No abstract

No abstract

Adding GI to the standard treatment of DKA reduced average time of recovery from DKA, without incurring episodes of hypoglycemia and hypokalemia. This also reduced in the time of recovery from DKA, amount of required insulin and the duration of hospitalization. It seems that the non-significant difference in the time of recovery from DKA be related to the small sample size and study design. Further studies are recommended.

BACKGROUND AND OBJECTIVESIron overload is a major problem in patients with beta-thalassemia major, and it has many structural and metabolic consequences. The aim of this study was evaluation of endocrine disturbances in patients with beta-thalassemia major who were older than 10 years of age.PATIENTS AND METHODSIn this cross-sectional study, investigators collected demographic data and medical histories, as well as menstrual history in females, from the medical records of 56 patients with beta-thalassemia major. Patients were examined to determine their pubertal status and the standard deviation score for height for evaluation of short stature. For evaluation of glucose tolerance, a fasting blood glucose and oral glucose tolerance test were performed. Evidence for diabetes mellitus was based on American Diabetes Association and World Health Organization criteria. Serum levels of calcium, phosphorous, thyroid-stimulating hormone, free thyroxin, luteinizing hormone and follicular-stimulating hormone, and estradiol in girls and testosterone in boys were measured.RESULTSThe mean and standard deviation for age in the 56 patients (36 males and 20 females) was 15.62±4.44 years. Diabetes mellitus was present in 5 patients (8.9%), impaired fasting glucose was found in 16 patients (28.6%) and an impaired glucose tolerance test was found in 4 patients (7.1%). Short stature (standard deviation score <−2) was seen in 25 (70%) boys and 14 (73%) girls. Impaired puberty was found in 40 patients (71%). Hypocalcaemia and primary overt hypothyroidism were present in 23 (41%) and 9 patients (16%), respectively. Only eight patients (14.3%) had no endocrine abnormalities.CONCLUSIONDespite therapy with deferoxamine to treat iron overload, the risk of secondary endocrine dysfunction remained high. Hypogonadism was one of the most frequent endocrine complications. Impaired glucose tolerance, short stature, hypocalcemia, subclinical and overt hypothyroidism are also frequent.

Thyroid diseases may cause signs and symptoms of neuromuscular dysfunction. Hypothyroidism has been associated with the clinical features of proximal muscle weakness, mononeuropathy, and sensorimotor polyneuropathy. This study aimed at evaluating the electrophysiologic findings in patients with untreated spontaneous hypothyroidism and comparing them with a healthy control group. In a case-control cross-sectional study, 40 patients with definite diagnosis of clinical hypothyroidism and 40 healthy control subjects were evaluated by electromyography and nerve conduction studies in the specialized clinic of the Tabriz University of Medical Sciences during an 18-month period. Seven male and 33 female patients with a mean age of 39.5 ± 11.8 years were enrolled. In this group, there were 12 cases (30%) with clinical muscle weakness, with severity of approximately 4/5, 18 cases (45%) with decreased or absent deep tendon reflexes, 6 cases (15%) with neuropathy, including 4 sensory and 2 sensorimotor, of which 5 cases were mild and 1 case was moderate, 3 cases (7.5%) with myopathy, and 13 cases (32.5%) with carpal tunnel syndrome, which was mild in 7, moderate in 10, and severe in 2 hands. Patients with neuropathy were significantly older than those without neuropathy (P = 0.001). There was no significant relation between gender, duration of the disease, serum TSH level, and the presence of clinical muscle weakness with the occurrence of neuropathy or myopathy. Female gender, increasing age, duration of the disease, and the frequency of clinical weakness were, however, significantly related to the presence of carpal tunnel syndrome (P < 0.05). In conclusion, in patients with untreated primary hypothyroidism, majority had the carpal tunnel syndrome. Mild neuropathy mainly of sensory type and myopathy were uncommon and rare findings, respectively. Early treatment would hinder the progression of mentioned abnormalities and minimize their occurrence.