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Papers by Dineshkumar Dhanwal

Indian Journal of Endocrinology and Metabolism, 2016

A previous hospital based study from Delhi revealed a high prevalence of hypothyroidism in pregna... more A previous hospital based study from Delhi revealed a high prevalence of hypothyroidism in pregnant women. Several other studies with small sample size also indicate a rising trend of prevalence of hypothyroidism during pregnancy in India. To assess prevalence of hypothyroidism in pregnant women from various states/cities across India. This was a cross-sectional multicenter study conducted at Allahabad (Uttar Pradesh), Bengaluru (Karnataka), Chennai (Tamil Nadu), Kolkata (West Bengal), Hyderabad (Telangana), Nasik (Maharashtra), Rohtak (Haryana), Pune (Maharashtra), New Delhi (Delhi), Srinagar (Kashmir), and Vizag (Andhra Pradesh) enrolling 2599 pregnant women. Estimation of thyroid stimulating hormone (TSH), free T4, and antithyroid peroxidase (TPO) antibodies was carried out using Roche modular kit using ECLIA technology in a central laboratory. We found in our study population that 13.13% of pregnant women have hypothyroidism (n = 388), using a cutoff TSH level of 4.5 μIU/ml. This prevalence was much higher using the American Thyroid Association criteria. Anti-TPO antibodies were positive in 20.74% of all pregnant women (n = 613), whereas 40% (n = 155) of hypothyroid pregnant women were positive for anti-TPO antibodies. This study concludes that there is a high prevalence of hypothyroidism (13.13%), majority being subclinical in pregnant women during the first trimester from India and universal screening of hypothyroidism may be desirable in our country.

MAMC Journal of Medical Sciences, 2016

Context: Hypothyroidism has been associated with neurocognitive deficit, but status of cognitive ... more Context: Hypothyroidism has been associated with neurocognitive deficit, but status of cognitive function in subclinical hypothyroidism is unclear. Also, cognitive impairment found in these patients has been associated with aging. Aims: The purpose of this study was to evaluate cognitive function in hypothyroid and subclinical hypothyroid patients using objective methods and to correlate it with age, thyroid stimulating hormone (TSH) level, and education status of patients. Settings and Design: It was a cross-sectional study conducted on 90 female participants aged 30-50 years. Thirty patients diagnose with subclinical hypothyroidism (group 1) were compared with 30 age- and sex-matched hypothyroid patients (group 2) and euthyroid controls (group 3). Subjects and Methods: Cognitive function was evaluated using three parameters such as mini mental scale examination (MMSE), event-related potentials - P300latency and amplitude, auditory and visual reaction time. Statistical Analysis Used: SPSS version 17 was used for statistical analysis. The data were also analyzed for variables related to age, TSH, and education level. Results: Significant delay in P300latency and prolonged reaction time was found in both subclinical hypothyroid and hypothyroid group compared to controls (P < 0.001). P300amplitude and MMSE score showed no significant difference in all groups. In hypothyroid patients, P300latency at Fz, Pz was positively correlated with age while nonsignificant correlation was observed in subclinical hypothyroid patients. TSH and education level of patients showed no significant correlation with cognitive function tests. Conclusions: Delayed P300latency and prolonged reaction time in both subclinical hypothyroid and hypothyroid patients shows that cognitive function is affected adversely. Event-related potentials may be more sensitive than clinical evaluation by MMSE, for early diagnosis of mild cognitive impairment in subclinical hypothyroidism.

Indian Journal of Orthopaedics, 2010

Indian Journal of Endocrinology and Metabolism, 2011

Thyroid diseases have widespread systemic manifestations including their effect on bone metabolis... more Thyroid diseases have widespread systemic manifestations including their effect on bone metabolism. On one hand, the effects of thyrotoxicosis including subclinical disease have received wide attention from researchers over the last century as it an important cause of secondary osteoporosis. On the other hand, hypothyroidism has received lesser attention as its effect on bone mineral metabolism is minimal. Therefore, this review will primarily focus on thyrotoxicosis and its impact on bone mineral metabolism.

Indian Journal of Medical Research, 2018

© 2018 Indian Journal of Medical Research, published by Wolters Kluwer Medknow for Director-Gener... more © 2018 Indian Journal of Medical Research, published by Wolters Kluwer Medknow for Director-General, Indian Council of Medical Research The body fat has been classified as subcutaneous or peripheral fat and visceral or central fat. The visceral fat, which is the fat around the viscera, is metabolically active, and releases certain inflammatory cytokines which predisposes to atherogenic end events, such as acute coronary syndrome, stroke and peripheral vascular disease. The central obesity along with hypertension, diabetes mellitus and dyslipidaemia is known as metabolic syndrome and has been clubbed together, because of their heightened atherosclerosis predisposing risks. ‘Asian phenotype’ is a term used to denote this body habitus of central obesity with thin limbs, which is so commonly seen in Indian, Japanese, Chinese and other Asian populations1. This has been attributed to lifestyle changes of decreased physical activity, intake of high calorie but less nutritious food, psychosocial stress, poor sleep and possibly different genetic milieu in Asians2,3.

Indian Journal of Endocrinology and Metabolism, 2016

Indian Journal of Endocrinology and Metabolism, 2016

A previous hospital based study from Delhi revealed a high prevalence of hypothyroidism in pregna... more A previous hospital based study from Delhi revealed a high prevalence of hypothyroidism in pregnant women. Several other studies with small sample size also indicate a rising trend of prevalence of hypothyroidism during pregnancy in India. To assess prevalence of hypothyroidism in pregnant women from various states/cities across India. This was a cross-sectional multicenter study conducted at Allahabad (Uttar Pradesh), Bengaluru (Karnataka), Chennai (Tamil Nadu), Kolkata (West Bengal), Hyderabad (Telangana), Nasik (Maharashtra), Rohtak (Haryana), Pune (Maharashtra), New Delhi (Delhi), Srinagar (Kashmir), and Vizag (Andhra Pradesh) enrolling 2599 pregnant women. Estimation of thyroid stimulating hormone (TSH), free T4, and antithyroid peroxidase (TPO) antibodies was carried out using Roche modular kit using ECLIA technology in a central laboratory. We found in our study population that 13.13% of pregnant women have hypothyroidism (n = 388), using a cutoff TSH level of 4.5 μIU/ml. This prevalence was much higher using the American Thyroid Association criteria. Anti-TPO antibodies were positive in 20.74% of all pregnant women (n = 613), whereas 40% (n = 155) of hypothyroid pregnant women were positive for anti-TPO antibodies. This study concludes that there is a high prevalence of hypothyroidism (13.13%), majority being subclinical in pregnant women during the first trimester from India and universal screening of hypothyroidism may be desirable in our country.

MAMC Journal of Medical Sciences, 2016

Context: Hypothyroidism has been associated with neurocognitive deficit, but status of cognitive ... more Context: Hypothyroidism has been associated with neurocognitive deficit, but status of cognitive function in subclinical hypothyroidism is unclear. Also, cognitive impairment found in these patients has been associated with aging. Aims: The purpose of this study was to evaluate cognitive function in hypothyroid and subclinical hypothyroid patients using objective methods and to correlate it with age, thyroid stimulating hormone (TSH) level, and education status of patients. Settings and Design: It was a cross-sectional study conducted on 90 female participants aged 30-50 years. Thirty patients diagnose with subclinical hypothyroidism (group 1) were compared with 30 age- and sex-matched hypothyroid patients (group 2) and euthyroid controls (group 3). Subjects and Methods: Cognitive function was evaluated using three parameters such as mini mental scale examination (MMSE), event-related potentials - P300latency and amplitude, auditory and visual reaction time. Statistical Analysis Used: SPSS version 17 was used for statistical analysis. The data were also analyzed for variables related to age, TSH, and education level. Results: Significant delay in P300latency and prolonged reaction time was found in both subclinical hypothyroid and hypothyroid group compared to controls (P < 0.001). P300amplitude and MMSE score showed no significant difference in all groups. In hypothyroid patients, P300latency at Fz, Pz was positively correlated with age while nonsignificant correlation was observed in subclinical hypothyroid patients. TSH and education level of patients showed no significant correlation with cognitive function tests. Conclusions: Delayed P300latency and prolonged reaction time in both subclinical hypothyroid and hypothyroid patients shows that cognitive function is affected adversely. Event-related potentials may be more sensitive than clinical evaluation by MMSE, for early diagnosis of mild cognitive impairment in subclinical hypothyroidism.

Indian Journal of Orthopaedics, 2010

Indian Journal of Endocrinology and Metabolism, 2011

Thyroid diseases have widespread systemic manifestations including their effect on bone metabolis... more Thyroid diseases have widespread systemic manifestations including their effect on bone metabolism. On one hand, the effects of thyrotoxicosis including subclinical disease have received wide attention from researchers over the last century as it an important cause of secondary osteoporosis. On the other hand, hypothyroidism has received lesser attention as its effect on bone mineral metabolism is minimal. Therefore, this review will primarily focus on thyrotoxicosis and its impact on bone mineral metabolism.

Indian Journal of Medical Research, 2018

© 2018 Indian Journal of Medical Research, published by Wolters Kluwer Medknow for Director-Gener... more © 2018 Indian Journal of Medical Research, published by Wolters Kluwer Medknow for Director-General, Indian Council of Medical Research The body fat has been classified as subcutaneous or peripheral fat and visceral or central fat. The visceral fat, which is the fat around the viscera, is metabolically active, and releases certain inflammatory cytokines which predisposes to atherogenic end events, such as acute coronary syndrome, stroke and peripheral vascular disease. The central obesity along with hypertension, diabetes mellitus and dyslipidaemia is known as metabolic syndrome and has been clubbed together, because of their heightened atherosclerosis predisposing risks. ‘Asian phenotype’ is a term used to denote this body habitus of central obesity with thin limbs, which is so commonly seen in Indian, Japanese, Chinese and other Asian populations1. This has been attributed to lifestyle changes of decreased physical activity, intake of high calorie but less nutritious food, psychosocial stress, poor sleep and possibly different genetic milieu in Asians2,3.

Indian Journal of Endocrinology and Metabolism, 2016