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INTRODUCTION: Corona virus disease-19 (COVID-19) is one among the worst pandemics faced by mankind and there are various neurological manifestations either direct or indirect effect of Corona virus. Here we report a case of foot drop secondary to entrapment peroneal injury in COVID-19 patient as a sequelae of prone positioning. CASE REPORT: A 55-year-old gentleman was diagnosed with RT PCR positive COVID19 and was hospitalized for severe respiratory syndrome. HRCT thorax done showed CORADS score of 6 with severity index of 14/25. During this period, patient was on treatment according to ICMR guidelines and prone position for about 20 hours/day for 20 days for severe pneumonia. During follow up after 15 days of discharge, he had developed features of foot drop secondary to common peroneal nerve palsy which was later conrmed by electro diagnostic studies and nerve ultrasound. Patient was started on oral steroids and along with supportive measures. He is followed up for a period of 3 months and has noted 50% improvement in his symptoms. CONCLUSION: While prone positioning should continue to be utilized in COVID-19 pneumonia as dictated by the current literature, precaution has to be taken with it. Changing patient positioning at shorter intervals and timely mobilization are necessary.

Background: Type 2 diabetes mellitus is a chronic metabolic disorder due to insulin resistance caused by destruction of beta cells of pancreas. Insulin resistance in newly diagnosed type 2 diabetes mellitus patients leads to hyperglycemia. Serum adiponectin is a more sensitive and specific biomarker for early detection of diabetic nephropathy than urinary microalbuminuria.Methods: This is a case-control study conducted in Akash Institute of Medical Sciences, A total 180 subjects (120 cases and 60 controls). All the subjects included after informed consent, blood samples and urine samples are collected from the all the subjects. The serum Adiponectin and was estimated by using enzyme-linked immunoassay (ELISA) and fasting blood sugar (FBS), post prandial blood sugar (PPBS) and renal function test (RFT) was also estimated by laboratory standard methods.Results: This study was evaluated the FBS, PPBS, RFT and serum adiponectin levels in patients with type 2 diabetes mellitus patients and compare them with healthy controls. The serum adiponectin levels more significantly elevated in newly diagnosed type 2 diabetes mellitus patients and compared with the healthy controls. The study also found that significantly elevated levels of FBS, PPBS and RFT in type 2 diabetes mellitus patients and compared with the healthy controls, The statistically significant levels of serum adiponectin in patients with type 2 diabetes mellitus and when compared with the controls (p= 0.0001).Conclusions: The study suggesting that the s estimation of serum adiponectin levels in newly diagnosed type 2 diabetes mellitus patients useful for early detection of diabetic nephropathy. Because elevated levels of serum adiponectin in patients with newly diagnosed type 2 diabetes mellitus, this levels are positively correlated with the FBS and PPBS.

Background: Type 2 diabetes mellitus is a chronic metabolic disorder due to insulin resistance caused by destruction of beta cells of pancreas. Insulin resistance in newly diagnosed type 2 diabetes mellitus patients leads to hyperglycemia. Serum amylase and lipase levels is an exocrine enzyme produced by acinar cells of pancreas. Altered levels of serum amylase and lipase leads to endocrine disorders, metabolic syndrome and diabetes mellitus.Methods: This is a case-control study conducted in Akash Institute of Medical Sciences, A total 100 subjects (50 cases and 50 controls). All the subjects included after informed consent, blood samples are collected from the all the subjects. The serum amylase and was estimated by using enzymatic commercial available kits and fasting blood sugar (FBS), post-parandial blood sugar (PPBS), renal function test (RFT) and liver function test (LFT) was also estimated by laboratory standard methods.Results: This study evaluated the FBS, PPBS, RFT, LFT, Amylase and Lipase levels in patients with newly diagnosed type 2 diabetes mellitus patients and compare them with healthy controls. The serum amylase and lipase levels more significantly elevated in newly diagnosed type 2 diabetes mellitus patients and compared with the healthy controls. The study also found that significantly elevated levels of FBS, PPBS, RFT and LFT in newly diagnosed type 2 diabetes mellitus patients and compared with the healthy controls, The statistically significant levels of serum amylase and lipase levels in patients with newly diagnosed type 2 diabetes mellitus when compared with the controls (p=0.0001).Conclusions: The study suggesting that to estimation of serum amylase and lipase levels in newly diagnosed type 2 diabetes mellitus patients useful for early detection of diabetes mellitus and its complications. Because elevated levels of serum amylase and lipase in patients with newly diagnosed type 2 diabetes mellitus, these levels are positively correlated with the FBS and PPBS.

Background: One of the most serious complications of portal hypertension is the development of esophageal varices and variceal bleeding due to the rupture of varices. The purpose of the study was to assess the efficacy of various clinical and laboratory parameters in predicting the presence and severity of esophageal varices in cirrhotic patients.Methods: This is an observational cross-sectional study done in the department of medicine in Vydehi Institute of Medical Sciences, Bengaluru over a period of one year. Total of 76 patients above the age of 18years with the diagnosis of cirrhosis of any etiology were included. Multivariate Backward method was applied and Portal vein diameter, Platelet count, PT INR, FIB-4 score, APRI, AST/ALT ratio were included as predictors in the model.Results: No statistically significant correlation was found between platelet count, portal vein diameter, FIB 4 score, APRI, AST/ALT ratio and presence of esophageal varices.Conclusions: Present study showed that the non invasive markers such as platelet count, portal vein diameter, FIB 4 score, APRI and AST/ALT ratio are not reliable in predicting the presence of esophageal varices.

We discuss a case of primary hyperparathyroidism caused by a giant cystic parathyroid adenoma presenting with neck swelling and hypercalcemic crisis. Fine-needle aspiration cytology of presumed thyroid swelling from one of the two sites aspirated yielded clear fluid but was not attributed to parathyroid pathology. Elevated serum calcium and intact parathormone (iPTH) levels suggested preoperative parathyroid pathology. Ultrasound neck and sestamibi scan for parathyroid localization were not conclusive. Due to resistant hypercalcemia, the patient underwent emergency bilateral neck exploration and excision of the identified left superior parathyroid cyst along with total thyroidectomy. Monitoring of intra-operative iPTH helped complete removal of hyperfunctioning parathyroid tissue. Histopathological examination confirmed the parathyroid cyst. Cystic parathyroid adenoma should be considered in the differential diagnosis of cystic neck lesions.