TSH secreting adenoma: a rare cause of severe headache

31 years old male patient admitted to the emergency department because of recurrent severe headaches which continued for two years. The patient has been consulted our clinic of internal medicine because of thyroid function abnormalities. Laboratory investigations revealed elevated serum TSH of 8,6 mU/L (normal range (N); 0.34-5,6), free T4 (fT4) of 1,73 (N;0,61-1,12ng/dl), and free T3(fT3) of 5,48 (N; 2,5-3,9pg/mL). Other laboratory parameters were normal. Physical examination revealed stage 3 goiter. The other system examinations were normal. We have learned that two years ago brain computed tomography scan was performed due to headache and result was reported as normal. Considering secondary hyper thyroidism pituitary MR was performed. Pituitary MR revealed a 13x18 mm macro adenoma (Figure). The patient underwent transphenoidal surgery. Final diagnosis was TSH secreting adenoma after pathological examination. After surgery headache and hyperthyroidism were recoveredPan African Medical Journal 2016; 2

The relationship between HbA1c and carotid intima-media thickness in type 2 diabetic patients

Introduction: The aim of this study was to investigate the relationship between HbA1c and carotid intima-media thickness (cIMT) which is noninvasive marker of atherosclerosis in type 2 diabetic patients. Methods: 81 type 2 diabetic patients were enrolled in this study. Demographic, clinical and laboratory features of the patients were obtained from hospital records. cIMT values were measured by high resolution B-mode ultrasound. Patients were divided into two groups according to cIMT values: cIMT < 0,9 mm group and cIMT ≥ 0,9 mm group. Increased cIMT values were accepted as ≥ 0,9 mm. Then we compared HbA1c and other collected features between normal and increased cIMT groups. Results: 69,2% of the patients were female, 30,8% were male. The mean age of the patients were 58,4±10,7 year. The mean HbA1c values of the patients were 8,6±2,03%. The mean cIMT values of the patients were 0,74±0,22 mm. Result with Student T test and ROC curve analysis HbA1c values were’nt different between the groups (p >0.05). Conclusion: in this present study we demonstrated that HbA1c could not be a marker for subclinical atherosclerosis in diabetic patients.Pan African Medical Journal 2016;

The Role of Sleeve Gastrectomy on Preventing Type 2 Diabetes Mellitus

AIM: To investigate the effect of bariatric surgery on HbA1c and serum cortisol levels in morbidly obese patients without type 2 diabetes mellitus.MATERIALS AND METHODS: Twenty-nine patients who underwent sleeve gastrectomy and whose body mass index was> 40 were included in the present study. Patients' files were reviewed retrospectively. Those with diabetes mellitus and those with age <18 were excluded from the study. Pre-operative and 1-year post operative data were documented. The obtained data were analysed by SPSS statistical program.RESULTS: The mean age of the patients was 27.4 ± 8.4. 5 of the patients were male, and 24 were female. The mean body mass index of the patients was 44 ± 2.3. 1 patient [3.4%] had hypertension. Four patients [13.7%] had gastroesophageal reflux disease. The number of smokers was 7 [24.1%], and the number of alcohol users was 3 [10.3%]. There was a statistically significant decrease in HbA1c, body mass index values after operation [p value <0.01], but cortisol was not different [p value = 0.72].CONCLUSION: In this present study we found that bariatric surgery caused a significant decrease in HbA1c levels in non-diabetic patients, suggesting that bariatric surgery may prevent Type 2 Diabetes Mellitus in obese patients

Predictive Contribution of Neutrophil/Lymphocyte Ratio in Diagnosis of Brucellosis

Here we wanted to investigate predictive value of neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) in the diagnosis of brucellosis. Thirty-two brucellosis patients diagnosed with positive serum agglutination test and thirty-two randomized healthy subjects were enrolled in this study retrospectively. Result with ROC analyzes the baseline NLR and hemoglobin values were found to be significantly associated with brucellosis (P=0.01, P=0.01, resp.). Herein we demonstrated for the first time that NLR values were significantly associated with brucellosis. This situation can help clinicians during diagnosis of brucellosis

Sarcopenia in diabetic nephropathy: a cross-sectional study

Objective. To investigate the relationship between sarcopenia and diabetic nephropathy

INVESTIGATION THE EFFECT OF HYPOTHYROIDISM ON HEMATOLOGICAL PARAMETERS

Aim: To investigate impact of the hypothyroidism on hematological parameters.Material and Method: Twenty patients with hypothyroidism and twenty two healthy subjects were enrolled in this study between February 2015 and July 2015. We collected clinical and laboratory data of patients with hypothyroidism and randomized healthy subject’s from the Adıyaman University Medical Faculty Hospital records retrospectively. The patients with anemia, rheumatic diseases, chronic kidney diseases, chronic liver diseases, chronic obstructive pulmonary disease, chronic heart diseases, inflammatory bowel diseases, malignancy and acute infections were excluded from the study. Patients were divided into two groups; hypothyroid group and healthy group. TSH values were increased in all of the hypothyroid patients. We compared hematological parameters consist of hemoglobin, platelet count, white blood cell (WBC), red cell distribution width (RDW) and mean platelet volume (MPV) between the two groups. Results: 70% of patients with hypothyroidism were female and 30% of patients were male. Mean age of patients with hypothyroidism were 44,8±13,4. 72,7% of  healthy subjects were female and 27,3% of healthy subjects were male. Mean age of healthy subjects was 31±14,6. In the result with Independent sample T test increased RDW-CV values was significantly associated with hypothyroidism (P value =0.01). The other hematological parameters weren’t different between the groups (P value >0.05).Conclusion: The present study demonstrated that increased RDW values was associated with hypothyroidism. Key words: Hypothyroidism, RDW, MP

Hypokalemia- induced myopathy and massive creatine kinase elevation as first manifestation of Conn′s syndrome

Click on the link to view the Letter.Nigerian Medical Journal | Vol. 54 | Issue 4 | July-August | 201