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Among risk factors for SB, maternal endocrine diseases (ED), such as thyroids dysfunction and gestational diabetes mellitus (GDM), are the most frequent. This study aimed to investigate the rate of ED in a population of SB cases collected prospectively, and the relationship between these and causes of death.This is an area-based, prospective cohort study conducted in Emilia-Romagna, Italy between January 2014 and December 2020. Data included all cases of SB (22 weeks).From 2014 to 2020, 766 SB occurred out of a total of 232.506 births (SB rate:0.3/1000). The ED were present in 197/766 cases of SB (25.7%), respectively, 104 thyroid disease (52.8%), 74 GDM (37.5%), and 19 cases of concomitant GDM and thyroid disease (9.6%). Women who had SB associated with ED presented significantly higher mean maternal age (ED was more frequent in older and obese women experiencing SB. The main cause of death was abruptio placentae. This information can be helpful when counseling mothers with ED and planning antenatal management to prevent SB.

Purpose The aim of this study was to evaluate in a population of patients with erectile dysfunction (ED): (a) the prevalence of a previously unknown endocrine/glycemic disorders; (b) the correlation between ED severity and endocrine/glycemic disorders. Methods 1332 patients referred for ED from 2013 to 2020 were included. The ED diagnosis was made using the International-Erectile-Function-Index-5 questionnaire. ED severity was considered according to presence/absence of spontaneous erections, maintenance/achievement deficiency. All patients were subjected to search for sociodemographic and clinical characteristics: age, ethnicity, marital status, previous use of PDE5i, previous prostatectomy, diabetes mellitus (DM), prediabetes, endocrine dysfunctions. Results The mean ± SD age was 54.3 ± 13.7 years. The 19.1% (255/1332) of patients were already in treatment for prediabetes/diabetes or endocrine dysfunctions. Among the remaining 1077, the prevalence of previously unknown endocrine and glycemic disorders was 30% (323/1077). Among them, 190/323 subjects (58.8%) were affected by hypogonadism, with high estradiol level observed in 8/190 (4.2%). The prevalence of new glycemic alterations was 17.3% (56/323) [specifically, 32/56 (57.1%) DM, and 24/56 (42.9%) prediabetes]. A thyroid dysfunction was observed in 40/323 subjects (12.3%) and hyperprolactinemia in 37/323 (11.5%). Patients with new diagnosis of DM showed more severe form of ED compared to the total group {difficulty in the achievement of erection: 46/56 [82.2%, vs 265/1332 (19.9%), p p Conclusion ED is an early marker of endocrine/glycemic disorder, and a previously unknown dysfunction was found in more than a quarter of patients. A newly diagnosed DM is associated with ED severity, especially in elderly man and in presence of hypertension.

Fil: Genéz Yeza, Edith N. Hospital Regional de Encarnación; Paraguay. Fil: Mir, Claudia N. Misiones. Ministerio de Salud Pública; Argentina. Fil: Mir, Claudia N. Universidad Nacional de Misiones. Facultad de Ciencias Exactas, Químicas y Naturales; Argentina. Fil: Ares, Rocío M. Misiones. Ministerio de Salud Pública; Argentina. Fil: Ares, Rocío M. Universidad Nacional de Misiones. Facultad de Ciencias Exactas, Químicas y Naturales; Argentina. Fil: Pedrozo, Williams R. Misiones. Ministerio de Salud Pública; Argentina. Fil: Pedrozo, Williams R .Universidad Nacional de Misiones. Facultad de Ciencias Exactas, Químicas y Naturales; Argentina. Fil: Bonneau, Graciela A. Misiones. Ministerio de Salud Pública; Argentina. Fil: Bonneau, Graciela A. Universidad Nacional de Misiones. Facultad de Ciencias Exactas, Químicas y Naturales; Argentina. Thyroid dysfunctions are a cause of morbidity and disability worldwide. Little information has been found on the prevalence of thyroid dysfunctions in Paraguay, so this study provides data on their presentation. The objective was to determine the prevalence of thyroid dysfunction and its relationship with the lipid profile in adult outpatients attending the laboratory of the Regional Hospital of Encarnación, during January-November 2016. A descriptive cross-sectional study was performed, based on the review of 250 medical records, 84% of whom were women; the median age was 39 (35-47) years in men and 36 (32-43) years in women. Thirty percent were hypothyroid and 3% hyperthyroid; the most frequent thyroid dysfunction was subclinical hypothyroidism with 19%. Highly significant differences were found for total cholesterol, LDL, VLDL and thyrotrophin between hypothyroid vs euthyroid, with the former having more atherogenic profiles. Logistic regression was used to assess the contribution of dyslipidaemia, finding a significant association with hypothyroidism (OR=3.24(1.81-5.81), p

Background. The article presents an analysis of the literature and the results of our own research on the role of thyroid dysfunction in the development and progression of cardiovascular pathology in young and elderly people. The purpose of the study to to study and analyze the role of thyroid dysfunction in the development and progression of cardiovascular pathology in patients of different ages. Materials and methods. 229 patients aged 25 to 75 years were examined. The subjects were divided into 2 groups by age: 1 group - young patients (from 25 to 44 years) – 154 persons and 2 group – elderly patients (from 60 to 75 years) – 76 persons. Depending on the level of thyroid-stimulating hormone, patients were divided into three subgroups: with subclinical hypothyroidism, with a concentration of thyroid-stimulating hormone from 4.01 mU/L to 10 mU/l; with high-normal thyroid-stimulating hormone from 2.01 mU/l to 4.0mU/l; with low-normal thyroid-stimulating hormone from 0,4 mU/l to 2,0 mU/l. Thus: subclinical hypothyroidism was found in 94 patients in the 1 group and in 15 patients in the 2 group; low-normal thyroid-stimulating hormone was detected in 30 persons in the 1 group and in 41 persons in the 2 group; high-normal thyroid-stimulating hormone was noted in 30 persons in the 1 group and in 20 persons in the 2 group. Results. Among the subjects in the 1 group, the highest values of both systolic blood pressure and diastolic blood pressure were found in the presence of subclinical hypothyroidism. According to the duplex scan of the common carotid artery, it was found that among young patients, the thickness of the intima-media complex in the presence of subclinical hypothyroidism by 33.3 % on the right and 35.0 % on the left was thicker than in high-normal thyroid-stimulating hormone. In this group of patients with subclinical hypothyroidism, a direct correlation was found between thyroid-stimulating hormone and body mass index, total cholesterol, triglycerides, low-density lipoprotein, atherogenic coefficient, and an inverse strong correlation between thyroid-stimulating hormone and high-density lipoprotein. In addition, patients of the 1 group showed a positive correlation between thyroid-stimulating hormone levels and very-low-density lipoprotein levels. In patients in the 1 group with subclinical hypothyroidism, the values of waist circumference and waist circumference to hip circumference coefficient, left ventriclewall thickness were also higher than in other subgroups, although the values of these indicators did not exceed the norm. In the patients of the 2 group, hypertension was detected in all patients, its average duration was 15.6 ± 6.2 years. A significant proportion of patients with dyslipidemia were found in this group. According to the duplex scan of the common carotid artery, it was found that in the 2 group the frequency of thickening of the carotid artery wall > 0.9 mm or the presence of plaque in the group with low-normal thyroid-stimulating hormone was probably lower than in the subgroup with subclinical hypothyroidism. The higher frequency of detection of atherosclerotic lesions of the carotid arteries in patients with subclinical hypothyroidism, especially in the elderly, corresponds to the literature, and also coincides with the higher frequency of detection of dyslipidemia in them. Conclusions. As a result of the study, we confirmed the role of subclinical hypothyroidism in the development of dyslipidemia in young and elderly people. The functional state of the thyroid gland in patients of different ages with cardiac pathology affects the frequency and severity of risk factors and lesions of target organs in hypertension, which requires timely careful monitoring. Therefore, it is important to comprehensively examine patients at a young age., Актуальность. В статье представлен анализ данных литературы и результаты собственных исследований о роли дисфункции щитовидной железы в развитии и прогрессировании сердечно-сосудистой патологии у лиц молодого и пожилого возраста. Цель исследования: изучить и проанализировать роль дисфункции щитовидной железы в развитии и прогрессировании сердечно-сосудистой патологии у пациентов разных возрастных групп. Материалы и методы. Было обследовано 229 пациентов в возрасте от 25 до 75 лет. Обследованные были разделены на 2 группы по возрасту: 1 группа – пациенты молодого возраста (от 25 до 44 лет) – 154 человека и 2 группа – пациенты пожилого возраста (от 60 до 75 лет) – 76 человек. В зависимости от уровня тиреотропного гомона, пациенты были разделены на три подгруппы: с субклиническим гипотиреозом, с концентрацией тиреотропного гомона от 4,01 мЕд/л до 10 мЕд/л с высоконормальным уровнем тиреотропного гомона, тиреотропного гомона от 2,01 мЕд/л до 4,0мЕд/л с низконормальным уровнем тиреотропного гомона, тиреотропного гомона от 0,4мЕд/л до 2,0мЕд/л. Таким образом: субклинический гипотиреоз установлен у 94 пациентов 1 группы и у 15 – во второй группе, низконормальный уровнень тиреотропного гомона обнаружено у 30 человек 1 группы и у 41 – 2 группы; высоконормальный уровнень тиреотропного гомона отмечен у 30 человек 1 группы и у 20 человек 2 группы. Результаты. Среди обследованных первой группы более высокие значения как систолическое артериальное давление, так и диастолическое артериальное давление обнаружено при наличии субклинического гипотиреоза. По данным дуплексного сканирования общей сонной артерии, установлено, что среди пациентов молодого возраста толщина комплекса «інтима-медиа» при наличии субклинического гипотиреоза на 33,3 % дело и 35,0 % слева была больше чем при высоконормальным уровнем тиреотропного гомона. В этой группе у пациентов с субклиническим гипотиреозом выявлена прямая корреляционная связь между уровнем тиреотропного гомона и индексом массы тела, общим холестерином, триглицеридами, липопротеидами низкой плотности, коэффициентом атерогенности и обратная сильная корреляционная связь между уровнем тиреотропного гормона и липопротеидов высокой плотности. Кроме того, в 1 группе было выявлено положительная корреляционная связь между уровнем тиреотропного гомона и уровнем липопротеидов очень высокой плотности. У пациентов 1 группы с субклиническим гіпотиреозом отмечены также больше, чем в других подгруппах, значение обода талии и коэффициента соотношения обвода талии до обвода бедер, толщины стенок лівого желудочка, хотя значения указанных показателей не превышали норму. Во второй группе артериальная гипертензия выявлена у всех пациентов, средняя продолжительность ее составила 15,6±6,2 лет. В этой группе было выявлено значительную долю пациентов с дислипидемией. По данным дуплексного сканирования общей сонной артерии, установлено, что во 2 группе частота утолщения стенки сонной артерии > 0,9 мм или наличие бляшки в группе с низконормальным уровнем тиреотропного гомона была достоверно ниже, чем в подгруппе с субклиническим гипотиреозом. Большая частота выявления атеросклеротического поражения сонных артерий у пациентов с субклиническим гипотиреозом, особенно в пожилом возрасте, соответствует данным литературы, а также совпадает с большей частотой выявления у них дислипидемий. Выводы. В результате проведенного исследования, нами подтверждена роль субклинического гипотиреоза в развитии дислипидемии у лиц молодого и пожилого возраста. Функциональное состояние щитовидной железы у больных разного возраста с кардиологической патологией влияет на частоту и выраженность факторов риска и поражения органов-мишеней при АГ, что требует своевременного тщательного его контроля. Поэтому важно комплексное обследование пациентов уже в молодом возрасте., Актуальність. У статті представлено аналіз даних літератури та результати власних досліджень щодо ролі дисфункції щитоподібної залози в розвитку та прогресуванні серцево-судинної патології в осіб молодого та похилого віку. Мета дослідження: вивчити та проаналізувати роль дисфункції щитоподібної залози в розвитку та прогресуванні серцево-судинної патології у пацієнтів різних вікових груп. Матеріали та методи. Було обстежено 229 пацієнтів віком від 25 до 75 років. Обстежені були розділені на 2 групи за віком: 1 група – пацієнти молодого віку (від 25 до 44 років) – 154 особи та 2 група – пацієнти похилого віку (від 60 до 75 років) – 76 осіб. У залежності від рівня тиреотропного гормону пацієнти були розділені на три підгрупи: з субклінічним гіпотиреозом, з концентрацією тиреотропного гормону від 4,01 мОд/л до 10 мОд/л; з високонормальним, тиреотропний гормон – від 2,01 мОд/л до 4,0мОд/л; з низьконормальним, тиреотропний гормон – від 0,4мОд/л до 2,0мОд/л. Таким чином: субклінічний гіпотиреоз встановлено у 94 пацієнтів 1 групи та у 15 – у другій групі; низьконормальний рівень тиреотропного гормону виявлено у 30 осіб 1 групи та у 41 – 2 групи; високо нормальний рівень тиреотропного гормону відзначений у 30 осіб 1 групи та у 20 осіб 2 групи. Результати. Серед обстежених першої групи вищі значення як систолічного артеріального тиску, так і діастолічного артеріального тиску виявлено при наявності субклінічного гіпотиреозу. За даними дуплексного сканування загальної сонної артерії, встановлено, що серед пацієнтів молодого віку товщина комплексу «інтима-медіа» при наявності субклінічного гіпотиреозу на 33,3 % праворуч та 35,0 % зліва була більшою, ніж при високонормальному рівні тиреотропного гормону. У цій групі серед пацієнтів з субклінічним гіпотиреозом виявлено прямий кореляційний зв'язок між рівнем тиреотропного гормону та індексом маси тіла, загальним холестерином, тригліцеридами, ліпопротеїдами низької щільності, коефіцієнтом атерогенності та зворотній сильний кореляційний зв’язок між рівнем тиреотропного гормону та ліпопротеїдами високої щільності. Окрім того, у 1 групі було виявлено позитивний кореляційний зв’язок між рівнем тиреотропного гормону та рівнем ліпопротеїдів дуже низької щільності. У пацієнтів 1 групи із субклінічним гіпотиреозом відзначені також більші, ніж у інших підгрупах, значення обвід талії та коефіцієнту обводу талії/обводу стегон, товщини стінок лівого шлуночка, хоча значення вказаних показників не перевищували норму. У другій групі артеріальна гіпертензія виявлена у всіх пацієнтів, середня тривалість її становила 15,6±6,2 років. У цій групі було виявлено значну частку пацієнтів з дисліпідемією. За даними дуплексного сканування загальної сонної артерії встановлено, що у 2 групі частота потовщення стінки сонної артерії >0,9 мм або наявність бляшки у групі з низько нормальним рівнем тиреотропного гормону була вірогідно нижчою, ніж у підгрупі із субклінічним гіпотиреозом. Більша частота виявлення атеросклеротичного ураження сонних артерій у пацієнтів із субклінічним гіпотиреозом, особливо в похилому віці, відповідає даним літератури, а також співпадає з більшою частотою виявлення у них дисліпідемій. Висновки. У результаті проведеного дослідження, нами підтверджено роль субклінічного гіпотиреозу у розвитку дисліпідемії в осіб молодого та похилого віку. Функціональний стан щитоподібної залози у хворих різного віку з кардіологічною патологією впливає на частоту і вираженість факторів ризику і уражень органів-мішеней при артеріальній гіпертензії, що потребує своєчасного ретельного його контролю. Тому важливим є комплексне обстеження пацієнтів вже в молодому віці.

PURPOSE There is some uncertainty about the optimal ranges for urinary iodine concentration (UIC) during pregnancy. This study aimed to explore associations between maternal UIC and thyroid function in iodine sufficient and mildly iodine deficient areas. METHODS It was a cross-sectional study in which 1461 healthy pregnant women were enrolled to collect their blood and urine samples during their routine antenatal care in Tianjin and Wuqiang, China. Wuqiang was a mildly iodine-deficient region, while Tianjin was iodine sufficient. UIC, free triiodothyronine (FT3), free thyroid hormone (FT4), thyroid stimulating hormone (TSH), thyroid peroxidase antibody (TPOAb), thyroglobulin antibody (TgAb), serum iodine concentration (SIC) including total serum iodine concentration (tSIC) and non-protein bound serum iodine concentration (nbSIC) were assessed during the routine antenatal care visits. RESULTS The median UIC in pregnant women was 174 (113, 249) μg/L in Tianjin and 111 (63, 167) μg/L in Wuqiang, respectively. Compared with Tianjin, UIC, FT3 and TSH were lower, and FT4, tSIC, nbSIC, rates of TPOAb and TgAb positivity and the thyroid dysfunction rate (TDR) were higher in Wuqiang (P

Introduction Thyroid dysfunction is the most frequent endocrine immune related adverse event (irAE) in non-small cell lung cancer (NSCLC), typically arising 3–6 months into immune checkpoint inhibitor (ICI) therapy, but arising after ICI cessation, in some cases. Due to limited post-treatment adverse event reporting requirements on ICI trials, the incidence of ICI-induced thyroid dysfunction arising after therapy is unclear. We investigated ICI-induced thyroid dysfunction in a cohort of 294 NSCLC patients, with a specific focus on the post-treatment setting. Methods Retrospective analysis of ICI-induced thyroid dysfunction (clinically acted upon or laboratory only) was performed in 294 UCLA NSCLC patients treated 2012–2018. Clinically acted upon thyroid dysfunction was defined as thyroid diagnosis documentation and/or thyroid medication administration. Laboratory only dysfunction was defined as abnormal thyroid labs in the absence of clinical action. Timing of thyroid dysfunction relative to ICI treatment and thyroid monitoring patterns were also assessed. Results 82% (241/294) of ICI treated NSCLC patients had thyroid labs during treatment. Of these 241 patients, 13% (31/241) had clinically acted upon thyroid dysfunction prior to, 8% (18/241) during, and 4% (9/241) after ICI. Most patients, 66% (159/241), did not have thyroid labs after ICI, but in the 53 patients with labs and no prior clinical dysfunction, 17% (9/53) developed clinical dysfunction after ICI. In these 9 patients, median time from ICI initiation to dysfunction was 253 days. Two patients with post-treatment laboratory only dysfunction were observed. Conclusions ICI-induced thyroid dysfunction arising post-treatment appears more common than previously appreciated, warranting additional evaluation.

Mahmoud A Allam,1 Youssef A Nassar,1 Hosameldeen S Shabana,1 Sadek Mostafa,1 Farag Khalil,1 Hendawy Zidan,1 Mohammed Abo-Ghebsha,2 Amir Abdelghaffar,3 Ahmed Essmat,3 Essam Elmahdi4 1Department of Internal Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt; 2Department of Clinical Pathology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt; 3Department of Neurology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt; 4Department of Internal Medicine, Faculty of Medicine, Mansoura University, Mansoura, EgyptCorrespondence: Mahmoud A AllamDepartment of Internal Medicine, Faculty of Medicine, Al-Azhar University, Cairo, 11884, EgyptTel +20222602687Fax +20224020184Email dr.mahmoudallam75@gmail.comBackground and Aim: Diabetic peripheral neuropathy (DPN) is one of the most common and disabling complications of DM. Many studies documented the prevalence of clinical and subclinical hypothyroidism (SCH) in diabetic patients but not in the particular group of patients with DPN. The present study aimed to determine the prevalence of SCH in DPN patients and to evaluate its association with severity of DPN.Patients and Methods: The present cross-sectional study was conducted on 300 consecutive patients with DPN. The clinical manifestations of DPN were documented according to the validated Arabic version of the Michigan Neuropathy Screening Instrument. Severity of DPN was categorized into mild (6– 8 points), moderate (9– 11 points) or severe (12+ points) according to the Toronto Clinical Scoring System. All patients were submitted to careful history-taking and full clinical and neurological examination. Patients were diagnosed with SCH if they had TSH level above the upper limit of the normal reference range in association with normal free thyroxine (FT4) level.Results: SCH was prevalent in 53 patients (17.7%, 95% CI: 13.5%– 22.5%). Patients with SCH had significantly higher frequency of severe DPN (52.8% versus 28.3%, p=0.003). It was also shown that patients with SCH had significantly higher HbA1c (8.4 ± 1.0 versus 7.3 ± 1.2%, p< 0.001) and HOMA-IR (3.7 ± 0.8 versus 2.7 ± 0.9, p< 0.001) when compared with patients without SCH. Logistic regression analysis identified patients’ age [OR (95% CI): 1.06 (1.03– 1.08), p< 0.001], HbA1c [OR (95% CI): 2.2 (1.7– 2.9), p< 0.001] and SCH [OR (95% CI): 7.7 (3.6– 15.5), p< 0.001] as independent predictors of DPN severity.Conclusion: The present study showed that SCH is highly prevalent in DPN patients and is independently related to its severity.Keywords: diabetes mellitus, diabetic peripheral neuropathy, subclinical hypothyroidism, thyroid hormones, thyroid dysfunction

Appropriate care of pregnant women with coexisting thyroid dysfunction is still a subject of much controversy. In recent years, there has been a dynamic increase in the number of scientific reports on the diagnosis and treatment of thyroid diseases in women planning pregnancy, pregnant women, and women in the postpartum period. These mainly concern the management of hypothyroidism, autoimmune thyroid diseases, and fertility disorders. Therefore, the Polish Society of Endocrinology deemed it necessary to update the guidelines on principles of diagnostic and therapeutic management in this group of patients, previously published in 2011. The recommendations were prepared by Polish experts according to evidence based medicine principles, if such data were available.

Pregnancy is a complex endocrine and metabolic status in life of women, therefore role of the thyroid physiology during this period will be profoundly affected, this has been attributed to the complex interplay of Human chorionic gonadotrophin that acts as TSH receptors’ stimulant, more estrogen is produced by placenta will lead to rise in the serum level of Thyrogublin binding protein, change in iodine homeostasis, and hemodynamic changes. From 12th -16th week of pregnancy, the fetus is entirely dependent on the thyroid status of the mother, therefore any disruption in this metabolic milieu will lead to negative outcomes on both the fetus and the mother. Therefore, the current guidelines have stressed on appropriate management of thyroid dysfunction in pregnancy with particular interest on early pregnancy, a critical period for neurocognitive development, then throughout the pregnancy and postpartum period (Figure 1).

AIM: The objectives of the study were to study the signs of thyroid dysfunction in students at the Karaganda Medical University. MATERIALS AND METHODS: The survey was conducted among students of the Karaganda Medical University in the amount of two hundred people. Statistical methods were used for comparison among students of different courses. RESULTS: Among junior students, signs of thyroid dysfunction were more pronounced than among senior students. More than half of the examined students had a diagnosed thyroid pathology, which was more pronounced in students of one and two courses. CONCLUSION: Undergraduates are more likely to exhibit signs of stress-related thyroid dysfunction.

BACKGROUND It has been noted of the interdependence and impact of diabetes mellitus and thyroid dysfunction on each other. Prevalence of thyroid dysfunction was found to be higher in individuals with diabetes mellitus. Most commonly associated thyroid dysfunction in diabetes was hypothyroidism. Hyperthyroidism can precipitate complications in diabetes mellitus. The purpose of this study was to assess the prevalence of thyroid dysfunction and dyslipidaemia in type 2 diabetes mellitus patients. METHODS This cross-sectional study included a total number of 100 type-2 diabetic patients aged >15 years. All the patients were evaluated for thyroid dysfunction and dyslipidaemia by estimating triiodothyronine (T3), thyroxine (T4) and thyroid stimulating hormone (TSH) and lipid profile [total cholesterol (TC), triglycerides (TGA-c), high density lipoprotein (HDL-C), low density lipoprotein (LDL-C)].The correlation of prevalence of thyroid disorder with gender distribution, age distribution, HbA1C, duration of diabetes, family history of thyroid disorder, body mass index (BMI), usage of oral hypoglycaemic agents (OHA’s) and insulin and dyslipidaemia was carried out. The observations and interpretations were recorded and results obtained were statistically analysed. This study was conducted from December 2018 to November 2019 at Government Medical College, Kottayam, Kerala. RESULTS The study revealed a high prevalence (26 %) of thyroid disorders in patients with type 2 diabetes mellitus (T2DM), most common being hypothyroidism (20 %) which was further found to be more in females, patients with uncontrolled diabetes i.e. HbA1C values ≥ 8.7 or patients on OHA and patients with BMI > 25. High prevalence of dyslipidaemia in diabetics (62 %) was observed; of which 51 % had hypertriglyceridaemia, 49 % had decreased HDL-C, 47 % had hyper cholesterolaemia and 43 % had increased LDL-C. Only 30.6 % diabetics with dyslipidaemia had thyroid dysfunction. CONCLUSIONS Screening of thyroid dysfunction should be done in all diabetic patients especially in patients with poor glycaemic control as micro vascular complications were commonly observed in this group of patients with dual endocrine disorders. There is a high prevalence of dyslipidaemia in diabetics. KEYWORDS Diabetes Mellitus, Thyroid Dysfunction, Dyslipidemia

OBJECTIVES: To assess free thyroxine (fT4), thyroid stimulating hormone (TSH), and anti thyroid peroxidase antibodies (anti TPO abs) in adult Celiac disease patients and non-celiac controls and to find out any statistically significant difference in their corresponding means between the two groups. METHODOLOGY: The study design was analytical cross sectional. Sixty adult patients of celiac disease (CD) and 30 apparently healthy non-celiac adults were included in the study. CD patients had earlier been diagnosed by elevated levels of serological evidence of elevated (greater than 15X ULN) anti tissue transglutaminase (TTG) (IgA class) antibodies. CD was ruled out in the control group by normal levels of the antibodies. TSH, fT4 and anti TPO abs were obtained from all individuals of CD patient and control groups. RESULTS: Mean age of Celiac disease in patients was 23.85±5.43 years. Mean age of individuals in the control group was 24.26±5.55 years. Statistically significant difference in mean TSH and anti-TPO abs levels between the CD patient group and control group (p values of 0.03 and 0.038, respectively) was present. No statistically significant difference was seen between mean fT4 of patients and control group (p=0.74). Subclinical and overt hypothyroidism was present in 10% and 5% of CD patients, while anti TPO abs was positive in 16.6% of CD patients. CONCLUSION: There is a considerably high prevalence of subclinical and overt hypothyroidism as well as serological evidence of thyroid dysfunction in adult patients of CD.

Aims: Thyroid disease is a pathological state associated significantly with diabetes mellitus (DM) Type 1 and Type 2. As the prevalence of diabetes mellitus is on the rise in our population, so the purposed significance of our study was to evaluate the frequency of thyroid dysfunction in diabetic patients of our local population. Study Design: Cross-sectional study. Place and Duration of Study: This study conducted among patients of diabetes (Type 1 and Type 2) from September 2020 to March 2021 while their visit in Holy family hospital, Rawalpindi, for a routine clinical check-up on an OPD basis. Methodology: A total of 96 patients with diabetes mellitus on regular medication, 20 to 60 years of age, were included. Patients with diabetic ketoacidosis, hyperlipidemia, pregnant females, and those taking medication that can affect thyroid functions (dopamine antagonists, antiepileptics, oral contraceptives, lithium, glucocorticoids) were excluded. A venous blood sample was drawn and sent to the laboratory to analyze thyroid function tests for the presence or absence of any thyroid dysfunction. Data analysis was done through SPSS.v.23. Descriptive statistics and Chi-square analysis was used, and a p-value of ≤ 0.05 was considered significant. Results: The mean age of the patients was 42.97 ± 10.29 years. The majority of the patients, 37.50%, were between 41 to 50 years of age. Out of 96 patients, 61 (63.54%) were male, and 35 (36.46%) were females with a male to female ratio of 1.7:1. The majority of patients, 69 (71.88%), had type II diabetes mellitus. The frequency of thyroid dysfunction found in diabetic patients was 30 (31.25%), with hypothyroidism in 19 (19.79%) and hyperthyroidism in 11 (11.46%) patients. Conclusion: This study deduced that there is a high frequency of thyroid dysfunction in diabetic patients. In the same vein, hypothyroidism was the common thyroid dysfunction associated with diabetes mellitus.

Цель работы заключалась в изучении характеристик суточного профиля артериального давления у пациентов с артериальной гипертензией и сопутствующим гипотиреозом на основании результатов амбулаторного мониторинга артериального давления. В исследование были включены 50 пациентов с артериальной гипертензией и сопутствующим гипотиреозом. В зависимости от сывороточного уровня тиреотропного гормона пациенты были разделены на две группы, по 25 пациентов в каждой: с компенсированным (группа 1) и декомпенсированным гипотиреозом (группа 2). Уровень тиреотропного гормона 4,4 мМЕ/л считали критерием компенсации. Конт­рольная группа состояла из 30 пациентов с артериальной гипертензией и исключенной дисфункцией щитовидной железы. Проведено сравнение основных показателей амбулаторного мониторинга артериального давления в зависимости от компенсации гипотиреоза. Для выявления взаимосвязи клинических и анамнестических факторов и показателей ночного систолического давления был проведен регрессионный анализ.

Background and Aim. Currently two forms of levothyroxine are presented in pharmaceutical market of Armenia: Euthyrox and L-thyroxine. Local physicians have a choice of two different levothyroxine preparations, each of them with different dosage from 25 to 150mg. Oral levothyroxine (LT4) is the standard therapy for patients with hypothyroidism. The purpose of this report is to describe the adverse outcomes reported by endocrinologists, the frequent prescribers of levothyroxine, practicing in Armenia and to compare the rate of adverse reactions with data from different international research reports. Materials and methods. A Pharmacovigilance questionnaire was developed based on the literature reports to assess potential adverse events attributable to the use of levothyroxine products. Statistical Analysis Results were collected, interpreted and presented as percentages. Results. The study was with a cross-sectional design conducted in medical centers of Armenia using convenience sampling. The respondent parents of patients were selected using simple random sampling. Of the total 56 survey responses received, the majority 35 [63%]) reported no adverse events. The adverse effects were due to new or unexpected symptoms in 2 (25%), a TSH change alone in 1 (12%), or both in 6 (75%). Most the symptoms (5/8 [65%]) were consistent with thyrotoxicosis, arrhythmias were documented in three cases, while 35% (3/8) of cases had symptoms typical of hypothyroidism. Conclusions. Clinicians prescribing Euthyrox and L-thyroxine should be reminded that these products are from different manufacturers and patients/physicians should be made aware of all possible adverse reactions results, which could be different for these two products.

Гормоны щитовидной железы (ЩЖ) необходимы для нормального функционирования почек, которые, в свою очередь, являются не только органом для метаболизма и выведения гормонов ЩЖ, но и служат мишенью для действия некоторых тиреоидных гормонов. Гипотиреоз и гипертиреоз связаны с клинически значимыми изменениями в деятельности почек. Гипотиреоз сопровождается снижением скорости клубочковой фильтрации (СКФ), гипонатриемией и изменением способности почек выводить воду из организма. Повышенные уровни гормонов ЩЖ приводят к увеличению СКФ и почечного кровотока. Почечная недостаточность влияет на функцию ЩЖ. Хроническая болезнь почек сопровождается заметными эффектами на оси гипоталамус — гипофиз — щитовидная железа. Имеется связь между раком ЩЖ и опухолями почек. Данные последних исследований показывают, что гормоны ЩЖ, особенно Т3, можно рассматривать как маркер выживания у пациентов с заболеванием почек.

Introduction and Aim: The prevalence of thyroid disorders all over the world is on the rise. However, the diagnosis is complicated among the elderlies due to factors such as non-specific clinical manifestations and interacting medications. The aim of the study is to estimate the prevalence and type of thyroid dysfunction among the elderly. Materials and Methods: The cross-sectional study was undertaken in the Department of General Medicine of a tertiary care teachinghospital. The study included 100 subjects aged above 60 years, of both genders. Data for clinical examination and biochemical tests such as T3, T4, TSH and lipid profile were collected. Reports of USG/FNAC, performed in cases of thyroid nodule, were also checked.Results:The prevalence of thyroid disorders was 22% of the study population. Overt and subclinical hypothyroidism were observed among 4% and 17% respectively, with 1% having hyperthyroidism. Subclinical hypothyroidism was more common among women. No specific trend was observed with increasing age.TPO antibodies were positive among 73% of the cases. Patients with thyroid dysfunction had higher values of triglycerides, total cholesterol and LDL. The proportion of dyslipidemia was significantly higher among elderly with thyroid dysfunction as compared to people with no thyroid dysfunction (90.90% Vs 24.35%, P value < 0.001). Conclusion: Thyroid dysfunction in the elderly is common. Strong clinical suspicion of thyroid diseases in elderly patients presenting with non-specific symptoms is needed. This would aid in the diagnosis of thyroid disorders among the elderly.

Проаналізовано структуру та взаємозв’язок порушення функції щитоподібної залози та нетиреоїдної патології у підлітків. Проведення адекватної замісної терапії гіпотиреозу, що має на меті компенсувати його прояви, сприятиме не тільки покращенню соматичного стану пацієнта, а й слугуватиме профілактикою численних органних порушень, що виникають на тлі зниженої тиреоїдної функції.

In this article, the authors described and commented the main provisions of the new guidelines for the examination and treatment of patients with amiodarone-associated thyroid dysfunction. Their text is divided thematically into subdivisions (clinical studies, diagnosis, approaches to the management). At the same time, the text with references is presented first that followed by guidelines, which are given according to the level of evidence.

The article deals with the analysis of the literature on the study of the spectrum of therapeutic properties of Potentilla alba preparation, supplemented with selenium and zinc, which is prescribed in addition to standard management of patients with thyroid hyperfunction. Drug is used alone in subclinical thyrotoxicosis degree I, as well as in achieving stable compensation of diffuse toxic goiter; and as a part of comprehensive therapy — in subclinical thyrotoxicosis degree II, diffuse toxic goiter for normalization of T4 and T3 content in the blood., Статья посвящена анализу литературы по изучению спектра терапевтических свойств препарата лапчатки белой, дополненного селеном и цинком, назначающегося в дополнение к стандартному ведению пациентов с гиперфункцией щитовидной железы. В виде монотерапии — при субклиническом тиреотоксикозе первой степени, а также при достижении стойкой компенсации диффузного токсического зоба. В составе комплексной терапии — при субклиническом тиреотоксикозе второй степени, диффузном токсическом зобе при нормализации содержания Т4 и Т3 в крови., Стаття присвячена аналізу літератури з вивчення спектра терапевтичних властивостей препарату перстачу білого, доповненого селеном і цинком, що призначається на додаток до стандартного ведення пацієнтів із гіперфункцією щитоподібної залози. У вигляді монотерапії — при субклінічному тиреотоксикозі першого ступеня, а також при досягненні стійкої компенсації дифузного токсичного зоба. У складі комплексної терапії — при субклінічному тиреотоксикозі другого ступеня, при дифузному токсичному зобі при нормалізації вмісту Т4 і Т3 в крові.

Background Minor alterations in thyroid function are frequent, and interpretation of thyroid function tests in the individual patient can be challenging. Furthermore, the choice of thyroid function test is debatable. To inform the debate, we performed a comparative evaluation of the variation in thyrotropin (TSH) and thyroxine (T4) in two different cohorts to illustrate the precision of TSH and T4 in the diagnosis and monitoring of thyroid dysfunction. Methods A comparative analysis of two separate longitudinal studies previously surveyed with monthly blood sampling for one year among 35 subjects. Participants were included based on T4 within the reference range and TSH either within (euthyroid; n = 15) or above (subclinical hypothyroidism; n = 20) the laboratory reference range on two independent blood samplings before inclusion. Exclusion criteria were known thyroid disease or use of thyroid interfering medication. TSH and T4 in individual samples were measured in a single batch to prevent between-batch variation. The distributions TSH and T4 were compared among euthyroid and subclinical hypothyroid individuals, and bootstrap estimates were used to calculate area under the curve (AUC). Results Collection of twelve, monthly blood samples in the 35 participants provided 420 samples, and data completeness was 100%. The mean TSH was 1.27/7.19 mIU/L and the mean total T4 was 106/85 nmol/L in euthyroid/subclinical hypothyroid participants. The subclinical hypothyroidism state deviated from the euthyroid by 20% for total T4 and by 466% for TSH. The overlap between the euthyroid and subclinical hypothyroid groups was 92.6% (389/420) for total T4 and 9.0% (38/420) of test results for TSH. The estimated AUC was 0.999 (95%-CI: 0.995; 1.00) for TSH and 0.853 (0.736; 0.935) for total T4. There was no confidence interval overlap between participant groups for TSH while there was a considerable overlap for total T4 (p Conclusion The distributions of thyroid function tests illustrated how TSH outperforms T4 for detecting delicate differences in thyroid function in an individual. Thus, TSH was markedly better than T4 to discriminate between the subtle differences in thyroid function corroborating that TSH is the more sensitive and accurate index of thyroid function status in the individual patient.

Thyroid problems are more common in people with type 2 diabetes. They have microvascular problems as a result of hypothyroidism. Patients with diabetes and hypothyroidism have a higher risk of cardiovascular disease. Diabetic individuals who are screened for thyroid dysfunction will be able to receive early therapy for hypothyroidism. The goal of this study was to determine the extent of thyroid dysfunction in people with type 2 diabetes and the relationship between thyroid dysfunction and diabetic complications. This study is to be conducted at a tertiary care hospital in Chennai for a period of 1 year 200 patients were selected 100 were diabetics and 100 were controls (non-diabetic). 24 patients out of 100 subjects were detected to have thyroid dysfunction. 17 patients were detected to have SCH, 6 had primary hypothyroidism and I had primary hyperthyroidism. No case of subclinical hyperthyroidism was detected. TSH values were significantly higher in diabetics. Thyroid dysfunction especially SCH was prevalent in diabetics. There was a poor glycemic control in diabetics with thyroid dysfunction.

We aimed to assess the incidence, clinical and biochemical course of immunotherapy-induced thyroiditis and its implication on patients' survival, based on an extensive clinical experience from a tertiary cancer center.Analyses were based on data from the electronic medical records of cancer patients treated with CPIs. Data included demographic characteristics, cancer type, Thyroid function tests (TFT), and survival.Thyroid function tests were available for 934 patients. After excluding patients with impaired baseline TFT or levothyroxine treatment, 754 euthyroid patients were included in the core analyses. Of those, 301 (39.9%) patients developed thyroid dysfunction ('thyroiditis'). Thyroiditis was more prevalent in patients with renal cell carcinoma than other types of cancer. Survival rates were comparable in patients who developed thyroiditis and in those who did not. during the 5 years follow-up period, there was a non-significant trend toward improved survival in patients who developed TD in four predefined groups: melanoma, lung cancer, renal cell carcinoma, and transitional cell carcinoma. Nevertheless, we observed a highly significant survival benefit for patients with renal cell carcinoma who developed TD (HR = 0.19, 95% CI 0.06-0.60;Thyroiditis is common, often asymptomatic, and is more prevalent in patients treated with combinations of nivolumab and PD-L1 inhibitors, and in patients with renal cell carcinoma. Thyroiditis was associated with a trend for a survival benefit, particularly in patients with renal cell carcinoma.

Aim: The purpose of the study was to detect thyroid dysfunction in women who had abnormal uterine bleeding Study Design: Menorrhagia was the most common type of bleeding (36%). Thyroid dysfunction was discovered in 32% of the patients (Subclinical hypothyroidism in 17%, Hyper thyroid is 11% and hyperthyroidism in 4 % of cases). The researchers looked at 100 cases of Dysfunctional Uterine Bleeding that were clinically identified at Sree Balaji Medical College and Hospital between March 2014 and August 2016. The patients in this study ranged in age from under 20 to 45 years old. The number of instances with DUB who were between the ages of 31 and 40 is 38 %. Methodology: The parity of the patients ranged from unmarried to 0-5, with the parity 2 group accounting for 37% of all DUB patients and the following assessments were made. Results: Thyroid dysfunction was most common in cases of polymenorrhagia (42.8%), menorrhagia (33.3%), polymenorrhea (28.5%), and oligomenorrhea. (26%). Thyroid dysfunction was most common in the age group 31-40 years, accounting for 77.5% of the population. In 17 % of cases, the primary thyroid malfunction was subclinical hypothyroidism. 3% of hyperthyroid patients were also oligomenorrhocic. The most prevalent thyroid disorder in metrorrhagic patients was subclinical hypothyroidism.

Objective: The comparative effects of food restriction (FR), Diabecon treatment (DT) and their combined therapy (FR+DT) were studied in the regulation of alloxan-induced diabetes mellitus, alterations in thyroid hormones (TH) and oxidative stress. Methods: Young diabetic rats were either kept on 50% FR and/or DT (2 gm/Kg body weight) for two months and then alterations in serum glucose, insulin, TH concentrations, hepatic glycogen and pancreatic antioxidants along with oxidative stress markers were evaluated. Results: Significantly increased serum glucose, tissue stress markers with decreased TH, hepatic glycogen (P

What is known and objective The adverse events of thyroid dysfunction caused by the use of vascular endothelial growth factor receptor tyrosine kinase inhibitors (VEGFR-TKIs) have not been confirmed in a real-world investigation. The aim of this study was to evaluate the relationship between thyroid dysfunction and treatment using Food and Drug Administration (FDA)-approved VEGFR-TKIs. Methods Four data-mining algorithms were employed to detect thyroid dysfunction signals for VEGFR-TKIs, using data in the FDA Adverse Event Reporting System (FAERS) database from 68 quarters. MySQL Workbench and R were used to conduct statistical analysis. Results and discussion We identified 32679 reports of thyroid dysfunction, of which 1567 listed VEGFR-TKIs as the primary suspected drugs. All four algorithms showed that the strength of the signals for hypothyroidism were greater than those for hyperthyroidism, for all the VEGFR-TKIs. In most cases, the median appearance time was within 100 days of initiation of VEGFR-TKIs therapy, except in the case of ponatinib. This indicated the need to actively identify and manage thyroid dysfunction during the early stages of VEGFR-TKIs treatment. What is new and conclusions This study systematically identified the pharmacovigilance signals of thyroid dysfunction associated with the use of VEGFR-TKIs, using the FAERS database.

In this systematic review, we will investigate (1) the incidence or risk of thyroid abnormalities in patients on quetiapine, (2) the clinical factors associated with thyroid abnormalities on quetiapine, including the underlying psychiatric diagnosis, gender, age group, duration of treatment, and whether quetiapine was used as mono- or combination therapy, and (3) the underlying mechanisms of quetiapine-induced thyroid dysfunction.

This review synthesizes what is known about tracking obesity, its comorbidities, and reversibility thereof in one paper with evidence-based recommendations for exercise prescription to promote remission.

Introduction Immune checkpoint inhibitors are associated with immune-mediated thyroid disease and other endocrinopathies. Biotin is an over-the-counter supplement known to interfere with lab assays, including thyroid function tests. Biotin-induced complications with lab monitoring during immunotherapy have not been previously reported. Case report We present a case of a 68-year old woman with hypothyroidism after initiating immune checkpoint blockade therapy and abnormal laboratory monitoring values while concurrently taking biotin supplements. Management & outcome: The patient was initiated on levothyroxine with subsequent dose increases over a period of weeks with resolution of symptoms and normalization of free thyroxine levels. Thyroid stimulating hormone (TSH) levels appeared to remain elevated until biotin supplements were held and levels normalized. Discussion The purpose of this report is to provide the first known incidence of biotin complicating the routine monitoring of immune checkpoint inhibitors with elevated TSH levels and to alert providers to elicit accurate medication histories regarding over-the-counter supplements.

Objectives: To determine the frequency of thyroid dysfunction in chronic kidney disease patients. Methods: It was a Cross-sectional Study at department of Medicine, Bahawal Victoria Hospital, Bahawalpur. Duration of the study was from 20th October 2018 to 19th April 2019. 72 patients with chronic kidney disease, 20 to 60 years of age and of both genders were included. Patients with known thyroid disorders or taking medication that can affect thyroid function (dopamine antagonists, antiepileptic, oral contraceptives, lithium, and glucocorticoids) were excluded. Venous blood sample was taken and sent to the laboratory for thyroid function tests. Results: Age of the patients included in this study was from 20 to 60 year and mean age was 41.97 ± 9.76 years. Most of them 42 (58.33%) were between 41 to 60 years of age. Out of 72 patients, 44 (61.11%) were male and 28 (38.89%) were female with male to female ratio of 1.6:1. Mean duration of disease in our study was 5.71 ± 2.50 years .Mean BMI was 27.75 ± 3.01 kg/m2.Thyroid dysfunction was present in 23 (31.94%) patients of chronic kidney disease. Conclusion: Thyroid dysfunction is frequently found in chronic kidney disease patients.

ÖZET Amaç: Gebelerde ilk trimester TSH seviyelerinin fetal doğum ağırlıklarına ve maternal hemoglobin değerleri üzerine etkisini araştırmak Gereç ve Yöntemler: Çalışmamız Mart 2018-Nisan 2019 tarihleri arasında İkinci Basamak Devlet Hastanesi Kadın Hastalıkları ve Doğum bölümüne gebeliğinin ilk trimesterinde başvuran 293 tekil gebenin dahil edildiği retrospektif bir çalışmadır. Gebelik öncesi tiroid hastalıkları nedeniyle tedavi alanlar, diabetes mellitusu olanlar, preeklampsi gelişenler, kalp hastalığı olanlar, sigara ve alkol kullananlar, 37 haftadan önce doğum yapanlar çalışma dışı bırakılmıştır. Hastalar TSH seviyelerine göre üç gruba ayrıldı. Birinci grup TSH seviyesi 2,5 mU/L olarak alındı. Gruplar doğum kilosu, doğum şekli, maternal hemoglobin değeri açısından karşılaştırılmıştır. Hastalar bebek doğum ağırlıklarına göre 3 gruba ayrıldı. Bunlar 2500 gram altı, 2500-4000 gram arası, 4000 gram üzerine göre sınıflandırıldı ve TSH düzeylerine göre bebek doğum ağırlıkları karşılaştırıldı. Bulgular: Gruplar arasında doğum şekli açısından istatistiksel olarak anlamlı fark izlenmedi (p>0.05). TSH düzeyi 2,5’den düşük olan hastalarda maternal ilk trimester hemoglobin düzeyleri TSH düzeyi 2,5’den büyük olan hastalara göre istatistiksel olarak anlamlı düzeyde daha yüksek olarak saptandı (p=0,001). Her üç TSH grubunda da doğum ağırlıkları açısından sonuçlar benzerdi ve istatistiksel olarak anlamlı bir fark izlenmedi (p>0,05). Sonuç: Tiroid fonksiyon bozukluklarının gebeliğin seyrine olumsuz etkisi bilinmektedir. İlk trimester TSH düzeyiyle, fetal doğum ağırlığı ve maternal hemoglobin düzeyi arasındaki ilişkiyi tanımlamak için daha geniş çalışmalara ihtiyaç vardır.

Dementia; Dose-response; Thyroid dysfunction Demència; Dosi-resposta; Disfunció de la tiroide Demencia; Dosis-respuesta; Disfunción tiroidea Thyroid hormone, as a modifiable risk factor for dementia, promotes neurocognitive function and regulates metabolic processes. Various studies have defined different thyroid-stimulating hormone cutoffs, but the safest thyroid-stimulating hormone concentration was absent. A dose–response meta-analysis describing the overall functional relation and identifying exposure intervals associated with a higher or lower disease risk is thus desirable. Therefore, our current analysis was conducted to understand the influence of thyroid dysfunction on dementia risk. We searched PubMed, Embase, and Web of Science before May 1, 2020 for human studies published in English. Studies were considered for inclusion if they used a cohort study design to measure the risk of dementia in different thyroid function status groups, diagnosed thyroid functional status and all-cause dementia, included participants aged >18 years, and provided quantitative measures of data. The analysis contained 17 articles with 344,248 individuals with a 7.8-year mean follow-up. Ten studies with 329,287 participants indicated that only subclinical hyperthyroidism was associated with an increased risk of dementia. In contrast, subclinical hypothyroidism, clinical hyperthyroidism, and clinical hypothyroidism did not affect dementia. In the dose–response meta-analysis with 46,417 samples from 11 studies, the association of thyroid-stimulating hormone with the risk of dementia exhibited a U-shaped curve. Our study indicated that subclinical hyperthyroidism was associated with the risk of dementia and the thyroid-stimulating hormone concentration at around 1.55–1.60 mU/L as the optimum range for the risk of dementia. This work was supported by the National Natural Science Foundation of China (No. 82070851, 81870556, 81930019, 81670738), Beijing Municipal Administration of Hospital’s Youth Program (QML20170204), Excellent Talents in Dongcheng District of Beijing.

Background & Objective:Hypothyroidism is a prevalent condition in various regions all over the world, including Iran. This study aimed to identify the factors associated with thyroid dysfunctions in Ravansar area, Kermanshah province. Due to hypo and hyperthyroidism diversity and pathogeneses complexity, machine learning was also integrated; it is as an accurate and potent method for the dimensionality reduction to realize the study objective. Materials & Methods:In this study, 10069 individuals participated from Ravansar area. Data were taken from the Ravansar Non-Communicable Diseases (RaNCD) cohort study, which is a part of national PERSIAN cohort. Feature selection was done using random forests machine learning tool. The two thyroid diseases correlation was explored through conventional statistical procedures. Results:Female sex was the most significant risk factor for hypothyroidism (OR=6.24, CI: 4.13-9.63;PPP10 gr (OR=1.87, CI: 1.15-2.90;PPP Conclusion:Female sex is a global well-established hypothyroidism-associated factor. The results of the present study suggest taking some measures to reduce hypothyroidism, by addressing the intervening factors. Keywords:Hypothyroidism,Hyperthyroidism,Prevalence,Associations,Multifactor dimensionality reduction

The coronavirus disease-19 (COVID-19) is an infectious disease caused by the enveloped RNA β- severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). The COVID-19 may have a variable presentation, from an asymptomatic disease to acute respiratory distress syndrome (ARDS) and multi-organ failure. Impairment of endocrine systems may also occur in COVID-19 patients and thyroid gland involvement was reported in a not negligible number of patients, as documented in several studies since the pandemic outbreak. Abnormal thyroid function tests (TSH and/or thyroid hormones) are frequently reported in COVID-19 patients with variable prevalence and mild to moderate severity in available studies, as recently reviewed by our group [1]. In addition, to provide thyroid imaging and radioiodine therapy, nuclear medicine physicians are also involved, especially in Europe, in clinical patients’ management. Then, being aware of the multiple and complex interactions between SARS-CoV-2 infection and thyroid function is relevant to nuclear medicine physicians in order to provide adequate and high-quality diagnosis, treatment, and follow-up.

Radiation-induced thyroid dysfunction is very rarely associated with peptide receptor radionuclide therapy (PRRT) for neuroendocrine tumors using β-emitting radionuclides. With the emergence of α radionuclide such as 225Ac, PRRT using these radionuclides has shown better results; however, data on the toxicity profile are limited. This is a case report describing the thyroid dysfunction developed in a patient with inoperable metastatic neuroendocrine tumor with unknown primary after PRRT using 225Ac-DOTATATE, which has never been reported previously.

This review highlights the most interesting research in thyroidology conducted in 2020. The publications of interest discussed below dealt with the following topics: thyroid dysfunction, risk of thyroid cancer, molecular diagnostics and new therapeutics for thyroid cancer, and thyroid disease in the coronavirus disease 2019 pandemic era.

Thyroid stimulating hormone (TSH) immunoassays are known for giving varying results based on the platform of testing and the generation of kit used. It is generally expected that the results should not vary to affect clinical diagnosis and management. We aimed to perform method comparison study between two TSH assays by the same manufacturer Siemens Healthineers. Results show that there is a large proportional error between the assays with a bias of -3.71mIu/L indicating that TSH assay gives higher values for TSH for the same patient as measured against the TSH3-Ultra kit. This can affect interpretation of results leading to false increase in patients categorized under hypothyroidism and subclinical hypothyroidism. We strongly suggest, to prevent errors in clinical evaluation of a patient with thyroid dysfunction, validation of the performance of the assay and method comparison should be performed in-house.

Hyperthyroidism is one of the most common disorder of Thyroid gland which is increasing day by day globally especially in developing countries. Ayurvedic classics have no direct reference of Hyperthyroidism. Considering various factors, it can be compared with Atyagni or Tikshnagni or Bhasmaka Roga (related to increased agni). Approaximately 300 million people worldwide are affected by thyroid dysfunction as it is a common endocrine disorder. Globally about 1-5% population are affected by hyperthyroidism. The prevalence of thyroid disorders in Nepalese population is 4.32% and among them 13.7% population has Hyperthyroidism. Available treatments of Hyperthyroidism in contemporary medicine cause lots of adverse effects and complications in the long run. So, it is very necessary to find out an effective alternative treatment for hyperthyroidism. Therefore this study was an attempt to get the understanding of disease Hyperthyroidism as per Ayurveda through various Ayurvedic principles so as to set its management strategies. Keywords: Hyperthyroidism, Atyagni, Tiksnagni, Bhasmaka rog

Man has been struggling to get remedies for various life-threatening disorders which are common in the day to day life of the busy world. Many lifestyle disorders such as diabetes mellitus, hypertension, dyslipidemia, thyroid dysfunction, respiratory disorders, skin diseases, etc. arise due to incompatible diet, polluted atmosphere, sedentary life style, lack of exercise, lack of proper sleep, etc. Ayurveda, the science of life, advices to follow Dinacharya, Ritucharya, Sadvritta etc for the benefit of the common man to enhance longevity. Ayurveda utilizes the wide range of herbal drugs either as single drug or in combination for the purpose of health care remedies. The phyto constituents present in these drugs play the major role in treating the diseases. Ferula foetida, known as Hingu in Ayurveda has promising therapeutic value due to the presence of chemical constituents like sulphide derivatives, volatile oil etc. Many studies revealed the various pharmacological actions of Hingu such as carminative, antispasmodic, antimicrobial, antioxidant, etc. This review highlights the available information on the drug Hingu by due consideration to the action of Hingu on the respiratory system and the formulations with Hingu as an ingredient as available in the Ayurvedic texts in treating respiratory disorders. Some other aspects are also discussed in the review.

Aim: The study was undertaken with an objective to know the thyroid functions in Type 2 diabetics and to know the spectrum of thyroid dysfunction in Type 2 DM. Methods: The present study included 68OPD and IPD patients of Type 2 DM who attended the Department of General Medicine at Dhaka Medical College Hospital Dhaka. Detailed history and examination were done, fasting blood samples of all the subjects were taken and at the same time samples were tested for HbA1C and thyroid profile (T3, T4 and TSH). Result: in this study 68 established diabetics were screened for thyroid disorders by TFT. Abnormal thyroid function was found in 43 T2DM cases and remaining diabetics had normal thyroid function. Among 68 cases low thyroid function was noted in 20 patients and 18 subjects had Sub-clinical hypothyroidism. Hyperthyroidism was noted in 05 patients. Conclusion: Type 2 diabetes mellitus is a major problem all over the world and many patients of Diabetes Mellitus are associated with thyroid dysfunction. So diabetic patients s should be screened for thyroid disorder especially hypothyroidism. J Dhaka Medical College, Vol. 29, No.2, October, 2020, Page 149-152