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

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

Author(s):  
Anitha Nirakari B.

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.


2018 ◽  
Vol 41 (3) ◽  
pp. 159-164 ◽  
Author(s):  
Madhabi Baidya ◽  
Mahfuza Shirin ◽  
Liton Chandra Saha

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


2015 ◽  
Vol 13 (1) ◽  
pp. 33-36 ◽  
Author(s):  
Sundari Joshi ◽  
Megha Pradhan Pradhan ◽  
Ujjwal Joshi

Introduction: Anaemia is a pathologic deficiency in oxygen-carrying haemoglobin in red blood cells which may be the result of genetic diseases, infections and deficiency of several nutrients. Nepal is one of the developing countries where anaemia is one of the most serious public health problems. So, a study was planned to evaluate the prevalence of anaemia among children under five years in tertiary care hospital of Nepal. Methods: A cross-sectional study was carried out from August 2011 to January 2012 using a structured questionnaire interview and observation. The children were divided into three groups: group I (0-1 years), group II (>1-3 years), group III (>3-5 years). Anaemia was assessed using  haemoglobin measurement in gram in decilitre on Sysmex KX -21 (automated haematology analyzer). The severity of anaemia were grouped as follows: severe anaemia, < 7.0 g/dL; moderate anaemia, 7.0 to 8.9 g/dL; and mild anaemia, 9.0 to 10.9 g/dL as per WHO classification. Stool test was also carried out to assess worm infestation. Data were analysed using SPSS 11.5. Results: There were 208 children among which 52.9 % were male while 47.10 % were female.  The overall prevalence of anaemia was found to be 49.5% of which 43.3% had mild, 15.8% had moderate and 0.5% had severe anaemia. Out of 20 children in group I, 70 % were anaemic. Among the 94 each in group II and group III, children suffering from anaemia were 51% and 43% respectively. The stool investigations showed that 5.3 % children suffered from worm infestations.   Conclusions: prevalence of anaemia was seen in 49.5% of children below five years age group and the diet and worm infestations didn’t affect it.doi:  http://dx.doi.org/10.3126/mjsbh.v13i1.12998


Author(s):  
Nachiket Madhukarrao Palaskar ◽  
Nitin Dinkar Chaudhari ◽  
Garima Laxminarayan Balpande ◽  
Swapna Subhash Khatu

<p class="abstract"><strong>Background:</strong> Female pattern hair loss (FPHL) is a common form of nonscarring hair loss. We compared the usefulness and safety of topical minoxidil alone with combination of oral spironolactone and topical minoxidil in the treatment of FPHL.</p><p class="abstract"><strong>Methods:</strong> This prospective, single-centre, randomised open label study over 100 patients attending tertiary care hospital in Mumbai during period December 2011 to June 2012. The data were entered into SPSS version 21 for analysis. Data collected were coded and described as frequency and percentage for qualitative data and means and standard deviation for quantitative data. Statistical analysis was done using chi-square and student t test. Statistical significance was considered if p value was less than 0.05.<strong></strong></p><p class="abstract"><strong>Results:</strong> There were 48 patients in Group I and 46 patients in Group II. At 6 months, significantly higher mean Sinclair grade was observed among Group I patients as compared to Group II patients (2.85±0.68 vs 2.56±0.50, p=0.02). We observed a significant improvement in women’s androgenetic alopecia quality of life questionnaire in Group I patients at 12 months after treatment (26.93±2.25 vs 23.47±2.95, p&lt;0.001). Minoxidil and spironolactone were tolerated well by the patients.</p><p class="abstract"><strong>Conclusions:</strong> Combination therapy of topical minoxidil and oral spironolactone has an additive effect. However, plateau of effectiveness of the combination therapy in normoandrogenic patients at 6 months of therapy was observed. We recommend the combination for 6 months and continuation of therapy with minoxidil only.</p>


Author(s):  
Laxman Verma ◽  
Pankaj Kumar Chaudhary ◽  
Chandresh Gupta ◽  
Umesh Saroj

Background: Nontraumatic musculoskeletal disorders are the main reason for presentation to the emergency department with Rachialgia being the most common reason to request medical assessment among them. Methods: This was a prospective, randomized, parallel group open labelled study conducted in a district level tertiary care hospital attached to a medical teaching institute. Patients were randomized into two groups. Group I (63 patients) received tablet tramadol 50 mg twice daily orally and group II (63 patients) received tablet tapentadol 50 mg twice daily orally.Results: The mean age of the patients of group I was 40.6±9.6 years and in the group II was 42.7±10.6 years. A total of 61 males participated in the study of which 31 males were enrolled in group I and 30 in group II while 65 females participated in the study of which 32 females were enrolled in group I and 33 in group II. The mean reduction of pain intensity VAS score at the end of 4 weeks from baseline in group I and group II were 34.57 and 37.55 respectively. The difference in the mean reduction of pain intensity VAS between the two groups was not statistically significant.Conclusions: We conclude that both the drugs show significant reduction in the pain intensity in moderate to severe CLBP patients. Tapentadol is as efficacious as tramadol in moderate to severe CLBP. However, tapentadol is better tolerated than tramadol.


Author(s):  
Sudeb Mukherjee ◽  
Suhana Datta ◽  
Pramathanath Datta ◽  
Apurba K. Mukherjee ◽  
Indira Maisnam

<p class="abstract"><strong><span lang="EN-US">Background: </span></strong>The association between thyroid dysfunction and DM has long been recognized, although the prevalence of thyroid dysfunction among diabetes population varies in different studies. This study destined to know the prevalence of thyroid dysfunction of recently diagnosed type 2 diabetes mellitus patients.  </p><p class="abstract"><strong><span lang="EN-US">Methods: </span></strong>Retrospective chart review of 60 patients with type 2 diabetes mellituswas done. Total 60 patients (male 51, female9) fulfillingdiagnostic criteria for diabetes mellitus according to ADA (American Diabetes Association) criteria were analysed by doing Thyroid Function Test (FT4,TSH).</p><p class="abstract"><strong><span lang="EN-US">Results:</span></strong><span lang="EN-US"> 75% of patients have the biochemical features of thyroid dysfunction. Subcategorically in descending order of frequency they are - Subclinical hypothyroidism (33.33%) (defined by no symptoms or clinical fetures of hypothyroidism but biochemically TSH level in the range of above 5 mIU/ml but below 10 mIU/ml with normal FT4 level), 15% of patients each for overt hypothyroidism (either clinical features or Biochemically TSH &gt;10 mIU/ml or FT4 below normal), and subclinical hyperthyroidism (only biochemical low level of TSH &lt;0.34 mIU/ml in this study) and 11.667% patients show the features of clinical hyperthyroidism (clinical or FT4 level well above normal range along with low TSH).</span></p><p class="abstract"><strong><span lang="EN-US">Conclusions:</span></strong><span lang="EN-US"> Avery high prevalence of thyroid dysfunction in this part of world in contrast to Europe &amp; US suggest routine screening for thyroid disorder in recently diagnosed type 2 diabetes mellitus.</span></p>


Author(s):  
. Jyothi ◽  
S Latha ◽  
K Pavithra ◽  
M Nalini ◽  
Sowmya J Rao ◽  
...  

Introduction: Radiation therapy and chemotherapy are the standard treatment given for cancer, which leads to the variety of adverse effects of which Oral Mucositis (OM) is one of the common side-effects. It is responsible for patient discomfort and decreases their level of functioning. Both Chlorhexidine and Povidone Iodine have got antimicrobial and antifungal activity which decreases the severity of mucositis. Aim: To compare the effectiveness of Povidone Iodine and Chlorhexidine mouthwash on OM among cancer patients undergoing radiation therapy or chemotherapy. Materials and Methods: A prospective observational study was conducted in the tertiary care hospital of Mangaluru, Karnataka, India for the duration of one year and three months from December 2015-March 2017. Fifty cancer subjects aged between 25 to 65 years and who developed OM after radiation therapy or chemotherapy were selected by purposive sampling technique. Data were collected using the demographic profile, clinical proforma and World Health Organisation (WHO) OM grading scale (2004) from 19.09.2016 to 17.12.2016. Experimental group I received 10 mL of diluted Povidone Iodine mouthwash and group II received 10 mL of diluted chlorhexidine mouthwash. Level of OM in the group I and group II were assessed on the 1st, 3rd, 5th and 7th day using WHO OM grading scale (2004). The data were analysed by descriptive and inferential statistics (Wilcoxon signed- rank test, Mann-Whitney U test, Repeated measures ANOVA) using SPSS version 16.0. Results: Among the 50 cancer subjects, majority 30 (60%) were in the age group between 55-64 years and majority 35 (70%) were receiving radiation therapy. On day seven, in the group I (Povidone Iodine) majority 14 (56%) subjects had mild level of mucositis whereas in the group II (Chlorhexidine) majority 14 (56%) subjects had moderate mucositis. Comparison of the effect of Povidone Iodine and Chlorhexidine mouthwash using Friedman’s ANOVA showed that there was a difference in the level of mucositis (p<0.05) at 5% level of significance among two groups. The study findings also revealed a difference in the level of mucositis between day 1 to day 3, 5 and 7 (Mann-Whitney U test) (p<0.05) in both the groups. Conclusion: Povidone Iodine mouth wash was more effective than Chlorhexidine mouthwashes in reducing OM, and the patients were more comfortable after the use of the mouthwash.


2021 ◽  
Vol 8 (3) ◽  
pp. 146-153
Author(s):  
Sunil Arya ◽  
◽  
Chetan Panwar ◽  
Jyoti Prajapati ◽  
◽  
...  

Introduction: Neonatal Hyperbilirubinemia is the most common abnormal physical finding and themajor cause of neonatal morbidity during the early neonatal period. Early identification of infants atrisk might help in providing preventative therapy and follow-up. We aimed to assess whether arterialumbilical cord albumin level at birth predicts the development of neonatal hyperbilirubinemia in termnewborns at 48 hrs of life. Methods: This prospective observational cohort study was conducted ina tertiary care hospital over 1 year in 200 term healthy neonates. Cord blood albumin was estimatedat birth followed by serum bilirubin level on the 3rd postnatal day(48 hrs of age). Results: Total of200 neonates were divided into three groups based on cord blood albumin level of <2.8 g/dl(groupI), 2.8-3.4 g/dl(group II) and >3.4 g/dl(groupIII) with 32, 100 and 68 in three respective groups.19 newborns (59.4%) in group I,14 in group II, and 7 newborns (10.3%) in group III developedserum bilirubin levels above an intermediate high-risk zone in Bhutani nomogram at 48 hrs of age.newborn with low cord albumin (<2.8g/dl) were significantly associated with higher bilirubin levelsat 48 hrs of age. Conclusion: Neonates with cord blood albumin <2.8 gm/dl had a significantassociation of the development of hyperbilirubinemia at or above intermediate high-risk zoneaccording to Bhutani nomogram at 48 hrs of life.


2020 ◽  
Vol 42 (3) ◽  
pp. 32-37
Author(s):  
Binod Raut ◽  
Nimesh Paudel ◽  
Deepti Shrestha ◽  
Anant Bhosekar

Introduction Hyperlipidemia is one of the most contributing factors to coronary heart diseases. Statins have become standard medicine in clinical practice to reduce total cholesterol, low density lipoprotein and to increase high density lipoprotein cholesterol. This study is conducted to compare the effectiveness and safety of atorvastatin with rosuvastatin in hyperlipidemic patients. MethodsThis is a prospective observational study involving 150 patients conducted in the Department of Internal Medicine of Kathmandu Medical College and Teaching Hospital from July 2019 to March 2020. Patients newly diagnosed with hyperlipidemia were enrolled. Patients that were prescribed with 10 mg of atorvastatin and 5 mg of rosuvastatin by the treating physician once daily for 6 weeks were divided into two groups. Data was recorded in the customized proforma and the SPSS package version 20 was used for analysis. ResultsPatients that were prescribed with atorvastatin were put in group I and those prescribed with rosuvastatin were included in group II with 75 participants in each group. The mean age of the patients were 50.56± 10.08 years in group I and 52.45±10.20 years in group II with male to female ratio of 3:1. The mean BMI of group I was 25.36±1.74 and that of group II was 26.48±2.21 before therapy. There was a significant main effect of duration (F1,74=401.02, p<0.001) on the TG and TC levels (F1,74=1134.23, p<0.001) as well as (F1,74=614.99, p<0.001) on the LDL and HDL levels (F1,74=146.38, p<0.001). ConclusionRosuvastatin was significantly more effective than atorvastatin in reducing levels of TG, TC and LDL-C. Rosuvastatin also significantly increased the level of HDL.


2020 ◽  
Vol 78 (5) ◽  
pp. 247-254
Author(s):  
Senay AYDIN ◽  
Cengiz ÖZDEMIR ◽  
Ayşegül GÜNDÜZ ◽  
Meral E. KIZILTAN

ABSTRACT Objective: Seizures are a neurological condition commonly experienced during the follow-up period after systemic or metabolic disorders. The aim of the present study was to determine the etiological factors of seizures in patients at a tertiary care chest clinic. Methods: We reviewed all neurology consultations that were requested due to seizures in inpatient clinics in a tertiary care hospital specializing in respiratory disorders between January 2011 and January 2018 were retrospectively reviewed. Results: The present study included 705 of 2793 (25.2%) patients who requested consultations for seizures during the study period. The mean age of the sample was 64.05±17.19 years. Of the 705 patients, 307 (43.5%) had a previous history of epilepsy (Group I) and 398 (56.5%) had a first-time seizure and were considered to have symptomatic seizures (Group II). Multiple factors played roles in the development of seizures in 54.8% of the patients. In most patients, metabolic causes, systemic infections, and drug use were identified and an intracranial metastatic mass lesion was the major cause in patients with lung cancer. Rates of hypoxemia and respiratory acidosis were significantly higher in patients with symptomatic seizures (Group II) than in patients with primary epilepsy (Group I). Conclusions: Blood gas changes such as hypoxemia and respiratory acidosis were among the factors statistically associated with the development of symptomatic seizures in patients with respiratory diseases. Additionally, hypoxemia, hypercapnia, and respiratory acidosis were correlated with mortality in patients hospitalized for respiratory system diseases who requested consultations for seizures.


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