Background The significance of investigation for diagnosing and managing thyroid dysfunction in pregnant females has been extensively documented in the medical literature. This study aimed to determine trimester-specific reference ranges for thyroid-stimulating hormones (TSH), free T3 (FT3), and free T4 (FT4) in apparently healthy pregnant women attending tertiary care hospitals in Lahore. Methods This cross-sectional study was conducted at two tertiary care Hospitals in Lahore, Pakistan. In this multi-centric study, 500 pregnant females were initially enrolled from September 2019 to December 2019 who fulfilled the inclusion criteria. For measurement of serum FT3, FT4, thyroid stimulating hormone (TSH), anti-thyroid peroxidase (anti-TPO), and thyroglobulin antibodies, 5 ml of the blood sample was drawn, under aseptic conditions, from each subject using Maglumi 800 chemiluminescence immunoassay (CLIA) system. Results Out of 500 subjects, 23 subjects with positive anti-TPO, 19 subjects with anti-TG antibodies, and 12 subjects due to less volume of serum yielded from whole blood (serum less than 3 ml) were excluded from the analysis. Ten samples were hemolyzed and not included in the analysis. A total of 436 samples were examined for analysis. Of the remaining 436 subjects, 133 (30.5%) were from 1st trimester, 153 (35.1%) from 2nd trimester, and 150 (34.4%) from 3rd trimester. As the data were non-normal, the 2.5th, 50th, and 97.5th percentiles were calculated to express each group's results. Trimester specific range of TSH 0.168-4.294, 0.258-4.584 and 0.341-4.625 mIU/mL, FT31.857-4.408, 1.958-4.621 and 2.025-4.821 pmol/L and FT4 8.815-18.006, 8.306-17.341 and 7.402-17.292 pmol/L. Conclusion In this study, we established a trimester-specific reference range for our local population's thyroid function test. The results of this study have complemented the results of previous studies.
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Objective: To determine the frequency of Acute Kidney Injury (AKI) and its underlying risk factors in patients with Coronavirus Disease (COVID-19). Methods: This retrospective study was conducted by reviewing the medical records of patients admitted in Covid-19 Intensive Care Unit (ICU) of Farooq Hospital, West Wood Branch, Lahore during the period from 1st April, 2020 to 30th June, 2020. COVID-19 was diagnosed on basis of Real Time Polymerase Chain Reaction (RT-PCR) through nasal swab. Demographic, clinical and laboratory data were collected at the time of admission in the hospital. AKI was diagnosed on basis of ≥ 0.3 mg/dl increase in serum Creatinine (sCr) from baseline during the hospital stay. The outcome of study was AKI. Results: One hundred and seventy-six patients who fulfilled the inclusion criteria were recruited of which most were males (78.4%). The mean age was 51.26 ± 15.20 years and the frequency of AKI was 51.1%. The risk factors for AKI were increasing age (OR=2.10, p=0.017); presence of COVID-19 symptoms (OR=6.62, p=0.004); prolonged hospital stay (OR=2.26, p=0.011); Diabetes Mellitus (OR=1.81, p=0.057); hypoxemia (OR=5.98, p=0.000); leukocytosis (OR=2.91, p=0.002); lymphopenia (OR=5.77, p=0.000); hypoalbuminemia (OR=4.94, p=0.000); elevated C-reactive protein (CRP) (OR=6.20, p=0.000) and raised D-diamers (OR=3.16, p=0.000). Conclusions: AKI was present in half of the COVID-19 patients. The most significant risk factors for AKI were increasing age, prolonged hospital stay, hypoxemia, hypoalbuminemia, DM and raised inflammatory markers. doi: https://doi.org/10.12669/pjms.38.4.4980 How to cite this:Anees M, Farooq O, Raza M, Mumtaz A. Frequency and Risk Factors for Acute Kidney Injury in patients with COVID-19. Pak J Med Sci. 2022;38(4):---------. doi: https://doi.org/10.12669/pjms.38.4.4980 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Objectives: To determine the risk factors for Hyponatremia in Coronavirus disease 2019 (COVID-19) patients. Methods: Medical records of all patients admitted in COVID-19 Isolation Intensive Care Unit of Farooq Hospital Westwood Branch, Lahore from 1st July to 30th September, 2020 were retrospectively reviewed. Patients with confirmed diagnosis of COVID-19 by Real Time Polymerase Chain Reaction (RT-PCR) and having Hyponatremia (serum Sodium (s/Na+ <135mEq/L) were included, patients with Eunatremia (s/Na+ within 135 - 145mEq/L) were taken as control while subjects with Hypernatremia (s/Na+ >145mEq/L) at admission, incomplete medical records and pregnant females were excluded from the study. Demographic, clinical and laboratory data at time of admission in hospital was extracted. Results: Of 182 included patients, 79.1% (n=144) were male 40.7% (n=74) had Diabetes Mellitus (DM) and 44.5% (n=81) were hypertensive. Forty seven percent (n=86) patients had Hyponatremia while 52.7% (n=96) were eunatremic. Forty nine percent (n=90) patients had Acute Kidney Injury (AKI) and 4.9% (n=9) patients died. Risk factors for Hyponatremia were age >60 years (OR=2.52, p=0.006); DM (OR=2.79, p=0.001); Hypoxemia (OR=3.74, p<0.001); Lymphopenia (OR=7.62, p<0.009); Hypoalbuminemia (OR=9.15, p<0.001); high serum Ferritin (OR=4.46, p<0.001), high Neutrophil to Lymphocyte Ratio (NLR) (OR=3.58, p<0.001) and AKI (OR=3.40, p<0.001). Conclusions: Hyponatremia was common in COVID-19 hospitalized patients. Increasing age, DM, Hypoxemia, Hypoalbuminemia, high serum Ferritin and AKI were the most significant risk factors for Hyponatremia. Hyponatremic patients had comparatively higher mortality than Eunatremic patients. doi: https://doi.org/10.12669/pjms.39.1.5466 How to cite this: Anees M, Raza M, Farooq O, Mumtaz A. Risk factors for Hyponatremia in COVID-19 hospitalised patients. Pak J Med Sci. 2023;39(1):274-279. doi: https://doi.org/10.12669/pjms.39.1.5466 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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