Association of Thyroid Profile and Prolactin Level in Patient with Secondary Amenorrhea.

BACKGROUND: Amenorrhea is the absence of menstrual periods. It has multiple social consequences as it may leads to infertility. This case control study was conducted for determining the association of thyroid hormones with hyperprolactinemia in patient with amenorrhea. METHODS: We investigated 50 women with diagnosed cases of secondary amenorrhoea, who attended UCMS hospital, for hormonal evaluations. Fifty two healthy women were taken as the controls. The thyroid dysfunction and serum prolactin level were reviewed in cases and in the controls. RESULTS: Mean serum prolactin level was found to be significantly higher in the cases as compared to the controls. Mean serum fT3 and fT4 level in the hyperprolactinemic cases (mean = 2.67, SD = 1.04 pg/ml) and (mean = 1.38, SD = 0.51 ng/dl respectively) were slightly lower as compared to normoprolactinemic cases (mean = 3.21, SD = 1.86 pg/ml) and (mean = 1.73, SD = 1.37 ng/dl) respectively. Mean TSH of normoprolactinemic and hyperprolactinemic cases were comparable (P = 0.049). There was positive correlation between prolactin, BMI and TSH whereas negative correlation of prolactin was seen with fT3, fT4 and age. In hyperprolactainemic cases, prolactin was found to be negatively correlated with TSH (r = -0.155, P = 0.491) whereas prolactin was positively correlated with TSH (r = 0.296, P = 0.126) in normoprolactainemic cases. CONCLUSIONS: Thus, hyperprolactinemia with thyroid dysfunction may be contributory hormonal factor in patient with amenorrhoea and as such, estimation of prolactin, fT3, fT4 and TSH should be included for diagnostic evaluation of amenorrhea.

Microalbuminuria in Patients with Hypertension Visiting Tertiary Care Centre, Western Nepal.

BACKGROUND: Renal complications of hypertension are associated with high morbidity and mortality. Prediction of such complications at the earliest is of utmost importance. We aimed to assess the prevalence of microalbuminuria in hypertensive patients. METHODS: A total of 130 clinically diagnosed hypertensive patients were enrolled in the study. Biochemical parameters that included serum creatinine, urinary albumin, and urinary creatinine were measured using standard methods. Albumin Creatinine ratio and estimated glomerular filtration rate were calculated. Albumin Creatinine ratio values between 30-300 mg/g were considered as microalbuminuria. Statistical analysis was performed on 120 samples after excluding frank proteinuria. RESULTS: The prevalence of microalbuminuria in hypertensive patients was 19.16%. Mean ranks of systolic blood pressure, pulse pressure, and serum creatinine levels were significantly higher in hypertensive patients with microalbuminuria. Mean estimated glomerular filtration rate was significantly low in hypertensive patients with microalbuminuria. Older age and increased duration as well as severity of hypertension were not associated with a higher prevalence of microalbuminuria. CONCLUSIONS: The prevalence of microalbuminuria was high in hypertensive patients. Serum creatinine and estimated glomerular filtration rate were significantly altered in patients with microalbuminuria. Early screening of microalbuminuria in such patients might help prevent renal complications.

Iodine Status among Subclinical and Overt Hypothyroid Patients by Urinary Iodine Assay: A Case-Control Study.

OBJECTIVES: The objective of the study was to assess the differences of iodine status as measured by urinary iodine excretion (UIE) between cases of hypothyroidism and healthy controls. MATERIALS AND METHODS: The study was conducted in cases with subclinical hypothyroidism (n = 58) and overt hypothyroidism (n = 41) and compared with age- and sex-matched healthy euthyroid controls (n = 52) attending Universal College of Medical Sciences Teaching Hospital, Bhairahawa, Nepal. Serum free triiodothyronine (fT3), free thyroxine (fT4), and thyroid-stimulating hormone (TSH) were estimated by competitive ELISA and sandwich ELISA, respectively (Diametra, Italy). The urinary iodine concentration (UIC) in urine samples was estimated by ammonium persulfate digestion method recommended by the WHO. RESULTS: A significantly higher median UIC was observed among cases of subclinical hypothyroidism (224.90 µg/l) and overt hypothyroidism (281.0 µg/l) as compared to the controls (189.90 µg/l) (P = 0.0001, P = 0.001). Serum TSH in the cases of subclinical hypothyroid was higher, whereas fT3 was lower as compared to controls (P = 0.028, P = 0.0001), respectively. Similarly, serum TSH in the cases of overt hypothyroid was higher and fT3 and fT4 were lower as compared to controls (P = 0.0001, P = 0.0001, P = 0.015), respectively. There was positive correlation of UIC with TSH (r = 0.269, P = 0.0001), whereas negative correlation was seen with fT3 (r = -0.328, P = 0.0001) and fT4 (r = -0.145, P = 0.076). The test of multiple regression has shown that fT3 (ß = -0.262, P = 0.012) as an independent predictor in association with UIE in cases. CONCLUSION: Excessive iodine intake was found in hypothyroid patients as assessed by UIE concluding that it may trigger the thyroid hypofunction. Cohort studies to generate further evidence should be done to explore potential mechanism of hypothyroidism in excess iodine intake.

Association between serum uric acid, urinary albumin excretion, and glycated hemoglobin in Type 2 diabetic patient.

BACKGROUND: Diabetes mellitus (DM) is a chronic disease characterized by insulin deficiency or peripheral resistance resulting in hyperglycemia. Poor glycemic control leads to diabetic complications. Hyperuricemia has been reported with increased risk of renal insufficiency. The aim of this study was to evaluate the relationship between serum uric acid concentration, degree of urinary albumin excretion (UAE) and glycated hemoglobin (HbA1c) in Type 2 DM (T2DM) patients. MATERIALS AND METHODS: Serum uric acid concentrations, urine microalbumin, and HbA1c were measured in fifty T2DM patients. We then evaluated relationship between uric acid concentrations, degree of UAE and glycemic control as well as other confounding variables. RESULTS: Serum uric acid concentration correlated positively with UAE (r = 0.323, P < 0.05), age (r = 0.337, P < 0.05), age at onset (r = 0.341, P < 0.05), and duration of DM (r = 0.312, P < 0.05). Multiple regression analysis demonstrated that serum uric acid concentration (ß = 0.293, P < 0.0001), duration of DM (ß = 0.261, P < 0.0001), HbA1c (ß = 0.173, P < 0.005), and systolic blood pressure (ß = 0.268, P < 0.005) were independent determinants of UAE. CONCLUSIONS: Serum uric acid concentration is associated with microalbuminuria and HbA1c in T2DM patients.