A Study of Clinical Profile of Thyroid Disorders in Children in A Tertiary Care Hospital, Kurnool

2021 ◽  
Vol 8 (2) ◽  
pp. 966-970
Author(s):  
Vedartham Ramesh ◽  

Background: Thyroid hormone abnormalities are the commonest endocrine disorder in India and also the commonest preventable cause of mental retardation, so we want to determine the prevalence of thyroid dysfunction in children at kurnool district. Materials and Methods: A hospital based prospective observational study performed in new born and children below 18 years fulfilling the inclusion criteria visiting the pediatric OPD and IPD in Viswabharathi medical college, Kurnool if they had clinical suspicion of thyroid dysfunction. If suspicion of hypothyroidism, Free T4, Total T4, TSH levels and if suspicion of hyperthyroidism Free T3 and TSH were done. Results: Out of 70 case 3 cases (4.3%) are hyperthyroidism and 67 cases (95.7%) are hypothyroidism in these 3 (4.3%) cases had family history of thyroid disorders, male to female ratio was 1.3:6 and prevalence rate was high in the age group of 10 - 12 years 32.9% (23 cases). 13 (18.6%) cases had thyroid enlargement and 48 (68.57%) cases had anaemia. Treatment was started according to standard guidelines. Conclusion: The higher prevalence rate of thyroid disorders in childhood that to in female children and age group of 10 - 12 years in and around kurnool. Hence, screening of all new-borns and children should be mandatory as early diagnosis and treatment helps in prevention of complications of thyroid disorders. KEY WORDS: Free T3, Free T4, Goiter, Hyperthyroidism, Hypothyroidism, and Thyroid stimulating hormone.

2021 ◽  
pp. 20-25
Author(s):  
Ajit Kumar Nayak ◽  
Manorama Swain ◽  
Sujata Misra ◽  
Manju Kumari Jain

Thyroid disorder is a very common endocrine problem encountered by pregnant women. Maternal thyroid dysfunction is associated with adverse outcome both in mother and fetus. The aim of the study: to find out the prevalence of various thyroid disorders in pregnant women attending antenatal clinic. Materials and methods. This prospective cross-sectional study was carried out in the Department of Obstetrics and Gynecology, F.M. Medical College & Hospital, Balasore, Odisha from June 2020 to May 2021. 220 women with uncomplicated singleton pregnancy were included. Serum Thyroid-stimulating hormone (TSH), free T4 (FT4) and free T3 (FT3) were estimated by using electro-chemiluminescence immunoassay technique. Results. Out of 220 pregnant women screened for thyroid dysfunction, 68 were found to have thyroid disorders. 27.3 % of pregnant women had subclinical hypothyroidism, 1.4 % had overt hypothyroidism, 1.8 % had subclinical hyperthyroidism and 0.5 % had overt hyperthyroidism. Prevalence of subclinical hypothyroidism was 6.36 % when the upper reference limit of TSH level taken as 4 mIU/L. Prevalence of thyroid disorder among pregnant women in the age groups 18–25 years, 26–30 years and 31–40 years were 28.9 %, 32.1 % and 38.9 % respectively. There were 35.5 %, 28 % and 26 % pregnant women with thyroid disorders in the first, second and third trimester respectively. Prevalence of both subclinical and overt hypothyroidism were more in multigravida compared to primigravida. Conclusion. Our study revealed high prevalence of thyroid disorders in pregnant women and maternal subclinical hypothyroidism was the most common pattern.


2021 ◽  
Vol 17 (1) ◽  
pp. 32-37
Author(s):  
A.G. Sazonova ◽  
T.V. Mokhort ◽  
N.V. Karalovich

Background. Chronic kidney disease (CKD) is known to affect the thyroid axis, including thyroid hormone metabolism. It has been established that a decrease in renal function can be combined with changes in thyroid function. Thyroid dysfunction also has implications for renal blood flow, glomerular filtration rate (GFR), tubular transport, electrolyte homeostasis, and glomerular structure. The purpose of the study was to determine the features of thyroid function in patients with type 1 diabetes mellitus (T1DM) and CKD and develop recommendations for hormonal testing of thyroid pathology. Materials and methods. One hundred and twenty-one patients with T1DM with CKD were divided into 3 groups: group 1 — 78 individuals with GFR ≤ 60 ml/min/1.73 m2, group 2 — 20 people receiving renal replacement therapy (RRT), group 3 — 23 patients after renal transplantation (RT) with adequate graft function (the duration of the renal transplant is 3.62 (1.47; 4.28) years). Results. In T1DM and CKD group, the diagnostic value of thyroid-stimulating hormone is reduced due to the absence of differences in its values with a decrease in T4 and T3. Free T3 is the most sensitive marker of thyroid dysfunction in CKD. Thyroid disorders in T1D and CKD patients have a non-immune genesis. T1DM patients on RRT after hemodialysis (HD) procedure have an increase in total and free T4 and free T3, consequently, monitoring of thyroid disorders should be done immediately after the HD session. The restoration of normal values of peripheral conversion index and free T3 occurs within 1–2 years after TR, depending on the duration of RRT receiving. After more than 3 post-transplantation years, there is an increase in peripheral conversion index, which characterizes the imbalance of peripheral thyroid hormones towards a decrease in free T3 with relatively stable free T4. Conclusions. Thyroid dysfunctions are typical for all stages of the pathological process in CKD in patients with type 1 diabetes mellitus, including patients at the terminal stage and after successful kidney transplantation. The changes in thyroid hormones are associated with the RRT experience and can potentially affect the survival of patients.


2021 ◽  
Vol 12 (10) ◽  
pp. 47-50
Author(s):  
Ritu Gupta ◽  
Akhil K Vijayan ◽  
Sushma Choudhary

Background: Metabolic syndrome is characterized by hypertension, dyslipidemia, central obesity, glucose intolerance, insulin resistance. Thyroid hormone acts as general pacemaker, accelerating metabolic process and may be associated with metabolic syndrome. There is no information available in literature regarding the prevalence and association of thyroid dysfunction in metabolic syndrome in this central region of the country. Aims and Objective: To estimate the prevalence of thyroid dysfunction in patients of metabolic syndrome. Materials and Methods: It is a duration based prospective cross sectional study including 200 patients of metabolic syndrome. A detailed history, clinical examination and relevant investigations including serum Free T4 (FT4), Free T3 (FT3), Thyroid Stimulating Hormone (TSH) were done. Range, frequencies, percentage, mean, standard deviation and P value were calculated. P value of < 0.05 was taken as significant. Results: Prevalence of thyroid dysfunction in metabolic syndrome patients was 28.5%. Prevalence of subclinical and overt hypothyroidism was 18.5% and 8.5% respectively. In patients with both metabolic syndrome and thyroid dysfunction, most common components associated are diabetes mellitus and hypertriglyceridemia. Conclusion: Thyroid dysfunction is significantly common in metabolic syndrome patients. It should be aggressively detected and treated in these patients for better outcome.


2016 ◽  
Vol 175 (1) ◽  
pp. 49-54 ◽  
Author(s):  
David Strich ◽  
Gilad Karavani ◽  
Shalom Edri ◽  
David Gillis

ObjectiveWe previously reported increasing free T3 (FT3) to free T4 (FT4) ratios as thyroid-stimulating hormone (TSH) increases within the normal range in children. It is not known if this phenomenon is age-related among humans, as previously reported in rats. This study examines the relationships between TSH and FT3/FT4 ratios in different ages.DesignRetrospective examination of thyroid tests from patients without thyroid disease from community clinics.MethodsFree T3, free T4, and TSH levels from 527 564 sera collected from patients aged 1 year or greater were studied. Exclusion criteria were the following: missing data, TSH greater than 7.5mIU/L, and medications that may interfere with thyroid hormone activity. A total of 27 940 samples remaining after exclusion were stratified by age. Samples with available anthropometric data were additionally stratified for body mass index (BMI). Correlations of TSH to FT4, FT3, and FT3/FT4 ratios by age group were examined.ResultsUp to age 40, for each increasing TSH quartile, FT3 and the FT3/FT4 ratio increased and FT4 decreased significantly (for both FT3, FT4 and FT3/FT4 ratio,P<0.05 for every TSH quartile when compared with the 1st quartile, except FT3 in the 30–40 age group). In older age groups, increasing TSH was not associated with increased FT3/FT4 ratio.ConclusionAs TSH levels increase, FT3/FT4 ratios increase until age 40, but this differential increase does not occur in older age groups. This may reflect a decrease in thyroxine (T4) to triiodothyronine (T3) conversion with age, which may be part of the aging process.


Author(s):  
Shalini Singh ◽  
Pragya Shree ◽  
Vaibhav Kanti ◽  
Kalpana Kumari ◽  
Rajeev Suchdeva

Background: Hormonal changes and metabolic demands during pregnancy result in profound alterations in the biochemical parameters of thyroid function. Screening for thyroid disorders and initiation of its management at the earliest stage during first trimester is essential as maternal thyroid failure during the first half of pregnancy has been associated with several pregnancy complications and intellectual impairment in offspring. Aim was to evaluate the prevalence of thyroid dysfunction during the first and second trimester of pregnancy among women of Rajasthan state in India.Methods: The study comprised a cohort of 313 consecutive pregnant women in the first and second trimester that attended the OPD and were admitted as pregnant women in Obstetrics and Gynecology Department of the NIMS Medical College and Hospital, Jaipur, Rajasthan. Thyroid stimulating hormone (TSH) levels and free T4 (fT4) were estimated. The subjects were grouped into six groups based on the value of serum TSH and fT4.Results: Out of 313 antenatal women enrolled in the study, 213 (68%) attended antenatal clinic in first trimester of pregnancy and 100 (32%) women in their second trimester. The prevalence of thyroid dysfunction was 15.97% (overt hypothyroidism 1.28%, subclinical hypothyroidism 4.79%, isolated hypothyroxinemia 4.47%, overt hyperthyroidism 1.92%, and subclinical hyperthyroidism 3.51%). The women with overt hypo- or hyperthyroidism and subclinical hypothyroidism were older than euthyroid women. Maternal weight was high in pregnant women with overt hypothyroidism (58.22±6.18 kg) and subclinical hypothyroidism (52.04±2.94 kg). Gravid status was high in pregnant women with overt hypothyroidism, subclinical hypothyroidism and isolated hypothyroxinemia, but low in hyperthyroid group. History of miscarriage was high in pregnant women with subclinical hypothyroidism.Conclusions: With this study, it was concluded that there is high prevalence of thyroid dysfunction in pregnancy predominantly in rural population of Rajasthan. Majority among these being subclinical hypothyroidism and hypothyroxinemia.


Author(s):  
Balakrishnan Thenmozhi Priya ◽  
Chellam Janaki

<p class="abstract"><strong>Background:</strong> To study the varied clinical presentations, the predominant etiological agent and incidence of tinea pedis in relation to sex, age group, occupation and aggravating factors among the patients. Also an attempt was made to know if any significant association is there with blood group and the occurrence of tinea pedis.</p><p class="abstract"><strong>Methods:</strong> A study was conducted among 75 patients who attended Mycology clinic in tertiary care hospital. Detailed history was taken along with complete physical examination and local examination. All cases of tinea pedis were first confirmed by KOH examination. Isolation of the agent was done in Modified SDA medium with cycloheximide. Differentiation of the species was done by culturing on corn meal agar.<strong></strong></p><p class="abstract"><strong>Results:</strong> Prevalence of tinea pedis infection was more common among males with male: female ratio of 2.26:1. The 21- 30 years age group was commonly affected by tinea pedis. The distribution of blood groups reflected the general distribution pattern of the population. Culture positivity was recorded in 81.3%.</p><p><strong>Conclusions:</strong> More incidences of bilateral involvement and recurrent episodes were noted among the shoe wearing population than in the non-shoe wearing population. Any patients diagnosed with tinea pedis should be screened for diabetes as implied by the outcome of the study. Infected toe nails may be the site of primary infection and fungal disease can spread to other body areas from these primary sites. <em>Trichophyton rubrum</em> happened to be the chief isolate. <br /><br /></p>


2013 ◽  
Vol 54 (1) ◽  
pp. 42-47 ◽  
Author(s):  
Paolo Marraccini ◽  
Massimiliano Bianchi ◽  
Antonio Bottoni ◽  
Alessandro Mazzarisi ◽  
Michele Coceani ◽  
...  

Background Iodinated contrast media (CM) may influence thyroid function. Precautions are generally taken in patients with hyperthyroidism, even if subclinical, whereas the risks in patients with hypothyroidism or low triiodothyronine (T3) syndrome are not considered as appreciable. Purpose To assess the presence and type of thyroid dysfunction in patients admitted for coronary angiography (CA), to assess the concentration of free-iodide in five non-ionic CM, and to evaluate changes in thyroid function after CA in patients with low T3 syndrome. Material and Methods We measured free T3, free thyroxine (T4), and thyroid-stimulating hormone (TSH) in 1752 consecutive patients prior to CA and free-iodide in five non-ionic CM. Urinary free-iodide before and 24 h after CA, and thyroid hormone profile 48 h after CA were also made in 17 patients with low T3 syndrome. Patients were followed up for an average duration of 63.5 months. Results The patients were divided into four groups: euthyroidism (60%), low T3 syndrome (28%), hypothyroidism (10%), and hyperthyroidism (2%). The free-iodide resulted far below the recommended limit of 50 μg/mL in all tested CM. In low T3 syndrome, 24-h free-iodide increased after CA from 99.9± 63 ug to 12276±9285 ug (P< 0.0001). A reduction in TSH (4.97±1.1 vs. 4.17±1.1 mUI/mL, P < 0.01) and free T3 (1.44±0.2 vs. 1.25±0.3 pg/mL, P < 0.01), with an increase in free T4 (11.3±2.9 vs. 12.5±3.4 pg/dL, P < 0.001), was found. Patients with functional thyroid disease in the follow-up had a significant lower rate survival compared to euthyroid patients (90.7 vs. 82.2%, P < 0.00001). Conclusion Thyroid dysfunction is frequent in patients who perform a CA, and low T3 syndrome is the predominant feature. The administration of contrast medium may further compromise the thyroid function.


2020 ◽  
pp. 63-64
Author(s):  
Srenivas. A ◽  
Sathiya Suresh

Seizures represent signal of neurological disease in the newborn period and these convulsive phenomena are the most frequent of the overt manifestation of neonatal neurological disorders.. The objective of this study was to study the incidence of pediatrics (0-12 years) seizures. To study the etiology and pattern of seizures. Methods: 200 Subjects who had seizures were included in the study. Relevant history was ascertained from a patient’s parents or a reliable relative or attendant, medical records and the referring physicians note, specifically from mother in case of neonatal seizures i.e. age at onset of seizures, seizure activity with special emphasis on occurrence of 1st seizures, duration of seizures, number and type of seizures, associated autonomic changes, medications required to control seizures, response time to medications, and possible causes for determination of etiology. A detailed antenatal, natal and postnatal history was taken. Results: Out of 200 study subjects 35.89% were in neonatal age group, of which 64.10% and 35.90% were male and female respectively and 64.11%. out of neonatal seizures, 64.10% neonates were male and 35.90% were female. Male: Female ratio was 1.79:1. The seizures were common in male neonates. Subtle seizures were the commonest type of seizures observed both in term and preterm neonates. Conclusions: The various types of seizure were compared with the preterm and term neonates and it was found statistically significant


Biomedicine ◽  
2021 ◽  
Vol 41 (2) ◽  
pp. 448-453
Author(s):  
Sadhna Sharma ◽  
Biju Govind ◽  
T.S.A. Satyamaharshi ◽  
M.Divya Vani ◽  
, M. Shivshankar

Introduction and Aim: The prevalence of thyroid disorders all over the world is on the rise. However, the diagnosis is complicated among the elderlies due to factors such as non-specific clinical manifestations and interacting medications. The aim of the study is to estimate the prevalence and type of thyroid dysfunction among the elderly. Materials and Methods: The cross-sectional study was undertaken in the Department of General Medicine of a tertiary care teachinghospital. The study included 100 subjects aged above 60 years, of both genders. Data for clinical examination and biochemical tests such as T3, T4, TSH and lipid profile were collected. Reports of USG/FNAC, performed in cases of thyroid nodule, were also checked.Results:The prevalence of thyroid disorders was 22% of the study population. Overt and subclinical hypothyroidism were observed among 4% and 17% respectively, with 1% having hyperthyroidism. Subclinical hypothyroidism was more common among women. No specific trend was observed with increasing age.TPO antibodies were positive among 73% of the cases. Patients with thyroid dysfunction had higher values of triglycerides, total cholesterol and LDL. The proportion of dyslipidemia was significantly higher among elderly with thyroid dysfunction as compared to people with no thyroid dysfunction (90.90% Vs 24.35%, P value < 0.001). Conclusion: Thyroid dysfunction in the elderly is common. Strong clinical suspicion of thyroid diseases in elderly patients presenting with non-specific symptoms is needed. This would aid in the diagnosis of thyroid disorders among the elderly.


Author(s):  
Aravind Gutlur Nagarajaiah Shetty ◽  
Suma Lingaraju ◽  
Manohara Melur Chandregowda

Background:The prevalence and incidence of thyroid disorders is influenced primarily by sex and age are more common in women and in older adults. Thyroid disorders if left untreated will increase risk of cardiovascular diseases and osteoporosis. Hence, screening for thyroid dysfunction must be done as routine investigation in the women presenting with menopausal symptoms.Methods:This case control study includes 50 pre-menopausal women of age group 34-49 years and 50 post-menopausal women of age group 50-55 years, visiting General medicine department of Victoria hospital and hospital affiliated to Bangalore Medical College and Research Institute. All the subjects were subjected for serum triiodothyronine (T3), tetraiodothyronine or thyroxine (T4), thyroid stimulating hormone (TSH), free T3 and T4 levels.Results:Out of all subjects; 23 were hyperthyroid out of which 14 were post-menopausal women, 37 were hypothyroid out of which 19 were post-menopausal women. Chi-square test showed no significant association. Negative and weak correlation was seen between total T3 and age; total T4 and age; TSH and age; free T3 and age; free T4 and age in pre-menopausal women. Negative and moderate correlation was seen between total T3 and age; total T4 and age; free T3 and age. There was a positive and weak correlation seen between TSH and age; weak positive non-significant correlation seen between free T4 and age. Significant correlation was seen between total T3 and age in post-menopausal women.Conclusions:Post-menopausal women should be monitored for serum T3, T4, TSH levels for reducing risk of thyroid dysfunction. 


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