Résumé
Background: Hypothyroidism alone is not a risk factor for osteoporosis but the patient on treatment with levothyroxine in chronic terms have the greater chances of osteoporosis. This study is to evaluate the role of chronic levo-thyroxine treatment on bone mineral density and the development of osteoporosis.Methods: A cross sectional descriptive study in which patients with recently diagnosed as hypothyroidism were taken as the first group and the second group as those who were having hypothyroidism for more than 2 years plus on chronic treatment with levothyroxine. Healthy premenopausal women were the control group. TSH was measured in all and the T score were used to measure osteoporosis severity. T score of lumbar vertebra and neck of femur were used for comparison. The description of qualitative data was done in absolute frequencies and percentages. The description of quantitative data were done as the, mean standard deviation, median, minimum and maximum. In the comparison of qualitative data between groups, the Chi-square test and contingency tables was used by rearranging the percentages of several variables (TSH, t-score). The statistical significance was set p<0.05.Results: TSH levels in the first group were slightly different from rest of the groups. T score were significantly lesser in patients in the second group who are diagnosed with hypothyroidism and on treatment with levothyroxine.Conclusions: The treatment for hypothyroidism with levo thyroxine reduces both TSH and bone mineral density in the study groups. Proper control of risk factors and avoidance of high dose thyroxine supplements are an effective way in prevention of osteoporosis.
Résumé
Background: Stress is a word very difficult to define. No one is stress-free nowadays. Stress has an impact on mental and physical wellbeing. Everyone has an ideal level of stress, but it differs from person to person. A certain amount of stress is necessary to perform at the optimum. If the stress is perceived as negligible or as exceeding one’s capacity to cope, then distress results. Stress among students of medical field (medical, dental and nursing) has gained more focus in recent years. Aim of the study: To assess the magnitude of stress among First-Year Nursing students of RMMCH, Annamalai University, Tamil Nadu. Materials and methods: The present study was a descriptive cross-sectional study. Data was collected using a proforma which included socio-demographic profile and PSS-14. Data were analyzed using SPSS software. Results: Study showed that 96% of students had stress. 94% of students had mild to moderate stress while 2% had severe stress. Conclusion: The prevalence of stress among Nursing students was high and there is a need for support services like stress management programs, relaxation techniques and so on. Support services may help to improve their ability to cope up with the demands of the course and also to have a stress free life.
Résumé
Hepatocellular carcinoma (HCC) is one of the most common cancers in the world. Infection with the hepatitis B virus (HBV) is one of the high-risk factors for the development of HCC, particularly in Asia and Africa. Other risk factors include hepatitis C virus (HCV) infection and, to a certain extent, exposure to a liver-specific carcinogen such as aflatoxin B, and alcohol consumption. In the present retrospective study, we analysed the clinical profile and aetiological role of HBV and HCV in HCC. A total of 40 cases of HCC (33 males and 7 females, age range 22-80 years) were seen from January 1999 to June 2001 at our institute. A detailed history of age, sex, past history of liver disease, clinical symptoms and presenting complaints was recorded. The most common presenting complaints were abdominal distention, pedal oedema and pain abdomen. Underlying cirrhosis of the liver was seen in 30 cases (75%), Child's A in 6, Child's B in 11 and Child's C in 13 cases. A history of alcoholism was present in 6 patients. All the patients were tested for HBsAg and anti-HCV by ELISA. HBsAg and anti-HCV was positive in 19 (47.5%) and 8 patients (20%), respectively. The diagnosis in the majority of cases was derived by FNAC and in a few by imaging techniques plus alfa-fetoprotein (AFP) evaluation. The diagnosis was confirmed by FNAC in 34, CT scan and AFP in 2, and ultrasound abdomen and AFP in 4 cases. We conclude that viral infection (HBV > HCV) is still a major aetiological factor and the incidence of HCV infection appears to be increasing. The majority of the cases of HCC studied had a cirrhotic background.