The principle steroidal androgens are testosterone and its metabolite 5α-dihydrotestosterone (DHT), which is converted from testosterone by the enzyme 5α-reductase. Through the classic pathway with androgens crossing the plasma membrane and binding to the androgen receptor (AR) or via mechanisms independent of the ligand-dependent transactivation function of nuclear receptors, testosterone induces genomic and non-genomic effects respectively. AR is widely distributed in several tissues, including vascular endothelial and smooth muscle cells. Androgens are essential for many developmental and physiological processes, especially in male reproductive tissues. It is now clear that androgens have multiple actions besides sex differentiation and sexual maturation and that many physiological systems are influenced by androgens, including regulation of cardiovascular function [nitric oxide (NO) release, Ca2+ mobilization, vascular apoptosis, hypertrophy, calcification, senescence and reactive oxygen species (ROS) generation]. This review focuses on evidence indicating that interplay between genomic and non-genomic actions of testosterone may influence cardiovascular function.

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Aim of the Study:This study was to analyze the clinical outcomes of brain stem glioma treated with radiation therapy (RT) in our institution.Material and Methods:Records of 48 patients with brainstem glioma treated between January 2007 and January 2013 were reviewed. Demographic variables, clinical variables, radiological findings and treatment details with respect to age, sex, location of tumor ( pontine Vs non pontine ), signs and symptoms, RT dose, follow up period and outcomes were recorded. Patients were subdivided into two groups based on their age, age <15 years (Group I) and age >=15 yrs (Group II).Results:The median age at diagnosis was 10 years (range 4-50). Male to female ratio was 11:10. Of the 48 cases analyzed, 27 patients (56%) were in group I and 21 (44%) were in group II. Radiologically, 90.5% had involvement of pons. 10 (21%) patients received RT dose >60 Gy and 38 (79 %) patients received RT dose of 54-60 Gy. Median overall survival was 7months (range 3-44 months). Median overall survival in Group I and Group II was 4 months and 10 months respectively (P = 0.042).Conclusions:Brain stem glioma in pediatric age group is associated with worse outcomes than in adults.

Objective To review the results of gender reversal in six rearing, with ages ranging from 3 years to 16.5 years (mean 8.5) at the time of review. Two children have patients with 46XX congenital virilizing adrenal hyperplasia (CVAH).normal penises and four have a satisfactory result after two-stage repair of hypospadias/chordee. Patients and methods Fifty-one patients with 46XXCVAH were seen in an 8 year period; 45 were managed Conclusion Most patients with 46XX CVAH are preferably raised as females and require a feminizing by conventional feminizing genitoplasty, but six underwent gender reversal and were managed as males.genitoplasty. However, the clinical decision may be influenced by many factors, including delay in diagThe clinical decision for gender reversal was made after appropriate counselling and was based primarily nosis, social bias and the premium on male rearing in certain communities. When male rearing is chosen, on parental choice, this being influenced significantly by a delayed diagnosis in four patients. Surgical manearly gonadectomy and excision of Mü llerian structures, together with staged hypospadias repair, gives agement consisted of gonadectomy, excision of Mü llerian structures and staged hypospadias repair/ satisfactory results.

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