BACKGROUND Metformin is the cornerstone medication in the management of type 2 diabetes mellitus (T2DM) with estimates that it is routinely prescribed to 120 million type 2 diabetes patients around the world. Preceding studies say long term use of metformin in T2DM lowers vitamin-B12 levels and its clinical manifestations can be misdiagnosed as diabetic peripheral neuropathy. The aim of this study is to correlate haematological parameters with estimated serum Vit. B12 levels in T2DM patients on long term metformin in patient subjects and healthy volunteers. MATERIALS AND METHODS A total of 34 T2DM patients (cases) and 34 healthy volunteers (controls) were enrolled in the study from the outpatient department and in-patient wards of RVM Hospital, for over a period of 6 months. Serum vitamin-B12, HbA1c and haematological parameters were measured. RESULTS The clinical characteristics and serum vitamin-B12 levels of the study population were compared using chi-square cross tabulation. Vitamin-B12 deficiency was higher in T2DM patients taking daily dose of metformin >1000 mg/day. Hematological parameters estimation and peripheral smear study was done in all cases to identify macrocytic anaemia and hyper segmented polymorphs.

BACKGROUNDActinomycosis of the tonsillar tissue is a rare pathological condition whose clinical significance has been disputed by authors worldwide. This is a retrospective study of tonsillectomy specimens resected for chronic tonsillitis which showed actinomyces on microscopic examination. The histopathology of the tonsillectomy specimens revealed colonies of actinomyces in tonsillar crypts, along with cryptitis and reactive lymphoid hyperplasia. The question as to whether the presence of colonies in tonsils is incidental or causative for tonsillar lesions is still not definitely solved. The present study was conducted to determine the histopathological features of tonsils and significance of actinomycosis in chronic tonsillitis. The aim of our study is to evaluate the histopathological features of tonsillectomy specimens with actinomyces and to determine the etiological significance of actinomyces in chronic tonsillitis. METHODS30 chronic/recurrent tonsillitis patients who underwent bilateral tonsillectomy were subjected to histopathological study and 10 were found to have actinomycotic granules. The age group of the tonsillectomy patients in our study ranged from 7 to 32 years. Tonsillectomy biopsy specimens were stained with Haematoxylin-Eosin, Gram stain, PAS and GMS and were evaluated with light microscopy for the presence of actinomyces, signs of significant cryptitis or active tonsillitis and reactive lymphoid hyperplasia. The data was further analysed to determine the statistical significance. RESULTS10 cases (20 tonsillectomy biopsy specimens) with a mean age of 21.4 years (ranging from 13 to 32 years) were considered in this study. Actinomyces were seen in 12 tonsillar specimens only. Histopathological study of tonsillectomy biopsy specimens showed chronic tissue infection. We found a significant statistical relationship between the age and the presence of actinomycosis as actinomyces colonies were found more frequently in adult patients with female preponderance. There was no causative correlation between actinomyces colonies and chronic tonsillitis in our study.