RESUMO
PURPOSE: Gastrointestinal (GI) manifestations have been well documented in patients with coronavirus disease 2019 (COVID-19), but its clinical impact on the course of the disease is debatable. Majority of the available data is retrospective, and hence this prospective study was planned to study the impact of GI symptoms on COVID-19 outcome. METHODS: All COVID-19 patients admitted in a tertiary care centre from August-October 2020 were screened and patients without pre-existing GI diseases were included. A detailed history of the various symptoms including duration was documented. Various baseline laboratory investigations and inflammatory markers were conducted as per the protocol. Patients with and without diarrhea were compared for the various disease outcome parameters. RESULTS: Of the 244 patients screened, 203 patients (128 males; 63.1%) were included. Respiratory symptoms alone were present in 49 (24.1%), GI symptoms alone in 20 (9.9%) and 117 (57.6%) had both. Overall GI symptoms was noted in 137 (67.5%) cases with the commonest being diarrhea (61; 30.0%). Patients with both respiratory and any GI symptoms showed a lower trend towards need for mechanical ventilation (12.2% vs 7.7%; p â= â0.35) and mortality (10.2% vs 4.3%; p â= â0.14) compared to respiratory symptoms alone, although not statistically significant. Patients with diarrhea (n â= â61) had no mortality (0% vs 7.7%; p â= â0.036) or need for mechanical ventilation and shorter hospital stay compared to those who did not have diarrhea. CONCLUSION: GI symptoms are frequent in patients with SARS-CoV-2 infection and the commonest is diarrhea. Diarrhea is a harbinger of better outcome with lower mortality among COVID-19 positive patients.
Assuntos
COVID-19 , Gastroenteropatias , COVID-19/complicações , Diarreia/epidemiologia , Gastroenteropatias/diagnóstico , Humanos , Masculino , Estudos Prospectivos , Estudos Retrospectivos , SARS-CoV-2RESUMO
OBJECTIVE: To study the effect of octreotide therapy on endometriotic lesions in a patient with coexisting endometriosis and acromegaly. INTERVENTION PATIENT: A 34-year-old female was diagnosed with acromegaly and coexisting endometriosis. Post-surgical resection of the tumor, patient was initiated on octreotide therapy. RESULTS: There was improvement in menstrual bleeding as IGF1 levels decreased with Octreotide therapy. Resolution of the endometriotic lesions was observed during follow up. CONCLUSION: In this unusual case, the treatment of acromegaly concurred with regression in the endometriotic lesions. Causal or incidental association cannot be inferred from the present case.
RESUMO
BACKGROUND: The phenotypic variability among PCOS could be due to differences in insulin patterns. Hyperinsulinemia commonly accompanies Diabetes Mellitus (DM), obesity, hypertension and CAD, though, to a variable degree. We speculate that a family history of these diseases could differentially affect the phenotype of PCOS. AIM: To study the effect of DM/CAD/HT and obesity on the phenotype of PCOS. METHODS: PCOS patients and age matched controls were enquired for a family background of DM, hypertension, CAD and obesity among parents and grandparents. Regression modelling was employed to examine predictors of obesity and first symptom in PCOS patients. RESULTS: There were 88 PCOS women and 77 age-matched controls (46 lean, 31 obese). A high prevalence of DM, CAD, obesity and hypertension was observed among parents and grandparents of women with PCOS compared to controls. Hypertension and CAD manifested more in father's side of family. BMI of PCOS subjects was significantly related to parental DM and obesity after correcting for age. First symptom of weight gain was significantly associated with number of parents with DM (p = 0.02) and first symptom of irregular periods was associated with number of parents with hypertension (p = 0.06). CONCLUSION: A family background of DM/HT and obesity diseases affects the phenotype of PCOS.
