Function Tests In Patients Research Articles

Coronavirus disease 2019 and thyroid disease: Position statement of Indian Thyroid Society

About Coronavirus and Coronavirus Disease 2019 Coronavirus belongs to a large family of single-stranded RNA viruses Elderly people, and those with medical conditions such as hypertension, cardiac problems or diabetes, chronic obstructive airway disease, are more likely to develop serious illness [[2]] Thyroid Disorders in India Thyroid diseases are common worldwide The prevalence of hypothyroidism in T2DM and hypertension in India was found to be about 33% [[6]] Hypothyroidism and Coronavirus Disease 2019 There is no information on how it affects individuals with hypothyroidism [Extracted from the article] Copyright of Thyroid Research & Practice is the property of Wolters Kluwer India Pvt Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission However, users may print, download, or email articles for individual use This abstract may be abridged No warranty is given about the accuracy of the copy Users should refer to the original published version of the material for the full abstract (Copyright applies to all Abstracts )

Liver Function Tests in Patients of Acute Leukemia before and after Induction Chemotherapy

Background: Patients of acute leukemia require careful assessment of liver function prior to start chemotherapy to determine which drugs may be appropriate or to be modified. Post chemotherapy abnormalities of liver function tests may be due to drugs or due to disease process itself. Objective: To evaluate the status of liver function in acute leukemia patients before and after induction chemotherapy. Methodology: This was a prospective cross-sectional study conducted in the Department of Biochemistry, Dhaka Medical College, Dhaka, Bangladesh from January 2017 to December 2017 on fifty (50) newly diagnosed patients of acute leukemia who fulfilled the selection criteria. Blood samples for serum total bilirubin, alanine transaminase (ALT) and aspartate transaminase (AST) were collected before chemotherapy (Day 1) and after induction chemotherapy on 14th day and 30th day. Serum ALT and AST were measured by kinetic method and serum total bilirubin was measured by DMSO method. Data were analyzed and compared by statistical tests. Result: In this study, the mean level of serum total bilirubin before chemotherapy at day 1 was 0.89 ± 0.64 mg/dl. It was significantly (p < 0.001) raised to 1.55 ± 1.05 mg/dl at day 14 of chemotherapy, and again significantly (p < 0.002) reduced to 0.72 ± 0.35 mg/dl at day 30 of chemotherapy as compared to day 1. Similarly the mean serum ALT at day 1 was 47.46 ± 15.00 U/L which significantly (p < 0.001) raised to 87.08 ± 57.45 U/L at day 14 of chemotherapy and significantly (p < 0.001) reduced at day 30 of chemotherapy to 37.79 ± 11.69 U/L as compared to day 1. The mean serum aspartate transaminase (AST) before chemotherapy at day 1 was 38.00 ± 7.34 U/L that significantly (p < 0.001) increased to 44.96 ± 8.29 U/L at day 14 of chemotherapy and significantly (p < 0.001) decreased to 32.29 ± 4.78 U/L at day 30 of chemotherapy compared to baseline value at day 1. Conclusion: It is concluded that serum total bilirubin, ALT and AST increase in response to chemotherapeutic drugs during treatment of acute leukemia.

Assessment of Conventional Autonomic Function Tests in Patients with Acute Intermittent Porphyria

Background and Aim: To assess the autonomic nerve functions in latent and manifest patients of acute intermittent porphyria. The aim of the present study was to study cardiovascular responses to autonomic nerve functions in patients of acute intermittent porphyria, we also tried to find out the relative sensitivity of the various tests employed to study cardiac dysautonomia in these cases. Methods: The study was carried out on thirty cases of acute intermittent porphyria to assess the cardiovascular reflexes. Twenty five healthy subjects closely matched for age and sex served as control. The cases were diagnosed by modified Watson Schwartz test, the cases of acute intermittent porphyria were divided into three groups. Results: The values of different autonomic nerve function tests were compared with control group and among the different groups of patients. The results were complied, compared and a conclusion was drawn. Immediate heart rate response to standing is more sensitive test than the Valsalva maneuver. Immediate heart rate response to standing is more sensitive and quite reliable which can easily be performed at bed side or even in outpatient departments, the test is simple and non–invasive. In our opinion, the test, beat to beat variation of heart rate to single deep breath is though easy to perform and more understandable, but lacks the sensitivity of other two tests. Conclusion: Significant cardiac dysautonomia is present in asymptomatic group, it is more marked in acute attack group. Immediate heart rate response to standing could be a more sensitive and reliable test in this dysfunction.

The Effects of loW Dose tIcagrelor on Platelet Function Testing in Patients With Stable Coronary arTery Disease

The Effects of loW Dose tIcagrelor on Platelet Function Testing in Patients With Stable Coronary arTery Disease

The study of pulmonary function tests in patients with hypothyroidism

Background: Hypothyroidism is a common disease with a prevalence rate of 11% in India. It affects all organ systems in the body. Patients with hypothyroidism frequently have symptoms of fatigue and exercise intolerance. These symptoms could arise from a reduced pulmonary reserve, cardiac reserve or decreased muscle strength or increased muscle fatigue. This study aims to study the pulmonary function test in patients with hypothyroidism.Methods: This is a cross sectional study conducted on 100 patients divided into 2 groups (a) newly detected hypothyroids (b) normal control group. Cases were matched with controls in having similar environment exposure and age group. All patients had routine symptom and clinical assessment. Laboratory investigations such as complete blood picture, pulmonary function test, chest x ray and thyroid function test were done. Data was entered and analysed.Results: In this study conducted on 100 patients, case group had symptoms of easy fatiguability (36%), breathlessness (20%), menstrual abnormality (20%), weight gain (7%) and generalised body aches (5%). Mean FEV1 levels between cases and controls were 1.34 and 1.72 (p value 0.00), mean FVC were 1.88 and 2.09 (p value 0.114), FEV1/FVC ratio of 70.56, 81.98 respectively (p value 0.00). The distribution of PFT pattern was 32% obstructive, 28% mixed pattern and 22% restrictive pattern.Conclusions: This study shows that hypothyroidism causes significant decrease in FEV1 and FEV1/FVC ratio, thereby suggesting obstructive patterns of lung involvement .Therefore PFT can be used routinely as a screening test for all hypothyroid patients to detect early respiratory dysfunction and thereby optimise treatment especially in obese patients and patients with pre-existing lung disease as hypothyroidism adds to their respiratory dysfunction.

Longitudinal Analysis of Pulmonary Function in Survivors of Congenital Diaphragmatic Hernia

To analyze longitudinal trends of pulmonary function testing in patients with congenital diaphragmatic hernia (CDH) followed in our multidisciplinary clinic. This was a retrospective cohort study of CDH patients born between 1991 and 2013. A linear mixed effects model was fitted to estimate the trends of percent predicted forced expiratory volume in 1second (FEV1pp), percent predicted forced vital capacity (FVCpp), and FEV1/FVC over time. Of 268 patients with CDH who survived to discharge, 119 had at least 1 pulmonary function test study. The FEV1pp (P<.001), FVCpp (P=.017), and FEV1/FVC (P=.001) decreased with age. Compared with defect size A/B, those with defect size C/D had lower FEV1pp by an average of 11.5% (95% CI, 2.9%-20.1%; P=.010). A history of oxygen use at initial hospital discharge also correlated with decreased FEV1pp by an average of 8.0% (95% CI, 1.2%-15.0%; P=.023). In a select cohort of CDH survivors, average pulmonary function declines with age relative to expected population normative values. Those with severe CDH represent a population at risk for worsening pulmonary function test measurements who may benefit from recognition and monitoring for complications.

Effect of inhaler drug education on fatigue, dyspnea severity, and respiratory function tests in patients with COPD

ObjectiveThis study was conducted to examine the effect of inhaler drug education on fatigue, dyspnea severity, and respiratory function tests in patients with chronic obstructive pulmonary disease (COPD). MethodsThis randomized controlled study was conducted with a total of 85 patients treated at the chest diseases clinic and outpatient clinic of a state hospital. The data were collected using questionnaires, respiratory function tests, and the COPD and Asthma Fatigue Scale (CAFS) and Visual Analogue Scale (VAS-for dyspnea severity). ResultsIt was determined that after 4 weeks of inhaler drug education, the CAFS mean score decreased to 35.32 ± 14.36, the dyspnea severity mean score decreased to 4.76 ± 2.50, and the respiratory function tests mean scores increased to forced expiratory volume in 1 s (FEV1) = 58.83 ± 25.48, forced vital capacity (FVC) = 59.04 ± 19.19, and FEV1/FVC = 88.39 ± 21.59 in the intervention group (p < 0.05). No change was observed in the patients in the control group except for FEV1 and FVC mean scores (p > 0.05). ConclusionThese results demonstrate that inhaler drug education can improve fatigue, dyspnea severity, and respiratory function tests of patients with COPD. Practice implicationsThe training by nurses of every patient hospitalized in the clinic regarding inhaler drug therapy, and the regular checking of patients’ way of using the inhaled drugs, will contribute to COPD management.

Systematic review of the measurement properties of performance-based functional tests in patients with neck disorders

ObjectivesThe purpose of this systematic review is to identify and synthesise studies evaluating performance-based functional outcome measures designed to evaluate the functional abilities of patients with neck pain.DesignSystematic review.Data sourcesA...

Association of Endothelial Dysfunction and Antiretroviral Therapy in Early HIV Infection

Human immunodeficiency virus (HIV) infection is associated with increased cardiovascular disease (CVD) events. Endothelial dysfunction (EDF) is involved in CVD pathogenesis; however, EDF onset after HIV acquisition and the potential for reversibility with antiretroviral therapy (ART) have not been evaluated to date. To evaluate endothelial function with noninvasive reactive hyperemia index (RHI) in patients with early HIV infection at baseline and after ART initiation. Cohort study in which 61 members of the United States Air Force diagnosed with HIV infection from September 1, 2015, through September 30, 2017, were evaluated for baseline EDF. Natural log-transformed RHI values (lnRHI) of less than 0.51 and at least 0.51 were defined as abnormal and normal, respectively. The RHI interval changes were evaluated in a subgroup of 40 patients. Data were analyzed from September 30, 2017, through January 30, 2018. Early HIV infection. Baseline EDF at HIV diagnosis and interval changes associated with ART initiation. The 61 patients included in the analysis were predominantly male (58 [95%]) and mostly African American (35 [57%]), with a mean (SD) age of 28.1 (6.7) years at HIV diagnosis. Median time from estimated date of HIV seroconversion to RHI assessment was 10.6 months (interquartile range [IQR], 5.1-13.2 months), and the median CD4 lymphocyte count was 552/μL (IQR, 449/μL-674/μL). Patients had a mean (SD) body mass index of 26.2 (4.0), median (IQR) low-density lipoprotein cholesterol level of 97 (80-126) mg/dL, median (IQR) total cholesterol level of 163 (146-195) mg/dL, and no diabetes diagnoses. Overall mean (SD) lnRHI was 0.70 (0.29) at HIV diagnosis. Baseline RHI was normal in 47 patients (77%; mean [SD] lnRHI, 0.82 [0.20]) and was abnormal in 14 patients (23%; mean [SD] lnRHI, 0.30 [0.18]). Age (per 10-year increase) was not associated with an abnormal lnRHI (odds ratio, 2.15; 95% CI, 0.89-5.19; P = .09). Of the 41 patients with follow-up RHI assessments, 40 started ART immediately and repeated the RHI assessments at a median (IQR) of 6.4 (6.0-7.8) months. Use of ART was associated with an overall significan increase in mean (SD) lnRHI (0.13 [0.33]; P = .02). A greater increase in mean (SD) lnRHI was associated with abnormal (n = 11) compared with normal (n = 29) lnRHI at HIV diagnosis (0.33 [0.34]; P = .01 vs 0.04 [0.30]; P = .38). Among those with abnormal baseline lnRHI, 8 (73%) showed improved endothelial function after ART. The patient who declined ART converted from having a normal lnRHI (0.60) to an abnormal lnRHI (0.11) lnRHI after 8.3 months. In this study, EDF was common in early HIV infection, with associated reversal in most patients taking ART. Results suggest that persistent EDF and CVD complications may be associated with delayed ART. Further studies are necessary to define the role of noninvasive endothelial function testing in patients with HIV infection.

State of the Art Comprehensive Review of Individual Statins, Their Differences, Pharmacology, and Clinical Implications.

Statins are currently the primary treatment for hyperlipidemia, particularly for the treatment of high levels of low-density lipoprotein cholesterol (LDL-C), as many studies have proven benefit in a variety of populations. The benefits of statin treatment for high cholesterol have been proven in many trials. Forefront among different adverse events is statin-induced myopathy, which still eludes complete understanding, and may range anywhere from muscle soreness or fatigue to potentially extremely rare occurrence of rhabdomyolysis.As most adverse events are rare and not life-threatening, in high-risk patients, a high-dose statin should be started initially as data suggests that clinicians rarely up titrate statin therapy after initial prescription leading to under-treatment of many patients requiring high-dose statin therapy. As we will discuss in this paper, musculoskeletal side effects are the main concern and reason for discontinuing statin therapy. The occurrence and true association of other adverse events in patients on statin such as new onset of diabetes, hepatic toxicity, or cognitive impairment are rare, controversial, and not proven. In placebo-controlled studies, abnormal liver function occurs to a similar degree in statin- and placebo-treated patients. This led to FDA removal of the requirement to monitor liver function tests in patients on statin therapy.The combination of statins with other compounds such as ezetimibe or PCSK9 inhibitors has shown some additional benefits in the treatment of hypercholesterolemia. The goal of this manuscript is to conduct a comprehensive review about most commonly usedstatins and compare data on their history, structures, benefits, adverse effects, and clinical outcomes.

Pancreatic Function in Chronic Pancreatitis: A Cohort Study Comparing 3 Methods of Detecting Fat Malabsorption and the Impact of Short-term Pancreatic Enzyme Replacement Therapy.

Reliable pancreatic function tests in patients with chronic pancreatitis (CP) are needed. This cohort study identified malabsorption in people with CP compared with healthy people and then investigated short-term pancreatic enzyme replacement therapy (PERT) and fat malabsorption, nutritional status, and quality of life (QOL). Subjects with CP were evaluated before and after PERT and compared with the healthy cohort using coefficient of fat absorption (CFA), stool bomb calorimetry, and the malabsorption blood test (MBT). Anthropometrics, micronutrients, and QOL data were collected. Group means at baseline and after PERT were analyzed. The 24 subjects with CP had greater stool energy loss (5668 cal/g [standard deviation {SD}, 753] vs 5152 cal/g [SD, 418], P < 0.01), reduced triglyceride absorption (MBT, 8.3 mg·h/dL [SD, 4.3] vs 17.7 mg·h/dL [SD, 10.3], P < 0.001), lower fat intake, and poorer QOL. Differences in CFA were not significant (90.9% [SD, 12.8] vs 95.4% [SD, 9.3]). After PERT, triglyceride absorption (Δ = 1.7 [SD, 3], P < 0.05) and QOL increased. The MBT detected changes in triglyceride absorption in the absence of CFA changes. The MBT may be helpful in guiding PERT initiation in patients with CP before significant morbidity.

Efficacy of antioxidant supplementation on conventional and advanced sperm function tests in patients with idiopathic male infertility

Efficacy of antioxidant supplementation on conventional and advanced sperm function tests in patients with idiopathic male infertility

Serial Changes in Pulmonary Function Testing in A Patient with Tracheobronchial Amyloidosis: Relevance for Early Diagnosis

Amyloidosis is a disease of abnormal extracellular deposition of proteins within tissues, commonly affecting solid organs such as the heart, liver, and kidneys. Less commonly, amyloidosis may affect the proximal tracheobronchial tree. Clinical symptoms are vague and may include shortness of breath, stridor, hoarseness. Pulmonary function testing at the time of diagnosis usually reveals an obstructive pattern. Diagnosis is difficult, and patients with tracheobronchial amyloidosis are frequently misdiagnosed with asthma or chronic obstructive pulmonary disease. Early changes in pulmonary function testing in patients with tracheobronchial amyloidosis have not been described. We present a case of a firefighter who with obstructive symptomatology who was subsequently diagnosed with proximal tracheobronchial amyloidosis. As a component of his occupational health surveillance, yearly examinations and pulmonary function testing had been performed. Serial pulmonary function testing dating back fourteen years prior to diagnosis reveal an early decrease in peak expiratory flow. Over time and in retrospect, progressive blunting of the expiratory limb of his flow-volume loops is identified beginning ten years prior to presentation. These changes significantly predated his clinical symptomatology and may be useful for early identification of patients with tracheobronchial amyloidosis. The relationship between chronic smoke inhalation and the development of tracheobronchial amyloidosis is unclear.

Study of Liver Function Tests in Patients of Hypothyroidism

Study of Liver Function Tests in Patients of Hypothyroidism

The Effects of Chronic Kidney Disease on Liver Function Tests: The Laboratory Interpretation Perspective

The aim of the study was to determine the levels of routinely measured liver function tests such as liver enzymes (AST, ALT, ALP, GGT & LDH), serum proteins (albumin and total) and serum bilirubins in patients with Chronic Kidney Disease (CKD). Clinical management of CKD involves frequent laboratory monitoring of liver function tests. It is therefore important to understand the levels of these biochemistry parameters in both healthy individuals and those with CKD for easier and accurate interpretation. A cross-sectional study of two groups of study subjects including patients with CKD and control group was used. A total of 180 subjects with CKD were recruited for the study plus another 200 healthy subjects who served as the control group and were recruited from among blood donors. About 2.0 mL of venous blood specimen was removed from each patient and from control subjects. Levels of the enzymes Aspartate Transaminase (AST), Alkaline Phosphatase (ALP), Alanine Transaminase (ALT), Gamma Glutamyl Transferase (γ-GT) and Lactate Dehydrogenase (LDH) were measured. Levels of serum protein and bilirubin were also determined in the two groups of study subjects. The Kolmogrov-Smirnov test was used to test the data for normality. The data obtained was parametric in nature and was tabulated as a mean and standard deviation. Parametric method of data analysis was used. Descriptive statistics used included parameters of location and parameters of dispersion. Means differences between investigated groups (control and chronic kidney disease patients) were assessed by ANOVA and post Anova statistical analysis. There were statistically significant differences (p<0.05) in the levels of serum protein and liver enzymes between patients with CKD and control group but no significant differences in the levels of serum bilirubin (p>0.05). The results suggest that those patients with CKD exhibited low levels of AST and ALT while the levels of ALP, GGT, and LDH were relatively higher. The levels of serum proteins were relatively lower in patients with CKD as compared to the control group. There is, therefore, the need for a keen interpretation of liver function tests in patients suffering from CKD.

Liver function and serum amylase alterations following laparoscopic and open cholecystectomy and its significance

Background: Gall stone disease is the commonest gastro intestinal disease requiring surgical intervention, laparoscopic cholecystectomy (LC) which has replaced open cholecystectomy (OC). LC has more advantages over OC but has few drawback such as CO2 pneumoperitoneum leading to altered liver functions. The study was done with the aim to compare liver function tests in patients undergoing LC &amp; OC and to compare these values in two groups preoperatively and postoperatively at 24 hrs, 48 hrs, 72 hrs.Methods: A total of 151 patients were admitted with cholelithiasis, out of which 72 patients underwent surgery between January 2018 to January 2019. Patients were selected by block randomization method into 2 groups containing 28 in each (Group 1- OC and Group 2- LC). SGPT, SGOT, LDH, TB, DB, IB, ALP and S. amylase were studied pre-operatively and at intervals of 24 hrs, 48 hrs, 72 hrs postoperatively. Comparison was made between both groups.Results: Pre and postoperatively stage, the level of LFT in Group 1 and Group 2 were similar except IB, which was significantly high in Group 1. At 24 hrs the difference in TB, DB, SGPT and S. amylase were statistically significant (p&lt;0.05) between the groups. At 48 hrs difference between Group 1 and Group 2 in TB, DB, SGOT and SGPT were statistically significant (p&lt;0.05). At 72 hrs difference between Group 1 and Group 2 in only SGPT was statistically significant (p&lt;0.05).Conclusions: Cholecystectomy (OC and LC) lead to transient but reversible significant hepatic enzymes alterations. These alterations are self limited and return to reference values within 10 days of operation. The cause of alteration might be liver tractions, electrocoagulation’s and manipulation of duct.

Evaluation of Pulmonary Function Test in Patients with Amyotrophic lateral sclerosis and its correlation with the symptoms of the disease

Introduction: Amyotrophic lateral sclerosis (ALS) is a neurogenic progressive disease that leads to muscle atrophy. The purpose of this study was to evaluate pulmonary function test (PFT) in patients with ALS and its correlation with ASL symptoms. Materials and Methods: This cross-sectional study was performed on 32 ALS patients at Ghaem Hospital, Mashhad, Iran. All patients filled out a demographic form and underwent body plethysmography to determine forced vital capacity (FVC), forced expiratory volume in 1 sec (FEV1), and FEV1/FVC indexes based on their gender and age. Blood samples were also collected to analyze atrial blood gas (ABG) and the levels of oxygen and carbon dioxide. Finally, the data were analyzed by using SPSS20 software. Results: The mean age of the patients was 61.66±13.6 years. The prevalence of ALS was higher in females than in males. The study of the symptoms of the disease (87.1%) of the patients in the study was motor disorder, (0.31%) swallowing disorder, (48.0%) cough and shortness of breath and (40.0%) speech impairment. The results showed that there was a significant relationship between hypercarbia and night oxygen saturation , which the hypercarbia abundance was higher among patients whose night oxygen saturation was SO2 ˂90. But there was no significant relationship between hypercarbia and hypoxemia with symptoms of the disease.. Other results showed that the FEV1 test with swallowing disorder (P = 0.01) and cough and shortness of breath (P = 0.02) the results of FVC test with swallowing disorder (P = 0.01) and cough and shortness of breath (P = 0.02) and Also, there was a significant relationship between FEV1 / FVC test with swallowing disorder (P = 0.01) and cough and shortness of breath (P = 0.01) so that, With the normalization of the Pulmonary Function Test and the improvement of the patients , the symptoms of the disease also decreased. Conclusions: Overall, the results indicate that early detection of pulmonary involvement in patients with ALS can lead to interventions such as oxygen therapy and reduce symptoms and help improve their quality of life.

Effect of metformin on thyroid function tests in patients with subclinical hypothyroidism: an open-label randomised controlled trial.

Though most of the observational studies have shown that metformin can reduce serum thyroid stimulating hormone (TSH) level in patients of hypothyroidism with diabetes or polycystic ovarian disease, randomised controlled trials are sparse. The primary objective of this study was to evaluate the effect of metformin on thyroid function tests (TSH, free T4, and free T3) in patients with subclinical hypothyroidism (SCH). In this open label, parallel arm, randomised controlled trial, 60 patients of SCH (TSH 5.5-10mIU/L) were randomised to either metformin group (1500mg/day) or control group. A total of 46 patients (23 in each group) completed the study and no significant difference in serum TSH, free T4 or free T3 was found in between the 2 groups. Neither there was any significant change in serum TSH, free T4 or free T3 (pre and post 6months) within the individual groups. However, the rate of normalisation of serum TSH in patients with negative thyroid antibody was significantly higher than patients with positive thyroid antibody (71.4% vs. 18.8%; P = 0.026) in metformin group in post hoc analysis. Fasting plasma glucose, serum high-density lipoprotein and indices of insulin sensitivity significantly improved in metformin group. Four patients (17%) had mild gastrointestinal adverse effects in the metformin group. We did not find any significant change in thyroid function test in patients with SCH with metformin therapy.

Pulmonary Function Tests in Patients on Ticagrelor and Clopidogrel: A Comparative Study

Pulmonary Function Tests in Patients on Ticagrelor and Clopidogrel: A Comparative Study

Skeletal muscle fatty infiltration in the thigh, as assessed by MRI T2-weighted and 3-point Dixon sequences, is associated with poor performance on muscle function testing in patients with Cushing's syndrome in remission

Skeletal muscle fatty infiltration in the thigh, as assessed by MRI T2-weighted and 3-point Dixon sequences, is associated with poor performance on muscle function testing in patients with Cushing's syndrome in remission