delays progression to ESRD in these patients.

To establish HbA1c as a marker for glycemic control and dyslipidemia in diabetics in a tertiary care hospital. Material and Method:A single centered study of eighteen-month duration conducted in the general medicine department in a tertiary care teaching hospital of north India. A systematic protocol followed for obtaining permission from IEC by submitting a detailed Performa of study which include data collection form, patient information and consent form and evaluated biomedical literature or articles. The study was approved by the research ethical committee. Result: A substantial association was also found between HbA1c and lipid profile markers. Study was conducted on 170 patient. Raised triglycerides, total cholesterol and LDL levels were seen in 69.4%, 29.4% and 19.4% cases of type 2 diabetics while low HDL was observed in 50% cases. Conclusion:A high prevalence of dyslipidemia was observed among cases of diabetes. We also observed a significant correlation between HbA1c and lipid profile parameters. Thus better glycemic control reflected by HbA1c would also reflect better lipidemic state and vice versa.