ABSTRACT
Background: Lithium is used in the prophylaxis of long-term therapy of bipolar affective disorder (BPAD) as a mood-stabilizing agent. Thyroid function abnormality is very commonly seen adverse effect, more common in females than males. This study aimed to correlate lithium levels and thyroid function abnormalities associated with it. Methods: Evaluation of medical records of 150 patients in Father Muller Medical College with BPAD, who were treated for 6 months with lithium, carried out from February, 12 2014 to July, 20 2014. Serum lithium levels done by ion selective electrode method in ilyte analyzer and thyroid function test (TFT) by electrochemiluminescence. Data are analyzed by Karl Pearson correlation coeffi cient. Results: Correlation of lithium levels and TFT in BPAD patients according to Karl Pearson correlation coeffi cient was negative with signifi cant p<0.002. Among 150 enrolled candidates, 52 (34.67%) were females and 98 (65.4%) were males, 4% (6) patients (3 males and 3 females) had thyroid stimulating hormone (TSH) value <0.27 with an average lithium value of 1.35 mEq/L, 6% (9) patients (5 males and 4 females) had TSH value >4.2 with an average lithium levels of 0.44 mEq/L and 90% of the patients with an average lithium levels 0.66 mEq/L had no thyroid function abnormalities. Conclusions: As already known, Lithium is a drug of narrow therapeutic index and females are more prone for thyroid function abnormalities. Appropriate monitoring of serum lithium levels will aid in necessary dose adjustment and ensure proper utilization of drug.
ABSTRACT
Background: Hereditary hemolytic anaemias constitute important cause of mortality and morbidity in developing countries next only to infection and malnutrition.These group of anaemias have various clinical presentations starting from their age of onset of symptoms, failure to thrive, anaemia, prostration, jaundice, splenomegaly, cholelithiasis, cardiomegaly, congestive cardiac failure, severe life threatening infections and chronic disabilities leading to distress in the families. Methodology: An analysis of 40 cases of hereditary hemolytic anaemia in the age group of 2 months to 12 years was done in the present study. On the basis of clinical presentations, physical findings, routine hematological investigations and hemoglobin electrophoresis pattern in hemoglobin defects were carried out to identify the type of hemolytic anaemias. Results: This clinocohematological study of hereditary hemolytic anaemia showed membrane defects- Hereditary spherocytosis in 4 cases (10%). The remaining 36 cases were having diseases affecting hemoglobin molecule which included Sickle cell anaemia-5 cases (12.5%), Sickle cell trait- 1 case (2.5%), Sickle cell/ thalassemia-1 case (2.5%), thalassemia major- 23 cases (57.5%) and thalassemia trait 6 cases(15%). Hereditary hemolytic anaemia with enzyme defects were not observed in this study. Majority of these cases presented with progressive pallor and hepatosplenomegaly. Peripheral blood smear examination showed microcytic hypochromic anaemia (87.5%) in majority of the cases. All cases were associated with reticulocytosis. Hemoglobin electrophoresis confirmed the diagnosis. Conclusion: Inspite of advanced diagnostic inestigations, the basic hematological investigation remains first panel or step towards the approach to diagnose hereditary hemolytic anaemia and hemoglobin electrophoresis will help in confirming the diagnosis.