Background: Patients with hypothyroidism present a morbid life. The quality of life is low. Under this scenario, understanding the clinical profile of these patients helps to modest their quality of life by the physician. Objectives: To study the clinical profile of patients with hypothyroidism Methods: A hospital based cross sectional study was carried out to study the clinical profile of patients with hypothyroidism. Institutional Ethics Committee permission was obtained and informed consent was taken from each and every patient. A pre tested, semi structured questionnaire was prepared and the data was collected. Detailed history, complete general examination was carried out. Data was entered and analyzed. Results: females had a higher incidence of hypothyroidism than men. Most common symptoms are of dry skin, hair loss, weight gain, lethargy, constipation, menorrhagia and hoarseness of voice. On general examination most common findings are weight gain and dry skin found in around 49.99% and 83.33% of patients respectively. Goiter was found in 16.6% and pallor in 26.66% of patients. Pulse < 60 /min was found in 6 patients and BP above 140/90 mmHg was found in 3.33% of patients. Conclusion: This study comprised of 30 patients, all of them were newly diagnosed hypothyroid patients, with no other co-morbidity. As in most literature, there was a female preponderance in this study. Most patients belonged to the age groups of 21-60 years. The most common of the symptoms included weight gain, hair loss, dry skin, hoarseness of voice, lethargy, cold intolerance and constipation.

Background: Cervical spondylosis is a common disease of advancing age arising form the effects of a progressive degenerative changes affecting single or multiple inter vertebral disco and consequent hypertrophy, spurring and deformities of the discs and foramina. Objective: To study radiological profile of patients with cervical spondylosis Methods: A hospital based cross sectional study was carried out among 150 patients. Institutional Ethics Committee permission was obtained. From each and every patient, the informed consent was taken. A detailed history and thorough clinical examination was carried out. Data was entered and analyzed. Results: The maximum age of patient studied was 72 years, minimum age of patient studied was 16 years. Maximum patients were in 2^nd and 4^th decade of life. Maximum No. of cases were found in a group of sedentary workers (Doctors/Teachers/Clerks). Almost all cases present with symptom of neck pain followed by symptoms like Brachialgia, Para spinal muscle spasm, Paraesthesia. While difficulty in walking found in only 14 cases of cervical spondylosis. Conclusion: Cervical spondylosis was common in the 4^th decade of life. Sedentary work was the risk factor for cervical spondylosis. Neck pain was the most common presenting symptom.

Background: About 40% of the estimated 10.8 million annual child deaths worldwide occur in first two months of life. Besides mortality, infants experience at least five to six episodes of illnesses per year. Despite having the problem well defined there is no consistent evaluations and management approach to infants aged less than three months. Objective: To quantify the nature and burden of illnesses in the first months of life. Methods: This Prospective study was conducted among all consecutive subjects between 8 days to 90 days of age admitted during this period were subjects of this study. They underwent through a standardized set of enquiry, clinical examination and investigations. A precoded standardized assessment form was used for data recording. The study subjects were diagnosed and managed according to the protocol of treating unit under the supervision of the senior faculty. Results: The most common clinical signs was chest indrawing- 98 (64.9%), followed by tachycardia- 65 (44.4%). Following factors may have a higher risk of death: wasting, rapid breathing and respiratory distress, slow / irregular respiration, diarrhea, dehydration, low body temperature with or without impaired perfusion on admission and cyanosis. Conclusion: Presence of risk factors identified in this study should warrant immediate and appropriate measures.

Background & Objective: To evaluate awareness of diabetic retinopathy in self reported diabetic patients attending tertiary care centre in rural Telangana. Methods: This was a prospective study conducted on 215 diabetic patients attending department of ophthalmology (Chalmeda Anand Rao Institute of Medical Sciences) which included questionnaire and analysis of patients based on age, duration of diabetes mellitus (DM), education level and presence of diabetes. Results: Out of 215 patients (63% men, 37% female) participated in the study. Through analysis, results showed were 83% were aware of diabetic eye disease (DED), 60% knew the relationship between diabetic eye disease (DED) and diabetes. 50% go to eye checkups regularly and 53% had their vision affected. Conclusions: Patients with longer diabetes mellitus duration and more educated had marginally better awareness.

Background and objectives: India is among the largest countries to implement the RNTCP. This program provides intermittent regimens to the patients, where doses of isoniazide and ethambutol are more as compare to the daily regimen. The present study was undertaken to explore the early detection of ethambutol toxicity in the patients registered under this program. Methods: This was a prospective study of 180 eyes of 90 patients being with ethambutol in the Directly observed Treatment Strategy Centre (Chalmeda Anand Rao Institute Of Medical Sciences, Karimnagar, Telangana, India).In this study visual acuity, colour vision, fundus changes and visual fields were assessed. Examinations were done before the start of therapy, after 1 month and 2 months of treatment and 1 month after stopping ethambutol. Results: No visual functional defect was noted at baseline. On follow up, following changes were observed, decrease visual acuity seen in 10% (18/180) of the eyes (p=0.02). Color vision 12.2% (22/180)of the eyes(p=0.049),among them 6 eyes developed defect in Red-Green color perception and 16 eyes developed defect in Blue-yellow colour perception. Fundus changes were seen in 6.1% (11/180) of the eyes (p=0.032). Visual field defects developed in 5.5% (10/180) of the eyes (p=0.047). Patients with ocular symptoms were advised to stop ethambutol and they showed improvement in visual acuity and colour vision after follow up of one to two months. Conclusion: Visual acuity, color vision, fundus changes and visual field examinations are sensitive tests to detect early toxicity. The early recognition of ocular symptoms is important to prevent delay in diagnosis and probable irreversible visual loss.

Background: Urolithiasis is a well known cause of morbidity in Indian population. Objective: To know the Non-dietary factors causing Urolithiasis among the patients in Karimnagar district and to compare the extent of awareness, attitude and practices by the patients about non- dietary and dietary factors. Methods: Two resident doctors interviewed 1400 patients (720 urban, 680 rural) attending urban and rural hospitals in Karimnagar district using predesigned questionnaire regarding the non-dietary factors causing urolithiasis. Results: Overall prevalence of Urolithiasis was 7.7% seen among 109 patients. Patients with kidney stones were 92 (84.4%), with ureteric stones 14 (12.8%) while patients having both were 3 (2.8%). Significant Non- dietary factors include Age predilection for the age group of 15-45 years 74 patients (68%), Male sex predilection (p value < 0.00790961) , Family history 47 (43%), illiteracy(p value = 0.0001) , the presence of Urinary tract infections 51(47%), Less daily water intake 18(16.5%), obesity 13(12%), and Catheterization 9(8%) and Excess use of antacids 10(9%). Awareness and preventive care practices were less with non- dietary factors when compared with those of dietary factors. Conclusion: Some non- dietary factors were significantly associated with urolithiasis. But the patients were not aware of the significance of their role as they do with dietary factors. Hence poor attention was paid by the patients to the non dietary factors.

Background: Pancreas is an important organ and it is the target of major diseases like pancreatitis, diabetes mellitus, exocrine pancreatic insufficiency, cystic fibrosis, pseudo-cysts, annular pancreas, neoplasm etc. The growth and development of fetal pancreas are influenced by the intra-uterine environmental and genetic factors, which can exert stimulatory or inhibitory effects. So, understanding the development of pancreas helps in planning new therapeutic strategies that help in reducing mortality, morbidity, preventing and curing of these conditions. Objectives: The present study on human fetal pancreas specimens of different gestational ages was conducted with the following objectives to observe the growth and development of pancreas in length, width and thickness in relation to gestational age. Methods: This work was conducted on 100 formalin preserved dead fetuses and they were of both sexes between 20 weeks to 40 weeks of gestational age. Results: The length of pancreas was found to be increasing with fetal age, with more increase during 33- 40 weeks. The width of pancreas was found to be increasing with fetal age, with more increase of width during 33- 40 weeks. The thickness of Pancreas was found to be increasing with fetal age with more increase during 33-40-weeks of gestation. Conclusion: In the present study pancreas was gradually increasing in length, width, thickness according to gestational age.

Background: More of specialized branches of science are developing as year passes by. One such branch of science is in-utero & neonatal surgeries. In view of correcting the minor defects & avoiding major congenital anomalies the study of Head & Neck arterial system in fetus was taken. Objective: To find the variations in origin & course of lingual & facial arteries which supply blood to tongue, face & neck. Methods: 100 dead fetuses of 20 weeks to full-term gestational age were collected from Government Hospital, Hanumakonda, and Chandakanthaiah Memorial Hospital, Warangal. 20 cc to 100 cc of 10% formalin was injected into abdomen, thorax, cranium through orbits for preservation. All the fetuses were immersed in a container filled with fixative solution. In the present study 200 lingual and facial arteries were observed considering both the sides. Results: Among the II trimester group those 5 arising above greater cornu were the Linguo-facial trunk. Among the III trimester group those 2 arising above greater cornu were the Linguo-facial trunk. Conclusion: In present study the linguo-facial trunk was observed unilaterally in 5 of second trimester and in 2 of third trimester group of fetuses.

Background: Impact of Cervical cancer on the women's life is gradually increasing in India. The causative organism, Human Papilloma Virus (HPV) detection holds the potential to be used as a tool to identify women at risk. There is a pressing need for identifying prevalence of asymptomatic cervical HPV infection in the population to prevent its progression into cervical cancer. Objectives: The objectives of this study is to correlate some of the risk factors like education and financial status with the HPV positivity in women prone for cervical cancer. Materials & Methods: 50 women of reproductive age group visiting the gynecology outpatient department in Hyderabad were selected and subjected to polymerase chain reaction, using GP5, GP6 primers to detect HPV. Statistical Analysis of the data was done. Results: 7(14%) women tested positive for HPV DNA and HPV prevalence was noted to be more common among literates of middle & low income group. Conclusion: The study generates prevalence of sub-clinical HPV in the women visiting a tertiary care institute as well as peripheral health centers. This data if done in larger groups may be useful for laying guidelines for mass screening of HPV, treatment and prophylaxis in the population. In future perhaps cervical cancer screening will shift from a cytology based approach to one in which search for HPV becomes the focus of disease detection with refined and better protocols.

Background: After due analysis World Health Organisation (WHO) has determined that hypertensive disorders in pregnancies are the major cause of mortality. In spite of its prevalence and severity, no comprehensive theory or single factor has been suggested to explain the pathophysiology of this multi system disorder of pregnancy, with the only therapies being bad rest, pharmacological symptomatic management and if necessary early delivery. Objective: To Study autonomic functions in normal pregnancy and preeclamptic pregnancy Methods: The present study was carried out in the department of Physiology, Obstetrics & Gynaecology outpatient department (OPD) & ward. The study design is cross-sectional study conducted on two groups of subjects. Thus the total no of 100 subjects were included in the study. A detailed recording of medical, obstetric, personal and family history and clinical examination of the subjects was carried out and the subjects who met the criteria were accordingly selected for the study. The consent of subjects was taken before doing clinical examinations. Results: The systolic blood pressure of Group - I and Group - II was noted as 131.9 and 154.8 respectively and is found to be extremely significant. The diastolic Blood Pressure of Group – I, was recorded as 70.72 and Group - II was recorded as 100.4 and the P value was found as extremely significant. Conclusion: The normal pregnant (group - I), has significantly lower diastolic pressure and mean arterial pressure, significantly higher resting heart rate. Rise in SBP & DBP, to cold stimuli and handgrip is significantly increased in preeclamptic pregnant (group - II).

Background: Ptosis is a common public health problem worldwide. It is the lowering of eye lid or prolapse of an organ. In all major ocular surgeries the involvement of eye lid is seen. Etiology of ptosis is multifactorial. Objective: The main objectives of the study were degree of ptosis, refraction through clinical examination and measuring with refractionometer. Methods: The study was conducted in SD Eye Hospital, Hyderabad. 60 eyes of 55 patients with congenital ptosis were studied. Complex ptosis cases were excluded from study. Results: 37 patients were in the age group of 0-19 years & 18 in 20-39 years age group were in the study group. 31 patients of them were males. In five cases both eyes were involved. 10 cases of the studied were with severe ptosis. In 18 cases astigmatism was observed. Conclusion: In the present study congenital ptosis observed more in males in first two decades of life, unilaterally with more than 80% astigmatism. Ambylopia was associated more with severe ptosis.

Background: A lot of Ocular Surface Squamous Neoplasia(OSSN) may go unnoticed as they are asymptomatic and usually slow-growing. The prevalence of OSSN is more in tropical region and varies from 12 cases /million/ year in Uganda to 0.3 cases / million/ year in United States of America, possibly related to sunlight exposure. Objective: To study the clinical behaviour of Ocular Surface squamous neoplasia (OSSN) in HIV positive patients. Methods: This is a retrospective study done at the department of the oculoplastics and orbital diseases, Sarojini Devi Eye Hospital Hyderabad over a period of three years from February 2012 to January 2015. 26 cases of HIV positive patients with OSSN were included in the study and non HIV cases were excluded. Results: In our study of 26 cases 17 were males and 9 were females and average age of presentation was 34 years 10 to 15 years younger than non HIV cases. Histopathologically 18 cases were squamous cell carcinoma, 5 cases were carcinoma in situ and 3 cases were with moderate to severe dysplasia. Recurrence was seen in 8 cases (32.1%). Conclusion: OSSN presents at a younger age in HIV positive patients with aggressive behaviour clinically and histopathologically with more chances of recurrence.

Background: Lens induced glaucoma is a common occurrence. Secondary glaucoma has been found in 10% of senile cortical cataracts. Ruling out the coexisting primary glaucomas, lens induced glaucomas has been taken up for this interesting study. Objective: To analyze the different mechanisms and clinical features of lens induced gluacomas. Methods: This clinical study included 50 cases of different types of lens induced glaucomas in individuals whose age group varied from 12 to 90 years and both the sexes conducted on the in patients of Ophthalmology department. All the cases of secondary glaucomas suspected to be lens induced were admitted to the wards. Detailed history was ascertained. Previous history of extra-capsular lens extraction in the other eye was carefully noted. Results: Majority of the patients were in the age group of 50-75 years. The incidence of lens induced glaucoma was more among females (68%) than males (32%). Right eye was found to be more commonly affected (58%) than the left eye (38%) and both eyes were involved in 4% of cases.. The majority of the eyes affected had hypermature cataract (44%) followed by mature cataract (34%). Phacomorphic glaucoma caused by intumescent lens has been the major cause contributing to 54% of cases. 27 cases (54%) showed shallow anterior chamber. Conclusion: The incidence of lens induced glaucoma was more among females (68%) than males (32%). Right eye was found to be more commonly affected (58%) than the left eye (38%).Both eyes were involved in 4% of cases. The majority of the eyes affected had hypermature cataract (44%).

Pulmonary tuberculosis usually has a smouldering onset and progression, and patients typically present with the symptoms of cough, weight loss, anorexia, night sweats and malaise that is usually present for a few weeks before presentation. Up to 80% of cases of pulmonary tuberculosis have fever which is often low-grade and intermittent. We report a 26-year old man who was admitted with community acquired pneumonia having high grade fever. He did not respond to intravenous antibiotics for one week. Then, the sputum was induced by saline nebulisation and sputum examination revealed acid-fast bacilli. Anti-tubercular treatment was started and the fever resolved. This is unusual presentation of pulmonary tuberculosis. Hence, pulmonary tuberculosis must be considered in the differential diagnosis of a patient presenting with community acquired pneumonia.

Background: Tobacco and Alcohol are the most important substances which influenced the health status of the population worldwide. Globally over 450 million tobacco related deaths may occur. Objective: To study the substance abuse among workers at a construction site in relation to the socio demographic profile. Methods: study design – community based cross sectional study done at construction sites in suburban Hyderabad. Convenient sample of work sites and systematic sampling of individuals was taken. The sample size was 353 adults with 295 men (83.53%) and 58 women (16.4%) aged above 18years. The socio demographic profile, tobacco and alcohol use, known morbidity were recorded, Height, weight, chest expansion and blood pressure were measured. The results were analysed on MSExcel and SPSS systems. Chi square test and t test were used for analysis. Results: 53.1% were using either tobacco or alcohol. 25.3% were consuming alcohol and 38.6 % were using tobacco, 20.2% were smoking and 25% were chewing tobacco. 52% of men and 20.6% of women abuse substance. There was significance in substance use in relation to gender, family size and morbidity. The socio economic class, education and occupation did not show a marked difference in substance use. There was no significant difference in means of BMI (21.3), blood pressure- Systolic (118.8mmHg), diastolic Blood Pressures (78.5mmHg), but a significant difference was there in chest expansion (83.4 & 81.3) and morbidity states. Conclusion: Our study showed 25.3% using alcohol and 38.6% using tobacco. Nearly one third of the workers are abusing substance. Tobacco use especially chewing is very high in the study population.