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.

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Aim: To evaluate cardiac autonomic nervous system functions in patients with rheumatoid arthritis.Material snd Methods: The present study was carried out on both males and females of mean age group 44+12 years to study autonomic functions in RA. All parameters were recorded and studied on 35 volunteers, out of which 25 were diagnosed with RA and 10 were healthy individuals which served as controls.The cardiac functions were evaluated by six non-invasive standardized tests consisting of 30:15 ratio, standing / lying ratio, expiration / inspiration ratio, valsalva ratio, blood pressure response to standing, blood pressure response to valsalva maneuver and hand grip test.The tests were carried out on patient (in and out door) in department of Medicine, at DMC & H by using cardiofax Machine (Medicarid systems).Details of history and examination were recorded on special proforma.Results: In the present study standing to lying ratio (p<0.001),Expiration to inspiration ratio (p<0.01) both indicative of parasympathetic function were significantly less in RA patients as compared to control indicating an impaired vagal function in study group.On the blood pressure response to standing, the decrease in diastolic blood pressure was significant (P<0.01) in study group as compared to control which is indicative of hypofunctional sympathetic ANS.Conclusions: There is cardiac autonomic nervous system dysfunction (both sympathetic and parasympathetic) in the patients with Rheumatoid arthritis when compared to control.Autonomic function tests can help in predicting cardio vascular risk in Rheumatoid Arthritis patients.