ABSTRACT
Down syndrome (DS) is one of the most common chromosomal disorders. Although genitourinary anomalies, such as a cryptorchidism, micropenis, posterior urethral valves, and hypospadias, have been recognized as complications, the association of ambiguous genitalia with DS has been rarely reported. We report the case of a 1-year-old baby; assigned male sex at birth who was the first child born of a non-consanguineous marriage, by vaginal delivery at term with a birth weight of 2.2 kg. The baby had clinical features suggestive of DS with a micropenis, penoscrotal hypospadias, and incompletely fused labial-scrotal folds with palpable gonads. The external masculinization score was 3/12. The child was reared as a male and hormonal investigations were suggestive of androgen insensitivity. Karyotype was 47, XY, +21.
Subject(s)
Adolescent , Age Factors , Child , Child, Preschool , Diabetes Complications/epidemiology , Diabetes Mellitus, Type 1/epidemiology , Diabetes Mellitus, Type 2/epidemiology , Humans , Hypoglycemic Agents/therapeutic use , India/epidemiology , Mass Screening , Risk Factors , Risk Reduction BehaviorABSTRACT
Subclinical thyrotoxicosis as a definite entity has been recognised with the development of highly sensitive immunometric TSH assays. The condition is characterised by suppressed TSH in presence of normal T3 and T4. It may be due to exogenous or endogenous causes. The risks may be osteoporosis and atrial fibrillation. Exogenous subclinical thyrotoxicosis must be prevented by optimising laevothyroxine dosage. Endogenous subclinical thyrotoxicosis may or may not be treated depending upon the clinical situation and existing comorbidities.
Subject(s)
Atrial Fibrillation/etiology , Humans , Osteoporosis/etiology , Risk Factors , Thyrotoxicosis/complications , Thyrotropin/analysisABSTRACT
Until 1995 sulphonylureas and metformin formed the mainstay of oral pharmacotherapy of type 2 diabetes mellitus. Since then many new insulin secretagogues and new classes of oral antihyperglycaemic agents have been launched. This has improved the management of type 2 diabetes mellitus. Oral agents available currently in Indian market are: Those predominantly targeting beta cell dysfunction, those predominantly targeting insulin resistance and those inhibit carbohydrate absorption. Strategies for treatment with oral antihyperglycaemic agents are: Targeting fasting hyperglycaemia, targeting postprandial hyperglycaemia, minimising cost therapy, minimising weight gain and minimising patient effort strategies. Special situations where antihyperglycaemic agents used are: Teenage diabetes, elderly diabetes, persons with erratic lifestyle, persons with cardiac disease, renal disease and in pregnancy.