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Background: Carotid artery intima-media thickness (CAIMT) measurement in hypothyroidism will help assess the progression of atherosclerosis and timely intervention may prevent vascular complications.Methods: This study included 30 clinical hypothyroid (CH), 30 subclinical hypothyroid (SCH) and 30 euthyroid. As per procedure, informed consent was taken from the patients in prescribed formats before their participation in the study. Patients were divided into 3 groups of CHs, SCH and Controls after obtaining the thyroid function test values. CAIMT on the right side was measured in the three groups for comparison. Other parameters included age, sex, height, weight, body mass index (BMI), total cholesterol and triglycerides. After 4 months of levothyroxine therapy, CAIMT, total cholesterol and triglycerides were reassessed.Results: The CAIMT was increased in CH and SCH group when compared to euthyroid individuals. The mean CAIMT in CH group was 0.60±0.009cm, in SCH group it was 0.055±0.010 cm and in controls it was 0.047±0.006 cm. After 4 months of levothyroxine therapy, there was no change observed in the mean CAIMT values.Conclusions: CAIMT levels were increased in CH and SCH group when compared to euthyroid group. There was no regression of CAIMT after 4 months of levothyroxine therapy.

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BACKGROUND Extra-hepatic biliary tract obstruction can be due to a number of conditions. Most causes are due to stones in the common biliary duct or due to malignant obstruction. Malignant causes include carcinoma head of pancreas, periampullary carcinoma and cholangiocarcinoma. Besides calculus and malignant obstruction, benign and malignant strictures can also cause obstruction of extra hepatic biliary ducts. The objectives of the study were to describe the clinical profile of patients presenting with extra-hepatic biliary obstruction and to assess the known aetiological factors. METHODS The research was designed as a hospital based cross-sectional study in the general surgery wards of our institution from 2016 to 2017. All individuals who were diagnosed to have extra-hepatic biliary obstruction by imaging were included in the study. RESULTS Among the 66 cases studied, majority were due to malignancies and gall stones. The malignancies included carcinoma head of pancreas, periampullary carcinoma, cholangiocarcinoma and Klatskin’s tumour. Miscellaneous causes were bile duct stricture, cholelithiasis with biliary sludge and annular pancreas. For the malignant cases, Whipple surgery and its pylorus-preserving variant were the most common surgical procedures carried out. Biliary bypass procedures were also carried out in some patients. For patients with common bile duct (CBD) stones, cholecystectomy, choledocholithotomy and choledochojejunostomy were done. CONCLUSIONS Malignant causes of jaundice are more common than benign causes. Secondary stones are the commonest cause of non-malignant biliary obstruction. Jaundice is more severe and associated with pruritis and more intolerable and persistent in malignancy. Surgical bypass procedures give good palliation for obstructive jaundice. KEY WORDS Bile Ducts, Choledocholithiasis, Cholestasis, Extra Hepatic, Pancreatic Cancer, Periampullary Cancer