Iron deficiency anemia is common problem during pregnancy. Red cell size variation (anisocytosis) is the earliest morphologic changes in iron deficiency anemia. Red cell distribution width is a quantitative measure of red cell size variation and it can give the idea of early iron deficiency before other test to become positive.190 pregnant women were included in this study. Red cell distribution width was compared between iron deficient & non-iron deficient pregnant women. Red cell distribution width also compared with Hb level, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration and peripheral blood film in prelatent iron deficiency, latent iron deficiency, mild and moderate iron deficiency anemia. Red cell distribution width had sensitivity 82.3% and specificity 97.4%. Whereas Hb level, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration and peripheral blood film all had 56.6%, 29.2%, 68.1%, 15% and 38.9% sensitivity but specificity was 90.9%, 98.7%, 83.1%, 96.1% and 98.7% in the detection of iron deficiency. Red cell distribution width appears to be a reliable and useful parameter for detection of iron deficiency during pregnancy.
Background: The hyperuricaemia in gestational diabetes mellitus (GDM) has been explained to be a component of the metabolic syndrome which reflects insulin resistance. Gestational huperuricaemia was found to be significantly associated with a high rate of maternal and foetal complications along with proteinuria and hypertension. Aims of this study were to evaluate the serum uric acid levels in Bangladeshi women with GDM in their second and third trimesters of pregnancy. Methods: This descriptive cross-sectional study was conducted at Mymensingh Medical College Hospital from July 2013 to June 2014. Pregnant women, in their second and third trimester, attending the outpatient department of Obstetrics and Gynecology and the Department of Endocrinology were enrolled by purposive sampling technique. GDM was diagnosed on the basis of oral glucose tolerance test (OGTT) as defined in WHO criteria 2013. Results: Out of 172 participants, 86 had GDM (case) and 86 were normoglycemic (control). The mean age of GDM and control groups was 28.6±3.2 years and 27.3±3.1 years respectively. The BMI was 26.4±1.5 kg / m 2 and 26.3±1.3 kg / m 2. In this study we found serum uric acid levels in GDM and without GDM were 4.47±0.42 mg/dl and 4.48±0.41 mg/dl respectively (p>0.05). Serum uric acid level in GDM group was significantly (p<0.001) higher in third trimesters (4.48 ±0.41 mg/dl) compared to those without GDM (3.52 ±0.74 mg/dl). Conclusion: There was distinct alteration of serum uric acid level in GDM compared to normal pregnancy. Estimation of serum uric acid levels might be incorporated in every GDM cases for prevention of complications. Birdem Med J 2019; 9(1): 55-58
Background: Detection of iron deficiency early during pregnancy is essential for correct management. Red cell distribution width (RDW) is a new routine parameter in fully automated hematology analyzer that can give the idea of early iron deficiency before Hb%. This study was aimed to see the role of red cell distribution width and Hb% in determining early iron deficiency in pregnant women.Methods: In this study 190 pregnant women were included. CBC including Hb% and RDW and iron profile were done. RDW were compared with Hb% in various stages of iron deficiency.Results: RDW was more significant than Hb level in latent iron deficiency when Hb level was normal (p<0.05). In mild and moderate iron deficiency anemia, RDW was increased progressively though Hb level was reduced. In this study RDW had sensitivity 82.3% and specificity 97.4%. Whereas Hb level had sensitivity 56.6% and specificity 90.9% for iron deficiency.Conclusion: Latent iron deficiency without other complicating disease could be screened out early by increased RDW when Hb% was normal.Anwer Khan Modern Medical College Journal Vol. 9, No. 2: Jul 2018, P 137-141
Type 2 diabetes mellitus (T2DM) and thyroid disorders (TD) are the two most common endocrine disorders in clinical practice. They show mutually influence on each other. Unrecognized thyroid disorders may adversely affect the metabolic control and add more risk to an already predisposing type 2 diabetes mellitus. The objective of this study was to find out the association of thyroid hormone levels in patients with type 2 diabetes mellitus. This cross sectional study was conducted in the department of Biochemistry and outpatient department of Endocrinology of Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders, Dhaka, Bangladesh (BIRDEM) General Hospital, Bangladesh from July 2014 to June 2015. A Total of 200 patients were selected by applying inclusion and exclusion criteria. Of them, 115 were type 2 diabetic subjects and 85 were non diabetic. Diabetic patients were diagnosed according to WHO criteria from their previous medical records. All patients were underwent thyroid function tests; free thyroxine (FT4), free tri-iodothyronine (FT3) and serum TSH (thyroid stimulating hormone). Presence of TD in T2DM and non-DM patients were estimated. Comparison of all demographic characteristics and biochemical parameters were done among the groups. The percentage of TD in type 2 diabetic patients was 23.5% and in non diabetic subjects was 12%. Serum FT3 and serum FT4 did not show any significant difference among the groups. Type 2 diabetic patients with thyroid disorders had more elevated level of serum TSH level than those who were non diabetic subjects with TD. Thyroid disorders were significantly higher in female, overweight and obese subjects. Patients with TD had strong association with family history of TD. This study showed that the presence of TD in type 2 diabetes mellitus was very high. Regular screening for thyroid disorders in type 2 diabetic patients specially serum TSH level is recommended.
Molecular diagnosis is rapidly becoming an inseparable part of disease diagnosis. This cutting edge technology can be used to diagnose both infectious and malignant diseases as well as to help in determining drug dosage, tissue types for organ transplant and risk of inherent disorders. An added advantage is that it provides an indication of therapeutic choice, therapy response and disease prognosis. A survey was conducted among diagnostic laboratories and research institutes of Bangladesh to observe the existing range of molecular diagnostic tests in Bangladesh. It is found that though molecular tests started in diagnostics about 15 years before, range of tests is still very limited in the country. Challenges faced in establishing as well as sustaining these tests were noted and opinions recorded from stakeholders regarding further opportunities to improve this area. We found that challenges are limited knowledge on molecular tests among physicians, unfavorable custom regulations and inadequate after-sale support from suppliers, cost of the tests and strong advocacy and marketing strategies of neighboring countries. To overcome these challenges our recommendations are inclusion of molecular medicine in medical curriculum, dissemination of information about molecular tests to existing physician community, minimum custom duty and minimum profit margin by the stakeholders to reduce test price. In addition, review of policies regarding import and support of cutting edge technology in diagnostic sector with involvement of available experts in this field is essential to make this valuable sector viable.
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