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Shailendra Kumar Singh,1 Rina Singh,1 Santosh Kumar Singh,2 Mir Asif Iquebal,3 Sarika Jaiswal,3 Pradeep Kumar Rai4 1Department of Endocrine, Endocrine Clinic, Varanasi, Uttar Pradesh, India; 2Department of Endocrinology, Endocrine Center, Patna, Bihar, India; 3Division of Agriculture Bioinformatics, ICAR-IASRI, New Delhi, India; 4Department of Nephrology, Opal Hospital, Varanasi, Uttar Pradesh, IndiaCorrespondence: Shailendra Kumar Singh, Department of Endocrine, Endocrine Clinic, Varanasi, Uttar Pradesh, India, Email reenavns@gmail.comIntroduction: Prevalence of obesity is high in diabetes mellitus (DM) and is associated with hyperuricemia (HU), hypertension, metabolic syndrome, cardiovascular disease and dyslipidemia. In obesity, elevated serum uric acid (SUA) has been shown to be associated in many studies from different countries, but data from India are lacking. The aim of the present study is to know the prevalence of obesity and to know the relationship between obesity and SUA in newly onset DM.Methods: In this cross-sectional study from India, 402 consecutive newly onset diabetic patients (male: 284; female: 118) were enrolled. All patients were grouped into four based on BMI (body mass index): underweight (< 18.5 kg/m2), normal weight (18.5– 23 kg/m2), overweight (> 23-27.5 kg/m2), and obese (> 27.5 kg/m2). All participants were grouped into four quartiles based on SUA (Q1: < 4.23; Q2: ≥ 4.24– 5.19; Q3: ≥ 5.20– 6.16; Q4: > 6.16).Results: The mean age, BMI and SUA of the participants were 46.20± 0.52 years, 26.35± 0.21 kg/m2 and 5.24± 0.007 mg/dl, respectively. Overall prevalence of generalized obesity, central obesity and hyperuricemia (HU) were 35.07%, 85.82% and 13.43%, respectively. The prevalence of generalized obesity increased across the SUA quartile. A multinomial logistic regression analysis showed that serum uric acid level was independently associated with generalized obesity (p< 0.001).Conclusion: This first report from India shows a significant positive association between SUA and generalized obesity among newly onset DM. Therefore, routine estimation of SUA is recommended in newly onset DM to prevent and treat HU and its related complications.Keywords: newly onset, diabetes mellitus, hyperuricemia, obesity, association

AIM: To investigate the efficacy and safety of the treatment of endoscopic trans-ethmosphenoid optic canal decompression (ETOCD) with combination of steroid in patients with newly onset indirect traumatic optic neuropathy (ITON) and compare the outcome between immediate ETOCD treatment and ETOCD with preoperative steroid treatment. METHODS: Patients presented as newly onset ITON (suffered trauma within 3d) at a tertiary medical center between Mar 1st, 2016 and Mar 1st, 2018 were enrolled in this study. All patients were equally and randomly divided into 2 groups. Cases in group A were performed ETOCD immediately after admition while cases in group B were prescribed by methylprednisolone (20 mg/kg · d) for 3d before ETOCD. Methylprednisolone (20 mg/kg · d) was used after surgery for 6d in group A and 3d in group B. Follow-up was up to 3mo in all cases. Visual acuity (VA) before and after treatment between the two groups were taken into comparison. RESULTS: Complete postoperative data were acquired from 34 patients in group A and from 32 patients in group B. Group A had significantly higher effective rate in VA than group B (χ2 =4.905, P=0.027). CONCLUSION: For patients with newly onset ITON, combination treatment of ETOCD with high-dose steroid is an effective and safe way. Immediate surgery will lead to better prognosis for these cases.

This case report presented a rare cause of severe headache in a patient who developed episodes of acute severe headache for the first time. The earliest accurate provisional diagnosis is crucial for a new onset severe headache in adult. A good history taking and high index of suspicious are remained the most important clinical component in managing severe first time headache in adult. The differential diagnosis of subarachnoid hemorrhage, space-occupying lesion with increased intracranial pressure, acute intoxication, meningo-encephalitis and others must be ruled out as these conditions are benefited in early management. In this patient, progressive development of headache is masked by severe intense headache, which later will be described as acute headache. The causes of newly onset severe intense headache will be discussed in the discussion. [ABSTRACT FROM AUTHOR]

Aim: To investigate the efficacy and safety of the treatment of endoscopic trans-ethmosphenoid optic canal decompression (ETOCD) with combination of steroid in patients with newly onset indirect traumatic optic neuropathy (ITON) and compare the outcome between immediate ETOCD treatment and ETOCD with preoperative steroid treatment., Methods: Patients presented as newly onset ITON (suffered trauma within 3d) at a tertiary medical center between Mar 1 st , 2016 and Mar 1 st , 2018 were enrolled in this study. All patients were equally and randomly divided into 2 groups. Cases in group A were performed ETOCD immediately after admition while cases in group B were prescribed by methylprednisolone (20 mg/kg · d) for 3d before ETOCD. Methylprednisolone (20 mg/kg · d) was used after surgery for 6d in group A and 3d in group B. Follow-up was up to 3mo in all cases. Visual acuity (VA) before and after treatment between the two groups were taken into comparison., Results: Complete postoperative data were acquired from 34 patients in group A and from 32 patients in group B. Group A had significantly higher effective rate in VA than group B ( χ 2 =4.905, P =0.027)., Conclusion: For patients with newly onset ITON, combination treatment of ETOCD with high-dose steroid is an effective and safe way. Immediate surgery will lead to better prognosis for these cases., (International Journal of Ophthalmology Press.)