Spectrum of thyroid disorders in tertiary care hospital at Patancheru, Sangareddy, Telangana, India -A clinical study (original) (raw)
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Thyroid dysfunction in region of excess iodine intake of Eastern Nepal
International Journal of Scientific Reports, 2018
We conducted a cross sectional study from August 2015 to July 2016 in Udayapur district located in Eastern part of Nepal. Primary school aged children (6 years to 12 years) were enrolled from three schools. We randomly selected 200 healthy school going children from the three schools. Sample size was calculated on the basis of latest prevalence of excess iodine nutrition in children of ABSTRACT Background: Iodine deficiency as well as iodine excess can result in an increased prevalence of thyroid disorders. The prevalence of excess iodine nutrition is increasing all over the world. The aim of the present study was to find the occurrence of iodine nutrition status in primary school children of Eastern Nepal and find the prevalence of associated thyroid dysfunction among those with excess urinary iodine concentration. Methods: A community based cross sectional study was conducted in Udayapur district which is located in Eastern part of Nepal. Primary school aged children (6 years to 12 years) were enrolled in this study from three schools. Blood and urine samples were collected and assayed for urinary iodine concentration (UIC), free thyroid hormones (fT 3 and fT 4), and thyroid stimulating hormone (TSH). Results: The median UIC was 232.27 µg/L. The iodine status showed that 15.5% (n=31) had low UIC, 21% (n=42) had above requirement and 36% (n=72) had excessive iodine nutrition status. The mean concentration of fT 3 and fT 4 was 2.87 pg/ml and 1.21 ng/dl respectively, while the median TSH concentration was 3.03 mIU/L. The prevalence of thyroid dysfunction was 10% (n=20) with subclinical hypothyroidism being the most common. Majority of participants with subclinical hypothyroidism had excess UIC. Conclusions: Above requirement and excess iodine nutrition is more common in region where there is unregulated consumption and improper monitoring of iodized salt. Subclinical hypothyroidism is common in regions of excess iodine nutrition.
Status of thyroid function in Indian adults: two decades after universal salt iodization
The Journal of the Association of Physicians of India, 2012
The aim was to find impact of two decades of universal salt iodization on the prevalence of goiter, thyroid autoimmunity and thyroid dysfunction in Indian adults. This was a cross sectional study from Delhi, India. The subject population included 4409 adult members of resident welfare associations of 5 residential colonies, from 18-90 years of age, who participated in general health check-up camps. The subjects underwent a detailed evaluation including history, anthropometry, goiter grading, USG thyroid, thyroid auto-antibodies and thyroid function tests. All these subjects were regularly consuming iodized salt. Overall, 9.6% of subjects had clinical goiter (13.3% women and 3.3% in men). Prevalence of nodules on palpation was found to be in 1.6% which was lower in men. The nodule prevalence increased to 4.6% in men and 5.6% in women on ultrasonography. Thyroid hypoechogenicity was seen in 30.6% of subjects with severe hypoechogenicity higher in women (5.7% men and 15.5% women). TPO ...
Asian Journal of Medical Sciences, 2013
Background: Thyroid disorders constitute the most prevalent endocrine disorder in our country. Thyroid disorders are classified broadly as hyperthyroidism and hypothyroidism depending on the functional capacity of the thyroid gland. These two entities are further segregated as sub clinical and overt dysfunction. The present study attempts to evaluate the prevalence of thyroid disorders in north Indian population which is more prone to hypothyroidism due to iodine deficiency observed in the Himalayan belt.
https://www.ijhsr.org/IJHSR\_Vol.9\_Issue.10\_Oct2019/IJHSR\_Abstract.03.html, 2019
Background: With universal iodine fortification of table salt, there as been a decrease in the incidence of goitre due to its deficiency. There is an increase in the iodine excretion in urine and this is associated with autoimmune thyroiditis. However the reports are controversial hence this study was designed to see the urine iodine excretion in different groups of thyroid diseases-autoimmune (AITD) and non-autoimmune (NAITD) and compared with euthyroid controls. Methodology: The study included subjects with autoimmune thyroid disorder (AITD) group 1 (n= 95), non-autoimmune thyroid disorder (NAITD) group 2 (n=31) and compared with age and sex matched healthy euthyroid controls group 3 (n=29). Serum free thyroxine (FT4), thyroid peroxidase antibody (TPO Ab), thyroid stimulating hormone (TSH) and median urinary iodine concentration (UIC) in urine were estimated. Results: A statistically significantly higher median UIC was observed in group 1 and 3 as compared to group 2 (p=0.001). According to iodine nutrition status, in group 1, 51 subjects (53.68%) were in moderate iodine deficit state which was statistically significant when compared between group 2, 08(25.80%) p=0.01 and group 3, 10(34.48%) p=0.003. The NAITD group 2 subjects were more iodine deficit than the groups 1 and 3. There was positive correlation between median UIC and TSH (r = 0.36, P = 0.326) and with TPO (r = 116, P=0.075). Conclusion: NAITD subjects are more iodine deficient than the AITD subjects or the euthyroid controls. The UIC was significantly more in AITD than NAITD (p=0.001). We observed a positive correlation between UIC and TPO Ab titres. In adults the incidence of thyroid diseases has increased which may not be directly caused by iodine excess as our study reveals.
Public Health Nutrition, 2010
ObjectiveThe aim of the present study was to determine the impact of universal salt iodization (USI) on the prevalence of iodine deficiency in the population of an area previously known to have severe iodine deficiency in India.DesignIn a cross-sectional survey, a total of 2860 subjects residing in fifty-three villages of four sub-districts of Gonda District were examined for goitre and urinary iodine concentration. Free thyroxine and thyroid-stimulating hormone levels were also measured. Salt samples from households were collected for estimation of iodine content.ResultsA reduction in goitre prevalence was observed from 69 % reported in 1982 to 27·7 % assessed in 2007. However, 34 % of villages still had very high endemicity of goitre (goitre prevalence >30 %). Twenty-three per cent of households consumed a negligible amount (<5 ppm) and 56 % of households consumed an insufficient amount (5–15 ppm) of iodine from salt.ConclusionsAlthough there was an overall improvement in io...
Clinico-epidemiological spectrum of thyroid illness after salt iodination program in Nepal
2021
Background Thyroid disorder is an important endocrine disorder in Nepal which is mostly due to environmental deficiency of iodine. The earliest and potentially most damaging result of iodine deficiency is neonatal hypothyroidism and cretinism characterised by learning disabilities and poor motivation to achieve. Methods We selected one thousand known cases of thyroid disorders who visited biochemistry department of shree Birendra Hospital, chaunni for routine tests. A detailed history was obtained and free triiodothyronine (fT3), thyroxine (fT4) and thyroid stimulating hormone (TSH) estimation was done in Seimens CP Chemiluminiscence Immunoassay analyser. Result Puffiness of face, hoarseness of voice and weight gain were the presenting features in hypothyroid patients, whereas weight loss and restlessnes were predominant features in hyperthyroid patients. In our study the prevalence of hypothyroidism and hyperthyroidism was 27% and 12.5% respectively. Conclusion None of our patients...
Indian Journal of Child Health, 2021
Objective: To eliminate iodine deficiency disorders (IDD) in children, the Indian government implemented a universal salt iodization program more than 3 decades ago. Recently, it was identified that excess iodine intake could lead to autoimmune thyroiditis in children. We aimed to measure the level of iodine excretion as well as thyroid profiles as an option to identify autoimmune thyroiditis in school-going children. Materials and Methods: A total of 111 children between the ages of 6 and 12 years were subjected to a blood test to measure free thyroxine, thyroid-stimulating hormone, anti-thyroglobulin, and anti-thyroperoxidase levels. The children were categorized into control and case groups based on the clinical outcome. Biochemical analysis, thyroid gland assessment, fine-needle aspiration cytology (FNAC), and ultrasound sonography were performed. Urinary iodine excretion (UIE) level was measured by the Sandell-Kolthoff reaction method. Results: Approximately 90% of the study population was identified with a higher level of iodine in urine. A positive correlation was observed between the UIE, anti-TPO, and anti-TGO titers among the cases. Out of 61 cases, 21 children showed overt hypothyroidism (34.43%) and the remaining were identified with subclinical thyroid symptoms (65.57%). FNAC confirmed autoimmune thyroiditis in 43 children within the case group. Conclusion: Excess iodine intake may trigger thyroid autoimmunity in children. Children who are having higher levels of anti-thyroid antibodies are at risk of developing thyroid dysfunction if they consume more than the required iodine for metabolism. High levels of iodine in the urine of control children indicate that the IDD program in our nation is running successfully.
BMC Research Notes
Objectives: Deficiency as well as excess dietary iodine is associated with several thyroid disorders including Grave's disease and goitre. Previously, cross sectional studies conducted among school children in Nepal showed high prevalence of iodine deficiency. In contrast, recently, few studies have revealed emerging trends of excess urinary iodine concentration in children. This paper, reports excess urinary iodine excretion and thyroid dysfunction among school age children from eastern Nepal. Results: It was a community based cross sectional study in which we measured urinary iodine excretion levels among school age children at baseline and after educational program. The educational program consisted of audiovisual and pamphlets on thyroid health. We also screened them for thyroid function status by physical examination and measuring serum thyroid hormones. Our results show that 34.4% of the children had excess urinary iodine concentration above the WHO recommended levels. Overall, 3.2% of the children were identified to have thyroid dysfunction. Urinary iodine concentration was significantly different between types of salt used and between salt iodine content categories.
Thyroid Function Status in Indian Adult Nonpregnant Females in Ranchi, India
Indian Journal of Medical Biochemistry
Aim Thyroid disorders are one of the most common endocrine diseases in India. Thyroid disorders are more common in women than in men and contribute to significant morbidity. In this postiodization era, there is paucity of pan-Indian data of thyroid disorder status among adult nonpregnant women. This study was done to analyze the thyroid hormone levels in women of Jharkhand region, which is traditionally known to be an iodine-deficient area. Materials and methods Three hundred and forty nonpregnant adult females in Ranchi area who were consuming iodized salt formed part of the study group. Clinical evaluation was done by a gynecologist pertaining to thyroid illness. Thyroid function tests encompassing triiodothyronine, thyroxine, and thyroid-stimulating hormone were carried out by quantitative enzyme immunoassay method. Thyroid status of the population was defined as per kit reference range. Results Subjects with age range 20 to 67 years were divided into three groups as per clinical...
Does Iodine Excess Lead to Hypothyroidism? Evidence from a Case-Control Study in India
Archives of Medical Research, 2015
Background. Iodine deficiency disorders have been known to mankind since antiquity and various researchers elucidated the role of iodine in its causation. However, recent evidence shows that the entire control program ignored multi-causality and association of increased iodine intake with hypothyroidism. This study was conducted to assess differences of iodine intake as measured by urinary iodine excretion (UIE) between cases of hypothyroidism and healthy controls. Methods. A case-control study was conducted with three groups (cases, hospital controls and community controls) in two cities of India. Patients with overt hypothyroidism were cases (n 5 150) and were compared with age, sex and socioeconomic status-matched hospital (n 5 154) and community (n 5 488) controls. Thyroid function tests (T3, T4, TSH) were used as diagnostic and inclusion criteria. TPOAb and UIE estimation were carried out for all study participants. Results. Mean values of TPOAb and UIE were higher in cases as compared to hospital controls as well as community controls (p !0.05). With a cut off of 34 IU/mL for TPOAb, more cases had an anti-TPO level O34 as compared to hospital controls (p !0.001) as well as community controls (p !0.001); OR, 0.06 (95% CI, 0.03, 0.12) and 0.08 (0.05, 0.12), respectively. For UIE cutoff of 300 mg/L, more cases than hospital controls (p 5 0.090) and community controls (p 5 0.001) had higher levels; OR, 0.671, (0.422, 1.066) and 0.509, (0.348, 0.744), respectively. Conclusion. The study has clearly shown that cases of hypothyroidism are associated with excess iodine intake. Cohort studies to generate further evidence and an ecosocial epidemiological approach have been suggested as the way forward. Ó 2015 IMSS. Published by Elsevier Inc.