Indian Journal Of Clinical Practice最新文献

{"title":"Study of Thyroid Function Tests in Patients with Metabolic Syndrome","authors":"Balvir Singh, Pawan Kumar Vishwakarma, Abhinav Gupta, Ram Pratap Singh, Chandra Prakash, Dr Pawan Kumar, Vishwakarma Junior Resident","doi":"10.59793/ijcp.v24i4.965","DOIUrl":"https://doi.org/10.59793/ijcp.v24i4.965","url":null,"abstract":"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.","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":"141008972","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}

{"title":"Serum Uric Acid Levels and Risk of Gestational Diabetes","authors":"Dr Veena Aggarwal","doi":"10.59793/ijcp.v24i4.961","DOIUrl":"https://doi.org/10.59793/ijcp.v24i4.961","url":null,"abstract":"EDITORIAL","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":"141011460","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}

{"title":"Hypothyroidism in Metabolic Syndrome","authors":"Dr DARSHANA MAKWANA, Dr JIGNESH TANK, Dr DEEPAK KUMAR","doi":"10.59793/ijcp.v24i4.968","DOIUrl":"https://doi.org/10.59793/ijcp.v24i4.968","url":null,"abstract":"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.","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":"141010224","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}

{"title":"Hydroxychloroquine - An Antimalarial and Anti-inflammatory Drug","authors":"CR Anand, Moses","doi":"10.59793/ijcp.v24i4.963","DOIUrl":"https://doi.org/10.59793/ijcp.v24i4.963","url":null,"abstract":"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","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":"141008541","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}

{"title":"One-Step versus Two-Step Diagnostic Test for Gestational Diabetes Mellitus","authors":"Sukriti Gupta, Shashi Bala Arya, Rashmi Ramanuj, ‡. Prasad, JK Goel TARIQ MAHMOOD, Dr Shashi Bala","doi":"10.59793/ijcp.v24i4.966","DOIUrl":"https://doi.org/10.59793/ijcp.v24i4.966","url":null,"abstract":"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.","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":"141007792","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}

{"title":"Medication Reconciliation","authors":"P. Kasthuri, N. Chidambaranathan, ‡. Lathavenkatesan, Dr Kasthuri","doi":"10.1142/9789814354912_0009","DOIUrl":"https://doi.org/10.1142/9789814354912_0009","url":null,"abstract":"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","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":"141006839","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}

{"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}

{"title":"Risk Factors for “At-Risk Foot” in Diabetes","authors":"Dr Sanjay Kalra","doi":"10.59793/ijcp.v24i4.962","DOIUrl":"https://doi.org/10.59793/ijcp.v24i4.962","url":null,"abstract":"GUEST EDITORIAL","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":"141010528","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}

{"title":"Unveiling the Eschar: A Mite’s Mark in Scrub Typhus","authors":"Dr BV NAGABHUSHANA RAO, Dr T SRAVANTHI, Dr R SUNEETHA, Dr MS MOUNICA","doi":"10.59793/ijcp.v34i10.853","DOIUrl":"https://doi.org/10.59793/ijcp.v34i10.853","url":null,"abstract":"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.","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":"140212285","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}

{"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}