Spectrum of adrenal disorders in a referral hospital of Bangladesh

2021 ◽  
Vol 11 (2) ◽  
pp. 103-107
Author(s):  
Kazi Nazmul Hossain ◽  
SM Ashrafuzzaman ◽  
Md Faruque Pathan ◽  
Md Feroz Amin ◽  
Sultana Marufa Shefin ◽  
...  
Keyword(s):  
Adrenal Insufficiency ◽  
Cushing’S Syndrome ◽  
Tertiary Care ◽  
Gastrointestinal Symptoms ◽  
Adrenal Incidentaloma ◽  
Cushing's Syndrome ◽  
Care Hospital ◽  
Conn’S Syndrome ◽  
Endocrine Hypertension ◽  
Study Population

Background: Adrenal diseases are common and their presentations are variable. This study aimed to determine the frequency and presenting features of various adrenal diseases in a tertiary care hospital of Bangladesh. Methods: This retrospective descriptive study was carried out in Endocrinology in-patient department of BIRDEM General Hospital, Dhaka, Bangladesh, from October 2017 to December 2018. During this time, total 745 patients were screened; out of whom 91 had adrenal diseases. Results: Mean age of the study population was 39.6±11.5 years. Among them, 65.9% were male. Most (75.8%) cases had adrenal insufficiency, followed by endogenous Cushing’s syndrome (8.8%), Conn’s syndrome (6.6%), non-functioning adenoma (3.3%), congenital adrenal hyperplasia (CAH) (2.2%), pheochromocytoma (1%), myelolipoma (1%) and adrenal carcinoma (1%). According to functional status, most (75.8%) were hypofunctional. Of the patients with adrenal insufficiency, secondary adrenal insufficiency was the most common (78.3%). Among the secondary adrenal insufficiencies, 75.9% had iatrogenic adrenal insufficiency and 24.1% had pituitary diseases. Regarding the cases of primary adrenal insufficiency, 20% cases were due to adrenal tuberculosis, 6.6% were due to adrenal histoplasmosis and 73.3% were idiopathic. Most of the adrenal insufficiency patients presented with hypotension (66.7%), followed by gastrointestinal symptoms (76.8%), weight loss (55.1%), hyponatraemia (42%), pigmentation (13%) and hypoglycemia (10%). In this study, 9.9% patients had adrenal incidentaloma. Most of them (88.9%) were benign. Causes of Cushing’s syndrome among the study population were, iatrogenic (66.7%), adrenal (16.7%) and pituitary cause (16.7%). In this study, 16.5% patients had endocrine hypertension and the causes were endogenous Cushing’s syndrome (53.3%), Conn’s syndrome (40%) and pheochromocytoma (6.7%). Of the hypertensive patients, 60% had co-existing hypokalemia. Conclusion: Adrenal insufficiency was the most common adrenal disorder followed by endogenous Cushing’s syndrome, Conn’s syndrome, non-functioning adenoma and other adrenal disorders. Presentations of adrenal disorders are variable. Among the cause of adrenal insufficiency iatrogenic adrenal insufficiency was the most common. Birdem Med J 2021; 11(2): 103-107

scholarly journals Performance of salivary cortisol in the diagnosis of Cushing's syndrome, adrenal incidentaloma, and adrenal insufficiency

2013 ◽  
Vol 169 (1) ◽  
pp. 31-36 ◽  
Author(s):  
Filippo Ceccato ◽  
Mattia Barbot ◽  
Marialuisa Zilio ◽  
Sergio Ferasin ◽  
Gianluca Occhi ◽  
...  
Keyword(s):  
Adrenal Insufficiency ◽  
Hpa Axis ◽  
Cushing’S Syndrome ◽  
Salivary Cortisol ◽  
Healthy Subjects ◽  
Adrenal Incidentaloma ◽  
High Sensitivity ◽  
Cushing's Syndrome ◽  
Late Night ◽  
Late Night Salivary Cortisol

ObjectiveSalivary cortisol has recently been suggested for studies on the hypothalamic–pituitary–adrenal (HPA) axis. The lack of circadian rhythm is a marker of Cushing's syndrome (CS), and some authors have reported that low salivary cortisol levels may be a marker of adrenal insufficiency. The aim of our study was to define the role of salivary cortisol in specific diagnostic settings of HPA axis disease.Subjects and methodsWe analyzed morning salivary cortisol (MSC) and late-night salivary cortisol (LNSC) levels in 406 subjects: 52 patients with Cushing's disease (CD), 13 with ectopic CS, 17 with adrenal CS, 27 with CD in remission (a mean follow-up of 66±39 months), 45 with adrenal incidentaloma, 73 assessed as having CS and then ruled out for endogenous hypercortisolism, 75 with adrenal insufficiency, and 104 healthy subjects.ResultsA LNSC value above 5.24 ng/ml differentiated CS patients from controls with high sensitivity (96.3%) and specificity (97.1%); we found higher LNSC levels in ectopic CS patients than in CD patients. We found no difference in MSC and LNSC levels between patients with CD in remission and healthy subjects. Both MSC and LNSC levels were higher in patients with adrenal incidentaloma than in healthy controls. A MSC value below 2.65 ng/ml distinguished patients with adrenal insufficiency from controls with high sensitivity (97.1%) and specificity (93.3%).ConclusionsSalivary cortisol is a useful tool to assess endogenous cortisol excess or adrenal insufficiency and to evaluate stable CD in remission.

Subclinical Cushing's syndrome in adrenal incidentaloma

1998 ◽  
Vol 48 (1) ◽  
pp. 89-97 ◽  
Author(s):  
Terzolo ◽  
Osella ◽  
Alì ◽  
Borretta ◽  
Cesario ◽  
...  
Keyword(s):  
Cushing’S Syndrome ◽  
Adrenal Incidentaloma ◽  
Cushing's Syndrome ◽  
Subclinical Cushing’S Syndrome

scholarly journals Adverse Drug Reaction Policy in a Tertiary Care Hospital

2015 ◽  
Vol 3 (1) ◽  
pp. 41-47
Author(s):  
V Aggarwal ◽  
Shakti Kumar Gupta ◽  
DK Sharma ◽  
S Arya ◽  
S Singh
Keyword(s):  
Adverse Drug Reaction ◽  
Drug Reaction ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Healthcare Providers ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Cross Sectional ◽  
Study Population ◽  
Personnel Paramédical

ABSTRACT Adverse drug reactions (ADRs) are a significant cause of morbidity and mortality and contribute to the incidence of adverse events, resulting in increased healthcare costs. Healthcare providers need to understand their role and responsibility in the detection, management, documentation, and reporting of ADRs. The purpose of this study is to provide guidelines regarding the procedure of reporting ADRs to hospital authority. It was a descriptive cross-sectional study carried out between April and August 2013. The study population included doctors, nursing personnel, paramedical staff and quality managers of tertiary care hospital from one public and two private hospitals. Interaction was done with study population against the back drop of the checklist and ADR policy was formulated. How to cite this article Singh S, Gupta SK, Arya S, Sharma DK, Aggarwal V. Adverse Drug Reaction Policy in a Tertiary Care Hospital. Int J Res Foundation Hosp Healthc Adm 2015; 3(1):41-47.

scholarly journals Steroid-induced Rosacea- A Study From a Tertiary Care Hospital of Eastern Nepal

2021 ◽  
Vol 19 (1) ◽  
pp. 25-29
Author(s):  
Manoj Chaudhary ◽  
Sudha Agrawal
Keyword(s):  
Tertiary Care ◽  
Age Groups ◽  
Case Series ◽  
Sun Exposure ◽  
Care Hospital ◽  
Facial Erythema ◽  
Case Series Study ◽  
The Face ◽  
Triggering Factor ◽  
Study Population

Introduction: Topical corticosteroids (TC) are useful for treatment of various dermatological conditions in all age groups. Due to its cosmetic application TCs misuse is intertwined with fairness creams in our colour conscious society where people are obsessed with fair colour.   Aims and Objectives: To find the clinical presentations of steroid induced rosacea like-dermatitis on the face and to evaluate the purpose behind misusing TCs on the face.   Materials and methods: Descriptive prospective questionnaire-type case series study was approved by Institutional Ethical Committee of BPKIHS which involved 205 patients diagnosed as Steroid Induced Rosacea who consulted Dermatology OPD between March to June 2017.   Results: Among 205 patients enrolled, majority were from second to fourth decade (87.31%) of their life and maximum being females I.e. 91.2%. Around 97% of the study population were unaware of side effects of TCs. Most patients use Mometasone fuorate (58.04%) for melisma (88.29%). Friends acted as source of prescription (29.75%), followed by Pharmacist (24.88%) & Beauty centers (20%). Dermatologists prescribed TCs in only 6.34% cases. Sun exposure was identified as the triggering factor for steroid induced rosacea in 73.17% patients. Cheek was the commonest site involve in 92.19%, followed by forehead (65.36%), perioral area (46.83%), and chin (9.75%). Mixed type of lesions was the commonest lesion found in 52.20% patients, followed by diffuse facial erythema (36.09%), & telangiectasia (33.17%).   Conclusion: TCs misuse in the younger people for the sake of fairer skin with little or no knowledge about the adverse effects of this medication should be stopped.

scholarly journals Frequency of familial short stature identified in children presenting with short stature at a Tertiary Care Hospital in Multan, Pakistan.

2021 ◽  
Vol 28 (7) ◽  
pp. 993-996
Author(s):  
Waqas Imran Khan ◽  
◽  
Asia Noreen ◽  
Summera Tabasum ◽  
◽  
...  
Keyword(s):  
Short Stature ◽  
Tertiary Care ◽  
Female Gender ◽  
P Value ◽  
Care Hospital ◽  
Pediatric Endocrinology ◽  
Multicenter Studies ◽  
Study Population ◽  
Age Range ◽  
Study Setting

Objectives: The objective of my study was to determine the frequency of familial short height in children aged 3 to 14 years with short height. Study Design: Descriptive study. Setting: Department of Pediatric Endocrinology at The Children Hospital & Institute of Child health Multan (CH& ICH). Period: 1st November 2018 to 31st October 2019. Material & Methods: Eighty four patients were enrolled after taking informed consent from parents/guardians. Heights of all patients, parental heights, mid parental heights were plotted on CDC growth charts. Patients having familial short stature were noted down. Results: Out of 84 patients, 59 (70.2%) were males and 25 (29.85%) were females. Age range was 3-14 years. Mean age of the population was 8.68 ± 3.42 years and mean height and weight were 114.29 ± 24.62cm and 28.95±10.01 kg, respectively. Mean height for mother and father of the patients were 154.39 ±4.56cm and 171.10 ± 3.52cm, respectively. Out of 84 children, 21 (25%) patients had FSS. In our study population FSS was more seen in children < 8 years of age, female gender and families with income of > 20K/months with p value of 0.879, 0.129 and 0.592 respectively. Conclusion: Majority of children presenting with short stature have FSS and CDG and do not have an endocrine disorder. In our study, frequency of familial short stature in children aged 3 to 14 years was 25%. The results should be validated in multicenter studies.

scholarly journals A PROSPECTIVE OBSERVATIONAL STUDY OF CLINICAL PROFILE IN ETIOLOGY OF ANEMIA IN ELDERLY-A HOSPITAL BASED STUDY IN A TERTIARY CARE CENTRE IN SOUTH INDIA

2021 ◽  
Vol 9 (09) ◽  
pp. 961-972
Author(s):  
K. Shivaraju ◽  
◽  
Karanam Sai Arun ◽  
Mandhala Saikrishna ◽  
◽  
...  
Keyword(s):  
Tertiary Care ◽  
The Elderly ◽  
Moderate Degree ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Total Study Population ◽  
Study Population ◽  
Poor Outcomes ◽  
One Year ◽  
Severe Degree

Background: Anemia is often considered as a normal physiological process that occurs with aging. but recently since past 2 decades anemia of any degree is being recognized as significant independent contributor to morbidity mortality and frailty in elderly patients. It is easy to overlook anemia in elderly as symptoms of anemia like fatigue, SOB etc are often attributed to aging process itself. many evidences accumulated states that anemia of any degree reflects poor health and increased vulnerability to poor outcomes. Materials and methods: This study was conducted in the department of internal medicine in a tertiary care hospital over a period of one year with sample size of 362 subjects satisfying the inclusion and exclusion criteria after taking the consent form. Results: Moderate degree anaemia was the commonest around, 65.6% followed by severe degree anemia 20.1%. Easy fatigability was the commonest symptom and pallor was the commonest sign of anaemia in elderly. Anemia is not always a consequence of aging. Anemia of unexplained etiology constituted 15.97% of total study population. Conclusion: Anaemia in elderly is a challenge and has to be approached in an organized manner for appropriate diagnosis and evaluation to look into its cause and plan management to improve the quality of life of the elderly persons.An effort should always be made to reach etiological diagnosis before instituting specific therapy.

scholarly journals Pattern of upper gastrointestinal diseases: an audit of 1000 cases based on endoscopic findings from a tertiary care hospital in Mysore

2018 ◽  
Vol 5 (7) ◽  
pp. 2412
Author(s):  
Shashikumar H. B. ◽  
Madhu B. S. ◽  
Motati Harshini
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Gastrointestinal Symptoms ◽  
Gastrointestinal Diseases ◽  
Cross Sectional Study ◽  
Common Finding ◽  
Care Hospital ◽  
Cross Sectional ◽  
Endoscopic Findings ◽  
Upper Gastrointestinal

Background: Fibreoptic endoscopy is a highly efficient diagnostic tool, which is now increasingly being used in the diagnosis of upper gastrointestinal diseases. This study has been carried out to evaluate the distribution of various upper gastrointestinal diseases based on endoscopic findings in a tertiary care hospital in Mysore.Methods: A cross-sectional study was conducted based on data from endoscopic register of 1000 subjects who underwent endoscopy for various upper gastrointestinal symptoms from 1st January 2017 to 31st December 2017(one year).Results: Mean age of the study population was 50.23 years (SD-15.46). Minimum age was 12 years and maximum was 88 years. About 44.7% of the study subjects belonged to 40-60 age group.61.6% of the study subjects were males. Most common indication was pain abdomen (32.1%) followed by dysphagia (22.2%). Of the 1000 study subjects 18.6% had normal findings. Most common finding was Gastritis / Duodenitis /Gastric erosions (28%). Malignant lesions were noted among 11.1%, of which esophagus and stomach are 5.4% and 4.9% respectively.Conclusions: Endoscopic diagnosis is useful for early detection of UGI diseases and helpful for their management.

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