ABSTRACT
End-stage renal disease [ESRD] frequently causes Protein Energy Wasting [PEW], which is an important morbidity and mortality factor. Although it is difficult to assess PEW with a reliable method, there are various methods such as Handgrip strength test [HST], serum albumin, cholesterol, etc. HST is a simple and reliable antropometric method which is used for nutritional status and body muscle strength. This study aims to assess the relationship between HST and biochemical markers in evolution of nutritional status of ESRD patients. This cross-sectional study included 36 consecutive patients, who are on peritoneal dialysis and 36 healthy -control subjects. Jamar-hand dynamometer was used for handgrip strength test; a pinch gauge was used for key pinch. Other antropometric tests included skin fold thicknesses at biceps, triceps, umbilical, suprailiac and subscapular regions; circumferences at waist hip, neck and midarm. Biochemical tests were performed only in Peritoneal Dialysis [PD] group. SPSS for Windows ver. 15.0 was used for statistics. The mean age of patients was 49.3 +/- 14.4, and mean age of control group was 43.8 +/- 10.6 [p=0.075]. In PD group dominant hand dynamometer test 1,2 and 3 results were 19.3 +/- 9.3 kg, 25.3 +/- 10.8 kg, 25.5 +/- 10.6 kg and ; 34.2 +/- 10.3 kg, 34.4 +/- 9.8 kg, 34.6 +/- 10.0 kg for control group [p< 0,001]. Right key pinch results were 6.7 +/- 1.9 kg for patients; 13.5 +/- 4.5 kg for control group [p<0.001]. Left key pinch results were 6.8 +/- 1.9 kg for patients; 13.2 +/- 4.4 kg for control group [p<0.001]. There was not any significant relationship concerning handgrip or key pinch tests with biochemical parameters. Handgrip Strength Test and key pinch may be reliable, cheap and easily performed tests for the diagnosis of Protein Energy Wasting in patients on Peritoneal Dialysis
ABSTRACT
Thyrotoxicosis mostly presents with tachycardia, tremor, weight loss and other hypermetabolism signs. However, there are other unusual signs of thyrotoxicosis such as paralysis. This unusual clinical presentation may postpone prompt diagnosis and treatment. In this case report, we present a 27-years-old woman, who presented with quadriparesis at the emergency department