Medical Specialties Commons^™

Association Of Vaspin Levels And Its Snp Rs2236242 With Sestational Diabetes At A Tertiary Care Setting, Karishma Kanhya Lal, Rabail Jarwar, Sabah Farhat, Syeda Sadia Fatima

Medical College Documents

Objectives:
To evaluate and correlate vaspin levels and genotype frequency in gestational diabetes mellitus.
Methods:
The case-control study was conducted at Aga Khan University, Karachi, from November 2015 to December 2016, and comprised pregnant women in their second trimester with gestational diabetes mellitus. Healthy pregnant women with similar characteristics were enrolled as the control group. Tetra arms amplification system for vaspin gene was performed. SPSS 21 was used for data analysis.
Results:
Of the 112 pregnant women, 67(60%) were normo-glycaemic and 45(40%) had gestational diabetes. Those with gestational diabetes had a higher body mass index (p=0.047) and fasting blood glucose …

Rare Case Of Giant Asymptomatic Left Coronary Artery Aneurysm Of 10 Cm Associated With Coronary Cameral Fistula, Ali Afzal, Mohamad Sharbatji, Hussain Nawaz, Muqeet Siddiqui

Section of Internal Medicine

A giant coronary artery aneurysm (CAA) associated with a coronary cameral fistula is an extremely rare finding. Most cases of CAAs are asymptomatic. The incidence of CAA varies between 0.3% to 5.3%. Due to advancements in diagnostic technologies, the incidence of CAA is on the rise. Even in the modern days of medical science, the clinical course of CAA is still unpredictable and the suitable timing for the treatment of CAA is still open to debate. We reported a case of a giant coronary artery aneurysm in a 38-year-old female, which was 9.4 x 9.7 x 9.2cm in size, arising …

Diagnostic Value Of Gauze Filtration Technique: A Comparison With Conventional Methods In A Diagnostic Laboratory In Pakistan, Naima Maqsood, Aymen Shakeel, Najia Karim Ghanchi, Ahmed Raheem Buksh, ,Feroz Zaheruddin, Ghazala Jabeen, Afsheen Raza, Mohammad A. Beg

Section of Internal Medicine

Background: Intestinal parasites cause significant morbidity and impact human development with an enormous global burden. Diagnosis of intestinal parasites by conventional methods has several limitations. The gauze filtration technique is a relatively simple method that has been shown to identify intestinal parasites with a high sensitivity and specificity. The aim of this study was to determine the diagnostic value of this technique as compared to more conventional methods in a large acclaimed laboratory within Pakistan.

Methods: A total of 50 stool samples collected for routine diagnostic workup from patients age between 2-70 years were collected from the parasitology section of …

963. Whole Blood Transcriptome Analysis Reveals Differences In Erythropoiesis And Neurologically Relevant Pathways Between Cerebral Malaria And Severe Malarial Anemia, Srinivas Nallandhighal, Gregory Park, Yen-Yi Ho, Robert Opoka, Chandy John, Tuan Tran

Paediatrics and Child Health, East Africa

Background: Plasmodium falciparum malaria can rapidly progress to severe disease that can lead to death if left untreated. Severe malaria cases commonly present as severe malarial anemia (SMA), defined in children as hemoglobin (Hb) <5 g/dL with parasitemia, or as cerebral malaria (CM), which manifests as parasitemia with acute neurological deficits and has an inpatient mortality rate of ~20%. The molecular and cellular processes that lead to CM and SMA are unclear.

Methods: In a cross-sectional study, we compared genome-wide transcription profiles of whole blood obtained from Ugandan children with acute CM (n = 17) or SMA (n = 17) and community children without P. falciparum infection (n = 12) who were enrolled in a parent cohort study of severe malaria. We determined the relationships between gene expression, hematological indices, and plasma biomarkers, including inflammatory cytokines. …

Mapping Maternal Mortality Rate Via Spatial Zero-Inflated Models For Count Data: A Case Study Of Facility-Based Maternal Deaths From Mozambique, Osvaldo Loquiha, Niel Hens, Leonardo Chavane, Marleen Temmerman, Nafissa Osman, Christel Faes, Marc Aerts

Obstetrics and Gynaecology, East Africa

Maternal mortality remains very high in Mozambique, with estimates from 2015 showing a maternal mortality ratio of 489 deaths per 100,000 live births, even though the rates tend to decrease since 1990. Pregnancy related hemorrhage, gestational hypertension and diseases such as malaria and HIV/AIDS are amongst the leading causes of maternal death in Mozambique, and a significant number of these deaths occur within health facilities. Often, the analysis of data on maternal mortality involves the use of counts of maternal deaths as outcome variable. Previously we showed that a class of hierarchical zero-inflated models were very successful in dealing with …

Port Site Parasitic Leiomyoma After Laparoscopic Myomectomy: A Case Report And Review Of The Literature, Felix Oindi, Steve Mutiso, Timona Obura

Obstetrics and Gynaecology, East Africa

Background: Uterine fibroids are the commonest benign gynecological tumors. Laparoscopic myomectomy is becoming increasingly popular as one of the surgical treatment options for symptomatic cases. Large tissues such as leiomyomas or even the uterus need to be morcellated in order to be retrieved from the abdominal cavity. Some of the morcellated fragments or small fibroids may be accidentally left in the abdominal cavity during the retrieval process. These may subsequently become implanted in the abdominal cavity, develop blood supply from the surrounding structures, and grow to form parasitic myomas with varied clinical presentation, depending on the location and size.

Case …

Inheritance Patterns, Challenges, And Outcomes Of Fracture Management In Osteopetrosis Patients. Case Series And Review Of Pertinent Literature, Obada Hussein Hasan, Aly Zaheer Pathan, Hammad Naqvi, Pervaiz Hashmi, Riaz Hussain Lakdawala

Department of Surgery Docs

Background: Osteopetrosis (OP) is a group of rare inheritable genetic disorders which show increased bone radiodensity on radiography. As no cure exists, careful symptomatic treatment is the mainstay in management due to brittle bone and frequent complications. We would like to present a case series of OP patients, their management, a review of literature about this rare disease and its genetic and inheritance patterns.
Materials and methods: Retrospective case series of 6 patients with OP seen at our institution from 2010 to January 2018. We searched PubMed and Google Scholar for articles using the following keywords: Osteopetrosis, Radiology, Fracture and …

Levonorgestrel Only Emergency Contraceptive Use And Risk Of Ectopic Pregnancy In Eldoret Kenya: A Case-Control Study, Sahara Shurie, Edwin Were, Elkanah Omenge, Alfred Keter

Obstetrics and Gynaecology, East Africa

Introduction: ectopic pregnancy is one of the causes of maternal morbidity and mortality in Sub-Saharan Africa. Levonorgestrel (LNG) only emergency contraceptive pill is a well-established emergency contraceptive pill that is administered within 72 hours after unprotected intercourse. This study aimed at determining whether or not there is a significant association between levonorgestrel emergency contraceptive use and the occurrence of ectopic pregnancy.

Methods: case-control (1:3) study among 79 women with ectopic pregnancy (cases) matched against 237 women without (controls) at Moi Teaching and Referral Hospital in Eldoret, Kenya; Sociodemographic and clinical data were collected using a questionnaire. Association between ectopic pregnancy …

Spectrum, Management And Outcomes Of Structural And Functional Uropathies In Children Attending A Tertiary Care Center In Karachi; Pakistan, Arshalooz Rahman, Saima Hanif, Noor Ul-Ain Baloch, Abdul Rehman, Tauqeer Sheikh, Mohammad Irfan Ladhani

Department of Paediatrics and Child Health

Causes and outcomes of children diagnosed with hydronephrosis in resource-limited countries with a low utilization of antenatal ultrasonography remain unexplored. We performed a retrospective, crosssectional study of all paediatric patients diagnosed with hydronephrosis and managed at a tertiary care center in Karachi, Pakistan between 2005 and 2010. Data relating to demographics, clinical features, etiologies and treatment modalities were systematically collected. Of a total of 234 cases (74.4% male), 83 (35.5%) and 42 (17.9%) were neonates and infants respectively. Congenital urinary tract pathologies were noted in 192(72.2%) patients, of which only 96(50%) had undergone foetal ultrasonography and 77(40.1%) first presented after …

Genetics Of The Thrombomodulin-Endothelial Cell Protein C Receptor System And The Risk Of Early-Onset Ischemic Stroke, John W. Cole, Huichun Xu, Kathleen Ryan,, Thomas Jaworek, Nicole Dueke, Patrick Mcardle, Brady Gaynor,, Yu-Ching Cheng, Jeffrey O'Connell, Ayeesha Kamran Kamal

Section of Neurology

Background and Purpose: Polymorphisms in coagulation genes have been associated with early-onset ischemic stroke. Here we pursue an a priori hypothesis that genetic variation in the endothelial-based receptors of the thrombomodulin-protein C system (THBD and PROCR) may similarly be associated with early-onset ischemic stroke. We explored this hypothesis utilizing a multi-stage design of discovery and replication.

Methods: Discovery was performed in the Genetics-of-Early-Onset Stroke (GEOS) Study, a biracial population-based case-control study of ischemic stroke among men and women aged 15-49 including 829 cases of first ischemic stroke (42.2% African-American) and 850 age-comparable stroke-free controls (38.1% African-American). Twenty-four single-nucleotide-polymorphisms …

Novel Public-Private Partnerships To Address The Double Burden Of Malnutrition, Adam Drewnowski, Benjamin Caballero, Jai K. Das, Jeff French, Andrew M. Prentice, Lisa R. Fries, Tessa M Van Koperen, Petra Klassen-Wigger, Barbara J. Rolls

Department of Paediatrics and Child Health

Public–private partnerships are an effective way to address the global double burden of malnutrition. While public–private partnerships operate in multiple forms, their leadership usually falls to governments, public health agencies, or nongovernmental organizations, with the private sector taking a subordinate role. The rapid ascent of social media and mass communications worldwide has provided a disruptive technology for new nutrition intervention programs. A new model, provisionally called private–public engagement, takes advantage of social media, mass media, and integrated social marketing to reach parents, families, and communities directly. These new private–public engagement initiatives need to be managed in ways suggested for public–private …

Development And Internal Validation Of The Multivariable Cipher (Collaborative Integrated Pregnancy High-Dependency Estimate Of Risk) Clinical Risk Prediction Model, Beth A. Payne, Helen Ryan, Jeffrey Bone, Laura A. Magee, Alice B. Aarvold, J. Mark Ansermino, Zulfiqar Ahmed Bhutta, Mary Bowen, J. Guilherme Cecatti, Cynthia Chazotte

Department of Paediatrics and Child Health

Background: Intensive care unit (ICU) outcome prediction models, such as Acute Physiology And Chronic Health Evaluation (APACHE), were designed in general critical care populations and their use in obstetric populations is contentious. The aim of the CIPHER (Collaborative Integrated Pregnancy High-dependency Estimate of Risk) study was to develop and internally validate a multivariable prognostic model calibrated specifically for pregnant or recently delivered women admitted for critical care.
Methods: A retrospective observational cohort was created for this study from 13 tertiary facilities across five high-income and six low- or middle-income countries. Women admitted to an ICU for more than 24 h …

Myocardial Ischemia Reperfusion Injury: Apoptotic, Inflammatory And Oxidative Stress Role Of Galectin-3, Suhail Al-Salam, Satwat Hashmi

Department of Biological & Biomedical Sciences

Background/aims: Myocardial reperfusion has the potential to salvage the ischemic myocardium after a period of coronary occlusion. Reperfusion, however, can cause a wide spectrum of deleterious effects. Galectin-3 (GAL-3), a beta galactoside binding lectin, is closely associated with myocardial infarction (MI), myocardial fibrosis and heart failure. In our study, we investigated its role in ischemia-reperfusion injuries (IR) as this phenomenon is extremely relevant to the early intervention after acute MI.
Methods: C57B6/J wild type (WT) mice and GAL-3 knockout (KO) mice were used for murine model of IR injury in the heart where a period of 30 minutes ischemia was …

Tramadol: A Valuable Treatment For Pain In Southeast Asian Countries, Ramani Vijayan, Gauhar Afshan, Khalid Bashir, Mary Cardosa, Madhur Chadha, Pongparadee Chaudakshetrin, Khin Myo Hla, Muralidhar Joshi, Francis O. Javier, Asif Gul Kayani

Department of Anaesthesia

Background: The supply of controlled drugs is limited in the Far East, despite the prevalence of health disorders that warrant their prescription. Reasons for this include strict regulatory frameworks, limited financial resources, lack of appropriate training amongst the medical profession and fear of addiction in both general practitioners and the wider population. Consequently, the weak opioid tramadol has become the analgesic most frequently used in the region to treat moderate to severe pain.
Methods: To obtain a clearer picture of the current role and clinical use of tramadol in Southeast Asia, pain specialists from 7 countries in the region were …

Rubber Tourniquet Technique: A Simple, Safe, And Cost-Effective Methodof Hepatic Resection In Neonates And Infants, Zafar Nazir

Section of Paediatric Surgery

Background: Despite the improvements in patient care, understanding of surgical anatomy of liver and surgical techniques, liver resection is a high-risk procedure specifically in infants and neonates; whose blood volume is limited (80 ml/kg). This report shares the experience of hepatic resection with “Rubber tourniquet technique” in patients less than 6-months of age.
Methods: Hepatic resection in a 4-month-old pair of Conjoined twins with shared liver and a 3-day old baby with large Congenital Hepatoblastoma was performed using Penrose rubber drain as a tourniquet around the liver parenchyma to reduce blood loss.
Results: Blood loss was minimal (< 20CC) and all the three babies survived the procedure without complications.
Conclusion: Rubber …

Kawasaki Disease: Two Case Reports From The Aga Khan Hospital, Dar Es Salaam-Tanzania, Mariam Noorani, Nuruddin Lakhani

Paediatrics and Child Health, East Africa

Background: Kawasaki disease is a common childhood vasculitis which may result in cardiovascular morbidity if not adequately treated. Its epidemiology in the African region is not well described. Its features may mimic other childhood infections and hemoglobinopathies and it is rarely diagnosed in the East African region. These are the first reports of this disease from Tanzania. Case presentation We present two cases of complete Kawasaki disease seen over a 2 year period and diagnosed as per the criteria defined by the American Heart Association. One child was and infant and the other a 3 year old. Both of them …

Alma Ata And Primary Healthcare: Back To The Future, Zulfiqar Ahmed Bhutta, Rifat Atun, Navjoyt Ladher, Kamran Abbasi

Department of Paediatrics and Child Health

No abstract provided.

"It's A Precious Gift, Not To Waste": Is Routine Cross Matching Necessary In Orthopedics Surgery?: Retrospective Study Of 699 Patients In 9 Different Procedures, Obada Hasan, Eraj Khurshid Khan, Moiz Ali, Sadaf Sheikh, Anum Fatima, Haroon Ur Rashid

Section of Orthopaedic Surgery

Background: Orthopedic surgeries are usually associated with excessive blood loss which leads surgeons to overestimate need for blood transfusions and over ordering of blood. The cross matched blood, when not used, leads to the wastage of blood bank resources in terms of time, money and manpower. The objective of this study was to investigate the compliance to previously proposed MSBOS and to provide updated recommendations for all orthopedic procedures.
Methods: A retrospective analysis was conducted between 1st June 2015 and 31st May 2016. Patients admitted to the orthopedic surgery service for whom blood products were requested were included. Cross Match/Transfusion …

Expression Analysis Of Cyclooxygenase-2 In Patients Suffering From Esophageal Squamous Cell Carcinoma, Shahida Tasneem, Muhammad Tahir Sarwa, Muhammad Rizwan Bashi, Hamid Hussain, Jawad Ahmed, Shahid Pervez

Department of Pathology and Laboratory Medicine

Esophageal squamous cell carcinoma (ESCC) is one of the aggressive malignancies and mechanisms underlying its pathogenesis remain unclear. Cyclooxygenase-2 (COX-2) enzyme system plays a crucial role in many gastrointestinal malignancies and is an important regulator of cell growth, proliferation, apoptosis, differentiation and transformation. More precise outcome of COX-2 in ESCC is less investigated. In this study we investigated the risk factors of ESCC and expression of COX-2 in Carcinoma in situ (CIS) and ESCC compared to normal esophageal mucosa. ESCC relationship to clinico-pathological parameters using immunohistochemistry was also part of this investigation. Current study was conducted in the Institute of …

Determinants Of Uncontrolled Hypertension In Rural Communities In South Asia-Bangladesh, Pakistan, And Sri Lanka, Tazeen Jafar, Mihir Gandhi, Imtiaz Jehan, Aliya Naheed, H Asita De Silva, Hunaina Shahab, Dewan Alam, Nathasha Luke, Ching Wee Lim Wee Lim, Cobra-Bps Study Group

Community Health Sciences

Background: Uncontrolled blood pressure (BP) is a leading risk factor for death and disability in South Asia. We aimed to determine the cross-country variation, and the factors associated with uncontrolled BP among adults treated for hypertension in rural South Asia.
Methods: We enrolled 1718 individuals aged ≥40 years treated for hypertension in a cross-sectional study from rural communities in Bangladesh, Pakistan, and Sri Lanka. Multivariable logistic regression model was used to determine the factors associated with uncontrolledBP (systolic BP ≥140 mmHg or diastolic BP ≥90 mmHg).
Results: Among hypertensive individuals, 58.0% (95% confidence interval 55.7, 60.4) had uncontrolled BP: 52.8% …

Cd133 Expression In Glioblastoma Multiforme: A Literature Review, Syed Ijlal Ahmed, Gohar Javed, Altaf Ali Laghari, Syeda Beenish Bareeqa, Saba Farrukh, Shajeeah Zahid, Syeda Sana Samar, Kashif Aziz

Section of Neurosurgery

Glioblastoma, also known as glioblastoma multiforme (GBM), is the most common primary brain tumor. Extensive research has been carried out to discover the factors associated with the course and progression of GBM. CD133 is a glycoprotein antigen found in normal and malignant tissues. CD133 has been recognized as a marker for the growth of cancer cells. The association between this tissue marker and GBM is being investigated. The aim of this review was to evaluate the role of CD133 as a tumor marker for the prognosis of GBM.

Integration Of Postpartum Care Into Child Health And Immunization Services In Burkina Faso: Findings From A Cross-Sectional Study, Danielle Yugbaré Belemsaga, Anne Goujon, Aristide Bado, Seni Kouanda, Els Duysburgh, Marleen Temmerman, Olivier Degomme

Department of Obstetrics & Gynaecology

Background: The Missed Opportunities for Maternal and Infant Health (MOMI) project, which aimed at upgrading maternal and infant postpartum care (PPC), implemented a package of interventions including the integration of maternal PPC in infant immunization services in 12 health facilities in Kaya Health district in Burkina Faso from 2013 to 2015. This paper assesses the coverage and the quality of combined mother-infant PPC in reproductive, maternal, newborn and child health services (RMNCH).
Methods: We conducted a mixed methods study with cross-sectional surveys before and after the intervention in the Kaya health and demographic surveillance system. On the quantitative side, two …

Investigating Mpm-Iii, Sofa And Delta Sofa Scoring Systems As Predictors Of Mortality At A Tertiary Hospital In Nairobi, Kenya: A Retrospective Cohort Study, Lilian Lukoko

Master of Medicine in Anaesthesiology

Background: Despite major advances, management of critically ill patients worldwide is associated with high mortality rates. Assessment of disease severity is crucial in the analysis of ICU mortality. Although a variety of severity of illness scoring systems have been developed for this assessment and validated across Europe and the USA, few studies exist to show support of their utilization in African countries. There is conflicting evidence regarding the most reliable severity of illness scoring system suitable for resource limited countries as their mortality predictive values differ with different populations. SOFA is already in use at the AKUHN ICU and has …

Paradigm Shift In Anti-Coagulating Patients With Non-Valvular Atrial Fibrillation, Bushra Moiz

Department of Pathology and Laboratory Medicine

No abstract provided.

Vitamin D Status In Healthy Black African Adults At A Tertiary Hospital In Nairobi, Kenya: A Cross Sectional Study, Elizabeth Kagotho, Geoffrey Omuse, Nancy Okinda, Peter Ojwang

Pathology, East Africa

Background: Vitamin D has been known since the twentieth Century for its benefits in bone health. Recent observational studies have demonstrated its benefits in infectious diseases such as tuberculosis and non-communicable diseases such as diabetes mellitus, cardiovascular diseases and cancer. This has led to a dramatic increase in testing among adults. The cut-offs for vitamin D deficiency have been debated for decades and the current cut off is derived from a Caucasian population. Studies done among black African adults in Africa are few with vitamin D deficiency ranging from 5 to 91%. A few cut- offs have correlated vitamin D …

The Sleep Quality Using Pittsburgh Sleep Quality Index., Khushbakht Khan Awan, Muhammad Talha Farooq, Pashma Farooq, Muhammad Yasir Tarar

Pakistan Journal of Neurological Sciences (PJNS)

Good quality and enough sleep are necessary for the proper cognitive performance of medical students. There is a wide prevalence of sleep disturbances among Pakistani medical students and there is a need to spread awareness regarding the problems concerning sleep patterns. OBJECTIVE: To determine the quality of sleep among first and final year medical students. METHODOLOGY: It’s a cross sectional study conducted at Services Institute of Medical College Lahore from the 10th May to 15th June 2016.A total of 300 Male and female medical students of first and final year were administered PSQI and their socio-demographic profile along with academic …

Third Ventricular Tumors: A Comprehensive Literature Review, Syed Ijlal Ahmed, Gohar Javed, Altaf Ali Laghari, Syeda Benish Bareeqa, Kashif Aziz, Mehreen Khan, Syeda Sana Samar, Raja Azhar Humera, Alizay Rashid Khan, Muhammad Osama Farooqui, Amir Shahbaz

Section of Neurosurgery

Third ventricle tumors are uncommon and account for 0.6 - 0.9% of all the brain tumors. Tumors of the third ventricle are classified into primary tumors, such as colloid cysts, choroid plexus papillomas, and ependymomas, or secondary tumors, such as craniopharyngiomas, optic nerve gliomas, pineal tumors, and meningiomas. Third ventricular tumors are uncommon, and their treatment involves significant morbidity and mortality. The colloid cyst has a better surgical outcome and many approaches are available to achieve a complete cure. Choroid plexus papilloma is also a common tumor documented with its treatment majorly based on surgical resection. In addition to multiple …

Prospective Evaluation Of Serum Procalcitonin In Critically Ill Patients With Suspected Sepsis- Experience From A Tertiary Care Hospital In Pakistan, Sibtain Ahmed, Imran Siddiqui, Lena Jafri, Madiha Hashmi, Aysha Habib, Farooq Ghani

Department of Pathology and Laboratory Medicine

Background: Sepsis is the leading cause of mortality in critically ill patients. Procalcitonin (PCT) is a promising marker for identification of bacterial sepsis. The aim of this study was to determine the diagnostic accuracy of serum PCT concentration in patients with suspected sepsis admitted to mixed medical-surgical Intensive care unit (ICU).
Material and methods: A cross-sectional study conducted at section of Chemical Pathology, Department of Pathology and Laboratory Medicine and ICU. Patients with suspected sepsis were included, serum PCT cut off ≥0.5 ng/ml was taken for diagnosing sepsis. Diagnostic accuracy was measured in terms of sensitivity, specificity, positive predictive value …

Epidemiology Of Asthma And Associated Factors In An Urban Pakistani Population: Adult Asthma Study-Karachi, Shama Razzaq, Asaad Ahmed Nafees, Unaib Rabbani, Muhammad Irfan, Shahla Naeem, Muhammad Arslan Khan, Zafar Fatmi, Peter Burney

Community Health Sciences

Background: This study was conducted in order to determine the prevalence of asthma and associated risk factors in the adult population of Karachi, Pakistan.
Methods: This multi-stage, cross-sectional survey was conducted from May 2014-August 2015; comprising 1629 adults in 75 randomly selected clusters in Karachi, Pakistan. Definitions included: 'self-reported asthma', 'reversibility in FEV₁^' and 'respiratory symptoms and reversibility in FEV₁'.
Results: Prevalence of asthma was 1.8% (self-reported) (95% CI: 1.0-2.6), 11.3% (reversibility in FEV₁) (95% CI: 9.4-13.3) and 6.6% (symptoms and reversibility in FEV₁) (95% CI: 5.1-8.1). Asthmatics were more likely to …

Impact Of Ramadan Fasting On Thyroid Status And Quality Of Life In Patients With Primary Hypothyroidism: A Prospective Cohort Study From Karachi, Pakistan, Aisha Sheikh, Minaz Mawani, Saeed Ahmed Mahar

Section of Diabetes, Endocrinology and Metabolism

Objective: Ramadan is the ninth month in the lunar calendar, during which Muslims fast from predawn to sunset and major changes occur in their dietary, sleep, and physical activity patterns. Most patients with hypothyroidism are unable to comply with the proper timings of levothyroxine (LT4) administration. The objective of the study was to determine the change in thyroid-stimulating hormone (TSH) level and quality of life (QOL) before and after Ramadan in patients with primary hypothyroidism.
Methods: This prospective cohort study included adult patients on stable doses of LT4 who fasted for at least 20 days during the month of Ramadan …