Sickle Cell Disease A blood disease of genetic origin due to an abnormal Hemoglobin (Hb-s) was previously thought to be a disease of the African and African-American population and was infrequently seen in Saudi Arab, Greece, Turkey etc. The disease was seen to manifest in early childhood with persistent Anemia, Jaundice, enlargement of spleen and liver, recurrent bone pain and ultimately chronic damage to brain, kidney, bone etc. Rarely patients used to survive beyond 20 years of age. Though the disease was occasionally encountered in India especially in some tribal population of Orissa and Tamilnadu; Dr. B.C. Kar, after a large epidermiological study of several thousands of people showed that the disease is prevalent in whole of central India and is widespread amongst all castes, communities and religions. The abnormal gene has been reported by him to be found in 10-15 % of the population. His work also led to the discovery of:   a separate haplotype of s-gene   high levels of fetal hemoglobin in sickle cell disease patients   milder clinical course of the disease with longer survival of patients   rare occurrence of priapism, cerebral strokes and eye lesions etc. As such a study of the "Natural history of Sickle Cell Disease in India" is being under taken by Dr. B. C. Kar since 15 years and 1800 patients are being followed up presently. He is involved in diagnosis, clinical and hematological follow up of patients in his sickle cell clinic.   Diabetes Mellitus Diabetes is a condition caused by relative/absolute deficiency of Insulin. Insulin is a hormone secreted by the pancreas & is required for maintenance of normal glucose levels in blood. Hence Diabetes manifests as raised blood glucose levels. Classically it is of two clinical types:    Type I - Young lean patients with juvenile onset of disease who develop Ketosis without insulin    Type II – Obese patients with adult onset of disease, not Ketosis prone, not dependent on insulin for survival, can be controlled with oral drugs. Dr. B.C. Kar in his M.D Thesis(1963) on "Clinical patterns of Diabetes in India" encountered several new patterns of diabetes, eg:   Young Ketosis resistant diabetes(J-type)   Diabetes due to pancreatic calcification   Lean patients with Type II diabetes (Type II lean) and   Type II diabetes in the young These various unusual types have been much debated world wide and of late has been given recognition by WHO. He is still involved in management of diabetic patients at present.

When to suspect: Sickle Cell Disease   If parents or sibling is suffering   Pain in bones/joints and abdomen   Frequent cold cough and fever   Vision defected   Anemia   Jaundice Diabetes   Delayed healing of any wound   Excessive thirst   Excessive hunger   Excess urination   Repeated skin infections   Loss of weight   Kidney failure   Weakness Services offered at our center:   Dietary advice   Positive sickling test   High reticulocyte count   High serum filirubin   Blood sugar estimation   Hemoglobin Electrophoresis showing Hb-s and absence of Hb-A