A hospital based cross sectional study on clinical profile of patients with hypothyroidism

Background: Comorbidities and complications are more in patients with hypothyroidism compared to other people. hence early diagnosis and early treatment for hypothyroidism can prevent a lot of complications in patients with hypothyroidism and this is very true for subclinical hypothyroidism. Objective was to study the clinical profile of patients with hypothyroidism.Methods: A hospital based cross sectional study was carried out among 40 clinically diagnosed and biochemically confirmed hypothyroid cases of age group 21-60 years of age. Detailed clinical history was taken to note down the presenting symptoms. Thorough clinical examination was done to ascertain the clinical features and confirm. Data was analyzed using proportions.Results: The mean age of males was slightly more than females 36.8 years vs. 35.13 years. Total number of male patients was much lower i.e. only 10(25%) compared to 30(75%) female patients. The most common age group affected in either sexes was 31-40 years followed by 21-30 years. Among all the symptoms with which the patients presented, the most common symptom was weight gain which was seen in 29(72.5%) of the cases. The most common presenting sign was BMI >25 kg/m2 in 27 cases i.e. 67.5% of the cases followed by dry skin in 25 cases i.e. 62.5%.Conclusions: Any patient presenting with weight gain, lethargy, dry skin, hoarseness, dyspnoea, constipation, cold intolerance, depression, menstrual abnormalities, overweight, obesity, bradycardia, non-pitting edema, hypertension, pallor should be suspected of hypothyroidism and thyroid profile should be done to rule hypothyroidism.

Clinical study of cardiovascular involvement in patients with hypothyroidism

Background: Hypothyroidism is usually associated with the involvement of the cardiovascular system in the form of the cardiac abnormalities. The Research data on this has been found to be limited. The dysfunction of the cardiac caused by hypothyroidism is usually reversible. Objective was to study the incidence of cardiac abnormalities in patients with hypothyroidism.Methods: Total 40 confirmed cases of hypothyroid disease were included in the present study. General investigations, ECG, ECHO was done in all the patients to assess for cardiovascular involvement. The data was entered in the Microsoft Excel worksheet and analysed using proportions.Results: One fourth of the patients were found to have the bradycardia. The Delayed ankle jerk was seen in 67.5% of the cases and the next common CNS manifestation was the hoarseness of the voice. 30% of the case had normal ECG findings. 40% of the cases had the bradycardia. 35% of the cases had the low voltage complexes. 32.5% of the cases had the normal ECHO reports. 27.5% of the cases had the pericardial effusion. Same proportion of the cases were found to have the diastolic dysfunction. But most of them had the dysfunction and the severe cases were found to be very few. Only two patients had IVS thickness.Conclusions: Majority of the cases of the hypothyroidism in the present study were found to have the cardiovascular involvement. This points towards the importance of the early diagnosis of hypothyroidism and the prevention of complications like the cardiovascular system and the central nervous system involvement.

Risk factor analysis among patients with stroke: a cross sectional study at a tertiary care hospital

Background: Study of risk factors of stroke is very important in different settings to confirm their existence and to take necessary steps to prevent them especially in elderly so that incidence of stroke can be brought down. The objective of the present study is to perform the risk factor analysis among patients with stroke.Methods: A hospital based cross sectional study was carried out at a tertiary care hospital from June 2015 to March 2016. A total of 40 patients diagnosed with stroke were included in the present study. Detailed information and all necessary investigations were carried out. Risk factor analysis was done, and categorization was done for certain risk factors.Results: The predominant age group was 6-60 years. The age ranged from 1 month to 67 years. The Male: Female ratio was 14:9. The common etiologies were congenital, post infective and intracranial bleed in 26.1% (n=6) each. Favourable outcome was seen in 82.6% of cases. The failure rate was 17.4%. Most no of cases with favourable outcome was seen in 6-60 years age group, whereas >60 years age group had the most no of cases with poor outcome. The overall mortality rate was 21.6% (n=5). Wound related complication was seen in 1 patient (4.3%). Two (8.7%) patients required VP shunt post ETV. The cause of mortality was aspiration pneumonitis in 3 cases, CSF metastasis and wound infection in 1 cases each.Conclusions: The leading cause as well as risk factor for stroke was found to be hypertension followed by alcohol and smoking.

A hospital based follow up study on predictors of mortality in patients with Intra cranial hemorrhage

Background: Intra-cerebral hemorrhages account for approximately 10-15 percent of all stroke cases and are associated with the highest mortality rate (30-40%). Study of predictors can modify the mortality rates. The objective of the present study the predictors of mortality in patients with intra cranial hemorrhage.Methods: Hospital based cross sectional study was carried out. Forty patients with CT scan evidence of intra cranial hemorrhage admitted to our hospital were randomly selected. All investigations were done. Patient characteristics were noted down.Results: In the present study among 40 patients, 16 patients died. The mortality was 40%. As the age increased, the mortality rate increased. But there was no difference between the mortality among males and females. Mortality was more than twice among those with SBP more than 180 mmHg i.e. 58.8% compared to only 26.1% among those with SBP less than 180 mmHg. Similar findings were noted for DBP and MAP. As the severity of motor weakness increased, the mortality increased. Patients with presence of bilateral plantar extensor response were found to be more at risk of death with a death rate of 66.7% compared to only 18.2% among those without presence of bilateral plantar extensor response. As the Glasgow coma scale increased, the mortality decreased from 100% in patients with a score of 3-4 to only 31.2% in patients with a score of 9-13. Intra-ventricular extension of haemorrhage, presence of hydrocephalus, volume of hematoma >30 ml, decreased consciousness level was important predictors.Conclusions: Bad prognosis i.e. death can be expected if the patient is older, low GCS, hematoma size > 30 ml, gaze palsy, severe motor neuron weakness, abnormal pupils, ataxic respiration etc. hence intensive care should be given to such patients to bring down the mortality.