scholarly journals Thyroid function status in patients with thyroid associated ophthalmopathy: a study for Nepal

2019 ◽  
Vol 3 (1) ◽  
pp. 3-9
Author(s):  
Saurav Piya ◽  
Jeena Gurung ◽  
Anadi Khatri

Introduction: Thyroid Eye Disease (TED) is an organ-specific autoimmune inflammatory incapacitating eye disorder usually associated with Graves’ disease affecting the orbit. Objectives: To determine thyroid function status in patients with thyroid-associated Ophthalmopathy. Methods: This is a hospital-based cross-sectional study of sixty three clinically diagnosed new cases of thyroid-associated ophthalmopathy done at Nepal Eye Hospital, Kathmandu from February 2012 to January 2013. Detailed history, systemic & ocular examination with special emphasis on evaluation of extraocular movement, lid signs, exophthalmos with Hertel's exophthalmometer was done. Thyroid function test and endocrine consultation were also done in all cases. Results: There were an equal distribution of TED with hyperthyroid (34.95%) and euthyroid status (34.95%). The most common presentation of both euthyroid and hypothyroid patient was tremor (13.4%) and palpitation (13.45%). The most common symptom of TED was foreign body sensation (54 %) but in TED with euthyroid and hypothyroid status, redness (22.2 %) and diminution of vision (20.6 %) were more frequent symptoms respectively. The most common presenting sign was Von Graefe’s sign (69 %). Among TED with hyperthyroid and hypothyroid status, Dalrymple's sign (29.3%) and Mobius sign (17.4%) were most common respectively. Conclusion: Thyroid-associated ophthalmopathy is an important health concern among patients with a thyroid disorder. TED with hyperthyroid states present more severely than hypothyroid and euthyroid states. As TED occurred with a high prevalence in all thyroid states, a close collaboration between endocrinologists and ophthalmologists along with timely referrals of patients with any eye complaint is mandated.

2012 ◽  
Vol 9 (2) ◽  
pp. 7-10
Author(s):  
K Subba ◽  
D Karn ◽  
R Khatri

BackgroundVitiligo is a common pigmentary disorder of the skin, affecting individuals globally. Not only is this ailment psychologically incapacitating, it also has a high incidence of autoimmunity, signifying that its manifestations may be the portrayal of dysfunction of immune system. ObjectiveThe aim of this study is to find out the situations of abnormal thyroid function test (TFT) in vitiligo patients. MethodsA prospective cross sectional study was conducted at the Dhulikhel Hospital, KUTH, Dhulikhel during November 2008 to January 2011 with the objective to assess the thyroid function tests in vitiligo patients. ResultsTotal 66 vitiligo patients with male 30 (45%) and female 36 (55%). Total 26 (39.39%) vitiligo patients have been found to have abnormal thyroid function test. Among them 10 had abnormal T3, seven had abnormal T4 and 12 had abnormal TSH level. Thyroid function test were normal in other vitiligo patients. Total seven vitiligo had high level of T3 than normal value, four male and three female. Two had higher level of T4 above 2.0 ng/dl and all were male, while five had abnormally low level of T4 with three male and two female. There were seven vitiligo patient with increased T3 level and three with decreased T3 level, among them six were males and four were females, the age group was ranged from seven to 68 years old. The T4 level were found abnormal in seven vitiligo patients among which five were males and two were females with the age group ranging from 7 to 51 years. ConclusionsThere has been significant association of thyroid disorder in the patient with vitiligo. Therefore, patient with vitiligo need to undergo thyroid function test to rule out the thyroid disorder and prevent from long-term complications.DOI: http://dx.doi.org/10.3126/kumj.v9i2.6279Kathmandu Univ Med J 2011;9(2):7-10 


2016 ◽  
Vol 29 (1) ◽  
pp. 26-31
Author(s):  
Shaila Naznine Tania ◽  
Ferdousi Islam

Objective: The study was conducted to find out any alterations in thyroid function status in first half of pregnancy (up to 20 weeks), with ultimate aim of deciding the usefulness of routine screening of thyroid function in pregnancy.Material and methods: A cross-sectional study was conducted in the department of Obstetrics & Gynaecology, Dhaka Medical College and Hospital, Dhaka, Bangladesh, over a period of one year from July 2011 to June 2012 on pregnant women in their 1st half of pregnancy to screen for the thyroid function. Based on predefined eligibility criteria, a total of 230 pregnant women were purposively included in the study. Thyroid function status was assessed by measuring serum levels of TSH, free thyroxine (FT4), and free tri-iodothyronine (FT3). Women with thyroid disorders were excluded.Results: The mean age of the patients being 24 years. Over 90% of the women were housewife and majority (88.7%) was educated. Over one-quarter of women was overweight with mean body mass index being 22.1 ± 4.4 kg/m2. The women were predominantly multigravida with 56% in 1st trimester 44% in the 1st half of 2nd trimester of pregnancy (13-20 weeks). Based on trimester’s specific range of serum TSH in the 1st and 1st half of 2nd trimester (13-20 weeks) of pregnancy,13% of the patients were hypothyroid and 3% were hyperthyroid thus yielding a total of 37(16%) pregnant women with abnormal thyroid function status.Conclusion: The study concluded that one in every six women may have thyroid disorder in the first half of pregnancy and subclinical hypothyroidism is four times more common than the subclinical hyperthyroidism.Bangladesh J Obstet Gynaecol, 2014; Vol. 29(1) : 26-31


2022 ◽  
Vol 19 (1) ◽  
pp. 22-25
Author(s):  
Kavita Sinha ◽  
Ram Das ◽  
Homnath Adhikari

Introduction: Molar pregnancies represent a significant burden of disease on the spectrum of gestational trophoblastic diseases. Vaginal bleeding being the most common occasionally, molar pregnancy is complicated by hyperthyroidism, which may require treatment. Aims: To determine thyroid function test and association of hyperthyroidism among the cases of molar pregnancy. Methods: This is a hospital-based cross-sectional study conducted in the department of Obstetrics and Gynecology, Nepalgunj Medical College and Teaching Hospital, Kohalpur. Sixty cases of molar pregnancy were included during the study period from February 2020 to January 2021.Patients having history of known thyroid disorders were excluded. Results: Prevalence of molar pregnancy in our study was 5.4 per thousand pregnancies in our hospital. Molar pregnancy and hyperthyroidism, both were common in the age group of 21-35 years. Hyperthyroidism was present in 10% patients. Enlarged thyroid was seen in 3.3%, tremor was present in 3.3%, and palpitation in 21.5%. Five (8.3%) patients with hyperthyroidism were underweight. Majority of patients with hyperthyroidism, beta humanchorionic gonadotrophhin level was more than three lakhs and it was mostly associated with complete hydatidiform mole compared to partial hydatidiform mole. Thyroid storm was not experienced in any of the patients. Conclusion: The rate of molar pregnancy is high. Hyperthyroidism in molar pregnancy is not uncommon. High levels of human chorionic gonadotropin, complete hydatiform mole are directly associated with hyperthyroidism. Awareness of this condition is important for diagnosis and treatment to prevent life threatening complications.


2018 ◽  
Vol 5 (6) ◽  
pp. 2290
Author(s):  
J. Rukmani ◽  
C. Krishanamurthy ◽  
Denny Clarin

Background: Nephrotic syndrome in childhood is largely primary or idiopathic, although a small proportion of cases are secondary to infectious agents and other glomerular and systemic diseases. The etiology of nephrotic syndrome is age-dependent. Most cases appearing in the first 3 months of life are referred as congenital nephrotic syndrome (CNS) and are due to genetic diseases. The objective of this study is to study the correlation between thyroid profile and different types of nephrotic syndrome.Methods: This cross-sectional study was done between March 2017 to October 2017 in the Department of Pediatrics Tirunelveli Government Medical College. 40 cases of nephrotic syndrome between 1 to12 years, which include all types of nephrotic syndrome. After history taking and clinical examination, blood samples were collected from the patients for thyroid function test and analyzed with standard techniques.Results: Serum T3, T4, TSH were found to be within normal limits. But TSH values in remission were significantly elevated compared to the first episode.Conclusions: Thyroid profiles in control were within normal range. The T4 and T3 levels in nephrotic syndrome were low and TSH was high. Hypothyroidism was more common in children less than 6 years. 


2021 ◽  
Vol 59 (234) ◽  
Author(s):  
Manoranjan Shrestha ◽  
Reshmi Shrestha

Introduction: Thyroid dysfunction prevalence is high in females worldwide which increases with age. Postmenopausal and elderly women are particularly at risk of developing comorbidities and mortality related to thyroid dysfunction. We aimed to study the prevalence of thyroid dysfunction in postmenopausal women in the National Reference Laboratory of Nepal. Methods: A descriptive cross-sectional study was conducted in National Reference Laboratory from January 2019 to June 2019 including postmenopausal females, ≥49 years. The database of thyroid function test result was used for statistical analysis and proportion of thyroid dysfunction was calculated. The data was collected after approval from the institutional review committee. Statistical Package for Social Sciences version 21 was used to study descriptive data. Results: Out of a total of 160 postmenopausal females with thyroid function tests, 71 (44.4%) had thyroid dysfunction. Subclinical hypothyroidism was the frequently occurring thyroid dysfunction 51 (32%) followed by subclinical hyperthyroidism 13 (8%), hypothyroidism 3 (2%) and hyperthyroidism 3 (2%). In our study population, thyroid dysfunction peaked at 49 to 58 years of age interval 53 (33.1%) and subclinical hypothyroidism was the most frequent form 38 (23.7%). Conclusions: Subclinical hypothyroidism was the common thyroid dysfunction in postmenopausal age which peaked at 49 to 58 years of age group. Early postmenopausal females are predisposed to increased risk of comorbidities (cardiovascular disease, osteoporosis with high fracture, depression) which could be exacerbated with thyroid dysfunction; therefore awareness of thyroid dysfunction prevalence and thyroid screening for early management seems appropriate in Nepalese postmenopausal women.


2020 ◽  
Vol 42 (3) ◽  
pp. 7-11
Author(s):  
Suvana Maskey ◽  
Hima Rijal

Introduction Thyroid dysfunction has profound effects on menstrual function and female fertility. Hypothyroidism is often associated with increased prolactin level which again worsens the problem. This study was done to evaluate the prevalence of thyroid disorders in infertile women attending infertility outpatient department (OPD) in Tribhuvan University Teaching Hospital (TUTH) and to determine the association of hypothyroidism and hyperprolactenemia with obesity which is not well studied in our population. MethodsA hospital-based cross-sectional study was conducted in infertility OPD of TUTH reviewing women’s records who underwent infertility workup and relevant history, clinical finding and results of investigations including thyroid function test (TFT) and serum prolactin (PRL) level were documented. Descriptive and inferential statistical analyses were used to identify the prevalence and associations of predictors and outcome variables. ResultsOut of 213 participants, the majority of the participants were obese (90; 42.3%) with mean (±SD) body mass index (BMI) being 24.8 ± 4.5 kg/m2. The prevalence of thyroid disorder was 18.4% including hypothyroidism 13.6% and hyperthyroidism 4.8%. There was no significant association of BMI and hyperprolactinemia with thyroid disorder as well as of BMI with hyperprolactinemia however the thyroid stimulating hormone (TSH) had significant positive correlation with prolactin (r=0.23, p<0.001). ConclusionThyroid disorders and hyperprolactinemia are commonly observed in infertile women, so they should be routinely screened during initial evaluation of infertility. As majority of the study population were obese, despite no significant association of BMI with thyroid disorder and hyperprolactinemia, the effect of weight gain on infertility cannot be overlooked.


2021 ◽  
Vol 11 (2) ◽  
pp. 142-147
Author(s):  
Chingakham Arunkumar ◽  

Background: Dysfunction and anatomic abnormalities of the thyroid gland are among the most common diseases of the endocrine glands. The study has been undertaken with the aim to assess the different cardiovascular manifestations in patients of hypothyroidism and hyperthyroidism in Manipur and find out any correlation of it with age, sex, type of thyroid disorder and BMI. Materials and Method: The study was a cross sectional study of patients who were diagnosed as hypothyroid or hyperthyroid in the Department of Medicine, Regional Institute of Medical Sciences(RIMS), Imphal, Manipur. Clinical parameters including history and clinical examination were recorded including thyroid function testing, ECG, chest X-ray, trans-thoracic echocardiography. Results: Among 59 patients of thyroid disorder studied, 38 patients were found to be hypothyroid and 21 patients hyperthyroid. The average BMI in hypothyroid patient was 27.25. The average BMI in hyperthyroid patients was 25.41 which were lower than hypothyroid. Diastolic hypertension was found in 44.7% of hypothyroid patients. Sinus bradycardia and sinus tachycardia were the most common ECG findings in hypothyroid and hyperthyroid patients respectively. 15.8% had cardiomegaly on chest x-ray in hypothyroid patients while 9.5% had cardiomegaly in hyperthyroid patients. On echocardiographic evaluation, 13.1% and 9.5% had pericardial effusion in hypothyroid and hyperthyroid groups respectively.


2020 ◽  
Vol 4 (1) ◽  
pp. 12-18
Author(s):  
Nada Syazana ◽  
Huzairi Sani ◽  
Zahir Izuan Azhar

Non-severe hypothyroidism has no strong association with hyponatremia. However, thyroid function tests (TFT) continue to be ordered as a first-line investigation. The objective of this study was to establish the prevalence of inpatient hyponatremia and to reiterate the association between thyroid disorders and hyponatremia based on study findings and current literature. A cross-sectional study on 3,478 in-patients adults of both gender admitted to a Malaysian tertiary hospital was carried out.  Age, gender, sodium levels, thyroid stimulating hormone (TSH), free thyroxine (fT4) and clinical notes between 1/11/17-31/12/17 were extracted from the hospital’s information system. Bivariate analysis was performed using Mann-Whitney U, Chi-square and Spearman correlation tests. 21.9% of inpatients had hyponatremia of which 52% were mild. 359 (69%) of hyponatremic patients had a TFT sent where 71.9% were euthyroid. Sodium level is significantly correlated with age (R=-0.257, P<0.001). No correlations were found between sodium and TSH and fT4. Sodium was significantly lower in the non-thyroidal illness (NTI) group compared to the hypothyroid group. No significant differences in sodium were found between the hypothyroid group and other thyroid states. Hence it was conclude that in hyponatremia, TFT is indicated when there is clinical evidence of severe hypothyroidism, suspicion of hypothalamus-pituitary-axis disorder or when no cause of SIADH is apparent. Otherwise, TFT is unnecessary and costly as a first-line investigation.   Keywords: hyponatremia, hypothyroidism, hypothyroid, non-thyroidal illness, sodium


2020 ◽  
Vol 18 (3) ◽  
pp. 373-378
Author(s):  
Binu Gorkhali ◽  
Sita Sharma ◽  
Mrigendra Amatya ◽  
Devaka Acharya ◽  
Muna Sharma

Background: Psychiatric comorbidities are common in thyroid disorder patients and complicate patients’ life quality as well as disease management. We aimed to explore prevalence of anxiety and depression and identify associated characteristics among patients with thyroid function disorder. Methods: A descriptive, cross-sectional study was conducted on 129 thyroid disorder patients aged ?20 years. A semi-structured questionnaire, Beck Anxiety Inventory, and Beck Depression Inventory were used for sociodemographic characteristics, anxiety, and depression respectively. Group differences were compared (Chi square) or correlations were determined (Pearson’s correlation coefficient). Results: Patients’ mean age was 38.09±12.68 years; most were females (102, 79.1%) and hypothyroid (90, 69.8%). Overall prevalence of anxiety and depression were 50.4% and 42.6% respectively. Anxiety was more prevalent in females (54.9% vs 33.3% in males, p=0.046), low economic status (73.9% vs 35.5% in higher status, p=0.019), and hyperthyroid (64.1% vs 44.4% in hypothyroid, p=0.040). Depression was more prevalent in females (47.1% vs 25.9% in males, p=0.048), Janajati ethnic group (54.8% vs 31.1% in Brahmin-Chhetri, p=0.002), lower economic status (69.6% vs 35.5% in higher status, p=0.016), and hyperthyroid (56.4% vs 36.7% in hypothyroid, p=0.037). Associations with occupation, marital status, family type, religion, and duration of illness were not significant. Conclusions: Anxiety and depression are highly prevalent among thyroid disorder patients, especially in females, lower economic status, and hyperfunction type thyroid disorder. Management of thyroid disorders should incorporate treatment of anxiety and depression; routine psychiatric screening of the groups with higher prevalence is advisable. Keywords: Anxiety; depression; prevalence; thyroid function disorders


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