Cardioprotective function of progesterone: A new perspective

2016-10-25T07-06-56Z
Source: National Journal of Physiology, Pharmacy and Pharmacology
Asha Anand Dharwadkar, Raghuram Ramkumar Chitterusu, Anand Rajendra Dharwadkar, Bindu Balakrishnan Chenmarathy, Kavitarati Anand Dharwadkar.
Cardioprotective mechanism in females during reproductive phase is unclear. New perspective explains cardioprotective function of progesterone. Progesterone, the intermediary metabolic product in synthesis of steroid hormones, with t/2 of 30 min, stimulates respiratory center inducing respiratory alkalosis in turn lowers plasma ionic calcium. This results in decreased blood coagulability and cardiac contractility along with smooth muscle relaxation. Vascular smooth muscle relaxation, leading to generalized vasodilatation causes better tissue perfusion resulting in diminished erythropoietin, and erythrocyte count. This reduces blood viscosity and afterload on the heart. Cardiac contractility remains balanced due to opposing influences of decreased plasma ionic calcium and raised basal body temperature. On sudden withdrawal of progesterone, as during premenstrual, postpartum and postmenopausal periods, cardioprotective changes are reversed. The awareness helps to build better body buffer system, aiming to correct acid-base imbalance, during expected fluctuations of progesterone.


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Familial Idiopathic infantile arterial calcification presenting as a refractory hypertension and hypercalcemia in neonatal period.

2016-10-25T06-38-57Z
Source: The Southeast Asian Journal of Case Report and Review
Kanchan Subhash Channawar, VSV Prasad, Manoj Malviya.
Idiopathic infantilearterial calcification (IIAC) is a rare disease characterized by extensive arterial wall calcification. A total of 200 cases have been reported to dateand from India only 5 cases, with most cases diagnosed postnatally and less than 13 cases having been suspected antenatally.Case characteristics: Our case report is first from pediatric department. Message: It is important for clinician to suspect this condition prenatally and so that early diagnosis is associated with improvement in survival rates.


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Carcinoma ovary with carcinoma cervix - A rare case of synchronous malignancy

2016-10-25T06-38-57Z
Source: The Southeast Asian Journal of Case Report and Review
Ashwini Arvind Natekar, Gautam Kr Mandal, Subhasis Basu.
Synchronous malignancies of genital tract are rare. Case report We report a case of carcinoma ovary with incidentally diagnosed carcinoma cervix. The patient had undergone total abdominal hysterectomy with bilateral salpingo-opherectomy with omentectomy and pelvic lymph node dissection for a right ovarian tumor which was reported as borderline malignancy on frozen section. On histological examination the ovarian malignancy was diagnosed as borderline papillary serous carcinoma. The cervix section showed in situ squamous cell carcinoma. Pelvic lymph nodes and omentum were free of tumor. The postoperative period was uneventful and the patient has no signs of malignancy on follow up till date. Conclusion Synchronous malignancies are associated with better prognosis with surgical resection being the treatment of choice. Since synchronous malignancies are rare it has to be reported.


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Clinical profile and prognosis of patients with posterior circulation stroke

2016-10-25T04-38-40Z
Source: International Journal of Research in Medical Sciences
Kavita J. Rawat, Bhaskar S. Korde, Kavita S. Joshi.
Background: Posterior circulation stroke is less common than stroke involving the anterior circulation. An understanding of the Posterior circulation stroke phenomenology and mechanisms requires knowledge of neurovascular anatomy and of the structure-function relationships of this region of the brain. Identifying mechanisms of stroke is essential so that appropriate preventive therapies may be instituted. Methods: A prospective study was conducted over a period of 1 year after obtaining permission from institutional ethics committee. Recently diagnosed cases of posterior circulation stroke from medicine and neurology wards were enrolled, who fulfilled inclusion criteria. Results: Most common age for posterior circulation stroke in this study was 41-70 years of age with median age of 56.5 years. It is more common in males (55%) than females (45%). Ischemic posterior circulation stroke is more common (63.15%) than haemorrhagic posterior circulation stroke (36.85%). Most common presenting feature of posterior circulation was ataxia (77.3%). Most common risk factor for posterior circulation stroke was hypertension (60.5%) followed by dyslipidemia (55.26%). Most common site of involvement in ischemic posterior circulation stroke was cerebellum (37.5%) followed by occipital lobe (24%). Commonest site of bleed found was cerebellum (64.4%) followed by pons (35.6%). Mortality in posterior circulation stroke in present study was 15.78%. Conclusions: Posterior circulation stroke present with a wide variety of symptoms. Episodes are often staggering and more protracted than those of anterior circulation stroke. Further studies are needed to determine the safest and most effective treatment modalities for the various types of posterior circulation stroke.


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A clinical study of deviated nasal septum with special reference to conventional and endoscopic septoplasty

2016-10-25T04-38-40Z
Source: International Journal of Research in Medical Sciences
Mohammad Nizamuddin Khan, Kripamoy Nath, Shams Uddin.
Background: Deviated nasal septum is a very common condition. It causes nasal obstruction, epistaxis, sinusitis, headache and obstructive sleep apnea. Septoplasty is one of the most common procedures performed for correction of deviated nasal septum. The aim of our study was to determine the incidence of DNS with respect to age, sex, type of septal deviation and presenting complaints and compare if endoscopic septoplasty is better than conventional septoplasty. Methods: The present study was conducted among 115 cases of DNS for a period of one year. While detailed clinical study was done in 115 cases, surgery was performed in 60 cases. They were divided into group A and group B with 30 cases in each group. Conventional septoplasty was performed in group A while endoscopic septoplasty in group B. Results: The male to female ratio was found to be 2.19:1. Majority (37.18%) patients were of age group 11-20 years with deviation to the left (54.78%). Nasal obstruction (58.26%) was the commonest presenting complaint. Postoperatively, a significant relief of symptoms were observed in endoscopic septoplasty in terms of nasal obstruction (93.33%) and hyposmia (87.5%). Post-operative complications were higher in conventional septoplasty with significant rate of residual deviation. Conclusions: Our study showed that functional outcome was better and post-operative complications were less in endoscopic septoplasty. Endoscopic septoplasty provides better illumination which helps to identify septal deviation accurately while reducing the postoperative complications due to limited dissection and lesser trauma to septal cartilage.


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Single umbilical artery with antenatally diagnosed umbilical artery aneurysm in a newborn: a rare case report

2016-10-25T04-20-12Z
Source: International Journal of Contemporary Pediatrics
Ankur Gupta, Dhrithiman Shetty, Prijo Philip.
Single umbilical artery (SUA) is a situation when the umbilical cord contains only one umbilical artery rather than normally occurring two umbilical arteries. Presence of a SUA is associated with an increased risk of perinatal morbidity and mortality. This article reports a case of SUA with antenatally diagnosed umbilical artery aneurysm and its significance in a newborn. Histopathology report from site of insertion of umbilical cord to placenta had shown single umbilical artery aneurysm and persistent vitilo intestinal duct, dilated umbilical artery at insertion of the cord at placenta. ECHO report suggested 7 mm ostium secondum atrial septal defect, 3-4 mm patent ductus arteriosus, dilated right atria and ventricle, severe tricuspid regurgitation, severe pulmonary artery hypertension. Karyotyping was reported to be normal. Child had received treatment for congestive cardiac failure and intravenous antibiotics for Klebsiella sepsis. SUA with antenatally diagnosed umbilical artery aneurysm is a rare entity and has to be thoroughly investigated and treated.


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Thyroid function tests in polycystic ovarian syndrome

2016-10-24T08-48-04Z
Source: National Journal of Physiology, Pharmacy and Pharmacology
Samiksha Ganvir, Anagha Vinay Sahasrabuddhe, Shailesh Umakant Pitale.
Background: Polycystic ovarian syndrome (PCOS) or polycystic ovarian disease (PCOD) is the most common endocrine problem in young females with chronic anovulatory cycles occurring in 5-10% of reproductive women. PCOS is viewed as a heterogeneous disorder of multifactorial etiology also associated with increased metabolic and cardiovascular risk factors. Both PCOD and thyroid dysfunction have multiple common presentations and both have profound effect on fertility and reproductive biology. Hypothyroidism can initiate, maintain or worsen PCOD. Aims and Objectives: This study has been contemplated to investigate the prevalence of thyroid disorders in PCOS patients from Central India. Materials and Methods: Female patients in the age group between 18 and 30 years meeting Rotterdam criteria for the diagnosis of PCOS were included in the study. The patients were asked to report in fasting state for the following investigations: Fasting blood sugars, fasting insulin levels, serum luteinizing hormone (LH), follicle stimulating hormone (FSH), thyroid stimulating hormone (TSH), serum testosterone, dehydroepiandrosterone, and serum prolactin were done. FSH and LH were done on the 2nd or 3rd day of menstrual cycle. Gynecological ultrasound was done to assess ovarian condition and presence or absence of multiple cysts. Results: LH/FSH ratio of more than 2 was found in 60% of the cases, 41 subjects (68%) were insulin resistant. Raised serum testosterone was found in 64% of the cases. The mean TSH level in subjects was 4.219333 ± 1.877632. Subclinical hypothyroidism was seen in 16 (26.6%) cases and overt hypothyroidism in 12 (20%) cases. Total thyroid dysfunction (clinical and subclinical) was seen in 28 (46.66%) cases. Conclusion: The prevalence of thyroid dysfunction in PCOS is very high. All patients with PCOS should be screened for thyroid dysfunction.


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