No abstract

Background: Type 2 diabetes mellitus is a systemic disease with life-threatening complications and morbidity. The 12 lead ECG, an easily available investigation, when studied in detail can give a lot of information and predict various microvascular and macrovascular complications apart from coronary artery disease.Methods: A random cross sectional study involving 100 patients of type 2 diabetes mellitus, in the age group of 18-80 years were included in study after applying various inclusion and exclusion criteria. They were subjected to ECG, 2D echocardiography and laboratory tests. Data were collected and analysed.Results: Arrythmia was not detected in any patient. A resting tachycardia (HR >100) in 30 patients correlated with Prolonged QTc (>440 miliseconds) (p=0.04). QRS amplitude was reduced in 26 patients. Prolonged QTc also correlated with presence of diabetic complications, retinopathy of NPDR type and nephropathy (p=0.004). Hence about 30% of the study group did show signs of early diabetic cardiac autonomic neuropathy and cardiomyopathy.Conclusions: The statistically significant utility of electrocardiogram in predicting various complications of diabetes apart from coronary artery disease.

Background: Diabetes and diabetic complications are becoming major "health problems" in India. Diabetes affects all tissues, causing neuropathy, vasculopathy, myopathy, etc. Retina is both vascular and sensory neural tissue, and perhaps the damage is also two-fold. Aims and Objectives: To study incidence of diabetic retinopathy (DR) in a cohort of diabetic patients with nerve conduction velocity (NCV) proven neuropathy. Materials and Methods: a total of 50 diabetic patients aged more than 30 years, with NCV -proven diabetic neuropathy were selected for the study from a Tertiary Care Hospital in semi-rural Maharashtra. Fundoscopy after midriasis and fluorescein angiography, where indicated were performed in all patients. Data were tabulated and analyzed by multivariate analysis and then subjected to regression analysis and anova. Results: Of cohort of 50, 38 patients had retinopathy (76%), mean age of patients with retinopathy was 55.3, a male preponderance was seen 72.7%. Conclusions: higher incidence of retinopathy was seen in diabetic patients with neuropathy more so in patients with sensory neuropathy. Thus making us reflect on the possibility: of DR also being a neuropathy, to begin with and whether neuroprotective agents will have a role in preventing and postponing DR.

A 40 year old male, first presented with erythema nodosum, fever, weight loss and joint pains and did not respond to anti-tubercular treatment. One year later he came back with joint pains, erythema nodosum, fever and dry cough. He also had weakness in distal right lower limb more than left limb. He had raised ESR, hypocalcaemia, raised ACE levels and lymphnode involvement on HRCT, with skin biopsy suggestive of sarcoidosis. This time patient responded to treatment and is on regular follow up.

Chronic lymphocytic leukaemia is a haematological malignancy that occurs due to an increased proliferation of mature B lymphocytes. It is considered to be the most common leukaemia in adults. Hyponatremia is commonly seen in such patients. This case report is about a 75-year-old male, who presented with giddiness, followed by altered sensorium. However, the patient had no motor weakness or sensory loss. Initially, a diagnosis of posterior circulation stroke was made but Magnetic Resonance Imaging (MRI) brain did not show associated signs. The routine investigations showed highly elevated total leukocyte count and hyponatremia. The patient was worked up for malignancy and diagnosed with Chronic lymphocytic leukaemia. Oncology reference was taken and treated with tablet Ibrutinib. On discharge, the patient’s mentation improved, and he is on regular follow-up.