scholarly journals Trimester-Specific Reference Ranges for Thyroid Hormones of Pregnant Females at Tertiary Care Hospitals in Lahore, Pakistan

2021 ◽  
Author(s):  
Asim Mumtaz ◽  
Fauzia Sadiq ◽  
Saima Zaki ◽  
Hijab Batool ◽  
Muhammad Ibrahim ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Thyroid Function Test ◽  
Cross Sectional Study ◽  
Specific Reference ◽  
Reference Ranges ◽  
Free T4 ◽  
Cross Sectional ◽  
Pregnant Females ◽  
Aseptic Conditions ◽  
Tertiary Care Hospitals

Abstract Background: The significance of investigation for diagnosing and managing thyroid dysfunction in pregnant females has been extensively documented in the medical literature. This study aimed to determine trimester-specific reference ranges for thyroid-stimulating hormones (TSH), Free T3 (FT3), and free T4 (FT4) in apparently healthy pregnant women attending tertiary care hospitals in Lahore. Methods: This cross-sectional study was conducted at two tertiary care Hospitals in Lahore, Pakistan. In this multi-centric study, initially, 500 pregnant females were enrolled from September 2019 to December 2019 who fulfilled the inclusion criteria. For measurement of serum freeT3, free T4, TSH, anti-TPO, and Thyroglobulin antibodies, 5 ml of the blood sample was drawn, under aseptic conditions, from each subject using Maglumi 800 chemiluminescence immunoassay (CLIA) system. Results: Out of 500 subjects, 23 subjects with positive anti-TPO, 19 subjects with anti-TG antibodies, and 12 subjects due to less volume of serum yielded from whole blood (serum less than 3 ml) were excluded from the analysis. Ten samples were hemolyzed and not included in the analysis. A total of 436 samples were examined for analysis. Of the remaining 436 subjects, 133 (30.5%) were from 1st Trimester, 153 (35.1%) from 2nd Trimester, and 150 (34.4%) from 3rd Trimester. As the data were non-normal, the 2.5th, 50th and 97.5th percentiles were calculated to express each group's results. Trimester specific range of TSH 0.168-4.294, 0.258-4.584 and 0.341-4.625, FT3 1.857-4.408, 1.958-4.621 and 2.025-4.821 pg/mL and FT4 8.815-18.006, 8.306-17.341 and 7.402-17.292 pg/mL. Conclusion: In this study, we established a trimester-specific reference range for our local population's thyroid function test. The results of this study have complemented the results of previous studies.

scholarly journals Trimester-specific reference ranges for thyroid hormones of pregnant females at tertiary care hospitals in Lahore, Pakistan

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Asim Mumtaz ◽  
Fauzia Sadiq ◽  
Saima Zaki ◽  
Hijab Batool ◽  
Muhammad Ibrahim ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Thyroid Function Test ◽  
Cross Sectional Study ◽  
Thyroid Stimulating Hormone ◽  
Specific Reference ◽  
Thyroid Peroxidase ◽  
Reference Ranges ◽  
Cross Sectional ◽  
Pregnant Females ◽  
Tertiary Care Hospitals

Abstract Background The significance of investigation for diagnosing and managing thyroid dysfunction in pregnant females has been extensively documented in the medical literature. This study aimed to determine trimester-specific reference ranges for thyroid-stimulating hormones (TSH), free T3 (FT3), and free T4 (FT4) in apparently healthy pregnant women attending tertiary care hospitals in Lahore. Methods This cross-sectional study was conducted at two tertiary care Hospitals in Lahore, Pakistan. In this multi-centric study, 500 pregnant females were initially enrolled from September 2019 to December 2019 who fulfilled the inclusion criteria. For measurement of serum FT3, FT4, thyroid stimulating hormone (TSH), anti-thyroid peroxidase (anti-TPO), and thyroglobulin antibodies, 5 ml of the blood sample was drawn, under aseptic conditions, from each subject using Maglumi 800 chemiluminescence immunoassay (CLIA) system. Results Out of 500 subjects, 23 subjects with positive anti-TPO, 19 subjects with anti-TG antibodies, and 12 subjects due to less volume of serum yielded from whole blood (serum less than 3 ml) were excluded from the analysis. Ten samples were hemolyzed and not included in the analysis. A total of 436 samples were examined for analysis. Of the remaining 436 subjects, 133 (30.5%) were from 1st trimester, 153 (35.1%) from 2nd trimester, and 150 (34.4%) from 3rd trimester. As the data were non-normal, the 2.5th, 50th, and 97.5th percentiles were calculated to express each group's results. Trimester specific range of TSH 0.168-4.294, 0.258-4.584 and 0.341-4.625 mIU/mL, FT31.857-4.408, 1.958-4.621 and 2.025-4.821 pmol/L and FT4 8.815-18.006, 8.306-17.341 and 7.402-17.292 pmol/L. Conclusion In this study, we established a trimester-specific reference range for our local population's thyroid function test. The results of this study have complemented the results of previous studies.

Compliance and Adherence to Treatment in Hypertensive Patients in different Tertiary Care Hospitals in Lahore

2021 ◽  
Vol 15 (8) ◽  
pp. 1858-1860
Author(s):  
Junaid Mushtaq ◽  
Israr-Ul- Haq ◽  
Waqas Mahmood ◽  
Mujtaba H. Siddiqui ◽  
Atiq Ahmad ◽  
...  
Keyword(s):  
Medical Center ◽  
Tertiary Care ◽  
Educational Status ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Adherence To Treatment ◽  
Cross Sectional ◽  
Hypertensive Patients ◽  
Hospital Doctors ◽  
Tertiary Care Hospitals

Aim: To determine the factors that affect compliance and adherence to medications of hypertensive patients visiting OPD clinics. Study design: Descriptive-cross sectional study. Place and duration of study: Department of Medicine, Unit 1, Lahore General Hospital, Doctors Hospital & Medical Center and Farooq Hospital Lahore from 1st January 2019 to 31st December 2019. Methodology: One hundred and sixty five patients with hypertension were handed over questionnaire socio-demographic, compliance and adherence were recorded. Results: Patients who maintained BP charting were only 13(7.9%) and those without BP charting were 152(92.1%). Patients taking regular medications were only 20(12.1%). Forgetfulness in taking medications was found in 47.3% of patients. 20.6% of patients were unable to purchase medicines because of financial reasons. Thirty two patients (19.4%) thought that they should not take medicines as they were not having any symptoms. Conclusion: Major causes of non-adherence were expense of medications, lack of symptoms, lack of money, forgetfulness, lack of awareness due to poor educational status and nature of job. Keywords: Compliance, Adherence, Medications, Hypertension, Forgetfulness

scholarly journals Barriers to the early initiation of Insulin therapy among diabetic patients coming to diabetic clinics of tertiary care hospitals

2018 ◽  
Vol 35 (1) ◽  
Author(s):  
Iqra Arshad ◽  
Sara Mohsin ◽  
Sana Iftikhar ◽  
Tahseen Kazmi ◽  
Luqman F. Nagi
Keyword(s):  
Insulin Therapy ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Early Initiation ◽  
P Value ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Creative Commons ◽  
Oral Medications ◽  
Tertiary Care Hospitals

Background and Objective: Initiation of Insulin therapy during earlier stages has proved to significantly improve health outcomes among diabetics in comparison to oral medications. Not only patients but physicians are also often resistant to early initiation of insulin therapy. The objective was to assess misconceptions and barriers to early initiation of insulin therapy among diabetic patients coming to a diabetic clinic. Methods: This cross sectional study was conducted on 300 patients selected by convenience sampling arriving in Diabetes Outdoor Clinics of Mayo and Services Hospitals, Lahore during August 2017 to May 2018. The data was entered and analyzed by using SPSS version 17. Results: Out of 300 patients included in study, 39% (n= 117) were males and 61% (n=183) were females. The mean age of the participants at presentation was 48.46±13.15 years with a range of 13 to 80 years. Study participants considered it embarrassing to inject insulin in public place (p-value 0.01). The fear associated with lifelong commitment to insulin therapy once it is started, was also found statistically significant (p-value 0.001)particularly in subjects who have long duration of DM (>5 years). Conclusion: Perceptions of diabetic patients about insulin therapy are still barriers to early initiation of therapy and tend to prevail in Pakistan and around the globe. How to cite this:Arshad I, Mohsin S, Iftikhar S, Kazmi T, Nagi LF. Barriers to the early initiation of Insulin therapy among diabetic patients coming to diabetic clinics of tertiary care hospitals. Pak J Med Sci. 2019;35(1):---------. doi: https://doi.org/10.12669/pjms.35.1.237 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Thyroid dysfunction in patients of metabolic syndrome: A study from a tertiary care center in India

2021 ◽  
Vol 12 (10) ◽  
pp. 47-50
Author(s):  
Ritu Gupta ◽  
Akhil K Vijayan ◽  
Sushma Choudhary
Keyword(s):  
Metabolic Syndrome ◽  
Thyroid Dysfunction ◽  
Care Center ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Thyroid Stimulating Hormone ◽  
P Value ◽  
Overt Hypothyroidism ◽  
Free T4 ◽  
Cross Sectional

Background: Metabolic syndrome is characterized by hypertension, dyslipidemia, central obesity, glucose intolerance, insulin resistance. Thyroid hormone acts as general pacemaker, accelerating metabolic process and may be associated with metabolic syndrome. There is no information available in literature regarding the prevalence and association of thyroid dysfunction in metabolic syndrome in this central region of the country. Aims and Objective: To estimate the prevalence of thyroid dysfunction in patients of metabolic syndrome. Materials and Methods: It is a duration based prospective cross sectional study including 200 patients of metabolic syndrome. A detailed history, clinical examination and relevant investigations including serum Free T4 (FT4), Free T3 (FT3), Thyroid Stimulating Hormone (TSH) were done. Range, frequencies, percentage, mean, standard deviation and P value were calculated. P value of < 0.05 was taken as significant. Results: Prevalence of thyroid dysfunction in metabolic syndrome patients was 28.5%. Prevalence of subclinical and overt hypothyroidism was 18.5% and 8.5% respectively. In patients with both metabolic syndrome and thyroid dysfunction, most common components associated are diabetes mellitus and hypertriglyceridemia. Conclusion: Thyroid dysfunction is significantly common in metabolic syndrome patients. It should be aggressively detected and treated in these patients for better outcome.

Magnitude of thyroid dysfunction among antenatal women attending tertiary care centre

2019 ◽  
Vol 8 (11) ◽  
pp. 4371
Author(s):  
Deepa Shanmugham ◽  
Deepak Kannan Saravanan ◽  
Priyanka Shah
Keyword(s):  
Thyroid Dysfunction ◽  
Tertiary Care ◽  
Thyroid Function Test ◽  
First Trimester ◽  
Endocrine Disorders ◽  
Tertiary Care Centre ◽  
Free T4 ◽  
Cross Sectional ◽  
High Prevalence ◽  
The Mean

Background: Thyroid disorders constitute one of the most common endocrine disorders in pregnancy. However, there is no universal guidelines to screen every Pregnant Woman for Thyroid dysfunction in India. This study was conducted to evaluate the magnitude of thyroid dysfunction among ante natal mothers in a tertiary care centre.Methods: This was a cross sectional observational study conducted on ante natal mothers for a period of 6 months. All consecutive ante natal mothers in their first trimester were included in this study. Exclusion criteria was pre-gestational thyroid dysfunction, hypertension and diabetes mellitus. After obstetric examination and investigation, thyroid function test (Free T4 and TSH) was done in all patients.Results: Mean age of the patients enrolled was 26.2±3.54 years. Mean gestational age at which they underwent screening was 9±2 weeks. The mean BMI of the study patients was 21.7±4. The prevalence of hypothyroidism in antenatal mothers was 14.5%. 5 patients (5.5%) had hyperthyroidism. The calculated mean TSH value was 4.26 mIU/L.Conclusions: Universal screening for thyroid dysfunction during pregnancy should be made mandatory in India due to high prevalence, in order to prevent maternal and foetal complications.

scholarly journals A study on premenstrual syndrome symptoms and their association with sleep quality in nursing staff

2019 ◽  
Vol 8 (4) ◽  
pp. 1487
Author(s):  
Gauri Kore ◽  
Heena Merchant ◽  
Hiba Narvel ◽  
Ajita Nayak ◽  
Avinash De Sousa
Keyword(s):  
Sleep Quality ◽  
Nursing Staff ◽  
Premenstrual Syndrome ◽  
Rating Scale ◽  
Tertiary Care ◽  
Age Groups ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Premenstrual Symptoms ◽  
Tertiary Care Hospitals

Background: Symptoms in the premenstrual period can be debilitating and troublesome and impacts the general health of women. There is a dearth of studies examining the relationship between sleep quality and premenstrual symptoms in women, especially in Indian settings. The current study was conducted with the aim of looking at the frequency of premenstrual syndrome (PMS) in different age groups and the association of these symptoms with sleep quality in nursing staff.Methods: The cross-sectional study involved 450 female nursing staff between 25- 50 years of age from various tertiary care hospitals who were administered the Premenstrual Tension Syndrome Rating Scale (PMTS) and Pittsburgh Sleep Quality Index (PSQI). The data was then statistically analyzed.Results: The prevalence of premenstrual symptoms was found to be 85.6% amongst the participants (according to the ACOG criteria), while the proportion of females suffering from PMS (according to DSM IVTR criteria) was 36.5%. A correlation analysis between total scores of PMTS and PSQI showed a positive, linear and significant association.Conclusions: The intensity of PMS was associated with reduction in sleep quality in present study. Further studies on PMS and sleep related parameters need to carry out in larger samples to give impetus to our findings.

scholarly journals Study of genital dermatoses in pregnant females attending a tertiary care hospital

2019 ◽  
Vol 5 (3) ◽  
pp. 542
Author(s):  
Seeniammal Sivanu ◽  
Maalik Babu ◽  
Soundharyaa Moorthi Savadamoorthi
Keyword(s):  
Tertiary Care Hospital ◽  
Oral Candidiasis ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Cross Sectional ◽  
Sexually Transmitted ◽  
Pregnant Females ◽  
One Year ◽  
Infective Etiology

<p class="abstract"><strong>Background:</strong> Sexually transmitted infections (STI) prevalence in pregnancy is high and causes severe risk of transmission to the newborn. Usually they are asymptomatic and underdiagnosed. Most common STI’s are VVC, HPV, genital herpes, HIV, etc.</p><p class="abstract"><strong>Methods:</strong> A hospital-based cross-sectional study was done for a period of one year (September 2017- August 2018) and 31 pregnant genital dermatoses were encountered.<strong></strong></p><p class="abstract"><strong>Results:</strong> Among 31, infective etiology was seen in 15 cases (48%), non-infective etiology was seen in 3 cases (10%) and no STI’s were seen in 13 patients (42%). Vulvovaginal candidiasis was most common among pregnant females in 9 patients (60%) followed by genital warts in 3 patients (20%) followed by molluscum contagiosum, herpes genitalis and oral candidiasis in one patient (7%) respectively among infective etiology. Non-infective causes include vulval lymphangiectasia, epidermoid cyst and vascular swelling in one patient respectively (33.3%).</p><p><strong>Conclusions:</strong> Screening of antenatal cases is more important to prevent complications. </p>

scholarly journals Varying association of laboratory values with reference ranges and outcomes in critically ill patients: an analysis of data from five databases in four countries across Asia, Europe and North America

2021 ◽  
Vol 28 (1) ◽  
pp. e100419
Author(s):  
Haoran Xu ◽  
Louis Agha-Mir-Salim ◽  
Zachary O’Brien ◽  
Dora C Huang ◽  
Peiyao Li ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Cross Sectional Study ◽  
Specific Reference ◽  
Reference Ranges ◽  
Cross Sectional ◽  
Laboratory Values ◽  
Laboratory Results ◽  
The Usa

BackgroundDespite wide usage across all areas of medicine, it is uncertain how useful standard reference ranges of laboratory values are for critically ill patients.ObjectivesThe aim of this study is to assess the distributions of standard laboratory measurements in more than 330 selected intensive care units (ICUs) across the USA, Amsterdam, Beijing and Tarragona; compare differences and similarities across different geographical locations and evaluate how they may be associated with differences in length of stay (LOS) and mortality in the ICU.MethodsA multi-centre, retrospective, cross-sectional study of data from five databases for adult patients first admitted to an ICU between 2001 and 2019 was conducted. The included databases contained patient-level data regarding demographics, interventions, clinical outcomes and laboratory results. Kernel density estimation functions were applied to the distributions of laboratory tests, and the overlapping coefficient and Cohen standardised mean difference were used to quantify differences in these distributions.ResultsThe 259 382 patients studied across five databases in four countries showed a high degree of heterogeneity with regard to demographics, case mix, interventions and outcomes. A high level of divergence in the studied laboratory results (creatinine, haemoglobin, lactate, sodium) from the locally used reference ranges was observed, even when stratified by outcome.ConclusionStandardised reference ranges have limited relevance to ICU patients across a range of geographies. The development of context-specific reference ranges, especially as it relates to clinical outcomes like LOS and mortality, may be more useful to clinicians.

scholarly journals Stress gradation of medical practitioners during the pandemic (covid-19) along with ways to de-stress; a cross sectional study at tertiary care hospitals using Kessler’s 10 psychological distress scale.

2021 ◽  
Vol 28 (09) ◽  
pp. 1239-1244
Author(s):  
Umair Toqueer ◽  
Muhammad Usama Zardad ◽  
Mahwish Toqueer ◽  
Anila Riyaz ◽  
Sana Khan ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Junior Doctors ◽  
Sectional Study ◽  
Cross Sectional ◽  
Psychological Distress Scale ◽  
Tertiary Care Hospitals ◽  
Distress Scale ◽  
The Impact

Objectives: To determine stress grades of doctors working in tertiary care  hospitals by using a standard measuring tool i.e. Kessler 10 psychological distress scale along with finding out different coping methods adopted by doctors during the COVID-19 pandemic. Study Design: Cross Sectional study. Setting: Tertiary Care Hospitals of Khyber Pakhtunkhwa (KPK), Pakistan. Period: 15 March 2020 to 20 June 2020. Material & Methods: A structured questionnaire was sent online to the junior and senior doctors working during the pandemic. The data was automatically collected with the help of Google docs and then analysed using SPSS 26. Results: Of the 219 doctors who completed the questionnaire 142 were males (64.8%) and 77 were females (35.2%). Interestingly, analysis of the score revealed that 38.8% of the doctors were found likely to be well, 16.4% of the doctors were likely to have mild disease and 20.5% were likely to have a moderate disorder while 24.2% were likely to have a severe disorder. Further analysis showed that the mean of  Kessler’s score was greater for junior doctors as  compared to Consultants which was found to be statistically significant (p=0.044). Conclusion: The impact of Corona virus disease (COVID-19) on the stress levels of health workers warrants considerable attention as it was declared a pandemic. Assessing the psychological impact and ways to tackle them will not only help the health care workers during this pandemic but will be beneficial in future pandemics as well.

scholarly journals Awareness of human papilloma virus (HPV) vaccine female doctors working in tertiary care centres.

2021 ◽  
Vol 28 (04) ◽  
pp. 464-469
Author(s):  
Zahra Safdar ◽  
Faisal Ashraf ◽  
Alia Bashir
Keyword(s):  
Hpv Vaccine ◽  
Tertiary Care ◽  
Knowledge Score ◽  
Hpv Infection ◽  
Cross Sectional Study ◽  
Medical Sciences ◽  
Cross Sectional ◽  
Adequate Knowledge ◽  
Common Causes ◽  
Tertiary Care Hospitals

Objectives: The aim of the study is to assess the awareness about various aspects of HPV infection and vaccine among female doctors working in tertiary care centres. Study Design: Cross Sectional study. Setting: 3 Tertiary Care Hospitals Lahore. Period: Jan 2018 Jan 2019. Material & Methods: 478 female doctors from 03 tertiary care hospitals (Lady Atchison hospital, Lahore General Hospital and Services Institute of Medical Sciences) in Lahore who voluntarily filled 18-point self-administered questionnaire assessing their knowledge about HPV infection (8) HPV vaccine (5) and opinions about it (5). Knowledge score (range 0-8), assuming adequate knowledge > median. Factors associated with opinions were explored and analysed. Results: Most replied knowledge questions correctly 67.2%, 39.5% perceived it as frequently occurring infection. Median knowledge was 6 out of 8 questions; lack of knowledge was associated with non ob-gynae speciality or junior level. None of the participants were immunized but 46.3% were willing to get vaccinated themselves 78.1% were willing to get their daughters vaccinated. Self-perceived under exposure of HPV infection was 67.9%. Lack of feeling it as important in our social setting (28.6%), and expensiveness (19.4%) were most common causes of not counselling the patient about HPV vaccine and counselling to get vaccinated was most commonly done as it saves patients from cervical cancer (86.8%). Conclusions: Despite adequate knowledge of HPV infection and effectiveness of its vaccination, female doctors working in tertiary care hospitals of Lahore’s are not efficiently spreading awareness to the society and prescription of the vaccination is also deficient.

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