Objectives: To determine the frequency of endocrine disorders in Beta-Thalassemia Major (BTM) patients presenting for Endocrine Evaluation to the Department of Diabetes, Endocrinology and Metabolic Diseases, Hayatabad Medical Complex, Peshawar, Pakistan, a tertiary care hospital. Method: This descriptive study was conducted in the Department of Diabetes, Endocrinology and Metabolic Diseases, Hayatabad Medical Complex, Peshawar from October 2019 to August 2021. All patients with BTM presenting for endocrine evaluation were included in the study. Height and weight were assessed and plotted on the standard charts. For secondary sexual characteristics tanner staging was used. Blood samples for hormonal profile were taken according to standard protocol and sent for endocrine assessment. Results: A Total of 135 patients BTM were enrolled in the study comprising of 70 (51.9%) males and 65 (48.1%) females. Their mean age was 14.8±3.9 years, mean height 138.5±13.01 cm, mean weight 35.9±8.4 kg, mean BMI 18.6±2.8 kg/m2, mean age of transfusion started was 6.7±3.99 months, mean duration of transfusion 13.6±4.03 years and mean duration of chelation therapy received 6.1±4.5 years. Regarding endocrine complications, out of 135 patients assessed, one hundred (74.1%) had height less than 5th centile and fifteen (11.1%) had diabetes mellitus. For thyroid and parathyroid function, 58 and 13 were tested respectively, out of which 16 (27.6%) and 6 (46.2%) had thyroid dysfunction and hypoparathyroidism. Out of 91 patients assessed for pubertal delay, 61 (67.03%) had delayed puberty. Conclusions: High percentage of endocrine complications were found in patients with BTM. Severity and multiplicity of endocrine organs involvement was dependent on duration of the disease and lack of compliance with chelation therapy. doi: https://doi.org/10.12669/pjms.39.3.6837 How to cite this: Malik SE, Kanwal S, Javed J, Hidayat W, Ghaffar T, Aamir AH. Endocrine disorders in Beta-Thalassemia major patients at a Tertiary Care Hospital. Pak J Med Sci. 2023;39(3):726-731. doi: https://doi.org/10.12669/pjms.39.3.6837 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.

INTRODUCTION:  Hirsutism is a common condition affecting around 5-10% of female in the childbearing age. During menopausal evolution phase some terminal hair growth can occur in few females as part of normal aging process. However in a postmenopausal female, the presence of rapidly progressive hirsutism and other features of virilization require proper assessment for a sinister cause. CASE DESCRIPTION: A 61 years old lady presented with progressive hirsutism, deepening of voice and scalp baldness. She was postmenopausal for 20 years and hirsutism started about five years ago, initially involving face and then spread to rest of body including chest, abdomen and inner thighs. Her Body-Mass-Index was 27.5 kg/m2. She had hirsutism with a Ferriman-Gallwey score of 16/36 and signs of virilization in the form of deepening of voice, clitorimegaly, complete scalp baldness and masculinization. Relevant workup showed raised testosterone with normal values of Luteinizing hormone, Follicle Stimulating hormone, Prolactin, 17-OH-progesterone and Dehydroepiandrosterone-Sulfate (DHEA-SO4). Computed-tomography imaging of pelvis confirmed enlarged right ovary with dense stroma. Histopathology confirmed a rare ovarian tumour, Sclerosal stromal tumor (SST). Resection of mass resulted in normalization of testosterone levels and improvement in virilization features. CONCLUSION: Hirsutism and virilization in postmenopausal females must be assessed for rare but sinister causes like androgen producing adrenal and/or ovarian tumors. SSTs are rare tumors and usually present in the 2nd and 3rd decades of life but in our case it occur in the postmenopausal age. They are usually hormonally inactive but sometimes can secret androgens as in our patient.

OBJECTIVE: To determine the frequency of hyperuricemia in type 2 diabetes mellitus (T2DM) patients with BMI >23 kg/m2 MATERIALS AND METHODS: This descriptive study was conducted from February 2020 to September 2021. All patients with Type 2 Diabetes Mellitus (T2DM )with body mass index (BMI) >23 kg/m2 were assessed for hyperuricemia through Roche Cobas 6000 series C501 in MTI Hayatabad Medical Complex’s laboratory.      RESULTS: Total number of patients was 300, out of which 60 % were males. The studied population has a mean age of 59 (SD =±7) years, mean systolic blood pressure was 151 (SD = ±17) mmHg, mean duration of T2DM was 13 (SD = ±4) years, mean HbA1c was 10.9 (SD = ±2.5) %, mean BMI was 28.8 (SD = ±3.1) kg/m2 and mean serum uric acid was 5.7 (SD=±1.3) mg/dl. The overall prevalence of Hyperuricemia was 47% (36.7 % males and 62.5% females). Of those with hyperuricemia, 73 % were also found to have hypertension. Results showed that patients with hyperuricemia belonged to older age, and have higher Systolic blood pressure, raised BMI, and HbA1c. The mean differences were considered statistically significant with a p-value < 0.05 by using an independent sample t-test. CONCLUSION: The current study demonstrated a higher prevalence of hyperuricemia in T2DM patients with BMI> 23 kg/m2. Patients with hyperuricemia had a higher mean HbA1c, higher mean BMI, and raised systolic component of blood pressure. KEY WORDS: BMI, Hyperuricemia, Hypertension, Type 2 diabetes mellitus, HbA1c