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   2008| October-December  | Volume 12 | Issue 4  
    Online since August 13, 2011

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Hormonal Treatment Of Prostate Cancer
Prabirkumar Bandyopadhyay, Aniruddha Chakravarti
October-December 2008, 12(4):15-27
Prostate cancer has become the most common cancer of males in several developed countries. Prostate cancer is highest in western population, particularly among the black population of the United States. With widespread screening for prostate specific antigen (PSA) and digital rectal examination (DRE) as well as early treatment of localized prostate cancer, however, the age-adjusted rates of death due to prostate cancer have begun to decrease. Over 50 years since Huggins and Hodges first recognized the hormonal dependence of prostate cancer, androgen deprivation therapy (ADT) is the cornerstone treatment of advanced prostate cancer. Prostate cancer is the most sensitive of all hormone sensitive cancers to endocrine therapy. In addition to its well-established role in treating patients with metastatic disease, ADT is also used as adjunct the therapy for men undergoing radiation therapy for high-risk localized disease and in patients with increasing prostate-specific antigen (PSA) levels after local treatment even without radiographic or other evidence of metastatic disease. In the ear of PSA, more cancer are being identified at an early stage with 40-60% of them being localized at diagnosis, 30-40% being locally advanced and less than 5% with metastatic disease. There have been numerous changes in the management of prostate cancer over the last two decades. Consensus has not yet been reached on the best management for each stage of the disease. There is a strong rationale for the potential prevention of prostate cancer with hormonal therapy. Clinical states associated with androgen deficiency generally are associated with a lowered risk of prostate cancer. Neither benign prostatic hyperplasia nor prostate cancer has been reported in several kindreds of children born with variants of the 5a-reductase enzyme. Similarly, risk of prostate cancer is appreciably lower in individuals with cirrhosis and associated low levels of circulating androgens. Currently, there is little basis for determining which of the available androgen suppression treatments represents the best value. The costs and side effects of several antiandrogen therapies for advanced prostate cancer differ substantially.
[ABSTRACT]   Full text not available  [PDF]
  480 130 -
Lipid Profile In Type II Diabetes Mellitus Patients In Kashmir Region
Ishfaq Ahmed, Tabassum Ara, M Ashraf Ganie, Syed Mudassar
October-December 2008, 12(4):13-14
Background : Hyperlipidemia and dyslipidemia generally coexist in diabetic patients with poor glucose control. Although they have been shown to be independent significant risk factors for vascular complications, the interaction of hyperglycemia and dyslipidemia increases the risk of macro and micro vascular complications synergistically. Objective : To study lipid profile in diabetic patients as compared to healthy controls. Design : 56 subjects were recruited for this study from outpatient department of Endocrinology, SKIMS Srinagar. Their medical history was recorded and blood samples analysed for lipid profile. Results : Diabetic patients showed a significant increase in the levels of cholesterol, triglycerides and LDL as compared to controls. Also, among all risk factors obesity was the commonest one followed by hypertension. Conclusion : The present study shows high prevalence of dyslipidemia in subjects with type II diabetes.
[ABSTRACT]   Full text not available  [PDF]
  374 178 -
Down’s Syndrome : A Chromosome Study Of 118 Cases From Jammu & Kashmir, India
Wahied Khawar Balwan, T. R Raina, Parvinder Kumar, Shalu Sharma, Sunil Raina, Subash Gupta
October-December 2008, 12(4):5-8
Introduction : Down’s syndrome (DS), the commonest autosomal disorder, besides having mental retardation and development delay, have typical phenotype that make this syndrome different from other syndromes. Objectives: To compare our data on DS with other studies done in India and abroad. Material & Methods: Chromosome study was carried out in 118 cases of clinically diagnosed Down’s syndrome referred to Human Genetic Research cum Counselling center, Jammu. The study was carried out form the peripheral blood lymphocyte culture. Results: Charomosomal abnormalities could be detected in 59 cases (50.0%). In all these 59 cases trisomy 21 was detected, however 51 cases (43.22%) had Standard or Free Trisomy (47, XY+21 or 47,XX +21), one case (0.84%) was found to have double Trisomy (48, XXX+ 21) and 7 cases (5.9%) had Mosaicism (47,XY+21/46, XY and 47, XX+ 21/46, XX). Parameters like Parental age, Sex ratio (Male/Female), Consanguinity, Birth Order, Religion and Native place (rural/urban) were also studied to find out the association, if any, of these factors with the Down’s Syndrome birth. Conclusion: The present study though includes a small number referred cases, it clearly demonstrates the importance of chromosomal analysis for referred DS cases. Although DS can be clinically diagnosed, cytogenetic examination not only helps to confirm the chromosomal abnormality but is also indispensable for Genetic Counselling and prevention of further offspring with DS in affected families. The finding of this study will help in managing DS children and counseling the affected families.
[ABSTRACT]   Full text not available  [PDF]
  405 103 -
Hypocalcaemic Seizure As Initial Presentation In Pseudohypoparathyroidism Type IB - A Case Report
Manash P Baruah, Upsana Misra Baruah, Monalisa G Sharma, Sonali Bhuyan
October-December 2008, 12(4):33-34
Hypocalcaemia results from impaired mobilization of calcium form bone and urinary loss calcium due to parathyroid hormone unresponsiveness and reduced intestinal absorption of calcium via deficient generation of active Vitamin D. Hypocalcemia can have myriads of presentation. We present here an unusual case of hypocalcemia in an 8-year-old girl presenting as intractable seizure and treated successfully with oral calcium-calcitriol supplement which brought prompt relief from hypocalcemic symptoms and became absolutely seizure free within 5 months of followup.
[ABSTRACT]   Full text not available  [PDF]
  346 138 -
Adrenal Carcinoma Presenting As Triple Hormone Adrenal Hyper - Function - A Rare Manifestation
Ibrahim Masoodi, Mohd. Ashraf Ganie, Imtiyaz A Wani
October-December 2008, 12(4):39-40
Adrenal Cortical carcinoma is a rare malignant tumor with an incidence of 0.5-2 cases per million per year accounting for 0.2% of cancer deaths. Fifty percent of tumours are functional and Cushing’s Syndrome is the most common presentation. We present a 24-year female, para 2 presented with 5 months history secondary ammenorrhoea, male pattern hair growth, acne vulgaris, puffiness of feet, breathlessness on exertion and progressive weight gain. She has clinical and biochemical evidence of all three sets of hormone excess.
[ABSTRACT]   Full text not available  [PDF]
  363 98 -
Allgrove’s Syndrome Presenting As An Acute Adrenal Insufficiency Common Presentation Of An Uncommon Disorder
Bhat Mohammad Hayat, Manzoor Ahmad, Muzaffar Majeed, Ishrat H Dar, M. M. A Kamili
October-December 2008, 12(4):35-37
Allgrove syndrome is a rare autosomal recessive disorder characterized by the triad of alacrima, achalasia and adrenal insufficiency due to ACTH resistance (the triple A Syndrome). The syndrome usually presents during the first decade of life with dysphagia or severe (occasionally fatal) hypoglycaemic or hypotensive attack, related to adrenal insufficiency. A twenty five year old male developed worsening skin pigmentation. Patient had previously been operated for achlasia cardia at the age of six years. Investigations revealed, patient had acute adrenal insufficiency and alacrima and a diagnosis of Allgrove’s syndrome was made.
[ABSTRACT]   Full text not available  [PDF]
  317 127 -
New Technology : Fracture Risk Assessment
Bharti Kalra, Sanjay Kalra, Amit Sharma
October-December 2008, 12(4):29-31
Risk of fracture has traditionally been assessed by bone densitometry (1). However, good quality dual energy X-ray absorptometry (DXA) measurement remains out of reach of the vast majority of patients. A new tool (FRAXTM) (2) has been developed for assessment of fracture risk in individual aged 40 or more. It can used with, as well as without, bone mineral density (BMD) data. The FRAXTM utilizes clinical risk factors (CRFs) such as body mass index (BMI) past history of fracture, parental history of hip fracture, and causes of secondary osteoporosis. The causes of osteoporosis included in the model include used of oral glucocorticoids, rheumatoid arthritis, current smoking and alcohol intake. The fracture risk can be computed online, or with the help of downloaded tables. This tool is an efficient and simple way of determining fracture risk, even without availability of DXA.
[ABSTRACT]   Full text not available  [PDF]
  314 121 -
Adrenal Glands In Patients With Spontaneous Hyperocortisolism : A Retrospective Comparison Of Those Who Developed Nelson’s With Those Who Are Asymptomatic For At Least 6 Years Postsurgery
M Ashraf Ganie, Manash P Baruah, A. K Kark, Ashu Seth, M. L Khurana, A. C Ammini
October-December 2008, 12(4):9-12
Introduction : Although up to 90% of patients with Cushing’s disease go into remission following pituitary surgery, a substantial number relapses. Nodular hyperplasis of pituitary seen in some cases of Cushing’s disease is believed by some experts to be an indicator of primary hypothalamic defect and this party explains such high rate of disease recurrence. However nearly 50 % of all patients who undergo bilateral adrenalectomy as primary modality of treatment remain in remission without showing any evidence of pituitary or ectopic ACTH excess over long period of follow up. This raises the possibility of a primary adrenal pathology such as presence of aberrant ACTH- receptor in adrenal or adrenal stimulatory antibody. Objectives : To compare the histological features of adrenal glands in patients developing Nelson’s syndrome with those without any evidence of corticotroph adenoma or ectopic. ACTH excess after bilateral adrenalectomy. Material and Methods : Records of patients who underwent bilateral adrenalectomy as a primary modality of treatment after 1985 at our center and no regular follow up were reviewed. The patients were divided in to two groups I, Nelson’s syndrome and II, > 9 years of uneventful follow up. Histopathologic features of surgically removed adrenal were reviewed by an experienced pathologist who was blind to the background and outcome of patients. Focal lympho-plasmacytic infiltrate (FLPI) was intensely looked for and graded as mild, moderate and prominent. Results : There were a total of sixteen patients (5 M and 11 F) with a mean age of 27.6 ± 7.3 years (range of 14 – 42 year). Five patients (31.25%) developed Nelson’s syndrome and underwent pituitary surgery while eleven completed > 9 years (6-16; median 9 years) follow up without any evidence of pituitary or ectopic ACTH excess. All patients in either group had diffuse cortical hyperplasia. FLPI was seen in only two out of seven (28.57%) Nelson’s syndrome compared to five of eleven (45.45%) in the second group (16.6% mild, 66.6% moderate and 16.6% prominent). Conclusion : Absence of a pituitary adenoma at diagnosis and long postoperative follow up in some patients casts doubt over universality of primary role of pituitary in Cushing’s disease. The present analysis reveals much higher prevalence of lympho-plasmacytic infiltrate in addition to diffuse cortical hyperplasia in those who did not develop Nelson’s syndrome following bilateral adrenalectomy indicating possible role of autoimmune mechanism of hypercortisolism. Well designed prospective study including more patients is required to refute or confirm this possibility.
[ABSTRACT]   Full text not available  [PDF]
  325 104 -
Vitamin D Status In India – An Area Of Concern In Future
Nikhil Tandon, H. K Reddy
October-December 2008, 12(4):1-3
Full text not available  [PDF]
  196 166 -
Hypothyroidism As A Cause Of Ovarian Cyst
Dinesh Dhanwal
October-December 2008, 12(4):41-41
Full text not available  [PDF]
  145 148 -
Secondaries Pelvis Due To Carcinoma Prostate
Shiekh Aejaz Aziz, Manzoor Ahmad Banday
October-December 2008, 12(4):43-43
Full text not available  [PDF]
  146 116 -