scholarly journals The Effect of Daily versus Weekly Levothyroxine Replacement on Thyroid Function Test in Hypothyroid Patients at a Tertiary Care Centre in Haryana

2017 ◽  
Vol 6 (5) ◽  
pp. 250-254 ◽  
Author(s):  
Rajesh Rajput ◽  
Vaibhav Pathak
Keyword(s):  
Thyroid Function ◽  
Tertiary Care ◽  
Thyroid Function Test ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Function Test ◽  
Levothyroxine Replacement ◽  
Hypothyroid Patients

scholarly journals Thyroid disorder in pregnancy and postpartum with neonatal outcome a study in tertiary care centre

2019 ◽  
Vol 8 (5) ◽  
pp. 1795
Author(s):  
Bharati Das ◽  
Puspanjali Khuntia
Keyword(s):  
Thyroid Function ◽  
Post Partum ◽  
Tertiary Care ◽  
Thyroid Function Test ◽  
Thyroid Disorders ◽  
Thyroid Disorder ◽  
New Born ◽  
Pregnancy And Postpartum ◽  
Function Test ◽  
In Pregnancy

Background: Thyroid disorders are well known entity in pregnancy. Both mother and baby have to suffer from the consequences.  Lot of works has been done and many guidelines too came out over the years but what is actual understanding of the disease process by the mothers about themselves and for their babies especially in developing country like India remained uncovered. This has been analysed in present study.Methods: It is a prospective observational study done in the post-partum programmed department of SCB medical college and hospital, a tertiary care center in eastern part of India for 3 years period. Thyroid dysfunction of the mothers and new born screening of thyroid function of their babies has been assessed.Results: During this period total no of the babies along with their mothers were evaluated were 3762. Total no of thyroid disorders detected in 85 (2.25%) of mothers, among which hypothyroidism in 79 (2.09%) and hyperthyroidism in 6 (0.16%) were found. From total 85 cases, 79 (93%) mothers were hypothyroid   and 6 (7%) were hyperthyroid. Among the hypothyroid mothers 32 (40.5%) were diagnosed before present pregnancy and (59.5%) were diagnosed during pregnancy. In the babies of hypothyroid mother, new born screening for thyroid function was done only in 14 (17.7%) cases between 5-10 days.Conclusions: Thyroid screening should be done in pregnancy as universal screening instead of high-risk cases. Documentation and interdepartmental coordination are very much essential in thyroid disorders for further decision by the physician for necessity of continuation of treatment and thyroid function test in the post-partum period for the mothers and its long-term consequences. It also guides the neonatologist or pediatrician doing thyroid function test of their babies. Ideally All newborns should be screened for congenital hypothyroidism as a part of new born screening (NBS) programmed. Effective communication with the mother and the family is very much essential for monitoring and treatment of both mother and the baby.

scholarly journals SAT-LB85 Use of Weekly Levothyroxine Regimen for Rapid Normalization of Thyroid Hormone Levels: A Case Report

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Jose Renato Martinez Escudero ◽  
Johnathan Kirupakaran ◽  
Alice Yau ◽  
Giovanna Rodriguez ◽  
Gul Bahtiyar
Keyword(s):  
Thyroid Hormone ◽  
Thyroid Function ◽  
Time Course ◽  
Sinus Bradycardia ◽  
Hormone Replacement ◽  
Tertiary Care ◽  
Thyroid Function Test ◽  
Tertiary Care Centre ◽  
Endocrine Society ◽  
Thyroid Hormone Replacement

Abstract Background: Hypothyroidism affects around 4.6% of the U.S. population1. Non-adherence with thyroid hormone replacement is one of the biggest challenges in treating hypothyroidism1. The half-life of T4 and T3 in hypothyroidism is about 7.5 and 1.4 days respectively2. A large dose once-weekly administration of levothyroxine (Lt4) is possible3, 4. Recent publications suggest that once-weekly Lt4 does not increase the risk of cardiovascular events and is well tolerated by most of patients4. Once weekly Lt4 produces similar results as daily Lt4 as evidenced by thyroid function tests3,4, and potentially improves patient compliance and satisfaction with the treatment4. Clinical Course: A 29-year-old female with a history of Hashimoto’s hypothyroidism, polycystic ovarian syndrome, depression, presented with irregular menses. Her symptoms included depression, fatigue, increased appetite. Her TSH was grossly elevated at 217 uIU/mL (0.27-4.20 uIU/mL). However upon re-visit, after increasing Lt4 to 100 mcg daily her TSH increased to 280 uIU/mL. She admitted to non-adherence with her daily Lt4 prescription. Physical exam was notable for sinus bradycardia and slow mentation, otherwise unremarkable. Blood count, basic metabolic panel and hemoglobin A1C were within normal limits. Liver function tests showed mild transaminitis, ALT 46 U/L (10-45 U/L). Lt4 was started at 875 mcg per week. At five weeks, her TSH was 6.31 uIU/mL and at seven weeks, the patient was euthyroid with a TSH of 2.53 uIU/mL. Her periods have since normalized. Conclusion: The current discourse on weekly dosing mainly focuses on its use for non-adherent patients. This case provides a clear time course also demonstrating rapid normalization of TSH using weekly dosing. Weekly Lt4 dosing as first-line therapy in noncompliant depressed patients with severe hypothyroidism should be considered. 1.Hepp, Z., Wyne, K., Manthena, S., Wang, S. and Gossain, V. (2018). Adherence to thyroid hormone replacement therapy: a retrospective, claims database analysis. Current Medical Research and Opinion, 34(9), pp.1673-1678.2.Colucci, P., Yue, C., Ducharme, M. and Benvenga, S. (2010). A Review of the Pharmacokinetics of Levothyroxine for the Treatment of Hypothyroidism. European Endocrinology, 9(1), p.40.3.Jayakumari, C., Nair, A., Puthiyaveettil Khadar, J., Das, D., Prasad, N., Jessy, S., Gopi, A. and Guruprasad, P. (2019). Efficacy and Safety of Once-Weekly Thyroxine for Thyroxine-Resistant Hypothyroidism. Journal of the Endocrine Society, 3(12), pp.2184-2193.4.Rajput, R. and Pathak, V. (2017). The Effect of Daily versus Weekly Levothyroxine Replacement on Thyroid Function Test in Hypothyroid Patients at a Tertiary Care Centre in Haryana. European Thyroid Journal, 6(5), pp.250-254.

scholarly journals Prevalence and complications of Hypothyroidism during pregnancy in western Nepal

2014 ◽  
Vol 3 (1) ◽  
pp. 48-50 ◽  
Author(s):  
TL Upadhyaya ◽  
A KC ◽  
S Paudel
Keyword(s):  
Thyroid Function ◽  
Care Center ◽  
Tertiary Care ◽  
College Teaching ◽  
Thyroid Function Test ◽  
Overt Hypothyroidism ◽  
Medical College ◽  
Study Results ◽  
Function Test ◽  
Entire Pregnancy

Background: This study was designed to know the prevalence of hypothyroidism during pregnancy in western part of Nepal and its potential complications. Methods: One Hundred seven pregnant cases from Gandaki Medical college teaching hospital and Diabetes thyroid and Endocrinology care center, two of the tertiary care centers in Pokhara were enrolled in the study from the year 2011 January to 2012 December. Detailed history and physical examination was done. Thyroid Function test (FT3, FT4 andTSH) were performed after the confirmation of pregnancy. Patients were followed up during entire pregnancy. Seven patients dropped out from the study. Results: Out of 107 patients 56 patients had TSH below 6 mIU/L,31patients had TSH between 6mIU/L - 10 mIU/L and 13 patients had TSH more than 10 mIU/L. Seven patients dropped out from the study. There was1 miscarriage, 1 still birth from hypothyroid mother and 11 hypothyroid and subclinical hypothyroid mothers had preterm delivery. Conclusion: Prevalence of overt hypothyroidism is around 13% and subclinical hypothyroidism is around 31% in pregnant ladies in western Nepal. Also complications like stillbirth should be prevented by detecting and treating hypothyroidism early. So we recommend all patients with pregnancy to perform thyroid function test at the start of pregnancy. Nepal Journal of Medical Sciences | Volume 03 | Number 01 | January-June 2014 | Page 48-50 DOI: http://dx.doi.org/10.3126/njms.v3i1.10358

scholarly journals Dengue: experience from a tertiary care centre in Northern Karnataka, India

2019 ◽  
Vol 7 (7) ◽  
pp. 2803
Author(s):  
Mohammad A. Waheed
Keyword(s):  
Dengue Infection ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Febrile Illness ◽  
Severe Thrombocytopenia ◽  
Acute Febrile Illness ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Old Patients ◽  
Function Test

Background: Epidemiology of dengue infection is evolving, and research gap exists in the region. The clinical features, laboratory parameters, complications and treatment outcomes of patients diagnosed of dengue infection at a tertiary care centre were analysed in the present study.Methods: More than 12 years old patients, presenting with features suggestive of acute febrile illness were subjected to detailed history taking and thorough clinical examination. All the suspected cases were further evaluated with complete blood count, liver function test, kidney function test, along with ultrasonography of abdomen. Blood samples were tested for dengue antibodies (IgG and IgM) by hemagglutination inhibition method for confirmation of the diagnosis. The clinical course was closely monitored during hospital stay and complications and deaths, if any, were noted.Results: Total 140 patients were studied. Fever (100%), headache (80%) and myalgia (73.6%) were the commonest symptoms. Thrombocytopenia (136, 97.1%) was the commonest hematological finding, while severe thrombocytopenia (<50,000/cu. mm) was observed in 38 (27.1%) cases. Hepatomegaly (61, 43.6%), splenomegaly (42, 30.0%), ascites (54, 38.6%), pleural effusion and gall bladder edema (18, 12.9% each) were the commonest findings on ultrasonography. Shock and ARDS were the major complications.Conclusions: Dengue remains an important public health problem even at a tertiary care centre and strong suspicion is needed in adult patients with acute febrile illness. The management should focus on averting shock and ARDS, which would help in larger aim of reduction in mortality.

scholarly journals Hypothyroidism – An Underestimated Complication After Hemithyroidectomy: A Preliminary Study Report

2017 ◽  
Vol 25 (1) ◽  
pp. 19-26
Author(s):  
Neeraj Aggarwal ◽  
Sirshak Dutta ◽  
Tanaya Panja ◽  
Mainak Dutta ◽  
Sanjoy Kumar Ghosh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Thyroid Function ◽  
Tertiary Care ◽  
Thyroid Function Test ◽  
Lymphocytic Infiltration ◽  
Care Hospital ◽  
Function Test ◽  
Preliminary Study ◽  
Serum Tsh

Introduction Hypothyroidism is a significant but an under-appreciated complication of hemithyroidectomy. The focus of this study was to assess the incidence of hypothyroidism occurring after hemithyroidectomy, identify the risk factors and to suggest a possible follow-up guideline for diagnosis. Materials and Methods An institution based preliminary study was conducted in the Department of Otorhinolaryngology, in a tertiary care hospital, from August 2014 to December 2015 on 25 patients. The patients were regularly followed up in 1st month, 3rd month, 6thmonth, 9th month and 1 year period with the thyroid function test. Results Incidence of hypothyroidism occurring after hemithyroidectomy including transient and permanent cases is 32%. Increased age of presentation, longer duration of thyroid swelling, pre-operative serum TSH level >2.5 mIU/ml, lymphocytic infiltration in histopathology and right sided hemithyroidectomy were found to be the possible risk factors. Conclusion It is indicated from this preliminary report that there should be a serial thyroid function monitoring in every post-operative hemithyroidectomy patient, and special attention should be given to the risk group

EVALUATION OF THYROID STATUS WITH THE "EFFECTIVE THYROXINE RATIO" (E. T. R.®)

1974 ◽  
Vol 77 (2) ◽  
pp. 250-256 ◽  
Author(s):  
Klaus Kølendorf ◽  
Kaj Siersbæk-Nielsen ◽  
Jens Mølholm Hansen ◽  
Thorkild Friis
Keyword(s):  
Thyroid Function ◽  
Thyroid Function Test ◽  
Free Thyroxine ◽  
Normal Range ◽  
High Positive Correlation ◽  
Function Test ◽  
Free Thyroxine Index ◽  
Hypothyroid Patients ◽  
Hyperthyroid Patients

ABSTRACT A new in vitro thyroid function test, "Effective Thyroxine Ratio" (ETR®) has been tested in 170 patients, and the ETR values in patients with normal and abnormal thyroid function have been compared to the concentration of absolute free thyroxine and free thyroxine index in serum. Among 42 hyperthyroid patients tested with ETR, 13 had values within normal range (30.9 per cent). Three of 18 hypothyroid patients had normal values (16.8 per cent). Eighty-nine per cent of 27 pregnant women and all of 17 patients treated with genuine oestrogens had ETR values within normal range. A high positive correlation was found between values of ETR, absolute free thyroxine in serum (r = 0.62) and free thyroxine index (r = 0.83).

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