Is hypothyroidism a risk for gall stone disease? a study to assess the association

Background: Gall stones are one of the most common problems affecting the digestive tract requiring hospitalization. The disease frequently occurs in young, otherwise healthy people with a prevalence of 11-36 % on autopsy report. Thyroid diseases are, arguably, among the commonest endocrine disorders worldwide. In the present study, we have tried to determine an association between gall stone disease, and previously diagnosed and undiagnosed hypothyroidism in patients presenting to our hospital for treatment. The aim of this study was to determine association between gallstones and hypothyroidism and to study the prevalence of previously undiagnosed hypothyroidism in all patients of gallstones.Methods: The study was a hospital based cross sectional, observational study conducted on 200 patients with upper abdominal pain attending the Surgery OPD and Emergency over a period of 1 years. Patients were divided into 2 groups: Case group (100 patients) with gall stones on ultrasound and Control group (100 patients) without gall stones on ultrasound. Thyroid profile along with other biochemical investigations was done and both the groups were compared for the parameters.Results: Both groups were comparable for age and sex of the patients. On considering the thyroid profile of the patients in both the groups we observed that 14% of patients were hypothyroid in case group and 8% of the patients in control group. On comparing the two groups, there was no statistically significant difference in the prevalence of hypothyroidism (p value 0.175) between the two groups. There was a significant difference when serum cholesterol and bilirubin levels were compared between the two groups. 7 patients out of 100 cholelithiasis had Choledocolithiasis too, these patients had significantly raised cholesterol and deranged liver function tests.Conclusions: No significant relation between gallstones and hypothyroidism was found in this study (p value=0.175) and need further evaluation. Among the hypothyroid patients the incidence of gall stones was highest among 51-60 years of age so we recommend that TSH level should be measured for every patient with gallstone disease in this age range.

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Association of interleukin-17A rs2275913 polymorphism with rheumatoid arthritis susceptibility in Sudanese population

SAGE Open Medicine ◽

10.1177/20503121211020207 ◽

2021 ◽

Vol 9 ◽

pp. 205031212110202

Author(s):

Rgda Mohamed Osman ◽

Mounkaila Noma ◽

Abdallah Elssir Ahmed ◽

Hanadi Abdelbagi ◽

Rihab Ali Omer ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Confidence Interval ◽

Statistical Tests ◽

Demographic Data ◽

Control Group ◽

P Value ◽

Case Group ◽

Molecular Technique ◽

Interleukin 17A ◽

Significant Difference

Objectives: Rheumatoid arthritis is a chronic inflammatory autoimmune disease. This study aimed to determine the association of interleukin-17A-197G/A polymorphism with rheumatoid arthritis in Sudanese patients. Methods: A case–control study was conducted between March and December 2018. Clinical and demographic data of the study participants were collected and analyzed. Polymerase chain reaction restriction fragment length polymorphism molecular technique was done to investigate interleukin-17A-197G/A polymorphisms. All statistical tests were considered statistically significant when p < 0.05. Results: The study population included 266 participants aged between 1 and 85 years, with an average of 40 years, classified into 85 (31.2%) cases (mean age 48.5 ± 11.3 years), and 181 (68.8%) controls (mean age 35.3 ± 15.9 years). The interleukin-17A homozygote AA genotype was more frequent among the control group compared to the case group; 95 (52.5%) and 7 (8.2%), respectively. The homozygote GG and the heterozygote AG genotypes were proportionally not different among the cases and control groups; 13 (54.2%) and 11 (45.8%), and 65 (46.4%) and 75 (53.6%), respectively. According to the distribution of interleukin-17A genotypes, a statistically significant difference was observed among cases with the interleukin-17A AA and AG genotypes, p values 0.001 and 0.004, respectively. For the association interleukin-17A genotypes and family history a negatively significant association was reported (95% confidence interval, –0.219, p value = 0.001). There was also a negatively significant association of interleukin-17A genotypes and anti-cyclic citrullinated peptide (95% confidence interval, −0.141, p value = 0.002). Conclusion: This study is the first study in Sudan established the association between interleukin-17A-197G/A (rs2275913) polymorphisms and susceptibly to rheumatoid arthritis. These findings appeal for further research in Sudan to investigate the exact role of IL-17A in immunopathology and disease severity among Sudanese rheumatoid arthritis

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The Relationship between the Type of Milk Consumed and the Risk of Kidney Stones in Children Under Two Years of Age

Journal of Iranian Medical Council ◽

10.18502/jimc.v3i4.5192 ◽

2021 ◽

Author(s):

Hamideh Shajari ◽

Ahmad Shajari ◽

Mohammad Golshan Tafti ◽

Reza Samaninejad

Keyword(s):

Kidney Stones ◽

Statistical Significance ◽

Cow Milk ◽

Control Group ◽

P Value ◽

Case Group ◽

Growth Disorders ◽

Formula Milk ◽

Significant Difference ◽

Duration Of Breastfeeding

Background: Kidney stones are one of several serious health problems in childhood that cause nutritional and growth disorders, and may finally lead to chronic kidney failure in this group. Methods: In this analytical study conducted through a case-control design, 30 children under the age of two with kidney stones, and 125 children of the same age and sex without stones were studied. Patient information including personal profile and the results of some necessary tests were extracted from patient records and listed in a checklist. The data was analyzed using SPSS (Version 17.0). Statistical significance was considered when p-value was <0.05. Results: In terms of duration of breastfeeding, a significant difference was observed between the patients with stones and patients without stones; the duration of breastfeeding was longer in the control group (p=0.003). In addition, the duration of feeding with formula milk and cow milk was longer in the case group (p=0.038 and p=0.012, respectively). Conclusion: Breastfeeding can serve as a nutritional factor that plays a preventive and protective role against the formation of kidney stones in infants.

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Relationship of Migraine and Body Mass Index (BMI)

Journal of Enam Medical College ◽

10.3329/jemc.v6i2.27762 ◽

2016 ◽

Vol 6 (2) ◽

pp. 80-87

Author(s):

Mohammed Momenuzzaman Khan ◽

Md Nazmul Huda ◽

Manabendra Bhattacharjee ◽

Md Jalal Uddin ◽

Mustofa Kamal Uddin Khan

Keyword(s):

Social Life ◽

Overweight And Obesity ◽

Control Group ◽

P Value ◽

Case Group ◽

Increased Risk ◽

Significant Difference ◽

Associated Symptoms ◽

Migraine Group ◽

The Relationship

Background: Migraine is an important cause of headache and headache-related disabilities. It increases loss of working time, causes inability to carry out daily activities and disruption of family and social life. The pathophysiology of migraine is still poorly understood. On the other hand, the prevalence of obesity is constantly increasing worldwide. The consequence of overweight and obesity includes increased risk of diabetes mellitus, dyslipidemia, hypertension, cardiovascular disease and cancer.Objectives: This study was performed to assess the relationship between BMI and migraine by finding out the relationship between migraine frequency and duration in different BMI groups, comparing the socio-demographic variables in migraine and non-migraine patients and to find out the migraine related co-morbidities.Materials and Methods: This observational case-control study was conducted on 100 subjects aged 1250 years in the Neurology Outpatient Department, Mymensingh Medical College Hospital, Mymensingh in the period of January 2011 to December 2012. Out of total subjects fifty migraine patients were selected as cases and fifty nonmigraineurs as controls. Subjects were then categorized in three groups based on BMI: <23, 23 to 25 and >25. Collected data were compiled and appropriate analyses were done by using computer based software, Statistical Package for Social Sciences (SPSS) version 16.0. For statistical analysis one way ANOVA tests were done for comparing means of quantitative data and Chi-square tests were done for qualitative data. A p value <0.05 was considered statistically significant.Results: In this study, majority (>95%) of the study subjects were between 10 and 35 years of age. Mean age of case group was found 25.55 ± 5.87 and that of control was 25.53 ± 4.22 years. Case group contained 10 (20%) males and 40 (80%) females whereas control group had 14 (28%) males and 36 (72%) females. Number of female cases and controls were higher than that of male. In control group 30 (60%) were unmarried and 20 (40%) were married. There was no significant difference in the financial condition between case and control groups. Students and housewives occupied the largest number of study subjects who were unemployed. Regarding residence, rural and urban patients were equal in case group and in control group 29 (58%) were urban and 21 (42%) rural. Mean duration of headache was 8.9 ± 7.5, 5.8 ± 6.7, 9.6 ± 14.3 years in different BMI groups (<23, 2325, >25 respectively) in case group and 4.6 ± 5.3, 4.4 ± 3.4, 3.4 ± 1.4 years in control group respectively. There was significant difference in quality of headache. In migrainous group 58.6% in BMI <23, 30% in BMI 2325, 36.4% in BMI >25 noted their headache as throbbing, in contrast most of the nonmigrainous described them as dull in nature. Mean frequency of headache per month was significantly higher in migraine group compared to non-migraine group (p=0.02). Regarding associated symptoms, nausea, vomiting, photophobia and phonophobia were observed significantly higher in migraine patients in BMI <23 group. Odd ratios (ORs) for vomiting, photophobia and phonophobia with 95% confidence interval (CI) were 23.385 (2.75297.739), 16.500 (3.060 88.971) and 13.000 (2.92257.846) respectively. Smoking was found significantly higher in nonmigrainous group than migraine group in case of BMI <23.Conclusion: From the result of present study it can be concluded that there is statistically no significant relation of BMI with frequency of headache, but some relationship were observed for associated symptoms of migraine with low BMI.J Enam Med Col 2016; 6(2): 80-87

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Prospective randomised trial of standard pressure versus low pressure laparoscopic cholecystectomy in a tertiary care hospital from Kolkata: Our experience

Asian Journal of Medical Sciences ◽

10.3126/ajms.v9i4.19780 ◽

2018 ◽

Vol 9 (4) ◽

pp. 17-22

Author(s):

Bikash Chandra Ghosh ◽

Ambar Gangopadhyay

Keyword(s):

Laparoscopic Cholecystectomy ◽

Laparoscopic Surgery ◽

Gall Stone ◽

Low Pressure ◽

Stone Disease ◽

Care Hospital ◽

Significant Difference ◽

Gall Stone Disease ◽

Standard Pressure ◽

Symptomatic Gall Stone

Background: Laparoscopic cholecystectomy (LC), the procedure of choice for symptomatic gall stone disease. An emerging trend is to perform Low pressure pnuemoperitonium laparoscopic surgery as it has additive advantages over standard pressure to avoid complications while providing adequate working space.Aims and Objectives: The current study was designed with an aim to compare the advantage of low pressure pneumoperitoneum vs standard pressure pneumoperitoneum in laparoscopic cholecystectomy.Materials and Methods: The study was conducted in the department of General Surgery in R.G.Kar Medical College from January 2014 to June 2015. A total of 52 patients with symptomatic gall stone disease were recruited, 26 patients in each group randomly. Some intraoperative and post-operative parameters were studied.Results: All the intra-operative (IO) cardio-respiratory parameters (Pulse, Mean Arterial Pressure (MAP), End tidal CO2, spO2) were recorded just before incision, 20 minutes intra-operatively and before reversal of general anesthesia (GA). The IO parameters in our study, were found to be significant only at 20 minutes IO and before reversal of GA. The post-operative (PO) parameters (Pulse, MAP, Respiratory rate, spO2) and pain by VAS score at 6 hours, 12 hours and 24 hours post-operatively were studied. In PO period, we observed significant differences at 2 hours post-operatively in all parameters except MAP. There was significant difference in pain at 6, 12 and 24 hours when compared in both groups. The shoulder tip pain (STP) and 2 hours PO nausea and vomiting were found to be significantly higher in Standard pressure Laparoscopic cholecystectomy (SPLC) compared to Low pressure Laparoscopic cholecystectomy (LPLC). The operative time, duration of hospital stay and return to normal life after surgery though had differences but it was statisticallyinsignificant.Conclusion: Low pressure laparoscopic surgery is safe with least post operative complications when performed by experienced surgeons even in patients of ASA III.Asian Journal of Medical Sciences Vol.9(4) 2018 17-22

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Evaluation of relationship of body mass index with severity of cholecystitis

International Surgery Journal ◽

10.18203/2349-2902.isj20190570 ◽

2019 ◽

Vol 6 (3) ◽

pp. 868 ◽

Cited By ~ 2

Author(s):

Varun V. Chauhan ◽

Bhushan A. Shah ◽

Shivaratna J. Mahadik ◽

Rohan P. Videkar

Keyword(s):

Risk Factor ◽

Open Cholecystectomy ◽

Gall Stone ◽

Stone Disease ◽

Established Risk Factor ◽

Significant Difference ◽

Conversion To Open Cholecystectomy ◽

Gall Stone Disease ◽

Total Body ◽

A Prospective Study

Background: Obesity is an established risk factor for gall stone disease. Male sex has also been recently cited as a risk factor for severe symptomatic cholelithiasis. As a possible cause of several difference in regards to the severity of cholecystitis, many physiological differences between the two sexes can be examined. Many studies have been done on the risk factors for developing the gall bladder disease explaining its polygenic nature It is postulated that the total body fat, the main value of which is significantly higher for females than males, may contribute to this sex difference. Only a couple of studies are available on BMI and its effect on severity of cholecystitis hence depicting the need for this study in our setup.Methods: This is a prospective study carried out on 70 patients for cholecystitis whose weight and height measurements had been recorded on admission. Patients were placed in either group-Obese (BMI e” 25kg/m2) or Non-Obese (BMI <25kg/m2). The association between BMI and severity of cholecystitis was investigated.Results: 18% of the laparoscopic cholecystectomy surgeries required conversion to open cholecystectomy due to reasons like severe adhesions to an adjacent organ, etc. Pain in abdomen (100%) was the commonest complaint and was present in all the patients followed by dyspepsia (44%).69% of patients were having complaints for more than 72 hours. No significant difference observed among mean BMI of different grades of severity (p=0.963).Conclusions: There is negative correlation between BMI and grade of severity of cholecystitis and BMI is not a predictor for the conversion from laparoscopic to open cholecystectomy.

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A one-year study of cholelithiasis at a tertiary care hospital of South India

International Surgery Journal ◽

10.18203/2349-2902.isj20182502 ◽

2018 ◽

Vol 5 (7) ◽

pp. 2444

Author(s):

Ramalinga Reddy Rachamalla ◽

Kishore Kumar Markapuram ◽

Sreeram Satish

Keyword(s):

Gall Stone ◽

Stone Disease ◽

Hormonal Contraceptives ◽

Care Hospital ◽

Mixed Diet ◽

Female Ratio ◽

Gall Stones ◽

Increased Risk ◽

Gall Stone Disease ◽

One Year

Background: Gall stone disease is a chronic recurrent disease of hepatobiliary system characterised by formation of gall stones due to impaired metabolism of bile acids, cholesterol and bilirubin. The prevalence of cholelithiasis is variable and has been reported as 2-29% in India with differences in interstate and interregions. The objective of the present study was mainly focuses on the total clinical study with surgical management and their outcome.Methods: A prospective study for a period of one year was done after approval from ethical committee. The socio-demographic factors, clinical history, physical examination, laboratory investigations with ultrasound abdomen were done in all the cases. Surgical repair by Laparoscopic and open cholecystectomy was done.Results: Females were more predominant with male: female ratio of 1:1.97. Mean age of study population was 34.12±6.2 years and was more common during 5th decade of life. Pain in the hypochondrium was most common sign. Mixed stones were most common and mostly observed in cases of mixed diet. Laparoscopic cholecystectomy was most commonly performed with zero conversion rate. Wound infection was the most common post-operative complication in both the types of repair.Conclusions: To conclude, from the present study females were more commonly affected by cholelithiasis than males with a ratio of 1:1.97. Females are more prone during fertile age and reasons are multifactorial due to hormones, parity and hormonal contraceptives. Gall stone disease is more common during fourth and fifth decade of life in both males and females. Mixed diet (non-vegetarian) is associated with increased risk of developing gall stones than vegetarian diet.

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Association of metabolic syndrome with complicated gall stone disease: our experience

International Surgery Journal ◽

10.18203/2349-2902.isj20192989 ◽

2019 ◽

Vol 6 (7) ◽

pp. 2543

Author(s):

Narender Kumar ◽

Somendra Bansal ◽

Shalu Gupta ◽

Bhanwar Lal Yadav ◽

Pradeep Verma ◽

...

Keyword(s):

Metabolic Syndrome ◽

General Surgery ◽

Prospective Observational Study ◽

Gall Stone ◽

Daily Practice ◽

Stone Disease ◽

P Value ◽

Gall Stone Disease ◽

Biliary Pathology ◽

Surgery Department

Background: Gall stone disease is the most common biliary pathology and frequently encountered in our daily practice. Patients with gall stone that experienced at least one attack of acute cholecystitis is defined as complicated gall stone disease (CGSD). Aim of this study was to find out the association between complicated gall stone disease and the metabolic syndrome.Methods: This prospective, observational study was done from 1st March 2017 to 30th November 2018 in department of general surgery, SMS hospital Jaipur. All patients with cholelithiasis admitted in general surgery department were included. Metabolic syndrome was defined by adult treatment panel III (ATP III) criteria. All patients were divided in two groups: complicated gall stone disease (CGSD) and uncomplicated gall stone disease (UGSD).Results: Mean age was 47.2 years in CGSD group and 46.7 year in UGSD group. Female to male ratio was 8.2:1 in CGSD group and 4:1 in UGSD. Metabolic syndrome was presented in 64 patients (58.2%) of CGSD group and 24 patients (21.8%) of UGSD patients, which was statistically significant (OR 4.986, CI 2.763-8.995, p value <0.001). Five components of metabolic syndrome were compared in both CGSD group and UGSD group. Lower serum HDL-C level and hyperglycemias was statistically significant in CGSD group as compared to UGSD group.Conclusions: Metabolic syndrome can be use to predict complicated gall stone disease. Hyperglycaemia and lower HDL-C associated with CGSD. One should be aware about possible metabolic syndrome background when dealing with gall stone disease patients.

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Etiology and chemical composition of gall stone disease: a prospective observational study from the developing world

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20210997 ◽

2021 ◽

Author(s):

Syed Mushtaq Ahmed Shah ◽

Tahir Saleem Khan ◽

Ravi Kumar ◽

Tajddin Wani ◽

Adil Shadab Indrabi

Keyword(s):

Calcium Carbonate ◽

Chemical Composition ◽

Observational Study ◽

Prospective Observational Study ◽

Gall Stone ◽

Stone Disease ◽

Common Component ◽

Calcium Bilirubinate ◽

Gall Stones ◽

Gall Stone Disease

Background: Aim of the study was to assess the etiology and determine the chemical composition of gallstones in our population.Methods: This was a prospective observational study conducted at GMC Srinagar from 2018 to 2020. One hundred patients having gall stone disease were enrolled into the study and after cholecystectomy was performed the stones chemical composition was analyzed by fourier-transform infrared (FTIR) spectroscopy. The data was collated and analysed.Results: 54 patients had mixed stones with chemical composition of cholesterol, calcium carbonate and calcium bilirubinate; 39 had cholesterol stones and 7 patients had pigmented stone with chemical composition of cholesterol, calcium carbonate and calcium bilirubinate.Conclusions: Our results suggest that cholesterol, either singularly or in combination with calcium carbonate or bilirubin is a common component of gall stones in our population.

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Risk Factors for Gall Stone Diseases in Patients Presenting to General Practice Out Patient Department in a Tertiary Care Center in Nepal

Journal of Institute of Medicine ◽

10.3126/jiom.v41i2.26545 ◽

2019 ◽

Vol 41 (2) ◽

pp. 26-29

Author(s):

Ram P. Neupane ◽

Tirtha M Shrestha ◽

Shankar Raut ◽

Ramesh P Aacharya

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

General Practice ◽

Family History ◽

Gall Stone ◽

Vegetarian Diet ◽

Stone Disease ◽

Control Group ◽

Gall Stone Disease ◽

History Of

Introduction: Gallstone disease (GSD) is a major public health problem that is associated with a number of risk factors. This study aims to analyze the risk factors of GSD in patients visiting General Practice Outpatient Department of Tribhuvan Universtiy Teaching Hospital. Methods: A case-control study of 174 participants comprising 85 cases with GSD and 89 controls without GSD, as confirmed by ultrasonography of abdomen was conducted as hospital based in outpatient department of General practice, Tribhuvan University Teaching Hospital, Kathmandu from 1st February 2018 to 31st January, 2019. The participants were asked questions regarding putative risk factors for development of GSD and underwent physical and ultra sonographic examination. Risk factors included were age, sex, BMI, occupation, co-morbidities e.g. diabetes mellitus, hemolytic diseases, family history of GSD, smoking status, alcohol consumption, parity if applicable and dietary history. Data analysis was done by univariate method. Results: The mean age of the case group was 47.82 years whereas mean age for the control was 46.51 years (p=0.355). 22% of cases were male and 78% were female where as in control group 29% were male (p=0.3030). Majority of the participants in both group were housewife by occupation and Hindu by religion. Mean BMI of the cases and control were 24.05 kg/m2 and 21.13kg/m2 respectively. BMI was found significant for the gall stone diseases (p=<0.001). Similarly, Diabetes mellitus was found significant for GSD (p=0.001). 98% cases and 61% in control group were Non-vegetarians with significant p value of 0.021. Smoking (p=0.005), Non-vegetarian diet (p=0.021), family history of gall stone disease (p<0.001) and parity (p<0.001) were also found significant for the gall stone disease. Conclusion: High BMI, non-vegetarian diet, family history of gall stone disease, diabetes mellitus, smoking and increased parity were associated with gall stone diseases.

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LAPAROSCOPIC SURGERY;

The Professional Medical Journal ◽

10.29309/tpmj/2014.21.03.2138 ◽

2014 ◽

Vol 21 (03) ◽

pp. 529-534

Author(s):

Umar Fayyaz Ghani ◽

Faran Khan ◽

Ameer Yasser Zaid ◽

Khan Dost Afridi

Keyword(s):

Gall Stone ◽

Bile Leakage ◽

Stone Disease ◽

Safe Procedure ◽

Conversion To Open Surgery ◽

Iatrogenic Perforation ◽

Gall Stones ◽

Study Results ◽

Gall Stone Disease ◽

A Prospective Study

Objective: To observe the rate of complications during elective laparoscopiccholecystectomies. Design and study duration: It was a prospective study and was carried outfrom July 2011 to June 2012. Setting: The study was conducted at PAF Hospital Islamabad.Patients: 105 patients with gall stone disease who underwent elective laparoscopiccholecystectomy. Material and Methods: 105 patients ranging in age from 23yrs to 81yrs wereoperated. 12 were males and 93 were females. History, clinical examination and ultrasonographywere used to diagnose the presence of gall stones. Patients with acute symptoms were excludedfrom the study. Results: The main complications encountered were iatrogenic perforation of thegall bladder (8), haemorrhage (7), post-operative bile leakage (4), and large gut injury (1).Conversion to open surgery was done in three cases due to difficulty in identifying anatomy and incase of large gut injury. There was one death. Conclusions: Laparoscopic cholecystectomy (LC)has become the preferred method of treatment in surgery for gall stone disease. A soundknowledge of the complications and their management makes this a safe procedure.

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