Mosaic Variant of Turner Syndrome

Turner syndrome is the most common chromosomal abnormality leading to gonadal failure and primary amenorrhea. While half of the cases have monosomy of chromosome X, the remaining exhibit mosaicism resulting in wide variation of phenotypic characteristics and clinical manifestations. We present a case of a 24-year-old female with mosaic variant Turner syndrome. The diagnosis was confirmed by karyotype analysis and laparoscopy.

Conservative management of ovarian torsion in pregnancy

Adnexal torsion or other cyst accidents encountered during pregnancy carries a risk to intrauterine foetus. Delays or misdiagnosis can result in the loss of the affected ovary and subsequent reduced reproductive capacity. In this report, a 23-year-old second gravida with viable 9 weeks pregnancy with acute pain abdomen; presented in OPD and sent to labor room. Emergency laprotomy was done with provisional diagnosis of left adnexal torsion. We did detorsion and cystectomy followed by ovarian reconstruction. Repeat scan shows continuing intrauterine pregnancy. So, timely diagnosis and intervention reduces risk to ovary; along with some risk of the antepartum surgical intervention. Also, in place of oophorectomy; de-torsion is more conservative surgical approach that should be considered in all young women with ovarian torsion.

To Study the Association of Depression with Complications of Type 2 Diabetes and to Find Out any Correlation Between Type of Complication and Depression.

Background: Depression is common among people with diabetes and it is associated with poor outcomes. This study was carried out to investigate the association of depression with various complications of type 2 diabetes and to find out any correlation between type of complications and depression. Methods: 200 patients with established T2DM attending the Outpatient department and indoor wards of Medicine Department of Rajindra Hospital, Patiala were evaluated for depression by a previously validated depression questionnaire [PHQ-12 item]. Results: Patients with T2DM (n=200) were evaluated [94 (47%) male and 106 (53%) female]. Maximum number of patients i.e. 68(34%) were in 51-60 years age group. 57(28.5%) patients out of 200 had depression. Depression was commonly associated with retinopathy (68.57%), followed by neuropathy (61.2%), nephropathy (59.57%) & CAD (25.45%). It was most commonly associated with PDR (100 %) and least commonly with CAD. Conclusion: This study showed high prevalence of depression in patients with T2DM. The prevalence of depression is higher in T2DM subjects with retinopathy, neuropathy and nephropathy compared to those without the respective complications. The Chances of becoming depressed increased with increase in number of complications.

To Study the Prevalence of Thyroid Dysfunction in Newly Diagnosed HIV +ve Patients and Correlation between CD4 Count and Thyroid Dysfunction.

Background: Thyroid dysfunction is one of the common endocrine dysfunction in HIV Positive patients. Newly Diagnosed HIV Positive patients are rarely monitored for this problem. Objective:- To study the prevalence of thyroid dysfunction in newly diagnosed HIV positive patients & to Correlate it with CD4 Count. Methods: A prevalence study was carried out on 150 newly diagnosed HIV Positive patients with different CD4 Counts divided in three groups (Group A; CD4<350, Group B; CD4 350-550 and Group C; CD4>550) who were evaluated for thyroid dysfunction. Blood samples were collected for CD4 T Lymphocytes. Counts were determined by flow cytometry and Thyroid function was evaluated by chemiluminescence immunoassay. Results: Out of 150 cases studied, 47 Patients (31.33%) had thyroid dysfunction. Group A, B and C had Thyroid dysfunction in 40 %( 20), 32 %( 16) and 22 %( 11) patients respectively. All except one had hypothyroid state (TSH above normal range).When the results were analyzed for 150 patients with Pearson correlation coefficient. There was an inverse correlation of CD4 count and TSH. There was progressive decline in T3, T4 levels as CD4 count decreased. Conclusion: Thyroid dysfunction is frequent in newly diagnosed HIV positive patients and prevalence of thyroid dysfunction increased with decrease in CD4 count. TSH levels increased as CD4 count declined.

Tubercular Arthritis of Sternoclavicular Joint: A Case Report.

Sternoclavicular joint (SCJ) is a rare site for occurrence of tubercular arthritis. Diagnosis often gets delayed due to rarity, leading to annoyance to patient. Here we report a case of 66 years old female who presented to us with painful swelling of Right>Left sternoclavicular joint. Diagnosis was clinched by clinical evaluation, appropriate imaging and strongly positive Interferon gamma release assay and fine needle aspiration cytology. Patient was put on ATT with significant improvement after 2 months.

A Rare Case of Cor Triloculare Biventriculare Detected in a Postpartum Female.

Maternal heart disease complicates at least 1% of pregnancies and is one of the most important cause of maternal death. This is a case report of postpartum female incidentally diagnosed with cor triloculare biventriculare. Recognizing heart disease during pregnancy is challenging as physiological changes during pregnancy can cause signs and symptoms mimicking cardiac disease, e.g., fatigue, shortness of breath, edema and systolic ejection murmur. Early diagnosis, prompt and effective management is important in decreasing maternal and fetal mortality and morbidity.