Autoimmune Hypophysitis: A Case Report

Autoimmune hypophysitis is an autoimmune inflammation of the pituitary gland. It may result in hypopituitarism depending upon the part of pituitary affected. Here, we report the case of autoimmune hypophysitis in a 30-year-old male who was admitted with complaints of generalised swelling for one month and fever and cough for one week. The patient’s Thyroid-stimulating hormone (TSH) was more than 139, anti-thyroid peroxidase antibody (anti-TPO) was more than 1000 and serum sodium was 107 and a tiny streak of tissue along the periphery with an empty sella as seen on MRI. The patient was given tablet Levothyroxine 100 microgram, Telmisartan 40 mg and Hydrocortisone 10mg twice daily. With medications, the patient improved and was discharged

Obesity: a global health problem

Since time immemorial, obesity has engulfed the mankind. It’s a pandemic. The prevalence is increasing by leaps and bound. Evidences date back to 30,000 BC. Earlier it was linked to wealth and status and it took a long time for it to be considered as a disease. This change in mind-set of the people occurred in mid-19th century. Different formulas for calculating the BMI (Body Mass Index) were invented which was different for the world and the South-East Asians. Slowly it became a topic for research among the scientific society and first priority was given to finding out the cause of obesity. It could not be pointed down to one as many factors were found to contribute to the menace of obesity. Age, gender, genetics, environment, food habits, various co-morbid conditions and the list of contributing factors is endless. Studies done at the molecular level have shown that various cytokines like TNF, Interleukins, Monocyte Chemoattractant Protein, adipokines, etc., have been implicated in the pathogenesis of obesity. The first line in the management of obesity is to take preventive measure. Those who have started to develop the disease should undergo a few non-pharmacological treatment options like lifestyle modification, change in food habits and behavioural therapy. Initially drugs like fenfluramine and sibrutramine were developed. With newer researches coming up more safer and consistent molecules like Tesofensin have been found and undergoing trial. If not benefited by medical treatment the last option what remains for the patient is bariatric surgery but they are too costly for general population to afford. Finally, it is best seen that it is wise enough to follow the saying “Prevention is better than cure” for a disease with such a vast etiology.

The TACRD association is distinct from VACTERL association--a case report.

Tracheal agenesis is a rare malformation. A case of tracheal agenesis with associated ventricular septal defect, gastric hypoplasia, hiatus hernia, duodenal atresia, isomerism of the lungs, hypoplastic spleen with polysplenia, Meckel's diverticulum and fused crossed ectopia of the kidneys is presented. This case fits into a newly proposed TACRD association, an extremely rare condition composed of tracheal agenesis, cardiac, renal and duodenal malformations. It is distinct from the more common VACTERL association of which tracheo-esophageal fistula and not tracheal agenesis is a part. TACRD association has complex internal malformations and lacks the external skeletal manifestations of VACTERL association. Awareness amongst pathologists conducting neonatal autopsies is necessary for correct identification of this condition.

Congenital airway abnormalities in neonates.

Airway malformations such as laryngeal atresia, tracheal agenesis and subglottic stenosis are rare and present at birth with significant respiratory distress with or without stridor. There may be an initial improvement on bag and mask ventilation. Repeated attempts at intubation are met with failure. The related embryology and clinical aspect of airway malformations have been discussed. The prognosis in tracheal agenesis is universally fatal but cases with laryngeal atresia and subglottic stenosis may be saved with prompt tracheostomy and later surgical reconstruction.