Background and aims Diabetes is a chronic metabolic condition characterized with hyperglycemia and associated with several complications. Glycemic control is important factor in preventing the complications associated with diabetes. Pillars for good glycemic control are good life style modification with proper medication under medical guidance. The aim of this study was to study the effect of lock down on glycemic control in diabetic patients and possible factor responsible for this. Material and methods – Out of 407 only 143 diabetic patients who attended the our endocrine OPD in last 3 months who had good glycemic control in past without any chronic complication and willing to participate were included in study. They were advised for the self-monitoring of blood glucose for identifying the glycemic control and with questionnaire designed possible factor was identified during the lockdown period. Results – The patients were aged between 18 and 65 years with mean age of 54.68 years and male to female ratio was 91:52.56 (39.16%) patients reported worsening of hyperglycemia and requiring addition of medications for control of blood glucose and 3 (2.09%) patients reported hypoglycemic events and medications were stepped down. Psychological stress was most common factor worsening of hyperglycemia followed by change in diet and exercise.

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46XY complete gonadal dysgenesis (SWYER SYNDROME) is a rare type of Disorder of Sex Development. Herein we report a 15 years-old child, reared as female, presented with complaints of primary amenorrhoea, without short stature or Turner's stigmata. Secondary sexual development was normal. Biochemically, luteinizing hormone (LH) was 23.29 mIU/ml and follicle stimulating hormone (FSH) was 54.94 mIU/ml. Serum estradiol level was 15.33 pg/ml (21-51), and Testosterone was 14.04 ng/dl. USG abdomen revealed a small uterus with thinned endometrium. MRI Abdomen showed hypoplastic uterus with non-visualized B/L ovaries (? Complete/pure gonadal dysgenesis). Patient had withdrawal bleeding with estrogen progesterone challenge test. Karyotype analysis revealed 46XY with no evidence of mosaicism. Based on these results a diagnosis of Swyer Syndrome (complete gonadal dysgenesis: Disorder of Sexual Development) was suspected. Patient was managed with a multidisciplinary approach and various issues were discussed.

Background: Chronic Right Heart failure is known to cause Liver Cirrhosis but it is rare. Here we are reporting the case of cardiac cirrhosis presented to us with signs of Liver Failure. Case Report : 50 year male, farmer, chronic smoker presented with progressive abdominal distension and episodes of malena since 6 months and an episode of hematemasis. On work up Liver cirrhosis was diagnosed but cause for cirrhosis was not established and on general examination pulse was irregular and features of pulmonary hypertension were present. On reviewing he revealed history of chronic cough and breathlessness with winter exacerbations and pedal edema. Chest X-ray suggested cardiomegaly, ECG suggested low voltage complex with poor R wave progression and 2-D Echo suggested pulmonary hypertension with tricuspid regurgitation with right sided dysfunction suggesting cardiac cause for cirrhosis. Conclusion : Chronic Right Heart Failure is known but rare cause of Liver cirrhosis.

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