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The syndrome of intracranial venous sinus thrombosis termed as cerebral venous thrombosis is a distinctive cause of cerebrovascular disease in the young. CVT has been diagnosed almost exclusively at autopsy. However, with the advent of modern neuroimaging techniques, the quantum of CVT cases being diagnosed has increased significantly when compared to previous years. The annual incidence is currently estimated to be 3-4 cases for one million people. It accounts for 10% to 20% of the etiology of young stroke in India. 1 CVT is now typically recognized as a disorder with various clinical presentations and usually favorable outcome. Magnetic resonance imaging and magnetic resonance angiography are the best diagnostic methods available for diagnosis of CVT, and heparin is the first line treatment. But as the symptoms, modes of onset, and neuroimaging methods are diverse, the diagnosis of CVT is commonly overlooked. Pathological hallmark of CVT is hemorrhagic infarction. CVT is primarily a disease of a young man, can present in protean ways with a wide spectrum of clinical manifestations. These include headache, altered sensorium, seizures, focal neurological deficits, papilledema and cranial nerve palsies. The commonest dural venous sinuses involved are superior sagittal sinus and transverse sinus. Nearly 20% of cases of CVT are idiopathic in origin. However, in the Asian Studies, infectious puerperium seems to be the commonest cause of CVST. Though stroke due to arterial thrombosis is more common, cerebral venous sinus thrombosis especially in young strokes. The clinical and neurological presentation can be variable, hence there needs to be a high index of suspicion for venous sinus thrombosis in order to diagnose this entity clinically. There is a wide spectrum of underlying causes of this condition. The prognosis is good, especially when the diagnosis is prompt and treatment initiated. The aim of this study is to study the clinical profile of cerebral venous sinus thrombosis, to study the etiology factors of cerebral venous sinus thrombosis, to correlate the severity and clinical presentation with imaging studies to study the outcome at discharge and at follow-up if possible.

ABSTRACT:Ankylosing spondylitis belongs to a group of diseases known as Spondyloarthritides characterized by inflammatory low backache. It is a chronic inflammatory disease of unknown etiology, mostly associated with HLA B27 positivity affecting skeletal (both axial and extra-axial) and extra skeletal system. In general population Ankylosing spondylitis is likely to develop in about 1% to 2% of HLA-B27+ who have a disease-associated B27 subtype and is much more common among HLA-B27+ first degree relatives of HLA-B27+ AS Patients. Positive family history is a strong risk factor for the development of the disease. Ankylosing Spondylitis is a disease which mostly affects young males and working population. It is a chronic illness with exacerbations and remissions and leads to debility and significant morbidity and hence affects the quality of life significantly. This study has been carried out in Medicine department of Rangaraya medical college GGH Kakinada, Sraddha Hospital, Visakhapatnam, Andhra medical college, KGH, Visakhapatnam, GEMS College and Hospital, Srikakulam with an aim to study the articular and extra articular manifestations of Ankylosing Spondylitis, factors affecting exacerbations and remissions. Correlation between disease activity and acute phase reactants, familial association, and to study the short term treatment outcomes.

The prevalence of human immunodeficiency virus infection in India is estimated to be around 2.4 million. 1 HIV infection can lead to involvement of various organs and Systems including endocrine glands. Alteration in endocrine functions may be due to the possible relationship between the immune and endocrine systems, direct involvement of the glands by the virus itself, opportunistic infections or malignancies, highly active antiretroviral therapy and drugs used to treat opportunistic infections. 2,3 Thyroid hormones play a fundamental role in metabolism regulation of the immune system, modulating humoral and cell mediated immunity. 4 Many studies have evaluated the possible relationship of thyroid dysfunction in HIV. This study has been carried out in Medicine department of Rangaraya medical college GGH Kakinada, Sraddha Hospital, Visakhapatnam, Andhra medical college, KGH, Visakhapatnam, GEMS hospital Srikakulam with an aim to see the incidence of subclinical hypothyroidism in HIV I positive patients and its effect on diseases and possibility of an early diagnosis of hypothyroidism. Out of 102 patients 86(86.27%) are Euthyroid and 14(13.72%) are sub clinical hypothyroidism. Highest incidence is seen in stage 4. High incidence of thyroid dysfunction seen with low CD4 count. 10 females and 4 males are found. Out of 10 females 8 are not under ART have subclinical Hypothyroidism. In view of above high incidence of Thyroid Dysfunction in HIV patients with low CD4 counts has to be considered for screening.