Thyroid hormones & TSH are associated with the etiology of type 2 diabetes (T2DM) and probably contribute to the development of the various complications of T2DM. The association of thyroid hormones & TSH with cardiovascular diseases in confirmed hypothyroid patients is still not clear.The aim of our study is to determine the correlation of HbA1c with thyrotropin (TSH) and thyroid hormones in the development of cardiovascular diseases (CVD) in known patients of hypothyroidism. This was a case control observational study carried out among total of 172 patients (100 patients and 72 controls). They were divided into in to two groups cases which are hypothyroid patient and control group. Blood sample (3 ml) was collected and Fasting blood sugar, complete lipid profile were assayed on Vitros 250 auto analyzer Johnson and Johnson USA.The circulating thyroid hormones assayed for T3, T4 and TSH by enzyme linked florescent assay (ELFA) technique using Vidas auto-analyzer. Glycosylated hemoglobin measured by kit based method where anticoagulated whole blood used as sample. Body weight and height were measured for body mass index (BMI) (kg/m).Our study demonstrate that Mean of BMI, W.C, FBS,HbA1c, TC, TG, LDL and VLDL were higher in cases as compared to HDL which is higher in control group as compared to case group,Our study also shows that serum T3 values correlates positively and significantly with waist circumference and triglyceride also, while T4 correlates positively and significantly with waist circumference, fasting sugar level, triglycerides and LDL-C while correlates only positively with, HbA1c and HDL-C, whereas TSH correlates positively only with LDL and HDL Levels.Our study concludes that the cumulative quantification of indicators  like TSH & HbA1c will function as a  biomarker for  hypothyroid patients who are at risk to develop CVD in their later stages of life.

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One session of hemodialysis was done in view of azotemia (blood urea-193 mg/dL, serum creatinine-9.7 mg/dL) and persistent hyperkalemia. He improved hemodynamically and started accepting orally well with no loose motions over the next 2 days. He was shifted to step down care unit after a thorough cardiac evaluation. Later, on day 5, he was discharged in stable condition with necessary instructions for care and follow-up. DiscussionBradycardia, renal failure, AV nodal blocking drugs, shock, and hyperkalemia (BRASH) syndrome represents a vicious cycle involving bradycardia, renal failure, AV nodal block, shock, and hyperkalemia. It is frequently observed in the elderly with underlying comorbidities, such as CKD, coronary artery disease, and hypertension. This term was first used and reported by Farkas et al. in 2016. 1 However it was underreported earlier, but it has been 1,3,