Aims:To study the prevalence of upper airway obstruction (UAO) in “apparently asymptomatic” patients with euthyroid multinodular goitre (MNG) and find correlation between clinical features, UAO on pulmonary function test (PFT) and tracheal narrowing on computerised tomography (CT).Materials and Methods:Consecutive patients with apparently asymptomatic euthyroid MNG attending thyroid clinic in a tertiary centre underwent clinical examination to elicit features of UAO, PFT, and CT of neck and chest.Statistical Analysis Used:Statistical analysis was done with SPSS version 11.5 using paired t-test, Chi square test, and Fisher's exact test. P value of <0.05 was considered to be significant.Results:Fifty-six patients (52 females and four males) were studied. The prevalence of UAO (PFT) and significant tracheal narrowing (CT) was 14.3%. and 9.3%, respectively. Clinical features failed to predict UAO or significant tracheal narrowing. Tracheal narrowing (CT) did not correlate with UAO (PFT). Volume of goitre significantly correlated with degree of tracheal narrowing.Conclusions:Clinical features do not predict UAO on PFT or tracheal narrowing on CT in apparently asymptomatic patients with euthyroid MNG.

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This audit shows that all patients with insulinoma develop hypoglycemia within 48 h of fasting. CT of pancreas localizes the lesion in two thirds of cases and would be a useful initial investigation in patients with suspected insulinoma.

Background: Women with polycystic ovarian syndrome (PCOS) often have insulin resistance and hyperinsulinaemia and may therefore be at an increased risk for gestational diabetes mellitus (GDM). Metformin is widely prescribed to pregnant women with PCOS in an attempt to reduce pregnancy complications. Metformin is not approved for this indication, and evidence for this practice is lacking Aim: the objective of this study was to compare the pregnancy outcomes if metformin was continued till delivery in pregnant PCOS patientsto the outcomes if metformin was discontinued at 12 weeks. Materials and methods: this single institution study included 81 women diagnosed with PCOS who conceived with metformin and randomised into two groups, group 1 who continues metformin till delivery and group 2 who discontinued metformin at 12 weeks. Obstetrical outcomes measured were GDM, Gestational hypertension, fetal growth restriction (FGR) and preterm delivery. Results: Gestational hypertension was seen in 25% in group 1 and 33 % in group 2. 20% patients were found to have GDM in group 1 and 33% in group 2..Preterm labour rate in group 1 and group 2 were 25% and 33% respectively. Incidence of FGR was similar in both groups, 18%. Conclusion: Metformin appeared to reduce the incidence of GDM, especially need for insulin initiation if taken throughout pregnancy. It also appeared to reduce the incidence of hypertensive complications and preterm labour in this study. Metformin appeared to have no correlation to fetal growth restriction as evidenced by this study.