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Study of Thyroid Function Tests in Patients with Metabolic Syndrome 代谢综合征患者甲状腺功能检测研究
Pub Date : 2024-05-06 DOI: 10.59793/ijcp.v24i4.965
Balvir Singh, Pawan Kumar Vishwakarma, Abhinav Gupta, Ram Pratap Singh, Chandra Prakash, Dr Pawan Kumar, Vishwakarma Junior Resident
The metabolic syndrome is a constellation of clinical and metabolic abnormalitiesincluding abdominal obesity, hypertension, dyslipidemia and impaired fasting glucose orimpaired glucose tolerance. Metabolic syndrome and thyroid dysfunction are independentrisk factors for cardiovascular disease. Aims and objectives: To study the prevalence,symptomatology of thyroid dysfunction and fine needle aspiration cytology (FNAC) findingsof thyroid in the patients having metabolic syndrome. Material and methods: The study wascarried out in 60 cases of metabolic syndrome (according to NCEP ATP III criteria) selectedfrom the medicine outdoor clinic (including diabetic clinics, thyroid clinics) and medicineindoor wards in Post Graduate Department of Medicine, SN Medical College and Hospital,Agra. Diagnosis of thyroid dysfunction was made by history, examination and serum FT4and TSH. Result and observations: Out of 60 patients of metabolic syndrome, 30 patients(50%) were euthyroid, 13 patients (21.66%) had subclinical hypothyroid and 12 patients (20%)had overt hypothyroid. Five patients (8.33%) of metabolic syndrome had hyperthyroidism.Truncal obesity was most prevalent (80.0%) component of metabolic syndrome, followedby hypertriglyceridemia (70%). Diabetes mellitus was equally prevalent in both males aswell as females and was present in about 40.0% patients and 53% of patients with metabolicsyndrome were hypertensive. Conclusion: This study shows that 50% metabolic syndromepatients had thyroid dysfunction. About 21.66% had subclinical hypothyroidism, 20% hadovert hypothyroidism and 8.33% were having hyperthyroidism. The most common symptomin metabolic syndrome patients with hypothyroidism was lethargy/sleepiness followed bydry and coarse skin. The most common symptom in hyperthyroid patients was nervousness(100%) followed by sweating, heat intolerance and palpitation in 80% of the patients.
代谢综合征是指包括腹部肥胖、高血压、血脂异常和空腹血糖受损或糖耐量受损在内的一系列临床和代谢异常。代谢综合征和甲状腺功能障碍是心血管疾病的独立危险因素。目的和目标研究代谢综合征患者甲状腺功能障碍的患病率、症状和甲状腺细针穿刺细胞学(FNAC)检查结果。材料和方法:研究对象是从阿格拉SN医学院和医院医学研究生部的医学室外门诊(包括糖尿病门诊、甲状腺门诊)和医学室内病房中挑选出来的60例代谢综合征患者(根据NCEP ATP III标准)。通过病史、检查和血清 FT4 和 TSH 诊断甲状腺功能障碍。结果和观察结果:在 60 名代谢综合征患者中,30 名患者(50%)甲状腺功能正常,13 名患者(21.66%)亚临床甲状腺功能减退,12 名患者(20%)甲状腺功能明显减退。代谢综合征中最常见的是截肢性肥胖(80.0%),其次是高甘油三酯血症(70%)。糖尿病在男性和女性中的发病率相同,约 40.0% 的患者患有糖尿病,53% 的代谢综合征患者患有高血压。结论这项研究表明,50%的代谢综合征患者存在甲状腺功能障碍。其中约 21.66% 患有亚临床甲状腺功能减退症,20% 患有显性甲状腺功能减退症,8.33% 患有甲状腺功能亢进症。甲减代谢综合征患者最常见的症状是嗜睡,其次是皮肤干燥和粗糙。甲亢患者最常见的症状是紧张(100%),其次是出汗、热不耐受和心悸(80%)。
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引用次数: 0
Serum Uric Acid Levels and Risk of Gestational Diabetes 血清尿酸水平与妊娠糖尿病风险
Pub Date : 2024-05-06 DOI: 10.59793/ijcp.v24i4.961
Dr Veena Aggarwal
EDITORIAL
社论
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引用次数: 0
Hypothyroidism in Metabolic Syndrome 代谢综合征中的甲状腺功能减退症
Pub Date : 2024-05-06 DOI: 10.59793/ijcp.v24i4.968
Dr DARSHANA MAKWANA, Dr JIGNESH TANK, Dr DEEPAK KUMAR
Metabolic syndrome (Syndrome X/Insulin resistance syndrome) consistsof central obesity, hypertriglyceridemia, low high-density lipoprotein (HDL) cholesterol,hyperglycemia and hypertension as its major features. All of them can be influenced by thefunctioning of a 20 g endocrine organ, the thyroid gland. Aims and objectives: To studythe proposed association between metabolic syndrome and thyroid dysfunction. Materialand methods: Hundred subjects aged more than 18 years, willing to participate in the studyand fulfilling criteria of the National Cholesterol Education Program-Adult Treatment PanelIII (NCEP-ATP III) for diagnosis of metabolic syndrome were included. Detailed clinicalexamination and laboratory investigations of all subjects were done. Risk factors wereidentified and analyzed by comparing the subjects with and without thyroid dysfunction.Results: Eighty-one out of 100 subjects with metabolic syndrome belonged to the age groupbetween 41 and 70 years. Females comprised 60% of the total patient population with sedentarylifestyle as the major risk factor, whereas males comprising rest of the 40% had addictivebehaviors as major risk factors. Observation of individual parameters under NCEP-ATP IIIshowed that 57 patients fulfilled all 5 criteria, 34 patients fulfilled 4 and 9 patients fulfilled3 criteria. Obesity and dyslipidemia were common among female subjects, whereas impairedglucose tolerance and hypertension were common among males. Thyroid dysfunction inthe form of hypothyroidism was present in 30 subjects with females (23 patients) being thestatistically significant population (p < 0.0001). Hypothyroidism was of subclinical type in21 of these 30 subjects. None had hyperthyroidism. Left ventricular ejection fraction (mean± SD) was lowered to 42.67 ± 6.53 from 49.07 ± 7.48 in presence of thyroid dysfunction inthese subjects with metabolic syndrome (p < 0.0001). Conclusion: Metabolic syndrome andhypothyroidism (even subclinical) are both individual as well as combined risk factors fordevelopment of atherogenic dyslipidemia, diabetes mellitus and cardiovascular disease withelderly females comprising the high risk group.
代谢综合征(综合征 X/胰岛素抵抗综合征)的主要特征包括中心性肥胖、高甘油三酯血症、低高密度脂蛋白胆固醇、高血糖和高血压。所有这些都会受到一个 20 克重的内分泌器官--甲状腺功能的影响。目的和目标研究代谢综合征与甲状腺功能障碍之间的关联。材料和方法:纳入 100 名年龄超过 18 岁、愿意参加研究并符合美国国家胆固醇教育计划-成人治疗小组 III(NCEP-ATP III)代谢综合征诊断标准的受试者。对所有受试者进行了详细的临床检查和实验室检查。通过比较有甲状腺功能障碍和无甲状腺功能障碍的受试者,确定并分析了风险因素:结果:100 名代谢综合征患者中有 81 人的年龄在 41 岁至 70 岁之间。女性占患者总人数的60%,久坐不动的生活方式是主要风险因素,而男性占其余的40%,成瘾行为是主要风险因素。对 NCEP-ATP III 各项参数的观察显示,57 名患者符合全部 5 项标准,34 名患者符合 4 项标准,9 名患者符合 3 项标准。肥胖和血脂异常在女性受试者中很常见,而葡萄糖耐量受损和高血压在男性中很常见。30 名受试者存在甲状腺功能减退症形式的甲状腺功能障碍,其中女性(23 名患者)是具有显著统计学意义的人群(p < 0.0001)。在这 30 名受试者中,有 21 人属于亚临床型甲状腺功能减退症。没有人患有甲状腺功能亢进症。患有代谢综合征的受试者在出现甲状腺功能障碍时,左心室射血分数(平均值±标清值)从 49.07 ± 7.48 降至 42.67 ± 6.53(P < 0.0001)。结论代谢综合征和甲状腺功能减退症(即使是亚临床甲状腺功能减退症)既是导致动脉粥样硬化性血脂异常、糖尿病和心血管疾病的个体危险因素,也是导致这些疾病的综合危险因素,其中老年女性是高危人群。
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引用次数: 0
Hydroxychloroquine - An Antimalarial and Anti-inflammatory Drug 羟氯喹--抗疟消炎药
Pub Date : 2024-05-06 DOI: 10.59793/ijcp.v24i4.963
CR Anand, Moses
Hydroxychloroquine – a quinoline antimalarial, has hypoglycemic effects that manifest due toits action on the intracellular insulin metabolism in peripheral tissues. Recent studies confirmthat the use of Hydroxychloroquine can aid in preventing new onset diabetes and complicationsof diabetes, systemic lupus erythematosus and rheumatoid arthritis, as well as in improvingthe mortality rate of these patients
羟氯喹(Hydroxychloroquine)是一种喹啉类抗疟药物,具有降血糖作用,这主要是由于它对外周组织细胞内胰岛素代谢的作用。最近的研究证实,使用羟氯喹有助于预防新发糖尿病和糖尿病并发症、系统性红斑狼疮和类风湿性关节炎,并能提高这些患者的死亡率。
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引用次数: 0
One-Step versus Two-Step Diagnostic Test for Gestational Diabetes Mellitus 妊娠糖尿病的一步式诊断测试与两步式诊断测试
Pub Date : 2024-05-06 DOI: 10.59793/ijcp.v24i4.966
Sukriti Gupta, Shashi Bala Arya, Rashmi Ramanuj, ‡. Prasad, JK Goel TARIQ MAHMOOD, Dr Shashi Bala
Comparison between one-step Diabetes in Pregnancy Study Group India (DIPSI) andAmerican Diabetes Association (ADA) recommended two-step oral glucose tolerance test(OGTT). Material and methods: This study has a sample size of 200; 100 participants eachwere subjected to either of the two tests. Gestational diabetes mellitus (GDM) and non-GDMdiagnosed by one-step test versus two-step test, respectively, were compared to one anotherand results were compared on the basis of various antenatal complications and fetomaternaloutcomes. Results: No statistical difference was found between both the groups on the basis ofvarious antenatal and fetomaternal outcomes. Conclusion: In Indian subcontinent with poorresources and lack of follow-up, single-step DIPSI can be preferred to ADA recommendedtwo-step OGTT; however, large database studies are still required.
一步式印度妊娠糖尿病研究小组(DIPSI)与美国糖尿病协会(ADA)推荐的两步式口服葡萄糖耐量试验(OGTT)的比较。材料和方法:本研究的样本量为 200 人,其中 100 人接受了两种测试中的任何一种。将分别通过一步法测试和两步法测试诊断出的妊娠期糖尿病(GDM)和非GDM进行比较,并根据各种产前并发症和胎儿-产妇结局对结果进行比较。结果显示两组在各种产前并发症和胎儿结局方面均无统计学差异。结论在资源贫乏和缺乏随访的印度次大陆,单步 DIPSI 可优于 ADA 推荐的两步 OGTT;然而,仍需进行大型数据库研究。
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引用次数: 0
Medication Reconciliation 药物对账
Pub Date : 2024-05-06 DOI: 10.1142/9789814354912_0009
P. Kasthuri, N. Chidambaranathan, ‡. Lathavenkatesan, Dr Kasthuri
The Institute of Medicine (IOM) stated that preventable medication errors are the mostcommon type of errors in healthcare. It is of fundamental significance when building a safercare continuum, as it highlights the reason for continuous and more vigilant medicationreconciliation and required effort at all interfaces of care, including community. Without arobust medication reconciliation process, the potential for catastrophic outcomes remains aconstant concern. Prevention of medication errors is essential through strategies that are basedin evidence of medication reconciliation strategies on medication errors in community
医学研究所(IOM)指出,可预防的用药错误是医疗保健中最常见的错误类型。这对于建立更安全的持续护理至关重要,因为它凸显了在包括社区在内的所有护理界面上持续、更警惕地进行药物协调和所需努力的原因。如果没有一个健全的用药核对流程,发生灾难性后果的可能性就会一直存在。预防用药失误的关键在于根据社区用药失误的用药核对策略证据采取相应的策略。
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引用次数: 9
Is It Structural or Metabolic? A Diagnostic Dilemma 是结构性疾病还是代谢性疾病?诊断难题
Pub Date : 2024-05-06 DOI: 10.59793/ijcp.v24i4.969
Dr E Sumanraj, Dr N Vijayakumar, Dr A Nanjilkumaran, Dr R Umarani
Osmotic demyelination syndrome (ODS), a disease affecting chronic alcoholic and malnourishedpatients was described by Adams and colleagues in 1959. It is also known as pontinemyelinolysis. Pontine myelinolysis can be subdivided into central pontine myelinolysis (CPM)and extrapontine myelinolysis (EPM) depending upon the level of demyelination, within thepons or outside the pons, respectively. Rapid correction of hyponatremia contributes to thepathogenesis of ODS. Whenever a chronic alcoholic and/or malnourished develops confusion,quadriplegia, pseudobulbar palsy and pseudocoma (Locked-in-syndrome) over a period ofseveral days, a high index of suspicion for ODS must be held
渗透性脱髓鞘综合征(ODS)是亚当斯及其同事于 1959 年描述的一种影响慢性酒精中毒和营养不良患者的疾病。它也被称为桥脑髓鞘溶解症。根据脑桥内或脑桥外脱髓鞘的程度,脑桥髓鞘溶解症又可分为中枢性脑桥髓鞘溶解症(CPM)和脑桥外髓鞘溶解症(EPM)。快速纠正低钠血症是 ODS 的发病机制之一。只要慢性酒精中毒者和/或营养不良者在数天内出现意识模糊、四肢瘫痪、假性横臂麻痹和假性脑瘤(锁闭综合征),就必须高度怀疑 ODS。
{"title":"Is It Structural or Metabolic? A Diagnostic Dilemma","authors":"Dr E Sumanraj, Dr N Vijayakumar, Dr A Nanjilkumaran, Dr R Umarani","doi":"10.59793/ijcp.v24i4.969","DOIUrl":"https://doi.org/10.59793/ijcp.v24i4.969","url":null,"abstract":"Osmotic demyelination syndrome (ODS), a disease affecting chronic alcoholic and malnourishedpatients was described by Adams and colleagues in 1959. It is also known as pontinemyelinolysis. Pontine myelinolysis can be subdivided into central pontine myelinolysis (CPM)and extrapontine myelinolysis (EPM) depending upon the level of demyelination, within thepons or outside the pons, respectively. Rapid correction of hyponatremia contributes to thepathogenesis of ODS. Whenever a chronic alcoholic and/or malnourished develops confusion,quadriplegia, pseudobulbar palsy and pseudocoma (Locked-in-syndrome) over a period ofseveral days, a high index of suspicion for ODS must be held","PeriodicalId":506647,"journal":{"name":"Indian Journal Of Clinical Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141007062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Risk Factors for “At-Risk Foot” in Diabetes 糖尿病 "高危足 "的风险因素
Pub Date : 2024-05-06 DOI: 10.59793/ijcp.v24i4.962
Dr Sanjay Kalra
GUEST EDITORIAL
特约社论
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引用次数: 0
Unveiling the Eschar: A Mite’s Mark in Scrub Typhus 揭开疥疮的面纱恙虫病中的螨虫印记
Pub Date : 2024-03-22 DOI: 10.59793/ijcp.v34i10.853
Dr BV NAGABHUSHANA RAO, Dr T SRAVANTHI, Dr R SUNEETHA, Dr MS MOUNICA
Scrub typhus is an acute febrile illness caused by Orientia tsutsugamushi, a Gram-negative intracellular organism transmittedby Leptotrombidium mites, with wild rats serving as natural reservoirs. The disease is more common in the TsutsugamushiTriangle, often afflicting travelers and creating diagnostic challenges in clinical practice. We present the case of a diabeticpatient who acquired the infection while visiting an agricultural farm. Our discussion covers clinical manifestations,diagnostic markers and treatment modalities, emphasizing the significance of early recognition and the benefits of prompttreatment. The importance of searching for an eschar, a key physical sign, is underscored and potential serious outcomesare discussed. Recent advances and preventive measures are also highlighted. This synthesis of research and clinical insightsaims to enhance global awareness, prompt diagnosis and effective management of scrub typhus.
恙虫病是一种急性发热性疾病,由恙虫病原虫(Orientia tsutsugamushi)引起,它是一种革兰氏阴性的细胞内生物,由Leptotrombidium螨虫传播,野鼠是其天然储库。这种疾病在恙虫病三角区较为常见,经常困扰旅行者,给临床实践带来诊断难题。我们介绍了一例糖尿病患者在参观农业农场时感染该病的病例。我们的讨论涵盖了临床表现、诊断指标和治疗方法,强调了早期识别的重要性和及时治疗的益处。我们还强调了寻找焦痂(一个重要的物理标志)的重要性,并讨论了潜在的严重后果。此外,还重点介绍了最新进展和预防措施。这本研究和临床见解的综述旨在提高全球对恙虫病的认识、及时诊断和有效管理。
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引用次数: 0
Dyke-Davidoff-Masson Syndrome: A Rare Presentation 戴克-戴维多夫-马森综合征:一种罕见的表现
Pub Date : 2024-03-22 DOI: 10.59793/ijcp.v34i10.854
Dr GURDEEP KAUR, Dr RAHUL METRI, Dr AMIT POORIA, Dr ABHINAV, Dr RAJESH MEENA
Dyke-Davidoff-Masson syndrome (DDMS) is characterized by seizures, facial asymmetry, contralateralhemiplegia and mental retardation. The characteristic radiological features are cerebral hemiatrophy with homolateralhypertrophy of skull and sinuses. Case report: We report a case of DDMS in a 41-year-old female who presented withgeneralized tonic-clonic seizures, hemiparesis of the right upper and lower limb with deviation of the mouth to left.Noncontrast computed tomography (NCCT) head and magnetic resonance imaging (MRI) revealed hemiatrophy of the rightcerebral hemisphere. Conclusion: DDMS is a rare disease; hence, diagnosing and managing such patients may be challenging.Our aim is to draw attention of the treating physicians towards this disease with the help of this case report.
戴克-戴维多夫-马森综合征(DDMS)的特征是癫痫发作、面部不对称、对侧偏瘫和智力迟钝。其特征性影像学表现为大脑半萎缩,头骨和鼻窦同侧肥大。病例报告:非对比计算机断层扫描(NCCT)头部和磁共振成像(MRI)显示右侧大脑半球萎缩。结论DDMS 是一种罕见疾病;因此,诊断和处理此类患者可能具有挑战性。
{"title":"Dyke-Davidoff-Masson Syndrome: A Rare Presentation","authors":"Dr GURDEEP KAUR, Dr RAHUL METRI, Dr AMIT POORIA, Dr ABHINAV, Dr RAJESH MEENA","doi":"10.59793/ijcp.v34i10.854","DOIUrl":"https://doi.org/10.59793/ijcp.v34i10.854","url":null,"abstract":"Dyke-Davidoff-Masson syndrome (DDMS) is characterized by seizures, facial asymmetry, contralateralhemiplegia and mental retardation. The characteristic radiological features are cerebral hemiatrophy with homolateralhypertrophy of skull and sinuses. Case report: We report a case of DDMS in a 41-year-old female who presented withgeneralized tonic-clonic seizures, hemiparesis of the right upper and lower limb with deviation of the mouth to left.Noncontrast computed tomography (NCCT) head and magnetic resonance imaging (MRI) revealed hemiatrophy of the rightcerebral hemisphere. Conclusion: DDMS is a rare disease; hence, diagnosing and managing such patients may be challenging.Our aim is to draw attention of the treating physicians towards this disease with the help of this case report.","PeriodicalId":506647,"journal":{"name":"Indian Journal Of Clinical Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140214714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Indian Journal Of Clinical Practice
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