Saleh Mohammad, Ijaz H Malik, Ijaz U H Taseer, Ghulam M Choudhry, Abdul W Qazi.
Prospective Study of Clinical Menifestations of Thyrotoxicosis in Multan.
Biomedica Jan ;13(2):53-6.

In a prospective study of 100 patients of thyrotoxicosis admitted to 2nd Medical Unit, Nishtar Hospital, Multan during the period from November 1991 to April 1993. Clinical manifestations of disease were noticed. Of these, 90% were females with male to female ratio 1:9. Mean age was 40 ± 13.90 years with a range from 10-70 years and 68% belonged to rural area. Important clinical manifestations observed were palpitation in 94%, weakness in 89%, nervousness in 85%, tachycardia in 76%, goiter in 75%, tremors in 74%, skin changes in 68%, dyspnoea in 65%, increased perspiration in 64%, thyroid bruit in 53%, eye signs in 49%, sinus tachycardia in 57%, atrial fibrilation in 24%, other arrhythmias in 7%, heart failure in 9%, clubbing and acropachy in 1% each. Seventy five percent patients had mild to moderate anaemia; 2% had leucopaenia and 6% had lecocytosis. Five percent had diabetes mellitus and 7% had impaired glucose tolerance test (GTT). Radiological examination revealed cardiomegaly in 9% and pulmonary oedema in 1%. In all patients 13 and T4 values were more than normal and TSH value was less than normal. Patients > 60 years had mainly cardiac manifestations i.e. atrial fibrillation in 100%, heart failure in 58%, while younger patients (< 30 years) had mainly nervous or metabolic manifestations ranging from 54-87%.

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