Background: Diabetic nephropathy (DN) is one of the most serious microvascular complications of diabetes mellitus and a leading cause of end-stage renal disease. Microalbuminuria is recognized as an early marker of renal involvement, while glycated hemoglobin (HbA1c) reflects long-term glycemic control. This study aims to assess the correlation between microalbuminuria and HbA1c levels and their role in predicting the progression of diabetic nephropathy. Materials and Methods: A cross-sectional study was conducted on 150 patients with type 2 diabetes mellitus attending the outpatient department of a tertiary care hospital. Patients were stratified based on the presence and severity of microalbuminuria. HbA1c levels were measured using high-performance liquid chromatography (HPLC), and urinary albumin excretion was assessed using immunoturbidimetry. Statistical analysis included Pearson correlation and linear regression to determine the relationship between HbA1c and microalbuminuria. Results: The mean age of the participants was 56.3 ± 10.5 years, with a male-to-female ratio of 1.2:1. The average HbA1c was 8.4 ± 1.3%, and the mean urinary albumin excretion was 74.6 ± 25.8 mg/day. A significant positive correlation was observed between HbA1c and microalbuminuria (r = 0.68, p < 0.001), indicating that poor glycemic control is associated with increased albuminuria. Patients with HbA1c >9% had a markedly higher prevalence of moderate to severe microalbuminuria compared to those with HbA1c <7%. Conclusion: Microalbuminuria is strongly correlated with HbA1c levels in patients with type 2 diabetes, suggesting that tight glycemic control may reduce the risk of progression to overt nephropathy. Monitoring both parameters can provide valuable insight into renal prognosis and help guide early therapeutic interventions.

Introduction: Most cases of sub hepatic caecum and appendix are asymptomatic and hence remain unnoticed. Inflammation in sub hepatic located appendix may mimic hepatobiliary or gastric pathology clinically. This may lead to delayed diagnosis and results in many surgical complications.  It is a rare congenital anomaly and results due to anomalies of midgut rotation. Materials and Methods: Present cross-sectional cadaver-based investigation was conducted on a total of thirty (30) adult human cadavers of both sexes, representative of the North Indian population. The cadavers were obtained from the Department of Anatomy, ESIC Medical College and Hospital, Faridabad, Haryana. The study was carried out over a comprehensive period of three years, beginning in February 2022 and culminating in April 2025. During cadaveric dissection, detailed observations were made regarding the anatomical position. Result: In this present cadaveric study of 30 cadavers, the caecum was predominantly located in the right iliac fossa in 93.3% of cases, while a sub-hepatic position was observed in 6.6%. Regarding shape, the normal adult type was most common, seen in 83.3% of specimens, followed by the exaggerated type in 10%, and the infantile (conical) type in 6.6% of cases. Conclusion: This type of developmental error along with appendicitis can pose a significant challenge in its diagnosis and surgical management. Knowledge of such embryological variations are of paramount importance to surgeons and radiologists to prevent surgical complications.

Introduction: The Prevalence of ESBL producing Escherichia coli (E.coli) has increased throughout the world and is a major cause of treatment failure in Intensive Care Units (ICUs). The Antibiotic resistance is increasing at alarming levels and has emerged as a major public health concern of the 21^st century. The resistance to beta lactam antibiotics is a grave concern in treating infections in hospital settings especially in ICUs. The β-lactams are among the commonly used classes of antibiotics for treating infections however the production of beta lactamases by the bugs has made these antibiotics ineffective leading to drug resistance. This study has been done to determine the magnitude of extended spectrum beta lactamase (ESBL) producing E. coli isolates among the patients in ICUs of Government general hospital, Kakinada. Aims: To determine the prevalence of ESBLs among Escherichia coli isolates in ICUs of this region. Materials & Methods: This was a prospective study conducted for 3 months in the department of microbiology, Government general hospital Kakinada. The Escherichia coli isolates recovered from various samples of patient admitted to different ICUs, were subjected to ESBL production screening test by Kirby Bauer’s disc diffusion method as per CLSI guidelines. Results: A total of 138 samples were collected in this study out of which 64 were culture positives and 74 were culture negatives. Out of total 64 samples 21 (33%) were Escherichia coli isolates, Out of 21 Escherichia coli 8 were (38%) ESBL producers. The highest prevalence of ESBL producers was seen in Paediatric ICU 3 (37%) and Gynaecology ICU 3 (37%). In this study highest prevalence of ESBL producing Escherichia coli was observed in urine samples (62.5%) followed by pus samples (25%) and sputum 1 (12.5%). The most susceptible antibiotics to the ESBL producers of E .coli were piperacillin – tazobactam (100 % sensitive), followed by imipenem (62.5%), and cefoperazone- sulbactam (37.5%). Conclusion: This study highlights the prevalence of ESBL producing Escherichia coli in the ICUs of our hospital, and an in-depth analysis of their antibiogram will be helpful in formulating the antibiotic policy and prevent spread of ESBL strains. It is recommended that ESBL screening for all isolates, (Enterobacteriaceae family) for detecting antibiotic resistance and early institution of an appropriate antibiotic.