scholarly journals Clinical Characteristics of Atrial Fibrillation in Saudi Women Cohort and Its Clinical Impact in a Tertiary University Hospital

2015 ◽  
Vol 22 (2) ◽  
pp. 11-17
Author(s):  
Kamal W. AlGhalayini

A retrospective study was conducted to evaluate the characteristics of atrial fibrillation in a cohort of Saudi women, and its impact on morbidity. A complete medical history was obtained and all participants underwent a complete review of clinical data including electrocardiogram, echocardiogram, blood pressure measurement, and thyroid examination. The following laboratory examinations were performed: international normalized ratio; thyroid stimulating hormone; triiodothyronine; thyroxine; total cholesterol; triglyceride; low-density and high-density lipoprotein. A history of hospitalizations, stroke and in-hospital mortality were recorded. We recruited 84 women; the mean age was 61.8 years and the mean body mass index was 28.45 kg/m2. The mean hemoglobin level of the patients was 12.2 g/dL and the mean thyroid stimulating hormone level was 3.75 mIU/L. The target international normalized ratio was achieved in 58% of treated patients; 70% of the under target International Normalized Ration patients had been hospitalized more than once and 19% had suffered a stroke. Overall, international normalized ratio demonstrates gaps in the management of women with atrial fibrillation, and the negative impact on patient outcome, indicating the need to tailor treatment plans to the goals and requirements of these patients.  

KYAMC Journal ◽  
2021 ◽  
Vol 12 (1) ◽  
pp. 36-40
Author(s):  
Md Nahid Reza ◽  
M Fardil Hossain Faisal ◽  
Tahmina Noor ◽  
Riaz Mahmud ◽  
Monsur Miah ◽  
...  

Background: There was a long term perception that gall stone disease may have a hidden association to alteration of thyroid function. Objective: To find out the association between thyroid function status in gall stone disease. Materials and Methods: This case control study was conducted in department of Surgery, Bangabandhu Sheikh Mujib Medical University Hospital from July 2017 to June 2018. This study recruited 152 gall stone patients diagnosed with Ultrasonography (USG). The control group underwent USG to exclude any asymptomatic cholelithiasis. Fasting blood samples were taken from all participants for measurements of Fasting Blood Sugar (FBS), serum free thyroxine (FT4), serum thyroid stimulating hormone (TSH), total cholesterol, low-density lipoprotein (LDL), and high-density lipoprotein (HDL). Results: The mean serum TSH levels among cases (3.56±4.6) was higher than controls (2.46±1.68) (p<0.05). Subclinical hypothyroidism was noted in 11.8% of cases and all were found female and 3.8% of controls, whereas hypothyroidism was detected in 3 (3.8%) controls and 22 (14.5%) cases. The mean total cholesterol levels in cases was much higher than in controls, and was significant (p<0.05). Conclusion: Hypothyroidism has a significant role on development of gall stone disease with increasing age especially in female. KYAMC Journal.2021;12(1): 36-40


2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 767.2-768
Author(s):  
S. Lahrichi ◽  
K. Nassar ◽  
S. Janani

Background:Spondyloarthropathies (SpA) are a group of chronic and progressive diseases, characterized in particular by a progressive stiffening of the spine, spreading to neighboring joints or to certain tissues, which could lead in the long term to progressive stiffening and functional impairment. This conditioncancauseinsomnia problems and impaired sleep quality.Objectives:To assess the impact of SpA on the quality of sleep.Methods:This is a retrospective study over a period of 4 years from January 2015 to December 2019, including all the medical records of patients with SpA followed in the Department of Rheumatology of the University Hospital of Ibn Rochd, Casablanca. We evaluated for each patient two validated scores: the Epworth somnolence scale rated from 0 to 24, and the Pittsburgh sleep score rated from 0 to 21 with 7 components. Patients with a psychiatric history or who were followed up for neurological pathologies were excluded.Results:178 patients were included. 60.67% were men with an average age of 36.32 years (14-68 years). 45.01% had axial SpA, 29.77% had psoriatic arthritis, and 25.22% were followed for SpA associated with inflammatory bowel disease. 45% had associated comorbidities: there were 18 diabetics and 34 hypertensive, 16.58% were smokers. Clinically, 85.42% presented a back pain initially on examination, 55% presented a polyarthralgia, and 39.88% an oligoarthritis. 63% had radiological sacroiliitis, and 35.14% had bilateral coxitis. 13.48% had a positive HLA B27 and 58.89% had a positive inflammatory assessment with very high activity indices,with a mean of 4.6. 64.66% of the patients received NSAIDs,of which 11% responded well. 57% were treated with csDMARDs, and 17.86% were treated with biologics. At the time of our study, the mean visual analog scale was 5.84 ± 1.7 out of 10 (2-9). The mean Epworth score was 8.38 ± 5.2 (0-21). 56.1% of patients had no sleep debt, 33.3% had a sleep deficit, and only 10.6% had signs of drowsiness. For the overall Pittsburgh score, the mean was 7.02 ± 3.6 (1-18). The mean of “subjective quality of sleep” was 1.12, “sleep latency” was 1.22, “duration of sleep” was 1.06, “usual sleep efficiency” was 0.74, “Sleep disturbance” of 1.28, “use of a sleep medication” of 0.54, and the average of the component concerning “poor shape during the day” was 1.03 out of 3. The LEQUESNE index went from an average of 6 to 8, which corresponds to an average handicap (P = 0.2) over a period of 3 years. 68% of the patients had an alteration in the quality of sleep, starting on average three years after the onset of symptoms. 11% reported having experiencedanxiety and depressive symptoms, and reported having used antidepressants or anxiolytics in the past 5 years.Conclusion:Our study showed the negative impact of SpA on the duration and overall quality of sleep. The degree of pain as well as functional impairment can cause and worsen sleep disturbances in SpA. We have shown that the Pittsburg score increases significantly with the increase of pain.The Lequesne score and that the Epworth score increase with disease activity[1].References:[1]StolwijkC,vanTubergenA,Castillo-OrtizJD,BoonenA.Prevalenceofextra-articularmanifestationsinpatientswithankylosingspondylitis:asystematicreviewandmeta-analysis.AnnRheumDis2015;74:65—73.Disclosure of Interests:None declared.


Author(s):  
Giacomo Pucci ◽  
Edoardo Santoni ◽  
Valeria Bisogni ◽  
Camilla Calandri ◽  
Alberto Cerasari ◽  
...  

AbstractAtrial fibrillation (AF), the commonest sustained cardiac arrhythmia affecting the adult population, is often casually discovered among hospitalized people. AF onset is indeed triggered by several clinical conditions such as acute inflammatory states, infections, and electrolyte disturbance, frequently occurring during the hospitalization. We aimed to evaluate whether systematic AF screening, performed through an automated oscillometric blood pressure (BP) device (Microlife WatchBP Office AFIB, Microlife AG, Switzerland), is effective for detecting AF episodes in subjects admitted to an Internal Medicine ward. 163 patients consecutively hospitalized at the Unit of Internal Medicine of the “Santa Maria” Terni University Hospital between November 2019 and January 2020 (mean age ± standard deviation: 77 ± 14 years, men proportion: 40%) were examined. Simultaneously with BP measurement and AF screening, a standard 12-lead electrocardiogram (ECG) was performed in all subjects. AF was diagnosed by ECG in 29 patients (18%). AF screening showed overall 86% sensitivity and 96% specificity. False negatives (n = 4) had RR-interval coefficient of variation lower than true positives (n = 25, p < 0.01), suggesting a regular ventricular rhythm during AF. The repeated evaluation substantially confirmed the same level of agreement. AF screening was positive in all patients with new-onset AF (n = 6, 100%). Systematic AF screening in patients admitted to Internal Medicine wards, performed using the Microlife WatchBP Office AFIB, is feasible and effective. The opportunity to implement such technology in daily routine clinical practice to prevent undiagnosed AF episodes in hospitalized patients should be the subject of further research.


1988 ◽  
Vol 22 (3) ◽  
pp. 202-204 ◽  
Author(s):  
Merlin V. Nelson ◽  
Vickie Tutag-Lehr ◽  
R. Lee Evans

Nine normal, healthy male subjects had significantly elevated thyroid-stimulating hormone (TSH) concentrations while receiving oral lithium carbonate for two weeks. The mean minimum lithium serum concentration was 0.765 mEq/L. The TSH concentrations after 15 days on lithium were significantly correlated to the TSH concentration at baseline. No correlation was found between mean minimum lithium steady-state concentration and TSH concentration after 15 days on lithium. Further research is necessary to determine if a high baseline TSH concentration or an early rise in TSH will predict those patients who will eventually develop hypothyroidism after long-term lithium therapy.


2016 ◽  
Vol 45 (1) ◽  
pp. 1-5 ◽  
Author(s):  
Marufa Mustari ◽  
MA Hasanat ◽  
Qamrul Hasan ◽  
Sadiqa Tuqan ◽  
Md Shah Emran ◽  
...  

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


1998 ◽  
Vol 95 (2) ◽  
pp. 213-217 ◽  
Author(s):  
F. DE LORENZO ◽  
M. MUKHERJEE ◽  
Z. KADZIOLA ◽  
R. SHERWOOD ◽  
V. V. KAKKAR

1.A prospective study has been carried out, and 68 patients with hypercholesterolaemia have been investigated to study the effects of central cooling on serum lipid levels. 2.Central cooling was obtained by the exposure of the whole body to cold water. All patients were trained to gradually reduce the water temperature from 22 to 14 ;°C and to increase the time of exposure from 5 to 20 ;min over a period of 90 days. The 33 male and 35 female patients were aged between 40 and 60 years at entry with total cholesterol of 6.0 ;mmol/l or greater and low-density lipoprotein (LDL)-cholesterol of 4.0 ;mmol/l or greater. Thyroid-stimulating hormone, free thyroxine (FT4), total T3, total cholesterol, LDL-cholesterol, high-density lipoprotein (HDL)-cholesterol, triacylglycerols and total fat mass (determined by dual-energy X-ray absorptiometry scan) were obtained at baseline and after 3 months treatment with hydrotherapy. 3.Central cooling obtained by hydrotherapy results in a median fall in tympanic temperature from 0.2 ;°C (P< 0.001) to 0.8 ;°C (P< 0.001). We have observed in these patients a significant reduction in total cholesterol (-0.2 ;mmol/l, P = 0.006) and LDL-cholesterol (-0.2 ;mmol/l, P = 0.004). Serum FT4 level was higher than baseline results in 30 of these hypercholesterolaemic patients (15.5 ;pmol/l to 17.3 ;pmol/l) and there was no significant change in serum thyroid-stimulating hormone and total T3. 4.In conclusion, in our patients with hypercholesterolaemia we have observed a significant reduction of total cholesterol and LDL-cholesterol after body temperature regulation.


2019 ◽  
Vol 37 (6) ◽  
pp. 1114-1117
Author(s):  
Michael Apostol ◽  
Matthew Keeran ◽  
Nicholas Klempf ◽  
Victoria McCoskey ◽  
Amy A. Ernst ◽  
...  

Author(s):  
Mingjian Shi ◽  
Ali M Manouchehri ◽  
Christian M Shaffer ◽  
Nataraja Sarma Vaitinadin ◽  
Jacklyn N Hellwege ◽  
...  

Abstract Background A genetic predisposition to lower thyroid stimulating hormone (TSH) levels associates with increased atrial fibrillation (AF) risk through undefined mechanisms. Defining the genetic mediating mechanisms could lead to improved targeted therapies to mitigate AF risk. Methods We used two-sample Mendelian randomization (MR) to test associations between TSH-associated single nucleotide polymorphisms (SNPs) and 16 candidate mediators. We then performed multivariable Mendelian randomization (MVMR) to test for a significant attenuation of the genetic association between TSH and AF, after adjusting for each mediator significantly associated with TSH. Results Four candidate mediators (free T4, systolic blood pressure, heart rate, and height) were significantly inversely associated with genetically predicted TSH after adjusting for multiple testing. In MVMR analyses, adjusting for height significantly decreased the magnitude of the association between TSH and AF from -0.12 (s.e. 0.02) occurrences of AF per standard deviation change in height to -0.06 (0.02) (p=0.005). Adjusting for the other candidate mediators did not significantly attenuate the association. Conclusions The genetic association between TSH and increased AF risk is mediated, in part, by taller stature. Thus, some genetic mechanisms underlying TSH variability may contribute to AF risk through mechanisms determining height occurring early in life that differ from those driven by thyroid hormone level elevations in later life.


2016 ◽  
Vol 5 (3) ◽  
pp. 101-106 ◽  
Author(s):  
Akinori Sairaku ◽  
Yukiko Nakano ◽  
Yuko Uchimura ◽  
Takehito Tokuyama ◽  
Hiroshi Kawazoe ◽  
...  

Background The impact of subclinical hypothyroidism on the cardiovascular risk is still debated. We aimed to measure the relationship between subclinical hypothyroidism and the left atrial (LA) pressure. Methods The LA pressures and thyroid function were measured in consecutive patients undergoing atrial fibrillation (AF) ablation, who did not have any known heart failure, structural heart disease, or overt thyroid disease. Results Subclinical hypothyroidism (4.5≤ thyroid-stimulating hormone <19.9 mIU/L) was present in 61 (13.0%) of the 471 patients included. More subclinical hypothyroidism patients than euthyroid patients (55.7% vs 40.2%; P=0.04).’euthyroid patients had persistent or long-standing persistent AF (55.7% vs 40.2%; P = 0.04). The mean LA pressure (10.9 ± 4.7 vs 9.1 ± 4.3 mmHg; P = 0.002) and LA V-wave pressure (17.4 ± 6.5 vs 14.3 ± 5.9 mmHg; P < 0.001) were, respectively, higher in the patients with subclinical hypothyroidism than in the euthyroid patients. After an adjustment for potential confounders, the LA pressures remained significantly higher in the subclinical hypothyroidism patients. A multiple logistic regression model showed that subclinical hypothyroidism was independently associated with a mean LA pressure of >18 mmHg (odds ratio 3.94, 95% CI 1.28 11.2; P = 0.02). Conclusions Subclinical hypothyroidism may increase the LA pressure in AF patients.


2017 ◽  
Vol 41 (S1) ◽  
pp. S284-S284 ◽  
Author(s):  
R. Sallemi ◽  
S. Hentati ◽  
I. Feki ◽  
J. Masmoudi ◽  
M. Moala

BackgroundDue to their frequency and negative impact on quality of life, eating disorders in schizophrenia need to be considered and highlighting.ObjectiveTo identify the risk of eating disorders (ED) and its correlates among mental patients.MethodsIt was a descriptive and analytic study. It included 53 inpatients with DSM-5 diagnoses of schizophrenia or schizoaffective disorder, followed in the department of Psychiatry at the Hedi Chaker University Hospital of Sfax in Tunisia, during the three months of August, September and October 2016. Data collections were conducted using questionnaire exploring sociodemographic and medical data. The SCOFF (sick, control, one, fat, food) Questionnaire was used to screen ED. A total score of ≥ 2 was used as a cutoff point to select persons at risk of ED.ResultsThe average age of our patients was 30.47 ± 9.5 years old. The majority of our patients was male (71.7%) and single (71%). The mean of extra Body mass was 27.9. The mean duration of disease was 9.9 ± 8.1 years and patients were mostly (54%) in atypical neuroleptics. According to the SCOFF Questionnaire, 35.8% had a risk of ED. Female gender and treatment with atypical neuroleptics were significantly associated to ED risk with respectively P = 0.02 and P = 0.038.ConclusionEating disorders remain underestimated among patients suffering from schizophrenia. Yet, its screening prevention and management are crucial and must be multidisciplinary for optimal care.Disclosure of interestThe authors have not supplied their declaration of competing interest.


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