A negative association has been observed between diabetes and asthma in individuals. Earlier studies have shown that asthma and diabetes do not go hand-in-hand. However, recent reports suggest that there is a positive association between diabetes and symptoms of asthma.
One hundred and thirty eight asthma patients were included in the present study. These patients were admitted in Bombay Hospital between the period of January 2002 and July 2004. Retrospective analysis of available data was done and the blood sugar levels of diabetic patients and non-diabetic patients were analyzed. These patients were categorized in 4 groups - Chronic Bronchial Asthma. Acute exacerbation, status asthmaticus and late onset asthma.
Out of the 138 patients; 52 patients (37.68%) suffered from Asthma and Diabetes.
In the category of Chronic Bronchial Asthma out of 70 patients; 30 patients were diabetic (mean blood sugar level: 178.03 ± 78.39 mg%) while 40 patients were non-diabetic (mean blood sugar level: 98.16 ± 10.61 mg%). In the category of acute exacerbation out of 63 patients; 20 patients were diabetic (mean blood sugar level: 197.45 ± 86.72 mg%) while 43 patients were non-diabetic (mean blood sugar level: 97.69 ± 86.72 mg%). In the category of Status Asthmaticus out of 4 patients; 1 patient was diabetic (blood sugar level: 191 mg%) while 3 patients were non-diabetic (mean blood sugar level: 96.54 ± 12.08 mg%). In the category of Late Onset Asthma there was 1 patient who was diabetic and the blood sugar level was 228 mg%. Four patients out of the admitted 138 (2.90%) expired during hospitalization.
Our study shows that there is a positive association between asthma and diabetes. Similar reports have appeared in Lancet in 2001. Thus, our findings suggest that there may be common factors influencing susceptibility to the two disorders.

Relationship between asthma and family history of asthma was shown as early as 1923 by Coca. Further Nelson (1983) reported the role of aeroallergens in asthma. With this background, present study was planned to find out the possible role of family history and environment in the development of childhood asthma.
Prospective study of two hundred and fifty asthmatic children was planned from the city of Mumbai. This Study included: detailed history, physical examination, clinical examination, blood investigations along with skin prick test and respiratory function tests viz. FVC, EFV1, PEFR and MVV.
Results show that children as early as 1 to 2 years age having genetic predisposition were sensitive to house dust and house dust mite. Further study of 40 atopic and 25 nonatopic subjects was carried out particularly to observe the role of family history and environment in development of asthma. Atopic children showed higher sensitivity to HDM (62.5%) compared to non-atopic group. In atopic group, mite sensitive children showed severe obstruction 24%, against none in non-atopic asthmatics whereas moderate values were observed in 48% and mild in 28%.
Severity of asthma in atopic children, indicated that genetic predisposition possibly played an important role. Higher sensitivity to HDM in this group leading to significant changes in pulmonary functions emphasized environmental factor in aggravating the asthmatic symptoms.

Sensitivity to aeroallergen at younger age and severity of asthma particularly in the atopic children suggests that genetic and environmental factors go hand in hand.

Background : Typha angustata (TA), the ubiquitous and most common weed in Mumbai (India). To explore the allergenic significance of the pollen of T angustata, with a view to identify its major allergens causing allergic disorders in sensitive subjects.
Methods : The allergenic potential of the pollen extract was studied by skin prick tests (SPT). Nasal provocation test (NPT) with pollen extract of T angustata was done on 12 SPT positive patients. Identification of the major allergens of T angustata was done by sodium dodecylsulphate polyacrylamide gel electrophoresis (SDS-PAGE) and immunoblotting.
Results : Skin prick testing of 355 respiratory allergic patients with whole pollen extract exhibited positive response in 9.6% patients. In 86% subjects, the NPT with allergenic extract of TA lead to definite decrease in nasal airflow. Allergen extracts of TA resolved in 20-25 protein bands, in the molecular weight (MW) range of 10-100 kDa on 12.5% SDS-PAGE gel. Nine protein bands (in the MW range of 14-70 KDa) were found to be allergenic and could bind with specific IgE in the patient’s sera in immunoblotting.
Conclusion : The incidence of positive SPT responses to TA pollen was 8.2% among the general population. The IgE binding patterns of individual patients sera emphasize predominance of nine proteins in terms of their allergenicity and indentified as major allergens of Typha angustata.

Background : With the incidence of patients infected with human immunodeficiency virus (HIV) increasing in India, the neurological manifestations of the disease are being seen more frequently. The present study is an attempt to elucidate the spectrum of neurological involvement in patients with HIV infection.
Material and Methods : Case records of 102 HIV positive patients with neurological involvement admitted in Bombay Hospital were studied for demographic and clinical parameters.
Results : Majority of patients were between 30 and 39 years of age, with a male to female ratio of 4.5:1. The diseases with infectious aetiology were CNS tuberculosis (18.5%), cryptococcal meningitis (16.6%), toxoplasmosis (5.8%), progressive multifocal leucoencephalopathy (3.9%), CMV encephalitis (3.9%), cerebral abscess (2.9%) and herpes zoster (0.9%). The noninfectious lesions included cerebro-vascular events (16.6%), neoplasms (7.8%), AIDS dementia complex, neuropathy and demyelination (4.9% each), seizures and encephalophy (2.9% each).
Conclusion : CNS tuberculosis is the commonest secondary infection seen in HIV, and mycobacteria are frequently demonstrated in CSF of these patients. Cryptococcal meningitis is the next common and shows a striking male preponderance for reasons yet unknown. The commonest noninfectious lesions included cerebro-vascular events, followed by neoplasms. Neuropathies were less common than reported in western literature.

It is a hitech revolutionary path break in Phacoemulsifiction. It involves sophisticated instruments, machinery and skillful surgeons to perform the procedures.
Technique
It is performed through less than 2 mm clear cornea incision and side-port of 1.5 mm incision with introduction of sleeveless probe/microneedle through main incision and irrigating probe through side port. The bottle height is 250 gms and the ultrasound is kept at a minimum of 30 and aspiration between 130 and 150 on the (protege machine). The para meters would change on the millennium, infinity, legacy machines in which the vacuum would be the maximum.
The nucleus is chopped into multiple small pieces and has been phacoemulsified in the probe.
With the advent of such a microincision the modified rollabe foldable lenses are being injected through a much thinner cartridge.
Advantages : Due to the microincision the wound healing is much faster with negligible astigmatism. Due to less tissue handling and use of less ultrasound, corneal decompensation is at a much lesser Degree.
Disadvantages : It has a steeper learning curve with requirements of certain modified instruments.

Background : Cryptococcal meningitis is on the rise due to the advent of HIV infection. We tried to find out the incidence of Cryptococcal infection over a period of twelve months from January 2004 to December 2004.
Material and Methods : About 351 Cerebrospinal fluid samples were processed for Cryptococcal antigen detection by latex agglutination. The samples were also checked for capsulated yeast cells by India ink preparation.
Results : The latex agglutination test detected cryptococcal antigen in 14.2% cases. Cryptococcus neoformans was seen in only 11.1% cases by India ink preparation. About 98% of these cases, where Cryptococcal antigen was detected, were HIV positive. In only one case, though HIV negative, Cryptococcal meningitis was diagnosed.
Conclusion : Cryptococcal antigen detection test by latex agglutination is much more sensitive than India ink preparation. Though HIV positive status of the patient is indicative of Cryptococcal antigen detection, it is also recommended in HIV negative patients with clinical features.

Background : Any frank pus sample is expected to have pyogenic aetiology. But we have encountered no pyogenic organisms in some such samples prompting us to look for other aetiologies.
Material and Methods : About 5610 pus samples were processed over a period of 34 months from March 2002 to December 2004. These were evaluated for Acid fast bacilli by Ziehl Neelsen’s method and Auramine Rhodamine stains. The samples with no growths were further concentrated with sodium hypochlorite and the smears prepared were stained by Ziehl Neelsen’s method.
Results : The demonstration of acid fast bacilli was possible in 26% cases, where there was no growth on routine culture. Auramine rhodamine staining gave positive results in all these cases. Ziehl Neelsen’s staining gave only 12% positivity from these. On sodium hypochlorite concentration however, demonstration of tubercle bacilli was possible in all 26% cases.
Conclusion : Extrapulmonary tuberculosis must be borne in mind for every pus sample yielding no growth on culture. In such cases, the sensitivity of Auramine Rhodamine staining is definitely better. But sodium hypochlorite concentration also gives sensitivity on par with Auramine Rhodamine staining. If a laboratory does not have the luxury of fluorescence microscope in a developing country like India, the sodium hypochlorite concentration can be resorted to for demonstration of acid fast bacilli in pus samples.

Objectives : To study the rise of hepatitis E trends, which constitute one of the causes of viral hepatitis.
Introduction : Hepatitis E virus is single stranded RNA virus transmitted enterically, giving rise to epidemics. We have noticed the increase in positive samples in our laboratory over last 1 ½ years. Therefore we wanted to review the data available and analyse the results.
Material and Methods : Period of study from June 2003 to December 2004. Samples received for Elisa Anti HEV IgM test from indoor and outdoor patients at our laboratory were put up by commercially available ELISA kits from Globe Diagnostics Cut off was calculated as per product insert and samples with OD 450 nm values higher than the cut off were considered reactive.
Results : Total 552 samples received out of which 206 were reported to be positive.
l Maximum number of samples (71) were received in December 2004.
l Maximum positivity was also seen in December 2004, 45 out of 71 were positive.
l Maximum no. of positive samples were in the age group 21-30 years.
l No. of samples positive in females were 79/229.
l Rising trends of positivity were observed in the monsoon and post monsoon period.
Conclusion : Antibody to HEV IgM appears to be associated with acute stage of infection. The data reveals the rising trends of Hepatitis E virus. There is no vaccine for Hepatitis E the only way to prevent the disease is to reduce the risk of exposure to the virus that is by practising good hygiene and sanitation.

Objectives : To encourage voluntary blood donation among general population and ultimately achieving the goal of 100% voluntary blood donation.
Methods of achieving target :
Print media : Articles about blood donation in newspaper.
Audiovisual media : By showing Documentary films on blood donation for screening to colleges and office etc.
College students : Motivation by arranging debates, poster exhibitions, drawing and painting competitions by arraging blood donation drives.
SBTC/FBBB : Different motivational projects started by SBTC/FBBB.
Data : Last 5 year data of percentage of voluntary blood donation in Bombay Hospital Blood Bank. In year 1999 percentage of voluntary donors was 3.09% which is increased to 11.53% by year 2004.
Conclusion : To make blood transfusion safe and to avoid emergencies the only way is to increase the percentage of voluntary donation. So target of 100% voluntary blood donation is not difficult to achieve by inspiring and propagating the people to come forward and donate for noble cause.

We are presenting our experience with computer maintenance of our blood stock and advantages with the system.
l Blood stock is defined as
An organized format of stored blood, which is established after processing of the blood units. It constitutes a record of blood units, which are tested negative for HIV, HBsAg, HCV, VDRL and MP.
l What is stock register?
A Group Wise (ABO and Rh) listing of all blood units on stock with date of collection, date of expiry and quantity of blood.
It listed under the following headings.
1) DGS - Directed group specific, 2) Reserved - X matched units, 3) Available.
Computer updating this stock register after each transaction.
1) ABO and Rh, 2) Serology tests, 3) Blood issues, 4) Packed cell, 5) Discard
l Use and importance of stock register.
It helps to utilize the available blood unit for routine and emergency situations. To know which units are close to expiry. If blood bag going to expire in five days computer showing this type of symbol (*).
l Maintenance of blood stock register
Every morning a printout taken. Check actual physical stock with the printout. Any error is identified and rectified.
l Mandatory FDA requirement that stock should be maintained
Manually there is with great difficulty. The process is tedious and not accurate.

We have been maintaining a computer stock register since April 2003 and found following benefits.
a. Better management of available units.
b. Less number of “No Blood inform” (If patient needs blood and blood bank does not have that particular blood group then we inform the doctor).
c. Our stock situation is accurate.
d. We have increased our transaction with other blood bank based on our report of extra units especially Rh negative units.
e. Decreasing outdating.

A case of refractory anaemia was reported in a 77 year old female. Lab investigations revealed low RBC with low Hb and dimorphic picture. WBC were markedly reduced. Platelet count was normal. Serum Vitamin B12, Folate level were normal. Serum Iron studies showed reduced serum iron, reduced TIBC and increased transferrin saturation, serum ferritin was raised, serum bilirubin and LDH were elevated. Bone marrow examination revealed hypercellular marrow with dyserythropoietic features and presence of ringed sideroblasts. The case was diagnosed as Refractory anaemia with ringed sideroblasts (Myelodysplastic syndrome - MDS-Type II RARS).