Long standing hypothyroidism presenting as an ovarian mass has been well described in literature as the Van Wyk Grumbach syndrome (hypothyroidism, isosexual precocious puberty and ovarian mass). Here, authors report this entity in a 11 y 7 mo old girl child who was referred to a surgeon in view of intestinal obstruction along with a multiloculated ovarian cyst. On evaluation, she was found to have raised serum creatinine, short stature, delayed bone age and pituitary enlargement. She was diagnosed with autoimmune thyroiditis and was started on replacement therapy with thyroxine, after which the ovarian cysts regressed. This entity should be kept in mind in cases of ovarian cysts, especially those with isosexual precocity, to prevent unnecessary evaluation and surgical misadventures.

Purpose of review Dietary supplement usage by adolescents has been on the rise in the last decade and is expected to continue to grow, although the evidence of their benefits in healthy individuals remains unclear. This review aims to spread awareness about the poorly regulated supplements and their effects on the health of adolescents to minimize medical hazards. Recent findings In this review, we have attempted to summarize some of the commonly consumed supplements, their alleged benefits, effects and side effects, along with the motivation that drives adolescents into consuming them. Summary The widespread use of dietary supplements among adolescents, in the background of lack of knowledge and medical guidance, predisposes adolescents to significant health risks. Although supplements may be necessary and safely consumed in certain specific situations, most healthy adolescents do not need them. The lack of regulation of supplements encourages contamination and ensures indiscriminate, easy access.

BackgroundClinical empathy is standing in the patient's shoes and perceiving his/her emotions to experience the patient's feelings. Practicing empathy ensures an enticing prospect in patient care. This study was done among undergraduate medical students to assess their empathy level and the factors affecting it. MethodsThis was a cross-sectional study conducted with 400 medical students in Bihar, India. Students not willing to participate were excluded from the study. The coding system was designed to strictly maintain anonymity. The study tools included the Jefferson Scale for Physician Empathy -Student Version (JSPES), a semistructured questionnaire on the general profile, a perceived stress scale (PSS), and a multidimensional scale of perceived social support (MSPSS). Participants were allotted 20 minutes to complete the test and submit their responses. Results were expressed as means and standard deviations (SDs), with appropriate statistical tests applied. The data were presented in tables, and statistical significance was checked at a 5% level. All statistical analyses were conducted using SPSS software. ResultsThe arithmetic mean (±SD) of empathy scores was 99.87±14.71. Empathy was found to be positively correlated with social support and negatively with stress. The factors found to be significantly associated with empathy on univariate analysis were subjected to stepwise multiple linear regression, which provided a six-factor model comprising gender, choice of future specialty, stress, social support, residence, substance abuse, and stay in hospital as an attendant. ConclusionsStress and social support were found to be significant predictors of empathy. The female gender, living in urban areas, and having previous experience of hospital stay as an attendant of a patient were positively associated with empathy. In contrast, choosing a technical branch as a future specialty and substance abuse were negatively associated with empathy. Stress management, enhancement of social support, and avoidance of habit-forming substances could be beneficial in improving empathy among doctors. Since we could only identify a few factors, we recommend further studies on this topic to explore other factors.

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