Clinical spectrum of disorders of sexual differentiation

Objective: To describe the mode of presentation and causes of the disorders of sexual differentiation in patients presenting in the Endocrine Clinic. Study Design: Observational study. Place and Duration of Study: The Endocrine and Diabetes Unit of Jinnah Postgraduate Medical Centre [JPMC], Karachi, from July 2012 to July 2014

Methodology: Patients with phenotypic, psychosocial gender confusion or absence of gender appropriate secondary sexual maturation were enrolled in the study. Patients having chronic systemic disease, as cause of delayed puberty, were excluded from the study. SPSS 13 was used to evaluate the data

Results: A total of 48 patients registered in the study with mean age of 19.9 +/- 8 years. Female gender was assigned to 28 [58.3%] of which 8 [28.57%] had genital ambiguity. Male gender was assigned to 20 [41.66%] patients at the time of birth and 7 [35%] of them had ambiguous genitalia. Karyotyping could be done in 36 [75%] patients of which 17 [47.2%] were females and 19 [52.7%] were males. Karyotypic gender of the 19 [48.57%] male patients was 46 XX, 46 XY and 47 XXY; in 4 [21.05%], 5 [26.3%] and 10 [52.6%] patients, respectively with 9 Klinfelter syndrome. Karyotypic gender of 17 [47.42%] female patients were 46 XX, 46 XY and 45 X0; in 5 [29.4%], 3 [17.64%] and 9 [52.9%] patients, respectively

Conclusion: Disorder of sexual development constitutes a small but difficult area of endocrinology with disastrous consequences, especially if assigned wrong sex at birth. Mode of presentation of these cases was diverse ranging from delayed puberty, to gender confusion, to pregnancy in a male. Eventually in an adult patient assignment or reassignment of gender identity was primarily the patient's prerogative

Differences between aggressive and non aggressive students on hand test

Hand Test, a projective instrument using pictures of hand as stimulus material, has been found to be useful in differentiating between aggressive and non-aggressive persons, in several studies conducted in the West. The present investigation was carried out in order to find out if the test can differentiate between aggressive and non-aggressive children in Pakistani schools. Forty eight boys of grade nine, labelled as aggressive by their teachers, and sixty five unselected boys [non-aggressive] of the same grade were given Hand Test. The results showed significant differences on Acting Out Score and Pathological Score between the aggressive and non-aggressive subjects. No significant differences were obtained on Aggression variable. Significant differences on some other categories: Affection, Direction and Active, were also obtained although not in the expected direction. The findings suggest that the test may be useful for personality assessment in Pakistan