Endocrine Abstracts

Background: A previous short Synacthen test (SST) audit in our hospital (2012) showed 70% of initial SST tests were normal with 9% inappropriate requests. A new pro forma was devised whereby one of four criteria (specific symptoms, medications, previous diagnosis, and physical findings) had to be satisfied to be able to undergo a SST. Additionally, we noticed that a number of patients were probably being over-diagnosed wth adrenal insufficiency (AI) based on a single 30 min co...

Introduction: Interaction of growth hormone system with Hypothalamic pituitary axis can be complicated, and the effect of GH treatment on thyroid function is still not completely clear. GH has inhibitory effect on conversion of T4 to reverse T3, while enhancing extrathyroidal conversion of T4 to T3.Objective: To assess thyroid function test in patients with growth hormone deficiency, receiving growth hormone replacement therapy in Slemani, Kurdistan regi...

A 67-year-old lady was referred to Haematology for evaluation of Polycythemia (Haemoglobin 162 – 172 g/l, PCV 50 – 53%) A simultaneous referral was sent to Endocrinology for hirsutism, noting that her Testosterone level was 24 nmol/l, SHBG 33 nmol/l. Her past medical history was significant for hypothyroidism, hypertension and migraines for which she was on Levothyroxine, amlodipine and candesartan. She was a non-smoker and teetotaller. Her haematology workup was neg...

Insulin is a life-saving drug but can be life threatening if not prescribed properly. A prospective, consecutive audit of insulin prescription was carried out on all medical and surgical patients admitted to South Tipperary General Hospital with types 1 and 2 diabetes mellitus in November 2013. The practice was compared with hospital guidelines which are consistent with other hospitals nationally. Three prescribing practices were audited: i) the prescription of insulin on insu...

Introduction: The acute status of the hypothalamic-pituitary-adrenocortical (HPA) axis is routinely assessed by the measurements of cortisol in blood, saliva, and urine. Because cortisol is continuously deposited in the growing hair shaft, hair cortisol can serve as a practical measure of long-term retrospective HPA axis activity. The purpose of this review is to present the relevance of hair cortisol measurement in the diagnosis and management of Cushing’s syndrome and a...

Introduction: Fibroblast growth factor 21 (FGF21), a 181 amino acid peptide hormone predominantly produced by the liver, is a member of the endocrine FGF subfamily. It is involved in multiple physiological regulations and plays an important role in several pathological conditions. This literature analysis provides an update on the relevance of FGF21 in health and diseases.Methods: A systematic search of literature was conducted using the search terms fib...

Case history: A 75-year-old lady presented with sudden central chest discomfort to Emergency Department. The chest pain was preceded by palpitations. She had a background of Hypertension. She was non-smoker and otherwise fit and well. She mentioned receiving a steroid injection one day ago for joint pain. Her B.P on presentation was 226/106. Her physical examination was otherwise normal.Investigations: Her ECG on admission revealed atrial tachycardia and...

Background: Diabetes mellitus has become a serious problem worldwide. Effects of diabetes stress, in addition to the physical complications had mental complications that make its treatment difficult. Concept of empowerment, enabling patients to make informed decisions and play an active role in planning and decision-making in health-related activities\.Aim: To determine the effect of empowering on self-care and coping strategies with type 1 diabetes....

Hypothyroidism is a common endocrine condition and if untreated can have serious consequences in pregnant women. Generally, TSH receptor antibodies (TRAb) is performed in hyperthyroid pregnant women as high titres can cause foetal hyperthyroidism Neonatal thyrotoxicosis develops in 1% of infants born to thyrotoxic mothers due to placental transfer of TRAb.As part of management of hypothyroid pregnant women, TRAb are checked routinely in our hospital in k...

Background: Thyroiditis is ‘the disorder in which there is inflammation of the thyroid gland’. If diagnosed earlier have often good chances of recovery. Limited data is available related to this problem from low income countries and hence there is delay in the diagnosis and management of this important disorder. The objective of the study was to assess the clinical presentations and early outcome of patients presenting with thyroiditis in a tertiary care hospital.</p...