Ambiguous genitalia: a clinical and chromosomal study

Background: To correlate the findings of physical examination, ultrasonography and chromosomal analysis, so that to give proper advice to the concerned parents as early as possible in rearing up of the child as male or female according to the situation.Methods: The study is undertaken with forty cases with ages ranging from new borne to 20 yrs. Out of these 40 cases eight cases are below one year. In these cases physical examination is correlated with ultrasonography and chromosomal analysis.Results: In chromosomal analysis three persons out of forty cases were mosaics with 45, XO/46, twenty one cases who showed the chromosomal pattern as 46, XY mostly showed with no mullarian reminents. On examination palpable gonads were found in labio-scrotal sacs in seventeen cases. One of these cases was reared as girl found cytogenetically as 46, XY with the ultrasonographic impression as small uterus with no ovaries. Nineteen cases who with ambiguous genitalia showed the chromosomal pattern as 46, XX one out of these cases showed enlargement of the breast, and on examination of external genitalia found enlarged clitoris with labiamajora and minora. The child was brought up as male. Genitogram showed the absence of uterus.Conclusions: Chromosomal studies with ultrasonography can help in rearing a child male or female in young generation by surgical and Hormonal therapy. This prevents many problems in later life. This fact should be advertised openly in the public so that illiterate people should be alert.

Common and distinct neural effects of risperidone and olanzapine during procedural learning in schizophrenia: A randomised longitudinal fMRI study

© 2015 The Author(s). Rationale: Most cognitive domains show only minimal improvement following typical or atypical antipsychotic treatments in schizophrenia, and some may even worsen. One domain that may worsen is procedural learning, an implicit memory function relying mainly on the integrity of the fronto-striatal system. Objectives: We investigated whether switching to atypical antipsychotics would improve procedural learning and task-related neural activation in patients on typical antipsychotics. Furthermore, we explored the differential effects of the atypical antipsychotics risperidone and olanzapine. Methods: Thirty schizophrenia patients underwent functional magnetic resonance imaging during a 5-min procedural (sequence) learning task on two occasions: at baseline and 7-8 weeks later. Of 30 patients, 10 remained on typical antipsychotics, and 20 were switched randomly in equal numbers to receive either olanzapine (10-20 mg) or risperidone (4-8 mg) for 7-8 weeks. Results: At baseline, patients (all on typical antipsychotics) showed no procedural learning. At follow-up, patients who remained on typical antipsychotics continued to show a lack of procedural learning, whereas those switched to atypical antipsychotics displayed significant procedural learning (p = 0.001) and increased activation in the superior-middle frontal gyrus, anterior cingulate and striatum (cluster-corrected p < 0.05). These neural effects were present as a linear increase over five successive 30-s blocks of sequenced trials. A switch to either risperidone or olanzapine resulted in comparable performance but with both overlapping and distinct task-related activations. Conclusions: Atypical antipsychotics restore procedural learning deficits and associated neural activity in schizophrenia. Furthermore, different atypical antipsychotics produce idiosyncratic task-related neural activations, and this specificity may contribute to their differential long-term clinical profiles.Alexander von Humboldt Foundation; Biomedical Research Centre for Mental Health at the Institute of Psychiatry, King’s College London; South London and Maudsley NHS Foundation Trus

Variations in the Origin of Middle Hepatic Artery in Living Liver Donors using CT Angiography in South Indian Population: A Retrospective Study

Introduction: The middle hepatic artery is an artery which supplies blood to the fourth segment of the liver. Most commonly, it originates from the right hepatic artery. Injury to the middle hepatic artery during liver transplant surgeries may lead to ischaemia and also may lead to life threatening conditions like hepatic artery thrombosis in donor as well as recipient. The variations in the origin of the middle hepatic artery in the living donors were focused in the present study as it has surgical importance in the liver transplantations. Aim: To find out the incidence of the variations in the origin of the middle hepatic artery in living liver donors using Computed Tomography (CT) angiography. Materials and Methods: This was a retrospective observational study conducted from August 2018 to October 2021 in the Department of Anatomy, Deccan College of Medical Sciences, Hyderabad, Telangana, India. The images of CT angiographies of 100 living liver donors were collected from the Department of Radiology, Global Hospital, Hyderabad, Telangana, India. All the CT angiographs of the living liver donors were observed for any variations in the origin of the middle hepatic artery and recorded and the percentage of each variation was calculated. Results: Out of 100 CT angiographs studied, the incidence of the origin of middle hepatic artery was reported as 55% from right hepatic artery, 34% from the left hepatic artery, 5% from replaced left hepatic artery, 2% from the hepatic artery proper, 1% from the common hepatic artery, 1% from left gastric artery. Double middle hepatic arteries were observed in 1% of cases. Accessory middle hepatic artery was observed in 1% cases. Conclusion: To increase the success rate of liver transplantations, the clear knowledge on the possible variations of the middle hepatic artery is needed. The variations of the middle hepatic artery reported in this study are rare and will be useful for the liver transplant surgeons

Genetics Made Simple

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