SCHMIDT'S SYNDROME IN A 32 YEARS OLD FEMALE.

In polyglandular autoimmune (PGA) syndromes, there is immune dysfunction of two or more endocrine glands. Immunity mediated disorders of non-endocrine organs may also be seen. These syndromes are of two main types: type I and type II. We are reporting this case of a 32 years old lady who presented initially with hypothyroidism for many years and received thyroid replacement therapy. After that she was married and had children. After an interval of about seven years of the initial diagnosis of hypothyroidism, she was hospitalized in first trimester of pregnancy for severe vertigo, syncopal episodes and hypotension. She responded well to intravenous fluids and steroids. Further endocrine related, investigations revealed Addison's disease and the above episode were retrospectively diagnosed as Addisonian crisis. Thus the patient was diagnosed as Schmidt's Syndrome (Autoimmune polyendocrine syndrome type 2) since 2009.

Results of type-III supracondylar fracture humerus with open reduction and internal fixation in children after failed closed reduction.

BACKGROUND: Supracondylar fracture of humerus is the second most common fracture in children which account for 60-75% of all fractures around the elbow. There are various treatment modalities for type-III fracture, i.e., closed reduction and casting, skeletal traction, close reduction and percutaneous pinning and open reduction and internal fixation. This study was conducted to see the outcome of open reduction and internal fixation after failed closed reduction. METHODS: This study was conducted in the Orthopaedics Departments of Khyber Teaching Hospital Peshawar and Ayub Teaching Hospital Abbottabad from February 2007 to Nov 2007 on 30 children. Patients included were of either gender with age range from 5-12 years with displaced supracondylar fracture (type-III) after failed closed reduction. All fractures were fixed with two cross K-wires by open reduction and internal fixation. The patients were assessed both clinically and radiologically and results were tabulated according to Flynn criteria. RESULTS: Twenty-eight patients had excellent results while two had good results according to Flynn criteria. None of the patients had either fair or poor result. CONCLUSION: Open reduction and internal fixation is a good and reliable method after failed closed reduction and gives stable fixation with anatomical alignment.

Chlorido(dimethyl sulfoxide-κO)triphenyl-tin(IV).

In the title compound, [Sn(C(6)H(5))(3)Cl(C(2)H(6)OS)], the Sn(IV) atom is coordinated by three phenyl groups, a chloride ion and a dimethyl sulfoxide mol-ecule in a distorted trigonal-bipyramidal geometry. In the crystal, adjacent mol-ecules are linked through inter-molecular C-H⋯Cl hydrogen bonds, weak C-H⋯π inter-actions and π-π inter-actions [centroid-centroid distance = 3.934 (3) Å. An intra-molecular C-H⋯π inter-action is also observed.

2-(Aminocarbonyl)hydrazin-1-ium 6-carboxy-picolinate.

In the crystal structure of the title proton-transfer compound, CH(6)N(3)O(+)·C(7)H(4)NO(4) (-), O-H⋯O and N-H⋯O hydrogen bonds are formed respectively between the cations and the anions, each component affording a supra-molecular chain along the c axis. The cation and anion chains are further linked by N-H⋯O and N-H⋯N hydrogen bonds. A π-π inter-action is also observed between the pyridine rings; the inter-planar separation and the centroid-centroid distance are 3.3425 (6) and 4.6256 (11) Å, respectively.

Plasmacytoid/diffuse urothelial carcinoma: a single-institution immunohistochemical and molecular study of 69 patients.

Accurate diagnosis of plasmacytoid urothelial carcinoma (PUC) is important given its poor prognosis and frequent presentation at high stage. We aim to assess the clinicopathological features, molecular aberrations, and follow-up data in a series of PUC cases from a single tertiary cancer center. Seventy-two urinary bladder, ureteral, and renal pelvic specimens with urothelial carcinoma with plasmacytoid differentiation were identified. Immunohistochemical stains were performed on 48 cases. Among urinary bladder origin markers, GATA3 was most sensitive (96%). Breast carcinoma markers (estrogen receptor, mammaglobin) were usually negative, but progesterone receptor stained 1 case (4%). Neuroendocrine markers CD56 and TTF-1 were each positive in 1 case (4% and 4%, respectively). Gastrointestinal adenocarcinoma marker CDX2 was positive in 4 cases (15%), but nuclear ß-catenin was negative in all cases. CD138 was positive in 83% and E-cadherin expression was lost in 57% of cases. Fluorescence in situ hybridization using the UroVysion Bladder Cancer Kit and FGFR3 mutational analysis using polymerase chain reaction were performed on 15 cases; deletion of chromosome 9p21 was common (60%), and FGFR3 mutations were detected in 60% of cases (5 cases had both deletion 9p21 and FGFR3 mutations). Cases were divided into 3 morphologic groups: classic (29%), desmoplastic (35%), and pleomorphic (36%). The 3 morphologic subtypes had distinct survival outcomes (P = .083), with median survival for all patients 18 being months versus 10 months for the desmoplastic group.

Novelity in GB virus C/hepatitis G virus and its controversy.

Several novel human RNA viruses were identified in 1995-96 and were partially characterized that apparently can cause acute and chronic hepatitis both in monkeys and humans. These new viruses are related to the flavivirus hepatitis C. It is known to be distinct from other human hepatitis viruses (A, B, C, D, E). Three viruses, identified by investigators at Abbott Labs, have been termed GB-A, GB-B and GB-C. GB-A and GB-B are likely tamarin viruses whereas GB-C infects humans only. All these three viruses are the isolates of the same virus termed HGV, which is positive stranded RNA virus. The genomic sequences of these viruses have been determined by different researchers, which were found to be 1600 nucleotide long. Another group at Genelabs Technologies has identified and determined the complete genomic sequence of a virus they termed hepatitis G virus (HGV). Based on genomic sequence comparisons HGV is probably the same as GB-C. It is highly controversial virus regarding pathogenecity, mode of transmission and site of replication.