A prospective study for the assessment of thyroid function by pre and post supervised exercise protocol in newly diagnosed patients of subclinical hypothyroidism

Background: The presence of raised serum TSH with serum free T4 and T3 within the reference range falls in subclinical hypothyroidism. It is a well-known fact that exercise affects the activity of thyroid glands and the production of their hormones. Author studied the effect of regular exercise in patients of newly diagnosed subclinical hypothyroidism. Pre and post-exercise thyroid function tests were evaluated to decide about the necessity to start thyroid replacement therapy or to adopt wait and watch policy.Methods: Study enrolled 100 newly diagnosed subclinical hypothyroidism patients attending this tertiary care hospital and randomised them in two groups, one group was subjected to regular physical exercise of 45-60 minutes daily along with supervised treadmill exercise stage 0 for 45-60 minutes once weekly followed by re-evaluation of thyroid function test after 30 days and second group was re-evaluated for thyroid function test without exercise after 30 days.Results: Thyroid profile parameters were compared and analysed by paired ‘t’ test, statistically significant increase in serum T3 (p value <0.05) and serum T4 (p value <0.05), along with significant reduction in TSH level (p value <0.05) were found in exercise group, while in non-exercise group changes in thyroid profile parameters were statistically not significant. There was significant reduction in mean weight in exercise group (p value <0.05), while in non-exercise group changes in weight were not significant.Conclusions: Present study concluded that regular physical exercise can improve thyroid function in patients of newly diagnosed subclinical hypothyroidism and convert them to euthyroid state.

Wire Cutter: Improvised approach with Basic Instrument.

A good armamentarium is basic to a practicing oral and maxillofacial surgeon. Various instruments and equipment are being improvised on a continuous basis to curtail various inherent problems and disadvantages of these instruments. The wire cutter is one such instrument, which is used in day-to-day oral surgical practice and is not free of disadvantage like blunting of sharp edges as a result of repeated usage and sterilization process. In this article, we discuss about a commonly used basic instrument (nail cutter) which can be efficiently used as a wire cutter.

The different treatment modalities of pyopneumothorax- Study of 50 cases.

Background: Pyopneumothorax is defined as a collection of pus and air in the pleural cavity. It may be localised (encapsulated) or it may involve the entire pleural cavity. In India, Pyopneumothorax with pre-existing disease is treated with antimicrobial multiple antituberculous drugs and Intercostal drainage tube or surgery. Aims & Objective: (1) To know the age and sex incidence. (2) To study clinical presentation and characteristics of mode of onset (3) To obtain relationship with smoking. (4) To emphasise the importance of radiological and other investigations as an aid to diagnosis and management. (5) To find out the underlying lung pathology if any. (6) To decide the response to various modes of treatment. (7) To understand the complications of Pyopneumothorax. Material and Methods: This is a progressive study of 50 Indoor patients with pyopneumothorax admitted in the civil hospital, Ahmedabad in consecutive 3 years. Traumatic pyopneumothorax patients were excluded from the Study. The response to various modes of treatment and complications were noted. Results: The age incidences indicate that it was high in 21-30 years of age. Most common complaints were cough followed by dyspnoea and chest pain. The mycobacterium tuberculosis was the most common etiological factor. The best modality of treatment was intercostal drainage by tube with antibiotic coverage. Conclusion: Tuberculosis is main etiology in country like India. Intercostal drainage with under water seal was the treatment of choice in most of the patients. The commonest complication following ICD was surgical emphysema.

Improved cure rates in pulmonary tuberculosis category II (retreatment) with mycobacterium w.

A controlled study to improve sputum conversion rate of current short course chemotherapy using immunomodulator containing mycobacterium w had been shown earlier. The same randomised study was continued further till the end of therapy. At the end of the intensive phase, sputum conversion rate in category II was 75.51% in mycobacterium w (MW) group as compared to 51.85% in the control group. The cure rate in category II was 97.96% and 77.77% in MW and control groups, respectively. Treatment failure in category 11 was 2.04% and 22.22% in MW and control groups respectively. The therapy was well tolerated.

Effect of an immunomodulator containing Mycobacterium w on sputum conversion in pulmonary tuberculosis.

Sputum conversion is an important milestone in the management of pulmonary tuberculosis. Early sputum conversion is desirable. A controlled study was done to improve sputum conversion rate of current short course chemotherapy using immunomodulator containing mycobacterium w. The immunomodulator is very potent and freely available. It shares antigens with Mycobacterium tuberculosis. In a randomised pattern 69 of 134 patients suffering from pulmonary tuberculosis received the immunomodulator intradermally every 15 days along with chemotherapy. The use of the immunomodulator results in preponement of sputum conversion. The sputum conversion rate obtained by chemotherapy at 60 days was achieved latest by 30 days when mycobacterium w containing immunomodulator was used as an adjuvant therapy. This was found irrespective of bacterial load (1 +, minimal or 3+, maximal) in sputum or category (fresh or retreatment) of disease. The therapy was well tolerated.