Cardiac Evaluation Among Newly-Detected Patients of Clinical and Subclinical Hypothyroidism

Abstract

BACKGROUND Hypothyroidism is characterised by a low cardiac output due to the decreased heart rate and stroke volume. Systolic and diastolic functions are reduced at rest and during exercise, thus impairing quality of life. In particular, an increased risk of coronary heart disease events and mortality has been reported in young patients affected by subclinical hypothyroidism with TSH >10 mU/L. The aim of the study is to evaluate the cardiovascular system using electrocardiogram and echocardiogram among patients with clinical and subclinical hypothyroidism. MATERIALS AND METHODS A cross-sectional comparative study was conducted for a period of one year on 50 patients attending the Outpatient Medicine Department in our hospital. The 50 patients were made into 2 groups of 25 each, group I are patients with clinical hypothyroidism and group II are patients with subclinical hypothyroidism. The cardiac status of all the patients was assessed by doing ECG and a 2D echo was done to assess their systolic and diastolic function. RESULTS The systolic function was normal in both the groups except for a slight increase in the septal wall and posterior wall thickness of LV among the clinical hypothyroidism patients. There is no statistical significant difference in the diastolic parameters among the two groups (p >0.05), but it proves that there is a diastolic dysfunction, which would be in the starting stage in both the groups. Among the hypothyroid patients, 20% of them had mild pericardial effusion, which was detected through 2D echo, whereas none of the patients with subclinical hypothyroidism had pericardial effusion and this difference was found to be statistically significant (p <0.05). CONCLUSION Doppler echocardiography technique being a simple, reliable and reproducible method for assessment of heart functions has to be routinely done in patients with clinical and subclinical hypothyroidism to detect diastolic dysfunction at an early stage and manage them appropriately in such a way preventing morbidity and mortality due to cardiovascular system.

Proportion of needle stick injury and its characteristics among nursing staffs in a tertiary care teaching hospital in Trivandrum, South India

“…In a study conducted by Chinta Sujatha et al among health care workers in Trivandrum Medical College 10 , only 55% of them followed proper sharp disposal instruction. It was 92.5% in this study.…”

“…Attempt was made to cover at least 185 nurses, working in clinical departments where exposure to needle stick injury may occur. The calculated sample size was 185 (using formula 4PQ/d 2 , p=35%) 10 however final sample size was 200. Respondents, willing to participate and gave written informed consent were included.…”