The link between Diabetes mellitus & Tuberculosis has been recognizing for centuries. Recently Tuberculosis has re-emerged as a major health concern. There is growing evidence that Diabetes mellitus with Tuberculosis may affect disease presentation and treatment. The Tuberculosis also influences glucose intolerance and influences the glycaemic control in the people with Diabetes mellitus. Approximately 2 Million persons worldwide died of Tuberculosis and 9 Million become infected each year. (CDC, 2007) 1. With the convergence of tuberculosis and diabetes Mellitus epidemic, co-affliction with the two diseases is on the rise. The observational study was conducted with 100 patients. The patients with Pulmonary Tuberculosis sputum positive/negative with radiological lesions was admitted in medicine wards of our hospital between years 2009-2011. The aim of our study is to find out the prevalence of GTT in patients of Pulmonary Tuberculosis Age, sex distribution of impaired Glucose Tolerance Test (GTT) in Patients with pulmonary tuberculosis and study the correlation between impaired GTT with Sputum positivity and also radiological extent of disease. The patients were subjected to oral GTT and results were evaluated according to the WHO criteria and the statistical analysis was done to determine the P value and significance on the basis Chi-square test. The results found in the studied patient were that prevalence of abnormal GTT in Pulmonary Tuberculosis patients was found to be 22% (P=0.07). Abnormal GTT was more common in males as compared to females and this was found to be significant (P=0.692). Sputum positive Pulmonary Tuberculosis is strongly associated in patients with abnormal GTT (P=0.03), and bilateral lung involvement was more common among Pulmonary Tuberculosis patients with abnormal GTT.

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High risk patients with perforated peptic ulcer, where both the surgeon and anaesthetist are hesitant to operate, were managed by combined conservative management and bilateral percutaneous peritoneal drainage under local anaesthesia as a damage control approach; followed by either definitive surgery or omental patch closure. Here we study the management outcome in terms of morbidity & mortality of such patients.A prospective study of 60 patients presenting to VSSIMSAR, Burla was done between Feb 2018 and Jan 2020. Study population includes patients with perforated peptic ulcer confirmed by pneumo-peritoneum in X-ray and bilious peritoneal tap; with high peri-operative risk (PULP score 8-18). They were managed by combined conservative management and bilateral percutaneous peritoneal drainage under local anaesthesia. The outcome in terms of improved general condition and definitive/ omental patch closure, morbidity and mortality rates were noted. After risk stratification according to PULP score, total number of high-riskcases (PULP score >8) were 60 (male-39, female-21); Majority of them were elderly (90%). Most common complication was ARDS (28.3%). Maximum number of patients (75%) were improved by the damage control approach without significant complications and offered exploratory laparotomy & needful. Localised abscess were observed in around 13.33% patients; which were managed by image guided aspiration under antibiotic coverage. The overall mortality rate was 11.67%. Combined conservative management and percutaneous peritoneal drainage as damage control, which can be done in resource limited centre; followed by either definitive surgery or omental patch closure is associated with reduced mortality.

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Background: Cholelithiasis in children was reported about three centuries back and remained relatively uncommon in the past but now it is evolving and ever-increasing in frequency. We aimed to study the clinical presentation, predisposing factors, and treatment outcome of cholelithiasis in children in western Odisha. Methodology: The present prospective study was conducted on 38 patients less than 18 years old, with ultrasound proved cholelithiasis. Data were reviewed concerning patient demographic profile, clinical history including risk factors, imaging studies, operative techniques, postoperative complications, and treatment outcome. Results: 38 children (14 boys and 24 girls) with cholelithiasis were evaluated and treated during the study period and the mean age was 14.25±3.01 years (range 5 to 18 years). 44.73% of children (n = 17) belonged to rural backgrounds and the rest to urban setups, and 23(60.52%) of patients belonged to the Hindu religion. In 63.15% of patients, no risk factor could be traced. 73.68% of children had multiple gallstones. 28(73.68%) patients underwent laparoscopic cholecystectomy. The average duration of hospital stay was 4.42 days. No major intraoperative or postoperative complications could be detected. Conclusions: In this region of the country most of the children had no risk factors identified for cholelithiasis. Girls with middle socioeconomic status and urban areas belonging to the Hindu religion were more affected by the disease. In view of the high incidence of serious complications of gallstones in children and because of longer life expectancy we also recommend that expectant management of gallstones may not be safe and hence laparoscopic cholecystectomy must be done even in asymptomatic cholelithiasis.