Non-inferiority of liquid thyroxine in comparison to tablets formulation in the treatment of children with congenital hypothyroidism

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Flora Tzifi ◽  
Alexandra Iliadi ◽  
Antonis Voutetakis ◽  
Dimitris Platis ◽  
Panagiotis Girginoudis ◽  
...  
Keyword(s):  
Congenital Hypothyroidism ◽  
Liquid Solution ◽  
Thyroid Stimulating Hormone ◽  
Normal Range ◽  
Free T4 ◽  
Liquid Form ◽  
Significant Difference ◽  
Parental Informed Consent ◽  
Group A ◽  
Group B

Abstract Objectives The aim of the current prospective randomized control study was to assess efficacy, safety, and non-inferiority of a new liquid L-thyroxine formulation dissolved in glycerol and water (T4® drops, produced by a Greek pharmaceutical Company, Uni-Pharma, Athens, Greece) in comparison to the standard Tablets form (T4® tablets, Uni-Pharma, Athens, Greece) in the substitutive treatment of children with congenital hypothyroidism (CH). Methods Thirty-nine children with CH, aged 3–12 years old, were enrolled in the study, after parental Informed Consent has been obtained, while three patients were lost from follow-up. At baseline, all participants had normal thyroid-stimulating hormone (TSH) and Free T4 values. Patients were randomly subdivided according to the assigned treatment in Group A (n=17)-Tablet Form and Group B (n=19)-Liquid Form. TSH and Free T4 levels were evaluated at 0, 2, 4, and 6 months. Results TSH values showed a statistically significant difference (p=0.017) between groups only at six months (Group A having higher TSH levels than Group B, albeit within the normal range), while Free T4 levels had no statistical difference throughout the six month study period and were always within the normal range. Moreover, dose adjustments were more frequent in Group A (p=0.038) during the six months. Liquid L-thyroxine substitutive treatment exhibited no statistically significant adverse effects in comparison to the widely used tablets. Conclusions Levothyroxine (LT4) as liquid solution formulation is safe and noninferior to the widely used L-thyroxine Tablets, with less need for dose adjustment, and can therefore be safely used in the treatment of children with CH.

A CLINICO-COMPARATIVE STUDY ON THE EFFECT OF LASHUNA SIDDHA TAILPANA POORVAK VAMANA KARMA AND NITYA VIRECHANA BY GOMUTRA HARITAKI IN THE MANAGEMENT OF HYPOTHYROIDISM

2021 ◽  
Vol 12 (4) ◽  
pp. 49-55
Author(s):  
Sheetal R Tokle
Keyword(s):  
Comparative Study ◽  
Thyroid Stimulating Hormone ◽  
Normal Range ◽  
End Of Treatment ◽  
Group A ◽  
Insignificant Difference ◽  
Randomized Control ◽  
Drug Dependent ◽  
Group B ◽  
Stimulating Hormone

Hypothyroidism is a condition in which thyroid gland doesn’t produce enough thyroid hormone. This is more prevalent among women. Management through levothyroxine is safe & may bring the value of Thyroid stimulating hormone and thyroxine to normal range but the increased dosage and continuous medication are cost expensive and make the patient into drug dependent till the end of mortal life. So, better, therapy is needed for the society through the heritage of Ayurveda especially with Shodhana therapy. Aim of Clinico-comparative study was to evaluate and compare the efficacy of Lashuna siddha Tailpana Poorvak Vamana Karma and Nityavirechana by Gomutra Haritaki in the management of Hypothyroidism. Study was conducted at Govt. Akhandanada Ayurvedic hospital, Ahmedabad, Gujarat. This study was Open labelled parallel randomized control trial. 15 patients were treated with Lashuna siddha Tailpana Poorvak Vamana Karma in group A. 15 patients was treated with Nitya Virechana by Gomutra Haritaki in group B. Washout period was 14 days. Triiodothyronine and thyroxine were compared at the end of treatment by paired t-test and Mann Whitney-U test. Lashuna siddha Tailpana Poorvak Vamana Karma was more beneficial than Nitya Virechana by Gomutra Haritaki. Insignificant difference was found on subjective and objective parameters (Weight gain, Basal metabolic rate, Serum triiodothyronine) but significance difference found on objective parameters (Thyroid stimulating hormone, Serum thyroxine).

Copper and Iron Status in Myelodysplastic Syndromes.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 4593-4593
Author(s):  
Zoi Saouli ◽  
Zisis Kontoninas ◽  
Fotios Girtovitis ◽  
Georgia Kaiafa ◽  
George Ntaios ◽  
...  
Keyword(s):  
Myelodysplastic Syndrome ◽  
Iron Overload ◽  
Copper Deficiency ◽  
Iron Status ◽  
Mean Value ◽  
Normal Range ◽  
Flame Atomic Absorption ◽  
Significant Difference ◽  
Group A ◽  
Group B

Abstract Introduction: Copper is an essential mineral found in many tissues. It is involved in iron incorporation into hemoglobin, hemolytic syndromes, while copper deficiency provokes iron overload and induces dysplastic changes to erythrocytes. On the other hand, there are references that iron overload can result in mild copper deficiency. There seems to be equivocal relationship between these two elements. Aim: The aim of this study is to determine copper and iron status in myelodysplastic patients and to investigate if copper deficiency correlates with the type of myelodysplastic syndrome. Materials and methods: We studied 52 patients with myelodysplastic syndrome, 29 men and 23 women(mean age 67,05± years). No other simultaneous disease was confirmed which could contribute to copper disorders. Patients were categorized in two groups. Group A, composed of 21 patients frequently transfused(approximately once monthly), suffering from RAEB, RAEB-t AND CMML. Group B included 31 patients, who either didn’t often need transfusion, or responded to erythropoietin, suffering from RA and RARS. Copper, iron and ferritin levels measurments were performed. Copper was measured by flame atomic absorption spectrometry (normal range: 0,8–1,3mg/l). Results: Nine patients of group A revealed copper deficiency(mean value 0,66±0,06mg/L). Mean copper value was 0,8±0,11mg/L for that group. All of them had elevated iron levels (average:602,23±160,46μg/dl) and high ferritin levels(average:1769±693,85ng/ml) All group B patients were found to have normal copper levels(Mean value was 1,15±0,09), indicating a statistically significant difference compared to group A patients(p<0,0001). Iron and ferritin levels were within normal range(average105,22±28,63 and 82,9±28,42 respectively) Conclusions: Copper levels, in multitransfused patients with poor prognosis myelodysplastic syndrome and iron overload, are significantly lower than in oligotransfused ones with good prognosis who consequently present normal iron burden.

scholarly journals Association of Sub-Clinical Hypothyroidism with Abnormal Levels of Lipid in the Population of Nawabshah, Pakistan

2021 ◽  
pp. 452-458
Author(s):  
Nasrullah Aamer ◽  
Beenish Ghafar Memon ◽  
Abdul Rashid ◽  
Dayaram Makwana ◽  
Shahzad Memon ◽  
...  
Keyword(s):  
Subclinical Hypothyroidism ◽  
Thyroid Stimulating Hormone ◽  
Free Triiodothyronine ◽  
Cross Sectional ◽  
Significant Difference ◽  
Group A ◽  
The Mean ◽  
Group 2 ◽  
Group B ◽  
Stimulating Hormone

Aims: Aim of this investigation was to access the association of dyslipidemia with subclinical hypothyroidism. Methodology: In this cross-sectional investigation, 1948 participants were recruited. Two groups were made; participants up to 18 years were in group A and Subjects over 18 years were incorporated in group 2. They were subdivided into control, subclinical hypothyroid 1, and subclinical hypothyroid 2. SPSS 21 was used for data analysis. Results:  Data of 1619 individuals were analyzed. The mean age of Group A participants was 12.79 ± 2.779, and the mean age of Group B participants was 42.58 ± 18.012. The prevalence of subclinical hypothyroid was found at 13.5 %. Significant differences have been observed while comparing Group A and Group B (P <0.001). Free tetraiodothyronine and Free triiodothyronine also showed a significant difference in both groups. (P<0.05). No significant difference between mean Thyroid-stimulating hormone levels was observed (P>0.05). No significant association between Controls and High-density Lipid values was found between Controls and subclinical hypothyroid. Conclusion: We conclude that subclinical hypothyroidism leads to increased dyslipidemia. Lower Serum total cholesterol and low-density lipid levels were detected among children and participants under the age of 18 with Thyroid-stimulating hormone greater than 10 mIU/L. Thyroid-stimulating hormone less than 10.0 mIU/L had no lipid abnormalities in subclinical hypothyroid participants.

DeVega versus ring annuloplasty in severe functional tricuspid insufficiency and their impact on the right ventricle

2019 ◽  
Vol 1 (4) ◽  
pp. 133-139
Author(s):  
Yasser Hamdy ◽  
Mohammed Mahmoud Mostafa ◽  
Ahmed Elminshawy
Keyword(s):  
Right Ventricular ◽  
Tricuspid Valve ◽  
Tricuspid Regurgitation ◽  
Early Postoperative Period ◽  
Tricuspid Valve Repair ◽  
Ring Annuloplasty ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
The Right

Background: Functional tricuspid valve regurgitation secondary to left-sided valve disease is common. DeVega repair is simple, but residual regurgitation with subsequent impairment of the right ventricular function is a concern. This study aims to compare tricuspid valve repair using DeVega vs. ring annuloplasty and their impact on the right ventricle in the early postoperative period and after six months. Methods: This is a prospective cohort study of 51 patients with rheumatic heart disease who underwent tricuspid valve repair for secondary severe tricuspid regurgitation. Patients were divided into two groups: group A; DeVega repair (n=34) and group B; ring annuloplasty repair (n=17). Patients were assessed clinically and by echocardiography before discharge and after six months for the degree of tricuspid regurgitation, right ventricular diameter and tricuspid annular plane systolic excursion (TAPSE). Results: Preoperative echocardiographic assessment showed no difference in left ventricular end-systolic diameter, end-diastolic diameter, ejection fraction and right ventricular diameter, however; group A had significantly better preoperative right ventricular function measured by TAPSE (1.96 ± 0.27 vs1.75 ± 0.31 cm; p=0.02). Group B had significantly longer cardiopulmonary bypass time (127.65 ± 13.56 vs. 111.74 ± 18.74 minutes; p= 0.003) and ischemic time (99.06 ± 11.80 vs. 87.15 ± 16.01 minutes; p= 0.009). Pre-discharge, there was no statistically significant difference in the degree of tricuspid regurgitation, but the right ventricular diameter was significantly lower in group B (2.66 ± 0.41 and 2.40 ± 0.48 cm; p=0.049). After six months of follow up, the degree of tricuspid regurgitation (p= 0.029) and the right ventricular diameter were significantly lower in the ring annuloplasty group (2.56 ± 0.39 and 2.29 ± 0.44 cm; p=0.029). Although there was a statistically significant difference in preoperative TAPSE, this difference disappeared after six months. Conclusion: Both DeVega and ring annuloplasty techniques were effective in the early postoperative period, ring annuloplasty was associated with lesser residual regurgitation and better right ventricular remodeling in severe functional tricuspid regurgitation than DeVega procedure after 6-months of follow up.

Effect of short-term use of oral contraceptive pills on intraocular pressure

2020 ◽  
Vol 35 (3) ◽  
Author(s):  
Tayyaba Gul Malik ◽  
Hina Nadeem ◽  
Eiman Ayesha ◽  
Rabail Alam
Keyword(s):  
Oral Contraceptive ◽  
Childbearing Age ◽  
Short Term ◽  
Oral Contraceptive Pills ◽  
Contraceptive Pills ◽  
Time Period ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Short Time

Objective: To study the effect of short-term use of oral contraceptive pills on intra-ocular pressures of women of childbearing age.   Methods: It was a comparative observational study, conducted at Arif memorial teaching hospital and Allied hospital Faisalabad for a period of six months. Hundred female subjects were divided into two groups of 50 each. Group A, included females, who had been taking oral contraceptive pills (OCP) for more than 6 months and less than 36 months. Group B, included 50 age-matched controls, who had never used OCP. Ophthalmic and systemic history was taken. Careful Slit lamp examination was performed and intraocular pressures (IOP) were measured using Goldman Applanation tonometer. Fundus examination was done to rule out any posterior segment disease. After collection of data, we analyzed and compared the intra ocular pressures between the two groups by using ANOVA in SPSS version 21.   Results: Average duration of using OCP was 14.9 months. There was no significant difference of Cup to Disc ratios between the two groups (p= 0.109). However, significant difference was noted between the IOP of OCP group and controls. (p=0.000). Conclusion: OCP significantly increase IOP even when used for short time period.

Comparative Clinical study of Jatyadi Taila and Jatyadi Ghrita in the management of Dushta Vrana

2018 ◽  
Vol 3 (3) ◽  
Author(s):  
Rajendra Joshi ◽  
N. B. Mashetti ◽  
Rakesh Kumar Gujar
Keyword(s):  
Clinical Study ◽  
Burning Sensation ◽  
Normal Process ◽  
Surgical Practice ◽  
Local Factors ◽  
Significant Difference ◽  
Comparative Clinical Study ◽  
Group A ◽  
Contaminated Wound ◽  
Group B

Dushta Vrana is a common and frequently encountered problem faced in surgical practice. The presence of Dushta Vrana worsens the condition of the patient with different complications and may become fatal. Local factors on wound like slough, infection and foreign body, affect the normal process of healing. A healthy wound in a normal body heals earlier with a minimum scar as compared to a contaminated wound. Therefore in this study all the efforts are made to make a Dushta Vrana into a Shuddha Vrana. Once the Vrana becomes Shuddha, Ropana of the Vrana will start. The objective of the study was to evaluate the clinical efficacy of Jatyadi Taila and Jatyadi Ghrita in Dushta Vrana. Clinically diagnosed 60 Patients of Dushta Vrana were randomly divided into two groups, each consisting of 30 Patients. Group A were treated with the Jatyadi Taila and Group B was treated by Jatyadi Ghrita. The results observed was based on the relief obtained on the subjective and objective parameters taken for consideration for this study viz, size of ulcer, discharge, smell, pain, burning sensation, itching and granulation were found significant (P Lass Than 0.05). On the basis of assessment criteria and overall result of treatment, the patients of Jatyadi Taila group showed better results when compared to Jatyadi Ghrita group. Even though statistically there is no much significant difference between the two groups, but by seeing the effect on individual parameters (subjective and objective) and over all response, Jatyadi Taila seems to be effective when compared to Jatyadi Ghrita. It is having more Ropana qualities when compared to Shodhana.

Clinical effect of Suvarna Bindu Prashan

2017 ◽  
Vol 2 (3) ◽  
Author(s):  
Patil Aniket ◽  
Dindore Pallavi ◽  
Arbar Aziz ◽  
Kadam Avinash ◽  
Saroch Vikas
Keyword(s):  
Physical Health ◽  
Eating Habits ◽  
Control Group ◽  
Inform Consent ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Immune Booster ◽  
Mental And Physical Health ◽  
Apparently Healthy

The quest for excellence in mental and physical health is not new. We find various references and formulations in Ayurvedic classics meant for promoting mental and physical health of a child. Suvarna Prashan is one of the formulations explained in age old Ayurvedic classic Kashyap Samhita. This formulation is very widely used now days as a memory and immune booster for children. But there is very little systematic documented study which can be used to evaluate the efficacy of the formulation. Suvarna Bhasma was prepared in Ayurved Rasayani Pharmacy, Pune. Madhu and Ghrita were collected from KLE Ayurveda Pharmacy, Belgaum. Suvarna Bindu Prashan was prepared in KLE Ayurved pharmacy, Belgaum. It contains Suvarna Bhasma, Ghrita and Madhu. Twenty apparently healthy male and female children with age group of three to four years were ready to sign inform consent form were selected into two groups each. Subjects in Group A received Suvarna Bindu Prashan where as Group B (Control group) did not receive any treatment. Both the groups were observed for six months. Children in Suvarna Bindu Prashan group showed significant reduction in the scores of eating habits, behavior, mood, temperament and scores of event of illness. However there was no significant difference in the score of sleeping habit. There was significant increase in IQ percentage.

scholarly journals Microsurgical unilateral laminotomy for bilateral decompression of degenerative lumbar canal stenosis: a comparative study

2019 ◽  
Vol 55 (1) ◽  
Author(s):  
Mohamed I. Refaat ◽  
Amr K. Elsamman ◽  
Adham Rabea ◽  
Mohamed I. A. Hewaidy
Keyword(s):  
Patient Satisfaction ◽  
Blood Loss ◽  
Minimally Invasive ◽  
Invasive Technique ◽  
Decompression Surgery ◽  
Microsurgical Decompression ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Group A ◽  
Group B

Abstract Background The quest for better patient outcomes is driving to the development of minimally invasive spine surgical techniques. There are several evidences on the use of microsurgical decompression surgery for degenerative lumbar spine stenosis; however, few of these studies compared their outcomes with the traditional laminectomy technique. Objectives The aim of our study was to compare outcomes following microsurgical decompression via unilateral laminotomy for bilateral decompression (ULBD) of the spinal canal to the standard open laminectomy for cases with lumbar spinal stenosis. Subjects and methods Cases were divided in two groups. Group (A) cases were operated by conventional full laminectomy; Group (B) cases were operated by (ULBD) technique. Results from both groups were compared regarding duration of surgery, blood loss, perioperative complication, and postoperative outcome and patient satisfaction. Results There was no statistically significant difference between both groups regarding the improvement of visual pain analogue, while improvement of neurogenic claudication outcome score was significant in group (B) than group (A). Seventy-three percent of group (A) cases and 80% of group (B) stated that surgery met their expectations and were satisfied from the outcome. Conclusion Comparing ULBD with traditional laminectomy showed the efficacy of the minimally invasive technique in obtaining good surgical outcome and patient satisfaction. There was no statistically significant difference between both groups regarding the occurrence of complications The ULBD technique was found to respect the posterior spinal integrity and musculature, accompanied with less blood loss, shorter hospital stays, and shorter recovery periods than the open laminectomy technique.

scholarly journals The Role of Obesity in Predicting the Clinical Outcomes of COVID-19

Obesity Facts ◽  
2021 ◽  
pp. 1-9
Author(s):  
Serdar Sahin ◽  
Havva Sezer ◽  
Ebru Cicek ◽  
Yeliz Yagız Ozogul ◽  
Murat Yildirim ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Health Care Providers ◽  
Study Groups ◽  
Normal Weight ◽  
Overweight And Obesity ◽  
Care Providers ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Group D

<b><i>Introduction:</i></b> The aim of this was to describe the predictors of mortality related to COVID-19 infection and to evaluate the association between overweight, obesity, and clinical outcomes of COVID-19. <b><i>Methods:</i></b> We included the patients &#x3e;18 years of age, with at least one positive SARS-CoV-2 reverse transcriptase-polymerase chain reaction. Patients were grouped according to body mass index values as normal weight &#x3c;25 kg/m<sup>2</sup> (Group A), overweight from 25 to &#x3c;30 kg/m<sup>2</sup> (Group B), Class I obesity 30 to &#x3c;35 kg/m<sup>2</sup> (Group C), and ≥35 kg/m<sup>2</sup> (Group D). Mortality, clinical outcomes, laboratory parameters, and comorbidities were compared among 4 groups. <b><i>Results:</i></b> There was no significant difference among study groups in terms of mortality. Noninvasive mechanical ventilation requirement was higher in group B and D than group A, while it was higher in Group D than Group C (Group B vs. Group A [<i>p</i> = 0.017], Group D vs. Group A [<i>p</i> = 0.001], and Group D vs. Group C [<i>p</i> = 0.016]). Lung involvement was less common in Group A, and presence of hypoxia was more common in Group D (Group B vs. Group A [<i>p</i> = 0.025], Group D vs. Group A [<i>p</i> &#x3c; 0.001], Group D vs. Group B [<i>p</i> = 0.006], and Group D vs. Group C [<i>p</i> = 0.014]). The hospitalization rate was lower in Group A than in the other groups; in addition, patients in Group D have the highest rate of hospitalization (Group B vs. Group A [<i>p</i> &#x3c; 0.001], Group C vs. Group A [<i>p</i> &#x3c; 0.001], Group D vs. Group A [<i>p</i> &#x3c; 0.001], Group D vs. Group B [<i>p</i> &#x3c; 0.001], and Group D vs. Group C [<i>p</i> = 0.010]). <b><i>Conclusion:</i></b> COVID-19 patients with overweight and obesity presented with more severe clinical findings. Health-care providers should take into account that people living with overweight and obesity are at higher risk for COVID-19 and its complications.

scholarly journals Comparison of functional and oncological outcomes of innovative “three-port” and traditional “four-port” laparoscopic radical prostatectomy in patients with prostate cancer

BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ben Xu ◽  
Si-da Cheng ◽  
Yi-ji Peng ◽  
Qian Zhang
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Biochemical Recurrence ◽  
Laparoscopic Radical Prostatectomy ◽  
Positive Surgical Margin ◽  
Oncological Outcomes ◽  
Estimated Blood Loss ◽  
Significant Difference ◽  
Group A ◽  
Group B

Abstract Background To compare the functional and oncological outcomes between innovative “three-port” and traditional “four-port” laparoscopic radical prostatectomy (LRP) in patients with prostate cancer (PCa). Methods We retrospectively collected the data of PCa patients treated at our institutions from June 2012 to May 2016. According to the inclusion criteria, a total of 234 patients were included in the study, including 112 in group A (four-port) and 122 in group B (three-port). The perioperatively surgical characteristics, functional and oncological outcomes were compared between groups. Results There were no statistical differences in the baseline parameters between these two groups. Compared with group A, the operative time (OT) and estimated blood loss (EBL) were significantly less in group B. On follow-up, the rate of positive surgical margin (PSM), prostate specific antigen (PSA) biochemical recurrence and continence after LRP did not show any statistically significant difference between the groups. An identical conclusion was also received in comparison of overall survival (OS) and biochemical recurrence-free survival (BRFS) between both groups. Conclusions Innovative “three-port” LRP can significantly shorten the OT and reduce the EBL compared with the traditional “four-port” LRP. Meanwhile, it does not increase the rate of PSM and PSA biochemical recurrence. “Three-port” LRP could be popularized in the future in view of its superior surgical technique, considerably better functional outcomes and remarkable oncological control.

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