Case Of Iatrogenic Cushing's Syndrome By Topical Triamcinolone.

Cushing's syndrome is a collection of signs and symptoms due to hypercortisolism. Prolong use of topical steroid may cause this syndrome and suppression of hypothalamic and pituitary function, however such events are more common with oral and parenteral route. There are very few cases of Cushing's syndrome with a topical application amongst which triamcinolone is the rarest drug. We report a case of 11-year-old boy is presented who developed Cushing's disease by topical application. The child had body rashes for which the caregiver consulted a local quack, a topical cream of triamcinolone was prescribed. After application for three months, the patient became obese and developed a moon-like face. A thorough biochemical workup and diagnostic test for Cushing's disease was done to confirm. The following case report a dramatic example of development of the syndrome from chronic topical application of the least potent corticosteroid.

Presentation of parathyroid adenoma with genu valgum and thoracic deformities.

Parathyroid adenoma is the main cause of primary hyperparathyroidism. It is usually asymptomatic and occurs more commonly in adults. It presents with raised parathormone (PTH) and Ca+ levels in serum. Its presentation in adolescence is rare. We report one such incidence of a 14 years old girl who presented with bone pains short stature, and generalized muscle wasting. She was found to have genu valgum at the knee joint, pectus carniatum, scoliosis and cystic changes in pelvis and calvarium. Biochemical investigations and parathyroid Tc-99mMIBI scan confirmed the diagnosis of a parathyroid adenoma. The gland was removed by parathyroidectomy. Till date 12 such cases are reported and none had thoracic, vertebral or calvarium involvement.

Role of phytoestrogen in suppressing bone turnover in a group of postmenopausal women.

BACKGROUND: Osteoporosis has emerged a major health hazard in postmenopausal women. The process of osteoporosis accelerates two year prior to menopause, reaching the peak level during first 3 years of menopause when women loss 3 (see symbol) 5% of their bone mass per year. This study tried to find out the role of phytoestrogne in improving the bone mineral density and bone related biochemical parameters in group of postmenopausal women. METHODS: Fifty postmenopausal women with age range 50 (see symbol) 60 years were included in the study. Phytoestrogen with mineral supplement were given twice daily for 3 months. Biochemical parameters like serum calcium, magnesium, alkaline phosphatase, uric acid, total protein and oestrogen were determined before and after phytoestrogen therapy by autoanalyser and ELIZA (oestrogen assay). T-score before and after phytoestrogen were find out by densitometer DEXA. RESULTS: The level of serum calcium, magnesium, uric acid and oestrogen was increased in women after taking phytoestrogen but significant difference (p < 0.01) was only observed in case of serum calcium. Level of serum alkaline phosphatase and total serum protein were slightly increased with no significant different before and after phytoestrogen therapy. Value of T-score was although markedly decreased after phytoestrogen therapy but it showed no significant difference. CONCLUSION: It is concluded that as the early years of menopause are a period of rapid bone loss, and the risk for osteoporosis increases substantially, the habitual intake of soy protein and isoflavones may play a role in the retardation of bone loss.