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Obesity is a global epidemic with more than one billion overweight adults. Obesity is no longer a disease of adults. The problem of obesity and overweight among children and adolescents are rising gradually. This study was planned to study the prevalence of overweight and obesity among school going children attending pediatric Out Patient Department of a tertiary health care facility of Eastern India. A total of 601 study subjects participated in the study. Anthropometric measurements were taken using World Health 2 Organization (WHO) guidelines. Body Mass Index (BMI) was calculated using standard equation: BMI=weight (kg) / height (meter). BMI was plotted against gender specic WHO growth chart for 5years-19years. Percentiles expressed in Z scores determined the cutoff points for overweight and obesity at 85th and 98th percentiles, or +1 SD and +2 SD, respectively. Data was analyzed using The Statistical Package for Social Sciences for windows (SPSS, version 20.0). Chi-square test was used to show association between categorical variables. All statistical tests was 2-tailed and a p-value of

Real-world data on the effectiveness and safety of Gla-100 is limited in Indian people with T2DM. In a post-hoc analysis the effectiveness and hypoglycemia risk was studied in Indian T2DM participants (N=955) who started Gla-100 under daily routine practice and were followed-up for 6 months in the observational FINE-ASIA (overall N=2679) and GOAL (overall N=2704) registries. Mean age and duration of diabetes were 54.7±9.8 years and 9.8±6.3 years, respectively. HbA1c, FPG, body weight, dose, and incidence of hypoglycemia outcomes are summarized in Table. Mean HbA1c and FPG were significantly reduced after 6 months of Gla-100 treatment (-2.07±1.42%; -94.4±65.2 mg/dL). HbA1c targets of Disclosure V. C. Deshmukh: None. S. Mohanasundaram: Employee; Self; Sanofi. C. Trivedi: None. V. Salvi: Employee; Self; Sanofi. P. R. Narvekar: None. S. Kale: None. S. Ramakrishnan: None. G. Goyal: Advisory Panel; Self; Sanofi. T. Chaudhury: None. M. Chadha: Advisory Panel; Self; Sanofi, Speaker’s Bureau; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Merck Sharp & Dohme Corp., Novo Nordisk Pharma Ltd. M. S. Chawla: Speaker’s Bureau; Self; Abbott Diabetes, Boehringer Ingelheim Pharmaceuticals, Inc., Colgate-Palmolive, Eli Lilly and Company, Glenmark Pharmaceuticals Limited, Novo Nordisk. S. Mukherjee: None. S. U. Pitale: Speaker’s Bureau; Self; Sanofi. D. Basu: None. R. Ghosh: Employee; Self; Sanofi. A. Nair: Employee; Self; Sanofi. Funding Sanofi India

Background: With about 425 million patients globally and 72.9 million patients in India, diabetes mellitus (DM) is one of the global health emergency of 21st century. Perioperative hyperglycaemia is reported in 20-40% of patients undergoing general surgery. A substantial body of literature demonstrates a clear association between perioperative hyperglycaemia and adverse clinical outcomes. This study aims to find out the frequency of preoperative hyperglycaemia and factors influencing it among patients undergoing surgery at a tertiary health care hospital of Eastern India.Methods: This Institution based, cross-sectional, observational study was conducted among study subjects who were operated at IQ City Medical College and Multispecialty Hospital, Durgapur, India during January-February 2019. Relevant medical records were reviewed to collect data regarding clinic-social data. Estimation of fasting plasma glucose (FPG) has been done as per World Health Organization (WHO) guidelines. Hyperglycaemia was defined and classified as per American Diabetes Association (ADA). Anthropometric measurements were taken as per standard WHO protocols.Results: A total 158 study subjects participated in study. The mean age and mean FPG of the study subjects was 42.63±12.95 years and 103.3±17.37 mg/dl respectively. As per the ADA criteria, 58.9% had normal FPG, 24.0% had impaired fasting glucose (IFG) and 17.1% had diabetes. Out of total 27 T2DM patients, 22 (13.9%) were known cases of T2DM and 5 (3.2%) were undiagnosed. The frequency of preoperative hyperglycaemia i.e. sums of IFG and diabetes was found to be 41.1%. Increasing age, male gender and overweight and obesity significantly influenced the occurrence of preoperative hyperglycaemia.Conclusions: The prevalence of preoperative hyperglycaemia among patients undergoing surgery is higher than the prevalence of hyperglycaemia among non surgical patients. Routine HbA1C should be done in all surgical patients to differentiate between chronic undiagnosed hyperglycaemia and stress hyperglycaemia.

In this paper, we create EEG data derived signatures for differentiating epileptic patients from normal individuals. Epilepsy is a neurological condition of human beings, mostly treated based on a patient’s seizure symptoms. Clinicians face immense difficulty in detecting epileptic patients. Here we define brain region-connection based signatures from EEG data with help of various machine learning techniques. These signatures will help the clinicians in detecting epileptic patients in general. Moreover, we define separate signatures by taking into account a few demographic features like gender and age. Such signatures may aid the clinicians along with the generalized epileptic signature in case of complex decisions.

Background: Depression is a common comorbid condition found in chronic medical illnesses in general and diabetes mellitus (DM) in particular. Worldwide, more than 365 million people are estimated to have Type 2 DM (T2DM), and almost 300 million people have major depression. Depression can be viewed as a Modifiable independent risk factor for the development of T2DM and for progression of complications from either type 1 or T2DM. Objectives: The aim of the study was to find out the distribution and determinants of depression among T2DM patients attending an integrated diabetes and gestational diabetes clinic (IDGDC) of a tertiary care hospital of West Bengal, East India. Materials and Methods: This cross-sectional, observational study was conducted among T2DM patients who attended IDGDC during May 2017–June 2017. Public Health Questionnaire-9 was used to assess depression and its severity. A total of 196 study subjects participated in the study. Results: The prevalence of depression was found to be 54.6%. About 28.1% of the study subjects had mild depression, 17.9%, 6.1%, and 2.6% subjects had moderate, moderately severe, and severe depression, respectively. Women gender, increasing age, rural residence, low literacy, longer duration of diabetes, and overweight/obesity were significantly associated with high frequency of depression. Addiction was significantly higher among depressed T2DM patients. Mean hemoglobin A1c level was significantly lower among non-depressed T2DM patients. Conclusion: More than half of the T2DM patients are suffering from depression of varying severity. There should be a dedicated counselor in diabetes clinics for routine screening of depression among all T2DM patients to identify the high-risk patients requiring urgent psychiatrist consultation.

Background: Hypertension (HTN) is one of the most common diagnoses in a primary health care setting and it is one of the important and preventable contributors to disease and death. HTN is considered as an additional risk factor in anesthesia and HTN is of special importance to the anesthetist for various reasons. Tracheal intubation, surgical incision, recovery from anesthesia, and post-operative pain can increase blood pressure (BP). Objectives: This study aims to find out the burden of pre-operative HTN and its risk factors among patients who were admitted for surgical procedures at a tertiary health care facility of Durgapur, West Bengal, India. Materials and Methods: After obtaining permission from the Institutional Ethics Committee, an institution based, observational, and cross-sectional study was conducted from January 2019 to February 2019. A pre-tested, semi-structured schedule was used to collect Clinic Social data. Anthropometric measurements and BP were taken as per the world health organization STEP-wise approach to surveillance guidelines. BP was classified as per “The eighth joint national committee (JNC-8) guidelines. Results: Data were collected from 150 study subjects and were analyzed using SPSS, version 20.0 for windows. The frequency of pre-operative HTN and pre-HTN was found to be 38.0% and 32.0% respectively. As per JNC-8, 34.7% had Stage-1 HTN followed by 32.0% and 3.3% who had pre-HTN and Stage-2 HTN, respectively. Increasing age, male gender, smoking, increasing body mass index, dyslipidemia, and Type 2 diabetes mellitus (T2DM) were significantly associated with a higher frequency of HTN. Conclusion: There is a very high prevalence of pre-operative HTN and pre-HTN. Increasing age, male gender, smoking, overweight, obesity, dyslipidemia, and T2DM were significant risk factors for HTN. Routine screening of HTN should be done in surgical ward to see if there are cases of “white coat” HTN.

Background: Globally, about 425 million people are suffering from diabetes mellitus (DM) which will be about 629 million by 2045. India is popularly known as “World Diabetes Capital” and is presently home of about 72.9 million diabetes patients. Poorly managed DM will increase the burden of both microvascular and macrovascular complications. One of the most common complications among them is diabetic foot ulcer (DFU) which affects about 7%–24% of DM patients. Aims and Objectives: This study was planned to determine the burden of DFU and its determinants among Type 2 diabetes mellitus (T2DM) patients attending integrated diabetes and gestational diabetes clinic. Materials and Methods: An institution-based, observational, cross-sectional study was conducted from July to September 2018. A pre-designed, pre-tested, semi-structured schedule was used to collect clinicosocial data. Blood pressure of the study subjects was measured and classified as per Joint National Committee-8 guidelines. Peripheral vascular assessment of the feet was done by calculating “ankle-brachial index (ABI)” in both lower limbs using “Diabetik Foot Care India Pvt. Limited” vascular Doppler instrument having 8 MHz transducer. ABI ≤0.9 and absence of pulse in dorsalis pedis and/or posterior tibial arteries were considered as peripheral artery disease (PAD). Vibration perception threshold for peripheral sensory neuropathy was tested with the help of Diabetik Foot Care Pvt. Limited Digital Biothesiometer using 50 Hz frequency. Results: Data were collected from 338 study participants. The frequency of DFU was found to be 9.5%. Increasing age, longer duration of diabetes, poor educational status, overweight/obesity, poor glycemic control, treatment with insulin, PAD, diabetic peripheral neuropathy, hypertension, ischemic heart disease, and hypothyroidism were significantly associated with DFU. Conclusion: There is high frequency of DFU among T2DM patients. Most of the risk factors are modifiable and if taken care of the occurrence of DFU can be prevented and/or delayed.

Background: India is popularly known as “world diabetes capital” and is presently home of about 72.9 million diabetes patients. Physical activity (PA) is defined as “Bodily movement produced by the contraction of skeletal muscle that requires energy expenditure in excess of resting energy expenditure” and exercise is defined as “A subset of PA: planned, structured, and repetitive bodily movement performed to improve or maintain one or more components of physical fitness.” Aims and Objectives: This study aims to assess the PA level of type 2 diabetes mellitus (T2DM) patients and its impact on their glycemic control attending integrated diabetes and gestational diabetes clinic (IDGDC) of a tertiary health-care facility of Eastern India. Materials and Methods: An institution-based, observational, cross-sectional study was conducted among 347 T2DM patients attending IDGDC from May 2019 to June 2019. Venous blood sample for glycated hemoglobin (HbA1c) estimation was collected and medical records were reviewed to collect data regarding clinicosocial data. Data were analyzed using the Statistical Package for the Social Sciences for Windows (version 20.0). All statistical tests were two tailed and P < 0.05 was considered statistically significant. Results: About 50.0% of male had good glycemic control and only 32.1% of female had good glycemic control. About 34.9% of the study population had high PA followed by 34.0% and 31.1% who had low and moderate PA, respectively. Conclusion: There is high frequency of poor glycemic control as about 57.1% of study populations had HbA1c >7.0%. About three-fifth of the study population had either moderate or high PA.

Background: Parkinson's disease (PD) is one of the most common neurodegenerative movement disorders and its incidence is increasing worldwide along with population aging. Previous clinical and histologic studies suggest that the neurodegenerative process, which affects the brain, may also affect the retina of PD patients. Objective: The objective of this study was to determine the thickness changes of retina nerve fibers and macular volume with optical coherence tomography (OCT) in PD patients. Materials and Methods: The spectral domain OCT was used to assess the thickness of retinal nerve fiber layer (RNFL) and macular volume from 34 PD patients and 50 healthy age-matched controls. Results: Compared with healthy age-matched controls, the RNFL thickness of PD patients was much thinner (P < 0.05) in all retinal quadrants, with temporal thinning being more than nasal thinning. Macular volumes were diminished in both perifoveal and outer macular regions in all sectors (P < 0.05) with preserved foveal volume. The degree of tissue loss corroborated with the severity of disease as objectively assessed by standardized rating scales (UPDRS). Conclusion: There is generalized retinal nerve degeneration in patients of PD and the degree of loss correlated with the severity and duration of disease.

Cerebral hypometabolism of glucose, weight loss, and decreased food intake are characteristic features of sporadic Alzheimer's disease (AD). A systematic study on the serum levels of adipokines and insulin, the major hormones regulating energy metabolism, food intake, and body weight, in sporadic AD is necessary. The present study compares the serum levels of leptin, adiponectin, and insulin, measured by commercially available immuno-assay kits, between controls and sporadic AD subjects. The results show a conspicuous decrease in the level of leptin, a dramatic rise in the level of adiponectin, and also a statistically significant increase in insulin level, in the blood of AD subjects, with respect to controls. The changes in the serum levels of adiponectin and insulin in AD are positively correlated with the severity of dementia. Likewise, the serum level of leptin in AD subjects is negatively correlated with the degree of dementia. The changes in the levels of adipokines and insulin have implications in the amyloid pathology, neurodegeneration, and hypometabolism of glucose existing in the AD brain.

A Leishmania donovani species-specific monoclonal antibody (monoclonal antibody D2) was evaluated for its diagnostic and prognostic potential by a competitive enzyme-linked immunosorbent assay (C-ELISA) in sera from Indian patients with visceral leishmaniasis (VL) and seven patients with post-kala-azar dermal leishmaniasis (PKDL). These results were compared with those obtained by microscopy with Giemsa-stained tissue smears and a direct enzyme-linked immunosorbent assay (direct ELISA) with crude parasite antigen. Of 121 patients with clinically diagnosed VL examined, 103 (85.1%) were positive and 11 (9.1%) were negative by all three methods. An additional 7 (5.8%) who were negative by microscopy were positive by both C-ELISA and direct ELISA. Seven PKDL patients were also examined and were found to be positive by all three methods. Analysis of the chemotherapeutic response to sodium antimony gluconate of these 110 serologically positive VL patients showed that 57 (51.8%) were drug responsive and 53 (48.2%) were drug resistant. The C-ELISA with sera from 20 longitudinally monitored VL patients before and after chemotherapy showed a significant decrease in percent inhibition of monoclonal antibody D2 in drug-responsive patients. However, in drug-unresponsive patients, the percent inhibition of D2 was unchanged or was slightly increased. Our results therefore indicate (i) the applicability of L. donovani species-specific monoclonal antibody D2 for sensitive and specific serodiagnosis by C-ELISA, (ii) that the C-ELISA is more sensitive than microscopy, especially for early diagnosis, (iii) that L. donovani is still the main causative agent of VL, irrespective of the chemotherapeutic response, and (iv) that the C-ELISA can be used to evaluate the success of drug treatment.

Younger women exhibit more aggressive pathologic features of breast cancer (BC) compared to their older counterparts. Young age has been shown to be an independent predictor of adverse prognosis. These findings have raised the question of whether these differences are also present at the genetic level. Twenty-five early onset (ageor = 40 years) tumors including 4 bilateral tumors, and 26 late onset (40 years) breast tumors, including 2 bilateral tumors, were examined for loss of heterozygosity (LOH) at chromosome 1 using 11 polymorphic microsatellite markers. A comparative study revealed high frequencies of LOH in chr. 1p36 (61%), 1p31.3 (40%), 1p21.3 (50%) and 1q22-23.2 (56%) in a younger group, and chr. 1p36 (46%), 1p34.2 (48%), and 1q22-23.2 (52%) in an older group. These differences in LOH frequency in these two age groups were significant for chr. 1p21.3 (p = 0.025) only. These data suggest that the deletion pattern in early onset breast tumors is not fully identical to late onset breast tumors. Similar differential deletion patterns of LOH in the 5 highly deleted regions were seen in premenopausal and postmenopausal groups. An association was seen between LOH at chr. 1p34.2 and chr. 1q22-23.2 and higher grade of the tumors in older women. Among the highly deleted regions, the deletion at chr. 1p36 was found to occur early in both groups because of common allelic loss in the bilateral tumors.

We have developed a rapid, accurate, and inexpensive hemagglutination assay (HA) for diagnosis of Indian visceral leishmaniasis (VL) using achatininH, a 9-O-acetylated sialic acid binding lectin. The assay is based on the selective binding of achatininH to 9-O-acetylated derivatives of sialic acid (9-O-AcSA), which appears exclusively on the erythrocytes of patients with VL. Blood samples from 35 patients with demonstrable splenic or bone marrow amastigotes were assayed by HA and compared with an ELISA. All cases were correctly diagnosed by HA, and were in concordance with the ELISA. The increase in 9-O-AcSA was corroborated by direct fluorimetric estimation of sialic acid and its 9-O-acetylated derivative. Therefore, 9-O-acetylated derivatives of sialic acid, absent in normal erythrocytes, serve as an important biomarker, and indirectly reflect the presence of the parasite. Accordingly, this assay can be used for detection of active kala-azar cases and merits clinical consideration.

Background: The A 1 chieve, a multicentric (28 countries), 24-week, non-interventional study evaluated the safety and effectiveness of insulin detemir, biphasic insulin aspart and insulin aspart in people with T2DM (n = 66,726) in routine clinical care across four continents. Materials and Methods: Data was collected at baseline, at 12 weeks and at 24 weeks. This short communication presents the results for patients enrolled from North East, India. Results: A total of 730 patients were enrolled in the study. Four different insulin analogue regimens were used in the study. Patients had started on or were switched to biphasic insulin aspart (n = 518), insulin detemir (n = 88), insulin aspart (n = 74), basal insulin plus insulin aspart (n = 19) and other insulin combinations (n = 30). At baseline glycaemic control was poor for both insulin naïve (mean HbA 1 c: 9.5%) and insulin users (mean HbA 1 c: 9.2%) groups. After 24 weeks of treatment, both groups showed improvement in HbA 1 c (insulin naïve: −1.6%, insulin users: −1.5%). SADRs including major hypoglycaemic events or episodes did not occur in any of the study patients. Conclusion: Starting or switching to insulin analogues was associated with improvement in glycaemic control with a low rate of hypoglycaemia.