Context:Polycystic ovarian syndrome (PCOS), the most common endocrinopathy of women in the reproductive age group seems to be adversely affected by associated thyroid dysfunction. Both pose independent risks of ovarian failure and pregnancy related complications.Aims:The present study from Eastern India is, therefore, aimed to investigate the prevalence and etiology of different thyroid disorders in PCOS subjects.Settings and Design:Cross-sectional hospital based survey-single centre observational case-control study.Materials and Methods:This prospective single-center study recruited 106 female patients with hypertrichosis and menstrual abnormality among which 80 patients were defined as having PCOS according to the revised 2003 Rotterdam criteria and comprised the study population. Another 80 age-matched female subjects were studied as the control population. Thyroid function and morphology were evaluated by measurement of serum thyroid stimulating hormone (TSH), free thyroxine levels (free T3 and free T4), anti-thyroperoxidase antibody (anti-TPO Ab), clinical examination and ultrasound (USG) of thyroid gland.Statistical Analysis Used:It was done by Student's t-test and Chi-square test using appropriate software (SPSS version 19).Results:This case-control study revealed statistically significant higher prevalence of autoimmune thyroiditis, detected in 18 patients (22.5% vs. 1.25% of control) as evidenced by raised anti-TPO antibody levels (means 28.037 ± 9.138 and 25.72 ± 8.27 respectively; P = 0.035). PCOS patients were found to have higher mean TSH level than that of the control group (4.547 ± 2.66 and 2.67 ± 3.11 respectively; P value < 0.05). There was high prevalence of goiter among PCOS patients (27.5% vs. 7.5% of control, P value > 0.001). On thyroid USG a significantly higher percentage of PCOS patients (12.5%; controls 2.5%) had hypoechoic USG pattern also compatible with the diagnosis of autoimmune thyroiditis.Conclusions:High prevalence of thyroid disorders in PCOS patients thus points towards the importance of early correction of hypothyroidism in the management of infertility associated with PCOS.

Hypothyroidism presenting as recurrent hypokalemic paralysis is rare in the literature. This transient and episodic neurological condition is commonly associated with thyrotoxicosis. We report a case of young female admitted with recurrent paralytic attacks since last 1 year. She had no symptom of hypothyroidism. She had weakness of all four limbs, delayed relaxation of ankle jerks, and normal higher mental function. There was no enlargement of thyroid. Serum potassium level ranged from 1.6 to 3.2 meq/L during attack with high serum creatine phosphokinase level. Electromyography was normal. The patient was diagnosed having chronic thyroiditis with high thyroid-stimulating hormone and thyroid-related antibodies. Follow up shows satisfactory result with thyroxine replacement. It is an extremely rare and unusual presentation of hypothyroidism, probably the fourth reported case of hypothyroidism with hypokalemic paralysis, to the best of our knowledge.

Leptin therapy in human recombinant form has recently been used in HIV-associated lipodystrophy syndrome on experimental basis in some small short-term clinical trials. It has shown its beneficial effects only in hypoleptinemic HIV-infected patients by causing definite improvement in their insulin sensitivity, glucose tolerance, lipid status, and truncal obesity. Leptin prevents lipotoxicity and activates insulin signaling pathways through several postulated mechanisms. Central leptin insufficiency with peripheral hyperleptinemia has come out to be a significant contributor to the development of obesity and metabolic syndrome. In this article, we will review the basis of leptin therapy in HIV patients, with its promises. However, further larger clinical trials are needed to prove its long-term efficacy in the control of metabolic complications related to HIV therapy.

Background: It has been seen that Upper gastrointestinal bleeding (UGIB) is one of the most mutual gastrointestinal emergencies for physicians and surgeons. In the recent past studies, there is raised incidence of peptic ulcer with raised frequency of bleeding from it. The range of upper GI bleeding fluctuates from region to region and relies on the status of the centre in hospital hierarchy.Methods: An observational, cross-sectional, hospital-based, single centre study was carried out on 150 patients admitted in tertiary care hospital with the presentation of GI bleeding. A detailed patient history was taken followed by required clinical and laboratory investigations. Then patients were resuscitated and subjected to endoscopic procedure.Results: 150 patients were treated among which 105 were male (70%) and 45 females (30%). 111 patients (74%) had upper GI bleed, 28 patients (19%) had lower GI bleed, and 11 patients (7%) had obscure bleed. 41% of the population were diagnosed to have peptic ulcer (gastric or duodenal) as the cause behind GI bleed forming the main aetiology in this study population, 26% had oesophageal varices constituting second important cause of GI bleed, and 7% had obscure bleed. Those who had undergone UGI endoscopy or sigmoidoscopy or colonoscopy within last one month and who were having GI bleed following GI surgery were excluded from the study.Conclusions: It was seen that upper GI bleeding is more common than lower GI bleeding. Peptic ulcer was the chief cause resulting in gastrointestinal bleed followed by oesophageal varices. Gastrointestinal bleeding was more common in male population affecting mainly subjects over 40 years of age.