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.

A rational approach to short stature: focus on use and abuse of growth hormone.

The abundant supply of recombinant growth hormone has raised interesting possibilities of several new applications. While supplementation of the missing hormone in patients with growth hormone deficiency is still the undisputed primary indication for its use, there is now convincing evidence of its usefulness in the therapy of short stature due to Turner syndrome and pre-transplant chronic renal failure in childhood. Numerous studies on patients with other causes of short stature have failed to show any significant benefit in final adult height. Social pressures notwithstanding, it is still premature to advocate the use of this expensive therapy for indications other than the three stated above especially since our understanding of potential long-term complications from such treatment is far from complete.

A report of a rare chromosome 9 variant with an unusual G-banding pattern in the 9qh region.

We present a case of a Caucasian multigravida with advanced maternal age who showed evidence of an unusual heterochromatin banding pattern on chromosome 9 and a similar fetal karyotype on amniocentesis. Although unusual banding patterns of this region have been described earlier, we report a new, clinically insignificant pattern. This case illustrates the care needed in analysing the heterochromatin region for accurate clinical interpretation of chromosome 9 polymorphisms.

Recent advances in management of diabetic ketoacidosis.

Diabetic ketoacidosis is the most common endocrine emergency in children and frequently it is the initial presentation of insulin dependent diabetes mellitus. Despite sophisticated technology and our improved understanding of the pathophysiology of this disease, the mortality from intracranial complications remains constant over the past two decades. Several management protocols are used all over the world but the recent trend in opinion seems to be one of the slower rates of initial hydration aimed at matching the osmolarity of the infusion solutions with the patient's serum osmolarity. It remains to be seen if widespread use of this rehydration strategy will improve morbidity in the future. A protocol for managing diabetic ketoacidosis is suggested.