Background: Cardiovascular causes contribute towards the large proportion of increased morbidity and mortality,in patients ofChronic renal failure. Cardiac disease is the major cause of death in dialysis population. Methods: The present study was undertaken for documentation of various cardiovascular abnormalities in sixty patients with Chronic Kidney Disease at Government Medical College Patiala, using Electrocardiography and Echocardiography as investigation procedures.The present study is a descriptive -cross sectional study and data collected was analysed by frequency, percentage, chi-square test and by using p value. Results: ECG was normal in 15 out of 60 cases of CKD(25%), LVH present in 20 out of 60(33.33%), Left axis deviation in 9 out of 60(15%), Conduction disturbances in 10 out of 60(16.67%), Ischemia in 12 out of 60(20%), Arrhythmias in 2 out of 60(3.33%) and P-mitrale was found in 4 out of 60 cases(6.67%). The most common ECG change associated with cases with CKD was LVH (33.33%).The most common abnormality found on echo in CKD cases under study was LVH(56.67%) followed by Diastolic Dysfunction(38.33%). Conclusion: Left ventricular hypertrophy is the commonest abnormality observed in CKD both on ECG and Echocardiography. Echocardiography is a more sensitive diagnostic procedure to detect left ventricular hypertrophy. After LVH most common abnormality found on Echocardiography is Left ventricular diastolic dysfunction. Pericardial effusion and conduction abnormalities are more common in patients of CKD on hemodialysis.

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Background: Depression is common among people with diabetes and it is associated with poor outcomes. This study was carried out to investigate the association of depression with various complications of type 2 diabetes and to find out any correlation between type of complications and depression. Methods: 200 patients with established T2DM attending the Outpatient department and indoor wards of Medicine Department of Rajindra Hospital, Patiala were evaluated for depression by a previously validated depression questionnaire [PHQ-12 item]. Results: Patients with T2DM (n=200) were evaluated [94 (47%) male and 106 (53%) female]. Maximum number of patients i.e. 68(34%) were in 51-60 years age group. 57(28.5%) patients out of 200 had depression. Depression was commonly associated with retinopathy (68.57%), followed by neuropathy (61.2%), nephropathy (59.57%) & CAD (25.45%). It was most commonly associated with PDR (100 %) and least commonly with CAD. Conclusion: This study showed high prevalence of depression in patients with T2DM. The prevalence of depression is higher in T2DM subjects with retinopathy, neuropathy and nephropathy compared to those without the respective complications. The Chances of becoming depressed increased with increase in number of complications.

Background: Cardiovascular involvement is common in HIV reactive patients, although are clinically quiescent. Echocardiography in HIV reactive patients is important tool in recognizing these cardiac abnormalities. Methods: The study was conducted in 150 HIV reactive patients attending antiretroviral therapy centre and wards of the hospital. Echocardiography was done using GE Vivid 3 Milwaukee using 2.5 MHz variable frequency transducer and CD4+ count was measured by FACS (Flourescent Activator Cell Sorter). Patients with age <15 years, congenital heart disease, preexisting valvular heart disease, hypertension and diabetes mellitus were excluded from study. Patients were divided into three groups according to CD4+ counts: group 1 with CD4+ count <200, group 2 with 201-350 and group 3 with > 350 CD4+ cells. Data so collected was statistically analysed and correlation with CD4+ count was studied. Results: Out of 150 patients, echocardiographic involvement was shown in 62 (41.3 %) patients. Most common echocardiographic abnormality was diastolic dysfunction in 26 % (most of the patients had grade 1 diastolic dysfunction), followed by pericardial effusion in 8.6 %. 6.7% had systolic dysfunction and 5.3% had features of dilated cardiomyopathy. The mean CD4+ count in patients with grade 1 diastolic dysfunction and systolic dysfunction was significantly lower than in patients without diastolic dysfunction and systolic dysfunction (166.9 versus 210.65). Same was true with patients having pericardial effusion and dilated cardiomyopathy. Pulmonary hypertension was seen in 5.8 % of patients. Conclusion: The prevalence of echocardiographic manifestations in HIV reactive patients was quiet high. High index of clinical suspicion of cardiac involvement and its recognition in HIV patients at all stages help in early diagnosis and treatment which in turn will decrease morbidity and mortality.

Interaction of Hb S with beta thalassemia is being reported here as this type of case is rare. Hb S (β6 glu→val) is a genetic disorder which occurs due to beta globin gene mutation of hemoglobin. In India, the Hb S is prevalent in the central part, in the eastern, western and southern tribal belt regions. The Hb S carriers (Sickle cell trait) lead a normal life but the Sickle cell disease patients show certain clinical manifestation like joint pain, anemia and jaundice. The HPLC report of the patient showed Compound heterozygous for Hb S-β thalassemia. The complete blood count was measured in automated hematology analyser.