Hipotiroidismo subclínico y pérdida de embarazo: una revisión de la literatura / Subclinical Hypothyroidism and Pregnancy Loss: A Literature Review

Existe una alta prevalencia de hipotiroidismo subclínico (SCH) en el embarazo. Está vinculado a una importante morbilidad y mortalidad materna y fetal. Los efectos de SCH sobre el embarazo incluyen mayores riesgos de hipertensión gestacional y ruptura prematura de membranas (PROM). Sus fetos y bebés tenían más probabilidades de sufrir de bajo peso al nacer (LBW) y retraso del crecimiento intrauterino (IUGR). El riesgo de aborto espontáneo se informa alto en varios estudios para SCH no tratado. SCH se asocia directamente con una mayor presencia de anti -cuerpos anti TPO en suero materno. La detección temprana y el tratamiento de SCH han sido testigos de mejores resultados en términos de resultado del embarazo. Esta revisión se centra para establecer la relación de una mayor prevalencia de SCH en los países en desarrollo, así como su asociación con el aumento de los cuerpos anti TPO en suero materna y sacar una conclusión que puede ayudar a reducir las razones y proporcionar una solución. Este estudio concluyó que SCH es más frecuente en los países en desarrollo, ya sea debido a la deficiencia de yodo, una disminución de la conciencia sobre este problema o menos acceso a las instalaciones médicas. Por lo tanto, se sugiere que las hembras con antecedentes de partos prematuros, IUGR anteriores o abortos involuntarios deben someterse a una detección de hipotiroidismo subclínico y niveles de anticuerpos anti TPO durante sus visitas prenatales

There is a high prevalence of subclinical hypothyroidism (SCH) in pregnancy. It is linked to significant maternal and fetal morbidity and mortality. SCH's effects on pregnancy include increased risks of gestational hypertension and premature rupture of membranes (PROM). Their fetuses and infants had been more likely to suffer from low birth weight (LBW) and intrauterine growth retardation (IUGR). The risk of miscarriage is reported high in various studies for untreated SCH. SCH is directly associated with increased presence of anti TPO anti bodies in maternal serum. Early detection and treatment of SCH have witnessed better results in terms of pregnancy outcome. This review focuses to establish the relationship of increased prevalence of SCH in the developing countries as well as its association with increased anti TPO anti bodies in maternal serum and draw a conclusion which can help narrow down the reasons and provide solution. This study concluded that SCH is more prevalent in developing countries, either due to iodine deficiency, decreased awareness about this problem or less access to medical facilities. Therefore, it is suggested that females with history of preterm deliveries, previous IUGRs, or miscarriages should undergo screening for subclinical hypothyroidism and Anti TPO antibody levels during their antenatal visits.

UNA ENCUESTA DE CONOCIMIENTOS, ACTITUDES Y MEDIDAS PREVENTIVAS TOMADAS POR ESTUDIANTES DE MEDICINA Y ODONTOLOGÍA DURANTE LA PANDEMIA DE COVID-19 EN RIAD, ARABIA SAUDÍ / A Survey of Knowledge, Attitude, and Preventive Measures Taken by Medical and Dental Students during the COVID-19 Pandemic in Riyadh, Saudi Arabia

Objetivo: Con la enfermedad del coronavirus-2019 (COVID-19) convirtiéndose en una aflicción global, es imperativo evaluar el conocimiento, la actitud y las prácticas de los incipientes profesionales de la salud ante la pandemia. Por lo tanto, este estudio tuvo como objetivo evaluar el conocimiento y la actitud de los estudiantes de medicina y odontología frente a la infección COVID-19. Además, se analizaron las medidas preventivas ejercidas por ellos durante el brote. Método: Este estudio fue un estudio prospectivo, transversal, basado en un cuestionario. Se llevó a cabo en un período de 5 meses desde el 15 de abril de 2021 hasta el 15 de septiembre de 2021. Se difundió un cuestionario autoadministrado bien diseñado y validado a través de la plataforma Google Forms a 726 estudiantes de medicina y odontología de Riyadh, Arabia Saudita, después de obtener el consentimiento informado electrónico. Resultado: De los 726 encuestados, 490 eran mujeres y 236 hombres. Según los resultados, >50% de la población del estudio siguió al Ministerio de Salud, KSA, como su fuente de información para obtener las últimas actualizaciones sobre la infección por COVID-19, el 17,8% confió en las actualizaciones de la Organización Mundial de la Salud y el 17,1% recurrió a la red social actualizaciones Se encontró que el 92,33% de los estudiantes de medicina y odontología tenían un conocimiento adecuado de la pandemia y que el 96,55% demostró una actitud positiva hacia esto. Además, el 81,84% de los participantes adoptaron buenas prácticas con respecto a la infección. Conclusión: El presente estudio estableció que los estudiantes de medicina y odontología de Riyadh, Arabia Saudita, tienen un conocimiento adecuado sobre la pandemia. Los estudiantes también mostraron una actitud positiva hacia la situación. Sin embargo, con la disminución de la tasa de infección, las medidas prácticas se han reducido.

Objective: With coronavirus disease-2019 (COVID-19) becoming a global affliction, it is imperative to assess the knowledge, attitude, and practices of budding healthcare professionals toward the pandemic. Hence, this study aimed to evaluate the knowledge and attitude of medical and dental students toward COVID-19 infection. In addition, the preventive measures exercised by them during the outbreak were analyzed. Method: This study was a prospective, cross-sectional, questionnaire-based study. It was conducted over a period of 5 months from April 15, 2021 to September 15, 2021. A well-designed and validated self-administered questionnaire was disseminated through the Google Forms platform to 726 medical and dental students of Riyadh, Saudi Arabia, after obtaining electronic informed consent. Result: Of the 726 respondents, 490 were women and 236 were men. As per the results, >50% of the study population followed the Ministry of Health, KSA, as their source of information to obtain latest updates on COVID-19 infection, 17.8% relied on the World Health Organization updates, and 17.1% resorted to social network updates. It was found that 92.33% of the medical and dental students had adequate knowledge of the pandemic and that 96.55% demonstrated a positive attitude toward it. Furthermore, 81.84% of the participants adopted good practices with regard to the infection. Conclusion: The present study established that the medical and dental students of Riyadh, Saudi Arabia, have an adequate knowledge about the pandemic. The students also displayed a positive attitude toward the situation. However, with the decline in the infection rate, the practice measures have been reduced.

Effect of Iron Deficiency Anemia on Hba1c Levels in Controlled Plasma Glucose Levels

Anaemia is a major health issue that has a wide global impact involving approximately 1/3rd of patients with anaemia. HbA1C levels are not influenced by blood glucose levels alone. Studies suggest that conditions like IDA, haemolytic anaemia, alcohol ingestion, pregnancy, blood loss, and uraemia may alter HbA1C levels independent of glycaemic status. Methods: Totally 200 patients were included in the study.. 100 patients were controlled diabetics with iron deficiency anemia and 100 were controlled diabetics without iron deficiency anemia. Comparison of levels of HbA1c was done between the two groups. Results: Correlation between mcv and hba1c is -0.76716. Which is strongly negative correlated. P – Value for the correlation test is 0.000001. Conclusion: Iron deficiency anemia has role in elevating A1C in both the groups. Iron deficiency anemia elevates HbA1c levels in diabetic individuals with controlled plasma glucose levels. The elevation is more in patients having plasma glucose levels between 100 to 126 mg/dl. Hence, before altering the treatment regimen for diabetes, iron deficiency anemia should be treated first.

Lead Associated Nephrotoxicity: A Global Concern

Amongst toxic heavy metals, lead ranks as one of the most serious environmental poisons all over the world. An occupational and environmental exposure to lead remains a serious problem in many developing and industrializing countries, as well as in some developed countries. Lead exposure can be detrimental to every organ in the human body with kidney and brain being predominantly susceptible to its deleterious effects. An association between lead poisoning and renal diseases in humans has been recognized and documented by several studies. Excessive exposure to lead may cause acute or chronic nephrotoxic effects. Studies suggest that prolonged lead exposure may be an overlooked risk factor for chronic kidney disease. Majority of lead associated renal toxicity are a result of the previous chronic exposure, ongoing chronic exposure or current high acute exposure to lead. Both glomerular and tubular effects have been reported. Glomerular effects range from high molecular weight proteinuria to a nephritic syndrome whereas tubular changes consist of an enhanced urinary excretion of enzymes. Lead poisoning and associated nephrotoxicity is an important and preventable health problem that remains to be fully addressed. However due to lack of education regarding the dangers of working with lead or lead containing products, potential health hazards of lead poisoning still exist and are rising in India. The regulatory bodies should be more vigilant and make it mandatory to evaluate and create awareness among the workers as well as general population about the lead toxicity and should insist on regular health checkups to prevent adverse health effects.