scholarly journals Thyroid Hormone Tests Ordering Practice and Cost-Effectiveness in Samples Referred to International Clinical Laboratories from Addis Ababa Health Facilities

2020 ◽  
Vol 30 (3) ◽  
Author(s):  
Kifle Tilahun ◽  
Meaza Demissie ◽  
Tamrat Bekele ◽  
Mesfin Nigussie ◽  
Damen H/Mariam
Keyword(s):  
Cost Effectiveness ◽  
Thyroid Dysfunction ◽  
Arab World ◽  
Addis Ababa ◽  
Health Facilities ◽  
Sub Saharan Africa ◽  
Endocrine Disorders ◽  
Thyroid Function Tests ◽  
Thyroid Disorder ◽  
Cross Sectional

BACKGROUND: Thyroid dysfunction accounts for majority of endocrine disorders. In sub-Saharan Africa Graves’ disease and hypothyroidism have accounted for 13.1% and 8.8% while the burden of thyroid disorder has ranged from 6.18 to47.34% among countries in the Arab world. The cost for a primary thyroid test done to evaluate the gland function constituted a large proportion of the public health budget. For instance, 10 million thyroid functions have been done each year by laboratories which cost 30 million UK pounds, and they represent 8% of laboratory charge in the US. When a TSH-only protocol (guideline) was used, 95% of the requests were sufficient for diagnosis without requiring further tests, thereby resulting in 50% savings on FT4 reagent and reducing the annual TFT reagent cost by 25%. This is an original study, and its objective was to assess the ordering pattern of TSH tests and their cost-effectiveness in patients’ samples referred to ICL from Addis Ababa health facilities between July2015 to June 2016METHOD: An institution-based cross-sectional study design was utilized to study the ordering pattern of thyroid function tests using one-year retrospective data from ICL.RESULTS: Thyroid profiles were ordered more frequently (49.5%) compared to TSH only (24.3%). An additional 2625.70 USD was paid by patients for individual components in the profile tests that turned out normal.CONCLUSION: Guidelines advocate TSH as the initial test for thyroid dysfunction, but the use of a combination of tests is more common.

scholarly journals THYROID DISORDERS

2015 ◽  
Vol 22 (10) ◽  
pp. 1289-1297
Author(s):  
Liaqat Ali ◽  
Muhammad Tahir Mohy U Din ◽  
Imtiaz Ahmed ◽  
Rehan Riaz
Keyword(s):  
Thyroid Hormones ◽  
Cardiovascular System ◽  
Thyroid Disease ◽  
Thyroid Dysfunction ◽  
Cardiovascular Complications ◽  
Thyroid Function Tests ◽  
Thyroid Disorder ◽  
Cross Sectional ◽  
Study Results ◽  
Hypothyroid Patients

Background: Thyroid hormones have many effects on cardiovascular function,and deficiency or excess of thyroid hormones can result in cardiac dysfunction. Abnormalitiesof the cardiovascular system are often identified during examination of hyperthyroid andhypothyroid patients. Objective: The aim of this study was to address the effects of thyroidhormones on the cardiovascular system and the clinical relevance of the cardiovascularresponse to thyroid dysfunction. Study Design: Cross sectional study. Setting: The studywas conducted at Allied Hospital / Punjab Medical College Faisalabad and PINUM HospitalFaisalabad. Period: October 2014 to August 2015. Materials and Methods: Total 100 patientswith thyroid disease (Hypo/hyperthyroidism) were enrolled in the study. Any patient age ≥20years, that had documented history of thyroid disease (Hypothyroidism or hyperthyroidism) oron medications for thyroid disorder was recruited in this study. Results: Total 100 consecutivepatients with abnormal thyroid function tests who fulfill the inclusion and exclusion criteriawere enrolled in the study. Mean age was 47.9 ± 23.20 years. 16 % were male and 84%were female. Majority of the patients 37( 37%) were in age group 51 - 60 years. 53 % weresuffering from overt hyperthyroidism and 31 % were suffering from hypothyroidism. Subclinicalhyperthyroidism and hypothyroidism was present in 7% and 9% patients respectively. Goiterwas present in 24 % patients. Atrial fibrillation was observed in 34% hyperthyroid patients.Overall 23% were diabetics and 25% had H/O hypertension. Dyslipidemia was present in20% hyperthyroid and 25% hypothyroid patients. Echocardiography was performed in 19%patients. 7% patients undergone thyroid surgery. Overall 11% patients were suffering from CCF.Pulmonary hypertension was observed in 17% hyperthyroid and 35.48% hypothyroid patients.MeanFT4 in hypothyroid patients was 1.16±022 ng/dl. Mean TSH was 10.92±21.09 (μIU/ml)in hypothyroid and 0.19±0.14 (μIU/ml) in hyperthyroid patients. Conclusions: The outcomeof this study suggests that patients with untreated overt / subclinical thyroid dysfunction are atincreased risk of cardiovascular complications.

A STUDY OF PREVALENCE AND PATTERNS OF THYROID DYSFUNCTION IN HIV INFECTED PATIENTS FROM RURAL BACKGROUND OF EASTERN INDIA

2021 ◽  
pp. 31-33
Author(s):  
Amit Sarkar ◽  
Amritesh Biswas ◽  
Kalyan Kumar Bhowmik ◽  
Somnath Dasgupta
Keyword(s):  
Infected Patient ◽  
Thyroid Dysfunction ◽  
Thyroid Function Tests ◽  
Thyroid Disorder ◽  
Free T4 ◽  
Cross Sectional ◽  
Serum Free ◽  
Ciency Virus ◽  
Serum T3 ◽  
Thyroid Abnormalities

The national prevalence of HIV (Human Immunodeciency Virus ) infection among adults in India is estimated to be 0.22% in the year 2017 . Amongst all endocrine abnormalities , abnormal thyroid function tests are common among HIV infected patients . This study is an attempt to know the magnitude of thyroid dysfunction in HIV infected patient . This observational , cross sectional study was carried out on 153 adult patients attending ART centre of our institution . The gross prevalence of thyroid dysfunction in HIV infected patients and patterns of different thyroid abnormalities were assessed .The serum T3 , Free T4 and TSH were correlated with CD4 count and duration of HAART ( highly active anti retroviral therapy) . The prevalence of thyroid dysfunction in HIV infected patient is found to be 30.06% . The most common thyroid disorder , subclinical hypothyroidism was found in 20.26% of the HIV infected patients . Mean CD4 cell count is positively correlated with mean serum T3 and serum free T4 and negatively correlated with mean TSH without any statistical signicance in all study population . The correlation of duration of HAART with serum T3 is signicantly negative and with serum free T4 , TSH is nonsignicantly negative . So, denitely there is more prevalence of thyroid dysfunction in HIV infected patients than general population . Although there is normal serum free T4 level in subclinical hypothyroid patients , the serum free T4 level decreases within the normal laboratory reference range with severity of HIV infection . The thyroid abnormalities progress further in HIV infected patients who are on HAART . We conclude that more attention to thyroid dysfunction in HIV infected patient should be paid so that timely treatment is done .

Quality of Antenatal, Labour and Delivery Services in Selected Districts in Malawi, Zambia and Zimbabwe: A Descriptive Cross-Sectional Study

2021 ◽  
pp. 1-9
Author(s):  
Clara Opha Haruzivishe
Keyword(s):  
Perinatal Care ◽  
Neonatal Morbidity ◽  
Health Facilities ◽  
Sub Saharan Africa ◽  
Morbidity And Mortality ◽  
World Health ◽  
Performance Standard ◽  
Cross Sectional ◽  
Care Services

Background: High Maternal and Neonatal Mortality Ratios persist in Sub-Saharan Africa despite increasing perinatal care coverage. This suggests that coverage alone is not adequate to reduce maternal and neonatal morbidity and mortality. Quality of care should be the emphasis of maternal and child care services. Materials and Methods: A descriptive cross-sectional multicentre study was conducted in selected health facilities in Zambia, Malawi and Zimbabwe using purposive sampling. A World Health Organization-WHO 2016 Quality of Maternal and New-born assessment Framework and the WHO (2015) Service Availability and Readiness Assessment tool were used for data collection. Data was analyzed using Statistical Package for Social Scientist (SPSS) version 24.0. Results: Less than 43% of the health facilities satisfied at least three of the five Performance Standards of availability and adequacy of Antenatal infrastructure and supplies. Regarding Antenatal processes/care, an observation was the most common performance standard satisfied by 70.6% of all health facilities assessed while less than 30% fulfilled all other standards. Only 57.1% of the health facilities satisfied 5 of the 11 standards for labour and delivery infrastructure, while only 55.6% of the Health facilities satisfied only two of the 13 standards of Labour and delivery care. Conclusion: To achieve a significant and sustainable reduction in maternal and neonatal morbidity and mortality, there is a need for investment and improvement in maternity care services infrastructure and processes as opposed to focusing on mere attendance of Antenatal, and deliveries by trained birth attendants.

scholarly journals Prevalence of thyroid dysfunction and its effects on fetomaternal outcome in pregnant women of Eastern Uttar Pradesh, India

2018 ◽  
Vol 7 (11) ◽  
pp. 4379
Author(s):  
Ankita Kumari ◽  
Reena Srivastav ◽  
Shaila Mitra
Keyword(s):  
Thyroid Dysfunction ◽  
Uttar Pradesh ◽  
Overt Hypothyroidism ◽  
Thyroid Function Tests ◽  
Thyroid Disorder ◽  
Medical College ◽  
Thyroid Screening ◽  
Fetal Complications ◽  
Adverse Pregnancy ◽  
Eastern Uttar Pradesh

Background: The aim of the study is to determine the prevalence of thyroid dysfunction in pregnancy and its impact on obstetrical outcome in Eastern Uttar Pradesh.Methods: This was a prospective observational study undertaken at antenatal clinics and indoor of BRD Medical College, Gorakhpur. Total 720 antenatal women, ≤20 weeks of gestation were recruited for the study. In all patients’ routine obstetrical investigations and thyroid function tests were done. All patients were followed up to delivery. Maternal and perinatal outcome were ascertained.Results: Prevalence of thyroid dysfunction among pregnant was found to be 21.1% and subclinical hypothyroidism (15.9%) was the commonest thyroid disorder. Most common complication observed in subclinical and overt hypothyroidism was preeclampsia (9.56 % versus 20%) followed by preterm labour (7.82% versus 10%). Major fetal complications in hypothyroid mothers included intrauterine growth restriction, low birth weight and stillbirth.Conclusions: Prevalence of hypothyroidism was found to be high in our study and was associated with adverse pregnancy outcomes; hence, thyroid screening should be included in routine antenatal investigations.

scholarly journals Thyroid hormones profile of patients with type 2 diabetes mellitus in Kano, Nigeria

2020 ◽  
Vol 3 (1) ◽  
Author(s):  
Mustapha Zainab Abubakar ◽  
Kabiru Abdulsalam ◽  
Isah A. Yahaya
Keyword(s):  
Diabetes Mellitus ◽  
Thyroid Dysfunction ◽  
Cross Sectional Study ◽  
Endocrine Disorders ◽  
Cross Sectional ◽  
Type 2 Dm ◽  
Type 2 Diabetics ◽  
Patients With Diabetes ◽  
Considerable Impact

Diabetes mellitus (DM) and thyroid disease are the two most common endocrine disorders in the general population. Several Studies have shown that thyroid dysfunction is common in patients with DM, and thyroid dysfunction have been found to have a considerable impact on the glycaemic control and often increases the risk of development of long-term complications in patients with diabetes mellitus. This study determined the prevalence of thyroid dysfunction in patients with type 2 DM in Kano, North-Western Nigeria. The study was a descriptive cross-sectional study conducted on 250 participants made up of 130 patients with type 2 DM and 120 apparently healthy non-diabetic controls. Questionnaires were used to collect information on bio data, medical history, duration of diagnosis of diabetes and type of treatment. Also, blood samples of the participants were collected and analyzed for fasting plasma glucose, fT3, fT4, and TSH. The results were interpreted using American Thyroid Associations’ criteria and the data was analyzed using the statistical software package, STATA version 20. Two hundred and thirty-four (93.6%) of the participants were euthyroid while sixteen (6.4%) were found to have various forms of thyroid dysfunction. The prevalence of thyroid dysfunction was 10% and 2.5% among type 2 diabetics and controls respectively. Among the type 2 DM patients with thyroid dysfunction, 38.5% had hypothyroidism. Thyroid dysfunction was found to be commoner among type 2 DM patients than non-diabetic individuals with hypothyroidism being the commonest disorder.

scholarly journals Thyroid dysfunction in preeclampsia and related fetomaternal outcomes

2019 ◽  
Vol 8 (5) ◽  
pp. 1928
Author(s):  
Puja Banik ◽  
R. K. Praneshwari Devi ◽  
Aheibam Bidya ◽  
Akoijam Tamphasana ◽  
M. Agalya ◽  
...  
Keyword(s):  
Thyroid Function ◽  
Thyroid Dysfunction ◽  
Birth Asphyxia ◽  
Normal Pregnancy ◽  
Thyroid Stimulating Hormone ◽  
Severe Preeclampsia ◽  
Intrauterine Fetal Death ◽  
Overt Hypothyroidism ◽  
Thyroid Function Tests ◽  
Cross Sectional

Background: Changes in thyroid function in normal pregnancy are well-documented but in complicated pregnancy like preeclampsia, very little is known. Studies have shown evidences of hypothyroidism in preeclampsia necessitating thyroid function tests to be done in preeclampsia. The study was done to analyze the fetomaternal outcome of preeclampsia with coexisting thyroid dysfunction.Methods: A cross-sectional analytical study was done over 18 months on 95 preeclamptic patients admitted at the antenatal ward and fetomaternal outcomes were analyzed according to thyroid status.Results: Out of 95 patients with preeclampsia, 42 (44.2%) had thyroid dysfunction. Among these 42 patients, 37 (38.9%) patients had subclinical hypothyroidism, 4 (4.2%) had overt hypothyroidism and 1 (1%) had hyperthyroidism. Severe preeclampsia was seen in 64.3% of the patients with thyroid dysfunction compared with 39.6% in euthyroid patients. The mean thyroid stimulating hormone (TSH) level was significantly higher and means free thyroxine (fT4) level was significantly lower in severe preeclampsia compared with non-severe preeclampsia. Complications like abruption, intrauterine fetal death (IUD), intrauterine growth restriction (IUGR), oligohydramnios, preterm deliveries, postpartum hemorrhage (PPH), low birth weight babies, birth asphyxia in babies and subsequent neonatal intensive care unit (NICU) admissions were significantly higher (p <0.05) in the preeclampsia patients with thyroid dysfunction in comparison with euthyroid ones.Conclusions: Hypothyroidism may be a modifiable risk factor for preeclampsia. Thyroid screening early in pregnancy may be helpful in predicting the occurrence of preeclampsia and timely thyroid hormone administration can reduce the maternal and perinatal morbidity and mortality associated with preeclampsia.

scholarly journals Prevalence of thyroid dysfunction in patients with polycystic ovarian syndrome: a cross sectional study

2018 ◽  
Vol 7 (8) ◽  
pp. 3055 ◽  
Author(s):  
Deepa Shanmugham ◽  
Sindhu Natarajan ◽  
Arun Karthik
Keyword(s):  
Thyroid Dysfunction ◽  
Polycystic Ovarian Syndrome ◽  
Polycystic Ovary ◽  
Reproductive Function ◽  
Thyroid Stimulating Hormone ◽  
Endocrine Disorders ◽  
Free T4 ◽  
Cross Sectional ◽  
The Mean ◽  
Ovarian Syndrome

Background: Polycystic ovary syndrome (PCOS) and thyroid disorders are two of the most common endocrine disorders in the general population. Both of these endocrine disorders share common predisposing factors, gynaecological features and have profound effect on reproductive function in women. The aim of this study is to study the prevalence of thyroid dysfunction in patients with polycystic ovarian syndrome and to evaluate the relationship between polycystic ovarian syndrome and thyroid dysfunction.Methods: This is a cross sectional observational study done on 100 patients with Poly Cystic Ovarian Syndrome based on Rotterdam’s criteria. The exclusion criteria was hyperprolactinemia, congenital adrenal hyperplasia and virilising tumour. Thyroid function was evaluated by measurement of fasting serum thyroid stimulating hormone (TSH), free thyroxine levels (free T3 and free T4).Results: The mean age of the study patients was 26±4.2 years. Among the study patients, 11% of them had goitre. 18% of the patients with presented with subclinical hypothyroidism. The mean TSH levels in the study patients was 4.62±2.12 mIU/ml. The overall prevalence of thyroid dysfunction was 33% in the study patients with PCOS.Conclusions: This study concludes that the prevalence of hypothyroidism is increased in women with PCOS patients.

Magnitude of thyroid dysfunction among antenatal women attending tertiary care centre

2019 ◽  
Vol 8 (11) ◽  
pp. 4371
Author(s):  
Deepa Shanmugham ◽  
Deepak Kannan Saravanan ◽  
Priyanka Shah
Keyword(s):  
Thyroid Dysfunction ◽  
Tertiary Care ◽  
Thyroid Function Test ◽  
First Trimester ◽  
Endocrine Disorders ◽  
Tertiary Care Centre ◽  
Free T4 ◽  
Cross Sectional ◽  
High Prevalence ◽  
The Mean

Background: Thyroid disorders constitute one of the most common endocrine disorders in pregnancy. However, there is no universal guidelines to screen every Pregnant Woman for Thyroid dysfunction in India. This study was conducted to evaluate the magnitude of thyroid dysfunction among ante natal mothers in a tertiary care centre.Methods: This was a cross sectional observational study conducted on ante natal mothers for a period of 6 months. All consecutive ante natal mothers in their first trimester were included in this study. Exclusion criteria was pre-gestational thyroid dysfunction, hypertension and diabetes mellitus. After obstetric examination and investigation, thyroid function test (Free T4 and TSH) was done in all patients.Results: Mean age of the patients enrolled was 26.2±3.54 years. Mean gestational age at which they underwent screening was 9±2 weeks. The mean BMI of the study patients was 21.7±4. The prevalence of hypothyroidism in antenatal mothers was 14.5%. 5 patients (5.5%) had hyperthyroidism. The calculated mean TSH value was 4.26 mIU/L.Conclusions: Universal screening for thyroid dysfunction during pregnancy should be made mandatory in India due to high prevalence, in order to prevent maternal and foetal complications.

scholarly journals Prevalence of sleep disorders in Parkinson’s disease patients in Ethiopia

2019 ◽  
Author(s):  
Dereje Melka ◽  
Abenet Tafesse ◽  
James H. Bower ◽  
Demeke Assefa
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Sleep Disorders ◽  
Addis Ababa ◽  
Demographic Data ◽  
Previous History ◽  
Sub Saharan Africa ◽  
Poor Sleep ◽  
Motor Symptoms ◽  
Cross Sectional

Abstract Background: Non motor symptoms (NMS) of Parkinson’s disease (PD) are common and can be more disabling than motor symptoms.Sleep disorders can be seen in up to 98% of patients with Parkinson disease. Poor sleep quality has been associated with poverty and race, and yet there has been no prior report on sleep disorders in those with PD living in sub Saharan Africa. We wished to document the prevalence of sleep disorders in PD patients in Ethiopia. Methods: We conducted a cross-sectional point prevalence study from July 1 to October 30, 2015 of all patients attending the neurology outpatient department in Tikur Anbessa and Zewuditu Memorial Hospitals, Addis Ababa, Ethiopia. Demographic data, clinical history and physical examination findings were collected from participants using a structured questionnaire. We used the Parkinson’s disease sleep scale version two (PDSS-2) and Epworth Sleepiness Scale (ESS) to assess the sleep symptoms. Results: Of the 155 patients surveyed, all patients reported some sleep problem. Over 43.9% of patients had a PDSS score > 18. Presence of previous history of sleep disturbance before PD motor symptoms (OR 3.54; 95% CI 1.61-7.76, p=0.001) and unemployment (OR 2.27; 95% CI 1.07-4.79, p=0.023) associated with a high PDSS-2 score. The median score of ESS was 9 (IQR = 5-12), with 77/155 (49.7%) of the patients having possible or definite excessive daytime somnolence. Conclusions: In Ethiopian PD patients, the prevalence of those with severe sleep disorders is the highest reported to date. The prevalence of possible/definite EDS is amongst the highest in the world. Further investigation into whether poverty or race explains this finding is needed.

scholarly journals Study on Thyroid Dysfunction in Patients with Type-2 Diabetes

2020 ◽  
Vol 7 (52) ◽  
pp. 3142-3147
Author(s):  
Senthil Chander ◽  
Kalpana Dev Venkatesan ◽  
Christina Mary Paul
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Subclinical Hypothyroidism ◽  
Thyroid Dysfunction ◽  
General Medicine ◽  
Diabetic Patients ◽  
Endocrine Disorders ◽  
Cross Sectional ◽  
Patients With Diabetes

BACKGROUND Diabetes mellitus is one of the leading endocrine disorders worldwide. Thyroid dysfunction is a common endocrine disorder affecting the general population next to diabetes. The objective of this study was to determine the prevalence of thyroid dysfunction among patients with Type 2 diabetes. METHODS This analytical cross sectional study was conducted from June 2019 to Dec 2019. One hundred and fifty type–2 diabetes patients who attended the outpatient clinic of General Medicine Department, ACS Medical College and Hospital were included in the study. A detailed history and examination was done after getting informed consent. Blood samples were collected and sent to the laboratory for the evaluation of thyroid profile. RESULTS Thyroid dysfunction was found in 27 % of the patients with diabetes. Subclinical hypothyroidism was the most common thyroid dysfunction reported (14.7 %) followed by clinical hypothyroidism (10 %), subclinical hyperthyroidism (2 %) and clinical hyperthyroidism (0.6 %). CONCLUSIONS Thyroid dysfunction is common in patients with type-2 diabetes. A substantial proportion of the diabetic patients with thyroid dysfunction have subclinical hypothyroidism. Unidentified thyroid dysfunction could negatively impact diabetes and its complications. Therefore, early and routine screening of thyroid is recommended in all patients with diabetes to reduce the burden of the disease. KEYWORDS Type-2 Diabetes Mellitus, Thyroid Dysfunction, Hypothyroidism

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