Thyroid Function Abnormalities among Hospital Patients of Hilly Nepal

Introduction: Thyroid dysfunction stands as the second most common endocrine disease after diabetes mellitus. National reports on its prevalence are meagre. Hence, the study was conducted with the objective of exploring the prevalence of thyroid dysfunction among hospital patients of hilly region of Nepal. Methods: A hospital based, retrospective, analytical study was conducted in the department of biochemistry, Lumbini Medical College Teaching Hospital (LMCTH) from 15th February 2017 to 30th April 2017. The hospital records of patients from March 2014 to mid-February 2017 with suspected thyroid dysfunction and presented from different departments of hospital were reviewed. Data was entered in Excel 2007 and analysis was done with Statistical Package for Social Sciences (SPSS-21). Necessary descriptive and inferential statistical analysis was done. P value less than 0.05 was regarded as statistically significant. Results: Out of 3136 subjects, 601 (19.2%) were male and 2535 (80.8%) were female with F:M ratio of 4.2:1. Female were more likely to be suspected of thyroid dysfunction. Mean age of male was 39.28 years (SD = 19.01) and that of female was 39.60 years (SD = 14.63). Prevalence of thyroid dysfunction was 23.31%. Correlation of log10 TSH with age showed a significant relation (r = -0.05, p = 0.003).  Age group and thyroid function category among female patients was found to be statistically significant (p = 0.01). Conclusion: The prevalence of thyroid dysfunction was high in Tansen region, a hilly mid-west Nepal. Female above 40 yrs (post reproductive age) and male above 60 yrs (elderly group) were more prone to thyroid disorders. Also, the study revealed that younger people are more likely to be euthyroid whereas as age advances, people are likely to be either hypothyroid or hyperthyroid. These findings can be a guide for elaborative research in thyroid disorder in future

Cardiovascular Risk Factors among First Year Medical Students

Introduction: Detection of cardiovascular risk in young age is important to motivate them to modify life styles and seek health care early to lower the chances of acquiring cardiovascular disease in later age. This study was done to assess cardiovascular risk factors among first year medical students. Methods: A cross-sectional study was conducted throughout September and October 2017 in which all first year medical students from a medical college were assessed for the presence of cardiovascular risk factors. Participants’ demography, family history of illness, anthropometric measurements, and blood reports of lipid profile and fasting glucose were acquired. Data were analyzed with Statistical Package for Social Sciences (SPSS-21). Result: There were 99 participants; 55 males and 44 females. One or more risk factors were present in 87 (87.9%) participants. Moreover, 67.7% (n = 67) participants had more than one risk factors. Low HDL-cholesterol was the most common (n = 55, 55.6%) risk factor followed by elevated triacylglycerol (n = 47, 47.5%) and family history of hypertension (n = 45, 45.5%). There was no significant difference in presence of various risk factors between genders. Conclusion: There was higher prevalence of cardiovascular risk factors among first year medical students. Majority of them had more than one risk factors. Low HDL-cholesterol was the most common risk factor. The risk factors were comparable in males and females

Thyroid Function Abnormalities among Hospital Patients of Hilly Nepal

Introduction: Thyroid dysfunction stands as the second most common endocrine disease after diabetes mellitus. National reports on its prevalence are meagre. Hence, the study was conducted with the objective of exploring the prevalence of thyroid dysfunction among hospital patients of hilly region of Nepal. Methods: A hospital based, retrospective, analytical study was conducted in the department of biochemistry, Lumbini Medical College Teaching Hospital (LMCTH) from 15th February 2017 to 30th April 2017. The hospital records of patients from March 2014 to mid-February 2017 with suspected thyroid dysfunction and presented from different departments of hospital were reviewed. Data was entered in Excel 2007 and analysis was done with Statistical Package for Social Sciences (SPSS-21). Necessary descriptive and inferential statistical analysis was done. P value less than 0.05 was regarded as statistically significant. Results: Out of 3136 subjects, 601 (19.2%) were male and 2535 (80.8%) were female with F:M ratio of 4.2:1. Female were more likely to be suspected of thyroid dysfunction. Mean age of male was 39.28 years (SD = 19.01) and that of female was 39.60 years (SD = 14.63). Prevalence of thyroid dysfunction was 23.31%. Correlation of log10 TSH with age showed a significant relation (r = -0.05, p = 0.003).  Age group and thyroid function category among female patients was found to be statistically significant (p = 0.01). Conclusion: The prevalence of thyroid dysfunction was high in Tansen region, a hilly mid-west Nepal. Female above 40 yrs (post reproductive age) and male above 60 yrs (elderly group) were more prone to thyroid disorders. Also, the study revealed that younger people are more likely to be euthyroid whereas as age advances, people are likely to be either hypothyroid or hyperthyroid. These findings can be a guide for elaborative research in thyroid disorder in future

ROLE OF PROTEINS IN RELATION TO DIABETES MELLITUS

Though the mechanism of metabolism of carbohydrate and protein is different, they take place simultaneously in the human system and are closely integrated to each other. It is seen that protein malnutrition in young adulthood leads to a malnutrition related diabetic syndrome in many developing countries. 1 The possibility that malnutrition in early infancy and childhood can result in partial failure of the $-cell function and clinical onset of diabetes later in life deserves further study. 2 With experimental models of protein malnutrition it has been possible to reproduce the impaired glucose tolerance and decreased insulin secretory response to glucose in human Kwasbiorkor. -7 In vitro experiments on rats show that insufficient protein diet for a limited period results in diminished insulin secretory response to glucose after the rats are returned to an adequate diet. That protein malnutrition affects the insulin secretion and glucose tolerance has been shown by Ingemar Swenne and Workers 8 on experimental animals of same age and sex divided into two groups: one fed with low protein diet and the other fed the normal diet for a limited period of time. Subsequently, when both the groups were treated with a diet of high nutritional efficiency, it was seen that there was no change in weight gain and growth in protein malnourished rats compared to normal rats. However, in malnourished rats impairment of glucose tolerance and an increased hypoglycemic response to exogenous insulin was seen. These observations indicate that the impairment of glucose tolerance in protein malnutrition is caused by deficient insulin secretion rather than by changes in peripheral insulin action. On a diet of higher nutritional efficiency, the serum insulin levels of malnourished rats remain lower than the normal rats indicating a functional impairment of pancreatic islets due to protein malnutrition which is also irreversible. When different tissue samples of normal and protein malnourished rats were analysed 9 , it was observed that malnutrition resulted in decrease in pancreatic size, diameter and volume of pancreatic islets. It was also observed 9 that stimulation of pancreas with glucose load as well as with synthetic stimulators like A 23187 (Calcium ionophore which elicits first phase of insulin secretion