Speakers discuss Endocrine Emergencies, Renal disease in pregnancy besides Endocrinology and Thyroid diseases


 Proceedings of International Medical Conference by RCP and AZNMC-IV

Speakers discuss Endocrine Emergencies,
Renal disease in pregnancy besides
Endocrinology and Thyroid diseases

LAHORE: The second session on second day of the International Medical Conference jointly organized by Royal College of Physicians London in collaboration with Azra Naheed Medical College at Lahore during February 2016 was chaired by Prof. Faisal Sultan, Prof. M .Nasir Malik and Prof. Ali Jawa. Prof. John A. Wass from UK was the first speaker who talked about Endocrine Emergencies.  He discussed in detail the causes of SIADH and opined that one should treat the underlying causes, ensure fluid restrictions. Occasionally one might have to use 3% saline for acute symptomatic hypernatremia.  Use of Tolvaptan is quite safe and effective.

He then talked about pheochromocytom crisis and mentioned about palpation, headache, sweating. Beta blockers, Opioids, MAOIs, he said, are contra indicated in these conditions. He also referred to the features of Addison’s disease. Life threatening conditions require emergency management. While using steroids, prednisolone is quite safe and effective. Some of these patient may require minor, moderate and major surgery.  He also talked about causes of Cushing’s disease and sometime these patients need immediate treatment, he added.

Prof. Rezvi Shariff from Sri Lanka talked about renal diseases and pregnancy.  He discussed managing pregnancy during dialysis and pregnancy in women with existing renal disease. Prevalence of Chronic kidney disease in these patients is about 3%.He laid emphasis on early diagnosis. Women who suffer from uremia do not get pregnant because of anaemia and immunosuppression. He then discussed in detail the clinical practice guidelines for detection, evaluation and management of CKD in pregnancy in detail. He suggested that one should start low dose aspirin therapy in early stages. About 6% of pregnant women with Type 1 DM will have onset of Diabetic Nephropathy, LUTIs and UTIs.  Early referral, timely initiation of treatment, pre term delivery and neonatal consultant will ensure good outcome, he remarked.

Prof. John Wass’s next presentation was on Endocrinology of Thyroid and its diseases in 2016.  He pointed out that its prevalence is high in elderly females. Speaking about pregnancy and hypothyroidism, he opined that these pregnant patients need to be treated urgently.  Sub clinical Hyper thyroidism low TSH was a risk factor for a trial fibrillation, osteoporosis.  He then mentioned about the indications for treatment of sub clinical hyperthyroidism and suggested treatment with low dose anti thyroid drugs. Speaking about pregnancyand Hyperthyroidism he said that its prevalence is about 0.2% of all pregnancies. He also suggested pre pregnancy advice for all such patients. Management of the fetus was also discussed in detail. About 5-7% of patients develop post-partum hypothyroidism, he added.

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