Association of Secondary Hyperparathyroidism with Hemoglobin Level in Patients with Chronic Kidney Disease

Purpose: Secondary hyperparathyroidism (SHPT) is one of the less recognized reasons of anemia in chronic kidney disease (CKD). In this study, we evaluated the role of SHPT as a cause of anemia and correlation of intact parathyroid hormone (iPTH) and hemoglobin (Hb) level in hemodialysis (HD) patients. Methods: This cross-sectional study was carried out in 63 individuals admitted in HD unit of the institute. Serum samples were collected and urea, creatinine, Hb, ferritin and iPTH levels were measured. Statistical analysis was carried out using the SPSS software (IBM, NY, USA). Results: Mean ± standard deviation for serum urea, creatinine, Hb, ferritin and intact PTH were 177 ± 15.52, 15.16 ± 2.28 mg/dl, 7.03 ± 2.26 g/dl, 654.7 ± 563.4 ng/ml, 539.18 ± 493.59 pg/ml respectively. A reverse correlation was found between intact PTH and Hb level. Conclusions: A variety of postulated pathophysiological mechanisms linking SHPT and anemia in CKD are discussed. An efficient control of parathyroid hormone hypersecretion may be required to achieve a better management of anemia in HD patients

Evaluation of thyroid function in type 2 diabetes in north-eastern part of India: A hospital-based study

Background: Diabetes mellitus (DM) and thyroid dysfunctions are the two most common endocrine disorders to come across in any clinical practice. Both thyroid hormones and insulin act antagonistically in metabolic pathways or cycles of cells. The aim of our study is to look for thyroid dysfunction in patients with type 2 DM and its correlation with insulin resistance (IR). Methods: A cross-sectional study was carried out among 80 newly diagnosed type 2 diabetic patients. Thyroid-stimulating hormone (TSH), free triiodothyronine, free thyroxine, and insulin were measured in fasting serum sample. Homeostasis model assessment for IR was calculated as per formula. Results: Among 80 diabetic patients, 20 were hypothyroid, 4 were hyperthyroid, and 56 were found to be euthyroid. IR was found to be significantly higher in hypothyroid as compared to euthyroid patients. A positive association was found between TSH and IR (r = 0.230) among hypothyroid patients though association was not significant. In hyperthyroid patients, a strong negative correlation (r = −0.94933) was found between TSH and IR, but no association was found among euthyroid patients. Conclusion: The inability to recognize the presence of thyroid hormone dysfunction may be one of the important causes of poor management of type 2 DM. Therefore, there is a need for routine assay of thyroid hormones in type 2 diabetic patients to improve the medical management as well as to reduce the morbidity in them

Psychological impact of Covid-19 pandemic among the Healthcare workers in a North-Eastern state of India

Background: Previous studies done during SARS 2003 outbreak and early reports related to COVID-19 show that healthcare workers experience considerable anxiety, stress and fear. Although similar studies were done in other parts of India, there is dearth of data on this topic in the Northeastern region. Aim: This study aimed to assess the mental health status of Healthcare Workers during Covid-19 pandemic in the region. Methods: The study was conducted among the doctors and nurses of a Northeastern state of India through an online survey. PHQ-9, GAD-7 and ISI scales were used to assess depression, anxiety and insomnia among the participants. Results: The prevalence of depression, anxiety and insomnia among the HCWs was 74.5%, 42% and 32%, respectively. Moderate to Severe form of depression, anxiety and insomnia was experienced by 15.5%, 20.5% and 8.5%, respectively. Females and those who directly cared for Covid-19 patients were more prone to suffer from depression. Participants who reported having previous history of any psychological problems reported eight-fold, seven-fold and three-fold increased odds of developing depression, anxiety and insomnia, respectively, during the pandemic. Conclusions: A large proportion of HCWs reported symptoms of depression, anxiety and insomnia among the healthcare workers. Protecting the mental health of these health workers is paramount to ensure psychological wellbeing, which in turn will ensure a healthy and robust workforce. Relevance for Patients: Improves the productivity of Healthcare workers in terms of Patient care and Management