Unveiling the spectrum: A cross-sectional exploration of hirsutism causes in women.

Background and Objective: Hirsutism is a common endocrine disorder and its etiology varies from benign and idiopathic disorders to serious malignant diseases. Hirsutism creates negative impact on quality of life and considerable effects on fertility. Our objective was to determine the various causes of hirsutism in women presenting at two endocrine clinics. Method: This cross-sectional study was conducted at Baqai Institute of Diabetology and Endocrinology, Karachi and at Jinnah hospital, Lahore from August 2020 to December 2021 women between 12-45 years of age with complains of hirsutism were included in the study. Severity of Hirsutism was evaluated using modified Ferriman-Gallwey score (FG). Patients with modified FG score of 8 or more were considered having hirsutism. Results: The study had 113 patients with a mean age of 15.50+7.29 years with 89% having moderate hirsutism (FG score 16-25). Polycystic ovaries was the most common cause of hirsutism. Common sites for hirsutism included back (83%), arms (74%), buttocks (70%), and upper abdomen (47%). High BMI (p-value <0.01) and high Dehydroepiandrosterone levels were positively associated with the severity of hirsutism (p-value of 0.006.). Conclusion: The various causes of hirsutism identified were polycystic ovaries, followed by idiopathic, thyroid dysfunction, congenital adrenal hyperplasia, and hyperprolactinemia; therefore, all women presenting with hirsutism should be evaluated for potential serious and curable etiologies, before embarking on a treatment plan.

Predictive Value of Clinical and Questionnaire Based Screening Tools of Obstructive Sleep Apnea in Patients With Type 2 Diabetes Mellitus.

Background Obstructive sleep apnea (OSA) is a major health problem for people with type 2 diabetes mellitus (DM2) and is associated with poorer glycemic control. Early detection is critical to proper management. In this study, we planned to assess and compare the diagnostic accuracy of various OSA screening tools in patients with DM2. Methods In this cross-sectional study, we consecutively recruited 58 patients with DM2, presenting to the endocrinology department of Services Hospital Lahore between February 2020 to March 2021. Along with demographic and anthropometric measurements, including BMI and neck circumference, participants answered the snoring, tiredness, observed apnea, high blood pressure - BMI, age, neck circumference, and gender (STOP-BANG) questionnaire, Berlin questionnaire, and Epworth sleepiness scale. All participants then underwent an overnight, level 3 polysomnography. Results The overall prevalence of OSA, diagnosed by overnight polysomnography, was 65.5% in type 2 diabeticDM2 patients. The STOP-BANG questionnaire had the highest sensitivity for mild, moderate, and severe OSA i.e., 84.2%, 90.3%, and 100% respectively. Berlin questionnaire also had 100% sensitivity for severe OSA and was most specific for mild and moderate OSA (70% and 63% respectively) whereas the Epworth sleepiness scale had the highest specificity of 53.3% for severe OSA. Conclusion This study shows that OSA is highly prevalent in DM2 patients in Pakistan. The STOP-BANG and Berlin questionnaire proved to be effective screening tools, especially for severe OSA. Results of our study should encourage the routine use of these questionnaires in clinical practice, to help in the early identification of OSA in diabetics.

Reduction Of St Segment Elevation In Diabetic Patients With Myocardial Infarction After Thrombolytic Therapy.

BACKGROUND: Acute coronary artery disease (CAD) is one of the main causes of death in today's world. Myocardial infarction (MI) tends to be more common among diabetic patients. One of the most effective and used (in our settings) methods of resolution of MI is administration of streptokinase (SK). This study was conducted with the aim to determine the efficacy of thrombolytic therapy in reduction of ST segment elevation in acute MI patients presenting with diabetes. METHODS: A descriptive case series with selection of 130 patients through nonprobability purposive sampling was conducted at the Medical Departments of Services Hospital Lahore. The study was completed in 6 Months. Patients 18-80 years of age having either gender diagnosed with confirmed acute myocardial infarction were included in this study. All patients were then injected with streptokinase 1.5 mu. Pre S and Post SK ECGs were done and ST segment elevation measured also measuring reduction of ST segment. RESULTS: The mean age of the patients was noted as 54.42±8.80 years. There were 62.31% males. Mean reduction in ST-segment elevation of the patients was noted as 58.53±26.01. The efficacy was achieved in 47.7% patients. CONCLUSIONS: It is concluded that SK can be effective in almost half of diabetic patients with myocardial infarction.

Comparison Of Different Formulations Of Vitamin D.

BACKGROUND: Vitamin D Deficiency (VDD) is responsible for a wide spectrum of clinical diseases and vitamin D deficiency prevalence is frightening in most parts of the world including Pakistan. Therefore, supplementations of vitamin D are used in the population at high risk for the prevention and the treatment of vitamin D deficiency. Vitamin D supplementation comes in various formulations both oral and intramuscular. Cholecalciferol is the most commonly used preparation which is given through these routes of administration. There is need to study the fact that how much vitamin D levels are raised after administration of these different formulations as this can be a pivotal factor in determining dosage and route of vitamin D3. METHODS: This cross-sectional study conducted on 320 cases and compared the efficacy of various Vitamin D3 preparations in raising Vitamin D levels conducted in Department of Endocrinology and Metabolism, Services Hospital, Lahore from February to July, 2016. Blood serum was drawn for vitamin D level in the cases at the time of presentation and after treatment. RESULTS: Three hundred & twenty patients were enrolled in study and divided into four groups (A, B, C, D). There was no significant difference between groups (A, B, C, D) in change in vitamin d levels after 3 months of treatment (p-Value 0.446). CONCLUSIONS: Different preparations of vitamin D are equally effective in raising vitamin D levels at 12 weeks. However, there is a need to conduct large scale studies to further validate these results.