Background:The term "THYROID DIABETES" was coined in early literature to depict the influence of thyroid hormone excess in deterioration of glucose control. Although autoimmune thyroid disease is more prevalent in Type1 Diabetes mellitus as a result of their common origin, the prevalence of hypothyroidism and hyperthyroidism is supposed to be similar to that of general population in patient with type2 DM. The purpose of the study was to evaluate the prevalence of thyroid dysfunction in patients with type2 diabetes mellitus and to correlate thyroid abnormalities with insulin resistance and serum markers for autoimmune thyroiditis. Methods: 120 cases of type2 diabetes mellitus patients satisfying WHO criteria without pre-existing thyroid disease were included in the study. Thyroid function test, fasting serum insulin was done.HOMA-IR & HOMA-B (HOMA-Homeostatic model assessment) was calculated. Serum antithyroid peroxidase anibody (anti-TPO) and antithyroglobulin antibodies (anti-TG) and ANA were done. Results: Prevalence of thyroid dysfunction in type2 diabetes mellitus was 28.33% according to our study, which included overt hypothyroidism (15%), subclinical hypothyroidism (8.33%), secondary hypothyroidism (0.83%), overt hyperthyroidism (1.67%) and subclinical hyperthyroidism (2.5%). Anti TPO and anti TG antibodies were elevated in 62.07% cases of hypothyroidism, 40% cases of hyperthyroidism and 6.9% euthyroid cases of type2 DM. Anti TPO and antiTG antibodies were significantly raised in type2DM patient with hypothroidism than that of euthyroid (p value<0.0001).Compared to euthyroid diabetics, hypothyroid cases had lower values of insulin resistance markers like fasting insulin, HOMA-IR and HOMA-B. Hyperthyoid cases had higher values. Conclusion: Hyperthyroid diabetics have higher insulin resistance as fasting insulin, HOMA-IR, HOMA-B showed negative correlation with TSH. (p value<0.05).

Background: Although coronavirus disease-2019 (COVID-19) is predominantly a respiratory disease, cardiac involvement occurs commonly, especially in those with more severe illness. Echocardiography is the preferred imaging modality for diagnosing cardiac involvement in COVID-19. However, there are currently no data to describe echocardiographic abnormalities in Indian patients with COVID-19. Methodology: A cross-sectional observational analysis was performed among adult patients admitted to a tertiary care center between May 2020 and August 2020. Patients were included if they underwent transthoracic echocardiography during the hospitalization after a positive reverse transcriptase–polymerase chain reaction diagnosis for COVID-19 pneumonia. Demographic and clinical data were obtained and analyzed along with echocardiographic data. Results: During the study period, consecutive 245 patients were evaluated with echocardiography, of whom 11 were excluded due to nondiagnostic images. The remaining 234 (mean age 57 ± 16 years, 71.7% of men) were included in this analysis. All patients were admitted to intensive care unit or high-dependency unit. Right ventricular (RV) dilatation and/or dysfunction (37%) was the most common finding, followed by left ventricular (LV) systolic and diastolic dysfunction (27.7% and 23.1%, respectively). Pericardial effusion was present in 12% of cases. A total of 49 (20.9%) patients had preexisting LV systolic dysfunction (LVSD). After excluding them, the LVSD and LV diastolic dysfunction were observed in 8.6% and 2.7% of patients, respectively. Conclusions: This study demonstrates that RV dilatation/dysfunction is the most common echocardiographic abnormality in hospitalized patients with severe COVID-19. Further, larger, multicentric studies with systematic data collection and comparison with non-COVID patients are needed to determine the true incidence of echocardiographic abnormalities in COVID-19.

Introduction: Diffuse endothelial dysfunction in sepsis leads to an increase in systemic capillary permeability, the renal component manifesting as micro albuminuria. The degree of microalbuminuria correlates with the severity of acute insult, the quantification of which may serve to predict sepsis and mortality in critically ill patients. Objectives: 1. To evaluate the degree of microalbuminuria and correlate with severity of sepsis. 2. To evaluate levels of TNFαand severity of sepsis. 3. To correlate degree of microalbuminuria with levels of TNF α in patients with sepsis and its outcome. Methodology: The present study is prospective non interventional study. Patients admitted to medicine ward and ICU staying more than 24 hrs at S.C.B medical college, Cuttack are included in the study, during period of Sept'2011-Sept'2012. 1. Urine samples were collected within 6 hrs of admission and again at 24 hrs. 2. Urinary microalbumin assay by microalbumin kit (pyrogallol red immunobiometric method) 3.Urinary creatinine estimation by creatinine kit (mod jaffe's kinetic method) 4. Urinary Albumin Creatinine Ratio (ACR) 30-300 mg/gm is microalbuminuria. 5. TNF α is estimated in patients with sepsis by ELISA (bioplex). Results: Patients (n=75) were classified into sepsis,severe sepsis,septic shock and MODS according to American College of chest physician society of critical care consensus. ACR in sepsis group was significantly higher than control group (P=0.0001). Among sepsis cases ACR has a positive correlation with APACHE ІІ score and also distinguishes between survivors and nonsurvivors (p=0.001). ACR could easily distinguish patients of MODS from sepsis (p=0.03) and septic shock from sepsis(p=0.007). Values of TNFα can distinguish survivors from nonsurvivors (p=0.04) and TNFα also distinguishes patients of sepsis from septic shock (p=0.002). Conclusion: Microalbuminuria has a good diagnostic and prognostic significance in sepsis as compared to APACHE ІІ score and TNFα.