Mayer–Rokitansky–Küster–Hauser (MRKH) syndrome is a congenital condition characterized by agenesis of the uterus and vagina in females with normal ovaries and fallopian tubes, secondary sexual characteristics and 46XX karyotype. They present with primary amenorrhoea. Urinary anomalies, usually renal agenesis and rarely ectopia, occur. Skeletal abnormality can co-exist in about 10% of the patients. Simultaneous pulmonary hypoplasia has been reported very rarely in the literature. The normal external appearance of MRKH syndrome makes it difficult to diagnose until puberty. The purpose of this pictorial essay is to display the structural malformations of this rare disease. The presence of unilateral pulmonary agenesis is extremely rare. The use of invasive diagnostic laparoscopy and ionizing radiation, including intravenous urography or CT scan, has been reported in the literature for diagnosing MRKH. MRI is the mainstay of imaging in evaluating this syndrome, as it is free of radiation, non-invasive and has multiplanar capabilities.

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Introduction:Prevalence of diabetes is increasing worldwide. Good glycemic control is essential for prevention of complications of diabetes. Despite of availability of multiple medications, it is difficult to achieve good glycemic control. Insulin therapy is considered to be the best option available for attaining glycemic control. But, whether insulin therapy has achieved it is an important question to be addressed. Objective: To assess the glycemic control in subjects with diabetes on insulin therapy. Materials and Methods: A cross-sectional study was done at Karnataka Institute of Endocrinology and research, Bangalore, in 448 diabetic patients who were on insulin therapy as a part of their diabetic therapy. Data collected was analyzed using SPSS 22 version software. Results: Majority of the subjects were men (61.38%) and in the age group of > 60 years (44.9%). Many of the subjects on insulin therapy had duration of diabetes > 5 years, with 36.4% having duration of 10-20 years, while another 36% had duration of 5 -10 years. Premixed insulin (81.47%) was the most commonly used insulin regimen. 82.6% of the subjects were on conventional insulin and only 13.2% were on insulin analogues. Insulin syringe was the most commonly used delivery device, with 64.7% of subjects using it, while insulin pen was used by 33.5% subjects. Despite of insulin therapy, the glycemic control was poor and 81.4% had HbA1c >8%. Only 5.7% of the subjects had HbA1c <7%. 94.9% of the subjects reported that they were regular with their insulin therapy. Only 20.1% adjusted the insulin dose by self. Conclusions: The present study has found that despite being on insulin therapy, large percentage of subjects was unable to achieve good glycemic control.

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Aims and objectives: 1) To compare and correlate glycosylated haemoglobin (HbA1C) as an independent criteria in diagnosis. 2) To define the sensitivity and specificity of HbA1C estimates at the ADA recommended cut off of ≥ 6.5%. Study design and methods: Subjects were first tested for Fasting plasma glucose and two-hours post 75 grams glucose challenge, HbA1c was estimated for the all the subjects. Results: The sensitivity and specificity of HbA1C at the ADA recommended ≥ 6.5% cut off value in newly detected diabetic patients was 96.70% and 82.92% respectively with a positive predicted value of 56.05% and a negative predictive value of 99.11 % .75.00 % at a p<0.001. We find that we miss 42% of people with diabetes if fasting plasma glucose levels are considered. Given the risks associated with PPG levels in our population it is important that these criteria be used in screening programmes. Conclusion: Our study shows that HbA1C is comparable to FPG levels estimation but is not superior enough to replace blood glucose estimation. Use of post prandial glucose levels are better in detecting diabetes than fasting plasma glucose levels. A combination of post prandial glucose with HbA1C may be a superior single test that can overcome the cumbersome oral glucose tolerance test.