Background: Risk stratification is an essential and first component of the pre-Ramadan assessment of patients with diabetes mellitus (DM) who wish to fast. Limited data are reported from Bangladesh regarding risk stratification of people with DM who wish to fast. Objective: To determine the risk status of people with DM who wish to fast during Ramadan. Methods: This cross-sectional observational study was done among Muslim people of DM with at least one year of experience of Ramadan in previous years after their diagnosis. Along with baseline characteristics, the individual 14 risk elements of the International Diabetes Federation and Diabetes & Ramadan International Alliance (IDF-DAR) risk calculator- 2021 were assessed. Patients were categorized into low, moderate, and high risk with a total score of 0-3, 3.5-6, and ≥6.5 respectively. Moderate and high-risk patients were counseled about their risk of fasting and requested to reconsider their wishes. Results: Among 569 participants, (mean age 50.97±12.02 years, male-female ratio 36.2:63.8) 37.8%, 38.8%, and 23.4% had high, moderate, and low risk respectively. Risk scores were significantly higher in older age (p<0.001), male sex (p=0.024), residence in Chattagram than Rajshahi division (p=0.009) as well as housewife and businessman than other occupations (p=0.012). Despite knowing the risks of fasting, 88.8% of people with high risk and 96.8% of people with moderate risks still wished to fast. The people who still wished to fast despite knowing their risks of fasting had significantly lower percent of macrovascular disease (p=0.039), lower creatinine levels (p<0.001), with a lower percent of dipstick proteinuria (p=0.010), and use of insulin (p=0.021) than those who changed their decision. Conclusions: Nearly 90% of persons with DM with moderate/high risk for fasting still wished to fast despite their exemption. These at-risk population needs guidance, monitoring, and follow-up for safe fasting. J Rang Med Col. September 2022; Vol. 7, No. 2:4-11
Objectives: Several endocrine disorders have marked effects on fluid, electrolyte, and acid-base homeostasis including diabetic ketoacidosis, hyperglycemic hyperosmolar state, and acute adrenal crisis etc. An understanding of the etiology behind the development of these electrolytes along with calcium and magnesium imbalance helps to guide therapy and improves the clinical outcome. The aim of this study to see the pattern of electrolytes, calcium and magnesium imbalance with etiology assessment in patients admitted in endocrine department of a tertiary care hospital. Study design and methods: This cross sectional observational study was carried out from January 2018 to December 2018, at in-patient department of Endocrinology, BIRDEM General Hospital, Dhaka. Diagnosed (old and new) cases of diabetic and other endocrine disorders having electrolytes, calcium and magnesium imbalance were approached for sinclusion of the study. Sampling technique was purposively selected focusing on demographic profile and diagnosis of the disease. Results: Among the 100 participants, mean age of the study population was 46.26±16.97 years, ranging from 14 to 75 years. There were 50%-male and 50%-female. In result the most common electrolyte imbalance was hyponatremia (36%) that was more in type-2 DM patients (n=25) then in Addison's disease (n=4) and rest are in other specific form of DM (n=3), type-1 DM (n=2), DM with hypoparathyroidism (n=1) and hypoparathyroidism (n=1) which may be due to SIADH. Followed by hypokalemia (14%) which mostly encountered in type-2 DM patient (n=6) due to diuretics and in Conn's syndrome (n=4), hyperkalemia (10%) which mostly observed in type-1 DM patient (n=4) due to DKA, and hypercalcemia (8%) was found in non-diabetic endocrine disorders. Hypernatremia, hypocalcemia and hypomagnesemia were present in 7%, in 6%, and 6% cases, respectively. The most common precipitating cause of these electrolyte imbalances was vomiting (30%) due to different causes like urinary tract infection; acute gastritis and pancreatitis. Diuretic (Loop & Thiazide) therapy (10%) and HHS (8%) were the second and third most common cause behind these electrolytes imbalance Conclusion: In conclusion data obtained in this study showed hyponatremia was the most common findings which more observed in diabetic patients. As vomiting is the most common cause behind this so any diabetic patients either present with vomiting or any other illness should routinely advice electrolytes along with magnesium as hypomagnesemia also more observed in this group. To find out the cause of hypokalemia in non-diabetic patients should evaluate the Conn's syndrome and don't forget to measure the parathyroid hormone in hypercalcemic patient. Further study is needed to find out the causes of vomiting.
Thyroid cancer is the most common endocrine malignant lesion and its incidence continues to rise. The aim of this study was to assess association between thyroid antibodies and thyroid malignancies. This was a cross sectional study of 120 patients with thyroid nodules undergoing thyroidectomy with recorded preoperative thyroid antibodies [autoantibodies to thyroglobulin (TgAb)
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