Evaluation of body composition (BC) represents a valuable screening tool to assess nutritional status among diabetic patients. The most commonly used methods to evaluate BC in the clinical practice are based on bicompartmental models such as dual energy X-ray absorptiometry (DXA) etc. Factors like daily caloric intake (DCI), percentage of total body water (%TBW), muscle mass and bone mass and the changes that occur in these components with age could be related to the development of type 2 diabetes mellitus (T2DM). The objective of the study is to use Bioimpedance Analysis (BIA) as a screening tool to assess the correlation between these parameters in type 2 diabetic patients. This study was conducted on 200 T2DM patients aged 25-45 years for a duration of 6 months in an urban out-patients clinic after obtaining proper informed consent and ethics committee approval. A multifrequency body composition monitor TANITA MC 980 was used to analyse muscle mass, bone mass and %TBW. The impedance readings were entered into medically researched formulae to calculate body composition. The results were correlated with DCI. The study results showed a strong correlation between DCI and muscle mass (p<0.01). Scatter diagram analysis showed that muscle mass has a significant correlation with DCI at p<0.01. No significant correlation was observed between bone mass, and metabolic age with DCI. Joint regression analysis by ANOVA showed a significant correlation between %TBW and muscle mass with DCI at p<0.05. This study showed a strong correlation between DCI and increasing muscle mass and basal metabolic rate among diabetic patients. It also shows that BIA is a useful tool for clinical studies in assessing the correlation between DCI and body composition among type 2 diabetic patients.

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Objective: To evaluate feasibility and usefulness of ambulatory blood pressure monitoring (ABPM) in outpatient setting. Material and methods: In this prospective study, data of 58 patients who were evaluated with ABPM for diagnosis or therapeutic efficacy purpose were collected from their records. Demographic details of these were recorded. Patients were categorized into different categories based on 24 hours BP pattern. Dipping pattern was compared based on the gender, age, and presence of diabetes or hypertension. Number of patients diagnosed as hypertensive with ABPM reports was compared with office and home BP measurement. Results: Fifty-eight patients (mean age 57.8 years; 70.69% males) were included of whom 22 (37.93%) underwent ABPM for diagnostic purposes. There was gender-wise significant difference in terms of purpose of performing ABPM (p=0.040). Diabetes was present in 22 (37.93%) patients. Out of 36 known hypertensive patients, 17 (47.22%) patients were receiving dual therapy. Out of 45 patients whose records for active BP variability were available, 26 (57.78%) had high variability. The number and percentage of dippers, extreme dippers and reverse dippers as 23 (42.79%), three (5.56%), and six (11.11%), respectively. Depending on the age, there was significant difference in the dipping pattern (p=0.013). On office blood pressure measurement, 35 (64.81%) patients were found to have hypertension. ABPM revealed hypertension in 32 (59.26%). Masked hypertension and white-coat hypertension was observed in nine (16.17%) and 12 (22.22%) patients, respectively. Conclusion: ABPM is feasible and useful in routine outpatient clinical practice for diagnosis of essential hypertension, pattern of dipping, masked hypertension, and white-coat hypertension and also for the therapeutic evaluation of patients in clinical practice.

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Pseudomonal infection is a rare condition with multiple systemic complications. A new condition of interest is ecthyma gangrenosum in a patient with pseudomonas septicaemia with pancytopenia and megaloblastic anaemia. So here we present you the case of Ecthyma gangrenosum in a 20-year-old female with pseudomonas septicaemia due to pancytopenia. A high degree of clinical suspicion is required, but a tissue sample is ultimately necessary for definitive diagnosis.