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Background: Pituitary Microadenomas can be defined as small lesions less than 1 cm in the pituitary and detected as incidentalomas. Partial development or late development around puberty leads to maldevelopment of secondary sexual characteristics due to pituitary adenomas. Clinically this may manifest as secondary amenorrhoea and may lead to hyperprolactinaemia, galactorrhoea and Amenorrhoea. ACTH secreting micro adenomas of the Pituitary Gland is a clinical entity where the role of surgery is contemplated. This study attempted to explore the management options and strategies for pituitary microadenomas. The aim of the study: To highlight the characteristics of Cushing's disease and discuss the management strategies including trans-sphenoidal surgery to treat ACTH secreting pituitary microadenomas. Materials and methods: This was a non-randomised prospective observational study involving all adrenal tumors from 2007-2017 in Madras Medical College, Chennai. Two adrenocortical adenomas with virilising features were ruled out and 8 ACTH secreting Cushing's disease with microadenomas were identified. 3 Patients with ACTH secreting microadenomas of Cushing's disease underwent surgery whereas 3 underwent medical treatment based on which this paper attempted to discuss management strategies for Cushings disease. Results: ACTH levels were measurable with an average of 136.71pg/ml (normal 7.2-63.3 pg/ml) Corticotrophin releasing hormone test was planned to evaluate an exaggerated response of serum cortisol consistent with pituitary disease. It was not carried out and inferior petrosal sampling also was not done. Biochemical evaluation confirmed pituitary dependent Cushing's disease. MRI revealed a prominent circumscribed lesion suggestive of a Pituitary Micro Adenoma in All 6 Cases. Conclusion: Pituitary micro adenomas are operable and in Cushing's disease offer an effective cure. The outcome is good with minimal complications, but surgeons must have a thorough knowledge of the surrounding anatomy and potential complications. [ABSTRACT FROM AUTHOR]

Background: A urinary tract infection (UTI) is a common infection that can affect any part of the urinary system, including the kidneys, bladder, and urethra (the tube through which urine exits the body). The most common cause of UTIs is the transfer of bacteria from the rectum or vagina to the urethra. Around 80 percent are caused by E. coli bacteria commonly found in the gut or feces. Others, like Staphylococcus saprophyticus, are naturally found in the vagina and can be transferred to the urethra. The aim of the study: The study objectives were to assess the knowledge of adolescent girls regarding urinary tract infection and determine the association between knowledge regarding urinary tract infection and selected demographic variables. Materials and methods: This observational study was done in 2017-2018 at Department of Urogynecology, Institute Of Social Obstetrics, Government Kasturba Gandhi Hospital, Chennai. 200 female adolescents were included in the study. BMI was calculated from height and weight. Height, weight, and BMI were considered for assessing malnutrition in adolescent girls. Urine samples were collected from 23 girls for microscopic examination for pus cells. The faculty members followed the investigators and guided them during the survey. The survey was completed within two days. Any girl complaining of three criteria of the case definition of UTI viz: increased frequency of micturition with; burning during micturition and pus cells in the urine were considered as a case of UTI for the purpose of the study. Results: There was a significant association between prevalence of UTI and improper perineal washing technique (CI = 95%, p< 0.001), malnutrition (CI = 95%, p< 0.001), presence of vaginal discharge (CI = 95%, p< 0.001) and use of unsanitary pads during menses (CI = 95%, p< 0.001). Misconception included not taking bath during periods and not eating certain foods. Low socioeconomic status was chiefly responsible for frequent use of the same piece of cloth as sanitary pads during menstrual bleeding leading to urinary tract infection. UTI was more (7.7%) in malnourished girls than in those with normal nutritional status. Significantly more (7.7%) girls having symptoms of vaginal discharge were suffering from a urinary infection. Conclusion: For the short term, the need is to give immediate health education about the causes, prevention, and treatment of UTI among adolescent girls of both the villages and treatment of the identified cases with the urinary antibiotics etc. Long term measures include a periodical screening of the adolescent girls for UTI. [ABSTRACT FROM AUTHOR]

Background: Tuberculosis is a major public health problem in India. There is a paucity of literature on the hematological changes associated with tuberculosis, though tuberculosis is a common condition. Advances in the management of patients in terms of the diagnosis and treatment of hematologic malignancies and treatment-related complications, especially infectious complications, have increased survival time. However, more than half of the patients treated for hematologic malignancies will develop a pulmonary complication during their follow-up, with infectious pneumonia remaining the most common diagnosis that should be considered first regarding its potential severity. Otherwise, new complications that may involve different organs, including the lungs, have been increasingly reported. Currently, over a quarter of lung infiltrates occurring in the context of hematological diseases are due to noninfectious causes. Aim of the study: To evaluate the hematological parameters in patient with Ziehl Nelson smear positive pulmonary tuberculosis. Materials and methods: The study was conducted in the Department of Thoracic Medicine, Madras Medical College, Chennai from 2018-2019 (12 months). One hundred patients with sputum who were positive for acid-fast bacilli were included in the study. The various hematological manifestations in tuberculosis were studied using a hemogram by automated cell counter and peripheral smear examination. Results: Anemia was seen in 74% of patients. Despite the infection, 71 patients had a normal leukocyte count. Leukocytosis as a response to infection was observed in 26 patients. Thrombocytosis was observed in 24 patients while thrombocytopenia was observed in 9 patients. 99% of patients had increased ESR. Two patients had pancytopenia. Conclusions: Broad spectrum of hematological abnormalities has been demonstrated in patients with pulmonary tuberculosis in the present study. While many of them are consistent with reported literature and reinforce the fact that they can be valuable tools in monitoring e.g. anemia and increased ESR, other findings such as thrombocytosis, pancytopenia suggest the need for further studies in this field. [ABSTRACT FROM AUTHOR]

Background: Chronic kidney disease (CKD) is a global burden and is now recognized as a major public health problem worldwide. Patients with CKD have alterations in thyroid hormone metabolism. This study aims to evaluate the status of thyroid hormone profile in different stages of CKD. Aim of the study: To study the prevalence of thyroid dysfunction in patients with chronic renal failure. Materials and methods: This cross-sectional study was conducted in the year 2018, at Madha Medical College and Research Institute, Chennai. 50 patients were included in this study. Patients who fulfill the criteria for CRF and who were on conservative management were taken for the study. A thyroid profile was done in all patients who fulfill the criteria. Results: The prevalence of low T3 syndrome was 54% (27 cases) and the low T4 syndrome was 22% (11 cases). The prevalence of TSH in the hypothyroidism range was 4% (2 cases). Mean T3, free T4, and TSH levels in various stages of CKD. The mean T3 was decreased significantly with reduced creatinine clearance. The free T4 was also significantly decreased in stage 5 CKD. Conclusion: The number of patients with low T3 and T4 syndrome progressively increases with the severity of the renal failure. The serum level of total T3 and free T4 is directly proportional to the creatinine clearance level. Total T3 and free T4 correlated with the severity of the renal failure. TSH values will be useful to differentiate hypothyroidism from non- thyroidal illness due to CKD. [ABSTRACT FROM AUTHOR]