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Obtener intervalos de referencia (IRs) confiables para pruebas de laboratorio en pediatría es particularmente complejo y costoso. Una alternativa a este problema es el uso de métodos indirectos, donde se usan grandes bases de datos preexistentes de pacientes. Nuestros objetivos fueron: calcular IR para TSH y hormonas tiroideas (Perfil tiroideo, PT) en población pediátrica que asiste al Hospital de Pediatría Juan P. Garrahan, por método indirecto y verificar la confiabilidad de los mismos para su aplicación. Se recolectaron datos de 19.842 pacientes entre enero de 2020 y diciembre de 2021. Se aplicaron filtros para eliminar los pacientes que pudieran tener afectado el PT. Los 4.861 pacientes incorporados al análisis fueron divididos en 3 grupos: G1: 0-12 meses (n: 551), G2:13 meses- 7 años (n: 1347) y G3: 8 -18 años (n: 2963). Los IR fueron calculados por 2 métodos: el de Hoffman adaptado y el de CLSI EP28A3, para cada grupo de edad. TSH, TT3 y T4L se analizaron con Architect i4000-Abbott y TT4 con Immulite 2000XPi-Siemens. Para la primera etapa de verificación se utilizaron 20 sueros de pacientes provenientes de análisis prequirúrgicos. Los outliers se detectaron aplicando el método de Tukey. Los datos fueron procesados según CLSI EP28A3c. Los IR obtenidos fueron similares a los previamente publicados obtenidos por método directo. Los resultados de la verificación fueron en su mayoría aceptados. Por lo tanto, los métodos indirectos son una buena alternativa de cálculo de IR en pediatría (AU)
Obtaining reliable reference ranges (RRs) for laboratory tests in pediatrics is particularly complex and costly. An alternative to this problem is to use of indirect methods, where large pre-existing patient databases are used. Our aims were to calculate RRs for TSH and thyroid hormones (thyroid profile, PT) in children seen at Hospital de Pediatría Juan P. Garrahan by indirect methods and to verify their reliability for their application. Data were collected from 19,842 patients seen between January 2020 and December 2021. Filters were applied to eliminate patients in whom the PT was potentially affected. The remaining 4,861 patients included in the analysis were divided into 3 groups: G1: 0-12 months (n: 551), G2: 13 months-7 years (n: 1347) and G3: 8-18 years (n: 2963). RRs were calculated by 2 methods: the adapted Hoffman method and the CLSI EP28A3 method, for each age group. TSH, TT3, and FT4 were analyzed with Architect i4000-Abbott and TT4 with Immulite 2000XPi-Siemens. For the first stage of verification, 20 patient sera from pre-surgical analysis were used. Outliers were detected by applying the Tukey method. The data were processed according to CLSI EP28A3c. The RRs obtained were similar to those previously published using the direct method. The verification results were mostly acceptable. Therefore, indirect methods are a good option for calculating RRs in children (AU)
Subject(s)
Humans , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Reference Values , Thyroid Function Tests/methods , Thyroxine/blood , Triiodothyronine/blood , Thyrotropin/blood , Diagnostic Techniques, Endocrine/instrumentationABSTRACT
Background & objectives: One of the most common problems experienced by breast cancer survivors (BCSs) is fatigue. There has been little research about the status of hormones in breast cancer patients as an aetiology of cancer-related fatigue (CRF). Hence, a pilot study was conducted to assess the levels of hormones such as thyroid, cortisol, dehydroepiandrosterone sulphate (DHEAS), oestrogen and progesterone in BCSs with fatigue. Methods: BCSs with complaints of fatigue were assessed using the Brief Fatigue Inventory (BFI) tool and evaluation of the hormone profiles was done in moderate-to-severe fatigued survivors. Data collected were analyzed to look for any association between fatigue and altered hormonal levels. Results: In this study, 56 per cent (n=62) of survivors experienced moderate-to-severe fatigue out of 110 patients reporting fatigue. Thyroid functions were deranged in 22 patients (35.48%). The thyroid stimulating hormone (TSH) levels were found to have a significant negative association with the severity of fatigue, (P<0.05). Twelve patients (19.35%) had reduced DHEAS levels suggestive of impaired hormone synthesis in the adrenal gland. Twenty two postmenopausal survivors (35.48%) had raised oestradiol levels. Interpretation & conclusions: The findings of this study suggest that the hormonal milieu, especially thyroid hormone and DHEAS may have a role in CRF experienced by BCSs and needs further exploration.
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Background:Globally, an estimated 10.0 million (range, 9.0to 11.1 million) people infected with tuberculosis(TB). Developing country like India accounts for one fourth of the global tuberculosis burden. TB is associated with diffuse functional impairment of most endocrine organs.Methods:We conducted a study to evaluate the thyroid profile status in new sputum positive pulmonary tuberculosis patients, aged 12 years and above; attended and admitted to chest and TB, Medicine Department of SLN MCH, Koraput, Odisha from January 2019 to December 2019. Patients with H/o old pulmonary tuberculosis, patient with known neurological, hypothalamic-pituitary or thyroid disorders, kidney disease, malignancies and patients receiving medications known to interfere with thyroid hormone metabolism were excluded from the study.Statistical analysis was done by using SPSS version 21.0 software. Results were expressed in average±SD, frequencies and percentages. Continuous data were compared using Student’s t-test. A p value <0.05 was considered as statistically significant and p value <0.001 was considered as statistically extremely significant.Results:Mean age of the study group was 37.31±15.63 years. 54 patients (40.30%) were in 20to 40 years of age group. We found, 48 (35.82%) pulmonary tuberculosis patients had sick euthyroid syndrome out of 134 pulmonary tuberculosis patients. Conclusions: Sick euthyroid syndrome occurs commonly in pulmonary tuberculosis patients with increasing incidence with advanced age, and also seen in patients with advanced pulmonary tuberculosis patients; therefore, requires monitoring of thyroid functiontest for its timely initiation of therapy.
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Background: Cardiovascular diseases (CVDs) have nowbecome the leading cause of mortality in India. Acute coronarysyndrome (ACS) describes the range of myocardial ischemicstates that includes unstable angina, non-ST elevatedmyocardial infarction (MI), or ST-elevated MI. Hence; thepresent study was undertaken for assessing the prevalence ofsubclinical hypothyroidism of patients with acute coronarysyndrome.Materials & Methods: A total of 50 patients who wereadmitted due to acute coronary syndrome were enrolled in thepresent study. Blood samples were obtained and were sent tofor assessment of thyroid profile. Complete haematological andbiochemical profile of all the patients was also obtained. Forserum thyroid hormone profile was measured by Enzymelinked immunosorbent assay (ELISA) technique.Results: Subclinical hypothyroidism was found to be present in5 patients (10 percent of the patients). Non-significant resultswere obtained while correlating the presence of subclinicalhypothyroidism with age and gender-wise distribution ofpatients.Conclusion: Thyroid profile is altered significantly in patientswith acute coronary syndrome.
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Background: Hypothyroidism reflects decreased thyroid function and is one of the most common conditions seen in clinical practice. Practice of naturopathy and yoga has shown improvement in anthropometric variables and lipid profile in obesity and other chronic diseases. So, the aim of this study was to find out the effect of naturopathy and yoga in obese hypothyroid patients.Methods: A total of 60 subjects, of which 29 males (age 44.2±7.0 years) and 31 females (age 40.6±7.4 years) with body mass index (BMI), ?30 were randomly assigned to case group (n=30) and wait list control group (n=30). The subjects of case group underwent naturopathy and yoga intervention for 10 days. Anthropometric variables, viz., body weight, BMI, waist circumference (WC) and hip circumference, serum lipid profile, and serum thyroid profile were assessed at 1st day (pre), at the end of 10 day (post).Results: The result showed a significant reduction in body weight, BMI, WC, total cholesterol, low density lipoprotein-cholesterol (LDL-C) and thyroid stimulating hormone (TSH) along with significant improvement in high density lipoprotein-cholesterol (HDL-C) in case group compared with control group in independent samples t test. Significant reduction in body weight, BMI, total cholesterol, LDL-C and TSH were observed in case group unlike in control group in student's paired t test.Conclusions: Reduction in the body weight, BMI and improvement in serum lipid profile and serum thyroid profile in case group subjects compared to control group suggest that naturopathy and yoga have therapeutic and protective effects in the management of obese hypothyroid patients.
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Antiepilectic drug is the main stay of treatment for most patients with epilepsy. These may cause Patients with epilepsy are often required to take antiepileptic drugs (AEDs) for a long period of time. However, prolonged use of AEDs is known to be associated with adverse effects such as metabolic and organ toxicity, endocrine disturbance, negative cognitive effects, and psychiatric problems; particularly with alterations in thyroid function in patients with epilepsy and is thought to correlate with type of AED taken. Objective: To study the effect of antiepileptic drugs on serum thyroid profile in epileptic patients and to compare the relationship of change with type of drug intake. Study Design: A Case Control Prospective Study. Methods: A total number of 80 subjects presenting with epilepsy in the OPD of Medicine of Guru Nanak Dev Hospital, attached to Government Medical College Amritsar, were selected. 40 epileptic patients taking Antiepileptic Drugs for a minimum period of 1 year constituted case group and 40 normal healthy individuals constituted control group. They were again divided according to type of drug intake. Results: AEDs causes significant increase in TSH levels and this increase is further related to type of drug intake. Conclusion: ?
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Thyroid hormones are required for normal development as well as regulating metabolism in the adult. Thyroid gland disorders are the second most abundant endocrinal disorders after diabetes. A decreased thyroid hormone adversely affects erythropoietic system causes anaemia. Aim: The Aim and objective of the study was to compare the vitamin B12, Folate and Ferritin with thyroid hormones in hypothyroidism. Methods: In the present study, total 350 samples were included in which 175 were hypothyroid patients and 175 were normal individuals of age group between 15-65 years. Measurements of serum concentrations of Total T3, Total T4, TSH, Vitamin B12, Folate and Ferritin were done using Chemiluminiscence Immunosorbant Assay. Results: Serum TSH levels were significantly increased in Hypothyroidism as compared to normal individual (7.42±1.75 vs 2.72±1.28, p<0.0001*). The total T3 level was significantly decreased in Hypothyroidism in comparison to normal individual (0.43±0.41 vs 1.30±0.29, p<0.0001*). Similarly, total T4 level was significantly decrease in Hypothyroidism in comparison to normal individual (3.60±1.38 vs. 6.62±1.11, p<0.0001*). Level of Vitamin B12 was significantly decreased in Hypothyroidism in comparison to normal individual (210.45±129.30 vs 483.93±264.74, p<0.0001*). Folate was significantly decreased in Hypothyroidism as compared to normal (2.51±0.99 vs 6.67±0.83, p<0.0001*). Ferritin was also observed significantly decreased in Hypothyroidism in comparison to normal (23.08±1.18 vs 63.43±3.30, p<0.0001*). TSH was observed significantly correlated with Folate (r=0.187* p=0.013). Conclusion: The Lower values of above these parameters in hypothyroidism interpret that thyroid hormones are metabolic hormones and produce impact on our metabolic and hormonal balance in which hemopoetic system is highly effected.
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Background: In Indian societies womanhood is defined through motherhood and infertile women usually carry the blame for the couple’s inability to conceive. In many cases, the childless woman is made to feel inferior and may be abused or even tortured by the family. In India estimated infertility to be in the range of 4–6 %.Among all causes of female infertility, ovulatory dysfunction due to endocrinal abnormalities like, thyroid dysfunction and hyperprolactinemia are most common and most reversible (treatable) cause. Method: Hospital based study of thyroid dysfunction and prolactin level in infertile women a case control study. Hundred consecutive infertile women from Infertility clinic of OBGY department was enrolled and equal number of fertile women of reproductive age group, controls were taken from OBGY OPD. Result: Thyroid dysfunction (OR = 4.85, 95% CI = 2.39 – 9.81, P = 0.0001), Hyperprolactinemia (OR = 4.25, 95% CI = 1.82 – 9.92, P = 0.0004), Menstrual abnormalities (OR = 4.13, 95% CI = 2.12 – 8.02, P = 0.0001) were significantly associated with infertility. Difference between mean TSH values and mean prolactin level in cases and controls were found to be highly significant (p=0.0001). Conclusion:Thyroid dysfunction, hyperprolactinemia and menstrual abnormalitieswere significantly higher in infertile women as compared to the fertile women.There was weak positive correlation between hypothyroidism and hyperprolactinemia in infertile women.Routine screening of infertile women will facilitate early diagnosis and treatment of these two disorders which will certainly help in restoring fertility in these women.
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Introduction: Hypothyroidism is due to decreased circulating levels of Thyroid hormones and is caused by inade-quate functioning of thyroid gland. Pseudocholinesterase (PCHE) is a nonspecific cholinesterase enzyme that hydro-lyses choline based esters in plasma. The purpose of this study was to evaluate the serum level of PCHE in hypothy-roid patients. Methodology:The present study was conducted on 100 newly diagnosed hypothyroid patients attend-ing the Medical OPD. The results of patients were compared with 100 healthy controls of either sex of similar age group. Anthropometric measurements, T3, T4, TSH, PCHE & Cholesterol estimations were performed. Results:The mean serum PCHE (decrease) level was observed statistically highly significant (p<0.001) in hypothyroid patients as compared with healthy control subjects. A highly significant positive correlation between PCHE with T3 & T4 (p< 0.001) in hypothyroid cases. Conclusion:Serum Pseudocholinesterase may be helpful as biomarker in screening test for hypothyroidism along with thyroid stimulating hormone.
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Background: Today, globally up to 6–12% of the adult population suffered mental disorder and recurrent depression. The prevalence of depression in India was reported as 4.5% by WHO. Currently the diagnosis of major depression is carried out through symptom-based assessment process, which has limitation of the development of personalised treatment plans. Objective: To determine the association between various biochemical markers of the inflammation, lipid profile, BMI, thyroid profile and depression among the patients attending department of psychiatry in a tertiary care centre. Methods: A cross-sectional study conducted among 50 patients attending the psychiatry department at S.N. Medical college, Agra and diagnosed as Depression disorder, during April 2012 to December 2012. Hamilton rating scale (HAM-D) was used to assess the severity of depression. The patients were also assessed for their vitals, lipid profile, thyroid profile, ESR, CRP and BMI. Results: 19 (38%) study subjects were in the age group of 18yrs to 30 yrs with mean age as 34.2 ±14.57 years. 36(72%) were of normal weight or under-weight and14 (28%) were pre-obese. Among 14 pre-obese and obese study subjects, 2(15.4%) had mild, 4(18.2%) had moderate and 8(53.3%) had severe type of depression(p=0.03). ESR is more in severe depression as compared to mild and moderate depression. (p=<0.001%). C-reactive protein is statistically more in severe depression (T =2.25; P= < 0.001). Conclusions: There is a positive and significant relationship between the severity of depression and ESR, CRP and BMI among the patients attending department of psychiatry.
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Background: Association of hypothyroidism and cardiovascular diseases are important in development of Atherosclerosis. Hypothyroidism and sub clinical hypothyroidism reported highly risk factors due to lipid levels dearranged. Present study to demonstre of correlation of hypothyroidism and cardiovascular disease.Methods: The present study has carried out in the department of medicine and Biochemistry SRG Hospital and associated hospital, Jhalawar Medical College Jhalawar (Raj.) Total 100 Hypothyroidism cases and 100 euthyroidism subject were included in the study Information regarding clinical history were recorded in self Constructed present questionnaires Patients were examined and estimated TSH, T3, T4 total Cholesterol, LDLc, HDCc, TG data were analyzed by SPPS version 20.0.Results: Present study demonstrated increased levels of total cholesterol, LDH, VLDLC and TG and decreased level of HDLC and increased TSH level and decreased T3 and T4 Level in hypothyroidism cases when compared with euthyroid cases It was found significant.Conclusions: In present study hypothyroidism and hormone Level (TSH, T3, T4) and lipid level dearranged values are associated with development cardiovascular disease atherosclerosis.
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Background: Vitiligo is a common disorder causing depigmentation of the skin affecting patient’s quality of life. Various autoimmune disorders accompany vitiligo; this study was done to determine the prevalence of thyroid abnormality in children with vitiligo and compared with controls in this part of India. Materials and methods: Forty five children, suffering from non-segmental vitiligo, less than 16 years old and 60 healthy children were enrolled as cases and controls, respectively. Serum levels of Thyroid stimulating hormone (TSH), Free triodothyronine (fT3), Free thyroxine (fT4) and Anti-TPO antibody were accessed and compared with controls. Results: In both the groups, females outnumbered males. Thyroid function tests and thyroid autoantibodies abnormality were found in 15 (33.3%) cases. In controls, 8 (13.33%) children had increased TSH. The difference in both groups for thyroid function abnormality was significant (P= 0.0142). Conclusion: There is significant incidence of thyroid disease in children with vitiligo and hence they should be screened for thyroid function tests.
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Introduction: Diffuse hair loss is a very common problem in women. The condition has several causes. Anything that interrupts the normal hair cycle can trigger diffuse hair loss. Various studies have shown reduced levels of haemoglobin, serum ferritin, biotin, and thyroid abnormalities to be triggering factors for diffuse hair loss. Supplements of biotin and iron are commonly used in the management of diffuse hair loss in females. However contradictory observational data have so far failed to establish a conclusive evidence about the serum levels of biotin and ferritin. Materials and Methods: This study has been planned to evaluate the role of hemoglobin, thyroid hormones, serum levels of Biotin and Ferritin in female patients with diffuse hair loss of different types. 80 female patients presenting with diffuse hair loss were included in the study after considering the inclusion and exclusion criteria. Ethical clearance was taken from the institutional ethics committee before starting the study. Serum ferritin and serum biotin were estimated using ELISA method. Haemoglobin was estimated using an auto analyzer. Thyroid function test were evaluated using chemiluminiscence method. Results: Reduced haemoglobin was seen in 35 patients. However serum ferritin was reduced in only one patient. Hypothyroidism was detected in 8 patients. Serum biotin was normal in all the patients. However serum biotin was towards the lower limit of normal in many patients. Conclusion: From findings of our study, association of serum ferritin with hair loss is not conclusive and also the role of biotin in hair loss has to be evaluated with further larger studies.
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Background: In India, thyroid disorders are the most common among all the endocrine disorders and hypothyroidism being more common than hyperthyroid state and carcinoma. Bandi A, Pyadala N, Srivani N, Borugadda R, Maity SN, Ravi Kumar BN, Polavarapu R. A comparative assessment of thyroid hormones and lipid profile among hypothyroid patients: A hospital based case control study. IAIM, 2016; 3(9): 108- 114. Page 109 Objectives: The present study was undertaken to assess the association of dyslipidemia in hypothyroid patients. Materials and methods: A total of 50 study subjects of both gender groups were selected from the medicine ward of Maheshwara Hospital during the period from January 2016 to April 2016. Fasting venous blood sample were analysed for Thyroid hormones like, T3, T4, TSH and lipid profile. Statistical analysis was done using student unpaired t test. Result: The thyroid stimulating hormone (TSH) and total cholesterol, LDL, VLDL values were significantly higher, whereas T3, T4 and HDL values were in a decreasing order with that of control group. Conclusion: The present study concludes that hypothyroidism is associated with dyslipidemia having raise in all lipid parameters, which may increase the risk of cardiovascular diseases. Finally regular assessment of thyroid hormones and lipid profile among hypothyroid patients can prevent progression of the disease to severity
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Background: Thyroid disease is a disorder that affects the thyroid gland. Sometimes the body produces too much or too little thyroid hormone. Thyroid hormones regulate metabolism - the way the body uses energy and affect nearly every organ in the body. Thyroid hormone plays a critical role during pregnancy both in the development of a baby and in maintaining the health of the mother. Aim and objectives: To evaluate the thyroid status in pregnancy in light of controversial data and to project our values and ideas. Materials and methods: The present case control study was conducted on 100 patients (obstetric cases) attended and managed in the Department of Obstetrics and Gynecology attached to Geetanjali Medical College and Hospital, Udaipur. The results of the patients were compared with 100 age matched control females having gynecological problems (with normal thyroid values). Fasting blood sample was investigated for the following parameters: T3 (Triiodothyronine), T4 (Thyroxine), TSH (Thyroid Stimulating Hormone). p-value was calculated by using online student t-test calculator. Result: All the cases of the control group had normal T3 values. Values below normal were noted in one case each of I and III trimester and normal values were noted in 80.27 per cent in I trimester, 54.75 per cent in II and 55.28 per cent in the III trimester. Only 18.30 per cent cases of I trimester had raised values of T3 while same was observed in 44.03 per cent in II and 43.51 per cent in III trimester. Variable values of T4 were observed in various trimesters of pregnancy. Values of T4 were below normal in 2.81 per cent in I, 1.20 per cent in II and 1.14 per cent in the III trimester. On the other hand in II and III trimester T4 values were higher than normal in 6.02 per cent and 40.22 per cent respectively. TSH value below normal (0.27μIU/dl) were observed in 2 cases in I and II trimester each while normal values were noted in most of the cases i.e. 77.45 per cent in I, 71.41 per cent in II and 83.31per cent in III trimester. Fluctuating values of TSH above 4.2 μIU/dl were observed in 19.71per cent in I, 26.18per cent in II and 16.66 per cent in the III trimester. Conclusion: T3 values increased during pregnancy significantly more so in II trimester. T4 values were less during I trimester particularly at par during II trimester and increased during III trimester. Nepalia R, Lal RZ. Study of thyroid profile during pregnancy. IAIM, 2016; 3(4): 97-104. Page 98 Raised TSH values were observed during pregnancy as compared to non-pregnant women. Significant increase was observed during II trimester.
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Mesolimbic areas such as nucleus accumbens, amygdala and septal nuclei are known to influence food intake and body weight. However, the reports on gender difference in the neural regulation of obesity and energy homeostasis are incomplete. Therefore, the present study was conducted to assess the effect of lesions of nucleus septal medialis (NSM) and the gender difference of lesion on food intake (FI), body weight (BW), serum lipid profile, thyroid profile, glucose and insulin levels and glucoseinsulin ratio (GIR) in Wistar albino rats. Twenty-four rats were divided equally into control and experimental groups having 6 male and 6 female rats in each group. In the experimental group, bilateral electrolytic lesion of NSM was performed by stereotaxy and post-lesion parameters were recorded. In the control group, sham-lesions of NSM were produced. Following lesion, blood glucose and serum insulin levels were decreased and GIR was increased significantly in female rats, but not in male rats. It was concluded that NSM is involved in energy homeostasis, especially in female rats.
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Various brain areas like the ventromedial hypothalamus (VMH) are known to influence food intake and body weight. Though obesity is more common in females, the reports on gender difference in the neural regulation of energy homeostasis are not adequate. Therefore, the present study was conducted to assess the gender difference in the effect of VMH lesion on food intake (FI), body weight (BW), serum lipid profile, thyroid profile, glucose and insulin levels and glucose-insulin ratio (GIR) in Wistar albino rats. Twenty-four Wistar albino rats were divided equally into control and experimental groups with 6 male and 6 female rats in each. In the experimental group, bilateral electrolytic lesion of VMH was performed by stereotaxy and post-lesion parameters were recorded. In the control group, VMH sham lesion was made. Male-female difference in each parameter was determined. Following VMH lesion, FI was increased (females, P<0.01) and BW (males, P<0.05) and GIR decreased in males (P<0.001), which was significantly correlated with BW. T3 was more significantly correlated with FI and BW in females (P<0.000 and P<0.001). Following VMH lesion, male rats exhibited significant weight gain in the absence of proportionate hyperphagia indicating that weight-gain was mainly metabolic in nature. Also, the male rats developed more susceptibility to insulin resistance. The female rats developed resistance to weight-gain inspite of hyperphagia, which could be due to the higher T3 level.