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Ghani MH, Morshed MS, Haq T, Selim S, Khan MA, Mustari M, Rajib MH, Yadav A, Faisal I, Shah AK, Hossain MF, Hasanat MA, Fariduddin M. Vitamin D supplementation on prediabetic adults with vitamin D deficiency: a double-blind placebo-controlled randomized clinical trial. Bangabandhu Sheikh Mujib Medical Univ J 2023. [DOI: 10.3329/bsmmuj.v15i3.62956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Hypovitaminosis D (<20 ng/mL) is thought to increase insulin resistance and meta-inflammation contributing to the pathogenesis of diabetes mellitus (DM). Correcting vitamin D deficiency in people with prediabetes might halt its progression to DM. The aim of this study was to examine the effect of vitamin D supplementation on insulin resistance, glycemic status, and inflammation in prediabetic adults with vitamin D deficiency. This doubleblind randomized placebo-controlled trial was done among 27 newly detected prediabetic adults with hypovitaminosis D randomly assigned to 60,000 IU of vitamin D weekly for eight weeks followed by monthly for the next four months or placebo along with lifestyle modification in both groups [vitamin D (n= 14) vs. Placebo (n=13). They were comparable in terms of sex, age and borlymass index. Glycemic status, fasting plasma glucose (FPG) and Hemoglobin A1C (HbA1C), insulin resistance (homeostasis model assessment of insulin resistance (HOMA-IR) and inflammatory marker high sensitivity C reactive protein (hs-CRP) were measured at baseline and after six months of intervention. Vitamin D levels (ng/mL) increased in both groups from baseline (vitamin D vs. placebo: 12.2±5.9 vs. 3.9±3.5, mean±SD). FPG (mmol/L) significantly decreased in the Vitamin D group (before vs. after: 5.9±0.6 vs. 5.5±0.7, P=0.016, mean±SD), whereas HbA1C (%) and hs- CRP (mg/L) significantly increased in the placebo group (before vs. after- HbA1C: 5.8±0.3 vs. 6.0±0.4, P<0.001; hs-CRP: 5.0±4.4 vs. 5.6±4.9, P=0.039, mean±SD). Percent changes in glycemic status, HOMA-IR, and hs-CRP were statistically similar between the groups. Our study failed to demonstrate the positive effects of vitamin D supplementation on reducing glucose, insulin resistance, or inflammatory marker in prediabetic adult patients with hypovitaminosis D.
BSMMU J 2022; 15(3): 167-174
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Sultana N, Rijal A, Banu H, Jahan S, Fariduddin M, Dey BP, Hasanat MA. Localization and management of mediastinal parathyroid adenoma – a case report. IMC Journal of Medical Science 2022. [DOI: 10.55010/imcjms.16.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Ectopic parathyroid adenoma sometimes poses diagnostic challenge and can be a cause of persistent and recurrent primary hyperparathyroidism. Anterior mediastinum is one of the locations for ectopic parathyroid adenoma. Surgical excision is the only cure and for successful surgery, pre-operative localization is crucial. Chance of failed surgery is being increased without prior localization of the ectopic gland. The combination of single photon emission computed tomography (SPECT) and computed tomography (CT) has got high sensitivity for accurate localization of ectopic parathyroid. On the other hand, with accurate localization surgical outcome is excellent. Here we report, successful localization and management of a case of primary hyperparathyroidism due to adenoma in anterior mediastinum in 47-year-old man.
IMC J Med Sci 2022; 16(2): 003. DOI: https://doi.org/10.55010/imcjms.16.013
*Correspondence: Dr. Nusrat Sultana, Room no-1620, Block-D, 15th floor, Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. Email: nusrat_sultana@bsmmu.edu.bd
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Affiliation(s)
- Nusrat Sultana
- Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Amrit Rijal
- Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University
| | - Hurjahan Banu
- Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University
| | - Sharmin Jahan
- Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University
| | - M Fariduddin
- Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University
| | - Bishnu Pada Dey
- Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University
| | - MA Hasanat
- Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University
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Hannan MA, Kamrul-Hasan AB, Karim MN, Selim S, Stocker MR, Diug B, Ilic D, Mustari M, Haq T, Fariduddin M. Hypothyroidism in Bangladesh: Is Autoimmunity the Next Big Threat? Mymensingh Med J 2022; 31:449-457. [PMID: 35383766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
In many low and middle-income countries, iodine-deficient hypothyroidism leads to complex public health consequences. However, increasing evidence from population-based studies has linked thyroid autoimmunity with excess iodine intake. The iodine supplementation program in Bangladesh was a success story. This cross-sectional study aims to assess the pattern and predictors of autoimmunity among Bangladeshi hypothyroid patients. In this study, 154 consecutive, newly detected, biochemically-confirmed patients with primary hypothyroidism were recruited from the Endocrinology outpatient department of Bangabandhu Sheikh Mujib Medical University and tested for anti-thyroid peroxidase and anti-thyroglobulin antibody levels from October 2015 and November 2016. Patterns of thyroid autoimmunity were assessed via descriptive statistics. Predictors of autoimmunity were assessed with multivariable mixed-effect logistic regression. The mean age of participants was 36.1±11.0 years, and 70.1% were female. The frequency of thyroid autoimmunity in the study subjects was very high, 89.0% were positive for either anti-TPO or anti-Tg antibodies and 48.7% were positive for both. More participants were positive for anti-TPO antibodies (82.5%) than anti-Tg antibodies (55.2%). The risk of autoimmunity was associated with the thyroid's structural abnormalities but not with functional status. Weight gain and hypertension were associated with autoimmunity, whereas diabetes was protective against autoimmunity.
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Affiliation(s)
- M A Hannan
- Dr Mohammad Abdul Hannan, Associate Professor, Department of Endocrinology, North East Medical College, Sylhet, Bangladesh; E-mail:
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Khan MA, Fariduddin M, Selim S, Alam MM, Morshed MS, Ghani MH. Association of vitamin D and insulin resistance among the adults with newly detected prediabetes attending in a tertiary care hospital of Bangladesh. Bangabandhu Sheikh Mujib Medical Univ J 2022. [DOI: 10.3329/bsmmuj.v14i4.56617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Several studies have found an inverse association between vitamin D level and insulin resistance (IR) causing prediabetes and diabetes. So the current study was done to find out the association between serum vitamin D level and IR among adults with prediabetes. This cross-sectional study was carried out in 140 newly detected adults with prediabetes according to ADA 2018 criteria. The 25(OH) D cutoffs to define deficiency and insufficiency were used according to Endocrine Society (USA) criteria, measurement of vitamin D & insulin (fasting) was done by chemiluminescent microparticle immunoassay (CMIA). Data were analyzed using SPSS (version 22.0) and presented as table and figure. P-value ≤0.05 was considered significant. In this study, most of the population was 30 years and above (73%). The Male-female ratio was 1:7, the majority of participants came from urban areas (81%) and it was observed that there was an increasing trend of insulin resistance across increasing severity of vitamin D deficiency though it was not statistically significant (p= 0.74). In conclusion, vitamin-D deficiency/insuffi- ciency is common among individuals with prediabetes in our country, but there were no associ- ation had been found between vitamin D and insulin resistance in individuals with prediabetes
BSMMU J 2021; 14(4): 157-162
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Hassanein M, Al Sifri S, Shaikh S, Raza SA, Akram J, Rudijanto A, Shaltout I, Fariduddin M, Mohamed WMIBW, Al Awadi F, Durocher A, Cortese V, Alessa T. Descriptive Regional Subanalysis of a Real-World Study in Patients with Type 2 Diabetes Treated with Gliclazide MR During Fasting: DIA-RAMADAN. Diabetes Ther 2021; 12:1703-1719. [PMID: 33974216 PMCID: PMC8179867 DOI: 10.1007/s13300-021-01067-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 04/21/2021] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION To analyse the safety and effectiveness of gliclazide modified release (MR) in adults with type 2 diabetes mellitus participating in Ramadan from three geographically and culturally different regions of the world included in the DIA-RAMADAN study. METHODS DIA-RAMADAN was a real-world, observational, international, non-comparative study. The global study population was divided into three regional subgroups, with data gathered at inclusion 6-8 weeks prior to Ramadan (V0), during Ramadan (4.5 weeks) and 4-6 weeks after Ramadan (V1). Primary endpoint was the proportion of patients reporting ≥ 1 symptomatic hypoglycaemic events (HE), which were collected using a patient diary along with other adverse events. RESULTS Patient numbers from the three regions were n = 564 (46.5%; Indian sub-continent), n = 354 (29.1%; Middle East) and n = 296 (24.4%; South-East Asia). Patient baseline characteristics, demographics, fasting habits and antidiabetic treatments varied between regions. There were similar proportions of symptomatic HE between regions, with no severe HE. Significant weight reductions were observed in all regions following Ramadan, along with reductions in HbA1c and fasting plasma glucose. CONCLUSION These real-world study data indicate that gliclazide MR is safe and effective for management of type 2 diabetes during Ramadan in all three regions studied as part of DIA-RAMADAN. TRIAL REGISTRATION Clinicaltrials.gov identifier NCT04132934. INFOGRAPHIC.
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Affiliation(s)
- Mohamed Hassanein
- Department of Endocrinology, Dubai Hospital, Dubai, United Arab Emirates
| | | | - Shehla Shaikh
- Department of Endocrinology, Saifee Hospital, Mumbai, Maharashtra, India
| | - Syed Abbas Raza
- Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, Pakistan
| | - Javed Akram
- University of Health Sciences, Lahore, Pakistan
| | - Achmad Rudijanto
- Department of Internal Medicine, Faculty of Medicine, Brawijaya University/Dr., Saiful Anwar Hospital, Malang, Indonesia
| | - Inass Shaltout
- Department of Internal Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Md Fariduddin
- Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Wan Mohd Izani Bin Wan Mohamed
- Department of Medicine, Hospital Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
- School of Medical Sciences, Universiti Sains Malaysia (USM) Health Campus, Kubang Kerian, Kelantan, Malaysia
| | - Fatheya Al Awadi
- Department of Endocrinology, Dubai Hospital, Dubai, United Arab Emirates
| | - Alexandra Durocher
- Servier Global Medical and Patient Affairs-Diabetes, 35 rue de Verdun, 92284, Suresnes Cedex, France.
| | - Viviana Cortese
- Servier Global Medical and Patient Affairs-Diabetes, 35 rue de Verdun, 92284, Suresnes Cedex, France
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Pathan F, Selim S, Fariduddin M, Rahman MH, Ashrafuzzaman SM, Afsana F, Qureshi NK, Hossain T, Saifuddin M, Kamrul-Hasan AB, Mir AS. Bangladesh Endocrine Society (BES) Position Statement for Management of Diabetes and Other Endocrine Diseases in Patients with COVID-19. Diabetes Metab Syndr Obes 2021; 14:2217-2228. [PMID: 34040407 PMCID: PMC8140905 DOI: 10.2147/dmso.s293688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 03/26/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The year 2020 witnessed a largely unprecedented pandemic of coronavirus disease (COVID-19), caused by SARS COV-2. Many people with COVID-19 have comorbidities, including diabetes, hypertension and cardiovascular diseases, which are significantly associated with worse outcomes. Moreover, COVID-19 itself is allied with deteriorating hyperglycemia. Therefore, Bangladesh Endocrine Society has formulated some practical recommendations for management of diabetes and other endocrine diseases in patients with COVID-19 for use in both primary and specialist care settings. OBJECTIVE The objective of the article is to develop a guideline to protect the vulnerable group with utmost preference - the elderly and those with comorbid conditions. Therefore, to ensure the adequate protective measures and timely treatment for COVID-19 patients with diabetes, other endocrine diseases or any other comorbidities. CONSIDERING AND MONITORING ISSUES The risk of a fatal outcome from COVID-19 may be up to 50% higher in patients with diabetes than in non-diabetics.Patients with diabetes and COVID had CFR 7.3-9.2%, compared with 0.9-1.4% in patients without comorbidities.Diabetic ketoacidosis may be one of the causes of mortality in COVID-19.There is wide fluctuation of blood glucose in these patients, probably due to irregular diet, reduced exercise, increased glucocorticoids secretion, and use of glucocorticoids. HbA1c should be <7.0% for the majority of the patients, this target may be relaxed in appropriate clinical settings.More emphasis should be given on day-to-day blood glucose levels. Hypoglycemia (<3.9 mmol/l) must be avoided.Frequent monitoring of blood glucose is needed in critically ill patients. CONCLUSION The fight against COVID-19 has been proven to be a challenging one. Therefore, all healthcare personnel should make the best use of updated knowledge and skills to ensure adequate protective measures and timely treatment for COVID-19 patients with diabetes, other endocrine diseases or any other comorbidities.
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Affiliation(s)
- Faruque Pathan
- Department of Endocrinology, BIRDEM General Hospital, Dhaka, Bangladesh
| | - Shahjada Selim
- Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Md Fariduddin
- Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | | | - S M Ashrafuzzaman
- Department of Endocrinology, BIRDEM General Hospital, Dhaka, Bangladesh
| | - Faria Afsana
- Department of Endocrinology, BIRDEM General Hospital, Dhaka, Bangladesh
| | | | - Tanjina Hossain
- Department of Endocrinology, Green Life Medical College Hospital, Dhaka, Bangladesh
| | - M Saifuddin
- Department of Endocrinology, Dhaka Medical College Hospital, Dhaka, Bangladesh
| | | | - Ahmed Salam Mir
- Department of Endocrinology, BIHS General Hospital, Dhaka, Bangladesh
| | - On behalf of the BES Diabetes and COVID Task Force
- Department of Endocrinology, BIRDEM General Hospital, Dhaka, Bangladesh
- Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
- Bangladesh Endocrine Society, Dhaka, Bangladesh
- National Healthcare Network (NHN) Uttara EC, Dhaka, Bangladesh
- Department of Endocrinology, Green Life Medical College Hospital, Dhaka, Bangladesh
- Department of Endocrinology, Dhaka Medical College Hospital, Dhaka, Bangladesh
- Mymensingh Medical College Hospital, Dhaka, Bangladesh
- Department of Endocrinology, BIHS General Hospital, Dhaka, Bangladesh
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Hassanein M, Hussein Z, Shaltout I, Wan Seman WJ, Tong CV, Mohd Noor N, Buyukbese MA, El Tony L, Shaker GM, Alamoudi RM, Hafidh K, Fariduddin M, Batais MA, Shaikh S, Malek PR, Alabbood M, Sahay R, Alshenqete AM, Yakoob Ahmedani M. The DAR 2020 Global survey: Ramadan fasting during COVID 19 pandemic and the impact of older age on fasting among adults with Type 2 diabetes. Diabetes Res Clin Pract 2021; 173:108674. [PMID: 33493579 PMCID: PMC7826018 DOI: 10.1016/j.diabres.2021.108674] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 01/08/2021] [Accepted: 01/12/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVES The DAR Global survey of Ramadan-fasting during the COVID-19 pandemic aimed to describe the characteristics and care in participants with type 2 diabetes (T2D) with a specific comparison between those <65 years and ≥65 years. METHODS Participants were consented to answer a physician-administered questionnaire following Ramadan 2020. Impact of COVID-19 on the decision of fasting, intentions to fast and duration of Ramadan and Shawal fasting, hypoglycaemia and hyperglycaemia events were assessed. Specific analysis comparing age categories of <65 years and ≥65 years were performed. RESULTS Among the 5865 participants, 22.5% were ≥65 years old. Concern for COVID-19 affected fasting decision for 7.6% (≥65 years) vs 5.4% (<65 years). More participants ≥65 years old did not fast (28.8% vs 12.7%, <65 years). Of the 83.6%, participants fulfilling Ramadan-fasting, 94.8% fasted ≥15 days and 12.6% had to break fast due to diabetes-related illness. The average number of days fasting within and post-Ramadan were 27 and 6 days respectively, regardless of age. Hypoglycaemia and hyperglycaemia occurred in 15.7% and 16.3% of participants respectively, with 6.5% and 7.4% requiring hospital care respectively. SMBG was performed in 73.8% of participants and 43.5% received Ramadan-focused education. CONCLUSION During the COVID-19 pandemic, universally high rates of Ramadan-fasting were observed regardless of fasting risk level. Glycemic complications occurred frequently with older adults requiring higher rates of acute hospital care. Risk stratification is essential followed by pre-Ramadan interventions, Ramadan-focused diabetes education and self-monitoring to reduce and prevent complications, with particular emphasis in older adults.
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Affiliation(s)
- Mohamed Hassanein
- Dubai Hospital, DHA, United Arab Emirates; Gulf Medical University, United Arab Emirates; Postgraduate Diabetes Education, Cardiff University, UK
| | - Zanariah Hussein
- Department of Internal Medicine, Hospital Putrajaya, Putrajaya, Malaysia.
| | - Inass Shaltout
- Department of Internal Medicine, Hospital Melaka, Melaka, Malaysia
| | | | | | - Nurain Mohd Noor
- Department of Internal Medicine, Hospital Putrajaya, Putrajaya, Malaysia
| | | | | | - Gamal Mohamed Shaker
- Strategic Data Analysis, Research and Studies Department Dubai Health Authority, United Arab Emirates.
| | - Reem M Alamoudi
- Department of Medicine, King Abdulaziz Medical City, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Research Center, Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia.
| | - Khadija Hafidh
- Rashid Hospital, Diabetes Unit, Dubai Health Authority, United Arab Emirates.
| | - M Fariduddin
- Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh
| | - Mohammed A Batais
- Diabetes & Chronic Disease Management, Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | | | | | - Rakesh Sahay
- Department of Endocrinology, Osmania Medical College & Osmania General Hospital, Hyderabad, India
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Jahan S, Mahmood T, Fariduddin M, Faisal I, Morshed M, Yadav A, Shah A, Abdullah C, Chowdhury EUR, Begum F, Hasanat MA. Clinical, biochemical and imaging characteristics of adrenal histoplasmosis in immunocompetent patients in a non-endemic area: A case series. ASIAN PAC J TROP MED 2021. [DOI: 10.4103/1995-7645.326256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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R S, Ferdous M, Adhikary D, Salim M, Banerjee S, Fariduddin M, Biswas S. Expression of neutrophil elastase and myeloperoxidase genes in coronary atherosclerosis. Atherosclerosis 2020. [DOI: 10.1016/j.atherosclerosis.2020.10.363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Hassanein M, Al Sifri S, Shaikh S, Abbas Raza S, Akram J, Pranoto A, Rudijanto A, Shaltout I, Fariduddin M, Mohd Izani Wan Mohamed W, Al Awadi F, Alessa T. A real-world study in patients with type 2 diabetes mellitus treated with gliclazide modified-release during fasting: DIA-RAMADAN. Diabetes Res Clin Pract 2020; 163:108154. [PMID: 32330510 DOI: 10.1016/j.diabres.2020.108154] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 04/09/2020] [Accepted: 04/10/2020] [Indexed: 12/24/2022]
Abstract
AIMS To explore the real-world safety and effectiveness of gliclazide modified release (MR) in patients with type 2 diabetes mellitus (T2DM) fasting during Ramadan. METHODS DIA-RAMADAN (NCT04132934) was a prospective, international, observational study conducted in nine countries. Patients >18 years of age with T2DM (N = 1244) were examined at an inclusion visit (V0) occurring 6-8 weeks before the start of Ramadan. Patients received a diary to report treatment changes, hypoglycaemic events (HEs), and other adverse events. Gliclazide MR was taken once daily for 14-18 weeks. A second visit (V1) was conducted 4-6 weeks after the end of Ramadan. The primary endpoint was the proportion of patients reporting ≥1 symptomatic HE. Changes in HbA1c, fasting plasma glucose (FPG), and body weight were secondary endpoints. RESULTS The proportion of patients reporting ≥1 symptomatic HE during Ramadan was low (2.2%) with no reported severe HEs. There was a significant reduction in HbA1c (-0.3%), FPG (-9.7 mg/dL), body weight (-0.5 kg) and body mass index (-0.2 kg/m2) between V0 and V1 (p < 0.001). CONCLUSIONS Patients with T2DM treated with gliclazide MR during Ramadan have a low risk of hypoglycaemia and maintain glycaemic control and weight while fasting.
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Affiliation(s)
- Mohamed Hassanein
- Department of Endocrinology, Dubai Hospital, Dubai, United Arab Emirates.
| | | | - Shehla Shaikh
- Department of Endocrinology, Saifee Hospital, Mumbai, Maharashtra, India
| | - Syed Abbas Raza
- Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, Pakistan
| | - Javed Akram
- University of Health Sciences, Lahore, Pakistan
| | - Agung Pranoto
- Department of Internal Medicine, Faculty of Medicine, Airlangga University/Dr. Soetomo Hospital, Surabaya, Indonesia
| | - Achmad Rudijanto
- Department of Internal Medicine, Faculty of Medicine, Brawijaya University/Dr. Saiful Anwar Hospital, Malang, Indonesia
| | - Inass Shaltout
- Department of Internal Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Md Fariduddin
- Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | | | - Fatheya Al Awadi
- Department of Endocrinology, Dubai Hospital, Dubai, United Arab Emirates
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Rakibul-Hasan M, Sultana N, Jahan S, Hasan M, Fakhrul-Alam M, Zarin N, Fariduddin M, Roy PK, Hasanat MA. Diagnostic efficiency of diabetes in pregnancy study group of India versus World Health Organization 2013 criteria. Int J Diabetes Dev Ctries 2020. [DOI: 10.1007/s13410-020-00804-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Rafiq-Uddin M, Kamrul-Hasan AB, Asaduzzaman M, Aminul-Islam AK, Islam M, Rauniyar BK, Hoque A, Mustari M, Fariduddin M, Hasanat MA. Antithyroid Antibody Status in Non-Pregnant Adult Bangladeshi Patients with Subclinical Hypothyroidism. Mymensingh Med J 2020; 29:156-161. [PMID: 31915352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
Sub clinical hypothyroidism (SCH) is common in clinical practice. Autoimmunity is thought to be the most important cause of SCH. In this cross-sectional study, we investigated 120 SCH patients and 100 healthy controls attending the Endocrinology Outpatient Department of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from June 2014 to April 2015 for anti-thyroid antibodies (anti-TPO and anti-Tg). Measurement of serum TSH, FT4, anti-TPO, and anti-Tg antibodies were done by using the chemiluminescent sequential immunometric assay. SCH patients had a higher mean age; the frequencies of female subjects, those having family history of thyroid disease or other autoimmune diseases, and goiter were higher in SCH group than in the control group. Forty-five percent (45%) of SCH patients were positive for anti-thyroid antibodies (23.3% for both anti-TPO and anti-Tg, 16.7% for only anti-TPO, and 5% positive for only anti-Tg) in comparison to only 10% anti-thyroid antibody positive controls (none for both antibodies, 8% for only anti-TPO, and 2% positive for only anti-Tg). The SCH subjects in the lower age group, females and with a TSH >10μIU/mL had the higher frequency of thyroid autoimmunity. Female gender, high socioeconomic condition, the presence of other autoimmune diseases, the presence of goiter and TSH >10μIU/mL were associated with higher odds of anti-thyroid antibody positivity in the SCH group, though none were statistically significant. The frequency of anti-thyroid antibody was higher in SCH and was more prevalent among the females, younger patients and those having a goiter, other autoimmune diseases, and TSH >10μIU/mL.
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Affiliation(s)
- M Rafiq-Uddin
- Dr Md Rafiq Uddin, Assistant Professor, Department of Endocrinology, Chittagong Medical College, Chittagong, Bangladesh
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Jahan S, Hasanat MA, Mahmood T, Morshed S, Haq R, Fariduddin M. Postoperative expression of Cushing disease in a young male: metamorphosis of silent corticotroph adenoma? Endocrinol Diabetes Metab Case Rep 2019; 2019:EDM190046. [PMID: 31671410 PMCID: PMC6790907 DOI: 10.1530/edm-19-0046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 08/20/2019] [Indexed: 11/25/2022] Open
Abstract
SUMMARY Silent corticotroph adenoma (SCA) is an unusual type of nonfunctioning pituitary adenoma (NFA) that is silent both clinically and biochemically and can only be recognized by positive immunostaining for ACTH. Under rare circumstances, it can transform into hormonally active disease presenting with severe Cushing syndrome. It might often produce diagnostic dilemma with difficult management issue if not thoroughly investigated and subtyped accordingly following surgery. Here, we present a 21-year-old male who initially underwent pituitary adenomectomy for presumed NFA with compressive symptoms. However, he developed recurrent and invasive macroadenoma with severe clinical as well as biochemical hypercortisolism during post-surgical follow-up. Repeat pituitary surgery was carried out urgently as there was significant optic chiasmal compression. Immunohistochemical analysis of the tumor tissue obtained on repeat surgery proved it to be an aggressive corticotroph adenoma. Though not cured, he showed marked clinical and biochemical improvement in the immediate postoperative period. Anticipating recurrence from the residual tumor, we referred him for cyber knife radio surgery. LEARNING POINTS Pituitary NFA commonly present with compressive symptoms such as headache and blurred vision. Post-surgical development of Cushing syndrome in such a case could be either drug induced or endogenous. In the presence of recurrent pituitary tumor, ACTH-dependent Cushing syndrome indicates CD. Rarely a SCA presenting initially as NFA can transform into an active corticotroph adenoma. Immunohistochemical marker for ACTH in the resected tumor confirms the diagnosis.
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Affiliation(s)
- Sharmin Jahan
- Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh
| | - M A Hasanat
- Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh
| | - Tahseen Mahmood
- Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh
| | - Shahed Morshed
- Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh
| | - Raziul Haq
- Department of Neurosurgery, Dhaka Medical College and Hospital (DMCH), Dhaka, Bangladesh
| | - Md Fariduddin
- Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh
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Kamrul-Hasan ABM, Jar Gaffar M, Ahammed A, Hasanat M, Fariduddin M. Iodine nutrition status in Graves' disease: A single-center study from Bangladesh. Thyroid Res Pract 2019. [DOI: 10.4103/trp.trp_34_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Shah S, Banu H, Sultana T, Akhtar N, Begum A, Moriom Zamila B, Fariduddin M, Hasanat MA. Increased Ratio of Total Testosterone to Dihydrotestosterone May Predict an Adverse Metabolic Outcome in Polycystic Ovary Syndrome. J Endocrinol Metab 2019. [DOI: 10.14740/jem601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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16
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Shehab MA, Mahmood T, Hasanat MA, Fariduddin M, Ahsan N, Hossain MS, Hossain MS, Jahan S. A rare variety of congenital adrenal hyperplasia with mosaic Klinefelter syndrome: a unique combination presenting with ambiguous genitalia and sexual precocity. Endocrinol Diabetes Metab Case Rep 2018; 2018:18-0108. [PMID: 30328339 PMCID: PMC6198180 DOI: 10.1530/edm-18-0108] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 09/19/2018] [Indexed: 02/01/2023] Open
Abstract
Congenital adrenal hyperplasia (CAH) due to the three-beta-hydroxysteroid-dehydrogenase (3β-HSD) enzyme deficiency is a rare autosomal recessive disorder presenting with sexual precocity in a phenotypic male. Klinefelter syndrome (KS) is the most common sex chromosome aneuploidy presenting with hypergonadotropic hypogonadism in a male. However, only a handful of cases of mosaic KS have been described in the literature. The co-existence of mosaic KS with CAH due to 3β-HSD enzyme deficiency portrays a unique diagnostic paradox where features of gonadal androgen deficiency are masked by simultaneous adrenal androgen excess. Here, we report a 7-year-old phenotypic male boy who, at birth presented with ambiguous genitalia, probably a microphallus with penoscrotal hypospadias. Later on, he developed accelerated growth with advanced bone age, premature pubarche, phallic enlargement and hyperpigmentation. Biochemically, the patient was proven to have CAH due to 3β-HSD deficiency. However, the co-existence of bilateral cryptorchidism made us to consider the possibility of hypogonadism as well, and it was further explained by concurrent existence of mosaic KS (47,XXY/46,XX). He was started on glucocorticoid and mineralocorticoid replacement and underwent right-sided orchidopexy on a later date. He showed significant clinical and biochemical improvement on subsequent follow-up. However, the declining value of serum testosterone was accompanied by rising level of FSH thereby unmasking hypergonadotropic hypogonadism due to mosaic KS. In future, we are planning to place him on androgen replacement as well. Learning points: •• Ambiguous genitalia with subsequent development of sexual precocity in a phenotypic male points towards some unusual varieties of CAH. •• High level of serum testosterone, adrenal androgen, plasma ACTH and low basal cortisol are proof of CAH, whereas elevated level of 17-OH pregnenolone is biochemical marker of 3β-HSD enzyme deficiency. •• Final diagnosis can be obtained with sequencing of HSD3B2 gene showing various mutations. •• Presence of bilateral cryptorchidism in such a patient may be due to underlying hypogonadism. •• Karyotyping in such patient may rarely show mosaic KS (47,XXY/46,XX) and there might be unmasking of hypergonadotropic hypogonadism resulting from adrenal androgen suppression from glucocorticoid treatment.
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Affiliation(s)
- M A Shehab
- Department of Endocrinology, BSMMU, Dhaka, Bangladesh
| | | | - M A Hasanat
- Department of Endocrinology, BSMMU, Dhaka, Bangladesh
| | - Md Fariduddin
- Department of Endocrinology, BSMMU, Dhaka, Bangladesh
| | - Nazmul Ahsan
- Department of Genetic Engineering & Biotechnology, University of Dhaka, Dhaka, Bangladesh
| | | | - Md Shahdat Hossain
- Department of Genetic Engineering & Biotechnology, University of Dhaka, Dhaka, Bangladesh
| | - Sharmin Jahan
- Department of Endocrinology, BSMMU, Dhaka, Bangladesh
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Akter F, Kamrul-Hasan AB, Ahmed EU, Selim S, Aalpona FZ, Emran MS, Alam MS, Saifuddin M, Hasanat MA, Fariduddin M. Thyroid Dysfunction and Autoimmunity in First Trimester of Pregnancy, Single Center Experience in Bangladesh. Mymensingh Med J 2018; 27:603-609. [PMID: 30141452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
Study on thyroid function and thyroid autoantibody status in pregnancy considering the trimester specific range, is scarce in Bangladesh. This cross sectional study done in Bangabandhu Sheikh Mujib Medical University, Bangladesh from August 2012 to June 2013 encompassed 186 pregnant women of first trimester for study of thyroid function (TSH, FT₄) and anti-thyroid antibodies (anti-TPO, anti-TG). Age of the subjects was 25.4±4.9 years (mean±SD), median gestational age was 9 weeks. Applying the trimester-specific normal reference range set by American Thyroid Association (ATA), 48(25.8%) of the women were found to have thyroid dysfunction; 40(21.5%) subclinical hypothyroid (SCH), 1(0.5%) overt hypothyroid (OH) and 7(3.8%) hyperthyroid; 40(21.5%) women had goiter. If non-pregnant adult normal rage is used, 22 of SCH women as per ATA criteria will be labeled as normal and 19 normal women as per ATA cut off will be labeled as hyperthyroid. There was statistically significant disparity for functional status defined by these two references cut off value (p<0.001). 29(15.6%) women had thyroid autoimmunity and the autoantibody positivity was more frequent in women with thyroid dysfunction than euthyroid women (22.92% vs. 13.04%, p<0.001). Even though universal screening for thyroid dysfunction is not yet a recommendation, it should be considered in our population.
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Affiliation(s)
- F Akter
- Dr Farhana Akter, Assistant Professor, Department of Endocrinology, Chittagong Medical College Hospital (CMCH), Chittagong, Bangladesh; E-mail:
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Kalra S, Atkin S, Cervera A, Das AK, Demir O, Demir T, Fariduddin M, Vo KT, Ku BJ, Kumar A, Latif ZA, Malek R, Matawaran BJ, Mehta R, Tran NQ, Panelo A, Ruder S, Saldana JR, Shaikh KA, Shakya A, Shrestha D, Unnikrishnan AG. Multinational Consensus: Insulin Initiation with Insulin Degludec/Aspart (IDegAsp). Adv Ther 2018; 35:928-936. [PMID: 29796928 DOI: 10.1007/s12325-018-0712-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Indexed: 12/13/2022]
Abstract
Insulin degludec/aspart (IDegAsp) is the first soluble insulin co-formulation, combining a long-acting insulin degludec (IDeg) and rapid-acting insulin aspart (IAsp). In type 2 diabetes patients with oral antidiabetes agent (OAD) inadequacy, insulin initiation with IDegAsp once daily provides superior long-term glycemic control compared to insulin glargine, with similar fasting plasma glucose (FPG) and insulin doses, and numerically lower rates of overall and nocturnal hypoglycemia. Furthermore, in patients with uncontrolled type 2 diabetes previously treated with insulins, IDegAsp twice daily effectively improves glycated hemoglobin and FPG, with fewer hypoglycemic episodes versus premix insulins and basal bolus therapy. In patients with type 1 diabetes mellitus, IDegAsp once daily with two doses of IAsp is a convenient, yet effective, regimen as compared to the conventional 4-5 injection-based basal bolus therapy. IDegAsp is an appropriate and reasonable option for initiation of insulin therapy in both type 1 and type 2 diabetes.
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Affiliation(s)
- Sanjay Kalra
- Department of Endocrinology, Bharti Hospital Karnal, Karnal, India.
| | - Stephen Atkin
- Department of Medicine, Weill Cornell Medical College, Doha, Qatar
| | - Antonio Cervera
- Department of Endocrinology, Clínica de Mérida, Mérida, Yucatán, Mexico
| | | | - Ozgur Demir
- Department of Endocrinology and Metabolic Diseases, İbni Sina Hospital, Ankara, Turkey
| | - Tevfik Demir
- Department of Endocrinology and Metabolic Disease, Dokuz Eylul University, Balcova, İzmir, Turkey
| | - Md Fariduddin
- Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Khoa Tuan Vo
- Department of Endocrinology, 115 Hospital, Ho Chi Minh City, Vietnam
| | - Bon Jeong Ku
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chungnam National University Hospital, Daejeon, Korea
| | - Ajay Kumar
- Department of Diabetology, Diabetes Care and Research Center, Patna, Bihar, India
| | - Zafar A Latif
- Department of Endocrinology, General, BIRDEM Hospital, BIRDEM Academy, Dhaka, Bangladesh
| | - Rachid Malek
- Department of Medicine, Ferhat Abbas University of Setif, Setif, Algeria
| | - Bien J Matawaran
- Department of Medicine, Section of Endocrinology, Diabetes and Metabolism, University of Santo Tomas, Manila, Philippines
| | - Roopa Mehta
- Department of Endocrinology and Nutritión, Instituto nacional de ciencias médicas y nutrición, Salvador Zubirán, Mexico City, Mexico
| | - Nam Quang Tran
- Head of Endocrinology Department, Ho Chi Minh City University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
| | - Araceli Panelo
- Department of Medicine, UERMMMC College of Medicine, Manila, Philippines
| | - Sundeep Ruder
- Department of Endocrinology and Metabolism, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa
| | | | - Khalid A Shaikh
- Department of Diabetes, Faculty of Internal Medicine, Royal Oman Police Hospital, Muscat, Oman
| | - Amit Shakya
- Department of Endocrinology, Diabetes Thyroid Endocrine Center, Kathmandu, Nepal
| | - Dina Shrestha
- Department of Endocrinology, Norvic International Hospital, Kathmandu, Nepal
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Kalra S, Atkin S, Cervera A, Das AK, Demir O, Demir T, Fariduddin M, Vo KT, Ku BJ, Kumar A, Latif ZA, Malek R, Matawaran BJ, Mehta R, Tran NQ, Panelo A, Ruder S, Saldana JR, Shaikh KA, Shakya A, Shrestha D, Unnikrishnan AG. Correction to: Multinational Consensus: Insulin Initiation with Insulin Degludec/Aspart (IDegAsp). Adv Ther 2018; 35:937-938. [PMID: 29882121 DOI: 10.1007/s12325-018-0728-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Unfortunately, the fifth author name was incorrectly published in the original publication. The correct name should read as 'Ozgur Demir'.
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Affiliation(s)
- Sanjay Kalra
- Department of Endocrinology, Bharti Hospital Karnal, Karnal, India.
| | - Stephen Atkin
- Department of Medicine, Weill Cornell Medical College, Doha, Qatar
| | - Antonio Cervera
- Department of Endocrinology, Clínica de Mérida, Mérida, Yucatán, Mexico
| | | | - Ozgur Demir
- Department of Endocrinology and Metabolic Diseases, İbni Sina Hospital, Ankara, Turkey
| | - Tevfik Demir
- Department of Endocrinology and Metabolic Disease, Dokuz Eylul University, Balcova, İzmir, Turkey
| | - Md Fariduddin
- Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Khoa Tuan Vo
- Department of Endocrinology, 115 Hospital, Ho Chi Minh City, Vietnam
| | - Bon Jeong Ku
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chungnam National University Hospital, Daejeon, Korea
| | - Ajay Kumar
- Department of Diabetology, Diabetes Care and Research Center, Patna, Bihar, India
| | - Zafar A Latif
- Department of Endocrinology, General, BIRDEM Hospital, BIRDEM Academy, Dhaka, Bangladesh
| | - Rachid Malek
- Department of Medicine, Ferhat Abbas University of Setif, Setif, Algeria
| | - Bien J Matawaran
- Department of Medicine, Section of Endocrinology, Diabetes and Metabolism, University of Santo Tomas, Manila, Philippines
| | - Roopa Mehta
- Department of Endocrinology and Nutritión, Instituto nacional de ciencias médicas y nutrición, Salvador Zubirán, Mexico City, Mexico
| | - Nam Quang Tran
- Head of Endocrinology Department, Ho Chi Minh City University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
| | - Araceli Panelo
- Department of Medicine, UERMMMC College of Medicine, Manila, Philippines
| | - Sundeep Ruder
- Department of Endocrinology and Metabolism, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa
| | | | - Khalid A Shaikh
- Department of Diabetes, Faculty of Internal Medicine, Royal Oman Police Hospital, Muscat, Oman
| | - Amit Shakya
- Department of Endocrinology, Diabetes Thyroid Endocrine Center, Kathmandu, Nepal
| | - Dina Shrestha
- Department of Endocrinology, Norvic International Hospital, Kathmandu, Nepal
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Pathan MF, Fariduddin M, Nazimuddin K, Mollah AS, Islam Siddiqui MN, Hassan KA, Ferdous HS, Rahman MH, Ashrafuzzaman SM, Sobhan MJ, E-Tanvir Haider MR, Amin MF. The Incidence of Hypoglycemia among Insulin-Treated Patients with Type 1 or Type 2 Diabetes: Bangladeshi Cohort of International Operations-Hypoglycemia Assessment Tool Study. Indian J Endocrinol Metab 2018; 22:379-386. [PMID: 30090731 PMCID: PMC6063185 DOI: 10.4103/ijem.ijem_545_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES The objective of this study was to assess the incidence of hypoglycemia in patients with type 1 diabetes mellitus (T1DM) or type 2 diabetes mellitus (T2DM) in Bangladeshi cohort of the International Operations-Hypoglycemia Assessment Tool study. MATERIALS AND METHODS Patients diagnosed with either T1DM or T2DM, aged ≥18 years, treated with insulin (any regimen) for >12 months, and completed self-assessment questionnaires (SAQs) to record demography, treatment information, and hypoglycemia during the 6-month retrospective and 4-week prospective periods (a total of 7 months) were enrolled in the study. RESULTS A total of 1179 patients were enrolled and completed the SAQ1 (T1DM, n = 25; T2DM, n = 1154). Almost all patients (T1DM: 100.0% [95% confidence interval (CI): 86.3%, 100.0%] and T2DM: 97.0% [95% CI: 95.9%, 97.9%]) experienced at least 1 hypoglycemic event prospectively. The estimated rates of any and severe hypoglycemia were 26.6 (95% CI: 19.8, 35.0) and 14.1 (95% CI: 9.3, 20.4) events per patient-per year (PPY), respectively, for patients with T1DM and 18.3 (95% CI: 17.4, 19.2) and 12.1 (95% CI: 11.4, 12.9) events PPY, respectively, for patients with T2DM during the prospective period. At baseline, mean glycated hemoglobin (HbA1c) (±standard deviation) was 8.1 (±1.8%) for T1DM and 8.8 (±1.8%) for T2DM. Hypoglycemic rate was independent of HbA1c levels and types of insulin. CONCLUSIONS This is the first patient dataset of self-reported hypoglycemia in Bangladesh; results confirm that hypoglycemia is underreported.
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Affiliation(s)
- Md. Faruque Pathan
- Department of Medicine and Endocrinology, BIRDEM General Hospital, Chittagong, Bangladesh
| | - M. Fariduddin
- Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University, Chittagong, Bangladesh
| | - Khwaja Nazimuddin
- Department of Medicine, Bangladesh University of Health Sciences, Dhaka, Bangladesh
| | - Abdus Saleque Mollah
- Department of Endocrinology, Chittagong Medical College Hospital, Chittagong, Bangladesh
| | | | - Kazi Ali Hassan
- Department of Endocrinology, Square Hospital, Dhaka, Bangladesh
| | - H. S. Ferdous
- Department of Endocrinology, Popular Medical College Hospital, Dhaka, Bangladesh
| | | | | | - Md. Javed Sobhan
- Department of Clinical, Medical, Regulatory & Quality, Novo Nordisk Pharma (Private) Limited, Dhaka, Bangladesh
| | - Md. Reza E-Tanvir Haider
- Department of Clinical, Medical, Regulatory & Quality, Novo Nordisk Pharma (Private) Limited, Dhaka, Bangladesh
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Asaduzzaman M, Kamrul-Hasan ABM, Aminul-Islam AKM, Rafiq-Uddin M, Hasanat MA, Fariduddin M. Impact of iodine nutrition status on thyroid autoimmunity in subclinical hypothyroid patients attending a tertiary hospital of Bangladesh. Thyroid Res Pract 2018. [DOI: 10.4103/trp.trp_14_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Kibria KG, Alam MR, Paul HK, Fariduddin M, Hasanat MA. Pattern of dyslipidemia in hypothyroid patients: A cross sectional study. Bangabandhu Sheikh Mujib Medical Univ J 2016. [DOI: 10.3329/bsmmuj.v6i2.29133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
<p><strong>Background:</strong> An association between thyroid dysfunction and dyslipidemia prevails. Levels of total cholesterol, low density lipoprotein cholesterol, triglycerides tend to increase as thyroid function declines.</p><p><strong>Objective:</strong> To find out the pattern of dyslipidemia in hypothyroid patients. <strong></strong></p><p><strong>Methods:</strong> Sixty cases were selected as a sample of convenience in this cross sectional study from in-patienl depa1tment of Medicine and Endocrinology, BSMMU. Meticulous history taking and thorough clinical examinations were done. Report of lipid profile and thyroid function tests were recorded from patients file. All the information's were recorded in a pre-designed sttuctured questionnaire. Collected data were classified, edited, coded and entered into the computer for statistical analysis by using SPSS. <strong></strong></p><p><strong>Results:</strong> Among the 60 cases, 43 (72%) were female; 17(28%) were male. Age range was 24-59 years with a mean age of 38.80 (± I 0.35) years. Majority 38(65%) were housewife, followed by service holder 11(18.33%), 08(13.3%) were business men and 02(3.3%) had other occupations. Majority 42(70%) patients were taking thyroxin. Mean Total cholesterol (TC), LDL cholesterol, Triglyceride (TG) and HDL were 222.20(±42.25); 138.63(±31.51); 243.36(±83.13) and 37.30(±5.12) respectably. <strong></strong></p><p><strong>Conclusion:</strong> All hypothyroid subjects had dyslipidemia. The present study indicated that hypothyroidism was associated with an abnormal lipid profile, especially with respect to the levels of total cholesterol and triglyceride.</p>
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Hassan MQ, Hasanat M, Fariduddin M, Emran MS, Mustari M, Jahan S, Sultana N, Banu N, Biswas SK, Alam MR, Kamal M. Fine needle aspiration cytological diagnosis of thyroid nodule with its clinical correlation. Bangabandhu Sheikh Mujib Medical Univ J 2016. [DOI: 10.3329/bsmmuj.v6i2.29125] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
<p><strong>Background:</strong> Nodular goiter is common in Bangladesh. Thyroid nodules are important for their malignant potential especially the solitary and cold ones and when functionally euthyroid. <strong></strong></p><p><strong>Objectives:</strong> This study was designed to investigate the frequency of malignancy and cellular aberration detected by fine needle aspiration cytology (FNAC) in euthyroid nodules and its correlation with clinical findings.<strong> </strong></p><p><strong>Methods:</strong> Subjects with nodular goiter attending Endocrine out patient department [n=150, nonpregnant, age (mean± SD): 37±12 years; sex (male: female): 21:129] were recruited for this study. All subjects underwent clinical risk stratification, estimation ofFT4 and TSH as well as ultrnsonogram (USG) and isotope scan of thyroid. Thyroid nodules were categorized into malignant, suspicious, benign and indeterminant on the basis of cellular character by FNAC. Statistical analysis was done by Chi-square and multiple regression analysis.<strong> </strong></p><p><strong>Results:</strong> Patients were mostly females (86%) and 4.7% had family history of thyroid problems. Some had recent changes of size (14.7%), pain in the nodule (4%) and dysphagia (6%). Nodules were solitary in 45.3% and the rest (54.7%) had multinodular goiter. Enlarged regional lymph node was found in 12.7% patients. About 41 % were partially-cold followed by cold nodules (26.7%), patchy (16.7%), isoform (12%) and hot (4%) by isotope scan. Frequency of malignant (10%) character was highest in cold nodules followed by uniform (5.6%), patchy (4.0%) and partially cold (1.6%) while none in hot nodules; which were 22.5%, 11.1 %, 4.0%, 9.8% and 16.7% respectively for suspicious nodules. About 17% showed cellular aberration and 4.7% were clearly malignant, whereas 124 (82.7%) were benign. Of the malignant, 4 were solitary and 3 were multinodular; which were 10 and 9 among the suspicious ones. A significant number (77%, 20 out of 26) among the malignant/suspicious nodules fell into moderate to high risk category (x<sup>2</sup>=22.861, p<0.001), while 23.1 % of the FNAC proven malignant/suspicious nodules were of low risk category. Enlarged lymph nodes (p<0.001), increased diameter of nodules of >4 cm (p=0.039) and recent changes in nodular size (p=0.042) were independently and significantly related to cellular aberration. <strong></strong></p><p><strong>Conclusions:</strong> FNAC is a useful tool for cellular diagnosis of thyroid nodules. Clinical suspicion for malignancy strongly correlates with the FNAC findings. But a good number of clinically Low risk categories would escape malignant cellular character unless FNAC is done.</p>
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Mustari M, Hasanat MA, Hasan Q, Tuqan S, Emran MS, Aktar N, Banu H, Fariduddin M. Association of altered thyroid function and prolactin level in polycystic ovarian syndrome. Bangladesh Med J 2016; 45:1-5. [DOI: 10.3329/bmj.v45i1.28957] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
Polycystic ovarian syndrome (PCOS) is a common disorder for female with fertile age. Along with other clinical and biochemical manifestations, thyroid function and prolactin level may be altered in patients with PCOS. This study aimed to evaluate the clinical and biochemical status, as well as alteration of thyroid stimulating hormone (TSH), prolactin (PRL) level in patients with PCOS. Present study comprised of 100 diagnosed PCOS patients according to revised Rotterdem Consensus criteria. All patients were studied for serum testosterone, LH (lutenizing hormone), FSH (follicle stimulating hormone), blood glucose, lipid profile as well as TSH, FT4 (free thyroxin) and prolactin level. Out of 100 PCOS patients 97 had hirsutism, 64 had acanthosis nigricans, where menstrual irregularities were in 94 patients. Diastolic blood pressure (74±1.1 vs. 77±0.9, mmHg; p=0.017), total cholesterol (163±5.3 vs. 193±6.2 mg/dl; p<0.001), low density lipoprotein (LDL, 104±3.7 vs. 124±4.9 mg/dl; p=0.002) and frequency of acanthosis (25% vs. 75%; p<0.001) were significantly higher among the patients having BMI>25 Kg/m2 than those of have ? 25 Kg/m2. Among the fertile women (n=53), 47% had primary and 41.5% had secondary infertility; whereas of the total patients, 21% had altered thyroid function and 6.1% had raised prolactin (PRL, ng/ml) level. Differences of TSH (4.1±3.6 vs. 3.5±6.8, mIU/L; p=0.725) was not significant; whereas level of PRL (13.87±6.9vs. 9.4±5.2 ng/ml; p=0.018) was significantly higher in the group of primary infertility. Hirsutism, menstrual disturbance and acanthosis were very common in PCOS. Both primary and secondary sterility were also commonly observed and PRL was higher in primary infertility. About one fifth of PCOS had altered thyroid function.Bangladesh Med J. 2016 Jan; 45 (1): 1-5
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Urmi SJ, Begum SR, Fariduddin M, Begum SA, Mahmud T, Banu J, Chowdhury S, Khanam A. Hypothyroidism and its Effect on Menstrual Pattern and Fertility. Mymensingh Med J 2015; 24:765-769. [PMID: 26620017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Hypothyroidism is one of the most common endocrine disorders encountered in clinical practice. Thyroid disorder is very common among the female. The aim of this study was to evaluate the effects of hypothyroidism on menstrual pattern and sub-fertility. This cross-sectional comparative study was carried out in the Department of Obstetrics and Gynecology with collaboration of endocrine department of Bangabandhu Sheikh Mujib Medical University (BSMMU) from July 2006 to June 2008, cases were collected from the thyroid clinic of this hospital. Total study subject were 139, among them hypothyroid cases were 79 and euthyroid were 60. Among the hypothyroidism group 62.0% (n=49) had normal menstrual cycle, 21.5% (n=16) had oligomenorrhoea, 10.1% (n=8) had polymenorrhoea and 6.3% (n=6) had amenorrhoea. On the contrary in euthyroid group 86.7% (n=52) had normal menstrual cycle, 6.7% (n=4) had oligomenorrhoea, 5.0% (n=3) had polymenorrhoea and 1.7% (n=1) had amenorrhoea. Proportion of abnormal menstrual history was found to high among hypothyroid group almost 34% (n=27) compared to euthyroid group 13.4% (n=8) and the difference was statistically significant (p<0.001). The proportion of primary subfertility in hypothyroid 11.4% (n=9) whereas in euthyroid cases 1.7% (n=1) and secondary subfertility in hypothyroid 7.6% (n=6) where as in euthyroid cases 5.0% (n=3). So, sub-fertility was higher among hypothyroid group compared to euthyroid group but the difference was not statistically significant (p>0.05). Overall sub-fertility was 13.7% (n=10) and it was 6.7% (n=4) among the euthyroid group. Among total hypothyroid group 60.7% (n=48) are the overt hypothyroid and 39.20% (n=31) are the sub-clinical hypothyroid group. The effect of hypothyroidism is significant on menstrual pattern and on fertility. Hypothyroid women had more menstrual disorders and also suffering from sub-fertility.
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Affiliation(s)
- S J Urmi
- Dr Sharmin Jahan Urmi, Junior Consultant (Obs & Gynae), Upazilla Health Complex, Kaptai, Rangamati, Bangladesh
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Paul AK, Khan MA, Fariduddin M. Effect of Ramadan Fasting on Anthropometric Measures and Metabolic Profiles among Type 2 Diabetic Subjects. J Enam Med Col 2015. [DOI: 10.3329/jemc.v5i2.23382] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background: Fasting from dawn to dusk during the month of Holy Ramadan is obligatory for all healthy adult Muslims. Individuals are exempted from fasting if they are suffering from an illness that could be adversely affected by fasting. Although The Quran exempts sick people from fasting, many Muslim diabetic patients may not perceive themselves as sick and are keenly interested to fast. But they fast without proper medical guidance exposing themselves to certain risks as a direct consequence of fasting. So we designed this study to assess the impact of fasting during Ramadan and to evaluate the effects of fasting on their biochemical profiles in patients with diabetes.Objective: The objective of this study was to investigate whether Ramadan fasting has any effect on body weight, blood pressure, fasting glucose, HbA1C, serum lipids, serum creatinine among type 2 diabetic patients.Materials and Methods: Fifty two stable outpatients with type 2 diabetes with intention to fast were studied in the month of Ramadan 1434 Hijri calendar year (11th July to 9th August, 2013) at two points of time: one week before Ramadan (visit 1) and within last 3 days before the end of Ramadan (visit 2). During each visit the height, body weight and blood pressure were recorded. Blood samples were collected for fasting glucose, HbA1C, total cholesterol, triglyceride, high density and low density lipoprotein cholesterol and creatinine. Data were analyzed by Students paired t-test using SPSS system and results were expressed as mean ± SD. Probability values were considered to be significant if it was less than 0.05.Results: There were 30 (62.8%) males and 22 (37.2%) females with a mean age of 54.7 ± 11.55 (range 3580) years and mean duration of diabetes was 5.5 ± 5.2 years (range 9 months18 years). In this study mean weight of the patients decreased significantly from 60.5 ± 12.6 kg to 58.5 ± 11.3 kg (p<0.001). Blood pressure reduced but not significantly. Fasting blood glucose showed significant reduction from 10.7 ± 4.2 to 8.9 ± 3.7 mmol/L (p=0.002) at the end of the study though HbA1C showed no significant change. Lipid profile and serum creatinine values did not show any significant change.Conclusion: The effects of fasting during Ramadan on stable diabetic patients are minimal. So, stable diabetic patients can fast during Ramadan without significant detrimental effects.J Enam Med Col 2015; 5(2): 93-98
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Fariduddin M, Amin AH, Ahmed MU, Karim SS, Moslem F, Kamal M. Malignancy in solitary solid cold thyroid nodule. Mymensingh Med J 2012; 21:276-280. [PMID: 22561771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Solitary thyroid nodule is a common endocrine problem. The main concern of solitary thyroid nodule lies in excluding the malignancy & to operate on as few patients as possible. Other than history & clinical examination, hormone assessment, USG of thyroid gland, radionuclide scan & FNAC were used to differentiate malignant nodules from benign ones. In this study 127 cases with solitary thyroid nodule of all age group & both sexes were included from Endocrine & Thyroid clinic of BSMMU. They were clinically & biochemically euthyroid & had cold nodule on radionuclide scan. USG & FNAC were done & subsequently they underwent surgical procedure. On the basis of postoperative histopathological report the specimens were divided into benign & malignant groups. All the nodules were cold among which 104 were solid & 23 were mixed in consistency. Of the 104 solid cold nodules histopathology revealed 36(34.6%) malignant & 68(65.4%) benign cases. From the 23 mixed cold solitary nodule 5(21.7%) appeared malignant & 18(78.3%) were benign. So malignancy was higher in solid cold group than the mixed cold one but this was not statistically significant (p=0.673). FNAC was done & it revealed that 83(65.5%) cases were benign, 10(7.8%) cases were suspicious & 34(26.7%) were malignant. Finally histopathology showed 41(32.3%) cases were positive & 86(67.7%) cases were negative for malignancy.
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Affiliation(s)
- M Fariduddin
- Head Endocrine Wing (White Unit) Department of Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.
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Fariduddin M, Mahtab H, Latif ZA, Siddiqui NI. Practical management of diabetes during Ramadan fasting. Mymensingh Med J 2011; 20:541-546. [PMID: 21804526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Diabetes mellitus is a global epidemic including Bangladesh. It is a chronic, costly and deadly disease. Recent advancement gives us the opportunity to control diabetes and offer the patient to have a normal or near normal life. Fasting during Ramadan is one of the five pillars of Islam. Recent studies show that most of the type-2 diabetic patients can fast during the holy month of Ramadan safely. But they need pre-Ramadan counseling for assessment, education, motivation, dietary and drug adjustment. Ramadan is beneficial for health. Fasting improves metabolic control, reduces weight and helps to control hypertension. Fasting also associated with some risks like-hypoglycemia, diabetic ketoacidosis, hyper osmolar non ketotic coma and dehydration. All of these risks can be significantly reduced by pre-Ramadan counseling. Those who are at very high risks of hypoglycemia and acute diabetic or other complications they should not fast. After recovery they should complete their fast with the consultation of Islamic scholars. If there is hypoglycemia while fasting, fast must be broken. Islam allows us to have a regular blood sugar test during fast. Patient should follow a highly individualized management plan. Close monitoring is essential to prevent complications for safe Ramadan.
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Affiliation(s)
- M Fariduddin
- Department of Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
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Fariduddin M, Sultana N, Badiuzzaman M, Abdullah ABM, Hasanat MA. Clinical and Biochemical Evaluation of Subacute (De Ouervain's) Thyroiditis. Bangabandhu Sheikh Mujib Medical Univ J 2011. [DOI: 10.3329/bsmmuj.v3i2.7057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Sultana N, Chowdhury RK, Chowdhury NA, Fariduddin M, Jamal N, Hasanat MA. Castleman’s Disease - A Rare Cause of Pyrexia of Unknown Origin (PUO): Case Report. Bangabandhu Sheikh Mujib Medical Univ J 2010. [DOI: 10.3329/bsmmuj.v2i2.4764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Fariduddin M, Afroz SS, Hasanat MA, Chowdhury NA, Sultana N, Ghose A, Sobhan MA, Chowdhury HR, Aziz MM. Insulinoma Presenting with Psychiatric Manifestations: A Case Report. Bangabandhu Sheikh Mujib Medical Univ J 2009. [DOI: 10.3329/bsmmuj.v2i1.3710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Fariduddin M, Chowdhury N, Abdullah A, Karim M. Thyrotoxic periodic paralysis. Mymensingh Med J 2008; 17:89-92. [PMID: 18285742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
A young man of 30 yrs got himself admitted in Bangabandhu Sheikh Mujib Medical University (BSMMU) Hospital, Dhaka, Bangladesh with the complaints of suddenly developed weakness in his all four limbs. He had features of hyperthyroidism and he gave the history of similar attacks of weakness in his all four limbs in the previous months. His potassium was in the lower part of the normal range and his T4 and T3 were elevated but TSH was markedly low. He was diagnosed as a case of thyrotoxic periodic paralysis on the basis of clinical and biochemical findings. After treatment with carbimazole, propranolol and potassium replacement, patient's condition improved dramatically.
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Affiliation(s)
- M Fariduddin
- Dr M Fariduddin Associate Professor, Department of Endocrine Medicine, Room No. 504, D Block, Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahabag, Dhaka, Bangladesh
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Paul DT, Mollah FH, Alam MK, Fariduddin M, Azad K, Arslan MI. Glycemic status in hyperthyroid subjects. Mymensingh Med J 2004; 13:71-5. [PMID: 14747791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Abstract
This was an observational case-control study carried out in the Department of Biochemistry, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka jointly with the 'Thyroid and Endocrine Clinic' of the same institution during the period of January 2002 to December 2002. Sixty-five (65) newly diagnosed hyperthyroid patients between 20-60 years of age were studied, where forty-five (45) were Graves' disease and twenty (20) were TMNG (Toxic multinodular goiter) patients. Thyrotoxicosis was diagnosed by history, clinical examination and biochemical investigations- FT4, TSH, and Radioactive iodine uptake (RAIU) test. Thirty (30) age and sex matched healthy subjects were taken as control. The mean age was 33.02+/-9.24 years in Graves' disease and 37.55+/-9.49 years in TMNG. Female predominance observed in both the diseases. Glucose intolerance was found in 72.3% of thyrotoxic patients, which is much higher than European population. Our study showed Diabetes mellitus (DM) in 11% of Graves' disease patients. The incidence of DM in Graves' disease was slightly higher in our population. Incidence of DM in TMNG in our study was much lower (5%) than that of Graves' disease (11%) but the incidence of IGT (Impaired glucose tolerance) in TMNG was more (85%) in relation to Graves' disease (54%). Percentage of RAIU was more marked in Graves' disease than TMNG. There is a significant positive correlation (p<0.05) between plasma glucose and FT4 in Graves' disease. Glucose intolerance is frequently found in Thyrotoxic patients.
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Affiliation(s)
- D T Paul
- Department of Biochemistry, Jahurul Islam Medical College, Bagitpur, Kishoregonj
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Abstract
To study autoimmunity among thyroid diseases, 397 thyroid patients (age 30 (13) years; M/F 75/322) from two referral centres in Bangladesh and 94 healthy controls (age 30 (13) years; M/F 24/70) were studied for antimicrosomal and antithyroglobulin antibodies. Thyroid patients were clinically grouped as suspected autoimmune thyroid disease (AITD), non-autoimmune, or indeterminate groups (where no decision could be reached). Antimicrosomal antibody was strongly positive in 19.4% and weakly positive in 7.3% of patients but only 4.3% and 2.1% respectively in the controls (chi(2) = 17.852; p = 0.000) whereas strong and weak positivity were 27.2% and 6. 8% in patients compared with 8.5% and 4.3% respectively in the controls (chi(2) = 16.916; p = 0.000) for antithyroglobulin antibody. Antibodies were positive in 63.0% with Hashimoto's thyroiditis, 36.4% with Graves' disease, and 44.7% with atrophic thyroiditis among the autoimmune group. In the non-autoimmune group antibodies were positive in 100% with multinodular hypothyroidism, 46.7% with subacute thyroiditis, 40.0% with suspected iodine deficiency goitre, 31.3% with toxic multinodular goitre, 30.8% with non-toxic solitary nodules, and 19.4% with simple diffuse goitre. None was positive for antimicrosomal antibody without being positive for antithyroglobulin antibody. The two antibodies strongly correlated in both patients (r = 0.977, p = 0.000) and controls (r = 0.986, p = 0.000). About 9% (36/397) of patients were mismatched with the final diagnosis on antibody measurement; most of them had Hashimoto's thyroiditis (33/36). Prevalence of AITD among thyroid patients was 48.36%. Specificity of antimicrosomal and antithyroglobulin antibodies were 93% and 87%. It was concluded that AITD is not uncommon in Bangladesh; antimicrosomal antibody is a useful marker for AITD and unless antibodies are checked, an appreciable number of patients with AITDs will remain undetected.
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Affiliation(s)
- M A Hasanat
- Endocrine Clinic, Department of Internal Medicine, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh.
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Farghali H, Al Zuhair H, Al Windawi S, Al Hamdi A, Fariduddin M. Diuretic effect and duration of action of a single intravenous dose of furosemide in uremia and myocardial infarction. Int J Clin Pharmacol Ther Toxicol 1984; 22:659-64. [PMID: 6526541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Furosemide was given in a single dose of 80 mg to 10 normal subjects, 10 uremic and 6 subjects with uncomplicated myocardial infarction. Furosemide overall effects and rates of urine flow, sodium and potassium excretion in different pathophysiological states were compared. During 24 hours furosemide resulted in a two-fold increase in urine flow in both normal and myocardial infarction subjects when compared to 1.4 in uremic patients. Furosemide produced nearly a two-fold increase in 24 hours. Na excretion was in all the three groups studied. K excretion in 24 hours was higher in myocardial infarction patients than uremics and normals, but the difference was not significant (p less than 0.05). Rate-time plot for urine, Na or K excretion showed that the decline was slower in uremic or myocardial infarction patients than in normal subjects. The smaller decay constants for effect in both uremic and myocardial infarction subjects were indicative of longer duration of action of furosemide in these patients. No correlation was observed between overall Na or K excretion after furosemide and creatinine clearance. Changes in renal function or renal hemodynamics produced decreased but prolonged effects of furosemide and eventually the overall diuretic effect of the drug was slightly altered.
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