Thyroiditis is one of the manifestations of novel Covid-19 virus. Thyroid function test (TFTs) shows typical features of hyperthyroidism. Inflammatory markers and thyroid scan give clue to the diagnosis. This report is about a 39-year-old female who presented with signs and symptoms of thyrotoxicosis along with pain in the neck, odynophagia, and intermittent fever after recovering from Covid-19 a few weeks back. She had no significant history of past medical or endocrine disease. TFTs revealed high T3 and T4 and low TSH. Thyroid scan revealed decrease uptake and ESR was 115. She was started on NSAID, steroids, and beta blocker. Four weeks later, she reverted with the resolution of symptoms and normal TFTs. Keywords: Covid-19, thyroiditis.
Objective: The objective of this study was to assess liver cirrhosis with special reference to thyroid function. Study Design: The study was a cross-sectional one. Setting: Research was conducted at Department of Medicine, Shaikh Zayed Hospital, Lahore from August 2022 to January 2023. Material and Methods: In this study, 115 patients with cirrhosis who were both male and female and between the ages of 20 and 70 were included. These patients underwent thyroid function tests. Each patient provided written informed consent. Results: The average patient's age was 51.78±9.17 years old, and their ages ranged from 35 to 70. The vast majority of patients (n=119, or 55.6%) were between the ages of 53 and 70. Patients included 71 males (61.73% of the total) and 44 females (38.8%). The average duration of illness was 23.78 ±10.05 months, although it may be as little as 8 months. A total of 34 patients (29.56%) were classified as Child Class-B, while 81 patients (70.43%) were classified as Child Class-C. The range of serum TSH was from 3.5 to 5.8 uIU/ml (mean 4.32±0.43 uIU/ml), while the range of serum fT3 was from 1.2 to 2.9 pg/ml (mean 1.87± 0.38 pg/ml). The average serum fT4 concentration was 1.68 pg/ml (standard deviation = 0.47). Practical Implication: Especially in low and middle income countries, there is a lack of consistent data on the impact of cirrhosis on thyroid function and the association of thyroid hormone levels in patients with cirrhosis. In order to better understand the medical picture of cirrhosis of the liver and its relationship to thyroid function, the current investigation was carried out at a tertiary care center. Conclusion: Liver cirrhosis patients had lower mean blood levels of fT3 and fT4. However, the mean serum TSH level was higher in this group of individuals. It was shown to be significantly higher in patients with more advanced liver disease, but not to differ significantly by age, gender, or disease duration. Keywords: Thyroid Function, Liver Cirrhosis, Child-Pugh Classification
Introduction: Diabetes mellitus is a huge global health issue, affecting more than 350 million people worldwide, and the number might rise to 439 million in 2030. Diabetes Mellitus is associated with many complications. Most of these complications usually develop after many years or even decades of exposure to chronic hyperglycemia. Diabetic Nephropathy is one of the most common and grave complication of diabetes mellitus and is associated with increased morbidity and mortality. Study Design: A cross-sectional study was performed on 285 patients from August 2021 to February 2022 on all newly diabetic patients in Hayatabad Medical Complex, Peshawar. Their 24-hour urine for protein analysis was measured to screen them for proteinuria.After measuring the urine protein level in each patient, the study's total frequency was computed across all the patients who had been diagnosed. Data was recorded into a proforma. Results: The age range in this study was from 15 to 70 years with a mean age of 43.01±6.90 years, mean BMI was 27.67±1.99 Kg/m2, and mean proteinuria levels were 42.38±34.142mg/ dl. Males constituted the majority of the patient-group (62.1%). 34.7% of patients were also hypertensive. Proteinuria was seen in 114 patients (40%). Conclusion: This study has concluded that screening for the complications of diabetic patients is beneficial in the preventive management of the disease. Keywords: Diabetic patients, proteinuria
INTRODUCTION: Nephropathic cystinosis is a rarely occurring inherited metabolic disorder, leading to Fanconi syndrome, progressive renal failure and a range of extra-renal manifestations including endocrinopathies. There is no definitive cure for Cystinosis. Never the less, early introduction of cysteamine treatment and other supportive measures can adequately retard the occurrence of complications and improve prognosis. CASE DESCRIPTION: An 18-year-old boy who presented with complaints of abdominal pain, vomiting, polyuria and episodes of periodic paralysis for the last 01 year to the Endocrine Unit, Medical Teaching Institution Hayatabad Medical Complex, and Peshawar, Pakistan. He was lean and wasted with a BMI of 12.9kg/m2 (weight=32.59kg, height=159cm) having frontal bossing and splaying of bones at wrist joint with normal to low blood pressure. Investigations revealed hypokalemia, alkaline urine and metabolic acidosis on arterial blood gas analysis. Consequently, his symptoms were attributed to underlying renal tubular acidosis. Later, slit lamp examination revealed Cysteine crystals in the cornea confirming the diagnosis of Cystinosis as the underlying cause. He was started on supportive therapy including potassium chloride and citrate supplements, intravenous fluids, calcium and vitamin D supplements and Indomethacin. Senior nephrologist and Nutritionist were also taken on board regarding his management. Follow up at 02 months was suggestive of marked symptomatic and biochemical improvement. CONCLUSION: Data regarding the definitive cure for Cystinosis is scarce. Never the less, early introduction of cysteamine therapy and other supportive measures can adequately retard the occurrence of complications and improvise prognosis.
Objectives: To asses the seasonal variability in the hospital admissions of Diabetic Ketoacidosis (DKA) patients. Methods: This two year retrospective analysis was carried out from first November 2018 to 31st OCTOBER 2020, which involved medical chart reviewing of all those patients admitted to the Department of Diabetes, Endocrinology and Metabolic diseases, Hayatabad Medical complex, Peshawar, Pakistan with confirmed DKA. Data related to patient demography, past history, biochemical profile and treatment was collected and analysed using SPSS version 25. Results: During the above mentioned 24 months, 104 diabetic patients with confirmed DKA were admitted. Fifty-nine (57%) patients were male. Most of the patients had moderate DKA that is 42(40%). Seasonality was observed with majority of the patient admitted in winter season overall 62(60%). In both the years encounter with DKA patient peaked in January. DKA was found to be more severe in female and in age group 10-15 years. DKA severity was found to be significantly associated with age, gender, previous episodes of DKA, length of hospital stay and non compliance plus infection (p<0.05). Conclusion: We found seasonal variation and peaked cases of DKA in the winter season presenting at a tertiary care hospital in Pakistan. Noncompliance was found to be major contributory factor. doi: https://doi.org/10.12669/pjms.38.5.5227 How to cite this:Babar B, Aamir AH. Seasonal variation and severity of Diabetic Ketoacidosis in patients at a tertiary care hospital in Pakistan. Pak J Med Sci. 2022;38(5):---------. doi: https://doi.org/10.12669/pjms.38.5.5227 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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