Search

Introduction: COVID19* is a new disease with significant mortality risk. Because of the scarcity of the study on factors associated with the mortality in Tamil Nadu present study was done to determine the factors associated with the outcome of the COVID19 patients admitted in a tertiary care hospital, Madurai. Methodology: 4530 lab confirmed COVID19 patients admitted from March to August 31st, 2020; excluding the non-responders or who gave incomplete information were included in the study. Data retrieved from Case Investigation Forms *filled through telephonic interview. Chi -square test, Univariate and multivariate logistic regression were used to find out the association between the factors and risk of death(outcome). Results: Out of 4530 COVID19 positive patients 381(8.4%) died and 4149(91.6%) were discharged. Using multivariate logistic regression* following were the factors predicted to be associated with mortality:Age group

Introduction: Anemia is a significant public health concern, particularly among adolescents. With more than half of all adolescents living in Asia and a substantial portion in India, where adolescents make up 21% of the population, addressing anemia in this age group is vital. Objectives: 1.To estimate the validity of screening tool digital hemoglobinometer against the gold standard method- automated analyser, 2. To estimate the prevalence of anemia among the Government middle school children in Virudhunagar district using automated analyser. Method: This cross-sectional study was conducted over a three-month period from March to May 2023 and included 357 students from government schools in Virudhunagar. Cluster random sampling was employed to select representative schools, and a semi-structured questionnaire was used to collect demographic data and information on risk factors. Haemoglobin levels were measured using both the digital hemoglobinometer and the automated analyzer. Sensitivity, specificity, positive predictive value, and negative predictive value were calculated to assess the validity of the digital hemoglobinometer. Results: The study revealed that the digital hemoglobinometer had a sensitivity of 75.64% and a specificity of 76.702% when compared to the automated analyzer. While there was a statistically significant difference between the two methods, the digital hemoglobinometer demonstrated its effectiveness as a screening tool, particularly for identifying cases of moderate and severe anemia. The study suggests that in resource-limited settings, the digital hemoglobinometer could play a crucial role in early detection and intervention for anemia among school children. Conclusion: These findings underscore the potential of accessible digital hemoglobinometers in school health programs, where advanced laboratory equipment may not be readily available. The study also highlights the need for further research with larger sample sizes and diverse digital hemoglobinometer types to refine and expand the use of this technology in addressing anemia in school-aged children.

Purpose: The aim is to validate the third generation Thyrotropin receptor antibody (TRAb) assay for predicting neonatal thyroid dysfunction and adverse pregnancy outcomes in pregnant women with Graves' disease., Methods: This prospective cohort study was conducted in TRAb positive pregnant women with Graves' disease and their off springs. The primary outcome was to assess different forms of neonatal thyroid dysfunction in relation to maternal and neonatal TRAb levels. The secondary outcome was to predict adverse pregnancy outcomes by using maternal TRAb levels. Serum T3, FT4, TSH, TRAb levels were measured using electrochemiluminescence immunoassay., Results: 51 pregnant women were included. Five women had adverse pregnancy outcomes, TRAb levels of > 19.06 IU/L (10.9 times the upper limit of normal (ULN)) predicted adverse pregnancy outcomes with 100% sensitivity and 93.5% specificity. Among the 46 successful live births, 13 (28.3%) had neonatal thyroid dysfunction. Out of 13 neonates, 7 (32%) had neonatal thyrotoxicosis, 4 (18%) had primary hypothyroidism, and 2 (9%) had central hypothyroidism. Third trimester maternal TRAb levels of > 7.99 IU/L (4.6 times the ULN)and day three neonatal TRAb levels of > 5.03 IU/L (2.9 times the ULN), predicted the neonatal thyrotoxicosis with 100% sensitivity and 97.4% specificity., Conclusion: Very high maternal third generation TRAb levels strongly predicted the adverse pregnancy outcomes and neonatal thyroid dysfunction in pregnant women with Graves' disease. Neonatal thyroid function test along with the TRAb levels strongly correlated with different forms of neonatal thyroid dysfunction and is very useful in avoiding inadvertent treatment to neonates., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Objective: Insulin resistance and hyperinsulinemia plays an important role in pathogenesis of polycystic ovary syndrome (PCOS). Metformin, Myoinositol and d-chiro-inositol acts as insulin sensitizers and exerts a beneficial effects in PCOS. The objective is to compare the effect of metformin monotherapy versus a combination of metformin with Myoinositol and d-chiro-inositol in PCOS., Design: This study is a randomized controlled trial conducted over a period of 6 months. All overweight and obese women with PCOS with the age group between 18 and 35 were included and randomized into two groups, 27 in the metformin monotherapy arm and 26 in the myoinositol combination arm., Patients and Measurements: The variables assessed were duration of menstrual cycle, anthropometric parameters, modified Ferriman Gallwey score, global acne score, Fasting insulin, HOMA-IR, fasting lipid profile, serum testosterone, sex hormone binding globulin, luteinizing hormone, follicle stimulating hormone, anti-Mullerian hormone, and pelvic ultrasound to assess ovarian volume, PCOS Questionnaire score. Changes in the parameters from baseline at the end of 6 months of treatment were assessed and compared between the groups., Results: Menstrual cycle regularity improved in both groups with significantly greater improvement in the group receiving myoinositol-based therapy (p < .001). Pregnancy rate was equal in both the arms. There was a significant improvement in PCOSQ score in myoinositol-based therapy group (p < .001). However, there was no statistically significant difference in other hormonal, metabolic parameters between two groups in spite of symptomatic benefits., Conclusions: The addition of myoinositol to metformin exerts additional benefits in improving menstrual cycle regularity, and quality of life in women with PCOS., (© 2023 John Wiley & Sons Ltd.)

Aims and Objectives: Clinical, biochemical, and radiological profiles of Addison's disease and to assess the various etiological spectrum of primary adrenal insufficiency (PAI) in adults., Materials and Methods: A retrospective cohort study was carried out in the Department of Endocrinology, Madurai Medical College, Madurai between January 2014 and January 2021 over a 7-year period., Inclusion Criteria: All the patients with clinical symptoms and or signs of suspected PAI, such as hyperpigmentation, weight loss, persistent nausea or vomiting, fatigue, and hypotension, were recruited. All suspected cases underwent measurement of 8-AM plasma ACTH and cortisol levels. In possible cases and equivocal cortisol levels, patients underwent Co-syntropin/ACTH stimulation test. To know the underlying etiology of PAI, 21-hydroxylase autoantibodies (21OHAb), thyroid function test, Anti TPO, calcium, parathyroid hormone (PTH), LH and FSH, CT of chest and abdomen, and sputum AFB based on the clinical pattern of involvement were performed., Exclusion Criteria: Patients with onset of PAI at infancy and childhood, secondary adrenal insufficiency or exogenous Cushing's syndrome, and central hypocortisolism, including Sheehan's syndrome, were excluded., Results: Thirty-six patients were diagnosed with PAI in this study; 19 (53%) were females and 17 were males (47%). The median age of diagnosis was 35 years. Patients were divided into acute presentation and subacute presentation. Twenty-six patients presented with acute presentation and ten were presented with progressive evolved symptoms. Non-tuberculous etiology was the predominant finding noted in our cohort study (87%, 31 out of 36 patients). The other causes of Addison disease included isolated auto-immune PAI, polyglandular autoimmune syndrome type 1 and II, APLA Syndrome, and adrenal metastasis., Conclusion: Non-tuberculous causes of PAI are the leading etiology in our retrospective study. Autoimmune PAI and Polyglandular autoimmune syndromes are increasingly being recognized as the cause of Addison's disease. PAI individuals require lifelong surveillance for possible development of coexisting autoimmune syndromes and need for glucocorticoid/mineralocorticoid therapy., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Indian Journal of Endocrinology and Metabolism.)

Prader-Willi syndrome is a genomic imprinting disorder, characterized by obesity, hyperphagia, mental retardation, short stature and hypogonadism. The presenting signs and symptoms depend upon the age at which the patient is seen. Here we report a case of Prader-Willi syndrome, who presented at 16 years of age with diabetes mellitus and cryptorchidism., (© Journal of the Association of Physicians of India 2011.)