A study of gonadal dysfunction in women with thyroid disease

Background:Thyroid diseases are among the commonest endocrine disorders. It effects growth, embryonic development, tissue differentiation, maturation, metabolism, increases chronotropic and inotropic action of heart. The aim was to study gonadal dysfunction in womenwith thyroid disease; to study levels of FSH, LH, prolactin, estrogen and testosterone in hypothyroid and hyperthyroid.Methods:All participants fulfilling the inclusion criteria were interviewed as per proforma and medical details were recorded in proforma sheet and patients were subjected to necessary blood investigations.Results:Among 80 study subjects, majority were in the age group 26-35 years (60.1%) and majority had overt hypothyroid disease (72.5%). Symptoms of hypothyroid subjects mainly were fatigue, weight gain, hair loss, oligomenorrhea. Hyperthyroid subjects had fatigue, palpitations, oligomenorrhea, polymenorrhea. Prolactin had positive correlation with TSH in hypothyroid subjects, their LH, FSH levels were normal and sex steroid levels were low. In contrary, majority of the hyperthyroid subjects had normal prolactin and FSH, high LH and high sex steroid levels.Conclusions:The study demonstrated that thyroid disease in women causes menstrual abnormalities due to altered gonadotropinpatterns which in turn alter ovarian hormone pattern. Hypothyroidism is associated with hyperprolactinemia leading to anovulation and abnormal menstrual cycle. Hyperthyroidism is associated with increased levels of LH, estrogen and testosterone with normal levels of PRL and FSH. Screening, identifying and correcting thyroid disease should be undertaken to prevent infertility as early as possible.

Echocardiographic Evaluation of Patients with Goiter in a Nigerian Tertiary Hospital

Background: Goiter is endemic in iodine deficient areas of the world including Nigeria. Cardiovascular disorder is a cause of morbidity in patients with thyroid diseases. These cardiovascular disorders are more likely to be found in patients with hypothyroid or hyperthyroid goiter. Large euthyroid goiter can potentially compromise respiration with potentials for secondary cardiac changes. Despite these, echocardiography is not a routine assessment of these patients. This study set out to determine the baseline cardiac function in a cohort of patients with endemic goiter using echocardiography. Materials and Methods: A comparative study of One hundred goiter patients presenting consecutively at the out-patient clinic of a tertiary hospital and 50 age and gender matched healthy non-goitrous control subjects. They all had thyroid function tests, cardiovascular evaluation and echocardiography done. Results: The mean ages of the goiter and the control groups were 46.92 + 13.85 and 46.58 + 11.62 years respectively (P=0.8510). The goiter population comprised 12 males and 88 females while the control group had 6 males and 44 females. 47% of the goiter subjects were hyperthyroid, while 44% and 9% were euthyroid and hypothyroid respectively. All the control subjects were euthyroid. Systolic and diastolic dysfunction were seen in 18% and 24% of the goiter group respectively, compared to 2% and 5% of the control group (P<0.0001). Hyperthyroid and hypothyroid subgroups had higher rates of both systolic and diastolic dysfunction. Systolic dysfunction was seen in 6.4%, 4.5% and 100% of the hyperthyroid, euthyroid and hypothyroid subgroups respectively while diastolic dysfunction was seen in 23.4%, 9.2 and 100% of the subgroups. Prevalence of systolic and diastolic dysfunction in the euthyroid and control subjects were 4.5% vs 2% (P=0.1228) and 9.2% vs 5% (P=0.2018). Conclusion: This study concluded that cardiac dysfunction is common in both hypothyroid and hyperthyroid goiter population while the prevalence of cardiac dysfunction in the euthyroid population is not influenced by the presence of goiter. This may suggest that routine echocardiography is unnecessary in patient with euthyroid goiter

Study of left atrial volume and function by real-time three-dimensional echocardiography between hyperthyroidism and hyperthyroid heart disease / 中华超声影像学杂志

Objective:To explore the application value of real-time three-dimensional echocardiography (RT-3DE) in evaluating the characteristics and regularities of left atrial volume and function changes in patients with hyperthyroidism and hyperthyroid heart disease.Methods:Fifty-six patients who were diagnosed with hyperthyroidism and hyperthyroid heart disease without treatments in Henan Provincial People′s Hospital from March 2020 to September 2020 were selected. They were divided into hyperthyroidism group(30 patients) and hyperthyroid heart disease group (26 patients). Another 30 healthy volunteers were selected as the control group. The following parameters were obtained by RT-3DE left atrial automatic quantification technology, left atrial minimum, maximum, presystolic volume index(LAVImin, LAVImax, LAVIpreA), left atrial passive, active emptying volume index and stroke volume index (LAVIp, LAVIa, LAVIEV), left atrial passive, active, total ejection fraction(LApEF, LAaEF, LAEF), during left ventricular systole, early diastole, late diastole left atrial longitudinal strain (LASr, LAScd, LASct) and circumferential strain (LASr-c, LAScd-c, LASct-c). The differences of the above parameters between the two groups were compared.Results:Compared with the control group, LAVImax, LAVIpreA, LAaEF, LAVIEV, LAVIa, LASr, LASct-c increased and LApEF decreased in the hyperthyroidism group (all P<0.05). While, LAVImin, LAVImax, LAVIpreA and LAVIEV increased, and LAaEF, LApEF, LAEF, LASct, LAScd-c and LASr-c decreased in hyperthyroid heart disease group(all P<0.05). Compared with the hyperthyroidism group, LAVImin, LAVImax and LAVIpreA in hyperthyroid heart disease group were further increased, while LAEF, LAaEF, LASr, LASr-c, LASct, LASct-c and LAScd-c were decreased (all P<0.05). LAEF were positively correlated with LASr and LASr-c ( r=0.617, 0.837; all P<0.01), LApEF were positively correlated with LAScd and LAScd-c ( r=0.620, 0.800, all P<0.01), LAaEF were positively correlated with LASct and LASct-c ( r=0.680, 0.727; all P<0.01). Conclusions:In the patients with hyperthyroidism, the left atrial reserve and systolic function are increased, which are still in the compensation stage, and the pipeline function is decreased. The left atrial reserve, pipeline and systolic function in the hyperthyroid heart disease patients are all decreased, and the pipeline function may be impaired earlier than the systolic and reserve function.

Thyroid profile in pulmonary tuberculosis patients: a prospective study in a tertiary medical college of southern Odisha

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.

Circadian Rhythm of Oral Temperature in Adult Hyperthyroids, Sudan

Introduction: A 24 hours long cyclic change in body temperature, ie. body temperature circadian rhythm is used as a marker of other body circadian rhythms.Objectives:To determine circadian rhythm in oral temperature of adult hyperthyroidsat Nyala and Alfashir-western cities, Sudan.Study Design:A descriptive cross-sectional of stratified random sampling.Place and Duration of Study:Department of Physiology, Faculty of Medicine, Gezira University, Wadmadani, Sudan, from December 2006 to March 2007.Methodology: A sample of thirty clinically diagnosed thyrotoxic cases (females = 29, and a male) of age ranging from 18 to 50 years, attended to Sudanese atomic energy corporation (SAEC) for receiving positively confirmed laboratory tests were enrolled to conduct this study. Early morning and late evening oral temperatures were recorded by the mercury-in-glass thermometer. A questionnaire was used to exclude any other fever conditions. Thyroid hormones, ie. T3, T4, and TSH levels were measured by radioimmunoassay (RIA) at SAEC of Nyala with reference ranges 0.4 -4.4 mIU/L, 0.69 -2.02 nmol/L, and 50 -150 nmol/L for TSH, T3, and T4 respectively. Subjects of T3and T4 values above reference ranges with TSH below reference were considered hyperthyroid. The obtained data were analyzed statistically by the statistical package for the social science programme (SPSS), ie. T-test.Results:Mean oral temperature and circadian rhythm were found to be 37.25 ± 0.34ºC and 0.43 ± 0.30ºC respectively. The effect of sex on mean oral temperature was statistically significant (p = 0.01), whereas age did not show any statistical effect (p = 0.36).Conclusion:The decreased oral temperature circadian rhythm of thyrotoxic patients, confirms that other body functions also abnormallyaffected when body temperature circadian rhythmis abnormal

Evaluation of thyroid disorders in abnormal uterine bleeding

Background: Abnormal uterine bleeding (AUB) is a common clinical presentation in gynecology. Alteration in thyroid hormones level has been associated with menstrual disturbances. This study is aimed to know the prevalence of thyroid disorders amongst AUB patients and also the different patterns of menstrual abnormalities associated with thyroid disorders.Methods: 100 Patient of clinically diagnosed AUB were taken from gynecology OPD at RNT Medical College Udaipur from October 2019 to March 2019. All the patients from 19 to 45 age groups presenting with menstrual disturbances were tested for thyroid function by measuring ST3, ST4, and S.TSH. Statistical analysis done by percentage formula.Results: Out of 100 women of AUB, majority were in the age group of 31-40 years (38%). 44% presented with menorrhagia. 65% were euthyroid, 17% had subclinical hypothyroidism, 15% had overt hypothyroidism and 3% were diagnosed as hyperthyroid. Subclinical hypothyroidism, overt hypothyroidism and hyperthyroidism were detected mostly in the age group of 31-40 years. The commonest bleeding abnormalities in hypothyroid patient were oligomenorrhoea while most of the hyperthyroid cases were having menorrhagia.Conclusions: The study concludes that biochemical evaluation of thyroid function is an easy, reliable method and should be made mandatory in all cases of AUB.

An Evaluation of SGOT among the Patient which Suffered from Thyroid Disorders

Alkaline phosphatase, ALP is found in all tissue of the body.(4) The enzyme responsible for extracellular catabolism of glutathione’s is Gamma glutamyltransferase, GGT]. It is the main thiol intracellular antioxidant agent. The larger function of enzyme is to transport amino acid and peptide into the cell across the cell membrane in the form of gamma glutamyl peptidase. The only iodine containing amine hormones in the vertebrate are Triiodothyronine (T3) and thyroxine (T4). Methods: All samples were taken from hypothyroid, hyperthyroid and euthyroid subjects who fasted for at least 8 hours before the blood collection.Serum separated and analyzed for T3, T4, TSH, CK-NAC, CK-MB, LDH and AST(SGOT) . The sample was processed in standardized manner under set protocol in the Department of Biochemistry. Results: Among the total of 300 subjects of ages 25 -50 years of both sexes were included in the study, 100 were hypothyroid, 100 were hyperthyroid and 100 were euthyroid. Their serum levels of T3, T4 and TSH were estimated and confirmed. Conclusion: The present study might be beneficial in public health and clinical practice, as both thyroid disorders and cardiovascular diseases are important issue of concern to reduce the morbidity and mortality.

Effects of thyroid hormones on cardiac function in mice by inducing expression of B-cell activating factor in cardiomyocytes / 医学研究生学报

Objective　High levels of triiodothyronine (T3) can lead to hyperthyroid heart disease, but its mechanism is unclear. This study aims to investigate the effects of T3 on the expression of B-cell activating factor (BAFF) in cardiomyocytes and to explore its possible role in the pathogenesis of hyperthyroid heart disease.　Methods　Sixty healthy C57BL/6J mice were selected and randomly divided into two groups: the experimental group and the control group. The experimental group received intraperitoneal injection of T3 at 5 μg/ml, one time/d, for 42 consecutive days. The concentrations of serum T3 and tetraiodothyronine (T4) were detected by radioimmunoassay; ELISA was used to determine BAFF expression in peripheral blood, and the cardiac index and the transverse diameter of myocardial cells in each group were determined. Immunohistochemistry and Western blot were used to detect the expression of BAFF protein in myocardium and of myocardial tumor necrosis factor-α (TNF-α) protein; the expression of BAFF mRNA in myocardium was detected by Real-Time PCR; flow cytometry (FCM) was used to detect changes in the proportion of B-cells in the heart.　Results　Compared with the control group, the serum T3 concentration, cardiac index, BAFF and myocardial cell transverse diameter of the experimental group significantly increased (P<0.05), and the T4 concentration decreased (P<0.05). Under the light microscope, the cardiomyocytes of the control group were normal, while those of the experimental group were hypertrophied and disordered in structure. Compared with the control group (0.765±0.164), BAFF protein expression significantly increased in the experimental group (1.865±0.290) (P<0.05). Compared with the control group (0.537±0.089), the expression of TNF-α protein significantly increased in the experimental group (0.737±0.065) (P<0.05). Correlation analysis of T3 with BAFF gene expression in cardiomyocytes and BAFF level in peripheral blood showed that T3 was positively correlated with both the former with a correlation coefficient of 0.637 (P<0.01) and the latter with 0.778 (P<0.01). For FCM, compared with the control group [(12.40±1.09)%], the proportion of myocardial B-cells increased in the experimental group [(16.12±0.631)%] (P<0.05).　Conclusion　High concentration of T3 can promote the expression of BAFF in myocardial cells and lead to the activation of B-cells, thus increasing the inflammatory response and leading to myocardial hypertrophy.

Effects of thyroid hormone on myocardial T-type calcium channels at mRNA and protein levels in rats / 中国病理生理杂志

AIM:To observe the effect of thyroxine on the expression of T-type calcium channels Cav3. 1, Cav3. 2 and Cav3. 3 in rat myocardium, and to explore the possible biological mechanism between the changes of the ex-pression of T-type calcium channels and the arrhythmia in hyperthyroid heart disease. METHODS:Healthy SD rats (n=20) were randomly divided into normal control group (n=10) and hyperthyroid heart disease group (n=10). The animal model was established by intraperitoneal injection of levothyroxine for 35 d. The contents of T3 and T4 in serum, the heart-to-body weight ratio, the diameter of cardiac myocytes and electrocardiograph were measured to evaluate hyperthyroid heart disease. Moreover, the mRNA and protein expression levels of T-type calcium channels in the myocardium were measured by RT-PCR, immunohistochemistry and Western blot. RESULTS:After intraperitoneal injection of levothyroxine for 35 d, compared with the normal control group, the serum contents of T3 and T4, the heart-to-body weight ratio and the diameter of cardiac myocytes were significantly increased in hyperthyroid heart disease group (P<0.05), and arrhythmia occurred in hyperthyroid heart disease group. By immunohistochemistry and Western blot, the protein expression of Cav3. 1 in-creased significantly (P<0.05), while the protein expression of Cav3.2 decreased significantly (P<0.01). However, no change of the Cav3. 3 protein was observed. The results of RT-PCR were the same as immunohistochemistry and Western blot. CONCLUSION:Thyroxine promotes the expression of Cav3. 1 in the myocardium but inhibits the expression of Cav3. 2 at mRNA and protein levels, which might be involved in arrhythmia in hyperthyroid heart disease.

The protective effect of shenmaisanjie capsule combined with methimazole on L-thyroxine-induced hyper-thyroid hepatic damage in rats / 实用医学杂志

Objective To explore the protective effects and mechanism of shenmaisanjie capsule(SMSJC) combined with methimazole on the L?thyroxine? induced hyperthyroid hepatic damage in rats. Methods so rats were divided into 5 groups randomly as normal group,model group,SMSJC group(0.48 g/kg),methimazole group (12 mg/kg)and combination group. With the exception of the normal group ,all rats were administered L?thyroxine (800 μg/kg ,ig) daily for 6 weeks. Rats were sacrificed. Blood and liver samples were collected for detecting thyroid and liver function , histological analysis and hepatic activity of SOD , GSH?Px and MDA content. Results The levels of T3,T4,FT3,FT4,ALT,AST,ALP,TBIL in serum and hepatic MDA content declined significantly. Hepatic activity of SOD ,GSH?Px increased obviously. Liver morphologic changes improved in methimazole group and combination group,whereas no significant difference of serum FT3,FT4,TSH level and liver activities of SOD and GSH?Px was noticed in SMSJC group in comparison to model group. Compared with SMSJC or methimazole mono?therapy ,the effect of combination therapy was obvious. However ,serum TRAb level was not significantly different in five groups of rats. Conclusion SMSJC combined with methimazole plays a protective role on hyperthyroidism hepatic damage induced by L?thyroxine in rat. It is proposed that the effect is association with inhibiting hepatic oxidative stress.

Characteristics of hyperthyroid heart disease and radioiodine-131 treatment strategy / 实用医学杂志

Objective To discuss the clinical characteristics of hyperthyroid heart disease(HHD)and ex-plore the strategy to guarantee radioiodine-131 therapy(RAI)safety. Methods Clinical data and treatment regi-mens of 40 HHD patients admitted into our department from 2012-2016 were analyzed. Common complications as atrial fibrillation,heart failure,liver damage incidences and their characteristics were concluded. Curative effects of radioiodine-131 was evaluated. Results The incidence of atrial fibrillation(AF)was 45.0%. Heart failure (HF)of left ventricular ejection fraction(LVEF)was 80.0%.Severity of HF was accompanied with serum brain na-triuretic peptide(BNP)increase and LVEF decrease.Liver function was moderate-medium impaired(61.5%).De-gree of HF was positively correlated with direct bilirubinhe(R = 0.390,P = 0.012). The RAI one-dose cure rate for hyperthyroidism was 77.5%.ATD use before RAI has no effect on the cure rate. Four patients who can′t be treated with ATD deteriorated after RAI,two of them died because of seriously infection and HF,the other two re-covered with saturated solution of potassium iodide or lithium. Conclusion HHD treatment should be made fa-miliar. ATD before RAI treatment can avoid thyroid function impairment. If anti-thyroid medication can not be used on patients,glucocorticoids,saturated solution of potassium iodide or lithium can be applied according to the patients′conditions.

Correlation Analysis of Serum Thyroid Hormone NT-proBNP in Older Adults / 现代检验医学杂志

Objective To discuss the aged people N-terminal pro-B-type natriuretic peptide (NT-proBNP)changes in thyroid function disorder and its correlation.Methods With electrochemical luminescence analyzer,detected serum NT-proBNP lev-el 38 patients with hyperthyroid heart disease,68 patients with hyperthyroidism,31 patients with hypothyroidism,and 43 ca-ses of healthy controls.Compared each groupserum NT-proBNP level of older population with middle-aged people,and anal-ysied the correlation.Results The serum NT-proBNP level of Hyperthyroidism heart group,hyperthyroidism,hypothyroid-ism group and normal control group were 827.61±626.13,107.18±54.46,162.94±134.14,68.76±39.21 pg/ml,respec-tively.The serum level of HT-pro BNP.Hyperthyroidism group,hyperthyroidism,hypothyroidism group compared with nor-mal control group,there were statistically significan(t = 7.458,4.312,3.794,P = 0.000,0.000,0.001).Hyperthyroidism heart,hypothyroidism with hyperthyroidism group serum level of NT-proBNP comparison there was statistical significance(t=7.078,2.232;P = 0.000,0.032).Hyperthyroidism heartgroup,hypothyroidism group and normal control group older population was higher than the level of serum NT-proBNP middle-aged,difference was statistically significant (t=-3.216,-2.510,-2.653;P =0.007,0.016,0.014).Hyperthyroidism group of elderly serum NT-proBNP level higher than that of middle-aged people,but there was no statistically significant difference (t=-0.140,P =0.890).Multiple regression analy-sis in hyperthyroidism group serum levels of NT-proBNP and FT4 had positive correlation (r=0.224,P =0.033)and hypo-thyroidismgroup serum levels of NT-proBNP and T3 had negative correlation (r=-0.363,P =0.022).Conclusion Thy-roid dysfunction in elderly people for the level of serum NT-proBNP had significant influence.Auxiliary disgnosis and cura-tive effect observation of the serum level of NT-proBNP in people with different thyroid functional status has certain clinical value.

Clinical analysis of 40 cases with hyperthyroid heart disease / 中国综合临床

Objective To analyze the age of onset,duration and chnical characteristics of hyperthyroid heart disease and to investigate its pathogenesis,diagnosis and treatment.Methods Forty patients were selected as our subjects.The information of clinical symptoms,assistant examinations,diagnosis and treatment were collected.Results After comprehensive treatment,39 patients recovered and one patient died of complication pulmonary infection.Conclusion The key to hyperthyroid heart disease is early diagnosis and positive treatment and then reduce the morbidity and mortality of cardiovascular complications.

Clinicial analysis of 69 patients with acute hyperthyroid myopathy and its treatment / 中华内分泌代谢杂志

Sixty-nine cases of acute hyperthyroid myopathy admitted from 1990 to 2011 were retrospectively analyzed.Hoarseness was the most common symptom; 17.39％ of the patients had difficulty in breathing; respiratory muscle paralysis and aspiration pneumonia were the main causes of death.Efficient treatment lasting for two weeks was carried out in 81.16％ of the cases.Patients with severe bulbar palsy were often complicated with aspiration pneumonia and thus had high mortality rate.The main treatments in cluded anti-hyperthyroid drugs,corticosteroids,energy supports,and symptomatic management,which usually resulted in good clinical improvement.

Analysis of hyperthyroid heart disease by treatment with iodine-131 radioisotopes / 中国基层医药

Objective To analyze the effect of iodine-131I in the treatment of patients with hyperthyroid heart disease(HHD).Methods The clinical materials and therapeutic effect by 131 I were reviewed in 100 patients with HDD.Results The heal rate of hyperthyroidism and HHD were 82.3％,86.5％ in treatment group,and were higher than that of the control group (69.0％ and 76.2％ ) ( x2 =3.80,3.83,P ＜ 0.05 ) ; HHD with atrial fibrillation was 65.0％,average cardioversion after 131I treatment was 74.4％ after the treatment by 131I;The LVEDD、LVESD、LVEDV and HR after 131 I treatment were lower compared with before treatment ( all P ＜ 0.05 ),SV and EF were increased ( all P ＜ 0.01 ).Conclusion 131I treatment in patients with HHD,can significantly improve the efficacy of a heart disease

Efficacy and clinical effectiveness of steroid therapy of all body and local application on hyperthyroid Graves ophthalmopathy / 中国地方病学杂志

Objective To investigate the efficacy and clinical effectiveness of the steroid therapy with the all body and local application on hyperthyroid Graves ophthalmopathy.Methods A total of 57 patients (106 eyes)suffering from hyperthyroid Graves ophthalmopathy who hospitalized in the Department of Ophthalmology of the Second Affiliated Hospital of Harbin Medical University from Mar 2008 to Oct 2011 were enrolled in the study.Of the 57 patients,there were 21 males and 36 females,aged 18 to 57(average 37.28 ± 11.63).The clinical course was from 1 month to 5 years(average 29.63 ± 15.36 months).Based on the patient's age,sex and condition,the 57 patients were randomly divided into steroid pulse therapy with all body group(group SPT,29 patients,54 eyes)and peribulbar injection of long-term steraid group(group PI,28 patients,52 eyes).The patients in group SPT were treated with 0.5-l.0 g methylprednisolone by intravenous infusion daily for 3 days,and then stopped for 7 days,the treatment was repeated once.But the total application dose of methylprednisolone was not overruned 5.0-20.0 g.After that,the patients were treated with oral prednisone 40 mg/d.The dose of prednisone was reduced gradually to 5 mg/d.The total course of group SPT was 3 months.The patients in the group PI were treated with triamcinolone acetonide in periorbital injection of 20 mg once every two weeks for 3 months.After one month treated,all patients were visited.The patients' body weights of two groups were measured before the treatment and after one month treated.The ocular signs of the patients including visual acuity,diplopia,intraocular pressure,exophthalmos and horizontal visual palpebral fissure width were observed before and after the treatment.Results In the group SPT,the average body weight [(62.83 ± 7.23)kg]after the treatment was higher than that before the treatment[(57.03 ±7.13)kg],and also higher than that of the group PI[(59.89 ± 10.67)kg,t =25.25,2.08,all P＜ 0.05]after the treatment.In the group SPT,the average intraocular pressures before and after the treatment were (13.46 ± 1.78)and (13.69 ± 1.41)mm Hg(1 nm Hg =0.133 kPa),respectively.In the group PI,the average intraocular pressures before and after the treatment were (13.52 ± 2.19) and (13.77 ± 2.03)mm Hg,respectively.There was no significant differences before and after the treatment in both gr0ups(P＞ 0.05).In the group SPT and PI,the average exophthalmos after the treatment[(18.63 ± 2.22) and (14.85 ± 2.61)mm]were lower than those before the treatment[(20.78 ± 2.24) and (20.60 ± 2.81)mm,t =9.97,29.68,all P＜ 0.05],respectively.After the treatment,the average exophthalmos in the group PI was significantly lower than that of the group SPT(t =7.79,P＜ 0.05).In the groups SPT and PI,the average averagepalpebral fissure width after the treatment[(15.00 ± 1.80) and (11.65 ± 2.45)mm]were lower than those before the treatment[(17.22 ± 1.89) and (17.44 ± 2.37)mm,t =22.74,91.24,all P ＜ 0.05].After treatment of the group PI,the average exophthalmos was significantly lower than that of the group SPT(t =8.01,P ＜ 0.05).Conclusion Compared with the steroid pulse therapy with all body,the peribullbar application of long-term hormone for hyperthyroid Graves ophthalmopathy is more effective,with lcss side effects and worthy of promotion.

Relationship of Thyroid Hormones with Heart Rate Variability.

Background: Altered thyroid functions are associated with variation in autonomic regulation of cardiovascular activity. Cardiac Autonomic Nervous Activity (CANA) can be assessed quantitatively by analysis of Heart Rate Variability (HRV). Objective: To observe the relationship between CANA with altered TSH and FT4. Methods: This cross sectional study was carried out in the Department of Physiology, BSMMU, Dhaka between1st July 2007 and 30th June 2008 on 60 patients with excess thyroid hormone (group B, aged 30-50 years). Based on treatment, 30 untreated newly diagnosed patients were designated as group B1 and 30 patients under treatment with antithyroid drugs for at least 2 months were included into group B2 in order to observe the effect of treatment. All these patients were selected from the Out Patient Department of Endocrinology wing of Department of Medicine, BSMMU, Dhaka. Sociodemographically matched 20 apparently healthy euthyroid persons were selected for comparison (group A). To confirm thyroid status, serum TSH and serum FT4 levels were measured by AxSym system and some of the spectral HRV parameters i.e.mean R-R interval, mean heart rate, variance, LF n.u, HF n.u and LF/HF ratio were assessed by recordings of ECG for 5 minute (short term) with a polyrite. For statistical analysis Pearson’s correlation coefficient (r) test was used. Results: With serum TSH level, the LF n.u. power and LF/HF ratio showed significant (p<0.05) positive correlations but HF n.u. power showed significant (p<0.05) negative correlation in group B1. But these three parameters showed non significant correlations with TSH in the other two groups (A, B2). Similarly with serum TSH level, variance and mean R-R interval showed negative and mean HR showed positive correlation in group B1. In group A, all these parameters were positively correlated whereas in groupB2, RR interval and variance were positively and mean HR was negatively correlated. All these correlations were statistically non significant. With serum FT4 levels, mean R-R and HF n.u. were negatively and mean heart rate, LFnu, LF/HF were positively correlated in all three groups but variance showed positive in group A and negative correlation in B1 and B2. All these correlations were statistically non significant. Conclusion: From this study it can be concluded that changes in autonomic nervous regulation are related to altered serum level of TSH and FT4 in hyperthyroids.

The nursing and effect of radioactive iodum131 in treating hyperthyroid heart disease / 中国基层医药

Objective To explore the clinical value of radioactive iodum131 in treating hyperthyroidism.Methods 53 patients with hyperthyroid heart disease were treated with radioactive iodum131. The caring measure before and after the iodum131 treatment was introduced,including psychological and dietary caring,follow-up visit. Results After 12 months iodumted131 treatment, 39 cases were clinical healed ( healing rate 73.58% ), 10 cases (18. 87% )were remitted,4 cases (7. 55% )were inefficient, total effective rate was 92. 45%. Conclusion High quality caring has important clinical significance in safely and effectively developing iodum131 treating hyperthyroid.

Serum Creatine Kinase Activity in Thyroid Disorders

Thyroid function and creatine kinase activity was measured in 50 patients of thyroid disorders. The decreased serum levels of triiodothyronine (T3), thyroxine (T4) and increased level of Thyroid stimulating hormone (TSH) in hypothyroid patients is well established but whether there is any correlation of creatine kinase (CK) with hypothyroidism is not well established. Therefore, a study of serum CK and thyroid profile was carried out. In hypothyroid patients with decrease in serum T3, there is a significant increase in CK and findings were reversed in hyperthyroid patients. Serum creatine kinase levels thus, show an inverse relation with serum T3 and T4 levels.

In vitro Antibacterial Effect by Asi-antidiarrheal Capsule:An Experimental Study / 中华医院感染学杂志

OBJECTIVE To investigate the in vitro antibacterial effect of Asi-antidiarrheal capsule a Chinese herbal compound on hyperthyroid diarrhea.METHODS It was determined by drug dilution method in test tube to determine Asi-antidiarrhea capsule.The compound positive control drug was diphenoxylate co.We made in vitro antibacterial test with 8 kinds of bacteria respectively.RESULTS Asi-antidiarrhea capsule had powerfully bacteriostatic action on Shigella dysenteriae,Staphylococcus aureus and Streptococcus pneumoniae(MIC31.25 mg/L).But diphenoxylate co contrally was less effective on S.aureus,Str.pneumoniae,Str.pyogenes and Sh.dysenteriae(MIC 0.25 mg/L).CONCLUSIONS Asi-antidiarrhea capsule can be used to hyperthyroid diarrhea.Meanwhile,it has powerfully antibacterial effect.It provides evidence of pharmacodynamics for healing infectious diarrhea in the future.