Pseudohypoparathyroidism is an infrequently encountered disease. It is one of the causes of Fahr syndrome which also is a rare clinical entity caused by multiple diseases. A 4-year-old man hospitalized for sudden onset left hemiparesis and hypertension was diagnosed to have right thalamic and midbrain hemorrhage on plain CT scan of the head which also revealed co-existent extensive intracranial calcifications involving the basal ganglia and cerebellum bilaterally. General physical examination revealed features of Albright hereditary osteodystrophy, goitre, hypertension, left hemiparesis, and signs of cerebellar dysfunction. Laboratory findings suggested hypocalcemia, hyperphosphatemia along with high TSH, low FT4, low FT3, and high anti-TPO antibody. Though bilateral intracranial calcifications are usually encountered as an incidental radiological finding in the CT scan of brain, in this case, the patient admitted for thalamic and midbrain hemorrhage was on investigation for associated intracranial calcification, and goitre was also found to have coexisting pseudohypoparathyroidism and autoimmune hypothyroidism.
BACKGROUNDIndia is a country with the highest burden of TB. Vitamin D can lead to activation of immune system and prevent the growth of intracellular Mycobacterium tuberculosis. Good number of studies show that there is deficiency of Vitamin D in tuberculosis patients, though there are limited number of studies to show result on the contrary.This study was done with an aim to evaluate for any association of vitamin D with tuberculosis. MATERIALS AND METHODSThe study was undertaken with 52 number of patients newly diagnosed with tuberculosis, diagnosed by clinical criteria and usual laboratory tests. Serum samples were collected and 25-hydroxy vitamin D level was estimated in all of them using chemiluminescent immunoassay technology and compared with that of normal healthy controls. RESULTSThe study population included 52 patients (34 males and 18 females) diagnosed as TB, and healthy controls. 28 patients had pulmonary and 24 patients had extrapulmonary TB. Our study confirmed a high prevalence of vitamin D deficiency, 69.23% in patients with TB as compared to 34% of the healthy controls. The difference between the means were statistically significant with t=-2.41731 and p=0.008 (p<0.05). BACKGROUND Tuberculosis (TB) is a global pandemic that mainly affects the low-and middle-income countries. India, followed by Indonesia, China, Nigeria, Pakistan and South Africa account for 60% of the total TB statistics in the world. Despite advances in diagnostic technology and invention of new antituberculous drugs, TB continues to remain a major public health concern. In May 2014, the World Health Assembly at Geneva endorsed "The End TB Strategy" with an aim to end the global TB epidemic by 2035 with targets to reduce TB deaths by 95% and cut down the new cases by 90% and ensure that no family is burdened with catastrophic expenses due to TB. India contributes to one-quarter of the global TB burden. WHO statistics for 2015 gives an estimated incidence and prevalence of 2.2 and 2.5 million respectively for TB in India. CONCLUSION(1) TB along with HIV remains as one of the leading causes of morbidity and mortality among general population.
Hyponatremia is the most common electrolyte disorder in hospitalized patients in various clinical settings. Water intake and circulating Arginine Vasopressin constitute the two key effectors in the defense of serum osmolality; defects in one or both of these defense mechanisms cause most cases of hyponatremia. Hyponatremia and stroke are associated with poor outcome but outcome of hyponatremia in acute stroke is not well established and very few studies have been conducted in this regard and according to which the mortality ranges from 14%-44%. OBJECTIVE: This study aims to provide more data regarding impact of hyponatremia in acute stroke mortality. MATERIALS AND METHODS: The present study is a hospital based prospective, single Centre, observational study which was conducted in the
BACKGROUND The worldwide prevalence of diabetes has risen dramatically over the past two decades from 30 million cases in 1985 to 382 million in 2013. Infections are of particular concern in diabetics. Benign prostatic hyperplasia and benign prostatic enlargement are the most common diseases in aging men which can lead to lower urinary tract symptoms. AIMS AND OBJECTIVE The objective of this study. 1. To study various risk factors associated with Urinary tract infections in Diabetes with prostatomegaly. 2. To study causative microorganisms and their drug susceptibility in diabetics with Urinary tract infections having prostatomegaly. MATERIALS & METHODS: STUDY SETTING A hospital based prospective observational study conducted for a period of 1 year. 50 indoor cases meeting inclusion criteria were selected. INCLUSION CRITERIA Diabetics having prostatomegaly presenting with urinary tract infection or positive urine culture were included. RESULTS Out of 50 patients 46% had bacteriuria, 82% were above 50 years. Longer duration of diabetes >6years were associated with bacteriuria in 59.37% in contrast to <6 years in 22.22% of cases. Significant higher bacteriuria was seen in group noncompliant to treatment than those of compliant group, 64% vs 28%. Association of bacteriuria were lower in patients with HbA1C <7% whereas no difference was observed in relation to fasting and postprandial blood sugar levels. Bacteriuric patients also had significantly high post voidal residue >150 ml in contrast to those with <150ml (56.75% vs. 38%) and greater size of prostate volume >40cc in comparison with volume <40 (57.57% vs 23.53%). E. coli was the commonest organism followed by klebsiella in 56.52% and 17.39% respectively and were sensitive to imipenem, cefepime, aminoglycoside, fluoroquinolones and nitrofurantoin. CONCLUSION Urinary tract infection is frequently encountered in diabetics with prostatomegaly. Elderly patients aged >50 years, longer duration of diabetes, non-adherence to treatment, insulin therapy and prostate volume >40cc could be considered as significant risk for bacteriuric urinary infection. Uncontrolled blood glucose with HbA1 C>7%, post void residue >150 ml and prostate volume >40 cc are associated with bacteriuria. E. coli is the commonest organism and imipenem, cefepime, aminoglycosides, fluoroquinolones and nitrofurantoin showed favourable response.
BACKGROUNDVitamin D deficiency has been found to have an inverse relationship with the occurrence of type-2 diabetes mellitus. The aim of this study was to assess serum vitamin D level in patients with type 2 DM and correlate its finding with healthy controls, and to ascertain the relationship between low 25(OH) vitamin D levels and the marker of glycemic control, glycated hemoglobin A1c (HbA1c).
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