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Introduction: There is rising concern about vitamin D deficiency around the globe due to its increasing association with multiple medical disorders. Diabetes Mellitus (DM) is an established risk factor for atherosclerotic disorders, and Carotid Artery IntimaMedia Thickness (CIMT) is considered a radiological marker of subclinical atherosclerosis. Aim: To find a correlation between serum 25-hydroxy vitamin D (25-(OH)-D) levels and CIMT among patients with DM. Materials and Methods: A hospital-based cross-sectional study was conducted, including 100 adult patients with Type 2 DM who were admitted to the Department of Medicine at SCB Medical College and Hospital in Cuttack, Odisha, India from October 2020 to September 2021. Vitamin D deficiency was defined as serum 25-(OH)-D levels

Background: Intravenous (IV) iron sucrose is claimed to have better safety profile and efficacy in treatment of iron deficiency anemia than conventional oral iron supplements. Aim: The aim of the study was to compare the efficacy and safety of IV iron therapy with oral iron supplements in iron deficiency anemia. Methods: An observational study was carried out by allocating 100 patients with baseline hemoglobin between 5 and 10 g/dL into two groups of oral iron and IV iron group. Hemoglobin and serum ferritin levels were measured at admission, on day 14 and on day 28. Adverse effect profile for each group was tabulated. Mean and standard deviation were calculated for each group and compared. Results: A total of 100 patients participated consisting of 37 males and 63 females. Baseline hemoglobin and serum ferritin for both groups were comparable. After initiation of therapy, hemoglobin in oral iron group raised from 6.45 (0.72) to 8.84 (0.47) on day 14 and to 9.69 (0.47) on day 28. Hemoglobin in IV iron group increased from 6.34 (0.86) to 10.52 (0.61) on day 14 and to 11.66 (0.84) on day 28. Serum ferritin in oral iron group increased from 8.3 (1.9) to 33.8 (1.29) on day 14 and to 43.61 (8.8) on day 28. Serum ferritin in IV iron group raised from 8.23 (4.64) to 148.23 (11.86) on day 14 but decreased to 115.76 (15.3) on day 28. The data were statistically significant for IV iron therapy on day 14 and day 28. Of 100 patients, 18 patients (12 in oral and 6 in IV iron groups) had adverse effects. Among the oral iron group, metallic taste and constipation were major side effects followed by heart burn and nausea. In the IV iron group, arthralgia (4 patients of 6) was the major side effect observed. One patient (of 6) in IV group had hypotension. Anaphylaxis was not observed in any patient in either group. Conclusion: IV iron therapy is effective and safe for management of iron deficiency anemia.

Introduction: Organ dysfunction due to sepsis is manifested as acute rise of 2 points in quick Sequential Organ Failure Assessment (qSOFA) score from baseline, which is assessed by: 1) Systolic Blood Pressure (SBP) ≤100 mmHg; 2) Respiration Rate (RR) ≥22/min; 3) altered mentation, each having one point. For timely and specific management, an early diagnosis and stratification of severity of the sepsis is important. To predict the outcome of sepsis many scoring systems like SOFA, Acute Physiology and Chronic Health Evaluation II (APACHE II), Rapid Emergency Medicine Score (REMS), Mortality Prediction Model (MPM) have been developed. REMS is simple and feasible scoring system comprising of simple variables like, age in years, Pulse Rate (PR), RR, Mean Arterial Pressure (MAP), Glasgow Coma Scale (GCS) and SpO2 estimation. Aim: The aim of the study was to evaluate the efficacy of REMS score and to validate its utility in patients with sepsis to predict mortality. Materials and Methods: This was an observational, cohort study conducted in the Department of Medicine of SCB Medical College and Hospital, Cuttack. A total of 100 patients of sepsis admitted to medical wards and Intensive Care Unit (ICU) of Medicine department were included in the study. Vital parameters like PR, SBP, RR, GCS, SpO2 were noted. REMS score was calculated for patients with sepsis and septic shock, among survivors and non survivors. Primary outcome was either death or discharged. The observed data was statistically analysed for utility of REMS score in predicting mortality, which is the secondary outcome of the study. Student’s t-test and Mann-Whitney U test were used for comparing normally and non-normally distributed data respectively. Univariate and multivariate logistic regression was done for all parameters in REMS. Results: The average age of the patients was 49 years (SD 14.5) with males and females almost equally distributed. Major source of infection were pneumonia (24%) followed by urinary tract infections (19%). REMS score was calculated on the day of admission of all 100 patients. It clearly distinguished survivors from non survivors (p

Background: Sickle cell disease is the commonest inherited hemoglobinopathy. There are few reports point towards decrease incidence of diabetes mellitus in sickle cell disease patients. Materials and Methods: This cross-sectional study was conducted in VIMSAR, Burla, Odisha between Nov 2014 to Oct 2016. FBS and 2 hours OGTT reports of adult sickle cell disease patients were compared with the same reports from equal no of adult persons without sickle cell disease (controls) to found out any significant difference in prevalence of diabetes mellitus in sickle cell disease patients versus controls. Results: A total of 137 adult patients of sickle cell disease out of which males were 94 (68.61%) and females were 43 (31.38%) with an average age of (26.7 ± 10.9) years and an equal number of controls [males 87 (63.8%) and females 50 (36.5%)] with an average age of (47.6 ± 13.6) years were included in the study. We found diabetes mellitus in 2 (1.46%) out of 137 sickle cell disease patients with an average BMI 18.5 kg/m2 versus 12 (8.76%) in equal number of controls with an average BMI of 22.6 kg/m2. Conclusion: This study concludes that prevalence of diabetes mellitus in sickle cell disease patients is significantly lower than non-sickle cell disease persons. This may be due to less longevity and low BMI in sickle cell disease patients.

Introduction: It is well known that hyponatremia is common in severe malaria. However, there is scanty and conflicting literature regarding hyponatremia as a predictor of mortality in severe malaria. Aim: To determine the prevalence of hyponatremia in severe malaria and its association with mortality. Materials and Methods: It was a hospital based cross-sectional study conducted in a tertiary care referral hospital in the state of Odisha in India. Sample size was calculated to be 99 by using the prevalence of hyponatremia in severe malaria 55% with absolute precision of 10%. Taking into account of 10% drop out rates, the final sample size was determined to 109. Considering the prevalence of mixed plasmodium infection to be 13% and the proportion of falciparum to vivax infection to be 49:51, samples ≥45 in each group was adequate for comparison. Consecutive sampling was done over a period of two years. Severe malaria included either infection with Plasmodium falciparum alone or both Plasmodium falciparum and Plasmodium vivax along with any one feature of WHO criteria for severity. Patients aged more than 15 years with both smear positive and rapid card test positive were included. Vital parameters and electrolyte levels were measured for each patient. The data was analysed using SPSS and significance level was set at 95%. Results: Out of the total number of 110 cases of severe malaria, isolated falciparum malaria was 57.3% (n=63) vs. mixed falciparum-vivax infection of 42.7% (n=47); overall mortality was 6.3% (n=4) vs. 14.8% (n=7) respectively. Hyponatremia was observed in 63.6% (n=70) of the total cases. The difference in incidence of hyponatremia in both the groups was 133±6 mEq/L vs. 127±6.3 mEq/L respectively and was statistically significant. Among the hyponatremic group of patients, the difference in level of sodium in both the group was (128±3.5 vs. 124±3.2) mEq/L and was statistically significant. Overall mortality rate was 10% (n=11/110), however mortality rate among the hyponatremic patients was 15.7% (n=11/70; 12.1% vs. 18.9% in both the groups respectively). Hyponatremia at a cut-off of 126 mEq/L predicted mortality with a sensitivity of 81.8%, specificity of 78.8%, and negative predictive value of 97.5%. Conclusion: Hyponatremia was highly prevalent among the severe malarial patients. Higher degree of hyponatremia was observed in mixed plasmodium infection. Severe hyponatremia predicted mortality with high sensitivity and specificity.

Background Organophosphorus (OP) poisoning is a leading cause of mortality due to self-harm in Asian countries, including India. Red blood cell cholinesterase (RBC-ChE) and serum cholinesterase (serum-ChE) levels are used for predicting outcomes. There is a paucity of literature studying the RBC-ChE levels in OP poisoning and comparing it with the serum-ChE levels.