scholarly journals Diagnosis of diabetes mellitus on the basis of HbA1c: Is this true in hypothyroidism also?

2016 ◽  
Vol 7 (6) ◽  
pp. 36-39
Author(s):  
Abhishek Singhai ◽  
Prakhar Kabra
Keyword(s):  
Subclinical Hypothyroidism ◽  
Tertiary Care ◽  
Fasting Blood Glucose ◽  
General Medicine ◽  
Overt Hypothyroidism ◽  
Medical Sciences ◽  
Tertiary Care Centre ◽  
Free T4 ◽  
Erroneous Diagnosis ◽  
Hypothyroid Patients

Background: Hypothyroidism may leads to hypoproliferative anemia. It is possible that this reduced erythropoiesis may result false elevation of HbA1c in some cases and further leading to an erroneous diagnosis of pre diabetes or diabetes.Aims and Objective: This study was planned to assess changes in HbA1c after initiation of thyroxine replacement in patients with subclinical and overt hypothyroidism.Settings and Design: This prospective study was conducted at Department of General Medicine of a tertiary care centre over one year.Methods and Material: 100 subjects were recruited for the study. Fasting blood glucose, serum creatinine, hemoglobin, HbA1c, reticulocyte count, serum free T4 and TSH estimation done in all subjects. Hypothyroid patients were started on thyroxine. After three months of documentation of euthyroidism, same investigations were repeated.Statistical analysis used: Statistical software, SPSS version 17.0 was used for analysis.Results:  After correction of hypothyroidism, TSH decreased from 92.3(±30.9) to 3.4±2.9 µIU/L and 12.2(±4.5) to 4.4±2.9 µIU/ml in overt hypothyroidism and subclinical hypothyroidism respectively. There was a statistically significant fall in the HbA1c (SD) from 5.9% (0.8) to 5.6% (0.6) and 6.0% (0.3) to 5.7% (0.3) following the correction of hypothyroidism in overt hypothyroidism and subclinical hypothyroidism respectively. However, there were no statistically significant changes in the fasting as well as postprandial blood glucose.Conclusions: Our study demonstrated that HbA1c values are falsely increased in patients with hypothyroidism. This falsely raised HbA1c became normal after thyroxine supplement.Asian Journal of Medical Sciences Vol.7(6) 2016 36-39

scholarly journals Association of subclinical hypothyroidism and HbA1c levels in non-diabetic subjects attending rural tertiary care centre in central India

2017 ◽  
Vol 5 (8) ◽  
pp. 3345 ◽  
Author(s):  
Vidya Sagar Ram ◽  
Granth Kumar ◽  
Manoj Kumar ◽  
Vivek Kumar Verma ◽  
Dheeraj Kela ◽  
...  
Keyword(s):  
Subclinical Hypothyroidism ◽  
Tertiary Care ◽  
Elevated Serum ◽  
Control Group ◽  
Case Group ◽  
Diabetic Patients ◽  
Tertiary Care Centre ◽  
Hypothyroid Patients ◽  
Serum Tsh ◽  
Hba1c Levels

Background: Subclinical hypothyroidism is defined as an elevated serum TSH level and normal concentrations of free T3 (FT3), free T4 (FT4), T3 and T4. A positive association between thyroid and diabetes mellitus is well recognized but to study the effect of thyroid disorders on glucose metabolism in non-diabetic patients is an area for extensive research. Present study was planned to assess correlation between subclinical hypothyroidism and glycosylated haemoglobin levels in non-diabetic patients.Methods: A case-control study was conducted on total 209 subjects. 109 patients were allotted in case group and 100 in control group. Controls were relatives and friends of patients who were matched for age and sex. Comparison between the case and the control groups were made using Student’s t-test (unpaired) and Box and Whisker Plot and regression graph were presented for correlation between serum TSH and HbA1c.Results: It was found that there was a positive correlation between the levels of serum TSH (µU/L) and HbA1c (%) in all the participants of the study by Pearson’s correlation coefficient (r=0.35, p < 0.0001).Conclusions: HbA1c levels are increased in subclinical hypothyroid patients. The effects of the elevated levels of Serum TSH on the HbA1c must be considered when interpreting the HbA1c for the diagnosis of diabetes or pre-diabetes in the subclinical hypothyroid patients.

scholarly journals Study on thyroid function test in pregnancy in a tertiary care hospital

2021 ◽  
pp. 20-25
Author(s):  
Ajit Kumar Nayak ◽  
Manorama Swain ◽  
Sujata Misra ◽  
Manju Kumari Jain
Keyword(s):  
Pregnant Women ◽  
Subclinical Hypothyroidism ◽  
Thyroid Dysfunction ◽  
Tertiary Care ◽  
Overt Hypothyroidism ◽  
Thyroid Disorders ◽  
Care Hospital ◽  
Thyroid Disorder ◽  
Singleton Pregnancy ◽  
Free T4

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.

scholarly journals Study of febrile thrombocytopenia in Malwa region of India

2017 ◽  
Vol 8 (5) ◽  
pp. 83-86
Author(s):  
Vishal Yadav ◽  
Abhishek Singhai
Keyword(s):  
Lymphoblastic Leukemia ◽  
Tertiary Care ◽  
General Medicine ◽  
Liver Function Tests ◽  
Emerging Diseases ◽  
Medical Sciences ◽  
Tertiary Care Centre ◽  
Non Hodgkin Lymphoma ◽  
Function Tests ◽  
Complete Blood Counts

Background: Febrile thrombocytopenia is the thrombocytopenia associated with fever. Diseases which commonly present with fever and thrombocytopenia are malaria, leptospirosis, septicemia, typhoid, arbovirus diseases such as dengue.Aims and Objectives: The study was intended to know the underlying etiology of febrile thrombocytopenia in Malwa region and its various presentations.Materials and Methods: This study was conducted at Department of General Medicine of a tertiary care centre for two years. Five-hundred adult patients (age >18 years) of febrile thrombocytopenia were evaluated for possible inclusion in this study. Routine investigations including complete blood counts, peripheral smear examination, kidney function tests, liver function tests, ultrasound of abdomen were done in all subjects. The specific investigations were done as and when indicated.Results: Out of 500 patients of febrile thrombocytopenia, 298 were male, while 202 were female. Commonest symptom after fever was malaise (83%) followed by nausea-vomiting (76%), headache (63.4%), jaundice (26.8%), easy fatigability (22.4%), bleeding manifestations (7.8%), cough (6.8%), dyspnea (5.8%), rash (2.4%) and delirium (1.4%). Dengue was found in 178 patients. Malaria was found in 122 patients. Other causes of febrile thrombocytopenia were septicemia (22 cases), leptospirosis (12 cases), chikungunya fever (10 cases), viral hepatitis (9 cases), enteric fever (9 cases), acute lymphoblastic leukemia (2 cases), non-hodgkin lymphoma (one case), disseminated tuberculosis (one case).Conclusion: Febrile thrombocytopenia is an important clinical condition commonly caused by infections, particularly viruses and malaria. Such studies will help in finding changing trends of locally prevalent infectious diseases and finding some new emerging diseases not prevalent in the particular region.Asian Journal of Medical Sciences Vol.8(5) 2017 83-86

scholarly journals Prevalence of Metabolic Syndrome in Patients with Subclinical and Overt Hypothyroidism Visiting Tertiary Care Centre of Western Nepal

2020 ◽  
Vol 8 (1) ◽  
pp. 33-37
Author(s):  
Amit Chandra Jha ◽  
Kedar Nath Koirala ◽  
Archana Jayan ◽  
Narayan Gautam ◽  
Raju Kumar Dubey ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Subclinical Hypothyroidism ◽  
Tertiary Care ◽  
Colorimetric Method ◽  
Hormone Deficiency ◽  
Overt Hypothyroidism ◽  
Atherosclerotic Cardiovascular Disease ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Increased Risk

INTRODUCTION: Hypothyroidism is a syndrome resulting from thyroid hormone deficiency. Metabolic syndrome (MetS) is a cluster of metabolic abnormalities is associated with increased risk for atherosclerotic cardiovascular disease (CVS) and type 2 diabetes mellitus. Thyroid hormones are major regulatory hormones that control the rate of metabolic function; thus, alteration in the levels of these hormones may be associated with MetS. The objective of our study was to find out the prevalence of MetS in subclinical and overt hypothyroidism. MATERIAL AND METHODS: A hospital-based cross sectional study was conducted at Universal College of Medical Sciences Teaching Hospital (UCMS-TH) Bhairahawa from March to September 2019. A total of 222 hypothyroid patients were enrolled in this study. MetS was diagnosed by National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III; 2005) revision criteria. The anthropometric indices were recorded. fT3, fT4  and TSH were measured by chemiluminescence immunoassay (CLIA) method and other biochemical parameters were estimated by colorimetric method. Data were analyzed by using SPSS 16.0. RESULTS: Patients were aged between 10 and 60 years, with a mean age of 38.89 years. The prevalence of MetS was 44.1% of which 80.6% were females. Furthermore, the prevalence of MetS was found to be 43.7% in subclinical hypothyroidism and 46.6% in overt hypothyroidism. CONCLUSION: The prevalence of MetS is high in both overt and subclinical hypothyroidism. Screening for MetS in patients with hypothyroidism can reduce the risk for CVD, as well as the mortality rate and mortality associated with it.

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 Tubercular mastitis: An institutional experience from a tertiary care centre of northern India

2017 ◽  
Vol 8 (3) ◽  
pp. 72-75
Author(s):  
Amit Gupta ◽  
Lovenish Bains ◽  
Deepshikha Yadav ◽  
Prashant Durgapal ◽  
Manish Kumar Agrawal
Keyword(s):  
Tertiary Care ◽  
Needle Aspiration ◽  
Care Centre ◽  
Medical Sciences ◽  
Tertiary Care Centre ◽  
Aspiration Cytology ◽  
Northern India ◽  
Institutional Experience ◽  
Needle Aspiration Cytology ◽  
High Index Of Suspicion

Background: Tuberculous mastitis (TM) is a rare extra pulmonary presentation of tuberculosis. It may be problematic to distinguish from carcinoma breast, a condition with which it may coexist.  Fine needle aspiration cytology (FNAC) / biopsy are indispensable for diagnosis and tuberculosis culture when positive may be very valuable to guide antimicrobial therapy.Aims and Objectives:  To disseminate the message to the concerned expertise that it can present a diagnostic problem on radiological and microbiological investigations, and thus a high index of suspicion is needed.Materials and Methods: 19 cases of tubercular mastitis between  January 2012 to March 2014 were identified and included in the present study. Cytology and biopsy alongwith AFB stain was done for confirmation.Results: Age ranged between 23- 55 years (median 33 years). Axillary nodes were palpable in 9 (47.3%) patients. Acid Fast Bacilli stain which was positive in only 3 patients. All the 19 patients were started on antitubercular treatment.Conclusion: This study highlights the importance of early diagnosis and aggressive medical and if required surgical management to cure this disease.Asian Journal of Medical Sciences Vol.8(3) 2017 72-75

scholarly journals Study of cardiac manifestations in hypothyroid patients admitted in tertiary care centre

2021 ◽  
Vol 8 (12) ◽  
pp. 1852
Author(s):  
Parshv P. Shah ◽  
Harvy Parikh ◽  
Hemant Shah ◽  
Nilesh Doctor
Keyword(s):  
Early Recognition ◽  
Sinus Bradycardia ◽  
Tertiary Care ◽  
General Medicine ◽  
Thyroid Stimulating Hormone ◽  
Hormone Deficiency ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Cardiac Manifestation ◽  
Cardiac Manifestations

Background: Hypothyroidism is the most common pathological hormone deficiency. To study various cardiac manifestations in overt and subclinical hypothyroidism.Methods: The cross-sectional analytic study is carried out on 60 patients of hypothyroid subjects in indoor facility of general medicine department in SMIMER hospital.Results: This study shows positive correlation between thyroid stimulating hormone (TSH) level, electrocardiogram (ECG) and echocardiographic findings. In this study, there is female predominance, ECG findings most commonly suggestive of sinus bradycardia and ECHO findings are most commonly suggestive of diastolic dysfunction with pericardial effusion.Conclusions: The early recognition and early initiation of treatment of hypothyroidism may helpful to lowering heart changes as hypothyroidism is reversible cause for cardiac manifestation.

scholarly journals Response of leuprolide on gonadal functions of women with overt hypothyroidism: a tertiary care centre study from Uttar Pradesh - India

2019 ◽  
Vol 8 (1) ◽  
pp. 277
Author(s):  
Manish Srivastav ◽  
Alankar Tiwari ◽  
Nihit Kharkwal ◽  
Keshav Kumar Gupta
Keyword(s):  
Human Subject ◽  
Tertiary Care ◽  
Uttar Pradesh ◽  
Ovarian Response ◽  
P Value ◽  
Overt Hypothyroidism ◽  
Newly Diagnosed ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Healthy Females

Background: Hypothyroidism can cause menstrual disturbances mainly oligoanovualtory cycles and sometimes menorrhagia. It has also been seen to cause subfertility and pregnancy related complications. Various studies have been done to evaluate gonadal dysfunctions in overt hypothyroidism but very few studies are there which have done using a gonadotrophin response in that subset of patients. Present study evaluates the response of leuprolide on gonadal functions of women with overt hypothyroidism in a tertiary care centre at Meerut.Methods: In this study 50 females of age 20 to 40 years with newly diagnosed overt hypothyroidism were taken as cases and age and Body Mass Index (BMI) matched healthy females were taken as controls. Both in cases and controls, basal FSH, LH, estradiol was measured on 2nd day to 5th day of menstrual cycle. Thereafter Leuprolide 20 mcg/kg was given subcutaneously on the same day. Post leuprolide test, stimulated LH, FSH and estradiol were measured. Basal and stimulated values were compared between both groups.Results: Basal LH was significantly higher in controls (8.2±3.2 mIU/L) when compared to cases (6.45±2.75 mIU/L) with a p value 0.03(<0.05). Basal estradiol and FSH levels were found to be nearly similar and non-significant in cases and controls. No significant differences were found between stimulated mean LH and estradiol in both the groups. Leuprolide response after stimulation test was found to be sluggish in patients with overt hypothyroidism compared to normal euthyroid controls. This study is the rare one done on human subject in tertiary care centre of India, however large sample and multicentric trials are necessary before establishing the biochemical results.Conclusions: Pituitary and gonadal (ovarian) response to leuprolide was found to have impaired (decreased) in overt hypothyroidism cases. This is the first study to be done in overt hypothyroid subjects to asses both basal and stimulated gonadotropin levels.

scholarly journals High proportion of overt diabetes mellitus in pregnancy and missed opportunity for early detection of diabetes at a tertiary care centre in Pakistan

2019 ◽  
Vol 36 (ICON-Suppl) ◽  
Author(s):  
Aisha Syed Wali ◽  
Raheela Rafique ◽  
Sundus Iftikhar ◽  
Rakhshinda Ambreen ◽  
Mohammad Yawar Yakoob
Keyword(s):  
Diabetes Mellitus ◽  
Early Detection ◽  
Tertiary Care ◽  
Fasting Blood Glucose ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Family History Of Diabetes ◽  
Overt Diabetes ◽  
Missed Opportunity ◽  
In Pregnancy

Objectives: To determine the frequency of diabetes in pregnancy (DIP), namely pre-gestational, gestational (GDM) and overt diabetes mellitus (DM) in women registered for delivery. Methods: A retrospective chart review of antenatal women registered between January 01 to August 31, 2017 was performed. Gestational age, diagnosis of DIP, glucose levels at diagnosis and other relevant data was extracted. The effect of various fasting blood glucose (FBG) thresholds for diagnosis of DIP was assessed. Results: DIP was diagnosed in 21.8% women (pre-gestational: 2%, GDM: 81.2%, overt DM: 16.8%). In early registrants, 30.2% were detected through screening. However, 55.3% of women registered late. Women with pre-gestational DM were older, had more miscarriages, and greater personal and family history of diabetes versus GDM and overt DM. Raising the diagnostic threshold of FBG from 92 mg/dl to 95 mg/dl missed three women (0.1%) and to 105 mg/dl, missed six women (0.2%). Conclusion: We observed a high proportion of overt DM. In early registrants, almost one third of DIP was diagnosed in the first half of pregnancy, an opportunity missed in late registrants. Altering diagnostic thresholds of DIP affected only a small proportion of women. doi: https://doi.org/10.12669/pjms.36.ICON-Suppl.1723 How to cite this:Wali AS, Rafique R, Iftikhar S, Ambreen R, Yakoob MY. High proportion of overt diabetes mellitus in pregnancy and missed opportunity for early detection of diabetes at a tertiary care centre in Pakistan. Pak J Med Sci. Special Supplement ICON 2020. 2020;36(1):S38-S43. doi: https://doi.org/10.12669/pjms.36.ICON-Suppl.1723 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Study of caesarean section at tertiary care centre: a retrospective study

2020 ◽  
Vol 9 (5) ◽  
pp. 2138
Author(s):  
Varsha Kose ◽  
Kumari Sadhvi
Keyword(s):  
Retrospective Study ◽  
Caesarean Section ◽  
Tertiary Care ◽  
Fetal Distress ◽  
High Rate ◽  
Audit And Feedback ◽  
Research Centre ◽  
Medical Sciences ◽  
Tertiary Care Centre ◽  
Failure Of Induction

Background: Caesarean section (C-section) is one of the most widely performed surgical procedure in obstetrics worldwide. The WHO guidelines revised in 1994 states that the proportion of C-section birth should range between 5-15% but both in developed and developing countries C-section rate is on the rise. This study was conducted to analyse the frequency and indications for C-section and associated maternal morbidity and mortality.Methods: This retrospective study was conducted over a period from January 2018 to May 2019 at the department of obstetrics and gynecology, NKP Salve Institute of Medical Sciences and Research Centre and Lata Mangeshkar Hospital, Hingna, Nagpur, Maharashtra, India. Data of patients who delivered by C-section in our hospital during the defined study period were studied and statistically analysed according to various parameters namely, the frequency of caesarean section, its indications, age, parity and gestational age of the patient.Results: The total number of women delivered over the study period were 2811. Out of which C-sections were done in 1461 women (51.97%). Previous C-section was the leading indication in 35.72% women followed by fetal distress 14.09%, failure of induction 12.93%, arrest of labour 7.93%, PIH 7.18%, oligo/IUGR 6.50%, breech 4.44%, refusal of vaginal birth 4.24%, CPD 1.71%, bad obstetrics history (BOH) 1.43%, malpresentation 1.30%, prematurity 1.23%,  and multifetal gestation in 1.09% women. Two women had classical C-section 0.07. 14.09% women had various complications. There was no maternal mortality.Conclusions: A high rate of caesarean deliveries was observed. Individualization of the indication and careful evaluation, following standardized guidelines can help us to limit C-section. Audit and feedback are the best way to judge clinical practice and to reduce the frequency of caesarean section in any tertiary setup.

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