A Study On Relation Of Subclinical Hypothyroidism During Pregnancy With Its Outcomes In Gujarat

INTRODUCTION:Pregnancy is a period that places great physiological stress on both the mother and the fetus. When pregnancy compounded by endocrine disorders such as hypothyroidism, the potential for maternal and fetal adverse outcomes can be immense. Screening for subclinical hypothyroidism is essential in all pregnant women, especially in the Indian context, as Indian women have increased risk of developing iodine deficiency during pregnancy. Hence, this study planned to evaluate the effect of subclinical hypothyroidism on pregnancy outcomes.METHOD:It was a prospective analytical study. Sample size consisted of 73 pregnant women attending antenatal OPD. Thyroid profile (serum TSH, FT3 and FT4) was done during first visit. The results analyzed and SCH decided as per trimester specific cutoffs: TSH >2.5mIU/L in 1st trimester, >3mIU/L in 2ndtrimester and >3.5mIU/L in 3rd trimester. Information regarding general characteristics of participants recorded. The participants followed up to assess the mode of delivery, maternal and fetal outcome and any associated co-morbidities. Women with SCH treated accordingly. RESULTS: Seventy-three antenatal women underwent thyroid screening, of them 24.7% had subclinical hypothyroidism. Proportion of SCH women having age less than 25 years was 55.6% compared to 72.3% in euthyroid women. No significant difference observed between SCH and euthyroid groups for iodized salt consumption, type of diet and BMI (p>0.05). Compared with euthyroid status, SCH was associated with higher rates of High blood pressure (HBP) (27.8% vs 7.3%, p=0.02) and Low birth weight among babies (38.9% vs 14.5%, p=0.03). Proportion of Anaemia and Poor APGAR score was also high in SCH women compared to euthyroid. However, the significance was only marginally high. (Anaemia-72.2% vs 45.5%, p=0.049; Poor APGARscore-27.8% vs 9.1%, p=0.045).CONCLUSION:Prevalence of subclinical hypothyroidism among pregnant women is fairly high among Indians. Pregnant women with SCH had unfavourable maternal and fetal outcomes specifically there is an increased risk of high blood pressure and low birth weight babies. Thus, routine maternal thyroid function testing is necessary to improve maternal and [Type text]perinatal outcomes.

Nerve Conduction Studies In Lower Limb Weakness.

Introduction: Nerve conduction studies (NCS) are an essential part of the work-up of peripheral neuropathies. NCS with EMG allows diagnostic classification, understanding and separation of different neuropathies. Symmetrical lower limb weakness of neurological origin often demands EDX study. Neuropathies may be mixed or motor or sensory. Further it may be either axonal or demyelinating. Aims and objectives: To assess nerve conduction studies in symmetrical lower limb weakness patients with peripheral neuropathies. To estimate prevalence of neuropathies in this cohort. Material methods: Forty cases and equal no of controls underwent NCV study. Tibial peroneal motor and sural sensory nerve conductions were done. Data was stored in excel sheet for analysis. Different NCV variables were compared between the groups. Unpaired t’test was used for comparison of variables. Level of significance was kept at p value <0.05. Results: It was observed that DML, CMAP/SNAP amplitude, and CV of study group were significantly different as compared to control group (p value <0.05). Neuropathy was present in 31 (77.5%) cases. 25 (80.65%) cases were axonal and 6 (19.35%) were demyelinating neuropathies. NCV was normal in 9 (22.5%) cases. Conclusion: NCV study proved an essential tool in diagnosis of neuropathies in lower limb weakness cases. Axonal neuropathies were more prevalent as compared to demyelinating one. Mixed neuropathies were more frequent than isolated motor or sensory neuropathies. Presence of conduction block suggests acquired demyelination.

Metal complexes as magic bullet : an overview.

Magic Bullet comprises of a specific synthesized drug in which metal ions play an important role. These drugs can be designed to treat and cure a specific disease by attacking on specifically diseased cells leaving aside the healthy ones, there by, increasing the efficiency of a drug. As metal ions are used since ages as immuno-modulators, they trigger the immunity, if combined with the durg. Thus, combination of drug can be chelated with metal ions, which can help to develop innovative strategies for preparing combinatorial drug, also known as “Magic Bullet” or metal complexes or mixed ligand complex in the light of the chelate hypothesis.