Introduction: -Chronic obstructive pulmonary disease (COPD) has effects that seems to be related with systemic inflammation. The objective of the current study was to find the relationship of metabolic syndrome and C-reactive protein (CRP) levels, as a marker of systemic inflammation in stable COPD patients with different severity levels and in age and sex matched control group .Materials and  Methods:-100 stable COPD patients and 50 control subjects were included in the study. The severity level in patients with COPD were determined according to GOLD (Global Initiative for Chronic Obstructive Lung Disease) criteria. ATP III (The National Cholesterol Education Program’s Adult Treatment Panel III) was used in diagnosis of metabolic syndrome. Hs-CRP levels were measured in venous samples of patients and control subjects.  Results: - The frequency of metabolic syndrome was found higher in-patient group than control subjects, especially in GOLD stages I, II (p= 0.004). Abdominal obesity, hypertension, hyperglycaemia components of metabolic syndrome were significantly more prevalent in-patient group (p< 0.0001). Increased CRP levels were higher in control and patient groups in all GOLD stages, with metabolic syndrome than without metabolic syndrome (p= 0.046, p= 0.216, p< 0.001, p= 0.05, p= 0.466).

BACKGROUND-Pleural effusion is defined as collection of fluid between the two pleural covering. OBJECTIVE-To evaluate the different etiologies of pleural effusion according to laboratory report. METHODOLOGY-Data was collected  in a nonprobability convenience technique with descriptive cross- sectional study in  indoor patient of pulmonary medicine department of  Balangir Bhima  Bhoi medical college from 2017  nov to 2020 nov,202 patients  included in this technique.Diagnosis was confirmed by chest -x-Ray, and USG Chest in some cases, .Pleural fluid is aspirated from all and  analysed  with necessary investigation  carried out ,like pleural fluid cytology, Biochemical and culture .computed tomography ,echocardiography and  connective tissue profile for evaluating the underlying cause of pleural effusion. RESULT- Out of 202 patients 145 (73%) were male and 57(26)% were female Mean age was 44.8years with 19,832 SD .Among patients of pleural effusion most common cause was tuberculosis (65.3%). followed by Para pneumonic effusion/empyema (11.4%), malignancy both metastatic and primary accounted for (15%), heart failure also showed its presence in 5% of cases. Connective tissue disorder was found to be the cause in only one case (0.5%). In one case (0.5%) pleural effusion remained undiagnosed.

Eighty-six patient (49males, 37 females) with acute thrombosed external prolapsed haemorrhoids from January 2019 to January 2022 were treated topically with heparin sodium plus benzyl nicotinate along with 0.5% nifedipine ointment paste (t.i.d.) for 8 wk. All the patients were advised to take a high-fibre diet and assessed post-treatment at 2, 4 and 8 weeks. The healing of external thrombosed haemorrhoids and any side effects were recorded. The patients were again followed up subsequently in the outpatient department for the period of 2years and contacted by phone every three months thereafter, while they were encouraged to come back if symptoms recurred. Seventy-nine of the 86 patients followed the instruction regularly and completed the 8-wk treatment course, of them 77 patients (85.2%) achieved a complete remission indicated by resolution of pain and swellings symptoms and resolution of the thrombosis of haemorrhoids. Of the remaining nine unhealed patients (14.8%), 5 opted to undergo haemorrhoidectomy and the other 4 to continue therapy for four additional weeks, resulting in healing and resolution of pain and swellings symptoms and resolution of the thrombosis of haemorrhoids.