Even though, Hippocrates recognized gout as an affection of older men and a product of high living long back in 5th century BC, this painful condition promises to accompany humanity to the 21st century. The incidence is progressively rising and females are also affected in the modern era. There are also regional and ethnic variations in the incidence, the genetics of which is being studied. The recommended best therapy for the acute attacks and long term prophylaxis has improved remarkably in the recent years. However, patients are often treated inadequately and risk factors for their disease are not well explored in daily practice. Although well designed long term studies of current and newer treatment are welcomed, educating doctors especially the primary care physicians who manage majority of gout cases, in optimizing the currently available management options would improve the present care.Key words: disease aetiology and pathogenesis -human, gout, metabolic and crystal arthropathies drug treatment, metabolic and crystal arthropathies epidemiology, metabolic and crystal arthropathies inflammasome.

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BACKGROUND Stroke or cerebrovascular accident is a life-threatening neurological disorder comprising more than 50% of admissions in a hospital. Identification of predictors of mortality, especially modifiable ones is vital so that prompt therapeutic measures can be instituted to improve outcome. This study has been undertaken with the intention to determine the association if any between serum albumin and the severity as well as the short-term outcome of acute ischaemic stroke. MATERIALS AND METHODS This observational study was conducted in a tertiary care hospital in South India over a period of 1 year. The study population comprised of 100 patients who got admitted in medical wards with first ever acute ischaemic stroke within 72 hours of onset of symptoms. Stroke severity at admission was graded using the Scandinavian Stroke Scale and functional status on 7th day was assessed using Modified Rankin Scale. RESULTS The mean age of the study population was 58.44 ± 14.42 years. A significant association was observed between serum albumin and severity of stroke at presentation. A strong negative correlation was found between serum albumin at admission and MRS score, indicating a strong association between serum albumin and the functional outcome at 7 days. There was also significant association between the severity of stroke at admission and the functional outcome at 7 days. CONCLUSION The study found that the severity of stroke at onset had a definite association with outcome and serum albumin influences both stroke severity and outcome.

Introduction: Vitamin D plays an important role in glucose metabolism. Several pleiotropic effects of Vitamin D have been studied like regulation of cell proliferation, suppression of cell mediated immunity, Glial cell line-derived neurotrophic factor, stimulation of nerve growth factor, suppression of Renin-angiotensin-aldosterone system (RAAS), reduction of albuminuria, immunomodulatory effects, and anti-inflammatory effects.(1)Thus, vitamin D is implicated in the pathogenesis of retinopathy, neuropathy and nephropathy. Materials and Methods: A Cross-sectional case-control study of 206 patients (>30 years), who met the American Diabetes Association, 2011 criteria (2) for type 2 DM, was conducted. Subjects were evaluated for the presence of microvascular complications by clinical evaluation, urine examination, fundus examination, clinical neuropathy scoring, and various biochemical tests. 25-OH cholecalciferol levels were done and cut off level for vitamin D deficiency was 30 ng/ml. 72 Vitamin D sufficient and 134 Vitamin D deficient cases were studied. Results: A total of 134 T2DM cases with Vitamin D deficiency were studied. 72 age matched T2DM patients with sufficient Vitamin D levels served as controls. The mean age of cases under study was 47.58 ± 9.63 years compared to 51.24 ± 8.75 years of controls. 61.2% were females, whereas 38.8% were males in the case group while in the control group, 69.4% were males, and 30.5% were females. The mean duration of diabetes in the cases studied was 57.08 ± 18.13 months. It was 52.69 ± 17.98 months in the Vitamin D sufficient controls.  Significant statistical associations were established using Chi square test between Vitamin D status and development of microvascular complications like Diabetic nephropathy, retinopathy and neuropathy in Type 2 Diabetes Mellitus at p < 0.05. Conclusion and Implication: Vitamin D is an important factor in modifying the risk of Type 2 DM and its microvascular complications, especially Diabetic retinopathy, neuropathy and nephropathy. Administration of vitamin D supplements may prove to be a beneficial adjuvant therapy in mitigating microvascular complications. Frequent Monitoring of Vitamin D status can decrease the burden of co-morbidities in T2DM and thus can decrease the mortality rate associated with T2DM. However; the exact role of vitamin D in these processes requires further investigations. Keywords: Diabetes, Nephropathy, Neuropathy, Retinopathy, Vitamin D

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