Correlation of uric acid with microalbuminuria in Type-2 diabetic patients with normal creatinine.

Objective: To find the correlation of serum uric acid with microalbuminuria in Type-2 diabetic patients with normal creatinine. Methods: This cross-sectional study was conducted in the Department of Diabetes, Endocrinology and Metabolic diseases, Hayatabad Medical Complex, Peshawar, Pakistan from 1st April, 2022 to 30th September, 2022. Total 160 diabetic patients between the age of 30 and 65 years were enrolled in the study. Type-2 diabetic patients with microalbuminuria between 2.5 and 30 mg/mmol were included. The demographic details of patients were recorded in the questionnaire after taking consent. Fasting Uric acid, lipid profile and glucose along with creatinine and HbA1C were estimated from patient's venous blood samples. Ratio of albumin to creatinine (ACR) in the random spot urine sample was used to detect microalbuminuria. Results: Out of 160 participants enrolled in the study there were 86 (54%) males and 74 (46%) females with the mean age of 50.15 ± 11.1 years and BMI of 20.93 kg/m2. Ninety six (60%) of the patients had Type-2 DM for less than five years, while remaining 64 (40%) were more than five years diabetic. Mean serum uric acid calculated was 6.85±2.06(mg/dl), while microalbuminuria was calculated as 8.02±0.78 (mg/mmol). The Pearson correlation of serum uric acid and microalbuminuria based on sex and age was statistically significant(p<0.05). Conclusion: We found that uric acid level was significantly associated with microalbuminuria in people with Type-2 diabetes with normal serum creatinine. Uric acid level can be a potential screening tool for early detection of DKD.

Covid-induced thyroiditis.

Thyroiditis is one of the manifestations of novel Covid-19 virus. Thyroid function test (TFTs) shows typical features of hyperthyroidism. Inflammatory markers and thyroid scan give clue to the diagnosis. This report is about a 39-year-old female who presented with signs and symptoms of thyrotoxicosis along with pain in the neck, odynophagia, and intermittent fever after recovering from Covid-19 a few weeks back. She had no significant history of past medical or endocrine disease. TFTs revealed high T3 and T4 and low TSH. Thyroid scan revealed decrease uptake and ESR was 115. She was started on NSAID, steroids, and beta blocker. Four weeks later, she reverted with the resolution of symptoms and normal TFTs.

Seasonal variation and severity of Diabetic Ketoacidosis in patients at a tertiary care hospital in Pakistan.

Objectives: To asses the seasonal variability in the hospital admissions of Diabetic Ketoacidosis (DKA) patients. Methods: This two year retrospective analysis was carried out from first November 2018 to 31st OCTOBER 2020, which involved medical chart reviewing of all those patients admitted to the Department of Diabetes, Endocrinology and Metabolic diseases, Hayatabad Medical complex, Peshawar, Pakistan with confirmed DKA. Data related to patient demography, past history, biochemical profile and treatment was collected and analysed using SPSS version 25. Results: During the above mentioned 24 months, 104 diabetic patients with confirmed DKA were admitted. Fifty-nine (57%) patients were male. Most of the patients had moderate DKA that is 42(40%). Seasonality was observed with majority of the patient admitted in winter season overall 62(60%). In both the years encounter with DKA patient peaked in January. DKA was found to be more severe in female and in age group 10-15 years. DKA severity was found to be significantly associated with age, gender, previous episodes of DKA, length of hospital stay and non compliance plus infection (p<0.05). Conclusion: We found seasonal variation and peaked cases of DKA in the winter season presenting at a tertiary care hospital in Pakistan. Noncompliance was found to be major contributory factor.