KARACHI:TB patients with gland disorder increasing
KARACHI, Sept 5: Contrary to available western information, a significant number of tuberculosis patients in Indo- Pakistan subcontinent were also found to be inflicted with Addison Disease, a condition with lower function of adrenal gland which produces cortisol.
The point was highlighted by President of Indian Society of Endocrinology Prof Abdul Hamid Zargar, in his scientific presentation at the National Symposium, organised by Pakistan Endocrine Society, here on Tuesday.
“A lot of patients in this region presented with tuberculosis as a cause of this illness,” the senior endocrinologist based in Srinagar, Indian-held Kashmir said in his presentation.
Elaborating his stance, the speaker mentioned that while carrying out the work to study the function of adrenal gland in patient with active tuberculosis, the functions were much lower than required.
He also illustrated that maternal bleeding following delivery, is as a major cause of Addison Disease in Indo- Pak region, adding that this happens due to poor obstetric care in some of the remote areas.
Prof Zargar estimated that about 38,000 women are suffering some pituitary hormone deficiency as a result of this factor alone.
This implies first of all a need for a better obstetric care and then a need for the physicians to be aware of this possibility so that this could be diagnosed and treated at an early stage.
Professor of Endocrinology at the All-Indian Institute of Medicine, New Dehli, Prof Nikil Tandon in one of his papers referred to prevalence of goitre in a large part of northern India.
He stated that despite the introduction of iodised salt in India in 1986, there is a high prevalent rate of goitre in these areas.
“The study that we carried out was to look as the possible causes of this goitre persistence,” he said mentioning that over 15,000 children were studied and their urine iodine was assessed, (as an indictor of iodine uptake), and antibodies against thyroid.
They found that the iodine deficiency status was less than 6 per cent in these children, whereas about 10-15 per cent children were found to have antibodies not explaining the high incidence of goitre.
This was then possibly linked to some goitorogenous food element that has not been picked up. However, he stressed the need for continuation in the use of iodised salt to prevent the incidence of some serious type to thyroid deficiency leading to mental sub- activity.
In his next paper, Prof Tandon pointed towards the very high incidence of Vitamin- D deficiency in the people of India and Pakistan and other countries in the region.
Referring to studies of the region including Pakistan, the endocrinologist suggested measures for revising the normal range of Vitamin-D level.
“Moreover, there is a definite need for the population to provide a balanced nutrition to the children to prevent the Vitamin- D deficiency which may in the later life lead to a variety of bone problems,” he said.
Associate Professor at National Institute of Child Health, Dr Jamal Raza, in his presentation on “Growth Disorders in Children”, referred to the problem of “Tall” stature in children, consequent to a number of underlying problems requiring proper evaluation.
“As some children grow abnormally tall, there is a high number of those who experience growth deficiency and have short stature,” the speaker said.
He mentioned to have identified nearly 100 children who had a degree of mal-absorption to the wheat content of food.
“Eliminating wheat from their diet has now made them grow better,” he said, adding in other children various hormone problems, such as thyroid and growth hormone deficiency, was identified as the major cause of short stature.
Prof Nicholas Woodhouse from U.K. - currently serving as Professor of Endocrinology in Sultan Qaboos Hospital, Oman spoke about the problem of osteomalacia (soft bones) in women and attributed it mainly to Vitamin- D deficiency.
Dr Jawed Akhter presented his data on Osteomalacia (soft bones) among Pakistani women, showing almost 42 per cent of Pakistani women to have a variable degree of weakness in bones.
Dr. Ravinder J. Singh from Mayo Clinic-USA presented his work on newer techniques and assays that are now available in the USA which have improved the diagnosed work-up in various endocrine problems.
Prof. Zaman Shaikh said infertility in men was previously considered to be a psychogenic problem but has now been found out to be a blood vessel related problem. This may be a first marker of diabetes, hypertension and other vessel disease.—APP
