Search

Background: Thyroid physiology is perceptibly modified during normal pregnancy. These alterations take place throughout gestation, help to prepare the maternal thyroid gland to cope with the metabolic demands of pregnancy, are reversible post-partum and the interpretation of these changes can pose a challenge to the treating physician. Material and Methods: This is a prospective, descriptive and observational study conducted among hypothyroid pregnant women from their preconception to complete gestational phase (with whatever outcome), conducting to Index institute of Medical sciences and Hospital over a period of 2 years. The hypothyroid pregnant females visiting to Endocrine and Obstetric Department at the Index institute of Medical sciences and Hospital. All pregnant women who will be diagnosed hypothyroidism defined as either overt (elevated TSH and low FT4) or subclinical (elevated TSH and normal FT4) hypothyroidism and those labelled only 'hypothyroidism' (uncategorized) by the clinician either before or during pregnancy. Results: In my study most of the patients who were started on treatment responded well to it so that by 16 weeks 53% of them had their TSH restored to normal range. In my study of 266 patients started on Levothyroxine 140 of them (53%) had normal TSH by 20 weeks but 110 of them (41%) still had relatively higher levels of TSH which necessitated an increase in dose of Levothyroxine. In this table NA denotes those who abort spontaneously before 20 wks of gestation. In my study at 32 weeks period of gestation except for a single patient all the other patients attained normal TSH levels. one patient needed further increase in dose of Levothyroxine. Those who have been diagnosed before 10 weeks and on treatment, if their repeat TSH values become normal they were grouped under adequately treated group. Conclusion: Isolated Low free T4 followed by SCH have the highest rate of occurrence in the study sample. Though the occurrence of any low thyroid status, low isolated free T4 are more common in women with recurrent miscarriage, but the difference was not significant statistically. Anaemia in pregnancy was a mild public health problem in ours study. Ongoing interventions to target anaemia during pregnancy seem to be working in this setting and they should reach universal coverage. [ABSTRACT FROM AUTHOR]

Background: The incidence of autonomic dysfunction has increased in the presence of type 2 diabetes mellitus and various tools have been developed for assessing it. Classical autonomic function tests are one among them. Autonomic nervous system (ANS) innervates almost all organ systems and is primarily involved with homeostatic regulatory mechanisms. The important functions of ANS are maintenance of homeostatic conditions of the body; regulation of visceral activities; smoothening body's responses to environmental changes, stress, and exercise; and assisting endocrine system to regulate various functions. Materials and methods: This crosssectional study was conducted in the Department of Physiology, Tertiary Care teaching Hospital over a period of 1 year. Involves participants with T2DM (n = 70) and healthy volunteers (n = 70) with an age range of 30-60 years of both genders. Subjects ranging from 30 to 60 years of both genders who were diagnosed with type 2 diabetes mellitus for 3 years duration were recruited for the study. The controls were normal healthy volunteers in the same age group. The cases were selected from diabetology OPD and endocrinology OPD according to the inclusion criteria. The controls were selected from medical OPD who were non diabetic healthy volunteers. Details of present history, treatment history were obtained. Result: There was no significance in age between cases and controls as the p value was 0.2789. The mean SDNN of cases was 29.88 ± 3.99 and for controls was 37.65 ± 4.69. The difference in SDNN between cases and controls were significant as the p value was < 0.05. The mean RMSSD of cases was 20.61± 16.81 and for controls was 22.65 ± 3.85. The difference in RMSSD between diabetics and non - diabetics were significant as the p value was < 0.05. The mean VLF % of cases was 88.75 ± 12.75 and for controls was 80.35 ± 8.59. The difference in VLF % between cases and controls was significant as the p value was < 0.05. The mean rise in DBP after hand grip in cases was 5.25 ± 0.58 and for controls was 12.18 ± 3.94. Conclusion: Results of this study concluded that cardiac autonomic dysfunction was present in LT2DM patients without CAN (based on conventional autonomic test) characterized by predominant parasympathetic nerve function impairment and sympathetic overactivity. [ABSTRACT FROM AUTHOR]