A Study on Thyroid Function Tests in Chronic Kidney Disease patients

INTRODUCTION: Chronic kidney disease [CKD] is a worldwide health problem with an increasing incidence and prevalence, poor outcomes and high cost. The complex interaction of the kidney and thyroid gland is well known. The literature available regarding thyroid dysfunction in chronic kidney disease on conservative management is still low. The importance of knowing the prevalence of thyroid dysfunction in CKD patients lies in the fact that it adds to already high cardiovascular mortality risk in this patient group. This original research was undertaken to study the thyroid dysfunction that occurs in CKD patients not on maintenance dialysis. AIMS AND OBJECTIVES: 1. To study the proportion of thyroid dysfunction in chronic kidney disease patients on conservative management 2. To study the correlation between the severity of the renal dysfunction with the thyroid abnormality. MATERIALS AND METHODS: This is a prospective, cross sectional study conducted in Thanjavur Medical College, Thanjavur from January 2016 to June 2016. 100 chronic kidney disease patients in medical ward and out patient department fulfilling inclusion and exclusion criteria were included. RESULTS: 100 CKD patients on conservative management who fulfilled the criteria were studied and the results analyzed. Of 100 patients 66 (66%) were males and 34 (34%) were females. In our study 18 patients (18%) were stage 3 CKD, 43 patients (43%) were stage 4 CKD and 39 patients (39%) belonged to stage 5 CKD. Creatinine clearance varied from 5.5 to 60 ml/min/1.73m2.Serum TSH varied from 0.32 – 45 with mean of 4.71 and S.D. of 7.31. Serum Free varied from 0.12 – 1.76 with mean of 1.31 and S.D. of 0.26. Serum Total T3 ranged from 0.04 to 2 with mean of 0.8 and S.D. of 0.61.In present study overall 66 patients (66%) had thyroid dysfunction, 34 patients (34%) had normal thyroid function tests. Low T3 syndrome was the commonest thyroid dysfunction observed in 45 patients (45%). 3 patients (16.7%) of stage 3 CKD, 19 patients (44.2%) of stage 4 CKD and 23 patients (59%) of stage 5 CKD had low T3 syndrome. Subclinical hypothyroidism was the second common thyroid dysfunction. It was detected in 16 patients (16%). 1 patient(5.6%) of stage 3, 3 patients (7.0%) of stage 4 and 12 patients (30.8%) of stage 5 had subclinical hypothyroidism.5 patients had frank hypothyroidism in our study. 3 patients (7.7%) were stage 5 CKD. 1 patient (2.3%) in stage 4 and 1 patient (5.6%)in stage 3 CKD. Number of patients with low serum T3 levels increased proportionately with decreasing creatinine clearances with p = 0.023(S). Serum FT4 levels was not significantly related to worsening renal function p = 0.227 (NS). Higher Serum TSH levels were found in more number of patients as the creatinine clearance decreased with a p = 0.004(HS).The proportion of CKD patients with SCH was 5.6% in stage 3, 3.7% in stage 4 and 30.8 in stage 5 CKD. The Low T3 syndrome was found in 16.7% in CKD stage 3, 44.2% in stage 4 CKD and 59%in stage 5 CKD. Hypothyroidism was found in 5.6% of stage 3CKD, 2.3% of stage 4 and 7.7% of stage 5 CKD.76 patients (76%) were anemic with peripheral smear showing normocytic normochromic picture in 64 patients (84%) and microcytic hypochromic anemia seen in 12 patients (16%).Hypocalcaemia was noted in 62 patients (62%) and hyperphosphatemia was noted in 43 patients(43%).USG abdomen revealed bilateral shrunken kidneys in 80 patients (80%), Hydrouretronephrosis in15 patients (15%) and normal sized kidneys in (5%). Thyroid swelling was found in 5 patients. FNAC revealed multi nodular goiter in all 5 patients. CONCLUSION: Thyroid dysfunction occurred in 66% of Chronic Kidney Disease patients. Low T3 syndrome was the commonest thyroid abnormality detected. This can be viewed as protective mechanism to conserve protein in Chronic Kidney Disease patients.Subclinical hypothyroidism was the second most common thyroid abnormality detected. It occurred in 16% patients indicating significant alteration of thyroid hormone physiology in Chronic Kidney Disease patients. Frank hypothyroidism was the least commonly detected thyroid abnormality. Number of patient with Low T3 syndrome and subclinical hypothyroidism progressively increased with increasing severity of Chronic Kidney Disease

Acyclovir Loaded Self-Assembled PH Sensitive Nanoparticle as a Novel Drug Carrier for Targeting of Viral Infection

The present study to develop Eudragit® EPO based nanoparticle suspension of acyclovir in order to increase its solubility and efficacy. The nanoparticle suspension was prepared by nanoprecipitation technique. The 32 factorial designs were used to study the effect of Eudragit® EPO and Pluronic on characteristics of nanoparticle suspension of Acyclovir. The optimized formulation was subjected to lyophilization. The lyophilized nanoparticle suspension and the redispersed lyophilized nanoparticle suspension were characterized by particle size, drug content, entrapment efficiency, FTIR, DSC, SEM, in-vitro drug release, Kinetic drug release and stability studies. The present study was aimed to formulate pH sensitive nanoparticle by using polymers Eudragit®-EPO and surfactant Pluronic®-F 68 in order to treat the viral infections an attempt was made to study the effect of Eudragit®-EPO and Pluronic®-F 68 on characterization of nanoparticle. Literature survey on nanotechnology proved that the polymer and surfactant selected for the present study have good nanoparticle forming property there are some reports with this new combination of polymer and surfactant used for research work. Preformulation study was carried out for the drug identification. The identification of drug was determined by melting point, solubility, λ max, FTIR and loss on drying. The values of the study obeys that procured drug was confirmed as acyclovir. The present studies are focused on application of 32 factorial design for the formation of nanoparticle with desired particle size. The effect ratio of polymer and stabilizer were found to influence the particle size, drug content and entrapment efficiency. pH sensitive nanoparticle of acyclovir were prepared by nanoprecipitation technique. The prepared nanoparticles were characterized for particle size, drug content and entrapment efficiency. All the characterized parameters shows that formulation nanoparticle with desired size, high drug content and high entrapment efficiency

Spectrophotometric method for estimation of desvenlafaxine succinate in tablet dosage form

ABSTRACT Two simple and sensitive spectrophotometric methods (A and B) for the determination of desvenlafaxine succinate in tablet dosage form are described. In the method A -Simple UV Spectrophotometric method, distilled water was used as solvent and shows absorption maxima at 224.5 nm. In the method B -Difference Spectrophotometric method, the proposed method is based on the principle that desvenlafaxine succinate can exhibit two different chemical form in basic and acidic medium that differ in the absorption spectra in basic and acidic medium. The difference spectrum of desvenlafaxine succinate in 0.01 M Sodium hydroxide was recorded by taking desvenlafaxine succinate in 0.1 M Hydrochloric acid solution as blank. The difference spectrum showed that the maxima at 240 nm and minima at 224.5 nm. The Beer's law range for method A is 5 -40 µg/mL and 8 -40 µg/mL for method B. The linear regression for method A and B are found to be 0.99992 and 0.99994 respectively. When tablet dosage form where analyzed, the results are obtained by the proposed methods are in good agreement with the labeled amount and the results were validated statistically

Transmission Line Fault Monitoring and Identification System by Using Internet of Things

The fault location detection has been a goal of power system engineers, since the creation of distribution and transmission systems. Quick fault detection can help protect the equipment by allowing the disconnection of faulted lines before any significant damage of the equipment. The accurate fault location can help utility personnel remove persistent of the faults and locate the areas where the faults regularly occur, thus reducing the occurrence of fault and minimize the time of power outages. As a result, while the fault location detection schemes have been developed in the past, a variety of algorithms continue to be developed to perform this task more accurately and more effectively. The detection and location of faults on power transmission lines is essential to the protection and maintenance of a power system. Most methods of fault detection and location relate to the measurements of electrical quantities provided by current and voltage transformers. These transformers can be expensive and require physical contact with the monitored high voltage equipment

Glare Reducing Windscreen Using Principle of Selective Reflection

ABSTRACT:Automobiles are prone to accidents due to glare effect at night. The scope of this research is to reduce the glare. Theconcept of Electrochromic glass was used. A windscreen was made up of a pair of float glass enclosed with Twisted Nematic Liquid Crystals. The liquid crystal material exhibited a property of selective reflection of incident light. A liquid crystal material E48 was used for this purpose and the results were studied. The wavelength of light within a narrow range which caused glare was selectively reflected. This resulted in reduced intensity of glare thus protecting the driver from glare during night travel