Inflammation clock or iAge clock which was developed recently that can measure inflammation products in the body of an individual and can predict immunological decline. It is also capable of predicting incurring age-associated diseases. The quantity and quantity of these inflammatory products is also related physiological age. This will be useful information in the hands of researchers who are engaged in drug development. This will also be a helpful tool in therapeutics for clinicians.

Introduction: It is important to determine the epidemiological factors like etiology, age, sex, mode of clinical presentation and pattern of development of complications of chronic liver disease, so as to design optimal and cost effective preventive and treatment strategies for the same. Aim: To determine etiology of Chronic liver disease in Northern India. Material and Methods: This was a prospective study done at Medical Gastroenterology Department, PGIMS,Rohtak conducted over a period of ten years i.e. 01.01.2011 to 31.12.2020, on 1000 confirmed patients of chronic liver disease (CLD). Results: The most common etiology seen was Alcoholic liver disease (48.9%), followed by Nonalcoholic liver disease (26.4%), Chronic Hepatitis B (12.3%), Chronic Hepatitis C (9%), Cryptogenic (2.7%) and Autoimmune liver disease-related (0.7%). Conclusion: The present study reveals that alcohol is most common cause of chronic liver disease in Northern India. The males of middle age group with rural background are at significant risk of developing CLD, thus requiring immediate social and medical intervention.

Background: Tirzepatide is a dual receptor agonist of the 2 incretin hormones: glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) which is currently under development. Objective: To clarify the potential role of tirzepatide for treatment of type 2 diabetes and obesity. Methods: Pubmed search until August 5th, 2021. Search terms were GLP-1, GIP, incretins, tirzepatide, efficacy, safety. Clinical trials and pertinent reviews were included. Results: In one phase 3 clinical trial, mean reduction of glycated hemoglobin (HbA1c) with tirzepatide (5-15 mg/week) was -1.87 to -2.07% versus + 0.04% with placebo after 40 weeks. In another phase 3 randomized trial, tirzepatide decreased HbA1c levels by -2.01% to -2.3% versus -1.86% with semaglutide (1.0 mg/week) (P<0.0001). In the previous 2 studies, tirzepatide use was associated with dose-related mean weight loss at 40 weeks of -7.0 kg o -9.5 kg vs -0.7 kg with placebo (P<0.0001) and -7.6 kg to -11.2 kg vs -5.7 kg with semaglutide ((P<0.001). Tirzepatide had generally favorable effects on lipid profile, particularly on lowering serum triglyceride levels: -19% to -24.8% mean reduction compared with -11.5% with semaglutide. Gastrointestinal (GI) adverse effects were the commonest reported symptoms associated with tirzepatide use and occurred more frequently than with placebo and semaglutide. Hypoglycemia was reported more coomonly with high-dose terzipatide (1.7%) compared with semaglutide (0.4%). Drug discontinuation rates due to adverse effects were 6-8.5 % with tirzepatide vs 4.1% with semaglutide. Conclusions: Available data from 2 short-term randomized trials suggest that tirzepatide may be more effective than placebo and the GLP-1 agonist semaglutide in reducing HbA1c levels and body weight. Pattern of safety profile of tirzepatide is similar to that of GLP-1 agonists, but frequency of GI adverse effects and hypoglycemia is more common with tirzepatide.

Splenic abscess is a very rare entity with an incidence of about 0.14-0.7% in autopsy studies. Splenic abscess has been reported to have a mortality rate of about47%, it has various causes but usually associated with trauma and infections of the spleen. We report two cases of splenic abscess; a child with post traumatic cause and a middle aged lady with an unknown cause. Both cases were diagnosed of having the abscess following imaging; the first case had abdominopelvic ultrasound that showed an abscess cavity with a volume of about 11mls and subsequently resolved following medical treatment with intravenous antimicrobial agents. The second case however had an abdominopelvic computed tomography scan that showed a huge splenic abscess with a volume of about 1400mls; she had a successful splenectomy. We report the radiologic findings of these cases due to the rare nature of splenic abscess as reported in the literature.