European Journal of Molecular & Clinical Medicine

Thyroid gland is the foremost endocrine gland of the body. It controls metabolism, development, growth and maintenance of the body.Imbalance in secretions of thyroid hormones affects almost every aspect of health and metabolism. Disturbances in glucose homeostasis is obivious. Thyroid hormones have effect on glucose metabolism and probably on the development of insulin resistance (IR). Recently hypothyroidism has been linked to increased insulin resistance or decreased insulin sensitivity. The aim of this article is to review the earlier research work showing the effect of thyroid hormone deficiency on glucose metabolism, insulin levels and insulin resistance in hypothyroidism, to get a better perspectiveon association between hypothyroidism and insulin resistance.

Thyroid hormones play important role in normal growth and maturation of skeletal system.Thyroid function regulates a wide array of metabolic parameters. Thyroid gland produce two important hormones triiodothyronine (T3) and thyroxine (T4) which are known as T3 and T4. Hypothyroidism and hyperthyroidism are two primary pathological conditions that involve thyroid glands. Disorder of thyroid gland are among the most abundant endocrine disorders in India

Background: The prevalence of NAFLD in adults has been reported to be as high as 33% making it the most common cause of chronic liver disease. The present study assessed prevalence of non-alcoholic fatty liver disease in hypothyroid patients.
Materials & Methods: 82 patients of hypothyroidism of both genders were selected and assessment of hypothyroidism was done with measurement of T3, T4 and TSH. Ultrasonography (USG) of all patients was performed and steatosis was graded as 1 if less than 33% of the hepatocytes were affected, grade 2 when 33 - 66% of the hepatocytes were affected, and grade 3 if more than 66% of the hepatocytes were affected.
Results: Out of 82 patients, males were 50 and females were 32. TSH level <5 mIU/ml was seen in 7, 6-20 mIU/ml in 5, 21-35 mIU/ml in 10, 36-50 mIU/ml in 20, 50-65 mIU/ml in 16 and >65 mIU/ml in 24 patients. The difference was significant (P< 0.05). Fatty liver grade I was seen in 10, II in 18 and III in 6 patients. Serum ferritin level in grade I males was 164.5 and in females was 170.2. In grade II males was 512.4 and in females was 234.6 and in grade III males was seen in 586.2 and in females was 376.4. The difference was significant (P< 0.05).
Conclusion: Serum ferritin levels were found to be increased in patients of fatty liver with hypothyroidism. Serum ferritin could help in predicting the natural history of NAFLD in hypothyroidism patients.

Introduction: Thyroid disorders are among the most common endocrine disorders, with an
overall prevalence of Hypothyroidism about 10.95% in the general population. Prevalence of
the Metabolic Syndrome (MetS) in the Indian population is about 31.6%, with the prevalence
of 22.9% in men and 39.9% in women.
Aim: The aim of this study is to determine the prevalence of Metabolic Syndrome and its
components in people with Hypothyroidism.
Materials and Methods: A total of 200Hypothyroid patients attending our out-patient and
in-patient department were consecutively enrolled for the study. Clinical data were obtained
by interviewing the patients and referring to their case folders and prescriptions. The
anthropometric indices were recorded. The laboratory parameters that were analyzed included
fasting lipid profile, thyroid function tests, and fasting blood sugars.
Results: The patients were aged between 18 to >65years, with a mean age of 45.11 years,
and the female‑to‑male ratio was 1:2.48. The overall prevalence of the Metabolic Syndrome
was significantly higher than that in the general population, as reported earlier in various
studies. The most common occurring Metabolic Syndrome defining criterion was increased
waist circumference, and hypertension was the least documented criterion.
Conclusion: Metabolic Syndrome occurs in approximately every second patient of
hypothyroidism, and so, routine screening for components of Metabolic Syndrome may be of
benefit in this group.

Introduction: One of the most prevalent endocrinal disorder in India is dysfunctioning of thyroid gland. Age, sex, regional considerations, dietary choices, and iodine intake all affect the frequency and pattern of thyroid problems.
Aim and Objectives: To determine the frequency of hypothyroidism and the contribution of demographic factors, family history, medical history and dietary patterns.
Materials and Methods: A pre-designed questionnaire was used to interview 546 respondents from different geographic locations like rural and urban parts of District Moradabad (U.P.), gathering information on their demographics, family histories, eating habits, and potentially concerning symptoms.

Aim: To evaluate the role of Electrocardiographic, USG and Echocardiography in hypothyroidism
Material and methods: All patients were subjected to a detailed clinical history, clinical examination, and blood investigation including blood group, complete blood count, renal function test, liver function test, thyroid function test, ECG, 2D echo, and USG neck after obtaining informed written consent and clearance from the institutional scientific and ethical committee. The current gold standard for care calls for a TSH assay of the third generation. Automated platforms using state-of-the-art immunometric assays were used to conduct the TSH testing.
Results: The severity of hypothyroidism ranged from moderate (48.75%) to severe (31.25%) to mild (20%). Sinus bradycardia (32.5%) was the most prevalent ECG abnormality, followed by ST-T alterations (21.25%), while 21.25 % of patients had normal ECGs. USG neck was normal in 26.25% patients. Among abnormal USG , thyroiditis constitute 31.25% and was the most common usg neck finding in the study population. 2D ECHO finding was normal in 27.5% patients. Among abnormal 2D echo reports, diastolic dysfunction constitute 37.5% of the study population and was the most common 2D echo finding in the study population.
Conclusion: The findings of this research highlight the significance of assessing individuals with primary hypothyroidism for cardiovascular abnormalities, which might lead to timely therapies that enhance clinical outcomes.

Background:Body  adiposity,  especially  ectopic  fat  accumulation,  has  a  range  of  metabolic  and cardiovascular effects. This study aimed to investigate whether thyroid function is associated with various regional fat quantities in euthyroid subjects.
Materials and Methods: This is a cross sectional study conducted on 90 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 analyzed.
Results: In this study author observed a significant decrease in FEV1 and FEV1/FVC ratio in hypothyroids. FVC between cases and controls did not show statistical significance, although the mean FVC was found to be lower in cases (1.44) as compared to controls (1.79). The various respiratory patterns seen in cases were as follows: obstructive pattern (32%), followed by mixed pattern and restrictive pattern (28%, 22% respectively). Furthermore, we observed that there was no significant correlation between TSH or fT4 with FVC, FEV1, and FEV1/FVC.
Conclusion: 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 optimize treatment especially in obese patients and patients with pre-existing lung disease as hypothyroidism adds to their respiratory dysfunction.

Background: Thyroid disorders are the most common endocrine abnormality in the
world secondary to diabetes mellitus. Thyroid hormones are essential for growth,
neuronal development, reproduction and regulation of energy metabolism. It influences
the metabolism of all substrates including minerals. Many studies have shown that
mineral metabolism is frequently disturbed in thyroid disorders.
Materials and Methods: The study was conducted on sixty newly confirmed
hypothyroid cases based on the thyroid profile and sixty euthyroid cases were recruited
as controls. Blood samples were collected from all the patients for the estimation of
serum T3, T4, FT3, FT4, TSH, calcium, phosphorus and magnesium by auto analyzer
method. Modified spectrophotometric micro-method was used to measure Serum
copper using Bathocuprine Disulphonate Disodium Salt (BCDS) and Guanidine
hydrochloride salt. The Statistical software namely SPSS 18.0, and R environment
ver.3.2.2 were used for the analysis of the data.
Results: It was found that the levels of serum sodium, potassium and calcium were
significantly decreased in cases than the controls. Serum magnesium and phosphorus
were significantly elevated in cases than controls.
Conclusion: Serum calcium, magnesium and phosphorous levels are significantly
altered in patients having hypothyroidism. Thyroid diseases have wide spread systemic
manifestations including their effects on bone and mineral metabolism. Also thyroid
hormone affects the glomerular filtration rate, renal blood flow, tubular reabsorption
and excretion of minerals which have direct effect on Calcium, Magnesium and
phosphorous level. Thus monitoring of these minerals in hypothyroid patient will be of
great benefit in improving clinical manifestation and can be treated appropriately.

Context: Beta Thalassemia major is a genetic disease with an autosomal recessive pattern of
inheritance that occurs as a result of disorder in haemoglobin synthesis. In Beta Thalassaemia
major patients multiple blood transfusions, ineffective erythropoiesis and increased
gastrointestinal iron absorption lead to iron overload in the body. Iron overload can be
determined by Serum Ferritin measurement.
Aim and Objectives
1. To Assess the average frequency of blood transfusion in Beta Thalassemia Major patients
2. To measure Serum Ferritin level in Beta thalassemia Major patients
3. To determine the association between Serum ferritin level and age, average frequency of
blood transfusion in Beta Thalassemia Major Patients.
Methods and Material: Fifty blood samples of clinically diagnosed Beta Thalassemia major
patients were collected for estimation of Serum Ferritin levels. Serum Ferritin measurement
was performed using indirect enzyme linked immune sorbent based assay kit. Data were
analysed to determine association between Serum Ferritin and age, gender and frequency of
blood transfusion.
Statistical analysis used: Descriptive statistics, Regression, Correlation
Results: The mean Serum Ferritin level was found to be 3639.75 mg/ml. Five patients had
Serum Ferritin <1000 mg/ml, Twenty three patients had Serum Ferritin between 1000-3500
mg/ml and twenty two patients had Serum Ferritin >3500 mg/ml.
Conclusion: The study showed high levels of Serum Ferritin in Beta Thalassemia major
patients. Serum Ferritin levels should be monitored regularly to assess the status of iron
overload and to rationalize the use of chelation therapy and avoid complications related to
iron overload.

Aim & objective:Maternal and Perinatal Outcome in Hypothyroidism in preganacy at tertiary care center.
Materials & Methods:A prospective observational study conducted in the Department of Obstetrics & Gynaecology a tertiary care hospital in Aurangabad district of Maharashtra from September 2020  to September 2021. All patients who fulfilled the inclusion and exclusion criteria during the study period were included in the study.
Observation & Results: In the present studymajority of pregnant women 63 (38.4%) belonged to the age group of 21-25 years & majority 69(42.1%) of them were nulliparous. The risk factors identified in majority 20 (12.19%) of women was h/o pre-eclampsia and in 12 (7.31%) cases previous preterm delivery was observed as risk factor. Further it revealed that, there was statistically significant association between GA and raised TSH level (p<0.05). Maternal complications such as anaemia, severe pre-eclampsia and abruptio placenta were significantly correlated with high TSH level. It was observed that maternal and fetal outcome were significantly associated with level of TSH at the time of delivery.
Conclusion: The study concluded that timely diagnosis and management of thyroid dysfunction is the key to avoid obstetric complications. Supplementing thyroxin in patients with hypothyroidism can prevent maternal and fetal complication, so routine screening of thyroid dysfunction is recommended in pregnant women.
    

Background:The postoperative consequences of thyroid surgery have long been
recognisedbygoitre surgeons. These problems may be serious enough to endanger the
patient's life or cause physical or physiological limitations. Given the severity of the
consequences, they must be kept to a minimum in this age of contemporary surgery.
Moreover, for surgery to remain a dominating treatment option for thyroid illness, its
complications must be less than other effective treatments. Aim: objectives of this study
is to investigate preoperative factors that influence complication rates, complication
rates linked with thyroid surgery type, problem types, complication onset time,
complication duration, complication management.
Materials and Methods: The current study lasted 18 months from January 2019 to July
2020. Princes Esra Hospital, Deccan College of Medical Sciences, Hyderabad. The study
included a prospective analysis of 80 goitre surgeries. These cases were clinically
investigated and recorded using the attached proforma.
Results: A study of 80 goitres having surgery(cases that underwent goiter surgery)
revealed Thyroid problems affect women more than men. The hospital saw the most
patients in their third decade. Multinodular Goitre in Euthyroid Status was the most
common clinical diagnosis. The most prevalent histology diagnosis was Nodular Colloid
Goitre. Subtotal thyroidectomy was the most common procedure for goitre.
Complications after surgery included wound infection. This trial had no fatality and
little morbidity. It is possible to do thyroid surgery with little morbidity and mortality
for a wide range of thyroid illnesses if done gently with thorough attention to hemostasis
and structural features.

Introduction: Thyroid disorders are among the most common endocrine disorders, with an overall prevalence of Hypothyroidism about 10.95% in the general population. Prevalence of the Metabolic Syndrome (MetS) in the Indian population is about 31.6%, with the prevalence of 22.9% in men and 39.9% in women.
Aim: The aim of this study is to determine the prevalence of Metabolic Syndrome and its components in people with Hypothyroidism.
Materials and Methods: A total of 200Hypothyroid patients attending our out-patient  and in-patient department were consecutively enrolled for the study. Clinical data were obtained by interviewing the patients and referring to their case folders and prescriptions. The anthropometric indices were recorded. The laboratory parameters that were analyzed included fasting lipid profile, thyroid function tests, and fasting blood sugars.
Results: The patients were aged between 18 to >65years, with a mean age of 45.11 years, and the female‑to‑male ratio was 1:2.48. The overall prevalence of the  Metabolic Syndrome was significantly higher than that in the general population, as reported earlier in various studies. The most common occurring Metabolic Syndrome defining criterion was increased waist circumference, and hypertension was the least documented criterion.
Conclusion: Metabolic Syndrome occurs in approximately every second patient of hypothyroidism, and so, routine screening for components of Metabolic Syndrome may be of benefit in this group.
 

Thyroid hormone abnormality is mutual in foremost psychiatric disorders. Thyroid hormones play critical function in the method of Neurogenesis and Neurodevelopment i.e., Myelination, dendrite proliferation and formation of synapses. There is link among thyroid axis and several experienced psychiatric disorders. Noteworthy results on cerebral thyroid characteristic are observed while there are even small variations in thyroid hormone levels, within the normal range. Alterations in mood, behaviour and cognition are resulting from this. Depression, psychosis and cognitive disorder are observed in the patients of hypothyroidism. Meanwhile, people with hyperthyroidism had been observed to have psychosis, aggression, anxiety as well as cognitive impairment. Memory impairment is related with Subclinical hypothyroidism.
The objective of this study was to analyse the socio-demographic profile with assessment and comparison the type of thyroid dysfunction among patients with major psychiatric disorders. This was a cross-Sectional Observational study on 166 patient samples. Assess serum thyroid stimulating hormone (TSH), T3 (triiodothyroxine), T4 (L-thyroxine), free unbound fractions of T3 and T4 (FT3 and FT4) with the COBAS e 411 ANALYSER at Kalpana path lab, R.M.R.S.M.B. govt. hospital, Udaipur for all recruited patients.
Result of our study is that thyroid dysfunction occurs significantly in patients with psychiatric disorders. Subclinical hypothyroidism was the most common abnormality observed in the study population. Thyroid dysfunctions were predominant in females. Most of the cases with thyroid dysfunction were from rural area and age group 41-50 years. In present study, 25% of total cases drug naïve for ≥ 6 months and 10.6% of total new cases had thyroid dysfunction. Most of the cases with thyroid dysfunction were related to F20-F29 block. Isolated increased FT4 level found in significant proportion of population. This is a useful finding as this calls for frequent monitoring of Thyroid function tests in all psychiatric patients on treatment, to enable proper management.

Background:Thyroid hormones influence renal development, renal hemodynamic, glomerular filtration rate (GFR), electrolytes, and water homeostasis. The location of the present study is situated at dDepartment of Biochemistry, Maheswara Medical College, Hyderabad with moderate prevalence of thyroid dysfunctions, especially hypothyroidism. The objective of this observational cross-sectional study is to substantiate the effects of thyroid hormonal status on kidney by estimating serum creatinine, serum urea, albumin-to-creatinine ratio (ACR), and estimated GFR (eGFR) among primary hypothyroid patients with age- and sex-matched control group. The collected blood and urine samples from the study population have been estimated for the study parameters. Both Chronic Kidney Disease Epidemiology (CKD- EPI) equation and four- variable Modification of Diet in Renal Disease (MDRD) Study equation were used to calculate eGFR. In the present study the mean values of serum creatinine, urea, and ACR are significantly increased among untreated patients with hypothyroidism, with the decrease in the eGFR, in comparison to healthy control group (p < 0.001). The results of eGFR and ACR are signifi cantly correlated with thyroid-stimulating hormone (TSH) values. Statistically significant alteration in renal function parameters is associated with untreated primary hypothyroidism. Moreover, with the initiation of the treatment for the same can cause reversal of the altered status of renal function.

Background: Although overt hypothyroidism is linked to lipid metabolic abnormalities, there are mixed results when it comes to the degree of lipid alterations in subclinical hypothyroidism (SCH).
Patients and Methods: In a cross-sectional investigation, the serum lipid parameters of 70 patients with subclinical hypothyroidism and 100 age and sex matched euthyroid controls were assessed.
Results: Patients with SCH had significantly higher mean serum total cholesterol (TC), triglycerides (TG), and very low-density cholesterol (VLDL) than controls (P<0.05). Patients with serum thyroid stimulating hormone (TSH) greater than 10 mU/L had higher mean TC, TG, and low-density cholesterol (LDL) concentrations than those with serum TSH equal to or less than 10 mU/L, although the difference was not statistically significant. The concentration of blood high-density cholesterol (HDL-C) and the amount of serum TSH had no correlation.
Conclusions: High TC, TG and VLDL were observed in our patients with SCH.

Background: Hypothyroidism is widely prevalent in pregnant women, since hypothyroidism is easily treated, timely detection and treatment of the disorder could reduce the burden of adverse fetal and maternal outcomes, which are very commonly encountered. Present study was aimed to study obstetric & neonatal outcomes in pregnancies with hypothyroidism.
Material and Methods: Present study was single-center, prospective, observational study, conducted in pregnant women with more than 28 weeks pregnancy, diagnosed as hypothyroid (TSH > 3.0 mIU/L after 12 weeks of gestation), delivered at our hospital.
Results: Out of 58 patients, majority patients were of 26-30 years age group (39.66 %), 62.07 % were nulliparous, delivered at term (> 37 weeks) (68.97 %), had Spontaneous Onset of labour (67.24 %) & vaginal route was most common Mode of delivery (70.69 %). Common maternal complications observed were haemoglobin < 9 gm% (32.76 %), preterm delivery (31.03 %), hypertensive disorders of pregnancy (22.41 %), oligohydramnios (15.52 %), PPROM (10.34 %), gestational diabetes mellites (6.90 %) & post-partum hemorrhage (6.90 %). No maternal mortality was noted. Birth weight was 2.5-4 kg in majority neonates (58.62 %), while APGAR ≤ 7 at 1 min (12.07 %) & APGAR ≤ 7 at 5 min (5.17 %) noted in few cases. Other characteristics such as meconium aspiration (15.52 %), Required neonatal resuscitation (18.97 %), Neonatal jaundice (22.41 %), Admission to NICU (37.93 %) & neonatal death (1.72 %) were noted.
Conclusion: Hypothyroidism during pregnancy had an impact on maternal as well as perinatal outcome. Routine screening of thyroid dysfunction is recommended to prevent adverse fetal and maternal outcome. Supplementation of thyroid hormone had obvious benefits of treatment to reduce potential adverse outcomes associated with maternal thyroid disorders.

Background: The objectives is to Screening of all the antenatal pregnant women for
thyroid dysfunction, To study the maternal and fetal noutcome in pregnancy thyroid
dysfunction, To provide adequate treatment and there by reduce adverse outcome,
Follow up of cases six weeks post partum.
Materials and Methods: Prospective, observational study. 110 patients were included.
The study was conducted at Department of Obstetrics and Gynecology (OBG), Modern
Govt MaternityHopsital, Petlaburz attached to Osmania Medical College, Hyderabad,
Telangana, India during the period from 1st December 2019 to 30th June 2021.Mothers
attending for ante-natal check-up and having either a detected or documented thyroid
dysfunction. An Institutional Ethics Committee approval was obtained. Written
informed consent was obtained from all the study participants. The mothers during
their first visit were included for detailed history, clinical examination and blood
investigations as follows.
Results: No age related influence in the presence of thyroid dysfunction, there was no
statistical significance. it was observed that 68% of abortions were in primigravida, it
was found that with increase in gravida abortion rate was less. the mode od delivery
had no significant variations in both hypo/hyperthyroidism. it was noted that
subclinical hypothyrid and overt hypothroid cases resulted in more preterm deliveries
than hyperthyroid patients.the study showed no significance difference in newborn
thyroxine levels among thyroid dysfunction groups.
Conclusion: The study showed that thyroid dysfunction is more among the pregnant
women. Hypothyroidism is the major thyroid dysfunction among the antenatal women.
The women with thyroid dysfunction had more incidents of adverse outcomes of
pregnancy like increased abortion rates, caesarean deliveries on the mothers and
preterm babies and lbw on the newborn.

Background: The aim is to study the serum electrolyte levels in thyroid patients
attending a tertiary care hospital.
Materials and Methods: Thyroid hormones plays vital role in maintaining body's
metabolism, BMR, thermoregulation and hemodynamic status and present study was
prospective study done in the patients attending TRR Medical College & Hospital. The
study was conducted over duration of 2 years from December 2019 to June 2021. All the
patients in the age group of 18- 40 years were taken in the study. Total 100 patients
were included in the study (50 cases, 50 controls) to study the evaluation of serum
electrolytes on thyroid patients.
Results: In the present study, with respect to association of cases and controls with age,
no significant causation was seen. In this study thyroid patients have no association with
age, with not much mean difference in age of cases (32.11 years) and controls (30.02)
years. Thyroid cases were found to be more females (90%) as compared to males (10%),
but the association of sex with disease is not significant. This further concludes that
though females are commonly affected with thyroid disorders, but their association is
by chance and not significant. All serum electrolytes (Na+, K+, Cl-), TSH shows a
positive relationship it signifies that as TSH increases in patient the level of these
electrolytes also increases, but this relationship of TSH with all the electrolytes was not
significant (p>0.05).

Background: To study serum insulin levels and atherosclerotic markers in patients with
acanthosis nigricans in a rural tertiary care center.
Materials and Methods: It was a Cross sectional study. The study was conducted in the
Departments of Biochemistry and Dermatology, Venereology, Leprosy (DVL), at
Kamineni Institute of Medical Sciences, India.
Results: Total number of patients recruited for the study was 50. Mean age of the
patient was 26.8 years. Females (60%) have outnumbered males (40%). Overall
majority of the acanthosis nigricans patients were students (46%). Among females
majority of them were housewives (22%). In a majority of the patients, neck was the
initial site of darkening (82%). Most of them have duration of darkening of skin for
more than one year (64%) and 84% of the patients had an insidious onset. Forty six
percent of patients had associated medical illness such as hypothyroidism (22%),
diabetes mellitus (10%), hypertension (8%), polycystic ovarian syndrome (4%),
psoriasis (2%). Neck(98%) is the most common site of acanthosis nigricans followed by
axilla(88%); elbow(42%); periorbital region(36%); groin(34%); knees(24%);
temples(22%); infralabial region(20%); antecubital fossa(14%); perioral and perinasal
(12% each); knuckles(10%); skin over hyoid bone(8%); sides of waist and
inframammary areas(6% each) and popliteal fossa(2%). Out of 50 patients, raised
serum insulin levels seen in 54% patients, of which 42% are non-diabetics and 12% are
diabetics. Also, 96% had normal fasting blood sugars (FBS <110mg/dL), 80% had
normal postprandial blood sugars (PPBS <140mg/dL). All patients (100%) had normal
total cholesterol (< 250mg/dL), 80% patients had normal HDLc (>35mg/dL), 98% had
normal LDLc (< 130mg/dL), 80% had normal triglycerides (<160mg/dL), 86% had
normal VLDLc < 40mg/dL, out of the total 50 patients with acanthosis nigricans.
Conclusion: Hypothyroidism was present in 22% of the patients with acanthosis
nigricans whereas diabetes mellitus was present in 10% of the patients with acanthosis
nigricans. Levels of fasting serum insulin were raised in 54% of patients having burke’s
neck severity score of 2, 3, 4 and neck texture score of 2,3 and axilla severity score of 2,3
in patients with acanthosis nigricans. About 20% of studied patients had decreased
HDL cholesterol levels(<35 mg/dL and increased serum triglycerides(>160 mg/dL).

Background: Abnormal thyroid function tests are frequently observed in patients of
chronic kidney disease. Kidneys plays a significant role in thyroid hormone metabolism
by conversion of T4 to T3 (the active metabolite). Low plasma free T3 in ESRD is a
marker of the inflammation and endothelial activation; and is known to predict all
cause mortality. The present study was done look for the biochemical abnormalities of
thyroid function tests in chronic kidney disease and to correlate the severity of CKD
and alterations of thyroid indices.
Materials and Methods: In a cross sectional study, thyroid function test [TT3, TT4,
FT4, TSH] were estimated by CLIA in 50 patients of chronic kidney disease who were
in various stages. Symptoms of hypothyroidism, thyroid hormone abnormalities and
CKD stage were analyzed using Chi square test and ANOVA tests.
Results: Among the mean age was 48.8 ± 12.2 years of which 33 were male and 17
females. The mean value of TT3 in CKD stage 3, 4, 5 were 1.01±0.39; 1.05± 0.6;
0.95±1.09 μg/mL respectively. (p= 0.02 Significant). The mean value of TT4 in CKD
stage 3, 4, 5 were 6.3± 2.4; 5.5± 1.5; 5.11 ± 1.01 μIU/ml respectively. (p=0.71 Not
significant).
Conclusion: Total T3 and total T4 were found to be progressively decreased as stage of
CKD increased. There was no significant correlation between TT4 and CKD stage.
There was a significant correlation between the prevalence of thyroid dysfunction and
the stage of chronic kidney disease.Higher the degree of renal insufficiency, the higher
was the prevalence of thyroid hormone abnormalities, the levels of thyroid profile i.e
T3, T4 decreases and TSH increases as severity of renal failure increases. Thyroid
hormone abnormalities could represent a risk factor for cardiovascular disease and
might also be implicated in kidney disease progression.

The thyroid peroxidase (TPO) is a 105 kDa glycoprotein enzyme and the main antigen of the
thyroid microsomal fraction. It catalyses iodine oxidation and thyroglobulin tyrosyl iodination
reactions in the thyroid gland. Anti-TPO antibodies activate complement and are thought to be
significantly involved in thyroid dysfunction and the pathogenesis of hypothyroidism. These
antibodies are significantly present in patientsof Hashimoto's thyroiditis,Gravesdisease and
even in non-thyroidal conditions such as diabetes. In sub-clinical hypothyroidism (SCH),
presence of these antibodies is associated with increased risk of developing overt
hypothyroidism (OH). In the present study, anti-TPO antibodies were tested on 33 individuals,
all of whom reported thyroid stimulating hormone (TSH) levels > 6μIU/mL. These included
18 with SCH and 15 with OH.Anti-TPO ab positivity (levels > 28.4 IU/ml) was observed in 17
patients (51.5%) which included 5 with SCH and 12 with OH. There was greater prevalence of
positivity in OH compared to SCH (80% vs 27.8%). 8 of 33 subjects (24%) had significantly
raised anti-TPO ab (>200 IU/ml). The Billewicz scoring system was used for assessment of
clinical features of hypothyroidism with value ≥25 strongly suggestive of OH. 9 of 33 subjects
had scores ≥25 and out of these, 7 had positive anti-TPO ab.Pearson correlation revealed the
serum TSH and anti-TPO levels to be strongly positively correlated, r(32) =
.7902, p <0.0001.The Billewicz diagnostic score was also correlated with anti-TPO levels, r(32)
= .4107 which was significant at p<0.05.Our results show that higher anti-TPO ab and
TSHlevels are associated with higher symptom scores, indicating underlying
pathophysiological and immunological processes and we suggest that antibodies against TPO
should be routinely assessed in patients presenting with either elevated TSH levels or with
symptoms suggestive of thyroid dysfunction.

Background:Thyroid function has been suggested to have a relationship with kidney function and chronic kidney disease. Present study was aimed to study renal function tests in patients with hypothyroidism attending a tertiary care hospital.
Materials and Methods: Present study was hospital based, case-control study, conducted in Cases (Patients 21-60 years, of either sex, newly diagnosed cases of hypothyroidism, attending the medicine outpatient department, willing to participate) & controls (healthy age-matched subjects).
Results: In present study 100 cases & 100 case-controlled matches were studied. Age, gender & BMI were comparable among cases & controls, difference was not statistically significant. Among cases 26 had overt hypothyroidism & 74 had subclinical hypothyroidism. We compared T3, T4, TSH, Urea and Creatinine values among cases & controls. TSH and Creatinine levels were more among cases as compared to controls & difference was statistically significant. While T3, T4 & Urea levels were comparable among cases & controls, difference was not statistically significant. Pearson correlation was significant for values between TSH and serum creatinine while correlation between TSH and serum urea was not significant.
Conclusion: Subclinical hypothyroid state is associated with a consistent elevation in the serum creatinine levels due to a decrease in the GFR.

Background:One of the most frequent chronic disorders is hypothyroidism. It affects various
organs including the salivary glands. It causes pathophysiological changes including
xerostomia. Alpha lipoic acid (ALA) can provide health benefits through its role as a potent
antioxidant, metal chelator and reducing agent of the oxidized forms of other antioxidants
such as vitamins C and E. Aim: To estimate the influence of hypothyroidism on rat’s parotid
gland and to illuminate the possible curative role of alpha lipoic acid(ALA). Methodology:
Thirty-six adult male rats were haphazardlyarranged into four groups; nine animals in each
as follows: Group 1 (control group): 4 rats were givenpurified water (vehicle of carbimazole)
for threeweeks, the other 5 rats were given a daily oral dose of 2ml /kg corn oil only (vehicle of
ALA) for four weeks after initiation of hypothyroidism. Group 2 (ALA group): were given a
daily oral dose of 60 mg /kg ALA dissolved in its vehicle for 4 weeks. Group 3 (hypothyroidinduced
group): were givena daily oral dose of 1.35 mg/kg of carbimazole liquified in its
vehicle for 3 weeks to induce hypothyroidism. Group 4 (hypothyroid- ALA group): were givena
daily oral dose of 1.35 mg/kg of carbimazole for 3 weeks followed by a daily oral dose of 60 mg
/kg ALA treatment for the consecutive 4 weeks.The animals were anaesthetized and
slaughtered at the end of the experiment. Parotid glands were collected, and the specimens
were prepared for light microscopic examination using Hematoxylin and Eosin and Masson's
trichrome stains were used, Morphometric analysis using ANOVA and Tukey's post hoc
testswas performed.Results: Hypothyroidism caused histopathological changes in the form of
general cellular distortion, cytoplasmic vacuolations, cellular infiltration, blood vessels
congestion and fibrosis and morphometric changes in the form of a significant increase of
collagen fibres in hypothyroid group. Alpha lipoic acid succeeded to improve those changes.
Conclusion: Hypothyroidism has destructive effects on the Parotid gland structure.
Fortunately, it is recommended to take Alpha Lipoic Acid in hypothyroid cases to help in
decreasingsuch effects.

Introduction: Hypertensive disorders complicate 5-10 percent of all pregnancies and contributes greatly to maternal and fetal morbidity and mortality. Women with gestational diabetes are at increased risk of preeclampsia and worsens the fetal prognosis. Thyroid hormones seem to be important in placentation and regulation of early pregnancy, partly explaining the association between hypothyroidism and preeclampsia. Incidence of both hypothyroidism and gestational diabetes was found significantly higher in women with Preeclampsia Induced Hypertension. There are few studies worldwide to establish the association between Preeclampsia, gestational diabetes mellitus and hypothyroidism in pregnancy. Objective: The objective of this study was to determine the association of dual endocrinopathy in pregnancy with severity of preeclampsia. Study Design: Prospective Observational Cross-sectional Study Material and Methods: 400 patients who met inclusion criteria and consented for the study were recruited in the study from November 2015 to October 2016 in the Department of Obstetrics and Gynaecology , SMGS Hospital, Govt Med College Jammu. All patients underwent relevant blood and urine tests. They were grouped into 2 groups – mild and severe preeclampsia. The association of two groups with dual endocrinopathy (hypothyroidism and gestational diabetes mellitus) was studied. Statistical analysis: Chi-square test was employed to determine association of dual endocrinopathy with severity of preeclampsia. P-value less than 0.05 was considered statistically significant. Results: In this study, majority of patients i.e. 70.50% (282 out of 400) were in the mild preeclampsia group and only 29.50% (118 out of 400) were in the severe preeclampsia group. According to present study, 14.4 % of severe preeclampsia patients had dual endocrinopathy while only 7.8 % of mild preeclampsia patients had dual endocrinopathy. This association was calculated using Chi-Square Test and was statistically significant (P value = 0.042).

Introduction: Thyroid dysfunction may have profound effect on the female reproductive system. Hypothyroidism results in change in cycle length and amount of bleeding leading to oligomenorrhea, amenorrhea, polymenorrhea, and menorrhagia Objective: This study was conducted to see menstrual patterns in hypothyroid females of reproductive age group in Kashmir, Jammu & Kashmir. Study Design: Prospective cohort study Material and Methods: 50 patients who presented to OPD with complaints of abnormal uterine bleeding in Dept of Obstetrics & Gynaecology, SKIMS, Kashmir were recruited. Statistical Analyses: Data presented as percentages for qualitative variables. For continuous variable, student ‘t-test’ was applied and to see for association among the variables , chi-square test was used. P value less than 0.05 was considered as statistically significant. Results: In our study among hypothyroid reproductive women, most common pattern of AUB was menorrhagia that was around 58% (29/50) followed by polymenorrhea 22 % (11/50). Hypomenorhea, oligomenorrhea and amenorrhea were present in 8%, 6 % and 6 % respectively. Conclusion: In hypothyroid females presenting with AUB, menorrhagia is the most common abnormal pattern of bleeding followed by polymenorrhea. Hypomennorhea, oligomennorhea and amenorrhea were less common.

Maternal hypothyroidism, is a deficiency of the transfer of thyroid hormones from the mother to the
fetus. This study was designed to investigate the effect of induced hypothyroidism in female rats during
gestation (G), lactation (L) and gestation and lactation (G+L) on thyroid and testicular functions of
their male offspring at puberty. The hypothyroidism state was induced by administration of
propylthiouracil (PTU) (0.2) mg/kg b.w/day orally to three pregnant female rats’ groups during
different physiological state as follows: gestational group (treated from day 6 till parturition),
lactational group ( treated from parturition till weaning) and gestational and lactational (treated from
day 6 of parturition till weaning), in addition, to pregnant control group which received distilled water
(D.W) only. All offspring were weaned at 30 days age and six male offspring of each group were
chosen randomly and left without treatment until puberty (60 days) postnatal. Blood samples were
collected to the measurement of serum level of some hormones including thyroid stimulating hormone
(TSH), thyroxin (T4), triidothyronine (T3), testosterone (T), luteinizing hormone (LH), and folliclestimulating
hormone (FSH). Thyroid glands and testes were removed for histopathology study. The
results of hormonal analysis revealed a significant (P≤0.05) increase of TSH concentration in G and L
groups and a significant (P≤0.05) decrease of T4 in all treatment groups while a significant decrease in
T3 was recorded in the G group compared with the control group. Histopathological results showed
histological changes in both thyroid glands and testes in G, L, and G+L groups. The present study
concluded that the different maternal hypothyroidism periods have a nearly different impacts on
offspring male rat, where the G group was the most affected than others.

Maternal hypothyroidism, is a deficiency of the transfer of thyroid hormones from the mother to the fetus. This study was designed to investigate the effect of induced hypothyroidism in female rats during gestation (G), lactation (L) and gestation and lactation (G+L) on thyroid and testicular functions of their male offspring at puberty. The hypothyroidism state was induced by administration of propylthiouracil (PTU) (0.2) mg/kg b.w/day orally to three pregnant female rats’ groups during different physiological state as follows: gestational group (treated from day 6 till parturition), lactational group ( treated from parturition till weaning) and gestational and lactational (treated from day 6 of parturition till weaning), in addition, to pregnant control group which received distilled water (D.W) only. All offspring were weaned at 30 days age and six male offspring of each group were chosen randomly and left without treatment until puberty (60 days) postnatal. Blood samples were collected to the measurement of serum level of some hormones including thyroid stimulating hormone (TSH), thyroxin (T4), triidothyronine (T3), testosterone (T), luteinizing hormone (LH), and follicle-stimulating hormone (FSH). Thyroid glands and testes were removed for histopathology study. The results of hormonal analysis revealed a significant (P≤0.05) increase of TSH concentration in G and L groups and a significant (P≤0.05) decrease of T4 in all treatment groups while a significant decrease in T3 was recorded in the G group compared with the control group. Histopathological results showed histological changes in both thyroid glands and testes in G, L, and G+L groups. The present study concluded that the different maternal hypothyroidism periods have a nearly different impacts on offspring male rat, where the G group was the most affected than others.

Introduction: Lichen planus, is a chronic autoimmune, mucocutaneous disease affecting the oral mucosa besides the skin, genital mucosa, scalp and nails.The exact etiology of oral lichen planus is unknown. The disease most commonly affects middle-aged females. Oral lichen planus usually presents as white striations (Wickham's striae), white papules, white plaque, atrophic , ulcerative, erosive or as blisters. There is a well established correlation between oral lichen planus and liver disease. Opinion amongst researchers vary on terminology of lichen planus and lichenoid drug reaction . Recent literature reported association between lichen planus and thyroid disease.
Aim: The main aim of this study is to evaluate the association between oral lichen planus and thyroid disease and its prevalence amongst patients visiting our dental institute.
Materials and methods: 67 case sheets of patients, diagnosed with oral lichen planus between June 2019 and March-2020 were retrieved from the electronic database . Collected data were entered into the Excel sheet and was analysed using SPSS analysis.
Results: Results showed a positive association between oral lichen planus and thyroid disease, mainly hypothyroidism (7.46%). Females were more affected than males (53.7%).The erosive variant of oral lichen planus was more prevalent among the study population (44.7%). There was a positive correlation between predominant clinical variety of Lichen planus and site involved. The positive correlation between hypothroid state and lichen planus is also reported.
Conclusion: In conclusion, our study establishes an association between oral lichen planus and a coexisting thyroid disorder mainly hypothyroidism .

The present study was designed to detect the effect of toxoplasmosis in the thyroid hormones level Samples were collected during the period from July2019 to January 2020. Where the separated serum was preserved at a temperature (-20) until use. The enzyme-linked immunosorbent technique (ELISA) was used to detect toxoplasmosis. Hormone levels (TSH, TSH, T3 and calcitonin) were also measured using ELISA technology, Hormonal study, the results of the current study showed significant increase (P