Background:Subclinical hypothyroidism (SCH) is a commonly encountered entity in day-to-day clinical practice and has been associated with adverse cardiovascular risk profile in adults and children. Data on children and adolescents with SCH, from India, are limited.Materials and Methods:This study was a cross-sectional case–control study, conducted at a tertiary care center in Northeast India. Twenty-seven children and adolescents aged 11 ± 2.4 years with SCH and thyroid-stimulating hormone >7.5 mIU/L were included in the study along with 20 age-, gender-, and height-matched controls. Multiple clinical, biochemical, and radiological cardiovascular risk factors were assessed and compared between the two groups.Results:Body mass index (BMI) (P = 0.048), waist circumference (P = 0.008), waist to height ratio (P = 0.007), low-density lipoprotein cholesterol (P = 0.04), triglycerides (TGs) (P = 0.038), TGs to high-density lipoprotein (HDL) cholesterol ratio (P = 0.005), non-HDL cholesterol (P = 0.019), fasting insulin (P = 0.006), and homeostasis model assessment of insulin resistance (P = 0.007) were found to be significantly higher while free T4 (P = 0.002) and HDL cholesterol (P = 0.019) were found to be significantly lower in SCH subjects compared to controls. On multiple regression analysis, BMI was found to have significant association with multiple cardiovascular risk factors.Conclusion:Children and adolescents with SCH were found to have adverse cardiovascular risk profile. Long-term follow-up studies are required to assess the clinical significance of these findings and requirement for therapy.

No abstract

OBJECTIVE: Screening mammography among 35-60 years of age group of patients has been clearly shown to reduce mortality from breast cancer. METHODS: Patients were selected from OPDs of various departments. Patients of 35-60 years of ages were included as part of the study. Detail family and menstrual history were taken and then mammography of both breasts was performed. RESULTS: Out of 60 cases coming for screening mammography, 42 were found to be some type of lesions in mammography; however 18 patients were with no findings. Commonest breast density found to be scattered areas of fibro glandular density followed by heterogeneously dense breasts. Most of the patients with heterogeneously dense breast density were found to be in their luteal phase of menstrual cycle. Lesions were classified according to BIRADS category. CONCLUSION: Screening mammography can detect various breast lesions both in symptomatic and asymptomatic individuals and thereby helping patient managements. KEYWORDS: Menstrual cycle, Luteal phase, Follicular phase, Breast, Mortality. INTRODUCTION:The use of mammography has increased rapidly over the last decade. The justification for mammographic examinations is the potential benefit they provide in detecting breast cancer at an early stage and reducing mortality. However, this benefit must be balanced against the associated potential risk of radiation carcinogenesis, economic costs, and a number of other factors. Most publications to date have used radiation risk factors and data from studies that were published over a decade ago, which now have been superseded by the results of more recent epidemiological studies. 1 It is recommended that women age 40 and older have regular mammograms. Screening is important because the earlier cancer is detected the better the chances are for successful treatment and survival. When detection occurs before any spread, the five-year survival rate is 97%. After spread to the local lymph nodes, it is 76%. After metastasis to other organs, the five-year survival rate is 20%. 2 Mammography is useful in discovering tumors too small to be felt. The procedure involves taking an X-ray of the breast with a very low radiation dose. It has been shown that there is little risk from the exposure for women over 35 who have annual mammograms. However, for younger women who are at high risk for breast cancer due to their BRCA status, exposure to X-rays may lead to an increase in risk. 1 Screening mammograms can find cancers and cases of ductal carcinoma in situ (DCIS, a noninvasive tumor in which abnormal cells that may become cancerous build up in the lining of breast ducts) that need to be treated. False-positive results occur when radiologists decide mammograms are abnormal but no cancer is actually present. False-positive results are more common for younger women, women who have had previous breast biopsies, women with a family history of breast cancer, and women who are taking estrogen (For example, menopausal hormone therapy).False-negative results occur when ma...

No abstract

Portal vein aneurysms are extremely rare and intrahepatic variety is the rarest. It is often an incidental, asymptomatic finding or may be associated with portal hypertension. Recognition of this finding can help to avoid potential confusion with abdominal masses of other aetiologies. In this report, we present a case of large intrahepatic portal vein aneurysm measuring approximately 7.7x6.4 cm. till date this is the largest intrahepatic portal vein aneurysm ever reported. KEYWORDS: Aneurysm, intrahepatic portal vein. CASE REPORT:A 25 years female with history of chronic vague abdominal discomfort was presented to the gastroenterology OPD. Per abdominal examination showed evidence of splenomegaly. There was no previous history of any surgical intervention or abdominal trauma. Liver function test showed elevation of hepatic enzymes. Complete haemogram and renal function test were within normal limits. She was advised a multiphasic CT abdomen to exclude any other abdominal pathologies. Multiphasic MDCT abdomen revealed a hypo dense lesion measuring approx 7.7cm x 6.4cm in size predominantly occupying the left lobe of the liver.No enhancement of the lesion is seen in the arterial phase. The lesion showed homogenous enhancement in the portal venous phase with branches of portal vein merging with the lesion suggesting portal venous origin of the lesion. The intrahepatic portal vein branches were otherwise ectatic. The main portal vein was also dilated and measures 18.5 mm near the splenoportal confluence. No thrombus is seen in the splenoportal axis. There was volume redistribution in the liver with enlargement of the left lobe and atrophy of the right lobe. No other focal lesion in the liver was seen. The paraumbilical vein was re canalised.The intrahepatic bile ducts, CHD, CBD and intrahepatic veins were unremarkable. The spleen was grossly enlarged. The splenic vein was also dilated and measures approx 16.6 mm. Superior mesenteric vein was normal. There was mild ascites. Pancreas was normal in size, shape and attenuation. No lymphadenopathy or any other abdominal pathology was seen. Constellation of findings suggested a saccular intrahepatic portal venous aneurysm with features of portal hypertension. DISCUSSION:Aneurysms of the portal vein is extremely rare and represent only 3% of all aneurysms of the venous system. 1 Barzilai and Kleckner 2 were the first to report a portal vein aneurysm, in 1956. The authors described the necropsy of a cirrhotic patient with a portal vein aneurysm and thrombus that ruptured into the biliary system. 2 Portal vein aneurysms are defined as focal dilatation of portal venous system, either extrahepatic or intrahepatic, extrahepatic being more common. Though exact mechanism is unknown, various etiologies ranging from congenitally defective regression of right primitive