Abstract: Post prandial hypoglycemia refers to low blood glucose levels in the post meal period. In absence of any gastro-intestinal abnormality or surgery, other less common conditions need consideration. Extended glucose tolerance test helps confirm the diagnosis. The timing of hypoglycemia post meals and the corresponding insulin and C-peptide values help in understanding its pathophysiology. Hyperinsulinemia in Insulin resistance can also rarely present initially with post meal hypoglycemia. Frequent low glycemic index meals along with alpha-glucosidase inhibitors help alleviating the symptoms. We report this case for its rarity and clinical relevance. PubDate: 28 Jan, 2020
Abstract: Assisted reproductive techniques have been developed for infertility related problems and to offer more treatment options with increased infertility rates. The aim of the study was to investigate the effect of Luteinizing hormone β receptor (LHβR) gene variants on outcome of In Vitro Fertilization (IVF). This study included 69 cases (29 cases with failured of IVF treatment in IVF Center of Ondokuz Mayis University Hospital by comparing with 30 healthy pregnant cases). DNA isolated from all the cases and LHβ gene was analyzed by next generation DNA sequencing method. PubDate: 13 Jan, 2020
Abstract: Background: Ovarian hyperstimulation syndrome (OHSS) is a rare but serious complication of ovarian stimulation occurring during assisted reproduction technologies (ART). It is characterized by increased vascular permeability and hypercoagulable states resulting in strokes and peripheral ischemia. Acute myocardial infarction and cardiac thrombosis, however, have been rarely reported complications of OHSS. Methods: A literature search was performed for reports on myocardial infarction and cardiac thrombosis associated with ovarian stimulation with a summary of their clinical characteristics. Results: A total of twelve published cases were reviewed with 5 out of 12 (41.67%) of the reported cases were 35 years of age or older. Myocardial infarction was reported in 10 out of the 12 cases (83.3%). Two of the cases were pregnant at presentation (16.67%). The mean duration between starting ovarian stimulation medications and clinical presentation was 23 days. Chest pain was the most common presenting symptom (66.67%), 2 cases presented with stroke (16.67%) and 2 cases presented with abdominal distention (16.67%). A total of 8 patients underwent coronary angiography with 2 of these cases were treated with percutaneous coronary intervention. No mortality reported in any of the twelve cases. PubDate: 29 Mar, 2019
Abstract: Periodic fl accid paralysis is related to loss of tone and power transiently and which occurs repeatedlyover time. Etiologies like channelopathies, myasthenia gravis and thyroid disorders are common. Therehave been case reports of thyroid disorders leading to periodic paralysis. The pathophysiology attributedto it is the increased uptake of potassium by the cells in the thyrotoxic state. Thyrotoxicosis is also anuncommon cause for distal renal tubular acidosis. PubDate: 16 Jul, 2019
Abstract: Type A Insulin Resistance Syndrome is due to heterozygous mutations in the insulin receptor (INSR) gene or its signaling pathway.We present a premenarcheal 14 year-old girl with normal BMI, severe hirsutism, acanthosis nigricans, clitoral hypertrophy, deep voice, enlarged polycystic ovaries, severe hyperinsulinemia and biochemical hyperandrogenism. We identified a novel heterozygous missense variant in the tyrosine kinase domain of INSR (p.Leu1150Pro) and an heterozygous missense variant in SH2B adapter protein 1 involved in the insulin pathway (p.Ala663Val). Interestingly, the patients’ mother and brother had the same INSR mutation although of a milder phenotype, reason why their IR went undiagnosed. PubDate: 13 Jun, 2019
Abstract: Hypertension in pediatric patients,unlike adults, is mostly secondary to systemic disorders which may be renal,cardiovascular or endocrine, among others.Apparent mineralocorticoid excess (AME) is one such cause of hypertension. PubDate: 12 Nov, 2019
Abstract: Diabetes Mellitus is a group of metabolic disorders associated with microvascular and macrovascular complications. The rapidly increasing prevalence and incidence of this disease is causing a major worldwide health problem. Maturity onset diabetes of the young (MODY) is a rare monogenic form of diabetes resulting from mutation in a single gene. There are 13 types of MODY genes identified currently. The two main types of MODY is caused by mutations in the hepatocyte nuclear factor 1A and glycolytic enzyme glucokinase (GCK). Genetic testing is the gold standard for diagnosing MODY. It is essential to identify the MODY subtype to determine the management and treatment options. PubDate: 12 Feb, 2019
Abstract: Background: Diabetes increases the risk of periodontal disease. Integrating periodontal care with the treatment of type 2 diabetes (T2DM) may facilitate the management of both diseases.Aim of the study: To evaluate the periodontal status at two years in patients with T2DM and assess glycated hemoglobin (HbA1c) according to the severity and extension of periodontitis.Methods: This is a descriptive cohort study. Full-mouth periodontal evaluation was performed and blood samples were obtained to analyze HbA1c at baseline, 3, 12 and 24 months. Clinical attachment level, probing depth, bleeding on probing and oral hygiene were measured. We analyzed mean HbA1c according to severity and extension of periodontitis. PubDate: 11 Feb, 2019
Abstract: Thyroid cancer can be largely classifi ed as well-differentiated, poorly differentiated, medullary and anaplastic. Differentiated thyroid cancer (DTC) includes follicular and papillary subtypes, with the incidence of papillary thyroid cancer (PTC) on the rise. PubDate: 09 Sep, 2019
Abstract: A deep understanding of the cardiopulmonary and hemodynamic changes from acute immediate tochronic long-term in the patients undergoing TIPSS is essential for providing a base for timely interventionto decrease the associated morbidity and mortality in the patients post TIPSS . The hemodynamic statusof patients has shown a specifi c pattern of alternations in the different time periods post TIPSS. Most ofthe hemodynamic parameters which increases immediately after TIPSS i.e. including the CO, MAP, PcWP,RAP seems to normalize within 2 months to 1 year duration, PubDate: 09 Jul, 2019
Abstract: Myxedema coma is a rare clinical condition that represents severe hypothyroidism decompensation usually occurs in patient with long-standing undiagnosed hypothyroidism and is usually precipitated by infection and discontinuation of supplements treatment. Clinical symptoms are a mental decreased status, hypothermia, bradycardia, hypotension, hypoglycemia and hypoventilation. Thyroid hormone measurement allows the diagnosis. Protocols with rapid intravenous high doses of thyroid hormone, warming and mechanical ventilation may improve the prognosis. The purpose of the present article is to describe a fatal case of myxedema coma in elderly-woman occurring in the context of immunodeficiency. PubDate: 02 May, 2019
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