Thrombocytopenia is the commonest haematological abnormality seen in chronic liver disease. Thrombocytosis is of two types: Primary and secondary. In secondary form of thrombocytosis usually there is mild to moderate elevation of platelet count. Here, we present a case of 60 year old patient, a known case of chronic liver disease who presented with severe thrombocytosis secondary to iron deficiency anaemia. Thrombocytosis normalized with treatment of iron deficiency anaemia with parenteral iron.

Dengue is an important viral cause of febrile illness in tropical and subtropical regions. Manifestations may range from an asymptomatic infection to life threatening hemorrhagic fever and shock syndrome. Neurological presentations of this disease are rare. Here, we are presenting a case series of three confirmed cases of dengue fever with hypokalemic paralysis presenting as acute pure motor reversible quadriparesis. A clinician should keep dengue virus associated hypokalemic paralysis in mind while dealing with a case of fever with quadriparesis

Introduction: Thyroid diseases are public health problem worldwide with hypothyroidism more being more common. Its risk increases during menopause due to hormonal transition among women. There is no Indian guideline related to screening among this population. Methods: Review was undertaken in multiple ways including internet and library. Studies published in English were included. Results: A total of 8 studies were included in the review. The prevalence of hypothyroidism ranged from about 7% to 24% in India and globally across the world. Conclusion: The prevalence is high among menopausal women. There is need for further research into associated factors leading to high risk among these women. Screening guidelines need to be formulated in India for hypothyroidism among menopausal women.

Vitamin D is unique as it is both a nutrient and hormone that provides wide variety of health benefits to human health. The health benefits of vitamin D are beyond bone heath confirmed from various studies viz vitamin D not only regulate calcium metabolism but also regulates insulin production, reduces the risk of diabetes and cancer, rennin production, helps in destruction of infectious agents, regulation of cell growth, enhances immunity, maintenance of vascular tone of the body, myocardial function and helps in many more complex diseases as well. Recently, Vitamin D has received enormous attention worldwide and referred as drug of the decade when its deficiency referred pandemic [1]. The quantum of problem can be understood by looking at its (vitamin D) deficiency in Indian subcontinent with a prevalence rate between 70 to 100% [2]

We present a case of 42 year-old female, who presented with generalized tonic-clonic seizures with altered sensorium, not responding to antiepileptic medications. She was a diagnosed case of hypothyroidism since last three years and was on replacement therapy. Her systemic examination including the neurological examination did not point to any specific diagnosis. Her routine investigations, brain imaging and CSF analysis were also within normal limits. Thyroid function test revealed raised thyroid stimulating hormone and anti-TPO antibody with normalT4 and T3 levels. Here we considered diagnosis of “Encephalopathy Associated with Autoimmune Thyroid Disease”. She was given intravenous methylprednisolone pulse to which she responded dramatically and seizures were controlled. She was discharged on oral anti-epileptics and steroids in a stable condition

“Overlap syndrome” is a term used to describe variant forms of autoimmune hepatitis (AIH) which present with characteristics of AIH and primary biliary cirrhosis (PBC) or primary sclerosing cholangitis (PSC). Patients with overlap syndrome present with both hepatitic and cholestatic serum liver test and the clinical, biochemical, and histological features of these autoimmune diseases are overlapped. Thus, it is difficult to appreciate overlap syndrome as an actual diagnostic entity. AIH-PBC is the most common form of overlap syndrome, affecting almost 10% of adults with AIH or PBC. Transitions from PBC to AIH-PBC overlap syndrome have also been reported. Ursodeoxycholic acid is usually combined with immunosuppressive therapy but end-stage disease requires liver transplantation. We present a case of Overlap Syndrome (AIHPBC) in a 16 year old girl who presented to us with features of obstructive jaundice. She had six months history of generalised itching, yellow discoloration of skin and urine, decreased appetite and intermittent abdominal pain. Liver function test revealed conjugated hyperbilirubinemia, with moderate elevation of liver enzymes. Antinuclear, anti-muscle M2 and anti-glycoprotein 210 antibodies were positive. Liver biopsy showed features of primary biliary cirrhosis. The patient responded to ursodeoxycholic acid and immunosuppression.