Prabhakar Adake, Abhishek Acharya, Susheela Halemani, Mahalaxmi Petimani,
Volume 16, Issue 1 (Jan-Feb 2022)
Abstract
Background and objectives: Coronavirus disease 2019 (COVID-19) has been reported to be more severe and highly fatal in patients with co-morbidities. Thyroid dysfunction leads to multisystem derangements, as thyroid hormones have major role in the development and functioning of all the human cells. The present study evaluated the variation in the clinical and biochemical parameters of COVID-19 patients with preexisting hypothyroidism.
Methods: This retrospective cohort study was carried out on eight COVID-19 patients with hypothyroidism who were admitted to a tertiary care hospital in Mangalore, India. Various clinical and biochemical parameters of the patients were recorded.
Results: Out of eight patients, three were men and five were women. With respect to other co-morbidities, six patients had associated type-2 diabetes mellitus and the remaining two patients had no other co-morbidities apart from hypothyroidism. Regarding the severity of COVID-19, one patient had mild symptoms, two had moderate symptoms, and the remaining five patients had severe COVID-19 symptoms. Most biochemical and hematological parameters in all patients were deranged from normal values. Moreover, only 25% of the patients recovered from the disease.
Conclusion: Most COVID-19 patients with hypothyroidism had low oxygen saturation and high level of inflammatory markers. In addition, the risk of mortality in COVID-19 patients with hypothyroidism and type 2 diabetes mellitus was higher compared to patients with hypothyroidism alone. It is recommended to closely monitor COVID-19 patients with hypothyroidism and limit the use of steroids during the course of treatment.
Thivyah Prabha, Rasheed Khan, Shruthi Cn, Rathi Priya,
Volume 17, Issue 6 (Nov-Dec 2023)
Abstract
Background: Thyroid disorders are the most common cause of endocrine dysfunction among women of childbearing age. It is well-established that hypothyroid dysfunction can have significant adverse effects on pregnancy and fetal development. This study aimed to determine the prevalence of thyroid disorders among antenatal women and assess the maternal and fetal outcomes in pregnant women with hypothyroid disorders.
Methods: This prospective study was conducted in the antenatal clinic of the Department of Obstetrics and Gynaecology in association with the Biochemistry Department. After obtaining written informed consent, antenatal women aged 18-40 years were included in this study, regardless of their gestational period. Venous blood samples were collected from the antecubital vein, and thyrotropin, free triiodothyronine (free T3), and free thyroxine (free T4) levels were measured. Hypothyroid antenatal women were monitored throughout their pregnancies to evaluate maternal and fetal outcomes.
Results: Among the participants in this study, 149 antenatal women had thyroid disorders, with a prevalence rate of 12.6%. Subclinical hypothyroidism, overt hypothyroidism, subclinical hyperthyroidism, and overt hyperthyroidism were observed in 6.9%, 3.2%, 1.8%, and 0.7% of cases, respectively. Maternal complications included oligohydramnios (5.8%), preeclampsia (13.3%), and preterm delivery (5%), while fetal complications included low birth weight (20.8%), hyperbilirubinemia (9.1%), and neonatal intensive care unit (NICU) admissions (13.3%).
Conclusion: A high prevalence (12.6%) of thyroid disorders, particularly hypothyroidism (10.1%), among pregnant women, emphasizing the importance of routine thyroid testing for all antenatal individuals.
Aradhana Harrison , Aswathy Prabha , Karishma Krishna , Vejay Viknesh Marudhadurai , Jahnavi Chikkegowda, Rajshree Choudhary ,
Volume 18, Issue 5 (Sep-Oct 2024)
Abstract
Background: β-thalassemia trait (BTT) can be screened by several discriminator indices (DIs) using complete blood counts (CBC). These DIs can help differentiate BTT from other causes of anaemia, thus reducing the financial burden of laboratory testing. At standard cut-off values, statistical analyses traditionally used to compare the diagnostic competence of these DIs give variable results. This study establishes new optimal cut-off values to improve the applicability of these DIs for BTT screening.
Methods: This was a retrospective study conducted on anaemic adults whose high-performance liquid chromatography (HPLC) and CBC results achieved over the past 6 months were reviewed. Based on HPLC reports, patients were categorised into BTT and non-BTT groups, with each group comprising 25 age- and sex-matched patients. Discriminator indices, including Mentzer’s Index (MI), Green and King Index (GKI), Sehgal Index (SI), Shine and Lal Index (SLI), Srivastava Index (SrI), and England and Fraser Index (EFI), were calculated for both groups. Statistical analysis was performed respective to standard cut-off values to establish new optimal cut-off values with the highest sensitivity and specificity.
Results: According to the results, SrI emerged as the best index, offering high sensitivity, specificity, Youden’s Index, accuracy, and odds ratio. On the other side, SLI and GKI were observed to be poor indices with low sensitivity and specificity. The new optimal cut-off values for the best performance of each DI for BTT screening were as follows: SrI ≤3.5, MI ≤11.4, GKI ≤59.7, SI ≤709.4, SLI ≤941.1, and EFI ≤1.91.
Conclusion: The performance of DIs at standard cut-off values was poor to screen BTT. New optimal cut-off values provided maximal sensitivity and specificity thereby enhancing their performance as screening parameters for BTT in regions with a high-prevalence of the condition. Further studies are warranted to substantiate the new cut-off values for BTT screening.
