1.Plasmapheresis to treat Osmotic Demyelination Syndrome from overly rapid plasma sodium correction
Gayathri Devi Krishnan ; Dhayalen Krishnan ; Fung Yin Khe ; Chia Yuen Kang
The Medical Journal of Malaysia 2019;74(4):331-332
Osmotic demyelination syndrome results from overly rapid
serum sodium correction and is often iatrogenic. We report
a 50-year-old hypertensive woman on Indapamide
presenting with malaise, dizziness and serum sodium less
than 100mmol/l who developed osmotic demyelination
syndrome after correction of the hyponatremia. Good
neurological recovery was seen after plasmapheresis.
2.Case report of an adult female with neglected Congenital Adrenal hyperplasia (CAh)
Gayathri Devi Krishnan ; Norhayati Yahaya
Journal of the ASEAN Federation of Endocrine Societies 2018;33(2):199-201
An apparently well 27-year-old phenotypically male adult was seen at the endocrine clinic for gender assignment. Patient had been raised as a male and identifies as such. Abdominal CT scan showed a unilateral left adrenal mass and karyotyping revealed 46 XX female karyotype. She was diagnosed to have simple virilizing CAH and needed thorough counselling with subsequent management by a multidisciplinary team
17-alpha-Hydroxyprogesterone
3.Prevalence of Vitamin B12 Deficiency and its associated factors among patients with Type 2 Diabetes Mellitus on Metformin from a district in Malaysia
Gayathri Devi Krishnan ; Miza Hiryanti Zakaria ; Norhayati Yahaya
Journal of the ASEAN Federation of Endocrine Societies 2020;35(2):163-168
Introduction. Vitamin B12 deficiency is more common among metformin-treated subjects although the prevalence is variable. Many factors have been associated with this. The aim of this study is to determine the prevalence of vitamin B12 deficiency and its associated factors among patients with type 2 diabetes mellitus (DM) who are on metformin.
Methodology. A total of 205 patients who fit eligibility criteria were included in the study. A questionnaire was completed, and blood was drawn to study vitamin B12 levels. Vitamin B12 deficiency was defined as serum B12 level of ≤300 pg/ mL (221 pmol/L).
Results. The prevalence of vitamin B12 deficiency among metformin-treated patients with type 2 DM patients was 28.3% (n=58). The median vitamin B12 level was 419 (±257) pg/mL. The non-Malay population was at a higher risk for metformin-associated vitamin B12 deficiency [adjusted odds ratio (OR) 3.86, 95% CI: 1.836 to 8.104, p<0.001]. Duration of metformin use of more than five years showed increased risk for metformin-associated vitamin B12 deficiency (adjusted OR 2.06, 95% CI: 1.003 to 4.227, p=0.049).
Conclusion. Our study suggests that the prevalence of vitamin B12 deficiency among patients with type 2 diabetes mellitus on metformin in our population is substantial. This is more frequent among the non-Malay population and those who have been on metformin for more than five years.
Vitamin B 12
;
metformin
;
Diabetes Mellitus, Type 2