scholarly journals The Diurnal Variation of Thyroid Hormones in Individuals Attending Tertiary Care Hospital, Kanchipuram District

2020 ◽  
Vol 13 (4) ◽  
pp. 1729-1735
Author(s):  
Santhosh Viswan ◽  
Gurulakshmi Gurusamy ◽  
Khadeja Bi Altaff ◽  
Suganya Subbarayalu ◽  
Gomathi Surendran

Free thyroxin hormones FT4 and FT3 are unbounded thyroid hormone are biologically active and involves in regulation of metabolism. Measuring the concentrations of free thyroid hormones is of great diagnostic value. A cross sectional study was carried out during the March 2019 to September 2019 in patients between 18 years to 60 years. A total of 60 samples were collected from 30 patients attending Karpaga Vinayaga Institute of Medical Sciences at morning (6am-8am) and 2nd sampling at night (8pm-9pm). FT4, FT3 and TSH were measured by Enzyme linked immunosorbent assay, using Avantor kit.In our study 36.67% participants were males, 63.3% participants were females. The mean FT3, FT4 and TSH in day are 2.43±0.56, 1.14±0.44 and 2.74±3.16 respectively. The mean night FT3, FT4 and TSH are 2.66±0.55, 1.3±0.61 and 3.21±3.18 respectively. The one sample t test shows difference of FT3, t 4.489 and p value 0.000, FT4, t value 3.092 and p value 0.004 and TSH t value 3.394 and p value 0.002. The time of blood sampling has an important role in the interpretation of TSH levels. However fluctuations in diurnal variations in thyroid hormone levels are less. In our study although statistically significant, all the values are within the normal biological reference interval Further studies in larger cohorts is essential to desire important conclusions.

2021 ◽  
Vol 12 (2) ◽  
pp. 19-24
Author(s):  
Akshatha Rao Aroor ◽  
Archana Bhat ◽  
Maroli Roshan

Background: Thyroid hormone plays a pivotal role in the adaptation of metabolic function to stress and critical illness like sepsis. Thyroid dysfunction is associated with increased mortality in sepsis. The role of thyroid dysfunction as a prognostic marker in sepsis remains unclear. Aims and Objectives: To correlate the baseline thyroid function tests with APACHE II score and mortality in adult patients admitted with sepsis in Intensive Care Unit (ICU). Materials and Methods: This was a cross sectional, observational study done for a period of one year from September 2019 to September 2020 in a tertiary care referral hospital. Patients admitted with sepsis to ICU were scored on admission using APACHE II score. Blood was sent for thyroid function tests on admission. Patients were divided into survivors and non-survivors based on the outcome. Statistical analysis was done by calculating mean values, Fisher’s exact test and Pearson’s correlation. Results: A total of 52 patients were included. The mean age was 55.65± 18.55 years with a male predominance (M: F=1.4:1). Pneumonia was the commonest cause of sepsis in the study (20 patients,38.5%). Mortality was seen in 20 patients (38.5%) The mean values of thyroid hormones were lower in non-survivors. APACHE II Score was higher among the non-survivors as compared to survivors. (21.7±5.571 vs 19.78 ± 5.939, p value>0.05). Thyroid hormones (T3, T4, FT3, FT4) had a negative correlation with APACHE II score in non-survivors. TSH had significant positive correlation with APACHE II score in non-survivors (p value=0.027). Conclusion: Thyroid hormone levels did not correlate significantly with APACHE II score and mortality among the non-survivors of sepsis.


Background: Epilepsy is fairly a frequent occurrence in the elderly. It is commonly diagnosed after the episode of two or more unprovoked seizures. Unprovoked seizures in elderly are recurrent rather than younger individuals. This study was designed to estimate the concrete burden of frequent causes of epilepsy. Methods: A descriptive cross-sectional study with a total of 153 patients diagnosed case of epilepsy were included in this study at Jinnah Medical College Hospital from February 2018-August 2018. Mean was calculated for age, duration of disease of the patients. Causes of epilepsy, gender, and education was calculated and presented as percentages. Electrolyte readings were taken i.e., Sodium, Calcium and Magnesium levels and imaging was planned to rule out stroke, primary neurodegenerative disorders and tumors. Post stratification Chi square test was applied and p-value less than or equal to 0.05 was considered significant. Results: The mean age of the patients was 63.91±5.68 years and mean duration of the disease was 4.61± 1.07 months. The common causes of epilepsy were found to be cerebrovascular disease 56.9%, cryptogenic 54.2%, neurodegenerative disorder 20.3%, traumatic head injury 11.8%, metabolic abnormalities or electrolyte disturbances 10.5% and brain tumor 7.8%. Conclusion: Elderly patients with first seizure should present to a facility designed in a way that neurologist, cardiologist, rehabilitation and geriatrics work together to identify and treat the condition in a better way. Keywords: Epilepsy; Seizures; Cerebrovascular Disease; Neurodegenerative Disorder.


Author(s):  
Vanajakshamma Velam ◽  
Vyshnavi Kancherla ◽  
Latheef Kasala ◽  
Anusha Kancherla ◽  
Mounica Reddy Pillaram

Abstract Background This study was an attempt to assess and compare the gender-wise lifestyle patterns and well-being status among the employees of a tertiary care teaching hospital. Material and Methods This is a cross-sectional, questionnaire-based study conducted at a tertiary care hospital between May and August 2019. A total of 777 employees belonging to both genders (male and female) and working at different professional levels were assessed. All the enrolled employees were subjected to a comprehensive study tool consisting of various dimensions of their health, which included physical, mental, social, spiritual and intellectual health dimensions. Results Among the participants, 327 (42.1%) were male and 450 (57.9%) were female. There was no significant difference in the mean age of male (37.91 ± 7.52) and female (36.85 ± 8.16) employees (p = 0.07). A significantly higher proportion of diabetes and hypertension were seen in male employees (9.8% and 14.4%, respectively) than in female (5.6% and 6.2% respectively). The overall well-being was better in male employees than in females and was statistically significant (p < 0.0001). We found that male employees had statistically significant better well-being in terms of physical, mental and social health whereas female employees had intellectual health. Conclusion The overall well-being in healthcare staff was good at our tertiary care hospital, and the outstanding/good well-being rate was higher in male employees than in female employees. Female employees experienced risks with regard to their physical health.


2018 ◽  
Vol 41 (3) ◽  
pp. 159-164 ◽  
Author(s):  
Madhabi Baidya ◽  
Mahfuza Shirin ◽  
Liton Chandra Saha

Background: Adequate neonatal transport is a key component of care of the sick newborns who require referral to tertiary care center. Poor transportation is one of the iatrogenic factors associated with greater neonatal mortality. Neonatal transport is the greatest challenge faced today in our country. The purpose of this study was to find out characteristics of transport of referred neonates and to idention the factors that contribute to mortality.Methodology: This cross sectional study was conducted in Dhaka Shishu (Children) Hospital from June 2013 to November 2013. Both term and preterm neonates who were referred within first seven days of life were included and those with gross congenital abnormalities and left against medical advice were excluded from the study. After enrollment, data were collected using a structured questionnaire including birth details, interventions before transportation, reasons for referral, and details of transportation. Outcome & duration of hospital stay were also recorded. Neonates who were expired considered as group I and who were survived considered as group II. The study variables were analyzed for their association with immediate outcome by applying chi square test and t test. P value <0.05 was considered significant.Results: This study found that out of 332 neonates 181 were expired with 54.5% mortality rate. One eighty one neonates who were expired, considered as group I and one fifty one neonate were survived, considered as group II. The mortality was significantly high in male neonates [RR 0.80 (0.66-0.97)] and neonates those delivered at home [RR 1.34(1.10-1.64)] (p<0.05). Perinatal asphyxia, pre-term low birth weight, neonatal sepsis were the main causes of referral. It was found that transportation without any referral note [RR 1.40 (1.14- 1.71)], no advice regarding maintenance of airway[RR 1.50(1.17- 1.92)]and keeping warm [RR 1.51(1.17-1.950], resuscitation on admission [RR 1.63(1.23-2.17)] and transportation required > 3hours [RR 1.36(1.09-1.69)] were associated with significantly higher mortality among referred transported neonates(p<0.05).Conclusions: This study found that male neonates, home delivery, transportation without any referral note, no advice regarding maintenance of airway and keeping warm, resuscitation needed on admission and prolonged transportation time were significantly associated with mortality of referred transported neonates.Bangladesh J Child Health 2017; VOL 41 (3) :159-164


2019 ◽  
Vol 26 (05) ◽  
Author(s):  
Fehmida Parveen Memon ◽  
Majida Khan ◽  
Samya Aijaz

Objectives: To determine the thrombocytopenia as marker of maternal sepsis and its related maternal morbidity and mortality at tertiary care Hospital. Study Design: Cross-sectional study. Setting: Gynaecological and Obstetrical department of Liaquat University Hospital, Hyderabad. Period: 6 months from March 2017 to August 2017. Material and Methods: All the pregnant females with diagnosis of sepsis were enrolled in the study. All the females with chronic hepatitis were excluded. After complete clinical examination every women underwent 5cc blood sample for complete blood picture. Thrombocytopenia was characterized as a platelet count below 150.000/mm3. Data regarding maternal mortality and maternal complications was filled in the proforma. Results: Total 120 septic mothers were included in the study, 70 patients had thrombocytopenia and 50 were with normal platelets. Most of the women 71.7% were with age groups of 20-30 years. Out of total women 65.0% were un-booked. According to the maternal morbidity, septic shock was most common 36.7%, multi-organ failure was in 08.3%, prolonged Hospital stay was in 16.7%, ICU admission occurred in 18.3% patients, while renal failure, respiratory failure, hepatic failure, coagulopathy and metabolic acidosis were found with percentage of 09.2%, 02.5%, 10.8%, 10.8% and 03.3% respectively. Mortality rate was found among 8.3% out of total cases. Almost all complications were higher among women with thrombocytopenia as compare to women with normal platelets level, while statistically p-value was quite insignificant. Mortality was significantly high among patients with thrombocytopenia p-value 0.032. Conclusion: It was concluded that thrombocytopenia is a good marker for adverse outcome among septic mothers. Maternal morbidity and mortality was higher among septic women with thrombocytopenia.


2021 ◽  
pp. 1-3
Author(s):  
Ajay Pal Singh ◽  
Kailash Meena ◽  
Surinder Pal Singh ◽  
Avnish Kumar ◽  
Ashish Shukla ◽  
...  

INTRODUCTION: Spirometry is a vital tool for the assessment of pulmonary function status. Spirometry can be used to demonstrate the age-related decline in pulmonary function. The spirometry values can be used as reference values for a particular age group. The aims of our study was to compare spirometry values between the young and elderly groups and evaluate age-related changes in both groups. MATERIAL AND METHODS: A cross-sectional study was conducted on 600 adults, which divided into two healthy groups: one was of young adults (18-35 years), and other was of elderly adults (>60 years) of 300 persons, each taken over a period of one year, in the Department of pulmonary medicine, a tertiary care hospital, Punjab. We conducted spirometry in both age group. Spirometry values were measured FVC, FEV1, FVC/FEV1, PEFR, and FEF25- 75 % of each groups.The subjects were selected based on random sampling RESULT: Spirometry values compared between young and elderly adults. Mean BMI in young and elderly groups was 25.09±2.87 and 25.82±2.45, respectively. Spirometry values in FVC , FEV1, FEV1/FVC , PEFR and FEF25-75% in young was 4.31± 0.18 , 3.84,± 0.88± 0.02, 9.87± 0.38 and 3.75 ±0.26 and elderly age group 3.01±, 2.60 ±0.85± 0.02, 7.70± 0.30 and 2.82 ± 0.26. On statistical analysis, p value <0.001 in all spirometry parameters. CONCLUSION: The study shows that there was a decline in spirometry parameters of healthy adults with the increase in age. This decline was signicant in all spirometric parameters (FVC, FEV1, FEV1/FVC, PEFR, FEF25–75%) measured in the present study


2022 ◽  
Vol 71 (12) ◽  
Author(s):  
Sana Javed ◽  
Muhammad Zaid ◽  
Sumera Imran ◽  
Ayesha Hai ◽  
Muhammad Junaid Patel

Objective: To estimate the frequency of patients with fibromyalgia (by using the 2010 Modified Criteria for Fibromyalgia by American College of Rheumatology ( ACR ) presenting to Internal Medicine clinics  Methods: A cross-sectional study conducted in the department of Internal Medicine, the Indus Hospital, khi, Pakistan between December 2016 and March 2018. Patients who visited internal medicine clinics, met the selection criteria, were included in the study. After taking informed consent patients were assessed for fibromyalgia according to the new 2010 Fibromyalgia Diagnostic criteria questionnaire. The patients were asked the questions in the national language, Urdu. Data analyzed using SPSS version 21. P value of < 0.05 was considered significant. Results: Of the 267 patients presenting to the internal medicine clinics and consenting for participating in the study 149 (55.80%) met at least one of the 2010 Fibromyalgia Criteria. The prevalence of fibromyalgia as estimated in this study was 56% with no difference in gender. Mean age of patients with fibromyalgia was 42.3 ± 14.6 and patients without fibromyalgia was 38.9 ± 13.7 which was statistically significant (p-value = 0.05, 10% level of significance). Of the 267 patient 197 (73.8%) were female and 70 (26.2%) were males, a male to female ratio of 1:2.81.  Conclusion: All patients with generalized pain should be evaluated for fibromyalgia and a diagnosis made to reduce the cost of further referrals and investigations and delay in the management of this debilitating disorder. Keywords: Fibromyalgia, Chronic fatigue, Generalized Pain  


Author(s):  
Anitha Nirakari B.

Background: Infertility is a rising major problem affecting more than 50 million couples globally every year. Endocrine as well as immune system abnormalities can impair the fertility. Most of the studies globally indicated association of infertility with multiple factors like stress, luteal phase defects, structural and functional reproductive disturbances. Many infertile women with thyroid dysfunction had associated hyperprolactinemia with increases TSH in ovulatory dysfunction. The aim of the present study was to determine the association of hypo and hyperthyroidism with infertility among cases of primary infertility in women.Methods: A cross sectional study was conducted among the patients attending the infertility clinic for the first time. The study was approved by the institutional ethical committee and the study was carried as per the guidelines of the ethical committee. The serum levels of T3, T4 and TSH were estimated and Prolactin in cases where necessary by Chemiluminiscence immunoassay. The data was analyzed by using the unpaired “t” test. A ‘p’ value <0.05 was considered significant.Results: 285 cases were enrolled and majority (38.6%) was in 31-34 age groups with mean age of 24.2± 1.6 years. 30.53% were found with thyroid dysfunction. Majority (16.49%) were found with subclinical hypothyroid, followed in order by primary hypothyroid (9.82%), subclinical hyperthyroid (2.11%), primary hyperthyroid (1.05%), secondary hypothyroid (0.70%) and secondary hyperthyroid (0.35%).Conclusions: To conclude, thyroid dysfunction is a common cause of infertility and can be easily managed by correcting the levels of thyroid hormones. Present study suggests that thyroid replacement therapy in subclinical hypothyroidism at an early stage is justified in infertile women. Borderline variations in TSH levels should not be ignored in infertile women who are otherwise asymptomatic for subclinical hypothyroidism. Hence for better management of cases of primary infertility studies with large sample size and long term follow up are required to validate and justify the variation in TSH and prolactin levels.


Author(s):  
Hira Qadir ◽  
Nadia Nasir ◽  
Shaheen Kouser ◽  
Huma Mansoori ◽  
Nida Qadir ◽  
...  

Abstract Objective:To ascertain the frequency of markers of transfusion-transmitted infections. among blood donors in a blood bank at a tertiary care hospital Material and Methods:The study was a retrospective cross-sectional descriptive study, covering from 1stJanuary 2013- October 2018 and was conducted in the blood bank section, in the Department of Pathology at Dow University of HealthSciences, Hospital. All blood donors were screened for hepatitis B, hepatitis C, HIV (I & II), syphilis through electrochemiluminescence and malaria (immunochromatography).Data was entered and subsequently analyzed by statistical package for social sciences (SPSS) version 21. The frequency of infectious disease markers (HbsAg, Anti HCV, HIV, syphilis, and malaria) was calculated among blood donors. Results:The total number of donors in our study was 29732, out of which 2587 donors were positive for an infectious disease.Out of the total donors, 29712 were male and 20 were female. There were 12 volunteer donors and 29720 exchange donors. The mean prevalence of donors with positive infectious markers was as follows; Anti HCV was 3 %, HbsAg was 2.9%, Syphilis was 2.0%, HIV was 0.5% and Malaria was 0.02 %. Conclusion:HbsAg and Anti HCV were the most frequent infections (3%) found in our blood donors, followed by syphilis with a frequency of 2%. Keywords: Blood transfusion, transfusion-transmitted infections, blood donors.


Author(s):  
Sumitha Arumugam ◽  
Dhanasekaran Ramadoss ◽  
Parthiban Brindhadevi ◽  
Subbalakshmi Easwaran ◽  
Shanthi Santhosh Kumari

Introduction: During this COVID-19 lockdown period, telemedicine is widely being used by doctors for continuing clinical care of patients so that physical distancing can be maintained and the risk of contracting the virus can be avoided. Aim: To assess perception of doctors regarding quality of healthcare by telemedicine as compared to traditional face to face consultation and, to assess the opinion of doctors on whether telemedicine could be an option for future practice after lockdown period. Materials and Methods: A questionnaire based cross-sectional study was conducted in which perception of doctors regarding their telemedicine usage for general practice during this lockdown period has been evaluated. The study was done during April to June 2020 among doctors working in a medical college attached to a tertiary care hospital in Chennai and using telemedicine for their practice during COVID-19 lockdown period. After collection of responses, data obtained were entered in excel sheet and analysed using SPSS version 23.0. Chi-square test was used to assess the association between different variables associated with perception regarding telemedicine usage for general practice. A p-value <0.05 was considered as statistically significant. Results: Easy access to healthcare services can be done with telemedicine practice according to 73.7% of doctors. Nearly 60.6% of doctors like to continue telemedicine for their practice even after COVID lockdown period. Conclusion: Telemedicine has helped doctors for continuing patient care during COVID-19 pandemic, but the quality of care delivered by telemedicine consultation was not good as compared to the quality of traditional healthcare. Telemedicine could be an option for future practice of doctors if awareness regarding proper usage of telemedicine is created among patients and if guidelines regarding legal concerns in telemedicine are properly framed.


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