European Journal of Cardiovascular Medicine

Introduction: Hypothyroidism is associated with decreased thermogenesis, decreased metabolic rate, and has also been shown to correlate with a higher body mass index (BMI) and a higher prevalence of obesity. There is clinical evidence suggesting that even mild thyroid dysfunction in the form of subclinical hypothyroidism is linked to significant changes in body weight and represents a risk factor for overweight and obesity. It has been further noted that small variations in serum TSH caused by minimal changes in Thyroxin dosage during replacement therapy are associated with significantly altered resting energy expenditure in hypothyroid patients. Methods: This is a prospective study conducted in the Department of General Medicine, Shadan Institute of Medical Sciences Teaching Hospital and Research Centre over a period of 1 year among 60 subjects. The variables collected were gender, age, thyroid dysfunction etiology, TSH levels, free levothyroxine (FT4) levels, presence of thyroid autoimmunity (considered as detection of anti-thyroperoxidase antibodies and/or TSH receptor antibodies), BMI and weight at the time of referral to the Department and after normalization of thyroid hormone levels after treatment. Result: T3 and TSH of control group (2.32±0.21, 83.54±8.35) respectively. In the mean of them in the second visit (1.35±0.11, 36.23±16.24) respectively in comparison with control group. The correlation between T3 and T4 in the first visit which revealed that there was strong positive correlation (r=0.432) with a highly significant difference (P=0.00). Correlation between T3 and TSH in this table showed that there was a weak negative relationship (r =-0.103) with a non-significant difference (P=0.325). In correlation between T4 and TSH there was a weak negative correlation (r= -0.024) with a highly significant difference (P= 0.542). Between T4 and BMI there was a weakly negative correlation (r = -0.019) with a non-significant difference (P=0.431). Conclusion: The number of patients with an elevated BMI (obese) differs significantly from the others. Thyroxin played a part in a lower BMI. Finding hypothyroid patients as soon as feasible is crucial

Background: Miscarriage is considered the most common adverse outcome in early pregnancy. Thyroid autoantibodies have a role in these regions and have been linked to substantial changes in the path of pregnancy that affect the mother, foetus, & newborn. Aim: To estimate the prevalence of TPO antibodies in recurrent pregnancy losses, first trimester abortions and preterm deliveries. Material & Methods: Study Design: Descriptive Cross sectional study. Study area: Department of Obstetrics & Gynecology, Murshidabad Medical college and Hospital, Baharampur, West Bengal. Study Period: Jan 2022 – Dec. 2022. Study population: Pregnant women who had preterm deliveries, miscarriages attending outpatient as well as admitted in the antenatal & postnatal ward in the department of Obstetrics & Gynecology Sample size: Study consisted a total of 100 subjects. Study tools and Data collection procedure: The study group was comprised of all the pregnant women who had preterm deliveries and miscarriages regardless of the gestational age, that were fulfilling inclusion & exclusion criteria. Written informed consent was taken from all the patients participating in the study. They were subjected to a detailed history & thorough general & clinical examination, lab investigations, thyroid profile, thyroid peroxidase antibody testing (Normal range: TPO AB <9 IU/ML), ultra-sonic examination & other clinical work up was done. The study showed that the contribution of thyroid peroxidase antibody testing & its sensitivity determining risk of preterm deliveries and recurrent pregnancy loss. Results: The association between TPOAB and T3 category, among the high TPOAB (+ve) cases (n=11), 8 (72.7%) cases had normal level of T3, and, 3 (27.3%) cases had low level of T3. Whereas in the normal TPOAB (-ve) group (n=89), 5 (5.6%) cases had high level of T3, 84 (94.4%) cases had normal level of T3. The association between TPOAB and T3 category was shown statistically significant (P<0.0001). Conclusion: We concluded that, there was a statistically significant association of TPOAb with T3, T4, and, TSH (P<0.05) and it leads to developing hypothyroidism during pregnancy. The presence of TPO-Ab in pregnant women significantly increases the risk of preterm delivery. The screening of TSH and TPOAb was essential during pregnancy to avoid complications related pregnancy

Introduction Asthma is a long-term condition affecting children and adults. The air passages in the lungs become narrow due to inflammation and tightening of the muscles around the small airways. This causes asthma symptoms such as cough, wheeze, and shortness of breath and chest tightness. It can be difficult to coordinate breathing using an inhaler, especially for children and during emergency situations. The assessment of asthma control has become pivotal in the management of asthma. However, several surveys in developed nations have shown that the majority of patients with asthma do not enjoy adequate asthma control. This is not because asthma control is unrealistic and not achievable; the multicentre, multinational study of asthma management, the Gaining Optimal Asthma control (GOAL) study, has shown that well-controlled asthma is achievable in the majority of patients.  Materials and Methods: This is a descriptive and cross-sectional study to assess the levels of asthma control among adult patients attending Tertiary Care Teaching Center. The study used those (physician-diagnosed asthma patients) participants who volunteered. There is a causality department where patients presenting with acute asthma attack are managed. Complicated cases of asthma including status asthmaticus are managed in the high dependency unit. Results: Prevalence of bronchial asthma in adolescents was 13.1% (n = 110) of which 10.2% had episodes in the past 1 year. Prevalence was higher among males (6.23%) compared to females (3.94%). About 79.1% of total asthmatics were newly diagnosed cases. Prevalence was significantly higher among those having pets at home (P < 0.001), belonging to higher socioeconomic status (P = 0.021), using smoke producing fuel at home (firewood/cow dung/kerosene; P = 0.021), and with history of smoking among family members (P = 0.027). Among current asthmatics, 71.8% reported cold/rhinitis (51.3% in March–May duration), 59.1% nocturnal dry cough, 48.2% sleep disturbances, and 42.7% speech disturbances in the past 1 year. Discussion: In our study we found, there is significant increase in weight, BSA, BMI, where as significant decrease in DBP of diabetic group compared to Non-Diabetics & there is significant increase in FBS, HbA1C levels of Diabetic group significant decrease in LH levels of Diabetics compared to Non-Diabetics. However T3 levels of Diabetic and Non-Diabetic group were almost same, where as T4, Oestradiol and progesterone levels of diabetic group non-significantly increased and FSH and TSH levels non-significantly decreased in Diabetics. There is frequent co-existence of thyroid dysfunction and diabetes mellitus among post menopausal diabetic women. Conclusion: We estimated the global prevalence of ACO based on population-based studies and found that 2.0% of the general population is affected. However, the prevalence of ACO depends on its diagnostic criteria. Therefore, there is a vital need to better define the ACO diagnostic criteria, management and treatment. It is worth noting that the limitations of the present study include lack of studies in some region of the world and small number of studies included in the subgroup analyses

Objective: The introduction and use of antiretroviral therapies (ART) has revolutionized the management and treatment of Human Immunodeficiency Virus (HIV)/acquired immunodeficiency syndrome (AIDS). HIV/ AIDS globally resulting in increased life expectancy. Current treatment guidelines by WHO recommend the use of a combination of at least 3 ARV drugs which include: 2 Nucleoside Reverse Transcriptase Inhibitors (NRTIs) combined with 1 medication from either of the 2 remaining classes; the Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs) or the Protease Inhibitors (PIs). Micronutrients and electrolytes deficiencies are prevalent among HIV-infected populations. The use of Highly Active Antiretroviral Therapy (HAART) on the other hand has been shown to increase the life expectancy of HIV infected individuals. The present study was designed to determine the effects of HAART on serum micronutrients and electrolytes concentrations in HIV positive patients. Materials and Methods: A prospective randomized controlled clinical study was conducted in the with 231 HIV+ adults with low plasma zinc levels (<0.75 μg/ml), randomly assigned into zinc (12 mg of elemental zinc for women and 15 mg for men) or placebo, for 18 months. The primary endpoint was immunological failure. HIV-viral load and CD4+ cell count were determined every 6 months. Questionnaires, pill-counts, plasma zinc and C-reactive protein (hsCRP) were used to monitor adherence with study supplements and ART. Intent-to-treat analysis utilized multiple-event analysis, treating CD4+ cell count <200 cells/mm3 as recurrent immunological failure event. Cox proportional-hazard models and the general-linear model were used to analyze morbidity and mortality data. Results: Severe, moderate and mild malnutrition were detected in 15%, 38% and 24% of human immunodeficiency virus infected individuals respectively. Compared with the healthy control group, serum level of zinc and selenium in the human immunodeficiency virus infected subjects were significantly lower (P = 0.01 and P = 0.02 respectively). Discussion: In our study we found, there is significant increase in weight, BSA, BMI, where as significant decrease in DBP of diabetic group compared to Non-Diabetics & there is significant increase in FBS, HbA1C levels of Diabetic group significant decrease in LH levels of Diabetics compared to Non-Diabetics. However T3 levels of Diabetic and Non-Diabetic group were almost same, where as T4, Oestradiol and progesterone levels of diabetic group non-significantly increased and FSH and TSH levels non-significantly decreased in Diabetics. There is frequent co-existence of thyroid dysfunction and diabetes mellitus among post menopausal diabetic women. Conclusion: ART treatment did not complement zinc status in HIV infection while improving CD4+ T-cell count, hence the need to consider supplementation

Background and Objectives: Chronic lymphocytic thyroiditis is autoimmune thyroiditis; it is considered as second most common thyroid disorder diagnosed on FNAC following colloid goitre. FNAC is a reliable and efficient method for diagnosing these thyroid lesions. Chronic Lymphocytic thyroiditis frequently affects women, primarily compared to men and is commonly found with hypothyroidism, euthyroidism or every so often with hyperthyroidism. The incidence rate of Hashimoto’s thyroiditis is 1–4%, with an occurrence of 30–60/100000 population per year. Autoimmune thyroiditis can be categorized on the cytomorphological features of FNAC. Methods: To compare FNAC cytological findings with TFT in Chronic lymphocytic thyroiditis. One hundred ten patients with thyroid swellings were presented for FNAC examination, serology of TFT and Anti TPO antibodies and Ultrasonography during 2020–2021. In addition, fine needle aspiration cytology was performed using non-aspiration or aspiration techniques. TFT and Anti- TPO antibodies were performed on Avion CLX 120 auto analyser based on the Chemiluminescence method. Result: Out of 110 cases of midline neck swelling presented in our department, Autoimmune Thyroiditis was observed in 43 cases. The most affected age group of lymphocytic thyroiditis was 21–30 years, with the male: female ratio being 1:3. Most of the patients presented with diffuse swelling and few presented with nodular swelling. The Grading of the lymphocytic thyroiditis was done by the criteria used by Bhatia et al Anti-TPO antibody was elevated in 19 cases (26.2%), and TSH was elevated in 28 cases (40.81%). These cases were diagnosed as autoimmune thyroiditis on cytology, clinically and also correlating with radiological findings. Grade 3 lymphoid infiltrate was seen in 53.33% (16/30) cases, and Grade 2, lymphoid infiltrate was seen in eight cases (62.50%). Grade 1 lymphoid infiltrate was seen in five cases (11.63%). Among 43 cases, 28 cases (65.12%) show hypothyroidism, 7 cases (16.28%) show hyper, and 8 cases (18.60%) show Euthyroidism. Among these 43 cases, 26 cases showed diffuse thyroid swelling on ultrasonography, and 7 cases showed solitary nodule. Conclusion: Grade 3 lymphocytic infiltration statistically correlates with anti-TPO and TSH in conjunction with ultrasonography findings of diffuse enlargement of the thyroid gland. The presence of Hurthle cell change, giant cells, anisonucleosus, and granulomas do not find to be any statistical correlation with lymphocytic thyroiditis as these cases are primarily corresponding to Grade 1 and Grade 2. Through this study, we conclude that FNAC remains the gold standard method despite having different diagnostic modalities accessible for diagnosing thyroid lesions. Grading of FNAC Smears depends on lymphocytic infiltration of the thyroid follicles, along with positivity for antithyroid antibodies (anti-TPO antibody) and TSH. These findings are firmly associated with Chronic Lymphocytic Thyroiditis.

Background and Aim: Dyslipidemia is thought to confer risk of cardiovascular disease development. Overt hypothyroidism is associated with lipid abnormalities. As SCH is being diagnosed more frequently in young and middle-aged people, there is a need to know the effect of SCH on cardiovascular risk factors in young in tertiary centre in Gujarat, India. Therefore, the objective of this study is to analyze the relation between SCH and serum lipid parameters in this subgroup. Material and Methods: This observational study was conducted at Department of Medicine at Tertiary Care Institute of Gujarat, India in subjects diagnosed with Sub Clinical Hypothyroidism. Blood samples were drawn at early morning after an overnight fast in a sterile bottle. Serum was separated for the estimation of serum TSH, T3, T4, and total cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), which were derived from TC and TG, using Friedwald's Formula [LDL = TC - (HDL + TG/5)], Very low-density lipoprotein (VLDL) derived from TG.. Lipid profile was compared with matched controls. Results: The levels of TSH are significantly higher in group II compared to group I, which is statistically significant. (p≤0.05) There is a significant increase in the serum TC level in group II individuals when compared to group I, which is statistically significant. (p≤0.05). There is also a significant increase in serum LDL Cholesterol in group II individuals when compared to group I individuals, which is statistically significant. Conclusion: Subclinical hypothyroidism (SCH) is associated with increased serum TC and LDL-C levels. Therefore, there is a potential association between subclinical hypothyroidism and atherosclerosis. Larger studies are needed to prove this association in Patients.

Introduction: Thyroid disorders, affecting approximately 42 million individuals in India, pose significant public health concerns. This study focuses on determining the prevalence of undetected hypothyroidism and associated risk factors among adults in Odisha, India. Methods: A cross-sectional study at SLN Medical College, Odisha, involved 970 participants aged 20-70 years. Demographic data, symptoms, and TSH levels were recorded. Regression analysis assessed risk factors, and Anti-TPO antibodies were tested in a subset. Results: Undetected hypothyroidism prevalence was 16.8%, higher than previous studies. Females exhibited a higher prevalence (19.1%) than males (10.2%). Regression analysis identified gender and symptoms as significant correlates. Anti-TPO positivity was 94.8% in subjects with elevated TSH. Discussion: The prevalence increase suggests a growing health concern. Regional variations and environmental factors, including thyroid disruptors, demand further investigation. The impact on reproductive health emphasizes the need for early detection. Conclusion: Undetected hypothyroidism remains a prevalent issue in Odisha, with autoimmune factors playing a substantial role. Addressing this condition is crucial for enhancing population health and productivity.

Introduction: Renal function is evidently modified in both hypothyroidism and hyperthyroidism. However, there is a scarcity of clinical data on the relationship between thyroid disease and renal function. The objective of this study was to evaluate alterations in biochemical indicators of renal function in individuals with thyroid dysfunction and to correlate these measurements with the patient's thyroid hormones. Material and Methods: A total of 25 patients with primary hyperthyroidism and 294 patients with primary hypothyroidism were included as cases. A group of 100 persons who were in good health were selected as controls. Immunoassay was used to evaluate thyroid-stimulating hormone (TSH), free thyroxine (FT4), and free triiodothyronine (FT3). The serum levels of urea, creatinine, and uric acid were measured using an EM-360 autoanalyzer. The estimated glomerular filtration rate (eGFR) was calculated using the Modification of Diet in Renal Disease (MDRD) algorithm. Renal function tests were evaluated in all cases. Results: The results of our study showed a significant increase in the average levels of serum urea (36.26±3.69) and uric acid (6.55± 0.34) in patients with hypothyroidism. This increase was statistically significant (p value < 0.001). Similarly, we observed a significant increase (p value < 0.001) in serum urea (29.98±2.17) and uric acid (6.59± 0.34) levels in patients with hyperthyroidism. Nevertheless, hyperthyroid patients exhibited a decrease in serum creatinine levels (0.70± 0.04) compared to the control group, resulting in an increase in estimated glomerular filtration rate (eGFR) (121.55± 5.79). Conversely, the hypothyroid group showed a significant increase in creatinine levels (1.04± 0.05) (p value < 0.001), leading to a decrease in eGFR (102.05± 5.38) compared to the control group. Conclusion: Thyroid dysfunction is linked to abnormal renal function. The clinician should recognize the association between thyroid problems and abnormal kidney function to consider performing a thyroid function test for patients with slightly raised biochemical indicators of renal function during treatment. Monitoring creatinine levels is necessary for people with thyroid disease.

Background:  To explore the association of carotid intima medial thickness (CIMT) with TSH and other biochemical parameters among young adults with thyroid dysfunction. Material methods: Our study included 50 young subjects , 13-39 years, attending endocrinology clinic of our centre for thyroid dysfunction with no associated co-morbidities. BMI, thyroid and biochemical profile was assessed for all. All subjects underwent measurement of right and left CIMT using sonography (linear transducer 7mHz frequency). Statistical methods were then used to analyse the data. Results: CIMT values in our 50 subjects [hypothyroid:n=37 and hyperthyroid:n=13; age: 27.6±7.1 years ] fell in the normal range (Rt=0.53±0.10 mm ; Lt=0.52±0.11 mm).  Hypothyroids had a significantly higher HbA1C (p value;0.038) and Serum cholesterol (p value;0.028) levels as compared to hyperthyroid subjects. When the values for the entire group were studied, CIMT values did not correlate either with TSH or BMI [24.66±4.14 kg/m. sq.]; though it positively correlated with age and HbA1c (particularly right CIMT, correlation coefficient,0.50).  Hyperthyroid subjects had a significant positive correlation of TSH with Rt CIMT(0.750) and S.creatinine (0.780) and a negative correlation with cholesterol (-0.700). On the other hand, in hypothyroids, TSH levels did not significantly correlate with any parameters other than age (-0.38). Conclusion: Higher HbA1c (even in non diabetic range) are associated with higher CIMT among young patients of thyroid dysfunction, making it a useful tool for monitoring cardiovascular risk in conjunction with CIMT, especially in those with hypothyroidism.  

Background: Hypothyroidism and Type 2 Diabetes Mellitus (T2DM) are prevalent endocrine disorders, and their interplay has garnered significant attention due to potential bidirectional relationships. This study investigates the association of hypothyroidism in T2DM patients, focusing on prevalence, clinical correlations, and implications for management. Materials & Methods: A cross-sectional study was conducted at Hind Institute of Medical Sciences, Uttar Pradesh, involving 50 T2DM patients. Clinical assessments, thyroid function tests, and diabetes parameters were collected. Statistical analyses, including descriptive statistics, odds ratios, and correlation coefficients, were employed to explore associations. Results: Among T2DM patients, 20% exhibited hypothyroidism, emphasizing a noteworthy prevalence. Alterations in thyroid function parameters, including elevated TSH and decreased FT4 and FT3, indicated subclinical hypothyroidism. Glycemic control analyses revealed significant differences in FBG and HbA1c levels between euthyroid and hypothyroid individuals. Odds ratios demonstrated associations between hypothyroidism and age, BMI, and T2DM duration. Medication usage patterns highlighted the necessity of thyroid-specific interventions. Conclusion: This study uncovers a substantial prevalence of hypothyroidism in T2DM patients, emphasizing the intricate relationship between these endocrine disorders. Clinical correlations with age, BMI, and T2DM duration suggest the need for tailored therapeutic approaches. Recognizing the impact on glycemic control, screening strategies, and public health measures may enhance patient outcomes in this complex interplay.

Background: This study examines the correlation between thyroid function and obesity, an area of increasing clinical interest due to the rising prevalence of both thyroid disorders and obesity worldwide. Previous research has suggested potential links, but findings have been inconclusive, necessitating further investigation. Objectives: The primary objective was to explore the relationship between thyroid function tests and obesity indices in a cross-sectional population. The study aimed to contribute to the understanding of how thyroid function may influence or be influenced by obesity. Methods: We conducted a biochemical cross-sectional study involving 250 participants, selected based on predefined inclusion and exclusion criteria. Thyroid function was assessed using standard thyroid function tests (TFTs), including TSH, T3, and T4 levels. Obesity was evaluated using body mass index (BMI) and waist circumference measurements. Statistical analysis was performed to identify correlations between TFTs and obesity indices. Results: The study found significant correlations between certain thyroid function parameters and measures of obesity. Elevated TSH levels were notably associated with higher BMI and waist circumference. These associations persisted even after adjusting for potential confounders, such as age and gender. Conclusion: Our findings suggest a significant correlation between thyroid function tests and obesity, particularly an association between elevated TSH levels and increased obesity indices. This study enhances the understanding of the interplay between thyroid function and obesity, potentially guiding future clinical management and research.

Introduction: Liver cirrhosis is often associated with altered thyroid function, which may reflect the severity of liver dysfunction. Understanding this relationship can help in predicting disease progression and prognosis in cirrhotic patients. The aim of this study was to demonstrate the relationship between thyroid function tests and the severity of liver function in cirrhosis of the liver. Method: A total of 73 patients diagnosed with cirrhosis of liver based on clinical, biochemical, and radiological findings were included. Results: Majority of the patients belonged to the age group of 41-59 years (63%) with male predominance (79.4%). Alcoholism (84.9%) emerged as the leading cause of liver cirrhosis. Fatigue (73.9%), body ache (57.5%), and dysphagia (54.7%) were the most common clinical symptoms linked to thyroid dysfunction. Using the Child-Pugh classification system, 15 patients were categorized as Child A, 37 as Child B, and 21 as Child C. Hypothyroidism (65.7%) was more prevalent than hyperthyroidism among the patients. Significant correlations were found between T3, FT3, and TSH levels and the severity of liver dysfunction, as classified by the Child-Pugh score (p<0.05). Hepatic encephalopathy (42.85%) was the main complication causing mortality, and all fatal cases (7) had abnormal thyroid profiles. Conclusion: In conclusion, altered T3, FT3, and TSH levels were associated with disease progression in cirrhosis and can serve as valuable indicators for prognosis. These findings suggest that thyroid function tests should be considered in evaluating the severity of liver disease progression and outcome of cirrhosis in affected patients.

Background-Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease that can involve multiple organs, causing widespread inflammation and tissue damage. One organ often affected is the thyroid gland, which plays a critical role in regulating metabolism. Thyroid dysfunction, such as hypothyroidism, hyperthyroidism, and autoimmune thyroiditis, is frequently observed in SLE patients. However, the exact mechanisms linking these disorders and their clinical significance are not well understood. This study seeks to investigate thyroid dysfunction's prevalence and clinical implications in SLE patients to improve patient management and outcomes. Method-This was a prospective observational study conducted at a tertiary care hospital over a 6-month period. Fifty-two newly diagnosed SLE patients meeting the SLICC criteria were included. Their clinical data, including age, gender, and presenting symptoms, were collected. Disease severity was measured using the SLE Disease Activity Index (SLEDAI) at admission, with follow-up assessments at 3 and 6 months. Thyroid function was evaluated by measuring T3, T4, and TSH levels at baseline, 3 months, and 6 months. Routine blood investigations were also conducted.  Results-Among the 52 patients, 94.2% were female, with the majority (40.4%) aged between 18-25 years. Thyroid dysfunction was observed in 23.1% of the participants—7.7% had subclinical hypothyroidism, and 15.4% had clinical hypothyroidism. The study revealed significant improvements in disease activity (SLEDAI scores) across all thyroid status groups after 6 months of treatment. Euthyroid patients had a 79.73% reduction in SLEDAI scores, while those with subclinical and clinical hypothyroidism showed reductions of 57.89% and 82.35%, respectively. Statistical analysis indicated no significant differences in treatment outcomes among the thyroid status groups. Conclusion- This study confirms that thyroid dysfunction is common in SLE patients and significantly affects disease activity. Regular thyroid function screening in SLE patients is essential for timely diagnosis and management of this comorbidity, which could improve disease prognosis and treatment outcomes. Further research is required to explore the shared pathophysiological mechanisms between SLE and thyroid disorders.

Background: Cassava or tapioca is one of the staple foods of the people of Kerala. Population with tapioca as staple food should be studied in detail due to the increased toxicity of tapioca yields due to the greenhouse effect. It is rich in hydrogen cyanide, which is metabolized by the liver to thiocyanate.  Objective:The objectives of the study are to observe the variation in physiology of the human body due to the effect of low dose cyanide in the diet and the effect of thiocyanate in blood on the blood pressure and thyroid function. Methods: A descriptive cross-sectional study design was conducted in the department of General Medicine out-patient department of a tertiary care hospital of central Kerala. This research was conducted after obtaining ethical clearance from the institutional ethical committee.  Results: The blood pressure of each subject was recorded. The thyroid function tests (fasting TSH values) of each subject were determined. The BMI for each subject was calculated. There were not much changes in the systolic blood pressure in hypothyroid group and hyperthyroid group. There were not much changes in diastolic blood pressure in hypothyroid group and in hyperthyroid group. The TSH values in the hypothyroid group and in the hyperthyroid group were significant compared to the matched controls. There is significant increase in BMI in the hypothyroid subjects. There is significant decrease in BMI in the hyperthyroid subjects. Conclusion: The above study did not show much changes in the systolic and diastolic blood pressure. These findings are unusual. Thyroid dysfunction cause increase in blood pressure. This means low dose dietary thiocyanate, in a population with tapioca as staple food might be protective to the cardiovascular system. TSH values are comparable with the values obtained in other studies. Kerala is a developed state compared to other states of India. This allows the people to have more proteins and iodine in the diet. These protect the population from many toxic effects of cyanide in diet.

Background: Diabetes is increasingly prevalent in India, with over 62 million diagnosed cases. Studies suggest a complex interaction between diabetes and thyroid disorders, impacting glucose tolerance and insulin sensitivity. This study aimed to investigate the prevalence and types of thyroid dysfunction among type 2 diabetes mellitus (T2DM) patients in India, given limited data on the subject. Methods: This cross-sectional study was conducted at the Sri Aurobindo Institute of Medical College over 18 months, from September 2022 to February 2024. A sample of 130 patients with T2DM was recruited, excluding individuals with a known history of thyroid dysfunction or those on medications affecting thyroid function. Patients underwent clinical assessments and laboratory investigations for fasting blood sugar, postprandial blood sugar, HbA1c, and thyroid profiles. Thyroid dysfunction was categorized as hypothyroidism, hyperthyroidism, subclinical hypothyroidism, or euthyroid. Results: Among the 130 T2DM patients, 85.4% exhibited normal thyroid function, while 14.6% displayed thyroid abnormalities. Subclinical hypothyroidism was the most common (7.7%), followed by hypothyroidism (5.4%) and hyperthyroidism (1.5%). Thyroid dysfunction was more prevalent among female patients, who constituted 70.8% of the sample. A significant correlation was observed between blood glucose levels (fasting and postprandial), HbA1c, and TSH levels (p<0.05), though perfect correlations indicated potential data inconsistencies. Conclusion: Thyroid disorders, especially subclinical hypothyroidism, are relatively common in individuals with T2DM, particularly among women. The presence of thyroid dysfunction correlates with poor glycemic control, suggesting a need for routine thyroid screening in diabetic patients to enable early intervention and improve metabolic outcomes.

Background: Diabetes mellitus (DM) and thyroid disorders are among the most common endocrine diseases, with a well-documented association. Thyroid dysfunction, particularly hypothyroidism, can impact glycemic control and metabolic outcomes in diabetic patients. The prevalence of hypothyroidism varies across populations, with studies indicating a higher incidence in individuals with diabetes. This study aims to determine the prevalence of thyroid disorders in diabetic patients and assess their clinical and metabolic implications in a rural South Indian population. Methods: This hospital-based, cross-sectional study was conducted in the Department of General Medicine, Jhalawar Medical College, Jhalawar (Raj.), from September 2023 to August 2024. A total of 200 Type 2 diabetic patients were included. Clinical history, laboratory investigations including thyroid function tests (TSH, Free T3, Free T4), fasting blood sugar (FBS), postprandial blood sugar (PPBS), HbA1c, and lipid profile were assessed. Patients were categorized as euthyroid or having thyroid dysfunction based on standard diagnostic criteria. Statistical analysis was performed using SPSS version 25.0, with a p-value <0.05 considered statistically significant. Results: Among 200 diabetic patients, 48 (32%) had thyroid disorders. Hypothyroidism was found in 16 patients (10.67%), while 24 (16.00%) had subclinical hypothyroidism. The prevalence of thyroid dysfunction was significantly higher in females (44%) compared to males (20%) (p = 0.0027). Elderly individuals had a higher prevalence of hypothyroidism (15.52%) than middle-aged adults (7.61%). Patients with thyroid dysfunction had significantly higher TSH levels (p < 0.0001) and increased total cholesterol, LDL, and triglyceride levels compared to euthyroid diabetic patients. Additionally, a longer duration of diabetes was significantly associated with thyroid dysfunction (p = 0.0055). Conclusion: This study highlights a high prevalence (32%) of thyroid dysfunction in diabetic patients, with a greater burden on elderly individuals and females. Hypothyroid diabetic patients exhibited higher BMI, lipid abnormalities, and prolonged diabetes duration, emphasizing the need for routine thyroid screening in diabetic patients to prevent metabolic complications

Background: According to various past studies, conflicting information regarding the connection between Thyroid dysfunction and HAART is present. Therefore, the purpose of this study was to determine effect , compare & correlate ART on Thyroid Profile among HIV (+ve) patients. Material and Method: 102 patients were assessd for baseline data [CD4 level & Viral Load] then at 6 & 12 months after switching to 2nd line ART later asked for follows up for Thyroid Function test & FT3, FT4 and TSH. Result: We found that, for CD4, difference was not significant for FT3 & FT4 at baseline , 6th & 12 th month, while significant for TSH respectively. For VL, non- significant at baseline & 6th month for FT4 & TSH while significant for FT3 and finally at 12th month all the variables showed non-significant diffrence. Conclusion: Majority of the patient developed subclinical hypothyroidim, therefore follow up to be ensured and treat when indicated. 2nd line ART treatment is more effective treatment in reducing VL while increase CD4 count at subsequent follow up.

Background: It was discovered that thyroid hormones, which are classified as catabolic hormones, control several metabolic processes, such as lipid synthesis, mobilization, and breakdown. Thyroid hormones significantly affect lipoprotein metabolism as well as some CVD risk factors, thus influencing the overall CVD risk. Objectives: To find relation between abnormal thyroid functions and lipid levels Methods: It is a Cross-sectional study. Analysis of Total Cholesterol, Triglycerides and HDL Cholesterol was made using a fully automated Biochemistry analyzer. Serum T3, T4, and TSH were analyzed using Chemiluminescence assay. Correlation of Thyroid hormone and lipid ration were done. Results: Majority of them (39.2%) were 41-50 years age group, with female predominance (62.7%). Mean serum levels of TC, TG VLDL, LDL cholesterol and LDL/HDL ratio indicated significantly higher among hypothyroid group as compared to euthyroid group, whereas mean HDL level were significantly lower in hypothyroid group as compared to euthyroid group (p<0.05). Mean serum levels of TC, TG, VLDL, LDL cholesterol and LDL/HDL ratio were significantly lower among hyperthyroid group as compared to euthyroid  group (p<0.05), whereas mean HDL level were significantly higher in hyperthyroid group (p<0.05). Conclusion: Screening for lipid profiles is crucial in all patients with thyroid dysfunction, and it is essential to identify and address underlying lipid abnormalities

Background: Thyrotoxicosis is a clinical syndrome caused by excessive circulating thyroid hormones, leading to a hypermetabolic state. This study aims to evaluate the clinical profile of thyrotoxicosis patients and review its various etiologies. Methods: A prospective study was conducted on 50 patients of either sex, age more than 12 years, who fulfill the criteria for diagnosis of hyperthyroidism. A detailed clinical examination, routine investigations, thyroid profile, ultrasound of the neck, and thyroid scans were performed as needed. Results: Thyrotoxicosis was more prevalent in the younger population (<40 years), with a mean age of 41.12 years. A female predominance was observed. The most frequently reported symptoms included palpitationss, hand tremors, weight loss, nervousness, and dyspnea. Cardiovascular manifestations were common, with palpitations, dyspnea, arrhythmia, and heart failure being the most frequently observed. Tachycardia and atrial fibrillation were the most prevalent cardiovascular signs. Electrocardiographic changes correlated with thyroid hormone levels, indicating that increased Free T3 and Free T4 levels and decreased TSH levels were directly associated with heart rate and rhythm changes. Additionally, 32% of patients had elevated pulmonary hypertension, which showed potential reversibility with anti-thyroid treatment. Conclusion: Early diagnosis and identification of the etiology of thyrotoxicosis may help in reversing the condition and preventing complications. Appropriate treatment strategies should be implemented to manage cardiovascular manifestations and other systemic complications associated with thyrotoxicosis.

Background: Hypothyroidism is a common endocrine disorder that disrupts metabolic processes, including lipid metabolism, increasing cardiovascular risk. Thyroid hormones (T3, T4) regulate lipid homeostasis, and their deficiency leads to dyslipidemia. This study evaluates lipid profile alterations in geriatric hypothyroid patients and examines the correlation between thyroid-stimulating hormone (TSH) levels and lipid parameters. Methods: A cross-sectional observational study was conducted at Pt. B.D. Sharma PGIMS, Rohtak, over one year. A total of 100 geriatric patients (≥60 years) diagnosed with hypothyroidism were included. Medical history was recorded, and biochemical assessments of lipid profiles and TSH levels were performed. The lipid parameters analyzed were triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and very-low-density lipoprotein cholesterol (VLDL-C). Pearson correlation was used to assess associations between TSH and lipid parameters using SPSS version 21. Results: The mean levels were: TG 182.44 ± 44.67 mg/dL, TC 171.40 ± 37.32 mg/dL, HDL-C 55.76 ± 17.99 mg/dL, LDL-C 83.76 ± 24.11 mg/dL, and VLDL-C 33.92 ± 14.33 mg/dL. A significant positive correlation was observed between TSH and VLDL-C (r = 0.261, p = 0.009), while other lipid parameters showed no significant correlation with TSH. Conclusion: Geriatric hypothyroid patients exhibit dyslipidemia, particularly elevated TG, TC, and LDL-C. The significant association between TSH and VLDL-C highlights thyroid dysfunction’s role in lipid metabolism. Routine lipid assessment is crucial for cardiovascular risk management in hypothyroid patients. Further research is needed to explore underlying mechanisms and targeted interventions.

Background: Hypothyroidism is a common endocrine disorder characterized by elevated serum thyroid-stimulating hormone (TSH) and decreased thyroid hormone levels. Timely initiation and appropriate titration of levothyroxine are crucial for symptomatic relief and metabolic balance. This study evaluates the impact of levothyroxine dose adjustment on serum TSH levels and quality of life (QoL) in newly diagnosed hypothyroid patients over six months. Materials and Methods: A prospective observational study was conducted on 60 newly diagnosed hypothyroid patients aged 20–55 years at a tertiary care hospital. Levothyroxine therapy was initiated based on body weight and titrated every 6 weeks to achieve target TSH levels (0.5–4.5 µIU/mL). Serum TSH was measured at baseline, 3 months, and 6 months. QoL was assessed using the Thyroid-Specific Patient-Reported Outcome (ThyPRO) questionnaire at the same intervals. Results: The mean baseline TSH was 18.7 ± 5.4 µIU/mL, which significantly decreased to 6.1 ± 2.3 µIU/mL at 3 months and reached 2.9 ± 1.1 µIU/mL at 6 months (p < 0.001). QoL scores showed marked improvement, with the mean ThyPRO score improving from 72.4 ± 8.2 at baseline to 48.3 ± 7.5 at 3 months and 31.6 ± 6.4 at 6 months (p < 0.001). Most patients reached euthyroid status by the end of the study with individualized titration. Conclusion: Levothyroxine dose titration over a 6-month period significantly improves thyroid function and quality of life in patients with newly diagnosed hypothyroidism. Regular monitoring and individualized dosing are key to achieving optimal therapeutic outcomes.

Background: Subclinical hypothyroidism (SCH), characterized by elevated serum thyroid-stimulating hormone (TSH) with normal free thyroxine (FT4) levels, has emerged as a potential contributor to cardiovascular risk. Its prevalence in patients with ischemic heart disease (IHD) remains under-investigated, particularly concerning its impact on clinical outcomes. This study aims to assess the prevalence of SCH among individuals diagnosed with IHD and to evaluate its clinical implications. Materials and Methods: A cross-sectional observational study was conducted over a period of 12 months at a tertiary care center. A total of 150 patients with confirmed ischemic heart disease were enrolled. Thyroid function tests (TSH, FT4) were performed, and demographic, clinical, and biochemical parameters were recorded. Patients were classified into euthyroid and SCH groups based on TSH levels. Statistical analyses included chi-square test and logistic regression to identify associations between SCH and cardiovascular risk factors. Results: Out of 150 patients with IHD, 38 (25.3%) were found to have subclinical hypothyroidism. The SCH group had a significantly higher mean TSH level (6.9 ± 0.5 µIU/mL) compared to the euthyroid group (2.8 ± 0.7 µIU/mL, p<0.001). Patients with SCH also exhibited increased prevalence of hypertension (68.4% vs 51.2%, p=0.03), higher LDL cholesterol levels (137 ± 20 mg/dL vs 120 ± 15 mg/dL, p=0.02), and reduced left ventricular ejection fraction (48% vs 55%, p=0.04). Multivariate analysis indicated SCH as an independent risk factor for poor cardiac function. Conclusion: Subclinical hypothyroidism is notably prevalent among patients with ischemic heart disease and is associated with adverse cardiovascular parameters. Early identification and management of SCH in IHD patients may improve clinical outcomes and reduce disease burden.

Background: Two of the most prevalent metabolic disorders in the world are diabetes mellitus (DM) and hypothyroidism. Both illnesses are becoming much more common, and if left untreated, they can have long-term consequences. Aim: this study aimed to evaluate the relationship between thyroid related hormones and vascular complication in type 2 diabetes mellitus patients in a tertiary level hospital. Methods: This cross-sectional study included one hundred Types 2 DM patients. Thyroid function tests were performed on the subjects. TSH was divided into three levels: 0.27–2.49 mU/L, 2.5–4.2 mU/L, and >4.2 mU/L. Every participant had their risk for diabetic retinopathy, diabetic neuropathy, and diabetic nephropathy evaluated. TSH levels and microvascular consequences of type 2 diabetes were examined in relation to each other. Results: The TSH level and HbA1c did not significantly correlate (P>0.05). Microvascular disease affected 72% of the patients overall. There was no discernible correlation between TSH levels and neuropathy or retinopathy. There was no statistically significant correlation (P>0.05) between the presence of microalbuminuria and macroalbuminuria and elevated TSH levels. Higher TSH levels were shown to be significantly correlated with both diabetic kidney disease and reduced GFR (P<0.05). Conclusions: Since elevated TSH levels in Type 2 DM patients may be a sign of underlying microvascular problems, it is desirable to screen all patients for thyroid dysfunction.

Background: Thyroid nodules are commonly detected incidentally, and while the majority are benign, some may require further evaluation. Ultrasound plays a key role in the initial assessment by evaluating features such as size, composition, echogenicity, margins, and calcifications. It helps in risk stratification and determining the need for fine-needle aspiration biopsy (FNAB). This study focuses on the role of sonography in the characterization of thyroid nodules. Method: This cross-sectional observational study, was conducted at the F.H. Medical College, Agra over 18 months. In this study a total of included 138 patients with thyroid nodules. Patients with nodules ≥1 cm and those providing written consent were included, while those with diffuse thyroid enlargement were excluded. Ultrasound examinations were performed using high-frequency transducers and nodules >10 mm with normal or elevated TSH levels underwent ultrasound-guided fine-needle aspiration. The findings provide insights into the diagnostic utility of sonography in thyroid nodule evaluation. Results: In this study of 138 thyroid nodules, the majority of cases were observed in individuals aged 31-40 years (26.81%), and there was a higher prevalence in females (67.39%). Most nodules were multiple (78.26%) and classified as TIRADS 3 (32.6%). Cytopathological examination revealed 75.3% benign cases, 13% indeterminate, and 11.5% malignant. Taller-than-wide shape, irregular margins, and marked hypoechogenicity were significantly associated with malignancy. The risk of malignancy increased with higher ACR TIRADS scores, with TIRADS 5 showing an 87.5% malignancy risk. The diagnostic accuracy of ACR TIRADS was 85.83%, with high sensitivity (81.25%) and specificity (86.54%), making it a reliable tool for assessing thyroid nodule malignancy. Conclusion: Sonography is essential for evaluating thyroid nodules and helping assess malignancy risk. Key features like shape, margin, echogenicity, and composition are critical indicators. The ACR TI-RADS scoring system effectively categorizes nodules by malignancy risk, guiding clinical decisions for further testing and treatment.

Background: Hypothyroidism, a condition characterized by insufficient thyroid hormone production, is commonly caused by autoimmune thyroiditis, particularly Hashimoto’s thyroiditis. Vitamin D deficiency has been increasingly recognized as a factor in the development and progression of autoimmune diseases, including hypothyroidism. Despite growing evidence of a potential relationship between vitamin D levels and thyroid function, the exact correlation between vitamin D deficiency and hypothyroidism remains inconclusive. Objective: The objective of this study was to investigate the relationship between vitamin D deficiency and thyroid function in patients with primary hypothyroidism, specifically examining the association between serum vitamin D levels and thyroid-stimulating hormone (TSH), triiodothyronine (T3), and thyroxine (T4). Materials and Methods: This was a study conducted between January  2023 and December  2024 at Andhra   medical college, King George hospital , Visakhapatnam. A total of 221 patients, aged 20-60 years, diagnosed with primary hypothyroidism were included. The study excluded patients undergoing treatment for hyperthyroidism, those receiving thyroid hormone replacement therapy, and individuals on medications affecting thyroid function. Participants underwent clinical examinations, and laboratory tests were performed to measure TSH, T3, T4, and 25-hydroxyvitamin D (vitamin D) levels. Vitamin D levels were categorized as deficient (<20 ng/ml), insufficient (20-30 ng/ml), and sufficient (>30 ng/ml). The relationship between vitamin D levels and thyroid function was assessed using Pearson's correlation coefficient. Results: Among the 221 patients, 69.64% were vitamin D deficient, 16.74% had insufficient levels, and 13.62% had sufficient levels. A significant negative correlation was found between vitamin D deficiency and TSH (r = -0.336), with lower vitamin D levels associated with higher TSH, particularly in patients with overt hypothyroidism. Pearson’s correlation analysis also indicated a positive correlation between vitamin D deficiency and T3 (r = 0.248) and T4 (r = 0.291), suggesting a potential regulatory effect of vitamin D on thyroid hormones. Conclusion : The study confirmed a high prevalence of vitamin D deficiency in patients with primary hypothyroidism, with a significant negative correlation between vitamin D levels and TSH. The findings suggest that vitamin D deficiency may contribute to the progression of hypothyroidism, particularly in more severe forms.