ABSTRACT
Background: Emergence of hypothyroidism as a public health issue apart from a common clinical entity, has gained much attention nowadays. The non-specific features of hypothyroidism lead to incorrect diagnoses, inadequate treatment and complications in the future. The present study was designed to unravel the effects of hypothyroidism on physiological parameters and to highlight the importance of early diagnosis and treatment. This study was done to assess the effects of hypothyroidism on pulse rate, blood pressure and respiratory rate.Methods: This descriptive cross-sectional study was done in 60 hypothyroid patients of 18-45 years age, both males and females, who were either newly detected or on treatment for less than 6 months. Patients with history of other systemic diseases, pregnancy and hyperthyroidism were excluded. After obtaining written consent from the patients, clinical examination was done.Results: Student t-test and ANOVA were used for analysis. Physiological parameters like pulse rate, blood pressure and respiratory rate had variations in the patients and there were changes with age, gender and BMI even though they were not significant. These changes were attributed to increased arterial wall thickness and endothelial dysfunction in blood vessels.Conclusions: The patients showed changes in cardiovascular and respiratory profiles. The variations in systolic and diastolic blood pressures were significant with increase in age. Physiological parameters had variations with gender and BMI also. This proves the cardiovascular and respiratory morbidity in newly detected hypothyroidism, which emphasizes the importance of early diagnosis and treatment in them.
ABSTRACT
Objective To describe the clinical presentation, localization techniques, surgical procedures and outcome in patients with insulinoma. Methods Retrospective analysis of case records of patients diagnosed with insulinoma between January 1993 and June 2009 at a tertiary-care hospital was done. Seventeen patients underwent diagnostic 72-h fast. The sensitivity of computed tomography (CT) of pancreas was judged using intraoperative findings as the gold standard. Results Twenty-six patients (19 women) with mean age 42.2 years (median age 39.5 years) with biochemical/ imaging evidence of insulinoma were included. All patients who underwent 72-h fast developed symptomatic hypoglycemia within 48 h. The sensitivity and positive predictive value (PPV) of CT of pancreas was 68.4% and 92.8%, respectively. Twenty patients underwent surgery, of whom four were operated on without preoperative localization. Four patients had recurrence of symptoms. Of the six patients who were not operated upon, the lesion was localized in four. Conclusion This audit shows that all patients with insulinoma develop hypoglycemia within 48 h of fasting. CT of pancreas localizes the lesion in two thirds of cases and would be a useful initial investigation in patients with suspected insulinoma.