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Sheehan's syndrome may present with postpartum lactation failure and amenorrhea or with features of isolated hypopituitarism to panhypopituitarism. A high index of suspicion is required in a relevant clinical setting of postpartum hemorrhage., Competing Interests: The authors declare no conflicts of interests., (© 2024 The Authors. Clinical Case Reports published by John Wiley & Sons Ltd.)

Maturity onset diabetes in young (MODY) is the most common form of monogenic diabetes, which characteristically presents in adolescents and young adults. Till date, pathogenic variations involving 14 different genes have been causally implicated with the development of MODY. Maturity onset diabetes in young type 4 (MODY-4) is a very rare form of MODY. We present here case of 28-year-old nonobese male patient with distinct family history of diabetes spanning two generations, incidentally, detected to have a rare form of diabetes on genetic analysis when he presented with recurrent thromboembolic manifestations: deep vein thrombosis and pulmonary thromboembolism. Our case highlights a previously unknown disease association of a rare genetic disorder. Increasing awareness about this genetic disorder and early identification of such cases will enhance our understanding of hitherto unknown disease associations and the pathophysiological role of genetic mutations. This may contribute to the improved treatment and prevention of debilitating diseases such as diabetes., Competing Interests: The authors have none to declare., (© 2022 Director General, Armed Forces Medical Services. Published by Elsevier, a division of RELX India Pvt. Ltd.)

Population heterogeneity is ubiquitous among active living systems, but little is known about its role in determining their spatial organization and large-scale dynamics. Combining evidence from synthetic active fluids assembled from self-propelled colloidal particles along with theoretical predictions at the continuum scale, we demonstrate the spontaneous demixing of binary polar liquids within circular confinement. Our analysis reveals how both active speed heterogeneity and nonreciprocal repulsive interactions lead to self-sorting behavior. By establishing general principles for the self-organization of binary polar liquids, our findings highlight the specificity of multicomponent active systems.

Cell spheroids are in vitro multicellular model systems that mimic the crowded micro-environment of biological tissues. Their mechanical characterization can provide valuable insights in how single-cell mechanics and cell-cell interactions control tissue mechanics and self-organization. However, most measurement techniques are limited to probing one spheroid at a time, require specialized equipment and are difficult to handle. Here, we developed a microfluidic chip that follows the concept of glass capillary micropipette aspiration in order to quantify the viscoelastic behavior of spheroids in an easy-to-handle, more high-throughput manner. Spheroids are loaded in parallel pockets via a gentle flow, after which spheroid tongues are aspirated into adjacent aspiration channels using hydrostatic pressure. After each experiment, the spheroids are easily removed from the chip by reversing the pressure and new spheroids can be injected. The presence of multiple pockets with a uniform aspiration pressure, combined with the ease to conduct successive experiments, allows for a high throughput of tens of spheroids per day. We demonstrate that the chip provides accurate deformation data when working at different aspiration pressures. Lastly, we measure the viscoelastic properties of spheroids made of different cell lines and show how these are consistent with previous studies using established experimental techniques. In summary, our chip provides a high-throughput way to measure the viscoelastic deformation behavior of cell spheroids, in order to mechanophenotype different tissue types and examine the link between cell-intrinsic properties and overall tissue behavior.

Primary pulmonary synovial sarcoma is a very rare, but highly aggressive tumor. Metastatic pulmonary sarcoma due to hematogenous dissemination is much more common. Hence why in any case of pulmonary sarcoma, whole body survey is necessary to exclude a primary tumor elsewhere. No clinical or radiological presentations are specific for pulmonary sarcoma hence; it is often confused with bronchogenic carcinoma. On the other hand, image-guided fine needle aspiration cytology (FNAC) is very much helpful in diagnosis of bronchogenic carcinoma, whereas, it may be inclusive in cases pulmonary sarcomas including primary synovial sarcoma, especially in cases of huge pulmonary masses. So why image-guided tru-cut core biopsy or open lung biopsy and their histopathological examination, supplemented by immunohistochemistry are preferable for the tissue diagnosis of pulmonary synovial sarcoma, although FNAC and immunocytochemistry may be used for the diagnosis. Surgical resection is treatment of choice, if it is not possible, palliative chemotherapy may be an option. Here, we report a rare case of primary synovial sarcoma which occupied almost whole of the right hemithorax in a 60-year-old male farmer.

Background: Chronic obstructive pulmonary disease (COPD) is characterized by progressive deterioration of respiratory function along with systemic effects which have a great impact on health-related quality of life (HRQoL). Classification of severity of airflow limitation in COPD does not represent the clinical consequences of COPD. Hence, combined COPD assessment should be preferred. BODE index (Body mass index, Airflow obstruction, Dyspnea and Exercise capacity) has recently been proposed to provide useful prognostic information., Objectives: To find out correlations between the BODE index and HRQoL, and between GOLD classification of COPD severity and HRQoL in stable COPD patients, and to compare between these two correlations., Materials and Methods: A longitudinal observational study was carried out with 114 stable COPD patients recruited over 10 months at the outpatient clinic of a tertiary care hospital in Kolkata, India. Patients were classified according to GOLD classification of severity of airflow limitation after performing spirometry. BODE index was calculated for each patient. Saint George's Respiratory Questionnaire (SGRQ) was used to assess the HRQoL., Results: BODE scores were categorized into four quartiles, quartile one to four with scores of 0-2, 3-4, 5-6 and 7-10, respectively. Higher BODE quartiles were associated with higher total SGRQ scores and SGRQ subscale scores (symptom, activity and impact). Very strong correlations were found between BODE quartiles and total SGRQ scores (P = 0.914; P < 0.01). In contrast, GOLD classes showed moderate correlation with total SGRQ scores (P = 0.590; P < 0.01)., Conclusions: BODE index was strongly correlated with the HRQoL in stable COPD patients and it was better than GOLD classes of COPD severity to reflect the health status in patients with stable COPD.

Drug-induced flu-like syndrome is very rare. It is mainly produced by rifampicin. We report a case of pulmonary tuberculosis (PTB) that developed isoniazid-induced flu-like syndrome, but could be cured with a modified regimen replacing isoniazid with levofloxacin. A 10-year-old girl with PTB was treated with isoniazid (H), rifampicin (R), ethambutol (E), and pyrazinamide (Z). She developed features of flu from the sixth day. Symptoms recurred everyday within 1 h of drug ingestion and subsided automatically by next 12 h. After admission, HREZ were continued. She developed symptoms of flu after 1 h of drug ingestion. Antitubercular therapy (ATT) was stopped and symptoms subsided automatically. Individual drug was started one by one after three days. Severe symptoms of flu developed after taking isoniazid, while other drugs were tolerated well. Levofloxacin was used as an alternative to isoniazid. She was cured after 6 months of chemotherapy. Isoniazid can possibly cause flu-like syndrome and the treating physician should be aware of this possible side effect when using ATT.

Allergic Bronchopulmonary aspergillosis (ABPA) commonly presents with persistently uncontrolled asthma, despite of the therapy with highest possible anti-asthma medications. Most common cause of ABPA is Aspergillus fumigates. Hence, ABPA is one of the important differential diagnoses of difficult-to-treat asthma. Atypical presentation of ABPA misleads the diagnosis and asthma remains uncontrolled. Here we present such a case of 28-year-old non-smoker, normotensive male office worker who presented with persistent cough with scanty white, mucoid expectoration and gradually progressive breathlessness with bilateral crackles for last two years. Diagnosis of asthma was made based on clinical evidences and spirometry. Anti-asthma treatment was started and gradually stepped up. Further evaluation was done due to lack of clinical improvement, and diagnosis of ABPA was made from bilateral reticulonodular lesions on HRCT thorax, increased levels of serum IgE and Aspergillus fumigates specific IgE, and positive aspergillin skin test. Oral prednisolone and itraconazole were started with anti-asthma medications.

Eventration is a well-known congenital malformation of the diaphragm, usually asymptomatic and diagnosed incidentally on chest radiography. It is sometimes associated with a number of other congenital syndromes and anomalies. We report a rare case of eventration of left hemidiaphragm associated with gastric volvulus, ipsilateral thyroid agenesis and microphthalmia.

Agenesis of lung,a rare congenital anomaly,may present in adult life with features of recurrent chest infections and radiologically may mimic many common conditions presenting as opaque hemithorax with ipsilateral shifting of mediastinum.Here, a case of a young man presenting with frequent attacks of cough expectoration and progressive dyspnoea since childhood,proved to be a case of left pulmonary agenesis on CT scan and bronchoscopy, is to be discussed.