Technetium uptake predicts remission and relapse in Grave's disease patients on antithyroid drugs for at least 1 year in South Indian subjects.

CONTEXT: Most of the information on remission related factors in Grave's disease are derived from Western literature. It is likely that there may be additional prognostic factors and differences in the postdrug treatment course of Grave's disease in India. AIM: To study factors which predict remission/relapse in Grave's disease patients from South India. Also to establish if technetium (Tc) uptake has a role in predicting remission. SUBJECTS AND METHODS: Records of 174 patients with clinical, biochemical, and scintigraphic criteria consistent with Grave's disease, seen in our Institution between January 2006 and 2014 were analyzed. Patient factors, drug-related factors, Tc-99m uptake and other clinical factors were compared between the remission and nonremission groups. STATISTICAL ANALYSIS USED: Mann-Whitney U-test and Chi-square tests were used when appropriate to compare the groups. RESULTS: Fifty-seven (32.7%) patients attained remission after at least 1 year of thionamide therapy. Of these, 11 (19.2%) patients relapsed within 1 year. Age, gender, goiter, and presence of extrathyroidal manifestations were not associated with remission. Higher values of Tc uptake were positively associated with remission (P- 0.02). Time to achievement of normal thyroid function and composite dose: Time scores were significantly associated with remission (P - 0.05 and P - 0.01, respectively). Patients with lower FT4 at presentation had a higher chance of remission (P - 0.01). The relapse rates were lower than previously reported in the literature. A higher Tc uptake was found to be significantly associated with relapse also (P - 0.009). CONCLUSION: The prognostic factors associated with remission in Graves's disease in this South Indian study are not the same as that reported in Western literature. Tc scintigraphy may have an additional role in identifying people who are likely to undergo remission and thus predict the outcome of Grave's disease.

Hemostatic variables in Arab diabetics.

Blood coagulation studies showed that patients with non-insulin-dependent diabetes mellitus (NIDDM) had significantly higher fibrinogen, FVIII:C, ristocetin co-factor, FV, FIX, lower ATIII, and PCV than those with insulin-dependent diabetes mellitus (IDDM). Diabetics with IDDM had a significantly higher ATIII, ristocetin co-factor, lower plasminogen and alpa-2-antiplasmin, and more enhanced platelet aggregation responses to ristocetin than age-matched controls. Patients with NIDDM as compared with controls, exhibited higher levels of fibrinogen, ristocetin co-factor, FVIII:C, FIX, and platelet count, but lower plasminogen, alpha-2-antiplasmin and PCV, reduced platelet aggragability to collage, ADP, and ristocetin. Diabetics with retinopathy and nephropathy had still higher levels of fibrinogen, FVIII:C, ATIII and ristocetin co-factor than those without complications. These results are in accord with many similar studies in Caucasians. It is concluded that the pattern of the changes in hemostatic variables noted in Saudi diabetic do not confirm the existence of racial and/or geographical variations in the hemostatic changes associated with diabetes mellitus.