Cerebellar ataxia as presenting feature of hypothyroidism

SUMMARY Symptoms and signs of the hypothyroidism vary in relation to the magnitude and acuteness of the thyroid hormone deficiency. The usual clinical features are constipation, fatigue, cold intolerance and weight gain. Rarely it can present with neurologic problems like reversible cerebellar ataxia, dementia, peripheral neuropathy, psychosis and coma. Hypothyroidism should be suspected in all cases of ataxia, as it is easily treatable. A 40 year-old male presented with the history facial puffiness, hoarseness of voice and gait-ataxia. Investigations revealed frank primary hypothyroidism. Anti-TPO antibody was positive. Thyroxine was started and patient improved completely within eight weeks. Hypothyroidism can present with ataxia as presenting feature. Hypothyroidism should be considered in all cases of cerebellar ataxia as it is a reversible cause of ataxia.

Drug-induced diseases (DIDs): An experience of a tertiary care teaching hospital from India.

Background & objectives: Drug-induced diseases (DIDs) are well known but least studied. data on DIDs from India are not available. Hence, this retrospective cross-sectional study was undertaken using suspected adverse drug reaction (ADR) data collected form Pharmacovigilance Programme of India (PvPI) to evaluate profile of DIDs over two years, in a tertiary care teaching hospital from north India. Methods: the suspected ADRs in the form of DID were evaluated for drug and disease related variables and were classified in terms of causality. Results: DID rate was 38.80 per cent. Mean duration of developing DIDs was 26.05 ± 9.6 days; 25.16 per cent had more than one co-morbid condition. Geriatric population (53.99%) accounted for maximum DIDs followed by adult (37.79%) and paediatric (8.21%). Maximum events were probable (93.98%) followed by possible (6.04%). All DIDs required intervention. Gastritis (7.43%), diarrhoea (5.92%), anaemia (4.79%), hypotension (2.77%), hepatic dysfunction (2.69%), hypertension (1.51%), myalgia (1.05%), and renal dysfunction (1.01%) were some of the DIDs. Anti tubercular treatment (ATT ), anti retroviral treatment (ART), ceftriaxone injection, steroids, non-steroidal anti-inflammatory drugs, antimicrobials and anticancer drugs were found as commonly offending drugs. Interpretation & conclusions: Our findings show that DIDs are a significant health problem in our country, which need more attention.

Prevalence of Vitamin D Deficiency in Critically Ill Patients of Acute Coronary Syndrome.

To evaluate the prevalence of vitamin D deficiency among patients of ACS and establish any correlation between two states.This prospective observational cross sectional analysis was carried out. Group-1: included 50 patients of ACS of both sex with any co morbid condition and Group 2: included age matched 50 apparently healthy subjects of both sex. Vitamin D levels were measured by radioimmunoassay & compared statically to find out any possible correlation. In the current study vitamin D deficiency was recorded in 38% and insufficiency in 52% of total patients of ACS taking total count to 90% and only 10 % of the population had adequate Vitamin D levels. Significant (p<0.01) correlation between the vitamin D deficiency and ACS in comparison to healthy controls was recorded. Study recorded a very high vitamin D deficiency in patients of ACS and suggests significant correlation between the two.

Unilateral Lingual Hemangiomatosis.

Hemangioma are characterized by hyperplasia of blood vessels, usually veins and capillaries, in a focal area of submucosal connective tissue.We hereby report a case of unilateral lingual hemangiomatosis in a 57 years old female who presented to us with abnormal speech and blueish patches over the tongue.

Rhino-Orbital Mucormycosis in an Immunocompetent Adult.

Mucormycosis is a rare life threatening opportunistic fungal infection caused by fungi of Mycorales order belonging to the Phycomycetes class.Mucormycosis usually develops in the patients with diabetes,prolonged corticosteroid use, hematological malignancies, chronic renal failure and other immunocompromised states. Incidently we here by report a case of young immunocompetent adult without any obious risk factors for Mucormycosis presenting with rhinoorbital swelling.

Comparative Adverse Drug Profile of Deflazacort Vs Conventional Corticosteroids in Spontaneous Reporting System of Pharmacovigilance.

The current observational cross-sectional study was undertaken using suspected adverse drug data collection form available under (PvPI) to evaluate comparative ADR profile of DFZ Vs CCS for 3 years in spontaneous reporting system of ADRs in current PvPI. Total number of ADR reports during the study period was 3024, out of which ADRs reports due to CS were 112 accounting for a rate of 3.70%. The rate of total ADR events with CS was 4.11%. Geriatric, urban and female population predominated in contributing ADRs with both CCS and DFZ in the study. Self medication of CCS and DFZ contributed 10.95% and 7.69% of total ADRs. Oral route contributed maximal ADRs. Irrational drug prescription contributed substantially. Maximum ADRs due to CCS and DFZ were moderate, latent, non-serious, type A and were probable followed by possible in nature as per WHO UMC scale. Gastritis, new onset hypertension/ loss of hypertensive control, loss of diabetic control, obesity/overweight, dyslipedemia were common ADRs. Thus, ADRs due to CS is a substantial health problem. ADR profile did not vary although DFZ recorded less ADRs.

Idiopathic Tumoral Calcinosis With Unusual Presentation Involving Small Joints: Presentation of 4 Cases With Review of Literature.

Tumoral calcinosis is a rare familial disorder characterized by tumour like masses of calcification, usually in the soft tissues around large joints (para-articular). Masses of calcification sometimes cause gross deformity and disabilities requiring extensive surgical intervention. Involvement of distal joints like that of hand and feet is extremely rare. We present a series of 4 cases of tumoral calcinosis, two of them with unusual presentation involving great toe and thumb.