ABSTRACT
Introduction: The association of type 2 diabetes mellitus and thyroid dysfunction is well known. Thyroid dysfunction especially subclinical hypothyroidism has been reported to be a risk factor for sight threateningdiabetic retinopathy. Therefore, it is of importance to investigate the determinants of clinical and subclinicalhypothyroidism in patients with diabetic retinopathy. This study was aimed to investigate the effect of hypothyroidism on diabetic retinopathy and the determinants of hypothyroidism.Aims: To study the association of hypothyroidism and diabetic retinopathy and its effect on severity of retinopathy in type 2 diabetes and investigate the determinants of hypothyroidism in patients with diabetic retinopathy.Subjects and methods: A cross sectional study conducted on one hundred patients of type 2 diabetes withdiabetic retinopathy. They were evaluated for status of diabetes control, thyroid function, lipid profile andretinopathy grade. Those found to have clinical and subclinical hypothyroidism were analyzed for variousclinical and biochemical parameters for possible determinants of thyroid dysfunction.Results: There were seventy-four euthyroid patients and eighteen with subclinical hypothyroidism and five withclinical hypothyroidism. Patients with subclinical hypothyroidism had severe form of retinopathy (61.11%versus 32.43%). The odds of having a subclinical hypothyroidism in patients with severe form of diabeticretinopathy was found to be significant (OR 3.23; p=.048 CI=1.10-9.88). High HBA1c was an independent determinant of abnormal thyroid function.Conclusions: About one fourth of type II diabetes patients with retinopathy have thyroid dysfunction. Thesepatients are also likely to have severe form of the retinopathy especially those having subclinical hypothyroidism. Thus, we recommend thyroid function test should be done in all patients with type II diabetes mellitus withretinopathy. Those identified as having subclinical hypothyroidism should be closely followed so as, to detectand prevent vision threatening complications
ABSTRACT
Hanging is the suspension of a person by a noose or ligature around the neck and has been a common method of capital punishment since medieval times. Hanging is also a common method of suicide/homicide worldwide as also in India. We report a case of attempted suicidal hanging admitted in our intensive care unit. The patient, a 32-year old male, presented with poor clinical status, in gasping condition, hypoxemic and required immediate intubation, resuscitation, assisted ventilation and intensive care treatment. He received standard supportive intensive care and made a full clinical recovery without any neurological deficit. The purpose of the case report is to emphasize that the cases of near-hanging need to be aggressively resuscitated and managed irrespective of dismal initial presentation.