Background: T2DM is a metabolic disorder that is increasingly becoming a public health concern. The disease is associated with a variety of systemic macrovascular and microvascular complications. Diabetic peripheral neuropathy (DPN) is the most common complication, and it may eventually develop in up to 50% of patients. It is assumed that prolonged use of metformin causes vitamin B12 deficiency. The clinical presentation of vitamin B12 deficiency generally includes haematological and neurological manifestations. The aim of the study is to correlate vit b12 levels in relation to duration of usage of metformin for a period of more than 1 year. Methods: The study was conducted from November 2017 to June 2018 for a period of 7 months which included 50 subjects from both sex groups, aged 18 years and above, on metformin with subjective evidence of neuropathy and compared with vit b12 levels. Results: The study results indicate that there is no significant drop in vit b12 levels in metformin users in significant proportions to cause vitb12 deficient-neuropathy. The p value being 0.658 comparing vit b12 with metformin usage years (<2 yrs, 2-5yrs, 5-8yrs, ≥8yrs). Conclusions: This cross-sectional study indicates that diabetic patients who were on metformin were not having any vit b12 deficiency, though all patients had subjective neuropathy. This suggests that neuropathy is not related to metformin induced Vit B12 deficiency. Therefore, prescribing of vit b12 supplementation in any long term metformin treated patients is no longer necessary and reduces patients financial burden.

Background: The main aim of the present study is to investigate the differences in clinical, microbiological, characteristics of Urinary tract infection between diabetic and non-diabetic patients and influence of diabetes on the spectrum of URO pathogens and the antimicrobial resistance in patients with urinary tract infections.Methods: The present study is conducted from February 2018-April 2019 in Narayana general hospital. A total of 181 diabetics and 124 non-diabetics are included. A thorough history examination investigations done. The final data was analysed using statistical package SPSS. The percentages in different categories were compared using chi square test and means were compared using student ‘t’ test.Results: The mean age among diabetic and non-diabetic patients was 60.2+/-13.79 years and 53.47+/-18.56 years. Fever is the most common presenting symptom. BPH was the most common predisposing factor in both diabetes and non-diabetes followed by indwelling catherization but there was no statistically significant difference. Diabetics with UTI majority (87.14%) had glyco HBA1C >6.5% with p<0.001. The prevalence of recurrent UTI is higher in diabetics compared to non-diabetics however difference was not statistically significant. Recurrent UTI is higher in females in both diabetics and non-diabetics. The presence of E coli is significantly higher in diabetics compared to non- diabetics. The antimicrobial resistance pattern was similar in both diabetic and no-diabetic subjects in E coli with maximum sensitivity to meropenem and least to ampicillin and there is no statistically significant difference.Conclusion: The host factors found to be associated with UTI are female sex, presence of diabetes, poor glycemic control, presence of fever. No correlation was noted with age, duration of diabetes and type of treatment for diabetes. An elevated HBA1C correlates with occurrence of UTI. Escherichia coli (E. coli) was the most frequent uropathogen. The resistance of uropathogens to antibiotics are similar in patients with and without diabetes and non-diabetes.

Background: Iron deficiency anaemia still remains the most common cause of anaemia not only in India but also world over. According to world heath report, there are 1,788,600 people in this world suffering from Iron deficiency anaemia. Iron deficiency anaemia is foremost prevalent disease-causing morbidity in world and therefore it is always absolutely necessary to detect this particular condition in early stages before the eventual development of various dreadful complications like Heart failure and Myocardial infarction. The aim of the study is to find incidence of iron deficiency anaemia in patients with hypo proliferative anaemia presentation, with a possible iron deficient state, by analyzing the haematological and biochemical parameters. Methods: The study was conducted from November 2017 to May 2018 for a period of 6 months which included 50 subjects from both sex groups, aged 20-80 years with the diagnosis of hypo proliferative anaemia. Results:The study results indicate that females (60%) were significantly overrepresented compared to males (40%). Of the 50 subjects 38% were in stage of negative iron balance (stage1) and 32% were in stage of iron deficient erythropoiesis(stage2) and 30% were in normal stage. Conclusions: This Observational study showed a majority of patients with hypo-proliferative anaemia presenting at early stages of negative iron balance and iron deficient erythropoiesis thereby indicating the importance of initiating iron therapy at an early stage even without correlative iron studies.

Background: Diabetes mellitus refers to a group of common metabolic disorders that shares the phenotype of hyperglycemia. Complications of diabetes mellitus involve many organ systems only to play an important role in morbidity and mortality. Poor glycemic control is significantly associated with the development of macrovascular complications. Earlier studies have indicated that C-reactive protein (CRP) is an important risk factor for cardiovascular disease as evident from its higher levels in people with diabetes mellitus compared to those without. Not much is known whether CRP is related to the level of glycemic control. The purpose of this study is, to determine the relation between HbA1C, Lipid profile and CRP in individuals with type 2 diabetes mellitus.Methods: Fifty patients with T2DM reporting to Narayana Medical College and Hospital were included in the study, in whom CRP levels were estimated by using commercially available kits and correlated with HbA1C and other risk factors of coronary artery disease. Follow-up was done on 20 patients who were not on statin therapy with repeat HbA1C and CRP.Results: This study showed that both HbA1C and CRP levels had reduced significantly in follow-up patients after putting them on treatment (p<0.05). It was also found that lower the HbA1C, lower was the CRP. A positive correlation was found between HbA1C and CRP (p<0.05).Conclusions: In this study of 50 patients with T2DM, it was found that CRP is significantly correlated with HbA1C level. A positive correlation was found between serum CRP and HbA1C in the initial group and in the follow-up patients, showing that CRP levels lowers with better glycemic control and correlates with dyslipidaemia profile.