Metabolic dysregulation in early onset psychiatric disorder before and after exposure to antipsychotic drugs

Antipsychotic Drugs (APDs) are being widely prescribed to treat various disorders, including schizophrenia and bipolar disorder; however, abnormal glucose metabolism and weight gain have been reported with Atypical Anti-Psychotic drugs (AAPDs) that can lead to insulin-resistance and type 2 diabetes mellitus. The study was designed to assess various biochemical parameters including insulin and blood sugar before and after exposure to APDs in order to exclude the involvement of psychiatric disorders and certain other factors in metabolic dysregulations. Fifty seven APDs-naïve patients with first episode psychosis were divided into six groups who received olanzapine, quetiapine, risperidone, aripiprazole, haloperidol or combination of olanzapine with escitalopram and haloperidol. The serum samples were taken before the intake of the first dose and then on follow-up. Decrease in the level of elevated insulin and glucose was observed post-treatment in some patients, while others were observed whose insulin and glucose levels increased post-treatment, yet some patients did not show any disturbance in the insulin and glucose levels. It is concluded that psychiatric disorders by itself, narcotics, cigarette smoking and use of oral snuff may be also be implicated in metabolic dysregulations. The effects of APDs on insulin and glucose in healthy volunteers might be different than in patients with psychiatric disorders.

Frequency and clinical Importance of Anti - TG auto antibodies [ATG]

To note the frequency of anti thyroglobulin autoantibodies [ATG] and its clinical importance in 25 follow-up cases of differentiated thyroid cancer [DTC]. Design: A case control study. Place and Duration of Study: The total duration of study was one year [September 2000 to August 2001]. Majority of the patients included were the routine follow-up cases at IRNUM, Peshawar. However, few of the cases were also included from NORI, Islamabad and AFIP, Rawalpindi. Subjects and All the patients who had undergone sub-total or total thyroidectomy followed by I-131 ablation therapy were selected for this study. Thyroglobulin [Tg] and ATG were measured using immunometric assay technique with reference range of non-detectable to 40 IU/L. Patients with serum Tg level ' 10 ng/mL were included in group-1 [n=15] and all the remaining [n=10] in group-2. Overall, 11 patients showed ATG titer above the pre-defined threshold level. In group -1 patients, 8 had positive anti-Tg antibodies in their sera while in group-2, it was positive in only 3 cases. Risk of relapsing metastatic/recurrent disease in association with ATG was calculated which showed that patients with positive ATG have almost seven - fold increased risk of having recurrent/metastatic disease than those who do not. Samples for s-Tg measurements must also be evaluated for ATG status because more than one-third of these patients have positive ATG titer in their sera. Although in the presence of positive ATG, the risk of concurrent metastatic/recurrent thyroid disease is increased but still more studies are required to support its significance