ABSTRACT
Objective: To determine the frequency of thyroid dysfunction among patients of chronic hepatitis C [HCV] infection receiving combination of interferon-alpha and ribavirin therapy
Study Design: Cross-sectional study
Place and Duration of Study: Department of Medicine, PNS Shifa Naval Hospital Karachi, from September 2012 to March 2013 over a period of six months
Patients and Methods: In this study, 170 diagnosed patients of chronic HCV [confirmed by anti-HCV and HCV RNA-positive] presenting to medical OPD with normal thyroid functions were recruited. All patients fulfilled inclusion and exclusion criteria. They were prescribed IFN-alpha 2b [3 million units subcutaneously 3 days a week] and oral preparation of antiviral drug ribavirin [800 to 1200 mg daily in divided doses according to weight]. At the end of 12 weeks of combination antiviral therapy, their thyroid profile was worked up. Serum TSH, free T4 and T3 levels were determined by chemiluminescence technique in chemical pathology lab of the hospital. Statistical analysis was done on SPSS 17
Results: Out of 170 patients, 83 [48.82%] were females and 87 [51.18%] were males with the age ranging from 22-46 years [mean +/- SD: 33.86 +/- 5.32]. After 12 weeks of antiviral therapy, thyroid functions were normal in 156/170 [91.76%] patients, whereas in 14/170 [8.24%] cases thyroid dysfunction was observed. Out of those patients having thyroid dysfunction, 10/14 [71.42%] were hypothyroid whereas 4/14 [28.58%] had hyperthyroidism
Conclusion: Managing patients of chronic HCV with combination antiviral therapy comprising IFN-alpha 2b and ribavirin can cause thyroid dysfunction. These patients should be monitored before and during treatment to avoid complications and poor compliance
ABSTRACT
To determine the frequency of various risk factors of stroke. A descriptive study. Military Hospital Rawalpindi, from January 2011 to January 2012. Three hundred diagnosed patients with stroke were probed into for different risk factors, based on history, clinical examination and laboratory methods. Nineteen percent were female and eighty one percent were male patients. The mean age of the patients was 59 years. Minimum age was 38 years and maximum age was 90 years in the patients under study. Physical inactivity was the most common risk factor [78%] followed by hypertension [72%], obesity [67%], type 2 diabetes mellitus [42%], smoking [42%] etc. Physical inactivity is the most common risk factor followed by hypertension which contribute to the pathology of stroke
ABSTRACT
To determine the status of glycemic control in patients of type 2 diabetes mellitus. Cross sectional descriptive study. Medical out-patient/ in -patient departments at Military Hospital Rawalpindi from January 2011 to December 2012. Six hundred and fifty patients of type 2 DM fulfilling the required criteria were included in the study. Glycemic control of these patients was determined by estimation of blood glucose [fasting and random] and glycosylated haemoglobin [HbA1c]. The patients were grouped in three categories good, fair and poor diabetic control having their HbA1c values of being 6-7%, 7.1-8% and more than 8.1% respectively. Statistical package for social sciences [SPSS] version 15 was used for analysis. Out of 650 patients 377 [58%] had poor glycemic control with mean HbA1c of 9.5% +/- 0.95, 78 [12%] patients had fair control of glycemic control with mean HbA1c of 7.8 +/- 0.25, and 195 [30%] patients had good glycemic control with mean HbA1c of 6.4 +/- 0.17. Majority of patients had poor control of their glycemic status which is an important indicator and predictor of both micro and macrovascular complications
Subject(s)
Humans , Female , Male , Blood Glucose , Glycated Hemoglobin , Cross-Sectional StudiesABSTRACT
To find out the pattern of variations in thyroid stimulating hormone [TSH] levels in hospitalized patients with major Non-Thyroidal Illnesses [NTIs] leading to stressful state. A cross-sectional study was carried out in the Department of Chemical Pathology and Endocrinology, Armed Forces Institute of Pathology [AFIP] and the Department of Pathology, Army Medical College Rawalpindi in collaboration with Department of Internal Medicine MH, Rawalpindi. Two hundred patients, were selected by convenience sampling, who were suffering from acute febrile illness, acute psychiatric illness, acute myocardial infarction and surgical trauma [50 each]. Fifty age and sex matched subjects without present or previous history of thyroid disorders were also included as controls to neutralise the confounding variables affecting TSH estimation. Serum TSH, triidothyronine [T[3] and free tetraidothyronine [fT[4] were measured during the course of these illnesses and after complete recovery. Serum TSH, T[3] and fT[4] were estimated in the laboratory by chemiluminescence method using auto-analysers lmmulite-2000 [DPC-USA] and LIA-Mat [Sangtech-Germany] at AFIP and Army Medical College, respectively. Tests related to the concurrent illnesses e.g. liver and renal function tests and cardiac enzymes were assayed by routine end-point and kinetic methods using commercial kits manufactured by M/S Linear Chemicals [Spain] on Selectra 2 Chemistry Auto-analyser. [Mecrk-Germany]. In patients of acute febrile illness there was no statistically significant difference in serum TSH levels in patients [mean: 2.03 mlU/L] and control group [mean 1.99 mlU/L] [P>0.05]. Serum TSH was significantly higher in patients of surgical trauma [mean 3.87 mlU/L [J/L] acute myocardial infarction [mean 5.55 mlU/L] and in patients with acute psychiatric illness [mean: 3.94 mlU/L] as compared to controls [P<0.05]. The transient abnormalities in serum TSH levels can mimic or at times mask the biochemical changes observed in patients with intrinsic thyroid disease, so realisation and recognition of these responses help in avoiding misdiagnosis