ABSTRACT
Chronic Kidney failures are progressive diseases and are divided into stages 1 to 5 based on the severity. Glomerular filtration rate (GFR) falls as the severity of kidney failure increases. Hypothyroidism was found to be present along with chronic renal failure and a presence of Low T3 was associated with increased chance of mortality due to cardiovascular complications. Significant association was known to exist in between thyroid dysfunction and chronic kidney disease progression. Aims & objectives: To study the pattern of thyroid dysfunction in chronic kidney disease population (who are not dialyses dependent) admitted at a tertiary care hospital of Tripura & to evaluate the correlation existing in between severity of kidney failure and thyroid dysfunction. Methods: 260 chronic kidney disease patients were included in the study. Diagnosis of chronic kidney failure was performed as per criteria laid down by Kidney Disease Outcome Quality Initiative. Blood was drawn for estimation of serum creatinine, GFR and thyroid profile. Data collected were analysed statistically and P≤0.05 was considered statistically significant. The statistical software namely SPSS 15.0 were used for statistical data analysis. Results: Among 260 individuals 138 were male and 122 female with age ranging from 20 to 82 years with mean age of 60.08±11.35 years. Calculation of GFR showed a mean GFR of 35.37±26.20 & mean serum creatinine level of 2.74±1.61mg/dl. Of the 260 patients, 68(26.1%), 74(28.5%), 74(28.5%), 31(11.9%) & 13(5%) patients belonged to CKD Stages 5,4,3,2 & 1 respectively. Low T3 is the most common thyroid dysfunction & the earliest abnormality noticed in CKD patients. The prevalence of low T3 syndrome in this study was 41.5 %( n=108). Increasing trend for Low T3 prevalence with increasing severity of CKD was noticed in this study and was statistically significant(P<O.001). The prevalence seen for LowT3 was CKD1-7.7%; CKD2-16.1%; CKD3-29.7%; CKD4-50% & CKD5- 63.2%. Statistically significant correlation was also seen with increasing prevalence of hypothyroidism & fall in GFR as the severity of kidney dysfunction increased (P<0.001). Conclusion: The present study was done to study the correlation of thyroid dysfunctions and chronic kidney diseases. It was observed that hypothyroidism both subclinical and overt exist with CKD and the most early and common dysfunction was lowT3 syndrome. The prevalence of thyroid dysfunction increase significantly as kidney failure progress .Low T3 is associated with increased chance of mortality due to cardiovascular complications and serves as a prognostic indicator in CKD individuals.
ABSTRACT
Hydatid cyst caused by the parasite Echinococcus most commonly involve liver and usually presented with right hypochondrial pain which may be associated with jaundice, urticarial skin rashes, pruritus etc., We report here a case of 32 years old young lady who clinically presented with acute exacerbation of bronchial asthma of recent onset. Her chest x-ray was unremarkable except slightly pushed up diaphragm on right side. Ultrasonography of abdomen revealed a cyst in the right lobe of liver, suggestive of hydatid cyst. Following confirmation of diagnosis by computed tomography (CT)-guided Fine Needle Aspiration Cytology (FNAC) surgical resection of the cystic lesion was done. On subsequent follow up for one year she was found to be cured of bronchial asthma. This case of hepatic hydatid cyst is reported here for its unique clinical presentation exclusively with bronchial asthma which completely subsided with resection of the cyst.