ABSTRACT
Background: Cholelithiasis is a disease prevalent worldwide because of an imbalance of bile salt and cholesterol concentrations that leads to precipitation inside the gallbladder. Gall stones are the most common biliary pathology both in India and western countries. Recent studies concentrate on gall stones and thyroid hormones – T3 and T4 have an effect on both bile content and bile flow. Patients with hypothyroidism have a serum level of cholesterol approximately 50% higher level than in euthyroid patients and 90% of all hypothyroid patients have elevated cholesterol level. Likewise, low levels of t4 have an effect in relaxing the sphincter of odds, leading to biliary stasis and stone formation. The aim of the study: To check thyroid status in patients who are diagnosed with gallstone disease, thereby dividing into euthyroid, hypothyroid, hyperthyroid and subclinically hypothyroid, correlating the prevalence of subclinical hypothyroidism in patients with cholelithiasis. Materials and methods: This study was conducted in the Department of General Surgery, Government Stanley Medical College, Chennai in 2018. Patients were divided according to history, clinical examination, and USG neck and lab estimation of T3, T4, and TSH. Subclinical hypothyroidism: The symptom-free patient with TSH concentration above the upper limit of normal range and T3/T4or both decrease below normal limit. Clinical hypothyroidism: In which there were symptoms of hypothyroidism with TSH level above the upper limit and T3/T4or both decreases below normal limit. Euthyroid group: Where clinical and lab tests were within normal range. Manimegalai, T. Avvai. The prevalence of undiagnosed thyroid dysfunction and diagnosed diseases of gallstones. IAIM, 2019; 6(3): 231-236. Page 232 Results: The predominant age group was 51-60 years constituting 36.67% of patients. Youngest patient age was 21 years and the oldest was 80 years of age. Of the 60 patients, the majority of patients were euthyroid status 52 (86.67%). 6 (10%) patients were subclinical hypothyroidism, 2 (3.33%) were clinical hypothyroidism. Of the 60 patients, 52 were diagnosed with gallstone only and 8 were diagnosed with gallstone and CBD stones. In this study, hyperlipidemia was present in 7 of the hypothyroidism. Conclusion: There is a relationship between thyroid dysfunction particularly hypothyroidism and gallstone diseases. Hypothyroidism is seen more in GB stones patients compare with CBD stone patients. Subclinical hypothyroidism is more common than clinical hypothyroidism. Hypothyroidism has a higher prevalence in females than males. High cholesterol levels are seen in gallstone disease with thyroid dysfunction.
ABSTRACT
Introduction: Hypothyroidism is a common endocrine disorder resulting from a deficiency of thyroid hormone. It usually is a primary process in which the thyroid gland produces insufficient amounts of thyroid hormone. It can also be secondary that is lack of thyroid hormone secretion due to the failure of either adequate thyroid - stimulating hormone (TSH) secretion from the pituitary gland or thyrotropin-releasing hormone (TRH) from the hypothalamus (secondary or tertiary hypothyroidism). Pericardial effusion is frequently found in patients with hypothyroidism, but it is rarely associated with cardiac tamponade. Hypothyroidism complicated by cardiac tamponade is rarely referenced in the medical literature. The aim of the study: To find a correlation between severity of disease and presence of pericardial effusion. Materials and methods: The study was conducted in 2017. Patients attending the Outpatient Clinic of the Department of Endocrinology who satisfied the inclusion criteria were registered for the study after obtaining their consent. A detailed questionnaire was used to elicit symptoms of hypothyroidism. The patients were examined for signs of hypothyroidism. Special attention was given to the examination of the cardiovascular system to look for clinical features of pericardial effusion. Results: The prevalence of pericardial effusion in this study was 17%. 2 out of the 70 hypothyroid patients showed evidence of pericardial effusion. Mild pericardial effusion was found in 11 patients (15.71%) and moderate pericardial effusion in 1 patient (0.01%). Abirami Gunasekaran, Kamatchi Karunanidhi, Jayalakshmi Ramasamy. A study on prevalence of pericardial effusion in newly diagnosed adult hypothyroid patients. IAIM, 2018; 5(5): 83-86. Page 84 Conclusion: Clinical features of pericardial effusion show statistically significant association with its presence on echocardiogram. Macroglossia was more commonly found in patients with Pericardial Effusion. ECG and CXR can be used to predict the presence of Pericardial Effusion