BACKGROUND: Minimal hepatic Encephalopathy (MHE) has severe and important health implications which affects the quality of life as well as the survival of patients with liver disease. Psychometric hepatic encephalopathy score (PHES) has been validated for diagnosis of MHE. AIM OF THE STUDY:To detect the prevalence of minimal hepatic encephalopathy (MHE) in alcoholic cirrhosis patients and to compare the patterns of alcohol consumption in patients with MHE to those without MHE (NON-MHE). SETTINGS AND DESIGN: The study was conducted in Chettinad Hospital and Research Institute, Kelambakkam, a 1000 bedded academic medical centre in South India. This was a prospective observational study. MATERIALS AND METHODS: 25 alcoholic cirrhotic patients without overt hepatic encephalopathy and 20 patients who are alcoholics without any liver disease were given the five tests of PHES (Number connection test A (NCT-A), Figure connection test (FCT), Line Tracing Test (LTT), Circle Dotting Test (CDT) and Digit Symbol Test (DST)) in a quiet well lit room. Individual performance test values more than 1 S.D from the mean were considered abnormal. Based on the nomogram of healthy volunteers, the patients were classified as having MHE when they had impaired performance in ≥2 tests. RESULTS: There was no significant difference in the baseline characteristics between the two groups. In liver cirrhosis patients, MHE was diagnosed in 7 patients (28%). In NCT-A 28% (n=7) did abnormally, in FCT 16% (n=4), in LTT, CDT and DST 24% (n=6), 12% (n=3), 24% (n=6) respectively had impaired performance. NCT-A and LTT showed statistically significant difference between the study group. Hence these 2 tests were considered to have high sensitivity for screening of MHE (p-0.003, p-0.004). The proportion of patients with MHE increased as the duration of alcohol consumption increased. 73.3% of those with MHE had more than 10 years of alcohol consumption. CONCLUSION: The prevalence of MHE in alcoholic cirrhosis in our population was 28% which is close to that reported from other populations. Age and education had major influence on the overall test performance and it needs to be taken into consideration while interpretation of test results. The greater the duration of alcohol intake there was an increase in the occurrence of Minimal hepatic encephalopathy. Those even with harmful drinking pattern for longer duration are prone to develop DCLD and complications of hepatic encephalopathy.

AIMS AND OBJECTIVES: 1.To study the types of neuropathy in type 2 diabetes mellitus 2. To find out the commonest nerves involved using nerve conduction studies. MATERIALS: About 50 cases satisfying the inclusion criteria admitted in Chettinad health city and research institute during the period of October 2013 to October 2015 were taken up for the study. METHOD OF COLLECTION OF DATA: Our study was conducted with an informed consent obtained from these patients. A proper consent shall be obtained from these patients. They were interviewed for a detailed history and clinical examination. After ruling out other causes of peripheral neuropathy these patients were subjected to nerve conduction studies. The patients were explained about the procedure. Fasting blood sugar, postprandial blood sugar, random blood sugar and glycosylated were estimated for these patients. The results were analyzed with the help of appropriate statistical methods. RESULTS: 1) The incidence of neuropathy was found to be 90% 2) Tingling sensation was the most commonest complaint noted in 62% of patients 3) Polyuria and Polydipsia was noted in 34% of patients 4) Ankle jerk was absent in 48% of patients 5) Vibration sense was reduced in 44% of patients 6) Commonest pattern of neuropathy noted was distal symmetrical sensory polyneuropathy 7) The most commonest nerve involved was peroneal nerves. CONCLUSION: 1. The most common pattern of neuropathy noted in our study was distal symmetrical sensory and motor polyneuropathy. 2. Involvement of peroneal nerve is more common in patients with type 2 diabetes mellitus. KEYWORDS: Nerve conduction profile, Type 2 diabetes mellitus. INTRODUCTION:Diabetes is one of the oldest diseases known. Clinical manifestations of diabetes were limited only to selected regions in the olden days. Due to industrialization newer discoveries were made in the field of diabetes. It is defined as a disorder of chronic hyperglycemia along with alterations in carbohydrate, fat and protein metabolism due to impaired insulin secretion, action or both. The microangiopathy and macroangiopathy as a result of diabetes mellitus involves almost all the organs in the body.The main clinical manifestation of diabetes mellitus is polyuria, polydipsia, polyphagia and weight loss. The complications could be acute or chronic. Acute complications include diabetic ketoacidosis and hyperglycemic hyperosmolar state. Chronic complications include coronary artery disease, stroke, retinopathy, nephropathy and peripheral artery disease.Diabetic neuropathy is the commonest of all neuropathies in developing countries. Since, diabetic population is increasing, the incidence of diabetic neuropathy is also expected to increase in the future. Dyck PJ et al has estimated that 51% of type I and 45% of type II diabetes mellitus had diabetic neuropathy. The incidence of neuropathy depends on the duration of diabetes, HBA1C levels and the tests employed for the detection of neuropathy. A study that examined 8757 patients attending an OPD 32.3% was foun...