scholarly journals A study of thyroid profile in cases of primary infertility attending a tertiary care hospital of south India

2018 ◽  
Vol 7 (6) ◽  
pp. 2180
Author(s):  
Anitha Nirakari B.
Keyword(s):  
Subclinical Hypothyroidism ◽  
Thyroid Dysfunction ◽  
Early Stage ◽  
Tertiary Care ◽  
P Value ◽  
Large Sample Size ◽  
Care Hospital ◽  
Cross Sectional ◽  
Infertile Women ◽  
Primary Infertility

Background: Infertility is a rising major problem affecting more than 50 million couples globally every year. Endocrine as well as immune system abnormalities can impair the fertility. Most of the studies globally indicated association of infertility with multiple factors like stress, luteal phase defects, structural and functional reproductive disturbances. Many infertile women with thyroid dysfunction had associated hyperprolactinemia with increases TSH in ovulatory dysfunction. The aim of the present study was to determine the association of hypo and hyperthyroidism with infertility among cases of primary infertility in women.Methods: A cross sectional study was conducted among the patients attending the infertility clinic for the first time. The study was approved by the institutional ethical committee and the study was carried as per the guidelines of the ethical committee. The serum levels of T3, T4 and TSH were estimated and Prolactin in cases where necessary by Chemiluminiscence immunoassay. The data was analyzed by using the unpaired “t” test. A ‘p’ value <0.05 was considered significant.Results: 285 cases were enrolled and majority (38.6%) was in 31-34 age groups with mean age of 24.2± 1.6 years. 30.53% were found with thyroid dysfunction. Majority (16.49%) were found with subclinical hypothyroid, followed in order by primary hypothyroid (9.82%), subclinical hyperthyroid (2.11%), primary hyperthyroid (1.05%), secondary hypothyroid (0.70%) and secondary hyperthyroid (0.35%).Conclusions: To conclude, thyroid dysfunction is a common cause of infertility and can be easily managed by correcting the levels of thyroid hormones. Present study suggests that thyroid replacement therapy in subclinical hypothyroidism at an early stage is justified in infertile women. Borderline variations in TSH levels should not be ignored in infertile women who are otherwise asymptomatic for subclinical hypothyroidism. Hence for better management of cases of primary infertility studies with large sample size and long term follow up are required to validate and justify the variation in TSH and prolactin levels.

scholarly journals A study of thyroid dysfunction among elderly in a tertiary care hospital

Biomedicine ◽  
2021 ◽  
Vol 41 (2) ◽  
pp. 448-453
Author(s):  
Sadhna Sharma ◽  
Biju Govind ◽  
T.S.A. Satyamaharshi ◽  
M.Divya Vani ◽  
, M. Shivshankar
Keyword(s):  
Subclinical Hypothyroidism ◽  
Thyroid Dysfunction ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
The Elderly ◽  
P Value ◽  
Thyroid Disorders ◽  
Care Hospital ◽  
Biochemical Tests ◽  
Cross Sectional

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.

scholarly journals Frequency and pattern of thyroid dysfunction in diabetic and non-diabetic women with primary infertility: experience in a tertiary care hospital in Dhaka, Bangladesh

2020 ◽  
Vol 10 (2) ◽  
pp. 92-96
Author(s):  
Farzana Islam Bithi ◽  
TA Chowdhury ◽  
Ferdousi Begum ◽  
Farhana Sharmin Emu
Keyword(s):  
Thyroid Function ◽  
Thyroid Dysfunction ◽  
Tertiary Care ◽  
Primary Hypothyroidism ◽  
Care Hospital ◽  
Infertile Women ◽  
Primary Infertility ◽  
Group I ◽  
Low T3 ◽  
Group Ii

Background: Thyroid hormones have profound effects on reproduction and pregnancy. A relationship betweenthe thyroid gland and the gonads is suggested by the far more frequent occurrence of thyroid disorders inwomen. Hormonal disorders of female reproductive system are comprised of a number of problems resultingfrom dysfunction of hypo-thalamic-pituitary ovarian axis. These relatively common disorders often lead toinfertility. Concomitant Diabetes and other metabolic abnormalities or endocrinopathy flare up the condition.This study was conducted to find out any difference in thyroid function among diabetic and non-diabeticpatient presenting with primary infertility. Methods: In this study total 174 patients were included and allocated into two groups, 87 in each group.Group I were diabetic infertile women and group II were non diabetic infertile women. Thyroid hormoneprofile were done and compared between groups. The data were based on the answers came from interviewsand medical records registered in the OPD follow up, investigation report, treatment paper and notes inhospital file sheet. Data processing work was consisted of registration schedules, editing computerization,preparation of dummy table, analyzing and matching of data. Results: No difference was observed in respect of demographic profile. It was observed that, majority ofpatients 73(41.9%) belonged to age 26-33 years, mean age was found 26.3±10.9 years in Group-I and 26.7±11.6years in Group-II. Low T3 was found in 15(17.2%) patients and in 9(10.3%) patients group I and group IIrespectively. Mean FT4 was found 8.25±1.5 pmol/L in group I and 10.57±1.82 pmol/L in group II. Raised TSHwas found in 23(26.4%) patients and 13(14.9%) patients in group I and group II respectively. On interpretationof thyroid function test, 71.8% (125/174) patients had normal finding or in euthyroid status (64.3% in group Iand 79.3% in group II). Present study shows that, frequency of thyroid dysfunction was common in group-Ipatients than group-II (35.6% vs. 20.6%). primary hypothyroidism was predominant abnormality, noted15(17.2%) patients in group I and 9(10.3%) patients in group II patients. Conclusion: Hypothyroidism is the most common thyroid dysfunction found in infertile females and it ispredominant in diabetic infertile group. Hence assessment of thyroid function should be considered as animportant component in infertility work up of women. Birdem Med J 2020; 10(2): 92-96

Frequency of Subclinical Hypothyroidism among Patients of Polycysitic Ovarian Syndrome (PCOS)

2021 ◽  
Vol 15 (11) ◽  
pp. 3511-3512
Author(s):  
Arooj Fatima ◽  
Ammara Mansoor ◽  
Faiza Nawaz ◽  
Ayesha Ilyas ◽  
Mehwish Hassan ◽  
...  
Keyword(s):  
Risk Factor ◽  
Subclinical Hypothyroidism ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
P Value ◽  
Care Hospital ◽  
Pathology Laboratory ◽  
Cross Sectional ◽  
Polycystic Ovarian Disease ◽  
Ovarian Disease

Introduction: Polycystic ovarian disorder is the most frequent kind of persistent anovulation caused by androgen extra, affecting 6-12% of fertile women. PCOS is seen as a complex condition through a variable origin. It has also been linked to greater in metabolic and cardiovascular risk factors. The purpose of our research was to determine the frequency of subclinical hypothyroidism among patients of polycystic ovarian disease presenting in the outpatient department of tertiary care hospital Methods: The Study was a cross-sectional study which was conducted in Gynecology & Obstetrics Department, Lady Aitchison Hospital, Lahore. All polycystic ovarian disease patients were enrolled. Participants' blood samples were drawn utilizing aseptic methods and transported to a pathology laboratory for serum TSH levels to be measured. Subclinical hypothyroidism was found to be common in polycystic ovarian individuals diagnosed. SPSS v24 was used to enter and evaluate data. The Chi-square method was conducted to test the relevance of post-stratification. A p-value of 0.06 was believed important. Results: Total 136 cases with polycystic ovarian disease were selected for this study. Mean age was 28.4±7.9 years. Among 136 patients, 26(19.1%) had subclinical hypothyroidism. By stratification of subclinical hypothyroidism, it was found that age >30 years and obese had extensive effect having subclinical hypothyroidism (p=0.00001, p=0.002). Conclusion: Subclinical hypothyroidism may be a modifiable risk factor, associated with polycystic ovarian disease. Steps should be taken to minimize more this risk factor by screening and early intervention. Keywords: Subclinical Hypothyroidism, Polycystic Ovarian Disease.

Causes of Epilepsy in Elderly Patients Presenting in a Tertiary Care Hospital of Karachi

2020 ◽  
Keyword(s):  
Elderly Patients ◽  
Cerebrovascular Disease ◽  
Neurodegenerative Disorder ◽  
Tertiary Care ◽  
P Value ◽  
Care Hospital ◽  
Traumatic Head Injury ◽  
Keywords Epilepsy ◽  
College Hospital ◽  
Cross Sectional

Background: Epilepsy is fairly a frequent occurrence in the elderly. It is commonly diagnosed after the episode of two or more unprovoked seizures. Unprovoked seizures in elderly are recurrent rather than younger individuals. This study was designed to estimate the concrete burden of frequent causes of epilepsy. Methods: A descriptive cross-sectional study with a total of 153 patients diagnosed case of epilepsy were included in this study at Jinnah Medical College Hospital from February 2018-August 2018. Mean was calculated for age, duration of disease of the patients. Causes of epilepsy, gender, and education was calculated and presented as percentages. Electrolyte readings were taken i.e., Sodium, Calcium and Magnesium levels and imaging was planned to rule out stroke, primary neurodegenerative disorders and tumors. Post stratification Chi square test was applied and p-value less than or equal to 0.05 was considered significant. Results: The mean age of the patients was 63.91±5.68 years and mean duration of the disease was 4.61± 1.07 months. The common causes of epilepsy were found to be cerebrovascular disease 56.9%, cryptogenic 54.2%, neurodegenerative disorder 20.3%, traumatic head injury 11.8%, metabolic abnormalities or electrolyte disturbances 10.5% and brain tumor 7.8%. Conclusion: Elderly patients with first seizure should present to a facility designed in a way that neurologist, cardiologist, rehabilitation and geriatrics work together to identify and treat the condition in a better way. Keywords: Epilepsy; Seizures; Cerebrovascular Disease; Neurodegenerative Disorder.

scholarly journals Thyroid status and Treatment Response of Hypothyroid Infertile Women in Tertiary Care Center of Bangladesh

2017 ◽  
Vol 31 (2) ◽  
pp. 86-89
Author(s):  
Farzana Deeba ◽  
Parveen Fatima ◽  
Jesmine Banu ◽  
Shakeela Ishrat ◽  
Nurjahan Begum ◽  
...  
Keyword(s):  
Subclinical Hypothyroidism ◽  
Early Stage ◽  
Care Center ◽  
Tertiary Care ◽  
Target Population ◽  
Fertility Treatment ◽  
Tertiary Care Centre ◽  
Infertile Women ◽  
The Mean ◽  
Tsh Levels

Objective(s): Aim of this study was to find out the prevalence of hypothyroidism in infertile women as well as to assess their response to treatment.Materials and methods: This descriptive study was conducted in Infertility unit of Department of Obstetrics and Gynecology, Bangabandhu Sheikh Mujib Medical University, Bangladesh, a tertiary care centre from January 2014 to December 2014. Four hundred women who visited infertility clinic of the department for fertility treatment were the target population for this study. Routine investigations such as CBC, Blood sugar 2 hours postparandial or GTT, TSH and Prolactin was done. Subclinical hypothyroidism was diagnosed when there was increased TSH and normal FT4. Hypothyroid patients were given Levothyroxin depending upon TSH levels and continued until end of the study. Patients were followed up for six months even if pregnancy was attained.Results: Out of 400 women 55% were primary and 45% were secondary subfertility. Mean duration of infertility was 4.5 ± 1.2 years. Ninety two (23%) patients were hypothyroid. Among them 66 (16.5%) were subclinical hypothyroid and 26 (6.5%) were frank hypothyroid. The mean TSH levels were 7.34 ± 2.13 ìIU/ml, and the mean PRL levels were 52.46 ± 11.17 ng/ml. Out of 92 infertile women diagnosed as hypothyroidism 75 (81.52%) women conceived after treatment with drugs for hypothyroidism (dose depending upon severity of hypothyroidism, i.e. TSH levels). More than 90% women had regular ovulation for consecutive three cycles after initiation of treatment.Conclusion: The normal TSH levels are the pre-requisite for fertilization. The decision to initiate thyroid replacement therapy in both clinical and subclinical hypothyroidism at early stage is justified in infertile women.Bangladesh J Obstet Gynaecol, 2016; Vol. 31(2) : 86-89

scholarly journals Transport Factors Affecting the Outcome of Referred Neonates Admitted in A Tertiary Care Hospital

2018 ◽  
Vol 41 (3) ◽  
pp. 159-164 ◽  
Author(s):  
Madhabi Baidya ◽  
Mahfuza Shirin ◽  
Liton Chandra Saha
Keyword(s):  
Perinatal Asphyxia ◽  
Care Center ◽  
Tertiary Care ◽  
Preterm Neonates ◽  
P Value ◽  
Care Hospital ◽  
Cross Sectional ◽  
Neonatal Transport ◽  
Group I ◽  
Group Ii

Background: Adequate neonatal transport is a key component of care of the sick newborns who require referral to tertiary care center. Poor transportation is one of the iatrogenic factors associated with greater neonatal mortality. Neonatal transport is the greatest challenge faced today in our country. The purpose of this study was to find out characteristics of transport of referred neonates and to idention the factors that contribute to mortality.Methodology: This cross sectional study was conducted in Dhaka Shishu (Children) Hospital from June 2013 to November 2013. Both term and preterm neonates who were referred within first seven days of life were included and those with gross congenital abnormalities and left against medical advice were excluded from the study. After enrollment, data were collected using a structured questionnaire including birth details, interventions before transportation, reasons for referral, and details of transportation. Outcome & duration of hospital stay were also recorded. Neonates who were expired considered as group I and who were survived considered as group II. The study variables were analyzed for their association with immediate outcome by applying chi square test and t test. P value <0.05 was considered significant.Results: This study found that out of 332 neonates 181 were expired with 54.5% mortality rate. One eighty one neonates who were expired, considered as group I and one fifty one neonate were survived, considered as group II. The mortality was significantly high in male neonates [RR 0.80 (0.66-0.97)] and neonates those delivered at home [RR 1.34(1.10-1.64)] (p<0.05). Perinatal asphyxia, pre-term low birth weight, neonatal sepsis were the main causes of referral. It was found that transportation without any referral note [RR 1.40 (1.14- 1.71)], no advice regarding maintenance of airway[RR 1.50(1.17- 1.92)]and keeping warm [RR 1.51(1.17-1.950], resuscitation on admission [RR 1.63(1.23-2.17)] and transportation required > 3hours [RR 1.36(1.09-1.69)] were associated with significantly higher mortality among referred transported neonates(p<0.05).Conclusions: This study found that male neonates, home delivery, transportation without any referral note, no advice regarding maintenance of airway and keeping warm, resuscitation needed on admission and prolonged transportation time were significantly associated with mortality of referred transported neonates.Bangladesh J Child Health 2017; VOL 41 (3) :159-164

scholarly journals Mental stress in infertility: a tertiary care hospital-based study

2018 ◽  
Vol 7 (10) ◽  
pp. 4249
Author(s):  
Susmita Bhattacharya ◽  
Amit Kyal ◽  
Payel Mondal ◽  
Partha Mukhopadhyay ◽  
Mrinalini Chowdhury ◽  
...  
Keyword(s):  
Mental Stress ◽  
Married Couple ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Dyadic Adjustment ◽  
Care Hospital ◽  
Chi Square ◽  
Cross Sectional ◽  
Primary Infertility ◽  
Icd 10

Background: Most of the couples suffering from infertility report it to be the most stressful and depressing period of their life, more so if it is a primary infertility. Studies regarding the prevalence and role of infertility-specific stress especially in eastern part of India is very limited. The objective of the present study was to estimate the prevalence of infertility-specific stress and its role in marital adjustment in women diagnosed with infertility.Methods: It was a cross-sectional study done on 80 married couple diagnosed with infertility (both primary and secondary) over 1 year from July 2016 to June,2017. Dyadic Adjustment Scale (DAS), "semi-structured questionnaire" compiled by the authors and "ICD-10 Classification of Mental and Behavioral Disorders (Clinical Descriptions and Diagnostic Guidelines)" were used for the evaluation. The analysis was done using SPSS (version 16) and Chi-square test.Results: Around 86% infertile women and 21% infertile men were found to suffer from mental stress. Infertility related stress were more in patients with primary infertility than in secondary one. Women mostly (56.5%) coped with stress by self-blaming whereas men (58.2%) by blaming the partner.Conclusions: Mental stress was significantly associated with infertility. In fact, maladjustment in marital relation caused by the stress adversely affected the conjugal life and thus also the fertility. Proper counselling of both partners might be helpful to solve this problem.

scholarly journals Study of Fasting Lipid Profile in Patients with Subclinical Hypothyroidism in a Tertiary Care Hospital in Bangladesh

2021 ◽  
Vol 16 (1) ◽  
pp. 17-20
Author(s):  
Mohammad Afjal Hossain ◽  
- Atiquzzaman ◽  
Mirza Sharifuzzaman ◽  
Farzana Amin ◽  
Lutful Kabir ◽  
...  
Keyword(s):  
Lipid Profile ◽  
Subclinical Hypothyroidism ◽  
Tertiary Care ◽  
Thyroid Function Test ◽  
Significant Negative Correlation ◽  
Thyroid Stimulating Hormone ◽  
Care Hospital ◽  
Cross Sectional ◽  
Metabolic Complications ◽  
Normal Thyroid Function

Subclinical hypothyroidism (SCH) is a metabolic disorder with prevalence about 4-10% in general population. This study was conducted to observe the pattern of fasting lipid profile in SCH and to correlate the components of it with thyroid stimulating hormone and free thyroxin level. This cross sectional observational study included 31 newly diagnosed cases of SCH and 17 age and BMI matched healthy control subjects with normal thyroid function test. Fasting lipid profile was recorded and compared. TSH was significantly higher in SCH compared to controls (9.09±2.79 vs 2.31±0.92 μIU/ml; p=0.001). FT4 was comparable between the groups (1.17±0.18 vs 1.28±0.20 ng/dl; p=0.938). Significantly higher level of Total cholesterol and LDL-C were observed in SCH compared to controls (TC 194.77±29.70 vs 156.59±20.45 mg/dl; p=0.042 and LDL-C 124.81±27.85 mg/dl vs 88.59±18.41mg/dl; p=0.045 respectively). Triglycerides and HDL-C were comparable between the groups (TG 134.90±80.97 vs 118.12±49.14 mg/dl; p=0.171 and HDL-C 42.87±4.83 vs 44.47±5.66; p=0.633 respectively). TSH showed significant positive correlation with TC and LDL-C (r=0.591, p<0.001 and r=0.644, p<0.001 respectively), but not with TG or HDL-C (r=0.011, p=0.943 and r=0.115, p=0.435 respectively). FT4 only showed significant negative correlation with LDL-C (r=0.302; P=0.037) but not with TC, TG or HDL-C (TC: r=0.245, P=0.093; TG: r=0.121, p=0.411 and HDL-C: r=0.108, p=0.466 respectively). SCH is associated with raised TC and LDL-C. So patients with SCH are more vulnerable to develop future adverse cardio-metabolic complications. Faridpur Med. Coll. J. 2021;16(1):17-20

scholarly journals Thyroid dysfunction in patients of metabolic syndrome: A study from a tertiary care center in India

2021 ◽  
Vol 12 (10) ◽  
pp. 47-50
Author(s):  
Ritu Gupta ◽  
Akhil K Vijayan ◽  
Sushma Choudhary
Keyword(s):  
Metabolic Syndrome ◽  
Thyroid Dysfunction ◽  
Care Center ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Thyroid Stimulating Hormone ◽  
P Value ◽  
Overt Hypothyroidism ◽  
Free T4 ◽  
Cross Sectional

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.

scholarly journals MATERNAL SEPSIS;

2019 ◽  
Vol 26 (05) ◽  
Author(s):  
Fehmida Parveen Memon ◽  
Majida Khan ◽  
Samya Aijaz
Keyword(s):  
Maternal Morbidity ◽  
Tertiary Care ◽  
Morbidity And Mortality ◽  
University Hospital ◽  
P Value ◽  
Care Hospital ◽  
Maternal Complications ◽  
Cross Sectional ◽  
Maternal Morbidity And Mortality ◽  
Maternal Sepsis

Objectives: To determine the thrombocytopenia as marker of maternal sepsis and its related maternal morbidity and mortality at tertiary care Hospital. Study Design: Cross-sectional study. Setting: Gynaecological and Obstetrical department of Liaquat University Hospital, Hyderabad. Period: 6 months from March 2017 to August 2017. Material and Methods: All the pregnant females with diagnosis of sepsis were enrolled in the study. All the females with chronic hepatitis were excluded. After complete clinical examination every women underwent 5cc blood sample for complete blood picture. Thrombocytopenia was characterized as a platelet count below 150.000/mm3. Data regarding maternal mortality and maternal complications was filled in the proforma. Results: Total 120 septic mothers were included in the study, 70 patients had thrombocytopenia and 50 were with normal platelets. Most of the women 71.7% were with age groups of 20-30 years. Out of total women 65.0% were un-booked. According to the maternal morbidity, septic shock was most common 36.7%, multi-organ failure was in 08.3%, prolonged Hospital stay was in 16.7%, ICU admission occurred in 18.3% patients, while renal failure, respiratory failure, hepatic failure, coagulopathy and metabolic acidosis were found with percentage of 09.2%, 02.5%, 10.8%, 10.8% and 03.3% respectively. Mortality rate was found among 8.3% out of total cases. Almost all complications were higher among women with thrombocytopenia as compare to women with normal platelets level, while statistically p-value was quite insignificant. Mortality was significantly high among patients with thrombocytopenia p-value 0.032. Conclusion: It was concluded that thrombocytopenia is a good marker for adverse outcome among septic mothers. Maternal morbidity and mortality was higher among septic women with thrombocytopenia.

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