Prevalence of Depression Among Newly Detected Hypothyroid Patients Attending a Tertiary Care Hospital in Bangladesh

Background: Hypothyroidism is the most prevalent endocrine disorder worldwide. In patients with endocrine diseases, a high prevalence of mood disorders in general and particularly major depression (MD) has been commonly found, especially in thyroid diseases. Aim of the study: A descriptive, cross-sectional study was conducted from January 2021 to December to estimate the prevalence of depression among hypothyroid patients in Satkhira Medical College hospital a tertiary care hospital in Satkhira, Bangladesh. A total of 115 patients were included and analyzed in this study.Material & Methods:A cross-sectional study was conducted to estimate the prevalence of depression among hypothyroid patients in a tertiary care hospital in Bangladesh. Patients were screened for depression using the Patient Health Questionnaire-9 screening tool, obtaining their sociodemographic data, details of their thyroid function status, and other risk factors for depression. Also, used patient medical files were to get the laboratory results. Data were analyzed using the Statistical Package for the Social Science (SPSS) version 23. Continuous data were displayed using mean and standard deviation; categorical data were expressed in numbers and percentages. The Chi-square test was used to assess the relationship between the variables. A P value of less than 0.05 was considered statistically significant.Results:This is a descriptive cross-sectional study; 115 patients were enrolled and analyzed in this study. The mean age was 42.05 ± 11.49 years, ranging from a minimum of 23 years to a maximum of 72 years. The majority of patients were females (94.78% of patients were female and 83.9% of patients were male, respectively). Two-thirds of patients were married, 76(66.09%) and 64(55.65%) carried bachelor’s or diploma degrees, and only 8(6.96) % were illiterate. More than three quarters, 81(70.43%), were non-working [Table1]. Met a higher percentage of depressed patients among those who experienced stressful life events, with no statistically significant association [Table5].Conclusion: Depression was prevalent among hypothyroid patients, and screening for depression among hypothyroid patients is recommended.

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

Use of combination of Oral Levothyroxine and Liothyronine in severe Hypothyroidism with Massive Pericardial Effusion / Journal of the ASEAN Federation of Endocrine Societies

@#Thyroid hormone plays an important role in cardiovascular function. Pericardial effusions are commonly seen in cases of severe hypothyroidism. However, large to massive pericardial effusions with cardiac tamponade are exceptionally rare. Herein, we present two cases of severe hypothyroidism with massive pericardial effusion. Our first case demonstrates that a patient with large pericardial effusion can be managed conservatively with aggressive thyroid hormone replacement therapy. In our second case, pericardiocentesis was performed in addition to thyroid hormone replacement therapy as the underlying aetiology of effusion could not be reasonably limited to hypothyroidism. These two cases served to highlight and demonstrate rapid normalisation of thyroid function test by using aggressive oral thyroid hormone replacement therapy using liothyronine, in combination with levothyroxine, which led to resolution of pericardial effusion and prevent its re-accumulation.

Comparative Analysis of Serum Lipoprotein (a) in Hypothyroid and Healthy Subjects

This study is taken up to estimate and compare the level of serum Lp(a) in hypothyroid patients and in healthy controls. A total of 50 hypothyroidpatients within aged group 20-60 years and total of 50 healthy controls within 20-60 years were enrolled in the study after taking written consent. Thyroid profile and Lp(a) were measured by CLIA and immune turbidemetric method respectively. Data collected was analysed using Stata version 14.1 software. Result shows an increased level of Lp(a) among hypothyroid patients when compared to healthy controls

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.

Study of anemia in hypothyroid pregnant patients

Background: Hypothyroidism and anemia in pregnancy causes significantly high maternal and fetal morbidity and mortality. Aim of this study was to determine the prevalence of anemia, grade and type of anemia in hypothyroid pregnant patients.Methods: This prospective study was conducted at department of obstetrics and gynecology, CSSH, Meerut, Uttar Pradesh over a period of 2 years from August 2017 to August 2019. Patients who attended the OPD during the study period were included in the study according the inclusion criteria and were studied for the clinical profile, obstetric history and detailed examination. Investigations were done including hemoglobin, blood grouping, urine routine, HbsAg, Anti-HCV, HIV, RBS and serum TSH. The women with raised serum TSH, indicating hypothyroidism, test for free T3, free T4 and anti-TPO was done, and the hypothyroid females with anemia were further investigated with GBP for the type of anemia, data evaluated with adequate statistical analysis.Results: A total 223 patients, enrolled in the study, prevalence of anemia in hypothyroid patients was 69.95%. Most patients with overt hypothyroidism had mild anemia 26 (68.4%), while in sub-clinical hypothyroid patients’ group most of the patients had moderate anemia. In the overt hypothyroid and subclinical hypothyroid group dimorphic anemia was the most prevalent form of anemia with 52.6% and 74.6% respectively.Conclusions: Prevalence of anemia in hypothyroid pregnant patients is 69.95%. Dimorphic anemia is most prevalent; hence it is important to study anemia in antenatal patients with hypothyroidism and appropriate strategies should be used to prevent and treat anemia.

Effect of short-term naturopathy and yoga intervention on anthropometric variables, lipid profile and thyroid profile in obese hypothyroid patients: a randomised controlled trial

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.

Thyroid Profile of Patients with Non-alcoholic Fatty Liver Disease

Introduction: Non-alcoholic fatty liver disease (NAFLD) is associated with various metabolic abnormalities such as obesity, insulin resistance, and dyslipidemia. The prevalence of NAFLD is increasing gradually, which may progress to non-alcoholic steatohepatitis (NASH), cirrhosis of liver, and hepatocellular carcinoma. The important association of NAFLD and metabolic disease can lead to endocrinopathy, including thyroid diseases. Methodology: Serologically diagnosed NAFLD patient was evaluated biochemically for liver function and thyroid function to evaluate any association between these two. Results: The study shows female preponderance (63.3%) NAFLD. It was observed that 77.50% were having normal transaminase level and 22.50% had raised transaminase levels (NASH). Subclinical hypothyroidism was present among 18.30%, overt hypothyroidism was 7.50%, and hyperthyroidism was 0.80%. Among the individuals with normal transaminase level, 20.50% were hypothyroid (15.10% subclinical and 5.40% overt), and persons with raised transaminase levels (NASH), 44.44% were hypothyroid (29.63% subclinical and 14.81% overt). Conclusion: This study shows that though there was a female preponderance of NAFLD, raised transaminase was more common among male and so is the hypothyroidism. This may form a matrix to the future study for cause and effect relationship of NAFLD and thyroid disease

Congenital Hypothyroidism in children – A cross-sectional study in a tertiary centre in Malaysia / Journal of the ASEAN Federation of Endocrine Societies

Introduction@#The causes of congenital hypothyroidism (CHT) are thyroid dysgenesis (TD), dyshormonogenesis (TDH) or transient hypothyroidism (TH).@*Methodology@#This is a cross-sectional study looking at data over a period of 16 years (2000-2016). Confirmed cases had thyroid scan at the age of 3-years-old and repeated TFT (after 6 weeks off medications). Relevant data was collected retrospectively.@*Results@#Forty (60% female) children with CHT were included in the study. Thirty (75%) children presented with high cord TSH. Nine (23%) presented after 2 weeks of life. Majority were diagnosed with TDH (42.5%) with TD and TH of 40% and 17.5% respectively. Median cord TSH of children with TD was significantly higher compared to TDH and TH (p=0.028 and p=0.001 respectively). L-thyroxine doses were not significantly different between TD, TDH and TH at diagnosis or at 3 years.@*Conclusions@#TDH is highly prevalent in our population. TD may present after 2 weeks of life. One in five children treated for CHT had TH. Differentiating TD, TDH and TH before initiating treatment remains a challenge in Malaysia. This study provides clinicians practical information needed to understand the possible aetiologies from a patient’s clinical presentation, biochemical markers and treatment regime. Reassessing TH cases may be warranted to prevent unnecessary treatment.

Magnitude of thyroid dysfunction among antenatal women attending tertiary care centre

Background: Thyroid disorders constitute one of the most common endocrine disorders in pregnancy. However, there is no universal guidelines to screen every Pregnant Woman for Thyroid dysfunction in India. This study was conducted to evaluate the magnitude of thyroid dysfunction among ante natal mothers in a tertiary care centre.Methods: This was a cross sectional observational study conducted on ante natal mothers for a period of 6 months. All consecutive ante natal mothers in their first trimester were included in this study. Exclusion criteria was pre-gestational thyroid dysfunction, hypertension and diabetes mellitus. After obstetric examination and investigation, thyroid function test (Free T4 and TSH) was done in all patients.Results: Mean age of the patients enrolled was 26.2±3.54 years. Mean gestational age at which they underwent screening was 9±2 weeks. The mean BMI of the study patients was 21.7±4. The prevalence of hypothyroidism in antenatal mothers was 14.5%. 5 patients (5.5%) had hyperthyroidism. The calculated mean TSH value was 4.26 mIU/L.Conclusions: Universal screening for thyroid dysfunction during pregnancy should be made mandatory in India due to high prevalence, in order to prevent maternal and foetal complications.

The study of pulmonary function tests in patients with hypothyroidism

Background: Hypothyroidism is a common disease with a prevalence rate of 11% in India. It affects all organ systems in the body. Patients with hypothyroidism frequently have symptoms of fatigue and exercise intolerance. These symptoms could arise from a reduced pulmonary reserve, cardiac reserve or decreased muscle strength or increased muscle fatigue. This study aims to study the pulmonary function test in patients with hypothyroidism.Methods: This is a cross sectional study conducted on 100 patients divided into 2 groups (a) newly detected hypothyroids (b) normal control group. Cases were matched with controls in having similar environment exposure and age group. All patients had routine symptom and clinical assessment. Laboratory investigations such as complete blood picture, pulmonary function test, chest x ray and thyroid function test were done. Data was entered and analysed.Results: In this study conducted on 100 patients, case group had symptoms of easy fatiguability (36%), breathlessness (20%), menstrual abnormality (20%), weight gain (7%) and generalised body aches (5%). Mean FEV1 levels between cases and controls were 1.34 and 1.72 (p value 0.00), mean FVC were 1.88 and 2.09 (p value 0.114), FEV1/FVC ratio of 70.56, 81.98 respectively (p value 0.00). The distribution of PFT pattern was 32% obstructive, 28% mixed pattern and 22% restrictive pattern.Conclusions: This study shows that hypothyroidism causes significant decrease in FEV1 and FEV1/FVC ratio, thereby suggesting obstructive patterns of lung involvement .Therefore PFT can be used routinely as a screening test for all hypothyroid patients to detect early respiratory dysfunction and thereby optimise treatment especially in obese patients and patients with pre-existing lung disease as hypothyroidism adds to their respiratory dysfunction.

Study of prevalence and types of anemia in primary hypothyroidism

Background: Hypothyroidism is common disease with varying frequency between countries. Anemia in hypothyroidism can be normocytic normochromic, microcytic hypochromic and macrocytic hypochromic. Anemia severity is associated with hypothyroidism degree. Objective of this study to study the association between anemia and hypothyroidism and prevalence and types of anemia in primary hypothyroidism (subclinical and overt both).Methods: This cross sectional study was carried out at tertiary care hospital in North India. Newly diagnosed 100 primary hypothyroid patients and 100 controls with age and sex matched evaluated for anemia. Prevalence and types of anemia were studied and severity of anemia was correlated with that of hypothyroidism.Results: Anemia was observed in 90 patients with hypothyroidism. Symptoms due to anemia were higher in cases than in controls. RBCs morphology showed normocytic normochromic in 59, microcytic hypochromic in 26 and macrocytic hypochromic in 15 cases. Serum anti-TPO positivity was present in 71.1% in cases as compared to 33.33% in controls. Anemia was severe in cases with high TSH.Conclusions: Anemia was more prevalent in cases of hypothyroidism than in euthyroid controls. Normocytic normochromic type of anemia was most common type in this study. Serum anti-TPO positivity was 71.1% in cases. There was statistically significant negative correlation between TSH and haemoglobin. Symptoms of anemia were more in hypothyroid patients than in euthyroid anemic patients.

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.

A Randomized Prospective Trial To Study The Impact Of Thyroid Disorders On Fetomaternal Outcome

Objectives : To study the prevalence, maternal and fetal outcome in thyroid disorders in pregnancy. Methods : The study was conducted in the department of Obstetrics and Gynaecology, S.P. Medical College and Associated Group of Hospitals, Bikaner. This was an observational and prospective study conducted on 969 antenatal women attending OPD in first trimester from 1st October 2017 to 30th September 2018. Results : Majority of subjects 86.5% (n=838) were euthyroid, 0.6% (n=6) subjects were hyperthyroid and all were subclinical hyperthyroid, 2.2% (n=21) subjects were overt hypothyroid & 10.7% (n=104) subjects were subclinical hypothyroid. Conclusion : Hyperthyroidism in pregnancy is uncommon, effects on both the mother and fetus are critical. Due to immense impact of the maternal thyroid disorder on maternal and fetal outcome, prompt identification of thyroid disorder and timely initiation of treatment is essential.

Role of yoga in improving quality of life of hypothyroidism patients

Background: Yoga is science of simple living that enlightens all aspects of life physical, mental, psychic and spiritual. Yoga helps in balancing and harmonizing body mind and emotions. Yoga improves pulmonary ventilation and gas exchange. Thus, it improves respiratory health and general wellbeing of individual. Aim was to assess role of yoga in improving the quality of life of hypothyroidism patients before and after 6 months of yoga.Methods: Sixty adult patients of hypothyroidism participated in this prospective study and were divided into two groups. Quality of life of all the patients was assessed by WHO QOL BREF document in form of. The data obtained was analyzed using SPSS software (version 16.0). Four domain scores were assessed. Unpaired t test and paired t test was to compare normal controls with hypothyroid patients.Results: There was a significant improvement of 17.79% in the physical aspect of quality of life of patients in the yoga group at the end of six months as compared to the patients in the control group. Significant improvement of 18.38% was also observed in the psychological aspect of quality of life of patients in the yoga group at the end of six months as compared to control group.Conclusions: There is a profound improvement in physical and psychological domains of quality of life of hypothyroid patients. However, further studies over longer period of time may be helpful to evaluate the effect of yoga in these aspects of life.

Correlation Between Tsh And Body Mass Index In Male And Female Patients With Subclinical Hypothyroidism

Hypothyroidism is a syndrome resulting from thyroid hormone deficiency or rarely inefficacy. It is a common endocrinological problem affecting especially women and the elderly. Thyroid hormones play an important role in synthesis, metabolism and mobilization of lipids. One of the most important symptoms of hypothyroidism is weight gain or inability to lose weight. The rapid increase in the prevalence of obesity in the past 20 to 30 years emphasizes the important role of lifestyle and environmental factors, because genetic changes could not have occurred so rapidly. Obesity is a complicated process that depends on signals of satiety and hunger, genetics, endocrine abnormalities, and other factors. Our study purposes to investigate the relationship between BMI and thyroid function in patients of subclinical hypothyroidism. Objective of this study is to correlate thyroid stimulating hormones (TSH) and body mass index (BMI) in male and female patients with subclinical hypothyroidism. This cross sectional study included 42 Subclinical hypothyroid patients, both males and females between 20-45 years of age and without a history of alcohol or tobacco consumption, history of any cardiovascular disorders or diabetes mellitus and any drug history like corticosteroids, beta blockers. and TSH test estimated by VITROS 5600 integrated analyzer and correlated with body mass index. The results showed a positive Correlation analysis in subclinical Hypothyroid males between BMI and TSH, (r= 0.47), which was found to be statistically significant (p=0.02*) in case of subclinical Hypothyroid females the results indicated positive correlation between BMI and TSH (r= 0.58) which was found to be statistically significant (p=0.005*). A strong positive correlation between Body Mass Index (BMI) and Thyroid stimulating hormones (TSH).

Clinical, imaging and histopathological features of two cases of hypothyroid myopathy / 中国神经精神疾病杂志

Objective To study the clinical, laboratorial, histopathological, imaging features of two cases of hypothyroid myopathy. Method Clinical manifestations, thyroid function, electromyography, muscle MRI, muscle biopsy and follow-up results were collected, and analyzed with the literature. Result These two patients were middle-age to old age and the onset of disease was insidious. Their common clinical manifestations included subacute progressive weakness in the proximal muscles,myalgia after sports and reduction in tendon reflex.The blood test showed an increase in serum concentration of CK and TSH, and a decrease in FT3 and FT4. The electromyography showed suspicious myogenic damage.Muscle histopathological findings were largely nonspecific,such as type I fiber predominance and type 2 atrophy. The MRI revealed extensive muscular dystrophy and fatty filtration in the posterior group of thighs. Treatment of replacement therapy with L-T4 relieved the myopathic symptoms quickly. Conclusion When a patient presents with a subacute progressive weakness in the proximal muscles, the hypothyroidism should be consideration. Muscle histopathological findings may be nonspecific. The muscle MRI have a value of differential diagnosis and lesion assessment.

Electrocardiographic and Echocardiographic Evaluation of Heart in Newly Diagnosed Hypothyroid Patients.

Background: Hypothyroidism is a clinical syndrome resulting from a deficiency of thyroid hormones, which in turn results in a generalized slowing down of metabolic processes. Hypothyroidism affects 2% of adult women and 0.1-0.2% of adult men. Thyroid hormones exert direct cellular effects on almost all tissues of the body. It causes multi-organ dysfunction due to deranged metabolism. Objectives: To study Electrocardiographic and echocardiographic evaluation of heart in newly diagnosed hypothyroid patients. Methods: This study was a conducted as a prospective study carried out from January 2012 to July 2013 at Mediciti Institute of Medical Sciences. The criteria for diagnosis of hypothyroidism was Clinical assessment, Thyroid hormone assay–TSH - >5 μIU/ml, FT4 - < 0.7 ng/dl, FT3 - < 2.4 pg/dl. Investigations like Complete Blood Picture, Complete Urine Examination, Random Blood Sugar, Blood urea, Serum Creatinine, Fasting lipid profile, Chest X Ray, Standard 12 Lead ECG were done. Results: On systemic examination, Cardiomegaly and diminished heart sound was found in 13.3% and 9.99% patients. Normal ECG is found in 36.66% of patients before treatment and 66.66 % after treatment. Bradycardia is most common finding seen in 6 patients counting for 20%, followed by low voltage complexes and ST changes in 16.66% patients respectively before treatment. Echo findings are normal in 43.33% cases before treatment and 66.66% after treatment. Pericardial effusion and Diastolic dysfunction are the common findings seen in 8 cases each accounting to 26.66% cases, which reduced to 13.3% and 9.99% respectively after management. Systolic dysfunction was found in 9.99% of patients after treatment. Conclusion: Hypothyroid state, which has significant impact on cardiac structure/function associated with increased CVS morbidity and mortality is reversible with treatment.

Comparison of therapeutic effects of L-Thyroxin, apelin and a combination of both on antioxidant enzymes in the heart of PTU-induced hypothyroid rats

Atherosclerosis is one of the common disorders among hypothyroidism, which, increased the risk of cardiovascular diseases. Reactive oxygen species are associated with atherosclerosis development. Antioxidant defense systems are the scavenger for free radicals. Apelin is an endogenous ligand for the APJ receptor (apelin receptor) that exists in most tissues, acts as an adiponectin. It has been identified that apelin administration, improve the antioxidant capacity (TAC). Therefore, this study was conducted to assess, therapeutic effects of apelin, T4 (L-Thyroxin) or both on antioxidant capacity in 6-propyl-2-thiouracil (PTU)-induced hypothyroid rats. Forty male Wistar rats were randomly assigned into five groups: C: control group; P group (hypothyroid): PTU (0.05 %) administration for six weeks; P+A, P+T and P+A+T groups: after 4 weeks of PTU administration, animals treated with Apelin (200 μg/kg/day, ip) T4 (0.02 µg/g/day, gavage) and apelin+T4; for two weeks respectively accompanied by PTU administration. Aplein administration in P+A group and P+A+T group had beneficial effect to lowering of malondialdehyde (MDA) content as compared to hypothyroid group (8.52±0.64 and 8.53±1 vs. 13.67±1.64 nmol/g tissue, P<0.05) and also had increasing effect on Superoxide dismutase (SOD) and glutathion peroxidase (GPx) activity and the total antioxidant capacity (TAC) content compared to the hypothyroid group. This study showed that apelin was able to improve the oxidant-antioxidant balance in the heart tissue of the hypothyroid rats by elevating of antioxidant enzyme activity.