No abstract available.
Tetany*

The study on 2530 cases of neonatal death in the hospitals of 28 northern provinces showed 44 cases of neonatal tetanus, among them 33 deaths. The diseases distributed in 17/28 provinces with a highest incidence (of 1000 live born infants) in Lang Son province. The cases distributed only in 40/306 districts and over all months in the year. They occurred in ethnic minority mothers did not receive adequate vaccines and 94$ of diseases occurred by contagious tool to cut ombilical cordon (6% cut by bambo tool)
Tetanus ; Diseases ; Patients ; Tetany

BACKGROUND/AIMS: Oral sodium phosphate has been shown to be effective and safe but causes intravascular volume contraction, changes in serum calcium and phopshate level, and sleep disturbance when given two doses every 12 hours. Because the evening dose is inconvenient for many patients, we gave single morning dose, and compared it with conventional 12-hour-split dose. METHODS: Sixty one patients drank 90 mL of sodium phosphate at 7:00 AM and 58 patients drank 45 mL of sodium phosphate at 7:00 PM and 7:00 AM respectively. RESULTS: There was no statistical difference in bowel cleansing between two groups (p=0.871). There was no significant difference in patient's tolerance and symptoms between two groups except sleep deprivation which was more frequent in the split dose group. None of the patients complained of postural dizziness or presyncope in both groups. Serum phosphate levels were increased and serum calcium levels were decreased after preparation in both groups, but patients showed no significant clinical symptoms such as tetany. CONCLUSION: This study suggests that giving a single morning dose of sodium phosphate is effective, well tolerated and safe in most patients for precolonoscopic cleansing, compared to conventional split dose of 12-hour interval.
Calcium ; Colonoscopy ; Dizziness ; Humans ; Sleep Deprivation ; Sodium* ; Syncope ; Tetany

Idiopathic hypoparathyroidism is activating mutation of the calcium sensor receptor lead to inhibition of parathyroid hormone (PTH) secertion at inappropriately low serum ionized calcium levels and are a cause of autosomal dominant hypoparathyroidism. This disease often show slight mental retardation and associated endocrine abnormalities, most commonly hypothyroidism (without goiter) and hypogonadism. We diagnosed this in 20 year old male who presented with left foot pain with rigidity during he was treated for idiopathic epilepsy and had goiter. We report this case with a review of the literature.
Calcium ; Epilepsy* ; Foot ; Goiter ; Humans ; Hypogonadism ; Hypoparathyroidism* ; Hypothyroidism* ; Intellectual Disability ; Male ; Parathyroid Hormone ; Tetany ; Young Adult

Idiopathic hypoparathyroidism is activating mutation of the calcium sensor receptor lead to inhibition of parathyroid hormone (PTH) secertion at inappropriately low serum ionized calcium levels and are a cause of autosomal dominant hypoparathyroidism. This disease often show slight mental retardation and associated endocrine abnormalities, most commonly hypothyroidism (without goiter) and hypogonadism. We diagnosed this in 20 year old male who presented with left foot pain with rigidity during he was treated for idiopathic epilepsy and had goiter. We report this case with a review of the literature.
Calcium ; Epilepsy* ; Foot ; Goiter ; Humans ; Hypogonadism ; Hypoparathyroidism* ; Hypothyroidism* ; Intellectual Disability ; Male ; Parathyroid Hormone ; Tetany ; Young Adult

There are diverse neurologic manifestations in patients with idiopathic or pseudohypoparathyroidism. Although one knows that hypocalcemia provokes symptoms of tetany, there is little knowldege about the paroxysmal dystonic choreoathetosis(PKC). We report two patients with paroxysmal symptoms resulting from hypocalcemia associated with idiopathic hypoparathyroidism and pseudohypoparathryoidism respectively, which were misdiagnosed and treated as epilepsy. They showed repetitive paroxysmal dystonic choreoathetotic movements that lasted for several seconds and typically induced by sudden voluntary movement. The ne-uroimaging showed bilateral symmetrical calcifications., mainly in the basal ganglia. In the clinical setting, these types of paroxysmal movements may be readily misdiagnosed as partial seizure or tetany. Therefore, not only the laboratory work up for hypocalcemia, but careful history taking and clinical observation is important in differential diagnosis of epilepsy and paroxysmal movements in the patient with hypocalcemia.
Basal Ganglia ; Diagnosis, Differential ; Epilepsy ; Humans ; Hypocalcemia ; Hypoparathyroidism* ; Neurologic Manifestations ; Pseudohypoparathyroidism ; Seizures ; Tetany

PURPOSE: To describe the clinical characteristics of full-term neonates with hypocalcemia and to suggest factors associated with neonatal hypocalcemia METHODS: The medical records of full-term neonates with hypocalcemia were reviewed. Hypocalcemia was defined as an ionized calcium (iCa) concentration of <4 mg/dL. Parathyroid hormone (PTH) insufficiency was defined as a serum PTH level of <60 pg/mL or a serum phosphorus level higher than the serum calcium level in the presence of hypocalcemia. RESULTS: Fifty-three neonates were enrolled. The median age at diagnosis of hypocalcemia was 3 days. In all the neonates, formula feeding predominance was observed. Thirty-eight neonates (69.8%) were compatible with PTH insufficiency. The number of formula-fed neonates was significantly higher than that of breast-fed patients among neonates with PTH insufficiency (P=0.017). Intact PTH was negatively correlated with serum phosphorus levels. Twelve out of 14 neonates (85.7%) had 25-hydroxy vitamin D (25OHD) levels <20 ng/mL and 9 neonates (64.3%) had 25OHD levels <10 ng/mL. Twenty-one neonates had hypocalcemic tetany. The serum calcium and iCa concentrations of neonates with tetany were 4.2-8.3 mg/dL and 1.85-3.88 mg/dL, respectively. Three neonates showed symptomatic hypocalcemia with calcium levels over 7.5 mg/dL. Among the 16 neonates who underwent electroencephalography (EEG), 12 had abnormalities, which normalized after 1-2 months. CONCLUSION: Formula milk feeding, PTH insufficiency and low serum vitamin D concentration are associated with the development of neonatal hypocalcemia. Symptoms such as tetany and QT interval prolongation can develop in relatively mild hypocalcemia. Moreover, transient neonatal hypocalcemia can cause transient EEG abnormalities.
Calcium ; Diagnosis ; Electroencephalography ; Humans ; Hypocalcemia* ; Infant, Newborn ; Medical Records ; Milk ; Parathyroid Hormone ; Phosphorus ; Tetany ; Vitamin D

Both Gitelman syndrome and Bartter syndrome are autosomal recessively inherited renal tubular disorders characterized by hypokalemic metabolic alkalosis, salt wasting and normal to low blood pressure. Gitelman syndrome is caused by mutations in the thiazide-sensitive Na- Cl cotransporter (NCCT) and distinguished from Bartter syndrome, which is associated with mutations of several genes, by the presence of hypomagnesemia and hypocalciuria. In most of the patients with Gitelman syndrome, the disease manifests with transient episodes of muscular weakness and tetany in the adult period, but, often, is asymptomatic. We report here an 11 years-old female with Gitelman syndrome who presented with aggravation of epileptic seizure. The diagnostic work-up showed typical clinical features of metabolic alkalosis, hypokalemia, hypomagnesemia and hypocalciuria. We also identified a heterozygote mutation(642CGC(Arg)>TGC(Cys)) and an abnormal splicing in the SLC12A3 gene encoding NCCT.
Adult ; Alkalosis ; Bartter Syndrome ; Child ; Epilepsy* ; Female ; Gitelman Syndrome* ; Heterozygote ; Humans ; Hypokalemia ; Hypotension ; Muscle Weakness ; Tetany

tetany, chest pain and dizziness. Rebreathing into a paper or vinyl bag will reverse the alkalosis-induced symptoms and help the patient calm down. We report hyperventilation syndrome associated with extraction of mandibular third molar and describe the physiology and treatment. Accidental displacement of mandibular third molars is rarely reported complication. Most common anatomic structures of dislodgement are submandibular space, lateral pharyngeal space and pterygomandibular space. This report describe an unusual case of two roots of mandibular third molar that were displaced into submandibular space.]]>
Alkalosis, Respiratory ; Chest Pain ; Dizziness ; Humans ; Hyperventilation ; Molar, Third ; Paresthesia ; Physiology ; Spasm ; Tachypnea ; Tetany

A 27 years old female patient who had some features of idiopathic hypoparathryoid manifestation such as hypocalcemica, hyperphosphatemia. Chronic tetany, no evidence of osteomalacia, rickets and renal insufficiency, also was found to have certain characteristic skeletal and developmental abnormalities :rounded face, short neck, thick-set stocky body habitus, brachymetatarsia and mental retardation, which are attributable to Albright's Hereditary Osteodystrophy. On the basis of a circulating immunoreative Parathormone level, this case could be considered as idiopathic hypoparathyrodism rather than psuedohypoparathyroidism, despite of Albright's Hereditary Osteodystrophy because the patient's circulating parathormone level is normal range in C-terminal radioimmunoassay system. Presumably, the suggested explanation about the patients normal range of immunoreative parathormone is that the hypoparathyroid state is not a deficiency of circulating parathormone but an ineffectiveness of acitve parathormone because of a defect in conversion of secreted proparatbyroid hormone into an active form as proposed by Nusynowitz et al.(l973) The similar concentrations in immunoreactive parathormone levels of patient's family in same radioimmunoassay systems support this hypothesis. We concluded this case as idiopathic hypoparathyroidism with Albright's Hereditary Osteodystrophy.
Adult ; Female ; Humans ; Hyperphosphatemia ; Hypoparathyroidism* ; Intellectual Disability ; Neck ; Osteomalacia ; Parathyroid Hormone ; Radioimmunoassay ; Reference Values ; Renal Insufficiency ; Rickets ; Tetany