Ptyrggium and tear film abnormalities

The purpose of this study was to assess state of the precorneal tear film in eyes with pterygium. Thirty patients with unilateral primary pterygium were enrolled. Schirmer's I, basic tear secretion, marginal tear strip and tear film break-up time tests were evaluated in both eyes of each patient. A conjunctival biopsy was taken from both eyes of 12 patients to evaluate goblet cell density. Values of Schirmer's I and basic tear secretion tests were not significantly different between the pterygium and control eyes. BUT, goblet cell density were significantly reduced, as well as abnormalities in the marginal tear strip were detected in eyes with pterygium. Accordingly, tear film dysfunction can be considered as a predisposing factor in the pathogenesis of pterygium

Reliability of individual thyroid function tests in the assessment of thyroid dysfunction

We studied commonly used thyroid function tests [T4, T3, TSH, FT4I, FT3I, by RIA] as regards their diagnostic value, namely sensitivity, specificity, efficiency and predictive value in the evaluation of various types of thyroid dysfunction. Subjects were subdivided into a control group [n=22] and 4 clinical groups based on preliminary clinical evaluation which used standard data work sheets both for hyper and hypothyroidism in the Egyptian group of study. The groups included a hyperthyroid [n=38], hypothyroid [n=33], euthyroid [n=18] and hypothyroid group on thyroxin replacement therapy [n=31] including both Egyptian and American patients. The predictive value model was applied for the evaluation of thyroid function tests. Sensitivity and efficiency of the studied thyroid parameters were found higher among the Egyptian group than the USA group emphasizing the importance of careful clinical assessment prior to ordering laboratory tests. The most appropriate one step and two step tests were [T3 and T4 + T3] for hyperthyroidism, TSH and TSH + T4 for hypothyroidism, T4 and TSH + T3 for euthyroidism and T4 and T4 + TSH to monitor hypothyroid patients under thyroxin placement therapy. Careful clinical assessment and proper laboratory ordering according to the previous findings, may save much time and cost and may add to the accuracy of laboratory diagnosis of thyroid function

Diagnostic value of thyroid function tests in the euthyroid sick syndrome

We studied thyroid function tests in a group of non thyroidal illnesses "Euthyroid Sick Syndrome ESS" to find any possible alterations as well as the test most reliable in unraveling the actual state of thyroid function under such conditions. Serum T4, T3, FT4I, FT3I and TSH uere measured in patients with insulin dependent diabetes IDD [10 and 11], chronic renal failure CFR [10 and 9], hematologic malignancy [12 and 15] in an Egyptian and American sample respectively. Seventeen Egyptian patients with hepatosplenic schistosomiasis [HSS] and 17 American patients withacute psychiatric illnesses were also studied. There was a tendency for T3 to decrease in all groups of study and T4 to increase in the group uith acute psychiatric illnesses. TSH used to be the most useful test in all groups of study to diagnose euthroidism. It is to be concluded that thyroid function test my be altered in non thyroidal illnesses. These changes however seem to be minimal and correlate with severity of the underlying illness. TSH is the least likely to change and is the best diagnostic test which reflects the actual euthyroid state in such cases