About 300 million people across the world suffer from thyroid gland dysfunction. Environmental factors play an important role in causation of autoimmune thyroid diseases in susceptible individuals. Genetics contributes to 70% of the risk. In order to reduce the risk, we need to understand the association of environmental agents with thyroid dysfunction. These factors are especially relevant for those at increased risk due to positive family history. The ideal study to see the impact of a thyroid toxicant consists of directly measuring the degree of exposure to toxicant in an individual with his thyroid status. Knowledge of various factors influencing thyroid dysfunction can help in interpreting the results of such studies in a better way. This article is an attempt to highlight the various possible toxicants affecting thyroid function so that adequate measures can be undertaken to control excessive exposure in future to reduce the prevalence of thyroid disorders.

Background: Recurrent syncope is a distressing symptom in which the cause may remain undetermined. A definitive diagnosis may help the patients to lead a normal life and avoid the unnecessary risk to their lives. Objective: To evaluate the effectiveness and safety of Head up Tilt Test (HUTT) in patients with undiagnosed syncope and to detect and follow up any complications arising out of the procedure. Material and methods: The head up tilt table test was performed in department of cardiology. 72 patients with a history of syncope or presyncope underwent upright tilt table testing to exclude vasovagal syncope, with baseline tilt and if negative followed by progressively increasing doses of isoprenaline infusion. 70° tilt was used and continuous heart rate and non-invasive BP recordings were made every 2 minutes or earlier when symptomatic. Results: The mean age of the patients was 48±16 years. None of the patients had carotid sinus hypersensitivity. Forty-five patients (62.5%) were positive for syncope. Four (5.55 %) were positive during the baseline tilt and forty-one (56.9%) were positive with the use of isoprenaline during tilt. The majority of positive responses were mixed 23 (51.11%), 17(37.77%) were vasodepressor and 5(11.11%) were cardioinhibitory. The mean time to syncope was 31.84 ± 8.0 minutes. There was a mean drop of 55.65 mmHg in systolic blood pressure and 36.06 mmHg in diastolic blood pressure in the positive group (p = <0.001 for both).No statistical significance was observed as regards the age ,sex and type of response. No significant untoward incidents were noted except partial seizures in one patient. Conclusion:The head-up tilt test is a simple, non-invasive, relatively safe test which is useful in documenting objective measures of orthostatic hypotension that cannot be obtained in a clinical setting.

Background: Survival rates have been improved with concomitant use of anti-tubercular drugs in HIV subjects with tuberculosis. The use of anti-tubercular drugs combined with ART can lead to more drug interactions, non-compliance, toxicity, and adverse effects. Aim: To assess the pattern, severity, and prevalence of adverse drug reactions of first-line anti-tubercular drugs in HIV (Human Immunodeficiency Virus) positive subjects with tuberculosis. Methods: The present prospective, observational study included 391 subjects out of 19522 subjects who were diagnosed HIV Positive and scheduled for Anti-Retroviral therapy at the ART Centre. 102 subjects were enrolled as tuberculosis confirmation of HIV-TB Co-Infection disease during the study period. All the subjects were evaluated for adverse drug events including blurred vision, jaundice, neuropathy, skin infection, itching, blood urea, hepatotoxicity, tingling, numbness, pain, pancreatitis, diarrhea, skin rashes, and anemia. Results: The most prevalent side-effect noted was neuropathy reported in 26.13% (n=10) study participants followed by skin rashes reported in 21.05% (n=8) study subjects. Jaundice, vomiting, and body weakness were all reported in 15.78% (n=6) of study subjects each. Diarrhea, headache, hepatotoxicity, insomnia, mental confusion, and anorexia were all reported in 10.52% (n=4) of study participants each.

No abstract

No abstract