Polycystic ovary syndrome is the most common endocrinological disorder affecting 4–12% of women and also the most controversial. Metformin was logically introduced to establish the extent to which hyperinsulinaemia influences the pathogenesis of the condition. Early studies were very encouraging. Randomized controlled studies and several metaanalyses have changed the picture and put the drug that was once heralded as magic in a much contracted place.

Pregnancy has a profound impact on the thyroid gland and thyroid function since the thyroid may encounter changes to hormones and size during pregnancy. The diagnosis and treatment of thyroid disease during pregnancy and the postpartum is complex but knowledge regarding the interaction between the thyroids and pregnancy/the postpartum period is advancing at a rapid pace.

From the UKPDS it was concluded that metformin decreased cardiac events. However, this only occurred in a small group of obese subjects while in a larger group failing sulfonylurea therapy the addition of metformin resulted in an increase in cardiac events [1]. Indeed, a meta-analysis of metformin studies has shown that overall metformin does not decrease cardiac events. However, if in this meta-analysis the group utilizing metformin and sulfonylurea combinations were removed from the analysis then there was a significant decrease in cardiac events with metformin monotherapy

The hypothalamus is a portion of the brain that contains a number of small nuclei with a variety of functions. One of the most important functions of the hypothalamus is to link the nervous system to the endocrine system via the pituitary gland. The hypothalamus is located below the thalamus and is part of the limbic system. In the terminology of neuroanatomy, it forms the ventral part of the diencephalon. All vertebrate brains contain a hypothalamus. In humans, it is the size of an almond.

MicroRNAs (miRNAs) are short single-stranded noncoding RNAs (20- to 25-nucleotide (nt) long) representing a class of small regulatory RNAs. By inhibiting the translation of target mRNAs, miRNAs regulate gene expression posttranscriptionally and thus play an important role in a wide range of cellular processes (1). Currently, there are two known types of miRNAs: intergenic and intronic miRNAs

Cushing syndrome is a state of prolonged exposure to excess cortisol production. Causes can be varied ranging from exogenous intake or endogenous production from a pituitary source due to overproduction of adrenocorticotropic hormone (ACTH) or due to over secretion from unilateral or bilateral adrenal glands. Cushing syndrome in an adult can present with proximal muscle weakness, facial plethora, wasting of the extremities with increased fat in the abdomen and face, wide purplish striae, bruising with no obvious trauma, and supraclavicular fat pads. Here, we report a 38 year old male who presented with suspicion of having Cushing syndrome due to his clinical manifestations and high cortisol levels. He presented to the clinic with new onset diabetes, severe hypertension, chronic abdominal pain and distension which was being investigating by different specialties. The patient underwent CT scan of the abdomen which show right adrenal adenoma and on examination, he was found to have proximal weakness and purple striae. Laboratory data showed high morning cortisol, 24 urine free cortisol and ACTH levels which were strongly suggestive of ACTH independent Cushing syndrome.

Prolactinomas constitutes a major bulk of pituitary adenomas. All symptomatic prolactinomas require dopamine agonist (DA) therapy. Impulse control disorders (ICD) or pathological behaviours are rare adverse events described with use of DA. Herein we are describing a male patient with pathological gambling and doctor shopping following use of bromocriptine and higher dose of cabergoline.The pathological behaviour disappeard after debulking surgery, reduction in cabergoline dose and several sessions of counselling. Physicians prescribing DA should be aware of this potential adverse event.This should be emphasized to the patient and family members before starting DA and physician should be inquisitive for eliciting pathological behaviour on follow up.

Does low-fat diet for weight loss make the impaired microvascular dilation improved through switching to nitric oxide (NO)-dependent in obese adults? The answer is yes. Shane Phillips research group has tested this hypothesis through their most recent publication [1]. While systemic NO doesn’t change, localized NO was increased after a six-week low-fat diet for weight loss (~25% calorie deficit) but not for weight maintenance to obsess subjects with body mass index (BMI most subjects in 30-35, and only a few in 35-40 kg/m2) through increasing flow-induced dilation of arterioles.

Non-functioning pituitary adenomas (NFPA) are 30% of all pituitary adenomas. Although benign in nature but they may be invasive and recurrent. Markers of recurrence are needed to guide patient management. Recteptor Tyrosine Kinases (RTK) may sereve as therapeutic marker for recurrence as they can targeted by already available tyrosine kinase inhibitors. To examine differential RTK phosphorylation pattern of recurrent NFPAs, we recruited 20 patients and grouped them as non-recurrent (n=10), and recurrent (n=10). Recurrence was determined by follow-up of 15 years. We then performed a membrane-based antibody array (ARY001B) for the determination of the relative phosphorylation of 49 tyrosine kinases in recurrent NFPAs. As the experiment was replicated on two set of membranes, each tyrosine kinase was represented in quadruples. Student’s t-test was performed to compare the means between two groups. We found ErbB2, PDGFR beta, SCFR, Trk, VEGFR1, VEGFR2, EphA3, and Alk significantly hyperphosphorylated in recurrent NFPAs. Out of these eight hyperphosphorylated tyrosine kinases ErbB2 and EphA3 were 1.6 (p=0.01) and 1.9 (p=0.002) times hyperphosphorylated in recurrent NFPAs. This result indicates that EphA3 may be an effective therapeutic target in recurrent NFPAs.