scholarly journals Neonatal thyroid screening a tertiary care experience at VSS Medical College and Hospital, Burla

2021 ◽  
Vol 8 (2) ◽  
pp. 280
Author(s):  
Vidhyadhara Naik T. L. ◽  
Bineet Panigrahi ◽  
Sanjukta Panda
Keyword(s):  
Mental Retardation ◽  
Congenital Hypothyroidism ◽  
Tertiary Care ◽  
Recall Rate ◽  
Confirmatory Test ◽  
Neonatal Hypothyroidism ◽  
Care Experience ◽  
Thyroid Screening ◽  
Neonatal Thyroid Screening ◽  
Serum Tsh

Background: Congenital hypothyroidism is one of the most common preventable etiologies of mental retardation. The worldwide incidence of CH ranges from 1 in 3000 to 1 in 4000 live newborn. Objective of the study was to know the incidence of congenital hypothyroidism in this part of the country, which is necessary to understand the burden of congenital hypothyroidism to the society.Methods: Primary serum TSH measurement in screening neonates with backup thyroxine (T4) determination in infants with high TSH levels (>20 mIU/l). TSH and FT4 were estimated by chemi luminescence immunoassay (CLIA) method using reagent monobind, INC.Results: Serum TSH of screened neonates ranged between 0.16 mIU/l and 80.32 mIU/l, Mean±SD of sTSH being 5.80±3.96 mIU/l. Out of 2212 screened newborns, 9 newborns had sTSH value >20 mIU/l, who were recalled for confirmatory test, giving a recall rate of 0.4%. Out of 9 recalled newborns, 3 had persistently elevated sTSH >20 mIU/l making incidence of congenital hypothyroidism of 1:737 in our study.Conclusions: We found a higher incidence of 1:737 neonatal hypothyroidism in this region as compared to estimated national incidence. CH being preventable cause of mental retardation and other harmful effects on a growing newborn, neonatal screening programme for congenital hypothyroidism is highly recommended.

scholarly journals SCREENING FOR CONGENITAL HYPOTHYROIDISM WITH UMBILCAL CORD BLOOD TSH LEVEL ‘AN EXPERIENCE FROM A TERTIARY CARE CENTER'

2020 ◽  
pp. 26-27
Author(s):  
Rohan Modi ◽  
Harsh Mod ◽  
Aabha Phalak ◽  
Rutvik Parikh ◽  
Vilas Kavad ◽  
...  
Keyword(s):  
Mental Retardation ◽  
Cord Blood ◽  
Congenital Hypothyroidism ◽  
Care Center ◽  
Tertiary Care ◽  
Research Centre ◽  
College Hospital ◽  
Cross Sectional ◽  
Screening Programs ◽  
Serum Tsh

BACKGROUND:- Congenital hypothyroidism (CH) is the most common preventable cause of mental retardation. Screening for congenital hypothyroidism can be helpful in preventing mental retardation among general population. Umbilical cord blood TSH (CBTSH) estimation has been universally accepted and is one of the most cost effective screening programs in the field of preventive medicine and public health. AIMS AND OBJECTIVES:- This study was aimed to find the effectiveness of cord blood TSH as a screening tool for congenital hypothyroidism. MATERIALS AND METHODS:- This hospital based cross sectional study was conducted at GCS Medical College Hospital & Research Centre, Ahmedabad, over a period of one year in 1687 neonates. All newborns delivered at the institute were subjected to cord blood TSH level estimation and a repeat Serum TSH estimation was done at or after 72 hours of life. Diagnosis of congenital hypothyroidism is confirmed postnatally by standard Serum TSH value cut offs as per age. Data collected and statistically analysed. RESULTS:- Out of 1687 neonates born during the study period, 1548 formed the study group. 805 (52%) were males and 743(48%) were females. The birth weight of babies ranged from 850 gms to 4300 gms. The value of CBTSH varied from 1.3mIU/L to 101.4mIU/L with mean CBTSH of 7.21mIU/L. 28(1.8%) babies had CBTSH levels >20mIU/L. Out of which four were later diagnosed to have congenital hypothyroidism. All four had CBTSH levels >20mIU/L. All other neonates with CBTSH levels less than 20mIU/L were found to have normal screening later postnatally. CONCLUSION:- The current study concludes that cord blood TSH is a sensitive marker to screen for congenital hypothyroidism in neonates. A cut off value of cord blood TSH >20mIU/ml can be used for screening purpose.

Short Report: False-negative primary neonatal thyroid screening: the need for clinical vigilance and secondary screening

2003 ◽  
Vol 10 (1) ◽  
pp. 2-4 ◽  
Author(s):  
K A Yunis ◽  
M R Nasr ◽  
G Lepejian ◽  
S Najjar ◽  
R Daher
Keyword(s):  
Natural History ◽  
Congenital Hypothyroidism ◽  
False Negative ◽  
Thyroid Stimulating Hormone ◽  
Short Report ◽  
Thyroid Screening ◽  
Secondary Screening ◽  
History Of ◽  
Neonatal Thyroid Screening ◽  
Screening Result

The screening of newborn babies for congenital hypothyroidism has changed the natural history of this abnormality. We describe here a case of a female patient with congenital hypothyroidism that was missed by primary neonatal thyroid screening (using thyroid-stimulating hormone) at two days of age; it was detected only after the development and persistence of jaundice during the first three weeks of life. A normal neonatal screening result does not preclude the development of hypothyroidism later in infancy. Clinical vigilance must be maintained by practitioners. A second screening between two and six weeks of age may be useful in order to detect the few cases missed at first screening.

scholarly journals Newborn Screening for Five Conditions in a Tertiary Care Government Hospital in Bengaluru, South India—Three Years Experience

2019 ◽  
Vol 66 (3) ◽  
pp. 284-289 ◽  
Author(s):  
Anitha Kommalur ◽  
Sahana Devadas ◽  
Mallesh Kariyappa ◽  
Sarala Sabapathy ◽  
Asha Benakappa ◽  
...  
Keyword(s):  
Congenital Adrenal Hyperplasia ◽  
Newborn Screening ◽  
Congenital Hypothyroidism ◽  
G6pd Deficiency ◽  
Tertiary Care ◽  
Recall Rate ◽  
Large Sample Size ◽  
Adrenal Hyperplasia ◽  
Birth Cohorts ◽  
Government Hospitals

Abstract Purpose Newborn screening is the need of the hour in a developing country like India as there is paucity of data from studies conducted in government hospitals with large sample size. The purpose of the study is to estimate incidence rate and recall rates for five conditions screened in the neonatal period namely congenital hypothyroidism, congenital adrenal hyperplasia, glucose-6-phosphate dehydrogenase (G6PD) deficiency, galactosemia and phenyl ketonuria (PKU). Methods The study was conducted at VaniVilas Hospital attached to Bangalore Medical College and Research Institute. A retrospective analysis of the results of newborn screening programme during a 3-year period between January 2016 and December 2018 was done. There were 47 623 livebirths during this period out of which 41 027 babies were screened (coverage—86% of total livebirths). Heelprick samples after 48 h of life and prior to discharge were analysed by quantitative assessment. Neonates having positive screening results were recalled by telephonic call for repeat screening and confirmatory tests. Results G6PD deficiency was the most common disorder with an incidence of 1:414, followed by congenital hypothyroidism and Congenital Adrenal Hyperplasia with an incidence of 1:2735 and 1:4102, respectively. Galactosemia and PKU were found to be rare in our population. The overall average recall rate was 0.6% which meant that 24 normal newborns were recalled for testing for one confirmed case. The recall rate was relatively higher for galactosemia and G6PD deficiency which was at 0.25% each compared to the other conditions where it was below 0.05%. Conclusion The results of the study emphasize the need for universal newborn screening especially in all government hospitals with large birth cohorts.

scholarly journals Clinical presentation of primary congenital hypothyroidism: experience before mass screening

2005 ◽  
Vol 5 (4) ◽  
pp. 26-29 ◽  
Author(s):  
Husref Tahirović ◽  
Alma Toromanović
Keyword(s):  
Congenital Hypothyroidism ◽  
Screening Program ◽  
Thyroid Tissue ◽  
Thyroid Function Tests ◽  
Thyroid Screening ◽  
Clinical Center ◽  
Age Of Diagnosis ◽  
Study Population ◽  
The Difference ◽  
Neonatal Thyroid Screening

Primary congenital hypothyroidism is a common preventable cause of mental retardation. Neonatal thyroid screening is highly successful in early diagnosis and the improvement of developmental prognosis in the hypothyroid neonate. However, rarely cases could be missed, so doctors must be aware of the earl symptoms and signs of hypothyroidism. Therefore, the purpose of this study was to emphasize the presenting clinical features of primary congenital hypothyroidism at the age of diagnosis. The study population included 17 children with primary congenital hypothyroidism who attended the Department of Pediatrics, University Clinical Center Tuzla between 1986 and 1999. The diagnosis of all patients was confirmed by serum thyroid function tests (T4 and TSH). Of the 17 patients 10 (58.8%) were diagnosed in the first three months of life and 3 of them (17.6%) between fourth and sixth month of life. Four children (23.5%) were diagnosed after the age of six months. In the first three months of life hypothermia, constipation, jaundice, poor feeding, hoarse cry, macroglossia and hypoactivity were the moste common symptoms. Among the 17 patients with primary congenital hypothyroidism 5 of them (29.4 %) were diagnosed to have disgenetic thyroid tissue and 12 (70.6%) as having dyshormonogenesis. TSH and T4 levels were higher in patients in whom thyroid tissue was dysgenetic as comapared with those with dyshormonogenesis but the difference was not statistically significant (p > 0.05). Now it is expected that neonatal screening program in Bosnia and Herzegovina Federation will contribute to the detection of primary congenital hypothyroidism in early days of life. However, until an effective screening test is not yet routine in whole country, paediatricians should consider the diagnosis of hypothyroidism whenever it is clinically suggested.

scholarly journals High Incidence of Congenital Hypothyroidism in One Region of the Republic of Macedonia

2014 ◽  
Vol 17 (1) ◽  
pp. 31-35 ◽  
Author(s):  
V. Anastasovska ◽  
Koviloska R. ◽  
Kocova M.
Keyword(s):  
Congenital Hypothyroidism ◽  
Screening Program ◽  
Thyroid Stimulating Hormone ◽  
Republic Of Macedonia ◽  
Thyroid Screening ◽  
Significant Difference ◽  
High Incidence ◽  
Screening Coverage ◽  
The Republic ◽  
Neonatal Thyroid Screening

Abstract Congenital hypothyroidism (CH) is the most common preventable cause of mental retardation in children. Diagnosis is difficult at birth without neonatal screening. Neonatal thyroid screening was established in Prilep, Republic of Macedonia as an integral part of the nationwide screening program. To estimate the prevalence of CH in this region, neonatal thyroid screening was performed on 9757 newborns, during the period 2002-2011. The DELFIA method was applied to measure the thyroid-stimulating hormone (TSH) concentration in dried blood spot samples on standard filter paper taken 48 hours after birth by heel-stick. The TSH cut-off level was 10 mU/L. The neonatal thyroid screening coverage was 93.4%. Eight newborns with CH were detected, with an incidence of 1:1220 live births, significantly higher compared to the nationwide results 1:2602. The TSH level was not significantly dependent on the gender of the newborn. There was a statistically significant difference between the TSH level and the timing of newborn screening sampling (p <0.05) and between the TSH level and the newborn birth weight (p = 0.01). One point ninety-two percent of newborns with TSH levels above 5 mU/L indicated an iodine sufficiency in Prilep. The incidence of CH in Prilep, which is higher when compared with that reported in surrounding countries, might be a consequence of the higher percentage of the Romany population in this region. Further analysis of this population in other regions is warranted.

Clinical spectrum of colonic diverticulosis: a tertiary care experience in Saudi Arabia

2020 ◽  
pp. 1
Author(s):  
Abed AlLehbi ◽  
Abdullah AlMtawa ◽  
Adel Alqutub ◽  
Khalid Alsayari ◽  
Ahmed Alomair ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Tertiary Care ◽  
Clinical Spectrum ◽  
Colonic Diverticulosis ◽  
Care Experience

scholarly journals Prevalence of multidrug-resistant and extended-spectrum beta-lactamase producing Gram-negative isolates from clinical samples in a tertiary care hospital of Nepal

2021 ◽  
Vol 49 (1) ◽  
Author(s):  
Aryatara Shilpakar ◽  
Mehraj Ansari ◽  
Kul Raj Rai ◽  
Ganesh Rai ◽  
Shiba Kumar Rai
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Polymyxin B ◽  
Multidrug Resistant ◽  
Confirmatory Test ◽  
Clinical Samples ◽  
Care Hospital ◽  
Gram Negative ◽  
Extended Spectrum ◽  
Esbl Producers

Abstract Background The existence of multidrug-resistant organisms, including extended-spectrum beta-lactamases (ESBLs), is on rise across the globe and is becoming a severe problem. Knowledge of the prevalence and antibiogram profile of such isolates is essential to develop an appropriate treatment methodology. This study aimed to study the prevalence of Gram-negative isolates exhibiting ESBL at a tertiary care hospital and study their antibiogram profile. Methods A cross-sectional study was conducted at Shahid Gangalal National Heart Centre, Kathmandu, Nepal, from June 2018 to November 2018. A total of 770 clinical samples were collected and identified using the conventional biochemical tests following the Clinical and Laboratory Standard Institute (CLSI) guidelines. Antimicrobial susceptibility testing (AST) was performed using the standardized Kirby-Bauer disk diffusion method. The screening test for ESBL producers was performed as recommended by the CLSI and the confirmatory test was performed phenotypically using the E-test. Results Out of the 92 isolates, 84 (91.3%) were multidrug-resistant, and 47 (51.1%) were found to be potential ESBL producers. Of these, 16 isolates were confirmed ESBL producers by the E-test. Escherichia coli and Klebsiella pneumoniae were the predominant isolates and were also the major ESBL producers. Besides polymyxin B (100% sensitive), meropenem and imipenem showed high efficacy against the ESBL producers. Conclusion Multidrug resistance was very high; however, ESBL production was low. Polymyxin B and carbapenems are the choice of drugs against ESBL producers but should be used only as the last line drugs.

A retrospective analysis of congenital anomalies in congenital hypothyroidism

2020 ◽  
Vol 33 (9) ◽  
pp. 1147-1153
Author(s):  
Fatima Ali Mazahir ◽  
Manal Mustafa Khadora
Keyword(s):  
United Arab Emirates ◽  
Congenital Hypothyroidism ◽  
Clinical Laboratory ◽  
Tertiary Care ◽  
Significant Proportion ◽  
Cross Sectional Study ◽  
High Rate ◽  
Lingual Thyroid ◽  
Cross Sectional

AbstractObjectivesWe evaluated the spectrum of diseases accompanying congenital hypothyroidism (CH) in the United Arab Emirates and compared them with internationally studied patterns.MethodsThe presented retrospective cross-sectional study took place in two government tertiary care centres. In total, 204 patients with a confirmed diagnosis of CH and a minimum period of follow-up of 1 year were included. Patients with Down syndrome, infants born at <35 weeks of gestation, and babies with TORCH (Toxoplasma gondii, Other viruses [HIV, measles, etc.], Rubella, Cytomegalovirus, and Herpes simplex) infections were subsequently excluded from the study.ResultsOf the subjects with CH, 39% had associated extrathyroidal anomalies (ETAs); among these, 25% had a single anomaly. A significant proportion of Arab males were affected by CH as compared to other ethnic groups. Dyshormonogenesis was the commonest aetiological cause (55%) of CH. Males with an ectopic lingual thyroid gland had significant ETAs as compared to females of the same cohort. The most common ETAs were congenital heart disease (16%), followed by urogenital tract anomalies (14%).ConclusionsDetection of a high rate and variability of ETAs associated with CH necessitates the formulation of a structured screening programme including appropriate clinical, laboratory, and imaging tools to detect ETAs at an earlier stage.

Urinary iodine and thyroglobulin are useful markers in infants suspected of congenital hypothyroidism based on newborn screening

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Makiko Tachibana ◽  
Yoko Miyoshi ◽  
Miho Fukui ◽  
Shinsuke Onuma ◽  
Tomoya Fukuoka ◽  
...  
Keyword(s):  
Newborn Screening ◽  
Congenital Hypothyroidism ◽  
Clinical Course ◽  
Urinary Iodine ◽  
Iodine Status ◽  
Need For Treatment ◽  
Urine Creatinine ◽  
Few Data ◽  
The Relationship ◽  
Serum Tsh

Abstract Objectives Iodine deficiency and excess both cause thyroid dysfunction. Few data describe the relationship between iodine status and outcomes of congenital hypothyroidism (CH) in iodine-sufficient areas. We investigated urinary iodine (UI) concentration and its relationship with the clinical course of CH. Methods We reviewed and retrospectively analyzed patients with positive newborn screening (NBS) for CH from January 2012 to June 2019 in Japan, obtaining UI and UI-urine creatinine ratio (UI/Cr), serum TSH, free T4, free T3 and thyroglobulin (Tg) at the first visit, TSH at NBS, levothyroxine (LT4) dose, and subsequent doses. A UI value of 100–299 μg/L was considered adequate. Results Forty-eight patients were included. Median UI and UI/Cr were 325 μg/L and 3,930 µg/gCr, respectively. UI was high (≥300 μg/L) in 26 (54%) and low (≤99 μg/L) in 11 (23%). LT4 was administered to 34 patients. Iodine status was not related to the need for treatment. We found a U-shaped relationship between Tg and UI/Cr. Patients with high Tg (≥400 ng/mL) and abnormal UI levels required significantly lower LT4 doses (≤20 µg/day) at three years of age. Even if they showed severe hypothyroidism initially, they did not need subsequent dose increments. Conclusions Abnormal UI levels with Tg elevation were associated with lower LT4 dose requirements. The evaluation of iodine status and Tg concentrations were considered useful in patients suspected of CH.

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