Day 2 :
- Hypothyroidism
Session Introduction
Ismael Kalayu Sitotaw
Arsi University, Ethiopia
Title: Comparison of nutritional status and associated factors of lactating women between lowland and highland communities of district Raya, Alamata, Southern Tigiray, Ethiopia
Biography:
Abstract:
The Ethiopian regions have a relatively higher prevalence of under-nutrition are found in the lowlands of the country, with the exception of the highlands of Tigiray, where under-nutrition is also prevalent. A community based comparative cross-sectional study design was conducted from January 27- March 7, 2014. Sample size was determined by two population estimation formula. The total calculated sample size was 456. A stratified sampling technique was used to stratify the study area to highland and lowland. Study participants were selected by simple random sampling technique. Data were collected using anthropometric measurements and structured questionnaire. The raw data were entered and analyzed using SPSS version 20.0. Multivariable Logistic regression was done to determine the association between explanatory variable with chronic energy deficiency (CED) using body mass index (BMI), by computing odds ratio at 95% confidence level. A P – value < 0.05 was considered as statistically significant. The prevalence of CED of lactating mothers from lowland and highland was 17.5% and 24.6% respectively: age, husband occupation, taking vitamin A immediately after delivery or within the first eight weeks after delivery and consumption of extra food during lactation time were factors associated with chronic energy deficiency for lowland lactating women whereas parity, number of meals per day and household consumption of iodized salt were factors associated with CED for highland lactating women. CED in both comparative studies was a serious public health problem. As it is known food security does not mean nutritionally secured, Therefore, the need to develop nutrition intervention such as nutrition security programs to address under-nutrition in the study area is significant, as it was found food secured participants were slightly vulnerable than food insecure. The dietary diversity score of the participants were very low so that encourage the community about nutrition diversification is substantial for adequate nutrient intake.
Tika Ram Lamichhane
Tribhuvan University (TU), Nepal
Title: Status of hypothyroidism and its impact on molecular level
Biography:
Abstract:
Statement of the Problem: Routine assesment of thyroid status basically relies on ultrasonographic (USG) examinations and thyroid function tests (TFT) determining the serum concentrations of FT3, FT4 and TSH. Along with finding the prevalence of hypothyroidism, it is required to explore the biophsical insights in the molecular levels behind such disorders. Methodology & Theoretical Orientation: USG and TFT measurements of the patients were performed at Tribhuvan University Teaching Hospital (TUTH), Kathmandu, Nepal. The mutational and overt hypothyroidal impacts on thyroid hormone receptors (THRs) were studied by nanoscale molecular dynamics simulations in a high performance computer at Central Department of Physics, TU, Nepal. Findings: The prevalences of subclinical and overt hypothyroidism are 64.58% and 11.73% of 963 hypothyroid subjects based on TFT results under the study of 4438 subjects. In a total of 140 patients (mean age: 38.94±13.60 years) perfroming both USG and TFT observations, 22.86 % have hypothyroidism (mean TSH: 25.86 mIU/L) with mean size of left and right lobe, 4.92±3.24 mL and 5.66±3.93 mL, respectively finding multinodular goiters, hypoechoic lesions, chronic thyroiditis, benign/malignant nodules, and colloid cysts in some patients. Negative correlation between FT3/FT4 and TSH verifies the negative feedback mechanism of thyroid cycle. At overt hypothyroidism, THRs become free of T3 or T4 in their binding sites that reduce the gene transcription rate. By the molecular dynamics study of native stateTHRs, the heat capacity of T3 liganded THR-β is 9.76±0.38 kcal/mol/K and that of unliganded THR-β is 9.08±0.34 kcal/mol/K at 310 K. It makes change in heat transfer properties. Conclusion & Significance: In menarche and menopause periods, thyroid size of females is higer than that of males. Females are more vulnerable towards hypothyroidism. The mutated, T3-liganded and unliganded-THRs have the different structuaral and thermophysical properties like interaction energies, heat capacity, heat coduction and normal modes of vibrations.
Ramchandra Sargar
RUDN-University, Russia
Title: Radiological diagnostic method in subclinical hypothyroidism
Biography:
Sargar R.V is working in RUDN-University, Moscow, Russia. His wide range of publications in various national and international journals.
Abstract:
Purpose of study- To study the diagnostic capabilities of X-ray computed tomography (CT) for the evaluation of intra-thyroid hormone formation in diseases of the thyroid gland.
Material and Methods- Total number of patients were 236 women with thyroid disease, which caused disorders of the thyroid gland function. The control group consisted of individuals of 2 groups; first group who denied contact with iodine; 2) had contact with iodine. All patients were examined in accordance with the standards of care to conduct the evaluation of thyroid CT density in HU.
Results: In primary hypothyroidism (= 87), hyperthyroidism (â„– = 35), carriers of antibody (â„– = 28) thyroid HU density was significantly (p <0.05) reduced compared with the control group and was respectively (M ± m) 53 ± 2; 85 Ä… 9; 84 ± 6 units. With iodine induced hyperthyroidism ( = 8) and hypothyroidism (RL = 11), thyroid density in HU was significantly increased to 182 ± 7 and 181 ± 6 units compared to control group «1» »(CH = 36). In the control group "2" (CHO = 31) who consumed iodized sodium chloride, the thyroid density in HU was significantly increased to 162 ± 7 vs. 104 ± 8 in the control group «1) ».
It should be emphasized that the thyroid density in HU, determined at CT, is directly proportional to the concentration of intra thyroid stable iodine. In turn, 80% of the element iodine is in the phenyl ring of thyroid hormones. Consequently, the thyroid density index in HU reflects the level of hormone formation and the reserves of iodinated thyroid hormones directly into the thyroid gland. In this regard, it should be noted that the thyroid gland is the only endocrine organ that, after the synthesis of hormones lasting 50 days, stores them in the thyroid structure (colloid of thyroglobulin) and secretes thyroid hormones into the blood at the request of the body. Based on the literature data and the results of our own research, for all regions of Russia we have proposed the following fluctuations in thyroid density in HU, reflecting the euthyroid status and favorable future of the thyroid function: from 85 to 140 units. In those cases when there is an iodine- induced dysfunction of thyroid function, the thyroid density index in HU is increased above 140. If the synthesis of thyroid hormones (primary hypothyroidism) or synthesis is impossible, but pathological secretion with a lack of fixation in thyroid globulin collagen (diffuse toxic goiter with thyrotoxicosis), the thyroid density in HU decreases less than 85 units. It is important to note that in the determination of TSH in the blood, fasting, the use of a number of drugs, stress, sleep deprivation, severe illnesses of the subject can lead to errors in determining the concentration of TSH and thyroid hormones (due to so-called non thyroidal factors) in the direction of their change as in hypothyroidism with the presence of euthyroidism in fact. In this case, normal thyroid density in HU indicates euthyroidism.
Conclusions: One time assessment of thyroid density in HU with CT and blood serum TSH level makes it possible to perform differential diagnosis between iodine induced and true thyroid dysfunction and also to correct for the error in determination of TSH concentration as a result of the influence of non thyroidal factors. Evaluation of thyroid density in HU in CT should be used for screening the risk of thyroid dysfunction and for determining the need for individual and population iodine prophylaxis and monitoring its effectiveness in order to prevent iodine induced transient disorders of thyroid function.
Ramchandra Sargar
RUDN-University, Russia
Title: Radiological diagnostic method in subclinical hypothyroidism
Biography:
Sargar R.V is working in RUDN-University, Moscow, Russia. His wide range of publications in various national and international journals.
Abstract:
Purpose of study- To study the diagnostic capabilities of X-ray computed tomography (CT) for the evaluation of intra-thyroid hormone formation in diseases of the thyroid gland.
Material and Methods- Total number of patients were 236 women with thyroid disease, which caused disorders of the thyroid gland function. The control group consisted of individuals of 2 groups; first group who denied contact with iodine; 2) had contact with iodine. All patients were examined in accordance with the standards of care to conduct the evaluation of thyroid CT density in HU.
Results: In primary hypothyroidism (= 87), hyperthyroidism (â„– = 35), carriers of antibody (â„– = 28) thyroid HU density was significantly (p <0.05) reduced compared with the control group and was respectively (M ± m) 53 ± 2; 85 Ä… 9; 84 ± 6 units. With iodine induced hyperthyroidism ( = 8) and hypothyroidism (RL = 11), thyroid density in HU was significantly increased to 182 ± 7 and 181 ± 6 units compared to control group «1» »(CH = 36). In the control group "2" (CHO = 31) who consumed iodized sodium chloride, the thyroid density in HU was significantly increased to 162 ± 7 vs. 104 ± 8 in the control group «1) ».
It should be emphasized that the thyroid density in HU, determined at CT, is directly proportional to the concentration of intra thyroid stable iodine. In turn, 80% of the element iodine is in the phenyl ring of thyroid hormones. Consequently, the thyroid density index in HU reflects the level of hormone formation and the reserves of iodinated thyroid hormones directly into the thyroid gland. In this regard, it should be noted that the thyroid gland is the only endocrine organ that, after the synthesis of hormones lasting 50 days, stores them in the thyroid structure (colloid of thyroglobulin) and secretes thyroid hormones into the blood at the request of the body. Based on the literature data and the results of our own research, for all regions of Russia we have proposed the following fluctuations in thyroid density in HU, reflecting the euthyroid status and favorable future of the thyroid function: from 85 to 140 units. In those cases when there is an iodine- induced dysfunction of thyroid function, the thyroid density index in HU is increased above 140. If the synthesis of thyroid hormones (primary hypothyroidism) or synthesis is impossible, but pathological secretion with a lack of fixation in thyroid globulin collagen (diffuse toxic goiter with thyrotoxicosis), the thyroid density in HU decreases less than 85 units. It is important to note that in the determination of TSH in the blood, fasting, the use of a number of drugs, stress, sleep deprivation, severe illnesses of the subject can lead to errors in determining the concentration of TSH and thyroid hormones (due to so-called non thyroidal factors) in the direction of their change as in hypothyroidism with the presence of euthyroidism in fact. In this case, normal thyroid density in HU indicates euthyroidism.
Conclusions: One time assessment of thyroid density in HU with CT and blood serum TSH level makes it possible to perform differential diagnosis between iodine induced and true thyroid dysfunction and also to correct for the error in determination of TSH concentration as a result of the influence of non thyroidal factors. Evaluation of thyroid density in HU in CT should be used for screening the risk of thyroid dysfunction and for determining the need for individual and population iodine prophylaxis and monitoring its effectiveness in order to prevent iodine induced transient disorders of thyroid function.