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ORIGINAL ARTICLE
Year : 2018  |  Volume : 5  |  Issue : 3  |  Page : 178-181

Suspected thiamine deficiency presenting as peripheral neuropathy among peripartum women in a hospital in rural Assam: A neglected public health problem


Department of Internal Medicine, Makunda Christian Leprosy and General Hospital, Karimganj, Assam, India

Correspondence Address:
Roshine Mary Koshy
Makunda Christian Leprosy and General Hospital, Bazaricherra, Karimganj - 788 727, Assam
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/cjhr.cjhr_33_18

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Context: A single case of thiamine deficiency seen in a population reflects a public health problem which is preventable and easily treatable. Aim: This article describes suspected thiamine deficiency among peripartum women in a rural population in Assam presenting as clinically overt peripheral polyneuropathy. Materials and Methods: A retrospective review of the clinical presentation and electrodiagnostic features of peripartum women presenting with peripheral polyneuropathy during a 6-month period, showing improvement in clinical symptoms after administration of thiamine. Results: The clinical profile of 24 peripartum women described is consistent with features of thiamine deficiency presenting with peripheral polyneuropathy and/or cardiopathy. Of the patients followed up after thiamine supplementation, 90% (18) reported either improvement of neurological deficits or improvement in nerve conduction studies after an average of 10 days. Predominant use of polished rice, thiamine poor diet and habitual use of tea, betel nut, and fermented fish are observed to have precipitated the disease. Limitations of the study include the lack of biochemical measurement of tissue thiamine stores in patients. Conclusions: The observations made among peripartum women in this population assumes public health importance as thiamine deficiency is a preventable and easily treatable illness. There is an urgent need to initiate prospective studies including population surveys to conclusively prove the existence of clinically overt thiamine deficiency in this rural population and its likely causes so that effective public health strategies can be formulated to prevent the morbidity associated with this clinical entity.


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