Assessment of retinal manifestations of Parkinson’s disease using spectral domain optical coherence tomography: A study in Indian eyes

Purpose: To assess the retinal manifestations of Parkinson’s disease using optical coherence tomography. Methods: A prospective case?control study comparing 30 eyes from 15 patients with Parkinson’s disease and 22 eyes from 11 healthy age?matched controls. Total macular subfield thickness and the thickness of the ganglion cell layer, nerve fiber layer, and peripapillary retinal nerve fiber layer were measured with spectral?domain optical coherence tomography (SD?OCT). Results: The mean age of PD patients was 68.4 years ± 10.64 (range: 46–82) and in the control group was 66.36 ± 5.22 (range: 64–68). The average disease duration in patients with PD was 6.7 ± 2.8 years (range: 2–10 years). The mean best?corrected visual acuity in PD was 20/26 and 20/20 in controls, with P = 0.0059, which was significant. Significant difference was also found in the contrast sensitivity between both groups. Structural differences in the central macular thickness (P = 0.0001), subfield thicknesses in the superior (P = 0.003), inferior (P = 0.001), nasal (P = 0.004), and temporal subfields (P = 0.017) was seen. Severe thinning of the ganglion cell layer was seen in PD patients (P = 0.000) as well as of the nerve fiber layer (P = 0.004). Peripapillary retinal nerve fiber thickness measured showed significant thinning in superotemporal (P = 0.000), superonasal (P = 0.04), inferonasal (P = 0.000), inferotemporal (P = 0.000), nasal (P = 0.000), and temporal quadrants (P = 0.000). Conclusion: Visual dysfunction was observed in patients with PD along with structural alterations on OCT, which included macular volumes, ganglion cell layer, and peripapillary retinal nerve fiber layer.

Characterization of SH-SY5Y neurons subject to 92kHz ultrasound stimulation / Caracterización de neuronas SH-SY5Y sujetas a estimulación por ultrasonido de 92 kHz

SUMMARY: Cellular microstructural changes due to ultrasound exposure are critical to understand and characterize in order to further the establishment of ultrasonics in cell and tissue engineering and medicine. In this study, neurite length, nuclear morphology, and cellular toxicity are assessed at varying intensities of 92 kHz ultrasound provided by a piezoceramic disk element and incident upon SH- SY5Y neurons in vitro. Findings suggest that stimulation increases neurite length up to 2.73 fold tested at α = 0.05 in an intensity dependent manner. Additionally, stimulation causes a statistically significant (α = 0.05) decrease in nuclear area and less elongated nuclei, by 1.78 fold and 1.38 fold respectively, also in an intensity dependent manner. For maximum transducer surface intensities ranging from 0 to 39.11 W/cm2, the toxicity of 92 kHz ultrasound is assessed and a nontoxic range is determined using Caspase-3 and Annexin V staining, in addition to Calcium imaging via Calcein-AM staining. Intensities of up to 1.6 W/cm2 are found to be nontoxic for the cells under the parameters used in this study.

RESUMEN: Los cambios micro estructurales celulares debidos a la exposición a los ultrasonidos son fundamentales para comprender y caracterizar el establecimiento de los ultrasonidos en la ingeniería y la medicina de células y tejidos. En este estudio, la longitud de las neuritas, la morfología nuclear y la toxicidad celular se evalúan a intensidades variables de ultrasonido de 92 kHz proporcionado por un elemento de disco piezocerámico e incidente sobre las neuronas SH-SY5Y in vitro. Los resultados sugieren que la estimulación aumenta la longitud de las neuritas hasta 2,73 veces probada a α = 0,05 de una manera dependiente de la intensidad. Además, la estimulación provoca una disminución estadísticamente significativa (α = 0,05) en el área nuclear y núcleos menos alargados, en 1,78 veces y 1,38 veces, respectivamente y también de una manera dependiente de la intensidad. Para intensidades máximas de la superficie del transductor que oscilan entre 0 y 39,11 W / cm2, se evaluó la toxicidad del ultrasonido de 92 kHz y se determinó un rango no tóxico mediante tinción con Caspasa-3 y Anexina V, además de imágenes de calcio mediante tinción con Calceína-AM. Se encontró que las intensidades de hasta 1.6 W / cm2 no son tóxicas para las células bajo los parámetros usados en este estudio.

Nuclear elongation correlates with neurite induced cellular elongation during differentiation of SH-SY5Y neural cells / El alargamiento del núcleo se correlaciona con el alargamiento celular inducido por neuritas durante la diferenciación de las células neuronales Sh-Sy5Y

SUMMARY: Cellular differentiation is a highly regulated process that has vast implications for the mechanics of the cell. The interplay between differentiation induced cytoskeletal mechanical changes and strain on the nucleus is a potential cause of gene level changes. This study explores mechanical changes in SH-SY5Y neural cells during differentiation mediated by Retinoic Acid (RA) across Days 0 through 9. Findings suggest that cellular elongation increases 1.92-fold over a 10-day differentiation period, from 48.97 ±16.85µm to 93.96 ± 31.20 µm over 3 repeated trials and across multiple cells analyzed on ImageJ. Nuclear elongation increases less substantially from 17.51 ± 2.71 µm to 23.26 ± 3.10 µm over 3 repeated trials and across multiple cells. Results are statistically significant at a significance level of α = 0.05. This study is one of the first studies to show that during the process of RA mediated neural differentiation in SH-SY5Y neural cells, nuclear elongation is initially not significantly correlated with cellular elongation, but it becomes correlated during the differentiation process with an overall correlation coefficient of 0.4498 at a significance level of α = 0.05. Given the time course of the mechanical changes and the known coupling between the cytoskeleton and nuclear lamina, this study suggests a causative and correlative relationship between neurite-driven cellular elongation and nuclear elongation during neural differentiation.

RESUMEN: La diferenciación celular es un proceso altamente regulado que tiene vastas implicaciones para la mecánica de la célula. La interacción entre los cambios mecánicos citoesqueléticos inducidos por la diferenciación y la tensión en el núcleo es una causa potencial de cambios a nivel genético. Este estudio explora los cambios mecánicos en las células neurales SH-SY5Y durante la diferenciación mediada por el ácido retinoico (RA) durante los días 0 a 9. Los resultados sugieren que el alargamiento celular aumenta 1,92 veces durante un período de diferenciación de 10 días, de 48,97 ± 16,85 µm a 93,96 ± 31,20 µm en 3 ensayos repetidos y en múltiples células analizadas en Image J. El alargamiento nuclear aumenta menos sustancialmente de 17,51 ± 2,71 µm a 23,26 ± 3,10 µm durante 3 ensayos repetidos y en múltiples células. Los resultados son estadísticamente significativos a un nivel de significancia de α = 0,05. Esta investigación es uno de los primeros estudios en demostrar que durante el proceso de diferenciación neural mediada por RA en las células neurales SH-SY5Y, el alargamiento nuclear inicialmente no se correlaciona significativamente con el alargamiento celular, pero se correlaciona durante el proceso de diferenciación con un coeficiente de correlación global de 0,4498 a un nivel de significancia de α = 0,05. Dado el curso temporal de los cambios mecánicos y el acoplamiento conocido entre el citoesqueleto y la lámina nuclear, este estudio sugiere una relación causal y correlativa entre el alargamiento celular impulsado por neuritas y el alargamiento nuclear durante la diferenciación neural.

Unruptured ovarian ectopic gestation: a rare clinical scenario

Ovarian pregnancy is a rare event, with the incidence ranging from 1 in 2000 to 1 in 60 000 deliveries and accounts for 3% of all ectopic pregnancies. The first case of ovarian pregnancy was published by Saint Monnisey. Authors report a case of a 23-year-old patient with severe lower abdominal pain following five weeks of amenorrhea diagnosed as tubal ectopic pregnancy on ultrasonography. The patient was taken up for emergency laparoscopy and unexpected finding of ovarian pregnancy was established. Early diagnosis and prompt treatment go a long way to prevent serious outcomes and to ensure favourable future reproductive potential.

Vitamin K induced anaphylactic reaction in a child: a case report

Vitamin-K is commonly indicated in pediatric patients with coagulation disorders, hepatic disease, warfarin toxicity, sepsis-induced disseminated reaction. Minor complications are very well known, but anaphylactic reactions are rarely reported in children. We present a case of a 13-year-old child who developed anaphylactic reaction following intravenous administration of Vitamin-K. He was managed with Inj. Adrenaline 0.35mg IM, Inj. Avil 22mg IV slowly over 20 mins, Nebulization with salbutamol 1mg. The reaction was most probably due to an anaphylactic reaction to Vitamin-K.

Comparative study of intra and post-operative complications between total abdominal hysterectomy and laparoscopic assisted vaginal hysterectomy

Background: Vaginal hysterectomy is preferable due to faster recovery, decreased morbidity and absence of an abdominal incision. The aim was to compare the risks and complications of laparoscopy assisted vaginal hysterectomy and total abdominal hysterectomy in terms of intra-operative and post-operative complications.Methods: A retrospective observational study was conducted in the Gynaecology ward at Vinakaya Mission’s Kirupananda Variyar Medical College and Hospitals, Salem, Tamil Nadu, India. The data for the past 1-year record was taken for analysis. A total of 80 subjects were included in the study and were divided into two groups with 40 patients under TAH (total abdominal hysterectomy) group and 40 under LAVH (Laproscopic assisted vaginal hysterectomy) group. The primary outcome of the present analysis was incidence of perioperative complications like blood loss and the secondary outcomes were operating time, blood loss, urinary tract injury, rate of conversion to laparotomy, postoperative pain, and length of postoperative stay.Results: The mean intra-operative blood loss was measured among both the groups and it was found to be very high among TAH group (201 ml) compared to LAVH group (149.8 ml) and the difference was found to be statistically significant (p <0.05). Similarly, the duration of operative procedure was found to be less in LAVH group (57.9 mins) compared to TAH group (72.6 mins) and the difference was found to be statistically significant (p <0.05). Post-operative wound infection (14 vs 0) was found to be more among the patients in TAH group than that of the LAVH group and the difference was found to be statistically significant (p <0.05).Conclusions: LAVH is a safe and effective surgical treatment for benign gynaecological diseases and should be offered whenever possible, taking into account the low rate of complications and cost-effectiveness.

Kumkum-induced allergic contact dermatitis: Are we missing the actual culprit?

Background: Kumkum, made with turmeric and slaked lime along with colour enhancing dyes is known to cause allergic contact dermatitis. The possible contact allergens in kumkum include turmeric, Sudan-1, 4-aminoazobenzene, brilliant lake red R and cananga oil. We report patch test results among patients with suspected contact hypersensitivity to kumkum. Objective: To identify the allergen causing kumkum induced allergic contact dermatitis by patch testing and to advise patients about organic kumkum which doesnot contain colour enhancing dyes. Methods: Eighteen patients with suspected contact hypersensitivity to kumkum were patch tested with undiluted kumkum, undiluted turmeric, Sudan-1 (95%), 4-aminoazobenzene and allergens of the Indian Standard Series. Results: Of the 18 patients, 14 patients had patch test positivity to kumkum and 4 had a negative reaction to kumkum. Patch test with other suspected contact allergens showed positive reaction to turmeric in 4 patients, Sudan-1 in 3 patients and 4-aminoazobenzene in 2 patients. Among the allergens of the Indian Standard Series, positivity to nickel and fragrance mix was seen in 5 and 2 patients respectively. Positive reaction to PPD, chlorocresol and parthenium was seen in 1 patient each. Limitation: Small sample size. Conclusion: Allergic contact dermatitis to kumkum occurs both due to the dyes (added for enhancing the colour) and turmeric. All patients with suspected allergic contact dermatitis should be patch tested with kumkum, turmeric and dyes, based on which alternative non-allergic material could be advised. Kumkum dermatitis can also occur due to various other allergens, for which too patch testing should be done.

Diagnosis and Management of Gaucher Disease in India – Consensus Guidelines of the Gaucher Disease Task Force of the Society for Indian Academy of Medical Genetics and the Indian Academy of Pediatrics

Justification: Gaucher disease (GD) is amongst the most frequently occurring lysosomal storage disorder in all ethnicities. The clinicalmanifestations and natural history of GD is highly heterogeneous with extreme geographic and ethnic variations. The literature on GD haspaucity of information and optimal management guidelines for Indian patients.Process: Gaucher Disease Task Force was formed under the auspices of the Society for Indian Academy of Medical Genetics. Invitedexperts from various specialties formulated guidelines for the management of patients with GD. A writing committee was formed andthe draft guidelines were circulated by email to all members for comments and inputs. The guidelines were finalized in December 2016at the annual meeting of the Indian Academy of Medical Genetics.Objectives: These guidelines are intended to serve as a standard framework for treating physicians and the health care systems foroptimal management of Gaucher disease in India and to define unique needs of this patient population.Recommendations: Manifestations of GD are protean and a high index of suspicion is essential for timely diagnosis. Patients frequentlyexperience diagnostic delays during which severe irreversible complications occur. Leucocyte acid ?-glucosidase activity ismandatory for establishing the diagnosis of Gaucher disease; molecular testing can help identify patients at risk of neuronopathicdisease. Enzyme replacement therapy for type 1 and type 3 Gaucher disease is the standard of care. Best outcomes are achieved byearly initiation of therapy before onset of irreversible complications. However, in setting of progressive neurological symptoms such asseizures and or/ neuroregression, ERT is not recommended, as it cannot cross the blood brain barrier. The recommendations herein arefor diagnosis, for initiation of therapy, therapeutic goals, monitoring and follow up of patients. We highlight that prevention of recurrenceof the disease through genetic counseling and prenatal diagnosis is essential in India, due to uniformly severe phenotypes encounteredin our population

Identification of a novel frameshift mutation in PAX6 gene and the clinical management in an Asian Indian aniridia family

Purpose: This study aimed to characterize an Asian Indian aniridia family for both the phenotype and genotype of the disease for a better clinical management. Methods: The phenotype and genotype of the affected and unaffected individuals in the aniridia family were evaluated. The subjects underwent a standard ophthalmic evaluation followed by molecular screening of PAX6 gene in the peripheral blood for mutation detection. Results: The three affected individuals had aniridia with several common features and an uncommon presentation of bilateral congenital ptosis. Two affected siblings, a brother and a sister, had aniridia, nystagmus, ptosis, increase in central corneal thickness, cataract, and foveal hypoplasia. The sister had features of glaucoma. The offspring of the sister had all the features except cataract and rise in intraocular pressure. Mutation screening of PAX6 gene helped in identifying a novel heterozygous pathogenic variation g. 31801757dupG (c. 216-19dupG) that resulted in a frameshift mutation that extended into exon 7. Based on the evaluation and diagnostic testing, the family was clinically managed along with genetic counselling. Conclusion: Molecular diagnostic testing helps in genetic counseling of the family with aniridia to understand the nature of the disease and detection of complications early for better management.

Facial nerve palsy in a child: Bell’s palsy? Think again!

Introduction: Half of facial paralysis in children is idiopathic at origin. However, dismissing facialparalysis as being idiopathic without a thorough history and meticulous examination could bedisastrous as illustrated by this case.Case report: We report a case of sphenoid wing meningioma in a 4-year-old girl. She firstpresented with only facial asymmetry that was noticed by her mother. Examination suggested aleft upper motor neuron facial nerve palsy. A sphenoid wing meningioma was found on magneticresonance imaging (MRI) of her brain. She underwent craniotomy and total tumour excision.Histopathological examination of the tumour showed a grade 1 transitional type meningioma.Meningiomas in children are rare compared to the adult population. Presentations in childrenmay be delayed due to their inability to recognise or communicate abnormalities. Distinguishingbetween upper and lower motor neuron facial palsy is crucial in decision making for facial paralysisin children.

Pulmonary Arterial Hypertension in Glycogen Storage Disease Type I

Abstract Pulmonary arterial hypertension (PAH) is a rare and highly fatal disease that has been reported in 8 patients with glycogen storage disease type I (GSDI). We describe an additional case of an acute presentation of PAH in a 14-year-old patient with GSDI, which was successfully treated with inhaled nitric oxide and sildenafil. We investigated the incidence of PAH in 28 patients with GSDI on routine echocardiography and found no evidence of PAH and no significant cardiac abnormalities. This study highlights that PAH is a rare disease overall, but our case report and those previously described suggest an increased incidence in patients with GSDI. Should cardiopulmonary symptoms develop, clinicians caring for patients with GSDI should have a high degree of suspicion for acute PAH and recognize that prompt intervention can lead to survival in this otherwise highly fatal disease.

A comparative study of the effect of amikacin administered through autoinjector and manual injection on biochemical parameters in rats.

Objective: The objective was to compare the biochemical changes of amikacin by autoinjector delivery and manual injection in rats. Materials and Methods: Amikacin drug cartridge (500 mg/2 mL) for autoinjectors was diluted to 63 mg/mL and rats were administered 1.2 mL, i.p. One group was given 3 and a second group 7 injection on consecutive days. 3 and 7 days manual injection of same dose of amikacin (about 500 mg/kg, i.p.) and a control group (saline) were also included (total 5 groups). On day 4 or 8 biochemical parameters were studied. Results: Significant increase in urea, creatinine and aspartate aminotransferase were observed in 7 days administration in both autoinjector and manual injection groups compared to control group. All other parameters viz., glucose, cholesterol, total triglycerides, bilirubin, uric acid, total protein, albumin, alanine aminotransferase and alkaline phosphatase did not show any significant change. No significant change was observed in 3 days administration groups. Conclusion: High dose of amikacin for longer duration is known for its nephrotoxicity which is evidenced by the increase in urea and creatinine in both autoinjector and manual injection groups. This study shows that autoinjector device for amikacin which is new can be considered for further research work.

A cross sectional study on work related musculoskeletal disorders among software professionals.

Background: This study has been carried out to determine the prevalence and pattern of Musculo Skeletal Disorders (MSD) among software professionals and to evaluate the association between socio-demographic factors, computer work related factors and MSD. Methods: The study design was cross sectional with software professionals working in information technology (IT) companies in Chennai, Tamilnadu as the study population. The sampling method used for the survey is the non-probabilistic purposive sampling. Data was collected using a questionnaire which includes personal data, job details and standardized Nordic questionnaire. Results: Prevalence of work related MSD during last 12 months, during last 7 days and annual disability were 69%, 49.2% and 16.6% respectively. The common prevalence of work related MSD reported during last 12 months based on their body region were neck (29.56%), lower back (22.89%), shoulders (12.17%) and knees (9.56%). There was a statistically significant difference in terms of gender, regular exercise, more than 5 working days per week, more than eight hours of work per day and habit of taking lesser breaks during work hours at regular intervals. There were no statistically significant difference in terms of age, BMI and years of employment. Conclusions: The study has concluded that MSD is widely reported among software professionals working in the IT field in India. Hence, an appropriate prevention strategy needs to be carried out in order to enable them work comfortably.

Keratometric Changes after Corneal Collagen Cross linking for Keratoconus.

Background: Keratoconus is an asymmetric, non- inflammatory, and progressive ectasia of the cornea that is characterized by the thinning, steepening, and central scarring of the cornea. Corneal collagen cross linking with riboflavin and ultraviolet light is an accepted procedure to stabilize keratoconus. This study is aimed at finding out keratometric changes after corneal collagen cross linking. Methods: A total of 30 patients were enrolled, 15 males and 15 females. They were subjected to corneal topography, refraction, slit lamp examination, preoperatively and post operatively at 1 month 3rd moth and 6th month after corneal collagen cross linking. Results: Flattening of Keratometry values were noticed in 12 eyes (40%). The mean pre-operative K was 50.32 D. The mean post-operative K was 49.61 D. In 5 eyes (16.66%) the corneal curvature was unchanged and stable. Conclusion: There is significant decrease in mean keratometric values and flattening of cornea after corneal collagen cross linking.

Pulmonary Mycetoma Due To Candida Albicans Masquerading Bronchogenic Carcinoma In A Patient With Type -2 Diabetes Mellitus

Fungal lesions of lung presenting as a mass are called mycetomas. Mycetoma is a conglomeration of cellular debris and mucous with finely woven fungal hyphae present in a cavity in pulmonary parenchyma or a bronchus.The most common infections causing pulmonary mycetoma are aspergillus.Candida species causing pulmonary mycetoma is rare. A70 year old patient of Diabetes and chronic obstructive pulmonary diseases (COPD), presented with acute on chronic respiratory symptoms. On contrast enhanced CT scan of thorax he was diagnosed as having a heterogeneously enhancing mass lesion in left lower lobe and minimal pleural effusion with a provisional diagnosis of neoplasm. Thorough examination of oral cavity revealed thrush. CT guided biopsy confirmed pulmonary candidiasis. Patient responded well to medical treatment. Only a few such cases have been reported in literature.

Bilateral reversed palmaris longus muscle with trifid insertion, a rare variation.

Normally the palmaris longus muscle originates from the medial epicondyle of the humerus from common flexor origin. In the middle of the forearm, the muscle belly forms a tendon which is inserted into the flexor retinaculum and the palmar aponeurosis. In our study after dissection of both forearms of a 45-year-old male cadaver we found a reversed palmaris longus muscle. This means that the palmaris longus muscle was tendinous in its proximal part and muscular in its distal part. The fleshy belly of muscle was passing over flexor retinaculum, was ensheathed by separate fascia. The muscle belly was spreading on both the sides of each palm for insertion which was trifid, that is centrally into palmar aponeurosis, laterally continuous with the fascia covering the thenar muscles and medially with Abductor digit minimi. It was having tendinous interconnection with the muscle mass of both the sides. Bilateral reversed palmaris longus muscle mentioned in the literature, was a surgical finding in a patient who suffered from edema and pain in the wrist. The overuse of the reversed palmaris longus muscle can lead to the muscle’s local hypertrophy. As per the literature a reversed palmaris longus muscle may cause a compartment syndrome with pain and edema in the wrist area, the carpal tunnel syndrome and Guyon’s syndrome. The variation is also useful to the hand surgeon, as the palmaris longus muscle is an anatomical landmark for operations in this area.

HPTLC analysis of the essential oil from Pimenta dioica leaf.

The present study was done with an aim to standardize the volatile oil obtained from the leaf of Pimenta dioica (Linn.) Merill, belonging to the family Myrtaceae, commonly known as “Allspice”, by HPTLC analysis. The leaves of P. dioica is traditionally being used as a dental analgesic. The present investigation reports the seasonal variation in the content of eugenol, in the leaf volatiles of Pimenta dioica thereby giving insight into the most favorable month for the collection of the drug. Volatile oils are primarily composed of terpenes, the composition of which may alter depending upon the availability of sunlight. The results reveal that the oil collected in April and July showed good content of eugenol.

An important spice, Pimenta dioica (Linn.) Merill: A Review.

Pimenta dioica (Linn.) Merill. Family: Myrtaceae, well known for its berries called Pimento, has been used as an important spice since time immemorial, for its culinary as well as medicinal qualities. It is also known as Allspice due to its intricate aroma which is a medley of aroma from spices such as Clove, Nutmeg and Cinnamon. In India, the leaves of Pimenta are used to flavor rice which gives it a typical aroma. Traditional culinary practice uses the dried berries for marinating meat. Various compounds have been isolated from the plant which belong to categories like phenylpropanoids, tannins, glycosides and essential oil. The present article is a humble effort to study the work done till date on this important spice.

An important spice, Pimenta dioica (Linn.) Merill: A Review.

Pimenta dioica (Linn.) Merill. Family: Myrtaceae, well known for its berries called Pimento, has been used as an important spice since time immemorial, for its culinary as well as medicinal qualities. It is also known as Allspice due to its intricate aroma which is a medley of aroma from spices such as Clove, Nutmeg and Cinnamon. In India, the leaves of Pimenta are used to flavor rice which gives it a typical aroma. Traditional culinary practice uses the dried berries for marinating meat. Various compounds have been isolated from the plant which belong to categories like phenylpropanoids, tannins, glycosides and essential oil. The present article is a humble effort to study the work done till date on this important spice.

Diagnostic Re-evaluation of Children with Congenital Hypothyroidism.

Objectives: To investigate the causes of congenital hypothyroidism in children more than 3 years of age and to document the frequency of transient vs permanent hypothyroidism. Design: Hospital based observational study. Setting: Pediatric endocrine clinic of a medical college. Patients: Children over 3 years of age, on treatment for congenital hypothyroidism. Intervention: Thyroid function test (TFT) and thyroid ultrasound was done. Children with agenesis or hemiagenesis in thyroid ultrasound were identified. In children with normal or equivocal thyroid ultrasound, thyroxine was stopped and followed. Children with abnormal TFT on follow up had thyroid scintigraphy with or without potassium perchlorate discharge, after which, thyroid hormone supplement was restarted. Children who remained euthyroid on follow up were labeled as having transient hypothyroidism. Main Outcome Measure: Proportion of children with transient hypothyroidism. Results: Among 36 children studied (20 boys and 16 girls), eighteen (50%) had transient hypothyroidism and fifteen (41.7%) had thyroid agenesis. There was one with hemiagenesis, one with ectopic thyroid and another with dyshormonogenesis (2.8% each). Initial TSH level at the time of diagnosis was higher in permanent hypothyroidism as compared with transient group (83.0 ± 31.6 vs 47.0 ± 33.1 mIU/mL; P= 0.002). Conclusions: Thyroid hormone supplementation could be discontinued in 50% of children diagnosed with congenital hypothyroidism.