BACKGROUNDCurrently available literature highlights association of hypovitaminosis D with chronic diseases such as diabetes mellitus and systemic hypertension, but there are very few studies on role of vitamin D in pulmonary tuberculosis (PTB) in our population. MATERIALS AND METHODSVitamin D levels in 180 cases of newly diagnosed active pulmonary tuberculosis (Both sputum positive and sputum negative) and 180 age and gender matched healthy controls were estimated. 25 Hydroxy vitamin D3 levels were estimated by sensitive fully automated Chemiluminescent Immunoassay (CLIA) technique. Vitamin D3 levels were categorised as sufficient, insufficient and deficient. Patients were followed for six months for final outcome (Tuberculosis cured/not cured). RESULTSOut of 180 cases, 95 (52.78%) were sputum positive and the remaining 85 (47.22%) were sputum negative. Mean vitamin D levels were significantly low in cases (12.23 ± 5.99 ng/mL) as compared to controls (18.7 ± 10.19 ng/mL) (p value <0.001). Among the 180 cases, 158 (87.78%) had vitamin D deficiency, 18 (10%) had vitamin D insufficiency; whereas among controls, 105 (58.33%) had vitamin D deficiency, 46 (25.56%) had vitamin D insufficiency. The prevalence of vitamin D deficiency and vitamin D insufficiency was higher among cases compared to controls (p-value < 0.05). CONCLUSIONThere is significant deficiency of Vitamin D in patients with PTB. More prospective designed studies are needed to firmly establish the direction of association between PTB and vitamin D deficiency (VDD).
Graves' ophthalmopathy in a hypothyroid patient without treatment for hyperthyroidism is called hypothyroid Graves' ophthalmopathy. We report a case of Graves' ophthalmopathy presenting with overt hypothyroidism who was not treated for hyperthyroidism previously.
BACKGROUNDObjective-To examine cardiovascular manifestations in patients with hypothyroidism. MATERIALS AND METHODSIn this observational study, adult hypothyroid patients were screened for cardiovascular disease. Symptoms of hypothyroidism, cardiovascular system related symptoms, T3, T4 and Thyroid Stimulating Hormone (TSH) were compared between male and female patients. Association between thyroid stimulating hormone and heart disease was also evaluated. RESULTSHundred patients (male 32% and female 68%) with mean age of 39.2 + 9.28 years were enrolled. More number of females showed weight gain over a period of two years as compared to males (p= 0.0217). Dry skin was more common in females as compared to males (p= 0.0336). More females reported breathlessness and chest pain as compared to males (breathlessness p= 0.0187; chest pain p= 0.0008). Pulse rate of female patients was significantly lower than male patients (p= 0.0081). More number of females had raised jugular venous pressure as compared to males (41% vs 19%, p= 0.0475). Diastolic blood pressure was higher in females than in males (p= 0.023). There was no difference in the mean T3 (52.43 ± 14.35 pg/mL vs 46.53 ± 14.19 pg/mL; p= 0.1776), T4 level (4.48 ± 0.97 vs 4.06 ± 0.97; p= 0.1630) or TSH level (31.19 ± 11.9 vs 42.21 ± 26.98; p= 0.1260) between males and females. Number of females with cardiomegaly was higher compared to males [26 (38%) vs 2 (6%); p < 0.0001]. Significant association was observed between higher TSH and presence of breathlessness, chest discomfort and palpitations (p < 0.05). Significantly, more patients with higher TSH showed significantly more heart rate, raised jugular venous pressure and diastolic blood pressure (p < 0.05). Higher TSH was associated with pericardial effusion in more proportion of patients (p= 0.007). CONCLUSIONCardiac dysfunction is common in patients with hypothyroidism. Screening and treatment of cardiovascular disease in hypothyroidism may help to reduce morbidity and mortality in hypothyroidism. KEYWORDS BACKGROUNDHypothyroidism is a common endocrinological problem in clinical practice. The reported incidences of clinical hypothyroidism range from 0.5 to 1.9% in women and less than 1% in men. Subclinical hypothyroidism is more common than clinical hypothyroidism, both in females and males. 1 The prevalence of subclinical hypothyroidism is about 4 -10.5%. 2 Both clinical and subclinical hypothyroidism are shown to be associated with cardiovascular manifestations. As heart is
Background: Given the high incidence of asymptomatic or subclinical SARS-CoV-2 infection, reported cases likely underestimate the overall prevalence and infectivity of COVID-19. Serological test for IgG can provide a better measure of disease activity by identifying asymptomatic or subclinical infection. This study was conducted to estimate the seroprevalence of SARS-CoV-2 infection and to the determinants of SARS-CoV-2 infection in the hotspot area of COVID-19. Method: It was a community-based, cross-sectional study using multistage sampling with a sample size of 360. After informed consent, the demographic information, past history of SARI/ILI, contact, COVID-19 status were collected. The blood samples were taken from one family member for anti-SARS-CoV-2 IgG antibody by ELISA testing kit. Results: Majority of the study subjects had no history of SARI (86%) or any contact with COVID-19 case (98%). Overall seroprevalence of anti-SARS-CoV-2 of IgG antibody was 40% (95% CI 35–45%), infection fatality rate (IFR) was 0.7%. Seroprevalence varied significantly depending on religious background; with Muslims (53%) seroprevalence compared to other religious groups. Seroprevalence of homemaker/unemployed (49%) and laborer (55%) was significantly higher compared to business (30%) and service occupation (21%). Subjects with overcrowding conditions and poor ventilation was significantly associated with higher seroprevalence with odds ratio of 2.5 and 2.3, respectively. Conclusion: The antibody testing detects a large number of asymptomatic cases or previously infected cases which would have been missed by clinical history. Thus, the number of undiagnosed cases was found significantly higher even with rigorous implementation of lockdown.
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