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Context: Anthropometric parameters can play an important role in monitoring the progression and management of diabetes mellitus (DM). This study was planned to highlight the relationship of abdominal volume index (AVI) with glycemic control and the microvascular complication of albumin excretion. Aims: We aimed to study the association of AVI with glycemic control and urine albumin excretion in patients of type 2 DM. Settings and Design: This was a descriptive, observational, cross-sectional, hospital-based study. Subjects and Methods: The study conducted in a tertiary care health center of North India recruited thirty consecutive patients of type 2 DM attending the Medicine outpatient department. Anthropometric assessment was made, and samples for blood biochemistry including glycated hemoglobin (HbA1c) and urine albumin excretion were taken. Statistical Analysis Used: The association of AVI with degree of glycemic control and urine albumin levels was expressed as correlation coefficients (r) by using Spearman or Pearson correlation measures for qualitative and quantitative variables respectively. The ability of AVI to predict HbAlC and urine albumin-creatinine ratio was calculated by a simple linear regression technique. P <0.05 was considered statistically significant. Results: There was no statistical significance in the predictive ability of AVI and glycemic control, and microalbuminuria. Conclusions: Our study showed that AVI is not a reliable marker in diabetic patients to predict the degree of glycemic control and microalbuminuria. [ABSTRACT FROM AUTHOR]

Laparoscopic splenectomy has become an established standard of care in managing surgical diseases of the normal-sized spleen. Natural orifice transluminal endoscopic surgery (NOTES) is a step forward in making laparoscopic surgery even less invasive. In addition, the spleen can be accessed easily with the hybrid transvaginal approach. We present the case of a 38-year-old woman with medical refractory immune thrombocytopenic purpura. Hybrid notes splenectomy was performed using three working 5-mm abdominal trocars and a 10-mm camera port through the posterior fornix of the vagina. The organ was retrieved intact transvaginally. The patient had minimal post-operative pain and was discharged on the 1st post-operative day. Transvaginal hybrid NOTES approach is feasible for operative visualisation, dissection, clipping and specimen extraction in patients requiring splenectomy. It may offer better cosmesis and faster recovery. Comparative studies with conventional laparoscopic approach are desirable. [ABSTRACT FROM AUTHOR]

The major causes of hematuria in a middle-aged female include infections, renal calculi, or structural abnormalities of the urinary tract. Most patients are investigated and treated on an outpatient basis. While a possibility of malignancy of the bladder or kidneys may also be considered, hematological malignancy is an uncommon cause of hematuria. Detailed evaluation is important to rule out malignancy in new-onset hematuria. We report a case of a 49-year-old female who presented with gross hematuria, later diagnosed to have multiple myeloma (MM), despite the absence of its classical symptoms. This unusual presentation reaffirms its status as "The Great Masquerader." The case is worth highlighting because gross hematuria as the first presentation of MM is uncommon. The author wishes to stress that the clinician should also suspect blood dyscrasias with associated coagulation abnormalities in the workup of gross hematuria. [ABSTRACT FROM AUTHOR]

Poncet's disease is a rare form of tuberculosis (TB). It is described as a hypersensitivity reaction of extra-articular TB, which manifests as acute-onset non-destructive polyarthritis of large joints. It resolves completely on anti-tubercular therapy. We describe a case of a young female patient who presented with symmetrical polyarthritis on a background of tubercular lymphadenitis. The workup for rheumatological diseases was negative. A diagnosis of Poncet's disease or tubercular rheumatism was made by exclusion. There was complete resolution of symptoms of joint disease following anti-tubercular therapy. Poncet's disease should be kept under suspicion in TB endemic areas while investigating patients of arthritis. In a resource-limited setting, in patients with TB, the response of coincident inflammatory arthritis to anti-tubercular therapy may be first observed, before subjecting them to further investigations and/or empirical therapy. [ABSTRACT FROM AUTHOR]

Sir, Vector-borne diseases, malaria, dengue (DENV), chikungunya (CHIKV), filariasis, yellow fever, and Japanese encephalitis being the common ones, account for >17% of all infections globally, causing close to 700,000 deaths per annum.[[1]] In the tropics, febrile illness may result from co-infection with multiple arthropod-borne organisms. Virusdisease 2017;28:422-4. 7 Dev N. An infection cocktail: Malaria, dengue, chikungunya and Japanese encephalitis. We encountered a case of triple infection of malaria, dengue, and chikungunya in a 28-year-old nonpregnant female with no known comorbidities who presented with fever and epistaxis for 5 days. [Extracted from the article]

Dear Editor, We agree with the authors Rohisha and Jibin that "during or after this pandemic, there will be a new normal life for the Indians and they will be used to these life-style changes to protect themselves and the community from communicable diseases".[[1]] But as of June 2021, the active COVID-19 case load in India is steadily declining. Covaxin or BBV152 is a whole-virion inactivated SARS-CoV-2 vaccine adjuvanted with Algel-IMDG.[[6]] The other vaccine approved in India, the Covishield (ChAdOx1 nCoV-19 vaccine (AZD1222)), consists of a replication-deficient chimpanzee adenoviral vector ChAdOx1, containing the SARS-CoV-2 structural surface glycoprotein antigen (spike protein; nCoV-19) gene. Introducing the vaccine Covaxin, though in trial mode, ensured that the availability of vaccines did not become a limiting factor in its rapid immunization drive. [Extracted from the article]

We report a case of a 34 −year −old lady who presented with anemia and bad obstetric history. She was diagnosed to have Systemic Lupus Erythematosus (SLE) with Antiphospholipid Antibodies (APLA) Syndrome. She also had dilated and tortuous veins over the chest and upper abdomen. CT Venography was done, and she was detected to have complete thrombotic occlusion of superior vena cava, right brachiocephalic and right internal jugular veins, with multiple systemic venous collaterals. Patient was started on steroids and anticoagulation therapy which resulted in improvement of her general condition. This case is noteworthy as the patient was asymptomatic for extensive major vessel thrombosis and SVC syndrome. [ABSTRACT FROM AUTHOR]

We had encountered a very rare congenital anomaly of a preduodenal portal vein while doing laparoscopic cholecystectomy. More significant in our case is that this preduodenal vein is hiding behind omental adhesions with the gallbladder. We want to raise awareness about this very rare anomaly. Recognition and knowledge of this anomaly will prevent the potential of a serious operative misadventure. [ABSTRACT FROM AUTHOR]