Journal of Diabetes and Endocrinology Association of Nepal

Anxiety, Depression and Self-Care Management among Hypothyroidism Patients Attending Chitwan Medical College Teaching Hospital, Chitwan

D. Khanal — 2022-12-31

Background: Thyroid dysfunctions have been recognized to cause significant manifestations in physical health as well as mental health. A descriptive cross-sectional research design was used to assess anxiety, depression and self-care management among hypothyroidism attending Chitwan Medical College Teaching Hospital (CMC-TH).

Methods: A total of 258 patients diagnosed with hypothyroidism were selected by convenience sampling. Data was collected from the date June 6, 2021 to November 17, 2021 using face to face interview schedule. The data was analyzed in SPSS version 20 using descriptive and inferential statistics was used to analyze the data.

Result: Out of 258 respondents females constituted 64% of the sample. A total of 72.1% of the respondents had different level of anxiety based on GAD-7 among them 43.8% of the respondents had mild anxiety and 9.3% severe level of anxiety. Regarding depression 60.1 % of the respondents had different level of depression based on PHQ-9. Among them 27.1% had mild level of depression whereas 4.7% severe level of anxiety. More than fifty percentages of the respondents (54.3%) had inadequate level of self-care management. Anxiety was significantly associated with sex (0.044), marital status (0.000) and family history of mental illness (0.009) whereas depression was significantly associated with educational status (0.009) and duration of illness (0.002).

Conclusion: It is concluded that anxiety and depression was more prevalent among hypothyroidism patients so, routine screening of hypothyroidism patients for psychiatric disorder and treating by both an endocrinologist and a psychiatrist in liaison with each other is very important to optimize their management and improve quality of life.

An analysis of Clinical, Ultrasonological and Cytopathological findings of thyroid swellings at a teaching hospital in eastern Nepal

S.K. Thakur — 2022-12-31

Background: Thyroid swelling can be benign or malignant. It is evaluated by clinical examination, Ultrasonography (USG) and Fine Needle Aspiration Cytology (FNAC). This study was conducted with the aim of comparing discrepancy of diagnosis by USG, considering FNAC as gold standard.

Methods: A prospective observational study of thyroid swellings with convenient sampling was carried out over a year (20 October 2020 to 19 October 2021) at Outpatient department of Nobel Medical College, Biratnagar, eastern region of Nepal. Clinical, ultrasonological and cytological parameters were recorded. Sensitivity, Specificity, Positive predictive value (PPV) and negative predictive value (NPV) were calculated.

Results: Out of 120 study population, with a mean age of 45.37 years, there was female preponderance, 110(91.66%). The commonest age group was 30-40 years, 28(23.33%). On Ultrasonography, non neoplastic lesions diagnosed were in 104 (86.7%) cases, as compared to FNAC, 113(94.2%). While, malignancy was diagnosed in 16 (13.7%) cases, by USG, only 7(5.8%) cases were malignant on FNAC. The Sensitivity of USG for malignancy detection was 100%, Specificity was 92 %, Positive predictive value (PPV) was 43.75 % and Negative Predictive value (NPV) was 100% as compared to FNAC. Accuracy was 92.5%.

Conclusions: Ultrasonography has an excellent diagnostic sensitivity, specificity and accuracy compared to that of FNAC.

Spectrum of endocrine disorders in a hospitalized patient in a Tertiary University Hospital, Nepal

G. Yadav — 2022-12-31

Background: The epidemiological spectrum of endocrine disorders in hospitalized patients is not much explored in developing countries. Therefore, the spectrum to visualize a complete picture of the endocrine-related disease is still missing. The study aims to find the spectrum of endocrine-related-disorders in a hospitalized patient, characterize demographic variables, and the duration of hospital stay of patients.

Methods: This was a retrospective study of medical records of admitted cases between January 2014 to December 2018 in the Medicine Ward of BPKIHS. Records were retrieved from the Medical office and were entered into Excel and then transferred to SPSS and were analysed.

Result: Out of 26,590 admitted cases,1141 (4.3%) had endocrine-related-disease. This includes 565 males and 576 females (1.02: 1 ratio) with an overall mean age of 52.81 ± 16.21 years and median (IQR) age 53 (42-64) years. Among which 904 (79.2%) had Diabetes mellitus, 118 (10.3%) had Metabolic Disorders, 38 (3.3%) had Disorders of Thyroid gland, 38 (3.3%) had Other Nutritional Deficiencies, 29 (2.5%) had Disorders of other endocrine glands, 7 (0.6%) had other disorders of glucose regulation and pancreatic internal secretion, 5 (0.4%) had Overweight, obesity and other hyperalimentation, 2 (0.2%) had Malnutrition.

Conclusion: Diabetes and Metabolic disorders are the main components of the spectrum of endocrine disorders in admitted cases. Emphasizing the resources essential for further investigation will help both in dealing with and managing the cases of endocrine disorders.

A massive ovarian cyst masquerading as malignancy in unrecognised primary hypothyroidism

S.S. Sandhya — 2022-12-31

We report here probably a huge ovarian cyst of size 7.9x16.4x23 cms which regressed on thyroxine therapy with severe autoimmune primary hypothyroidism in a young woman. It is necessary to consider hypothyroidism and other endocrine disorders in the differential diagnosis of adult patients with ovarian multiple cyst formation in order to prevent inadvertent ovarian surgery.

Growth hormone therapy in a girl with Turner syndrome – An experience from Bangladesh

J. Nahar — 2022-12-31

Turner syndrome (TS) is the most common sex chromosome abnormality in females. Short stature and hypogonadism are principal signs of TS. Turner syndrome is well-established. There have been studies that have evaluated the benefits of growth hormone in TS with significant benefit in adult height. A 9-year 11 months-old girl who presented to the Paediatric Endocrinologist, with complaint of not growing according to her age. Her growth was noticed to be slow from early age but her parents initially thought it was normal. They however became worried when she was not growing yet to start pubertal development. Her parents eventually took her to this referral hospital for further evaluation and management.

DEAN NECON 2023 theme "Empowering endocrine practice in Nepal"

R. Maskey — 2022-12-31

No abstract available.