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Among the various post-COVID sequelae, thyroid function impairment stands as a significant concern. COVID-19-related primary hypothyroidism has been documented in the literature. This study aimed to determine the number of cases with subclinical hypothyroidism and a history of moderate COVID-19 pneumonia who progressed to clinically overt hypothyroidism at six months. A prospective casecontrol study enrolled adult patients with known subclinical hypothyroidism and a history of moderate COVID-19 pneumonia as cases. Detailed medical history and physical examinations were conducted for all participants. Thyroid profiles, including free T4 and TSH, were measured at baseline and again at six months for all cases. The results revealed that 20% of cases with a history of moderate COVID-19 exhibited low free T4 levels at six months following infection, indicating progression from subclinical to clinical hypothyroidism. The mean TSH level at baseline was 7.29 mU/L, which increased to 8.76 mU/L at six months. New-onset symptoms were more prevalent in these cases compared to the controls. Furthermore, the mean baseline TSH level for cases progressing to clinical hypothyroidism was significantly higher (9.17 ± 0.63 mU/L) compared to those who did not progress (6.82 ± 1.16 mU/L; p<0.001). These findings suggest that patients with subclinical hypothyroidism and a history of moderate to severe COVID-19 pneumonia should undergo periodic monitoring to ensure timely treatment initiation if overt hypothyroidism develops. [ABSTRACT FROM AUTHOR]

Background: Metabolic syndrome (MetS) in obese is a fairly common entity. However, excluding the waist circumference (WC) criteria, other components of the MetS are also seen in lean or nonobese people. Our study aimed to determine the prevalence of lean MetS among newly diagnosed MetS cases and compare the biochemical parameters and insulin resistance in lean versus overweight/obese MetS. Methods: A cross-sectional, observational study was conducted over 12 months and included adult patients of either sex, newly diagnosed with MetS. Fever cases, infections such as tuberculosis/HIV/chronic infectious disease, chronic inflammatory diseases, those having endocrine causes of obesity such as Cushing syndrome, known cases of ischemic heart disease, and those on antiobesity medications were excluded. Diagnosed MetS patients were categorized as lean or obese based on the standard criteria. A convenient sample of 50 was considered for either group (lean MetS vs. obese MetS). Included patients were investigated for lipid, liver, glycemic, and insulin resistance profiles. Other parameters included serum uric acid, thyroid function, whole abdomen ultrasound, electrocardiography, two-dimensional echocardiography (ECHO), fibroscan, and polysomnography for obstructive sleep apnea (OSA). Results: The prevalence of lean MetS was 9.87%. Variables such as body mass index, WC, low-density lipoprotein, and systolic blood pressure were significantly higher in the obese MetS in comparison to the lean MetS group. Fasting insulin was also significantly higher in the obese MetS compared to lean MetS. Biochemical measures such as aspartate aminotransferase and alanine transferase were significantly higher for the obese MetS, while the change was nonsignificant for other biochemical measures. Except for complications such as polycystic ovary syndrome, acanthoses nigricans, and gallstones which were significantly higher in the obese MetS group, the rest of the complications were similar in both groups. Conclusion: MetS among nonobese or lean subjects differs in certain aspects from those with obesity. As lean MetS is an emerging entity, clinicians must be aware of it to avoid morbidity. [ABSTRACT FROM AUTHOR]

This article discusses a case of disseminated tuberculosis in a patient with beta-thalassaemia major and uncontrolled type 1 diabetes mellitus. Beta-thalassaemia is a genetic blood disorder that can lead to iron overload in various organs, including the pancreas, which can result in abnormal glucose metabolism and diabetes. The patient in this case was a 31-year-old woman with beta-thalassaemia major and type 1 diabetes who presented with fever, cough, and sputum production. Laboratory tests confirmed the diagnosis of tuberculosis, and the patient was treated with anti-TB medication. The article highlights the rare association between beta-thalassaemia major, type 1 diabetes, and disseminated TB. [Extracted from the article]

Immunocompromised patients with human immunodeficiency virus (HIV) infection are prone to multiple infections, of which parasitic infections are an important cause. Parasitic protozoal infections - both by common and rare protozoa are documented in such patients. Here, we report a rare and interesting case of five protozoal infections affecting a single HIV-infected person at the same time of initial presentation. A 64-years-male came to us with complaints of chronic diarrhea for 6 months. He was investigated and found to be positive for HIV I. His stool examination revealed cysts of Entameba histolytica and Giardia lamblia and oocysts of Cryptosporidium species and Cystoisospora species. His toxoplasma IgG was also positive in high titer. The patient was medically diagnosed and was treated with medications as clinically prescribed - antiretroviral therapy was initiated and he was discharged in due course. A total of five protozoal infections were documented affecting a single person - newly diagnosed immunocompromised male, which by sheer qualitative count of patient case histories, indeed is a rare case reported in the medical literature. [ABSTRACT FROM AUTHOR]

Enterobius vermicularis, also known as pinworm or threadworm, is a large intestinal nematode which has a high prevalence among children and peripubertal age in our country. Transmission usually occurs by autoinfection like finger contamination of the embryonated eggs deposited by the gravid female worm on the perianal and perineal region. Globally, only a few reports are there regarding the isolation of the parasite from extra-intestinal sites. These are two rare case reports of ocular enterobiasis. The first case was a middle-aged female and the second one was a 14-year-old girl, both of whom were referred from other tertiary care hospitals to Calcutta School of Tropical Medicine and who presented with discharge of live motile worms from their eyes (conjunctiva). In both the cases, identification was done by saline wet mount and direct microscopy of a gravid female worm. Plano-convex embryonated eggs were also observed. The oval embryonated eggs, plano-convex in shape, and the gravid female, with its cervical alae near the anterior end and straight thin pointed tail, were identified under the microscope. Although E. vermicularis is a very common large intestinal parasitic infestation of children and adolescents, it can also rarely be isolated from unusual sites, which should be taken into account for effective diagnosis and treatment. [ABSTRACT FROM AUTHOR]

The sign and symptoms of coronavirus disease 2019 (COVID-19) and infectious disease caused by severe acute respiratory syndrome coronavirus 2 are not only restricted to the respiratory system but includes a myriad of clinical manifestations involving various systems. There are various sequelae of COVID-19 reported. Here, we report a series of three cases of tuberculosis along with new onset of diabetes mellitus and hypertension in previously euglycemic, normotensive patients following recovery from COVID-19. [ABSTRACT FROM AUTHOR]

To the Editor: Diagnosis of visceral leishmaniasis (VL), fatal if untreated, is complex because the symptoms are the same for many fever-associated ailments. Despite limitations, diagnosis remains based on finding [...]

Thalassemia is the most common genetic blood disease in the world and varies in different population group in the world. In thalassemic patients liver damage is augmented when age of the patients are increase. These are due to increasing age with advancement of disease progression, repeated blood transfusion, less use/ intolerance of iron chelating agent, decreased activity of hepatocyte to rescue them in such excess billirubin and iron flood. Secondary to hypersplenism. Iron overload due to frequent transfusions in β-thalassemia results in abnormal organ function tests. Proper and timely screening of these parameters can help in early diagnosis & prevention of iron overload. Iron overload is a main leading cause of elevated liver enzymes, and presence of HCV infection is significantly related to the increased iron overload14. Liver injury whether acute or chronic, eventually results in an increase in serum concentrations of Alanine transaminase (ALT) and Aspartate transaminase (AST). In transfusion dependent thalassemia patients iron overload is often inevitable and exposed to transfusionassociated infections. Apart from these when the age is more, the disease progresses with their complication like hepatic injury. The thalassemia patient develops liver fibrosis as a result of iron overload due to excessive blood transfusion and also from excess intestinal absorption. N Sultana et al.6 showed that serum ferritin and serum bilirubin parameter of iron over load and jaundice are correlated. [ABSTRACT FROM AUTHOR]

Visceral leishmaniasis (VL) or kala-azar is known to be associated with a mixed Th1-Th2 response, and effective host defense requires the induction of IFN-gamma and IL-12. We address the role of the differential decline of IL-10 and TGF-beta in response to sodium antimony gluconate (SAG) and amphotericin B (AmB), the therapeutic success of SAG and AmB in Indian VL, and the significance of IL-10 and TGF-beta in the development and progression of post-kazla-azar dermal leishmaniasis (PKDL). In the active disease, PBMC from VL patients showed suppressed Ag-specific lymphoproliferation, IFN-gamma and IL-12 production, and elevation of IL-10 and TGF-beta. Cure corresponded with an elevation in IFN-gamma and IL-12 production and down-regulation of IL-10 and TGF-beta. Both CD4(+) and CD8(+) T cells were involved in IFN-gamma and IL-10 production. Interestingly, the retention and maintenance of residual IL-10 and TGF-beta in some SAG-treated individuals and the elevation of IL-10 and TGF-beta in PKDL, a sequel to kala-azar, probably reflects the role of these cytokines in reactivation of the disease in the form of PKDL. Contrastingly, AmB treatment of VL resulted in negligible TGF-beta levels and absolute elimination of IL-10, reflecting the better therapeutic activity of AmB and its probable role in the recent decline in PKDL occurrences in India. Moreover, elucidation of immune responses in Indian PKDL patients revealed a spectral pattern of disease progression where disease severity could be correlated inversely with lymphoproliferation and directly with TGF-beta, IL-10, and Ab production. In addition, the enhancement of CD4(+)CD25(+) T cells in active VL, their decline at cure, and reactivation in PKDL suggest their probable immunosuppressive role in these disease forms.