Prevalence of thyroid dysfunction in neonatal population

Background: The objectives of this study was to study the prevalence of thyroid disorders in high risk neonatal populations and to study association of maternal thyroid dysfunction with neonatal thyroid problems and outcome.Methods: This was an observational study, conducted in NICU at Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar. The study included neonates born to mothers with thyroid disorder or with clinical features suggestive of thyroid dysfunction. Neonates with history of maternal thyroid dysfunction were screened at 72 to 96 hrs of postnatal age. Those with TSH >10 mIU/L or free T4 <1.1 ng /ml were followed up after two weeks. The neonates with clinical features suggestive of thyroid dysfunction were screened at presentation and those with abnormal thyroid profile were followed up after two weeks. Results obtained were statistically analyzed using SPSS 17.0 software.Results: Out of 260 neonates screened, 208 neonates were born to mothers with hypothyroidism, 6 neonates had increased levels of TSH during first week which normalised on follow up during third week. One neonate born to hyperthyroid mother, showed increased TSH levels during first week and 2nd week which declined to normal level on follow up at 3rd week. Out of 51 neonates with clinical features suggestive of thyroid dysfunction, born to euthyroid mothers, 3 neonates had increased levels of TSH on presentation which normalised on further follow up. Thus, majority of high risk neonates at birth show transient hypothyroidism.Conclusions: None of the neonate was labelled as hypothyroid, all the 10 neonates showed transient hyperthyrotropinemia.

Isolated diastolic hypertension and its risk factors in semi-rural population of South India

Background Isolated diastolic hypertension (IDH) has been actively discussed for the last two decades because of its prevalence in a younger population and its association with cardiovascular disease. Furthermore, the association of IDH is significant in South Asian Countries such as India because relatively younger populations are known to have a higher risk of cardiovascular events. Objective The objective of this study is to find prevalence of IDH and its risk correlates in a semiurban population of South Indian state of Andhra Pradesh. Methods Data were collected using the modified World Health Organization - STEPwise approach to Surveillance (WHO STEPS) questionnaire for 16,636 individuals from a group of villages under Thavanampalle Mandal. Collated data were analyzed for prevalence and risk factors of IDH. Results Prevalence of IDH was found to be 4.0% with mean age of 46.0 (±SD 13.6) years and a relatively higher prevalence in men (5.3%) as compared with women (3.2%). The prevalence of IDH peaked in the fifth decade of life (40–49 years of age) and declined thereafter. Among various risk factors that were analyzed for their association with IDH, only age, body weight, and body mass index retained their significance in multivariate binary logistic regression analysis. Conclusion There is a significant prevalence of IDH below 50 years of age in the semiurban population of South India. As IDH in young and middle age is known to be associated with increased risk of cardiovascular events and end organ involvement, it highlights need for study and development of effective IDH management strategies to reduce associated morbidity and mortality.

A 54-Year-Old Man with Tracheomegaly, Tracheal Diverticulas and Bronchiectasis — Mounier-Kuhn Syndrome.

Mounier-Kuhn syndrome is a rare idiopathic clinical, radiological and bronchoscopic disorder characterised by abnormal dilatation of the tracheo-bronchial tree. The usual presentation is with recurrent lower respiratory tract infections. Herein, we report the case of an adult male who was diagnosed to have Mounier-Kuhn syndrome based on radiographic finding of a tracheal diameter of 45.5 mm on computed tomography and dynamic complete collapse of the tracheo-bronchial tree on forced expiration, observed during ronchoscopy.

Multidrug Resistant Tuberculosis: Trends and Control.

Multidrug resistant tuberculosis (MDR-TB) has been an area of growing concern and is posing a threat to the control of tuberculosis (TB). The exact magnitude of problem of resistance to anti-tuberculosis drugs worldwide was not known till the 1994-97 global project on anti-tuberculosis drug resistance surveillance initiated by the World Health Organization (WHO) and International Union Against Tuberculosis and Lung Diseases (IUATLD). The Global Tuberculosis Report 2014 estimated that an 3.5% of newly diagnosed and 20.5% of previously treated TB cases had MDR-TB. It has been estimated that 480,000 cases emerged and 210,000 deaths occurred due to MDR-TB globally in 2013. In India, estimates showed that the prevalence of MDR-TB among new and previously treated patients was 2.2% and 15%, respectively. It is estimated that 99,000 cases of MDR-TB emerge every year of which 62,000 were among notified cases of TB in 2013. The MDR-TB is a human-made problem and results largely from poorly managed cases of TB. Adequate, timely diagnosis and optimal treatment of MDR-TB will help curb the epidemic. Efforts must be focused on the effective use of anti-tuberculosis drugs in every new patient, so as to prevent the emergence of MDR-TB.

Hydatid Cyst in Rectovesical Pouch

A 23 year old man presented with pain abdomen & burning micturation. Ultrasound & CT scan of abdomen showed hydatid cyst in rectovesical pouch. Surgery was performed and pathology of the excised mass confirmed the diagnosis. This case of primary hydated cyst in rectovessical pouch is being presented because of its rarity.

Anencephaly with Cystic Hygroma:Antenatal Detection.

Anencephaly is the most common neural tube defect which is detected prenataly. We report here a rare combination of anencephaly with cystic hygroma.

Hydrops fetalis:Antenantal Diagnosis.

Incidence of immune hydrops fetalis is decreasing with the liberal use of anti-D immunoglobulin, but this condition has not been eradicated. We report here a case of immune hydrops fetalis with meningocele detected on ultrasonography.

Ectopia Cordis with Association Foetal Anmalies: Antenatal, Ultrasonographic Detection.

A rare case of ectopia cordis with unusual associated anomalies detected during antenatal ultrasonographic examination is presented.

Meckel-Gruber Syndrome: Sonographic Detection.

Meckel-Gruber syndrome is a rare congenital foetal anomaly. We present a report of two cases where the diagnosis was made on antenatal ultrasound examination and confirmed later on when the pregnancies were terminated.