Thyroid Profile Research Articles

Sarcopenia in Type 2 Diabetes Mellitus: Study of the Modifiable Risk Factors Involved.

(1) Background: Sarcopenia has gained much interest in recent years due to an increase in morbidity. Sarcopenia is associated with type 2 diabetes mellitus (T2DM) and vice versa. There is a paucity of information regarding the prevalence and predictors of sarcopenia among T2DM individuals. The aim of the present study was to determine the prevalence and predictors of sarcopenia among T2DM individuals. (2) Methods: This study included 159 diabetics (cases) and 79 non-diabetics (controls) aged >50 years. The subjects were assessed for demographic and anthropometric parameters. Sarcopenia (according to the Asian Working Group for Sarcopenia 2019 criteria) was assessed using Jammer's hydraulic dynamometer for handgrip strength, dual-energy X-ray absorptiometry for muscle mass, and 6m gait speed. The biochemical investigations included glycated hemoglobin; fasting and prandial glucose; fasting insulin; lipid, renal, liver, and thyroid profiles; serum calcium; phosphorous; vitamin D; and parathyroid hormone (PTH). Appropriate statistical methods were used to determine the significance of each parameter, and a multivariate regression analysis was applied to determine the predictors. (3) Results: The prevalence of sarcopenia was significantly higher among the cases than the controls (22.5% vs. 8.86%, p-0.012). Body mass index (BMI) (OR-0.019, CI-0.001-0.248), physical activity (OR-0.45, CI-0.004-0.475), serum calcium levels (OR-0.155, CI-0.035-0.687), hypertension (OR-8.739, CI-1.913-39.922), and neuropathy (OR-5.57, CI-1.258-24.661) were significantly associated with sarcopenia following multivariate regression analysis. (4) Conclusions: T2DM individuals are prone to sarcopenia, especially those with a low BMI, low physical activity, hypertension, neuropathy, and low serum calcium levels. Hence, by modifying these risk factors among the elderly T2DM, sarcopenia can be prevented.

Role of Dynamic Magnetic Resonance Imaging in Differentiating Benign from Malignant Thyroid Nodule

Abstract Objective To determine the diagnostic accuracy of Diffusion-Weighted Imaging (DWI) and Apparent Diffusion Coefficient (ADC) in differentiating benign from malignant thyroid nodules Study Design A cross-sectional analytical study. Methodology Thirty-four patients who determined to have suspicious thyroid nodules by ultrasonography who attend endocrinology outpatient clinic at Ain-Shams university hospital, fulfilling the inclusion and exclusion criteria, were included in the study. They were evaluated on 1.5 Tesla MRI machine with T1- and T2- weighted imaging. DWI was done using b-values of 0 and 1000 s/mm2 and ADC values were calculated for the thyroid nodules. All of these patients were subjected to full history taking, general and local clinical examination, thyroid profile, TPO Abs, ultrasound, fine needle biopsy and histopathology results were correlated with ADC values. Results The benign nodules showed facilitated diffusion while malignant nodules showed restricted diffusion. T-test was used to assess the difference in mean ADC values between benign and malignant nodules. The mean ADC value of the malignant thyroid nodules (0.8±0.1 x 10-3 mm2/s) was significantly lower than that of the benign thyroid nodules (1.3±0.2 x 10-3 mm2/s) (p-value < 0.001). ADC value of 1.15 x 10-3 mm2/s was used as a cut-off, for differentiating benign from malignant thyroid nodules. The sensitivity, specificity, PPV, NPV and diagnostic accuracy of DWI and ADC values in differentiating benign from malignant thyroid nodules were 88.2%, 92.3%, 80%, 100% and, respectively. Conclusion FNAC is gold standard diagnostic modality but has limitations. However, DWI and (ADC) is a non-invasive diagnostic tool for characterization and differentiation between benign and malignant thyroid nodules. It decreases the burden of unnecessary surgeries when pre-operative FNAC and biopsy are inconclusive

The Prevalence of Thyroid Abnormalities in Patients With Chronic Kidney Disease: A Cross-Sectional Study at a Tertiary Care Hospital.

Background and objective Chronic kidney disease (CKD) is a clinical syndrome characterized by the irreversible loss of kidney function. It is a widespread condition affecting populations worldwide. The kidneys play a crucial role in the metabolism, breakdown, and elimination of thyroid hormone and thyroid-stimulating hormone (TSH). Consequently, thyroid dysfunction can occur as an endocrine manifestation in CKD patients. Previous studies investigating thyroid abnormalities and the severity of CKD have yielded diverse outcomes. In light of this, this study aimed to determine the prevalence of thyroid dysfunction in CKD patients and explore the association between different thyroid dysfunctions and markers of kidney function. Methods A total of 140 CKD patients who met the inclusion criteria were recruited, and their demographic details and routine investigations were recorded. Blood samples were collected for kidney function tests and thyroid function tests. The primary outcome measures included markers of kidney function [urea, creatinine, and estimated glomerular filtration rate (e-GFR)] and thyroid profile [TSH, free thyroxine (FT4), and free triiodothyronine (FT3)]. Mean and standard deviation (SD) were calculated for continuous variables, while frequencies were calculated for categorical data. Fisher's exact test was employed to evaluate the association between two categorical variables, and p-values below 0.05 were considered statistically significant. Results The mean (± SD) urea, creatinine, and e-GFR were found to be 139 (± 81.1) mg/dL, 5.33 (± 4.1) mg/dL, and 20.1 (± 15) ml/min/1.73 m2, respectively. Of note,133 (95%) patients had elevated urea levels, with the majority (n = 109, 77.8%) having urea levels between 40 and 199 mg/dL; 70 (50%) patients had creatinine levels less than 4 mg/dL, and 107 (76.4%) had e-GFR of less than 30 ml/min/1.73 m2. The mean (± SD) TSH, FT4, and FT3 levels were found to be 6.64 (± 11.2) mIU/ml, 13.6 (± 4.54) pmol/L, and 2.65 (± 1.89) pmol/L, respectively. It was observed that 18 (12.9%, 95% CI: 8.29-19.4%) of the CKD patients had hypothyroidism and 21 (15%, 95% CI: 10.02-21.8%) had subclinical hypothyroidism (SCH), while only two (1.4%, 95% CI: 0.39-5.05%) and five (3.6%, 95% CI: 1.5-8.08%) had hyperthyroidism and subclinical hyperthyroidism, respectively. Thirty-nine (27.9%, 95% CI: 21.1-35.8%) patients had low FT4 levels, whereas a considerable majority (n = 123, 87.9%, 95% CI: 81.41-92.28%) of the patients suffering from CKD were found to have low FT3 levels. The associations of urea levels with SCH, low FT4, and FT3 status were found to be statistically significant with p-values of 0.002, 0.033, and <0.001, respectively. The association between e-GFR and low FT3 status was also statistically significant, with a p-value of 0.014. Conclusion Nine out of 10 patients with CKD were discovered to have low FT3 levels, whereas one in four patients had low FT4 levels. The study participants also exhibited a significant presence of SCH and hypothyroidism, with prevalence rates of 15% and 12.9%, respectively. Urea levels and e-GFR, indicating the severity of CKD, showed a significant association with the presence of various thyroid abnormalities. Hypothyroidism in CKD patients can complicate disease progression, impact mortality rates, and affect overall quality of life. Therefore, routine screening for thyroid abnormalities should be conducted in all CKD patients.

Evaluation of Thyroid and Lipid Profile of Hiv Patients Seen in a Faith-Based Health Facility in Anambra State, Nigeria

Background: Human Immunodeficiency Virus (HIV) and thyroid function have been described. Prevalence pattern and atherogenic status significantly differ from HIV-negative control in several studies. Unfortunately, few studies have determined the prevalence of thyroid function and lipids among Nigerians living with HIV. Objective: This study is to evaluate thyroid hormones and lipid profiles in HIV-positive subjects attending a faith-based health facility in Anambra State Nigeria. Materials and methods: The serum concentration of Thyroid Stimulating Hormone (TSH), free Triiodothyronine (fT3), triiodothyronine (T3), free Thyroxine (fT4), Thyroxine (T4), Total Cholesterol [TC], Triglyceride [TG], High-Density Lipoprotein [HDL], Low-Density Lipoprotein [LDL] and Very Low-Density Lipoprotein [VLDL] was determined in 95 HIV positive subjects which include 48 patients who were on HAART- group 1 and 47 not on HAART- group 2; and compared to 30 HIV negative controls – group 3. Results: The level of TSH and fT3 was significantly (p &lt; 0.05) higher in group 1 participants than in group 2 and the group 3 participants. The level of T4 was significantly higher in group 2 than in group 1 and group 3 participants. The level of T3 was significantly lower in Control participants in comparison to both HAART and non-HAART participants. The prevalence of fT4 dysfunction across the groups was significantly different from each other. The total mean of Cholesterol (163.5 ± 22.7), Triglyceride (163.5 ± 22.7), and Very Low-Density Lipoprotein (14.2 ± 2.4) of the HIV-positive participants were significantly (p &lt; 0.05) lower than that of the HIV negative participants. Conclusion: The results obtained from this study indicate that serum levels of thyroid hormones may be used as baseline periodic markers during antiretroviral therapy and many people living with HIV may benefit from supplementation if appropriate.

Thyroid Function Status in Patient with Iron Deficiency Anaemia in A Tertiary Care Hospital of Lalitpur, Nepal

Introduction: Studies have found that iron deficiency anaemia (IDA) impairs thyroid hormone metabolism. The prevalence of thyroid dysfunction in adults in the general population ranges from 1 to 10 percent, and is even higher in selected groups. Thus, in this study we would like to see thyroid function status in people with IDA. Materials and Methods: It was Laboratory based cross sectional study conducted in the Department of Biochemistry of a tertiary care hospital of KIST Medical College and Teaching Hospital, Lalitpur, Nepal. Secondary data of 162 patients available in laboratory database of 3 years’ duration from August 2018 to August 2021 were taken. All Patients diagnosed with IDA whose thyroid profile was also done were included in the study. Data were entered in Microsoft Excel. Statistical analysis was performed using version 29 of the Statistical Package for Social Sciences (SPSS Inc, Chicago IL, USA). Results: Among 162 IDA patients, 86.4% (n=140) were females and 13.62% (n=22) were males. Age ranged widely from 19 to 88 years and median age was 38 years. Out of 162 patients most of the patients 68.5% were euthyroid, 8.7% had euthyroid hypothyroxinemia, 7.4% had primary hypothyroidism,3.7% had subclinical hypothyroidism, 3.1% had secondary hypothyroidism, 1.2% had primary hyperthyroidism, 1.2% had T3 toxicosis, 0.6% had euthyroid hyperthyroxinemia. Based on multiple independent KW test, relationship between category of thyroid disorders and iron profile as well as thyroid disorder and Hb level were found not to be statistically significant. No category of thyroid dysfunction was associated with value of haemoglobin level or severity of anaemia. Irrespective of category of thyroid profile including euthyroid, hypothyroid and hyperthyroid, no category is particularly associated with IDA. Conclusion: In patients with IDA, there is no significant association between Hb level or severity of iron deficiency irrespective of patient being euthyroid, hypothyroid or hyperthyroid.

Assessing the Influence of Propylthiouracil and Phenytoin on the Metabolomes of the Thyroid, Liver, and Plasma in Rats.

The thyroid hormones (THs) regulate various physiological mechanisms in mammals, such as cellular metabolism, cell structure, and membrane transport. The therapeutic drugs propylthiouracil (PTU) and phenytoin are known to induce hypothyroidism and decrease blood thyroid hormone levels. To analyze the impact of these two drugs on systemic metabolism, we focused on metabolic changes after treatment. Therefore, in a rat model, the metabolome of thyroid and liver tissue as well as from the blood plasma, after 2-week and 4-week administration of the drugs and after a following 2-week recovery phase, was investigated using targeted LC-MS/MS and GC-MS. Both drugs were tested at a low dose and a high dose. We observed decreases in THs plasma levels, and higher doses of the drugs were associated with a high decrease in TH levels. PTU administration had a more pronounced effect on TH levels than phenytoin. Both drugs had little or no influence on the metabolomes at low doses. Only PTU exhibited apparent metabolome alterations at high doses, especially concerning lipids. In plasma, acylcarnitines and triglycerides were detected at decreased levels than in the controls after 2- and 4-week exposure to the drug, while sphingomyelins and phosphatidylcholines were observed at increased levels. Interestingly, in the thyroid tissue, triglycerides were observed at increased concentrations in the 2-week exposure group to PTU, which was not observed in the 4-week exposure group and in the 4-week exposure group followed by the 2-week recovery group, suggesting an adaptation by the thyroid tissue. In the liver, no metabolites were found to have significantly changed. After the recovery phase, the thyroid, liver, and plasma metabolomic profiles showed little or no differences from the controls. In conclusion, although there were significant changes observed in several plasma metabolites in PTU/Phenytoin exposure groups, this study found that only PTU exposure led to adaptation-dependent changes in thyroid metabolites but did not affect hepatic metabolites.

Therapeutic effect of biosynthesized silver nanoparticles on hypothyroidism induced in albino rats

BackgroundIn this study, silver nanoparticles (AgNPs) were biosynthesized using Rhizopus oryzae. The therapeutic effect of AgNP treatment protocols for hypothyroidism induced in male albino rats via biochemical as well as hematological parameters, thyroid profile, and androgen male sex hormone (testosterone) was evaluated. ResultsFTIR, XRD, TEM, DLS, SEM, and EDX were used to comprehensively characterize the biosynthesized AgNPs. The AgNPs have a 17–35 nm diameter, according to the results of their characterization. The average size detected by XRD was 37.96 nm, while the average size of the biosynthesized AgNPs was 78 nm determined by DLS analysis. Furthermore, ALT, AST activity, urea, creatinine, and TSH levels revealed a significant increase in the untreated hypothyroidism group according to potassium dichromate-induced hypothyroidism compared to the normal control group. The untreated hypothyroidism group's FT3, FT4, and albumin levels, however, significantly decreased when compared to the normal control group. In contrast, when compared to the hypothyroidism-untreated group, the mean values of FT3, FT4, and TSH were all significantly higher and TSH was significantly lower in the hypothyroidism AgNPS-treated group. Furthermore, T. testosterone and F. testosterone levels revealed a significant decrease in untreated hypothyroidism group when compared to the normal control group. Contrarily, F. testosterone levels in the hypothyroidism-treated group were much higher than those in the hypothyroidism-untreated group. ConclusionsAgNPs were successfully biosynthesized which exhibited therapeutic potential to increase thyroid hormone levels and avoid the biochemical side effects of thyroid hormone deficiency in the animal model of hypothyroidism.How to cite: Saied E, Hussein AS, Al-Askar AA, et al. Therapeutic effect of biosynthesized silver nanoparticles on hypothyroidism induced in albino rats. Electron J Biotechnol 2023;65. https://doi.org/10.1016/j.ejbt.2023.06.001.

The impact of quetiapine monotherapy or in combination with lithium on the thyroid function in patients with bipolar depression: A retrospective study.

This study aims to investigate whether quetiapine monotherapy or in combination with lithium significantly disturbs thyroid function in depressed patients with bipolar disorder (BD), and whether difference exists in the post-treatment thyroid function between the two therapies. Based on the electric medical records, outpatients and inpatients with a current depressive episode of BD from January 2016 to December 2022 were screened. All patients were treated with quetiapine monotherapy or in combination with lithium. In addition to the demographic data and depression scale, thyroid profiles including total thyroxine (TT4), total triiodothyronine (TT3), free thyroxine (FT4), free triiodothyronine (FT3), thyroid-stimulating hormone (TSH), thyroid peroxidase antibody (TPOAb), and antithyroglobulin antibody (TGAb) were recorded, analyzed, and compared before and after the treatment. Totally, 73 eligible patients were enrolled, including 53 in the monotherapy group (MG) and 20 in the combined therapy group (CG). No significant differences in thyroid profiles were detected between the two groups at the baseline (p > 0.05). After one-month treatment, in the MG, serum levels of TT4, TT3, FT4, and FT3 reduced significantly (p < 0.05), while TSH, TPOAb, and TGAb increased significantly (p < 0.05). In the CG, serum levels of TT4, TT3, and FT4 reduced and TSH increased following one-month treatment (p < 0.05), with no significant change in FT3, TPOAb, or TGAb (p > 0.05). After one-month treatment, no difference of TT4, TT3, FT4, FT3, and TSH was found between the two groups (p > 0.05). Both quetiapine monotherapy and a combined therapy with lithium significantly disturbed thyroid function in patients with bipolar depression, while quetiapine monotherapy seems to be associated with immune dysregulation in the thyroid.

CLINICAL AND ETIOLOGICAL PROFILE OF ACUTE FLACCID PARALYSIS IN CHILDREN

Objective: This study was conducted to determine the clinical characteristics and differential diagnosis of individual cases of acute flaccid paralysis (AFP) reporting to tertiary care teaching hospital of Jaipur. Methods: This prospective observational study was conducted among patients attending outdoor, indoor, and neurology clinics with provisional diagnosis of AFP. The diagnosis was based on the available clinical data, vaccination status, and laboratory results (stool examination, arterial blood gas analysis, thyroid profile, serum electrolytes, electrophysiological studies, cerebrospinal fluid analysis, urinary pH, and imaging). Results: A total of 60 patients were evaluated over a study duration of 1 year. About 81.7% were male. Most common presenting complaint was lower-limb weakness (100%). None of the cases were identified as acute poliomyelitis or polio-compatible. Guillain–Barré syndrome (GBS) was the most common cause of non-poliovirus AFP (75%). Most common nerve conduction velocity findings in our study were bilateral motor axonal affection of common peroneal nerve (55%). Conclusion: The most common cause of AFP was GBS in all age groups. No case was diagnosed as poliomyelitis. All of the patients of GBS had progressive muscle weakness in a roughly symmetrical distribution, with areflexia of lower limbs.

Hyperandrogenism.

Hyperandrogenism is a common condition encountered by pediatric and adolescent physicians. Most girls with hyperandrogenism represent physiological pubertal variation; pathology may be present in a substantial minority. Systematic evaluation is essential to avoid unnecessary work-up in physiological causes while not missing pathological causes. Polycystic ovarian syndrome (PCOS), unexplained, persistent hyperandrogenism of ovarian origin, is the most common form in adolescent girls. The high prevalence of physiological peripubertal hirsutism, anovulation, and polycystic ovarian morphology results in mislabeling many girls as having the polycystic ovarian syndrome, a disorder with lifelong implications. The use of strict criteria of age-specific anovulation, hyperandrogenism, and duration is essential to reduce their stigmatization. The exclusion of secondary causes by screening tests (cortisol, thyroid profile, prolactin, and 17OHP) is essential before undertaking treatment for PCOS. Lifestyle measures, estrogen-progesterone preparations, antiandrogens, and metformin are the cornerstone of managing the disorder.

Refractory Seizures with Encephalopathy May be Due to Hashimoto Encephalopathy

Background: Hashimoto's encephalopathy, also known as steroid-responsive encephalopathy associated with autoimmune thyroiditis, is a relatively uncommon neurological disorder, mostly in adults, with an extremely rare occurrence in children. Clinical Description: A 9-year-old girl presented with unprovoked seizures and encephalopathy. She had been diagnosed with hypothyroidism, at around 6 ½ years of age, though was noncompliant to therapy with levothyroxine. Management: The child was managed with intravenous (IV) antiepileptics and other supportive care. Seizures were refractory and with worsening sensorium, she required mechanical ventilation. The magnetic resonance imaging of the brain was unremarkable, as also the cerebrospinal analysis. Autoimmune encephalitis panel was negative. The electroencephalogram showed background activity of 10–11 Hz and few areas with generalized slow waves. As she was a known case of hypothyroidism without taking thyroid supplements for the past few months, thyroid profile was sent. Reports showed FT3-1.1 pg/dL, FT4-0.515 ng/dL, and thyroid-stimulating hormone (TSH) - 107.3 μIU/mL. Thyroid antibody profile revealed antithyroid peroxidase antibody &gt;500 IU/mL and antithyroglobulin antibody &gt;1000 IU/mL. Following this, an ultrasound of the neck was done which showed features of thyroiditis. Considering the possibility that the underlying thyroiditis could explain the obtunded state and refractory seizures, the patient was started on levothyroxine and IV methylprednisolone. The sensorium of the child improved dramatically, and she got extubated. There were no further seizures and her TSH level reduced gradually and eventually, she was discharged. Conclusions: In a child with altered sensorium and refractory seizures, Hashimoto encephalopathy is a diagnosis of exclusion and may be considered when most of the common causes of encephalopathy and seizures have been ruled out, especially in the setting of some clinical clues of hypothyroidism. The condition is often reversible with good response to steroid therapy.

A CROSS-SECTIONAL STUDY ON THE FREQUENCY OF KURAIVEETHANA NOI (SUBCLINICAL AND CLINICAL HYPOTHYROIDISM) AMONG CHRONIC KIDNEY DISEASE PATIENTS

Background: Thyroid hormones have a major role in renal development and physiology. It has been shown that in chronic kidney disease (CKD), as the Glomerular Filtration Rate (GFR) falls, there is a higher possibility of developing clinical and subclinical hypothyroidism (SCH). With falling GFR, several abnormalities are growing in the thyroid gland at both structural and functional levels. Objective: To estimate the frequency of kuraiveethana noi (subclinical and clinical hypothyroidism) among CKD patients through lab investigation (Thyroid Function Test). Materials and Methods: It is a cross-sectional study carried out on 50 CKD patients reporting at the National Institute of Siddha using a non-random sampling method. After obtaining informed consent, Blood samples were collected from each patient to document their Thyroid profile. Results: Based on their report of thyroid profile, 19 patients had subclinical hypothyroidism, and 6 patients had clinical hypothyroidism. Conclusion: The study concludes that the frequency of subclinical and clinical hypothyroidism is found to be 38% (19 patients) and 12% (6 patients), respectively, among 50 chronic kidney disease patients who visited OPD of Ayothidoss Pandithar Hospital, National Institute of Siddha, Tambaram sanatorium.

Study to assess incidence and type of congenital heart defect in children with down syndrome presenting to tertiary care teaching hospital of Southern Rajasthan

Background: Down syndrome occurs in people of all races and economic levels. Cardiac anomalies with a prevalence of about 50% are the most common anomaly responsible for death during the 1st two years of life in children with down syndrome. Objective of the study was to Assess the incidence and type of congenital heart disease in children with down syndrome presenting to a tertiary care hospital. Methods: Hospital based descriptive study. Participants: All children (0 to 18 years) diagnosed (clinically or on karyotyping) with Down syndrome, presenting in RNT Medical College, Udaipur Each patient was evaluated with a pre-set Performa which contained detailed sociodemographic profile, maternal and clinical history including age of conception, detailed physical examination to look for features of down syndrome. Degree of Intellectual / Developmental retardation was assessed by Vineland Social Maturity Scale. 2D- echo, karyotyping was done in all patient. CBC, thyroid profile, CXR, USG- abdomen, Invertogram were done as per need. Results: Total 144 participants included in the study, 75 (52%) were females and rest were males 48%. Out of these 111 (77%) were aware about dog bite causes disease and among these 52 (46.8%) were aware that dog bite causes rabies. Among the participants, 138 (95.8%) were aware about the vaccine availability and 125 (90.5%) knew vaccine is available in Government Hospital. In the study 88% of dog bite victims received treatment. Conclusions: More than half of children with Down syndrome have congenital heart disease, mostly Acyanotic, more specifically VSD. Early screening and diagnosis re the key to avoid irreversible hemodynamic consequences.

Frequency of Thyroid Disorders in Rheumatoid Arthritis Patients and its Association with Disease Activity: A Hospital Based Study

Objective: To establish the frequency of thyroid disorders among Rheumatoid Arthritis patients and its association with disease severity measured by DAS28-ESR.&#x0D; Study Design: Prospective longitudinal study.&#x0D; Place and Duration of Study: Department of Rheumatology, Federal Government Policlinic Hospital, Islamabad Pakistan, from Jan to Jun 2021.&#x0D; Methodology: The study included 87 consecutive patients either gender with Rheumatoid Arthritis visiting Rheumatology OPD. Thyroid profile and DAS28-ESR were performed in all the patients.&#x0D; Results: Out of 87 patients, 73(83.9%) were females, and 14(16.1%) were males. The mean age was 45.54±13.50 years. The mean DAS28-ESR was 4.45±0.68, with a minimum DAS28-ESR of 1.25 and a maximum of 8.40. The Disease severity calculated by DAS28-ESR was mild in 19(21.8%), moderate in 44(50.6%) and severe in 24(27.6 %) patients. The thyroid gland was abnormal in 23(26.1%) patients. 18(78.2%) of 23 patients with thyroid disorders belonged to the moderate to severe Rheumatoid arthritis disease activity group.&#x0D; Conclusion: Thyroid disorders are very common in Rheumatoid Arthritis patients. Thyroid workup should be part of investigations of Rheumatoid Arthritis for early detection of thyroid disorder and better disease control.

STUDY OF THYROID PROFILE, URIC ACID, CREATININE AND LIPID PROFILE IN PRE-ECLAMPSIA PATIENT

Objectives: (1) To evaluate and compare the thyroid profile and lipid profile in preeclampsia in a normotensive pregnant female in the third trimester of pregnancy. (2) To estimate and compare serum uric acid and serum creatinine in preeclampsia in normotensive pregnant females. Methods: In the present study, 154 patients, of which 79 preeclampsia (cases) and 75 (controls), were selected randomly and matched with their gestational age in patients who attended an ANC clinic at the Department of Obstetrics and Gynecology, NSCB Medical College, Jabalpur, from March 2016 to August 2017. All patients were evaluated for their lipid profile, thyroid profile, serum uric acid, and serum creatinine. The study includes patient’s specific detailed clinical history, physical examination findings, and a report of relevant investigations recorded from the patient who presented with pre-eclampsia and normotensive pregnant female attending the ANC Clinic of N.S.C.B. Medical College, Jabalpur. Results: The most common age group for preeclampsia was 20–24 years. Preeclampsia was most common in the nullipara as compared to the multipara. Pre-eclampsia cases commonly occur in low-socioeconomic and rural areas. In this study, pre-eclamptic women showed higher serum concentrations of total cholesterol (221.60±22.55), low density lipoprotein (LDL) (134.44±16.96), Very LDL (48.48±6.88) and Triglyceride (243.50±32.33) when compared to normotensive women, which was statistically significant. In this study, a statistically significant decrease in HDLC (34.55±5.37) was observed in pre-eclamptic women. An increase in serum creatinine was observed in women with pre-eclampsia. The mean serum creatinine level was (1.21±0.47). Conclusion: Our study concludes that nulliparous and low-socio-economic women had a higher risk of pre-eclampsia. Maternal age between 20 and 24 years are more prone to develop pre-eclampsia. Serum uric acid levels are significantly higher in pre-eclampsia patients and could be a useful indicator of maternal and fetal complications in hypertensive patients.

Study of the photoperiodic dynamics of the peripheral dopamine content in comparison with the thyroid profile in various groups of men from the European North

Knowledge of the physiological mechanisms of adaptation arising in response to changes in photoperiods is especially important for residents of the European North. In the literature, there is practically no information about photoperiodic dynamics of serum dopamine level, despite its significant role in the regulation of the body's activity. The mutual modulating effect of the dopaminergic and thyroid systems is known. To show the ratio of dopamine levels and the content of hormones, protines and autoantibodies of the thyroid system, taking into account photoperiod of the year, in practically healthy populations of the European North. Healthy male population (20 men) of Arkhangelsk was examined in various photoperiods of the year (80 samples): an increase in the length of daylight hours (March), its maximum duration (June), a decrease (September), and a minimum duration (December). The inhabitants of the settlements and the nomadic aboriginal population (100 men) were examined during 2 photoperiods of the year - March and December. The serum levels of iodothyronines, TSH, TG, antibodies to TPO, antibodies to TG and plasma level of dopamine were determined using ELISA methods. Residents of Arkhangelsk in June compared to December have higher levels of dopamine (0.502 and 0.365 nmol/l, p=0.01), T3 (1.09 and 0.94 nmol/l, p=0.003), T4 (113.45 and 99.03 nmol/l, p=0.0002). In September, compared with June, a decrease in dopamine (0.235 nmol/l, p=0.0003), T3 (0.92 nmol/l, p=0.004) was recorded with an increase in T4/T3 ratio from 106.54 to 117.89 units (p=0.006). The nomadic aboriginal population in March compared with December showed a tendency to a higher content of dopamine (0.00 and 0.394 nmol/l, p=0.07) with the decrease in fT4 (15.20 and 13.90, p=0.015), fT4/fT3 ratio from 3.13 to 2.28 units (p=0.006). In December, 67% of nomadic population had undetectable dopamine values (0 nmol/l) and 22% - excess dopamine values, in March 27% - excess values. Unidirectional changes in dopamine and thyroid activity in men of the European North were shown with their decrease during periods of decrease and minimum daylight hours and an increase during periods of increase and maximum daylight hours.

Study on Thyroid Profile in Patients with Chronic Kidney Disease in Tertiary Care Centre

Study on Thyroid Profile in Patients with Chronic Kidney Disease in Tertiary Care Centre

Scientific yoga module for hypothyroidism: A study protocol for tele-yoga RCT

BackgroundManagement of thyroid dysfunction has a direct effect on the quality of life and studies have recognized that hypothyroidism has become a public health challenge. Although conventional medicine is widely used, its long-term side effects are elucidated. This study aims to conduct a randomized controlled trial (RCT) through tele-mode to assess the effectiveness of the newly developed and validated “Scientific Yoga Module” as a telehealth concept for improving the quality of life in patients with hypothyroidism along with management of other symptoms as compared to the standard of care. MethodThis is a single-blinded, two-arm, parallel-group RCT in which at least a total of 120 primary hypothyroid subjects both male and female between the age group 18 to 60 will be recruited from the database of Swami Vivekananda Yoga Anusandhana Samsthana (SVYASA). Participants will be randomly divided into a yoga intervention group (n = 60) and a waitlist control group (n = 60) as per the inclusion and exclusion criteria of the study. A tele-yoga intervention for six months will be administered and pre-interim-post data will be recorded for both groups. This protocol is designed to study the effect of Scientific Yoga Module intervention on primary assessments of SF-36 scale [health-related quality of life (HRQOL) that includes physical, mental, emotional, and social states] along with secondary assessments on the biochemical test of thyroid profile-{Triiodothyronine (T3), Thyroxine (T4), Thyroid Stimulating Hormones (TSH)}, Body Mass Index (BMI), Blood Pressure (BP), Fatigue Assessment Scale (FAS), Perceived Stress Scale (PSS), Gita Inventory of personality scale (GIP). ConclusionTo the best of our knowledge, this tele-yoga RCT for hypothyroidism will be the first clinical trial to analyze the effectiveness of a “Scientific Yoga Module” imparted through tele-mode.

Acquired Hypothyroidism in Children.

Acquired hypothyroidism is generally also referred to as juvenile hypothyroidism. Hypothyroidism is due to the deficient secretion of thyroid hormones causing metabolic and neurological sequelae at the cellular level. It can present as overt hypothyroidism wherein the thyroid hormones (T4 and T3) secretion fall and thyrotropin (TSH) rises. Acquired hypothyroidism frequently presents between 9 and 11 y of age and is rarely seen before 4 y of age. Approximately 80% of the children and adolescents are asymptomatic at the time of diagnosis. Children with moderate to severe hypothyroidism often present for evaluation of poor growth, constipation, lethargy and/or dry skin. A detailed history and examination will provide us with enough clues for diagnosing hypothyroidism. Primary hypothyroidism can be diagnosed with raised TSH with subnormal levels of T3 and T4. Titres of thyroid antibodies - Anti-thyroperoxidase (TPO) and anti-thyroglobulin (ATG) antibodies, will be high in autoimmune hypothyroidism. Subclinical hypothyroidism is diagnosed with mildly elevated or high normal levels of TSH with free T4 being in the normal range. Insufficient secretion of thyrotropin from the pituitary causes central hypothyroidism. Acquired hypothyroidism is treated by replacement with levothyroxine. Regular monitoring of thyroid profile is necessary for adjusting doses of levothyroxine. Close monitoring and individualization of levothyroxine therapy is essential for normal growth and development of the child.

Hemodialysis and thyroid disorders in chronic kidney disease patients at General Hospital of Douala, Cameroon

Background: kidneys' physiology is related to thyroid hormone functions. They play an important role in certain pathways of these hormones. Therefore the decline in renal function is accompanied by changes in thyroid function. Thyroid abnormalities are described in chronic hemodialysis but insufficiently elucidated in our area. Hence our interest was to evaluate thyroid function in chronic kidney disease patients to point out the implication of hemodialysis on thyroid dysfunction in our population. Method: we carried out a thyroid function test on a chronic hemodialysed patient admitted at Douala General Hospital (DGH) nephrology service for chronic kidney failure. Samples collected were tested for thyroid hormones total T3 (triiodothyronine), total T4 (thyroxine), and TSH (Thyroid Stimulating Hormone) using enzyme-linked immunosorbent assay (ELISA) technic. Epi Info was used for statistical analysis and 0.05 was significance threshold. Results: most of the participants were male-gendered (62.2%). The mean age was 49 years (41 ± 12.90) ranging from 20 and 79 years. Thyroid profile analysis of each patient highlighted 30 cases of hypothyroidism (36.59%) and 2 cases of hyperthyroidism (2.44%) out of the 82 enrolled subjects. Besides, our results showed that the duration of dialysis (P = 0.019) and old age (P = 0.04) were risk factors associated with hypothyroidism. Other factors such as gender and clinical history had no impact on the patient's thyroid status. Conclusion: our study indicated that hypothyroidism is a common endocrine disorder in patients who were going through chronic hemodialysis. A large population size study can be useful to set up systematic thyroid hormone checkups among chronic hemodialysis patients to improve population health conditions.