Background: One of the main cause of thyroid disease is autoimmune thyroid disease and anti thyroid peroxidase (TPO) antibodies is a major marker of the condition. There are very few studies in the country regarding the etiology of thyroid disorders and hence this study is being conducted for it. Methods: This is retrospective cross sectional study from 28 January 2019 to 29 July 2019 done at National Academy of Medical Sciences, Bir Hospital, Kathmandu. The laboratory serum sample data of all Anti TPO antibody results from patients seeking treatment at the instituition were analyzed for age and gender variation. Anti TPO antibody titre of equal or more than 34 IU/ml was considered as positive. Results: Out of 768 samples analysed for study, 79.9% were of women and 20.1 % were of men. A total of 205 (26.7%) were positive for anti TPO antibodies of which 83.4% were women and 16.6% were men . Women had more patients with anti TPO antibodies positive as compared men (27.9 vs 21.1%). Mean Anti TPO titre were also more in women as compared to men (61.01 vs 48.20 IU/ml). Conclusions: About one fourth of the patients had siginificant titers of anti TPO antibodies suggestive of thyroid autoimmunity. Both prevalence of positive anti TPO antibody titres and the mean anti TPO antibody titre values were more in women as compared to men. Further well designed larger community studies are required.
Background: Thyroid disorders represent an important public health problem worldwide. Excess thyroid hormone in the circulation due to any cause is termed as thyrotoxicosis. There are many causes of thyrotoxicosis, and it is important to find the cause as this will determine the management of the condition. 99mTcO4scintigraphy is diagnostic tool to differentiate various causes of thyrotoxicosis. This study aims to study the age and gender distribution of different causes of thyrotoxicosis. Methods: This is a retrospective analysis of technetium pertechnetate(99mTcO4) thyroid scintigraphy reports done of patients having thyrotoxicosis from the period of January 01, 2016, to December 31, 2016, at the Nuclear Medicine unit of National Academy of Medical Sciences, Bir Hospital, Kathmandu. Gender and age group analysis of the data was done using SPSS program. Results: A total of 211 reports of 99m TcO 4 thyroid scintigraphy were included in the study. There were 61 male patients and 150 female patients. Various causes of thyrotoxicosis like thyroiditis, Graves’ disease, autonomous functioning thyroid nodule, toxic multinodular goiter was detected. Apart from toxic multinodular goiter, these disorders were more common in the age group 18-50 years and females. Conclusion: 99mTcO4 thyroid scintigraphy is one of the easy and highly effective tools for the differential diagnosis of thyrotoxicosis. Both thyroiditis and Graves’ disease are more predominant in the age group 18-50 years and in females. Further large community-based studies will be required for exact prevalence of the diseases in the population.
Background: Diabetes Mellitus is one of the most encountered disease in our out patient department and metformin is the first drug of choice to treat Diabetes mellitus. As metformin is one of the cheapest drug, many patients use these drug for long period of time with consultation and without consultations with doctors. Patients under long term metformin use are not aware of Vitamin B12 deficiency and its associated signs and symptoms. In Nepal due to poverty, lack of education and awareness on diabetes mellitus we doctors find much difficult to explain patients on the consequences of diseases. So I decided to do this study which could be much easier to explain patients on effect of metformin of vitamin B12 levels and the consequences life style modifications and supplement of Vitamin B12 to the patients. Methods: This is a Cross-Sectional Study done in the patients with Type 2 diabetes were selected based on inclusion and exclusion criteria. Basic biochemical investigation were sent the lab of the National academy of medical science. Serum B12 assay were done. Vitamin B12 deficiency is defined as values <150pg/ml. Association between vitamin B12 deficiency with duration of metformin therapy, duration of diabetes, with age, sex were done. Results: The mean vitamin B12 level is low as the duration of metformin treatment increases. The sex, age relation with development of vitamin B12 deficiency was not significant. In my study out of 210 patients 107 patients were having severe vitamin B12 deficiency level and 63 patients had a borderline Vitamin B12 deficiency level which shows that the deficiency increases as per longer use of metformin, which shows prevalence of 50.95%. Conclusions: Vitamin B12 deficiency occurs in type 2 diabetes mellitus patients treated with long term metformin. The duration of metformin therapy significantly affects the development of vitamin B12 deficiency. As a treating physician we always need to explain our patients about the side effect of metformin and regular follow up and investigations must be done to early diagnosis of vitamin B12 deficiency to improve the quality of life.
Introduction: Diabetes Mellitus (DM) is clinical syndrome characterized by hyperglycemia due to absolute or relative deficiency of insulin. The metabolic dysregulation associated with DM causes multitude of secondary pathophysiological changes in multiple organ system causing macro vascular (coronary artery disease, peripheral vascular disease, cerebrovascular disease) and micro vascular (retinopathy, neuropathy, and nephropathy) complications. This study aimed to study the prevalence of peripheral vascular disease in patients with diabetic mellitus presenting to this tertiary care centre. Methods: This clinical study was conducted in first affiliated hospital of Yangtze university, Jingzhou. All patients with a diagnosis of diabetic mellitus who came to Out patient department of Endocrinology & diabetic clinic and admitted in the hospital during a period between October 2013 to October 2014, who fulfill, were enrolled for the study. This was a single centered retrospective observational analylitcal study conducted in Department of Endocrinology of First affiliated Hospital of Yangtze, China. Results: Peripheral vascular disease was found in 35% of patients studied . There was significant correlation. Conclusion: A significant number of diabetics presenting with diabetes mellitus have underlying peripheral vascular disease. The patients might not all be symptomatic or show obvious signs of PVD but need to be investigated for the same. The older the individual the more the chances of having peripheral vascular compromise. Also a tobacco user and patient presenting with worse clinical findings is more likely to have PVD. Thus the detection of peripheral vascular disease in patients using Arterial Doppler studies along with routine clinical and laboratory assessment can be of great value in long term care of these individualsith age, and history of tobacco use.
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