Prevalence of thyroid disorder in pregnancy and pregnancy outcome

Background and objectives: Thyroid disorders are among the common endocrine disorders in pregnant women. Our aim was to know the prevalence of thyroid dysfunction in pregnancy and its impact on obstetric outcome in Indian population. Materials and methods: It was a prospective study which involved screening of 1000 pregnant women coming to routine antenatal check-up in first trimester. TSH level was estimated. If it was deranged, then FT3 and FT4 levels estimated. Patients were managed accordingly and followed till delivery. Their obstetric and perinatal outcomes were noted. Results: Prevalence of thyroid dysfunction was high in this study, with subclinical hypothyroidism in (6.9%) and overt hypothyroidism in (3.4%) women. Overt hypothyroids were prone to have preeclampsia preeclampsia (14.7%), abruptio placenta (2.9%), preterm delivery (8.8%), abortion (11.8%), IUGR (11.7%), LBW (11.7%), still birth (2.9%), which is comparable to other studies. Overt hyperthyroids were prone to have miscarriage (66.7%) which was significantly high. Conclusion: Prevalence of thyroid disorders, especially subclinical hypothyroidism (6.9%) and overt hypothyroidism (3.4%) was high. Significant adverse effects on maternal and fetal outcome were seen emphasizing the importance of routine antenatal thyroid screening

Study of etiology, clinical features and outcome following treatment of hyponatremia in elderly in intensive care unit

Background: Hyponatremia is a common electrolyte disturbance in the hospitalized elderly sick patients. Objectives: To study etiology, clinical features and outcome following treatment of hyponatremia in elderly hospitalized patients. Materials and methods: All elderly patients being admitted to ICU were screened for hyponatremia and 100 patients with severe hyponatremia (<125 meq/L) were included in this study, these patients were investigated as per the protocol and were treated as per the standardized regimen. Results: 100 patients with severe hyponatremia (<125 mEq/L) were studied. There was female preponderance of cases (55%). The common causes of hyponatremia were SIADH (30%) and drugs (24%) of which diuretics (79%) was a major chunk. The common CNS symptoms were drowsiness, lethargy and irrelevant talk. The common co-morbid conditions were hypertension (62%) and diabetes mellitus (51%). Females tolerated hyponatremia better than males with mortality of 9.09% in females and 33.33% in males (p=0.0026). 20 (20%) patients succumbed to their primary illness with a possible contribution attributable to hyponatremia or its treatment. M. Krishna Naik, Md. Yousuf Khan, D. Prathima Raj, D. Venkatesh, Krishna Kumar T V. Study of etiology, clinical features and outcome following treatment of hyponatremia in elderly in intensive care unit. IAIM, 2017; 4(11): 144-152. Page 145 Conclusion: Hyponatremia is common in females and they seem to better tolerate it than their male counterparts. Early detection, strict adherence to treatment protocol is required. Diuretics should be used with caution in elderly.