is an international journal intended for professionals and researchers in all fields of Pahrmaceutical Science. IJPSI publishes research articles and reviews within the whole field Pharmacy and Pharmaceutical Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online
Abstract—Subclinical Hypothyroidism is a much more common disorder with a world-wide occurrence as compared to overt Hypothyroidism. Overt Hypothyroidism is associated with abnormalities of lipid metabolism, but the significance of dyslipidemia in subclinical hypothyroidism (SCH) remains controversial.
Aims: To compare the lipid profile between subclinical hypothyroid patients & healthy controls (age & sex matched) so as to determine any association between lipid profile & subclinical hypothyroidism.
Materials and Methods: In a case-control study, Thyroid stimulating hormone (TSH), free T3, free T4, anti thyroperoxidase (TPO) antibodies, total cholesterol, high density lipoprotein(HDL) cholesterol, low density lipoprotein (LDL) cholesterol, Very low density lipoprotein (VLDL) cholesterol, serum triglycerides were measured in 50 patients with subclinical hypothyroidism and 50 age- and sex-matched Euthyroid controls after an overnight fasting.
Results: Mean serum triglycerides (TG) and very low-density cholesterol (VLDL) were significantly higher in patients with SCH than controls (P < 0.05). No association was found between serum total cholesterol, high density lipoprotein (HDL) cholesterol, low density lipoprotein (LDL) cholesterol and SCH.
Conclusions: Dyslipidemia is more common in SCH compared to controls. High serum triglycerides and VLDL were observed in patients with SCH.
Study of serum magnesium and fasting blood glucose in hypertensioniosrjce
A study was carried out to determine the fasting blood glucose and serum magnesium levels in
patients with hypertension. A total of 80 hypertensive patients were evaluated, of which, 58 were males and 22
were females. The mean ages of male and female hypertensive subjects were 48.06±6.53 and 50.83±7.62
respectively. Hypomagnesemia was observed in 61.25% subjects and raised fasting blood glucose was identified
in 55.1% of individuals. Therefore occurrence of low serum magnesium and raised blood sugar level in patients
with hypertension was observed
ABSTRACT- In today’s modern lifestyle high blood cholesterol is one of the most dreaded causes of heart diseases among the global population. Fast lifestyle, lack of exercise, obesity and improper food intake all sum up to deranged lipid profile as well as diabetes. Diabetes and high blood cholesterol goes hand in hand which leads to an increased incidence of coronary artery and cardiovascular disorders which still remains as one of the leading causes of mortality overall. In the present study there has been an effort put to draw a correlation between glycosylated hemoglobin which is a marker for level of blood glucose in diabetic patients as well as deranged lipid profile. Blood samples collected in sterile vials were first centrifuged and then put into analyzer for the computation of the lipid profile and the glycosylated hemoglobin. Results computed were made a note of and then prepared for statistical analysis. Results thus obtained showed that females showed significantly higher levels of total serum cholesterol and Non-HDL compared to males other than that their lipid parameters were a little higher than males in general. Diabetic female patients showed a significantly higher level of glycosylated hemoglobin. There was a significant difference in the HDL values of patients in pre diabetic state and worst control of glycemic hemoglobin. There were also significant differences observed in the TGL, TGL/HDL and VLDL values between Diabetic and control patients. In general there were increased correlation of HbA1c with TSC and LDL and the respective ratios as HbA1c increases while LDL/HDL showed a significant increase with HbA1c.
Key-words- Cholesterol, Diabetes mellitus, Lipid profile, HDL, LDL, Lipid ratios
Abstract—Subclinical Hypothyroidism is a much more common disorder with a world-wide occurrence as compared to overt Hypothyroidism. Overt Hypothyroidism is associated with abnormalities of lipid metabolism, but the significance of dyslipidemia in subclinical hypothyroidism (SCH) remains controversial.
Aims: To compare the lipid profile between subclinical hypothyroid patients & healthy controls (age & sex matched) so as to determine any association between lipid profile & subclinical hypothyroidism.
Materials and Methods: In a case-control study, Thyroid stimulating hormone (TSH), free T3, free T4, anti thyroperoxidase (TPO) antibodies, total cholesterol, high density lipoprotein(HDL) cholesterol, low density lipoprotein (LDL) cholesterol, Very low density lipoprotein (VLDL) cholesterol, serum triglycerides were measured in 50 patients with subclinical hypothyroidism and 50 age- and sex-matched Euthyroid controls after an overnight fasting.
Results: Mean serum triglycerides (TG) and very low-density cholesterol (VLDL) were significantly higher in patients with SCH than controls (P < 0.05). No association was found between serum total cholesterol, high density lipoprotein (HDL) cholesterol, low density lipoprotein (LDL) cholesterol and SCH.
Conclusions: Dyslipidemia is more common in SCH compared to controls. High serum triglycerides and VLDL were observed in patients with SCH.
Study of serum magnesium and fasting blood glucose in hypertensioniosrjce
A study was carried out to determine the fasting blood glucose and serum magnesium levels in
patients with hypertension. A total of 80 hypertensive patients were evaluated, of which, 58 were males and 22
were females. The mean ages of male and female hypertensive subjects were 48.06±6.53 and 50.83±7.62
respectively. Hypomagnesemia was observed in 61.25% subjects and raised fasting blood glucose was identified
in 55.1% of individuals. Therefore occurrence of low serum magnesium and raised blood sugar level in patients
with hypertension was observed
ABSTRACT- In today’s modern lifestyle high blood cholesterol is one of the most dreaded causes of heart diseases among the global population. Fast lifestyle, lack of exercise, obesity and improper food intake all sum up to deranged lipid profile as well as diabetes. Diabetes and high blood cholesterol goes hand in hand which leads to an increased incidence of coronary artery and cardiovascular disorders which still remains as one of the leading causes of mortality overall. In the present study there has been an effort put to draw a correlation between glycosylated hemoglobin which is a marker for level of blood glucose in diabetic patients as well as deranged lipid profile. Blood samples collected in sterile vials were first centrifuged and then put into analyzer for the computation of the lipid profile and the glycosylated hemoglobin. Results computed were made a note of and then prepared for statistical analysis. Results thus obtained showed that females showed significantly higher levels of total serum cholesterol and Non-HDL compared to males other than that their lipid parameters were a little higher than males in general. Diabetic female patients showed a significantly higher level of glycosylated hemoglobin. There was a significant difference in the HDL values of patients in pre diabetic state and worst control of glycemic hemoglobin. There were also significant differences observed in the TGL, TGL/HDL and VLDL values between Diabetic and control patients. In general there were increased correlation of HbA1c with TSC and LDL and the respective ratios as HbA1c increases while LDL/HDL showed a significant increase with HbA1c.
Key-words- Cholesterol, Diabetes mellitus, Lipid profile, HDL, LDL, Lipid ratios
Thyroid Abnormalities in Correlation with Stage of CKD in Tribal Population o...ijtsrd
Chronic Kidney Disease is a worldwide health problem with an increasing incidence and prevalence. Abnormalities in the structure and function of the thyroid gland and in the metabolism and plasma concentration of thyroid hormones are common in patients with CKD. In view of variability of thyroid profile in CKD patients in previous studies, a prospective study of various thyroid function has been undertaken to establish a correlation if any between thyroid dysfunction and severity of renal diseases . Total number of 50 patients with Chronic Kidney Disease on conservative management fulfilling the criteria for CKD who were admitted in Department of Medicine under nephrology unit, Dr. Bhimrao Ambedkar Hospital Raipur C.G. , during the period of February 2018-March 2018 were selected in this prospective study. The result showed that out of the 50 patients with CKD 29 patients had low T3 syndrome 0.2-2.0ng ml, mean 0.67 which accounts for 58 of the patients, 12 patients had low T4 syndrome 0.5-8.5µg ml, mean 5.65 which accounts for 24 of the patients and 4 patients had primary hypothyroidism TSH 20µIU ml. Excluding Primary Hypothyroidism, analysis of serum T3, T4 and TSH in the study subjects shows very high significance, p 0.001. Thyroid Dysfunction occurred in 66 of the patients with chronic kidney disease in our study, it does not indicate a state of hypothyroidism, but a reflection of the state of chronic illness malnutrition. The low T3 state of CKD can be viewed as being protective, promoting conservation of protein. The number of patients with low T3 syndrome progressively increases with the severity of renal failure. Priya Banjare "Thyroid Abnormalities in Correlation with Stage of CKD in Tribal Population of Chhattisgarh" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-3 | Issue-2 , February 2019, URL: https://www.ijtsrd.com/papers/ijtsrd21418.pdf
Paper URL: https://www.ijtsrd.com/other-scientific-research-area/other/21418/thyroid-abnormalities-in-correlation-with-stage-of-ckd-in-tribal-population-of-chhattisgarh/priya-banjare
CholesLo shows clinical significance in
helping reduce plasma cholesterol and
homocysteine levels and therefore affects
favourably the risk of subsequent development
of cardiovascular disease. Furthermore, our
findings suggest that the dose required to cause
such improvements in plasma lipid profile is
safe enough to be considered for use in general
population.
In Pakistan, the overall prevalence of dyslipidemia in adolescents aged 10–18 years is 21.7~25.2%; prevalence is reported to be two times higher (53.1~56.1%) in obese adolescents. However, few studies have been conducted on the relationship between height and blood lipid concentrations in children and adolescents The recent emphasis on treatment of the dyslipidemia of the metabolic syndrome (hypertriglyceridemia, reduced high-density lipoprotein, and increased small, dense low-density lipoprotein particle number) has compelled practitioners to consider lipid-lowering therapy in a greater number of their patients, as one in two individuals over age 50 has the metabolic syndrome. Individuals with the metabolic syndrome typically have normal low-density lipoprotein cholesterol levels, and current lipid-lowering guidelines may underestimate their cardiovascular risk. Two subgroups of patients with the metabolic syndrome are at particularly high risk for premature CAD. One, individuals with type 2 diabetes, accounts for 20-30% of early cardiovascular disease. The second, familial combined hyperlipidemia, accounts for an additional 10-20% of premature CAD. Familial combined hyperlipidemia is characterized by the metabolic syndrome in addition to a disproportionate elevation of apolipoprotein B levels. The measurement of fasting glucose and apolipoprotein B, in addition to the fasting lipid profile, can help to estimate CAD risk in patients with the metabolic syndrome. In this research we compared allopathic medication and medicinal herb in treating hyperlipidemia.
Abstract— Non Alcoholic Fatty Liver Disease is also becoming public health impotance nowadays. So this study was aimed to determine the association of Non Alcoholic Fatty Liver Disease with metabolic syndrome and Cardio-Vascular disease along with assessment of degree of severity of NAFLD with respect to number of components of metabolic syndrome. This study includes a total of 222 subjects were enrolled as per the inclusion/exclusion criteria, out of which 110 cases who had NAFLD with hepatic steatosis on ultrasonography and 112 subjects who did not have NAFLD were considered control. These cases and controls were interrogated and investigated further. Observations were recorded and association of Non Alcoholic Fatty Liver Disease with metabolic syndrome and Cardio-Vascular disease along with assessment of degree of severity of NAFLD with respect to number of components of metabolic syndrome. Statistical methods used were unpaired student’s t-test for continuous variables, Fischer’s and chi-sq test for categorical variables using bivariate analysis by Graph Pad Instat Version 3.10. Risk was assessed in terms of Odd's Ratio. The patients with MS and NAFLD had a higher proportion of CVD compared with those who did not have NAFLD (29.1 vs 18.1 %). This study concludes that NAFLD is significantly associated with MS; most significant with WC, followed by TG and FBS and thus can be considered as hepatic component of MS. This needs more research with large multi-centric prospective studies to evaluate NAFLD as an independent risk factor for CVD.
Study of Endothelial Dysfunction in Type 2 Diabetes Mellitusiosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Regional variation in chronic kidney disease and associated factors in hypert...M A Hasnat
We aimed to determine the prevalence of chronic
kidney disease (CKD) and its cross-country variation among
hypertensive individuals in rural Bangladesh, Pakistan and
Sri Lanka.We also explored the factors associated with CKD in
these populations.
Copeptin as a Novel Biomarker in the Diagnosis of Acute Myocardial Infarction...Premier Publishers
To evaluate the diagnostic value of Copeptin as a novel biomarker in early diagnosis of Acute Myocardial Infarction. 56 patients with acute Myocardial Infarction (STEMI) and 25 healthy controls who were admitted to the Cardiology and Clinical Pathology Departments, national heart institute (NHI) from October 2015 to April 2016. The kit used a double-antibody sandwich enzyme-linked immune-sorbent assay (ELISA) to assay the level of Human Copeptin in samples. As regard copeptin, the median range of copeptin level was 242.5pg/ml in patient group and 75pg/ml in control group. The comparative study between the two groups shows a significant difference (p < 0.05) Conclusion: Copeptin is a reliable diagnostic tool in patients with AMI (STEMI) with sensitivity 85.7%, specificity 86.7%, PPV 96% and NPV 61.9%.
Thyroid Abnormalities in Correlation with Stage of CKD in Tribal Population o...ijtsrd
Chronic Kidney Disease is a worldwide health problem with an increasing incidence and prevalence. Abnormalities in the structure and function of the thyroid gland and in the metabolism and plasma concentration of thyroid hormones are common in patients with CKD. In view of variability of thyroid profile in CKD patients in previous studies, a prospective study of various thyroid function has been undertaken to establish a correlation if any between thyroid dysfunction and severity of renal diseases . Total number of 50 patients with Chronic Kidney Disease on conservative management fulfilling the criteria for CKD who were admitted in Department of Medicine under nephrology unit, Dr. Bhimrao Ambedkar Hospital Raipur C.G. , during the period of February 2018-March 2018 were selected in this prospective study. The result showed that out of the 50 patients with CKD 29 patients had low T3 syndrome 0.2-2.0ng ml, mean 0.67 which accounts for 58 of the patients, 12 patients had low T4 syndrome 0.5-8.5µg ml, mean 5.65 which accounts for 24 of the patients and 4 patients had primary hypothyroidism TSH 20µIU ml. Excluding Primary Hypothyroidism, analysis of serum T3, T4 and TSH in the study subjects shows very high significance, p 0.001. Thyroid Dysfunction occurred in 66 of the patients with chronic kidney disease in our study, it does not indicate a state of hypothyroidism, but a reflection of the state of chronic illness malnutrition. The low T3 state of CKD can be viewed as being protective, promoting conservation of protein. The number of patients with low T3 syndrome progressively increases with the severity of renal failure. Priya Banjare "Thyroid Abnormalities in Correlation with Stage of CKD in Tribal Population of Chhattisgarh" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-3 | Issue-2 , February 2019, URL: https://www.ijtsrd.com/papers/ijtsrd21418.pdf
Paper URL: https://www.ijtsrd.com/other-scientific-research-area/other/21418/thyroid-abnormalities-in-correlation-with-stage-of-ckd-in-tribal-population-of-chhattisgarh/priya-banjare
CholesLo shows clinical significance in
helping reduce plasma cholesterol and
homocysteine levels and therefore affects
favourably the risk of subsequent development
of cardiovascular disease. Furthermore, our
findings suggest that the dose required to cause
such improvements in plasma lipid profile is
safe enough to be considered for use in general
population.
In Pakistan, the overall prevalence of dyslipidemia in adolescents aged 10–18 years is 21.7~25.2%; prevalence is reported to be two times higher (53.1~56.1%) in obese adolescents. However, few studies have been conducted on the relationship between height and blood lipid concentrations in children and adolescents The recent emphasis on treatment of the dyslipidemia of the metabolic syndrome (hypertriglyceridemia, reduced high-density lipoprotein, and increased small, dense low-density lipoprotein particle number) has compelled practitioners to consider lipid-lowering therapy in a greater number of their patients, as one in two individuals over age 50 has the metabolic syndrome. Individuals with the metabolic syndrome typically have normal low-density lipoprotein cholesterol levels, and current lipid-lowering guidelines may underestimate their cardiovascular risk. Two subgroups of patients with the metabolic syndrome are at particularly high risk for premature CAD. One, individuals with type 2 diabetes, accounts for 20-30% of early cardiovascular disease. The second, familial combined hyperlipidemia, accounts for an additional 10-20% of premature CAD. Familial combined hyperlipidemia is characterized by the metabolic syndrome in addition to a disproportionate elevation of apolipoprotein B levels. The measurement of fasting glucose and apolipoprotein B, in addition to the fasting lipid profile, can help to estimate CAD risk in patients with the metabolic syndrome. In this research we compared allopathic medication and medicinal herb in treating hyperlipidemia.
Abstract— Non Alcoholic Fatty Liver Disease is also becoming public health impotance nowadays. So this study was aimed to determine the association of Non Alcoholic Fatty Liver Disease with metabolic syndrome and Cardio-Vascular disease along with assessment of degree of severity of NAFLD with respect to number of components of metabolic syndrome. This study includes a total of 222 subjects were enrolled as per the inclusion/exclusion criteria, out of which 110 cases who had NAFLD with hepatic steatosis on ultrasonography and 112 subjects who did not have NAFLD were considered control. These cases and controls were interrogated and investigated further. Observations were recorded and association of Non Alcoholic Fatty Liver Disease with metabolic syndrome and Cardio-Vascular disease along with assessment of degree of severity of NAFLD with respect to number of components of metabolic syndrome. Statistical methods used were unpaired student’s t-test for continuous variables, Fischer’s and chi-sq test for categorical variables using bivariate analysis by Graph Pad Instat Version 3.10. Risk was assessed in terms of Odd's Ratio. The patients with MS and NAFLD had a higher proportion of CVD compared with those who did not have NAFLD (29.1 vs 18.1 %). This study concludes that NAFLD is significantly associated with MS; most significant with WC, followed by TG and FBS and thus can be considered as hepatic component of MS. This needs more research with large multi-centric prospective studies to evaluate NAFLD as an independent risk factor for CVD.
Study of Endothelial Dysfunction in Type 2 Diabetes Mellitusiosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Regional variation in chronic kidney disease and associated factors in hypert...M A Hasnat
We aimed to determine the prevalence of chronic
kidney disease (CKD) and its cross-country variation among
hypertensive individuals in rural Bangladesh, Pakistan and
Sri Lanka.We also explored the factors associated with CKD in
these populations.
Copeptin as a Novel Biomarker in the Diagnosis of Acute Myocardial Infarction...Premier Publishers
To evaluate the diagnostic value of Copeptin as a novel biomarker in early diagnosis of Acute Myocardial Infarction. 56 patients with acute Myocardial Infarction (STEMI) and 25 healthy controls who were admitted to the Cardiology and Clinical Pathology Departments, national heart institute (NHI) from October 2015 to April 2016. The kit used a double-antibody sandwich enzyme-linked immune-sorbent assay (ELISA) to assay the level of Human Copeptin in samples. As regard copeptin, the median range of copeptin level was 242.5pg/ml in patient group and 75pg/ml in control group. The comparative study between the two groups shows a significant difference (p < 0.05) Conclusion: Copeptin is a reliable diagnostic tool in patients with AMI (STEMI) with sensitivity 85.7%, specificity 86.7%, PPV 96% and NPV 61.9%.
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
All manuscripts are subject to rapid peer review. Those of high quality (not previously published and not under consideration for publication in another journal) will be published without delay.
Journal of Schizophrenia Research is a peer-reviewed, open access journal published by Austin Publishers. It provides easy access to high quality Manuscripts in all related aspects of a mental disorder often characterized by abnormal social behavior and failure to recognize what is real with common symptoms including false beliefs, auditory hallucinations, confused or unclear thinking, inactivity, and reduced social engagement and emotional expression. The journal focuses upon the latest research in finding causes, understanding mechanisms, diagnosis, prevention, management, prognosis, epidemiology, ancestral history and treatment of schizophrenia.
Austin Publishing Group is a successful host of more than hundred peer reviewed, open access journals in various fields of science and medicine with intent to bridge the gap between academia and research access.
Journal of Schizophrenia Research accepts original research articles, review articles, case reports, mini reviews, rapid communication, opinions and editorials on all related aspects of schizophrenia including, finding causes, understanding mechanisms, diagnosis, prevention, management, prognosis, epidemiology, ancestral history and its treatment.
International Journal of Pharmaceutical Science Invention (IJPSI) inventionjournals
International Journal of Pharmaceutical Science Invention (IJPSI) is an international journal intended for professionals and researchers in all fields of Pahrmaceutical Science. IJPSI publishes research articles and reviews within the whole field Pharmacy and Pharmaceutical Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
All manuscripts are subject to rapid peer review. Those of high quality (not previously published and not under consideration for publication in another journal) will be published without delay.
Abstract—Periodontal disease is a destructive inflammatory disease inducing profound changes in the plasma concentrations of cytokines leading to a catabolic state characterized by altered lipid metabolism and hypertriglyceridemia. This study was conducted with the aim find out association of chronic periodontitis with serum lipid parameters. Study group consist of 30 cases of chronic periodontitis (case group) and control group consist of 30 healthy individuals. Age range was kept 25-60 years to avoid extreme ages. Periodontal parameters including Plaque Index, Gingival Index, Probing Depth and Clinical Attachment Level were recorded. Lipid profile comprising of total cholesterol, Triglycerides, HDL- Cholesterol and LDL was assessed and co related with periodontal parameters. This study confirms significantly higher levels of mean cholesterol, triglycerides and LDL in periodontitis group as compared to healthy group. Also, there is significant negative co relation of HDL with probing depth and clinical attachment loss. Association of hyperlipidemia and chronic periodontitis is evident in developed state of disease. With this study, this relation is confirmed based on Factor and Outcome.
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
All manuscripts are subject to rapid peer review. Those of high quality (not previously published and not under consideration for publication in another journal) will be published without delay.
Similar to International Journal of Pharmaceutical Science Invention (IJPSI) (20)
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
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Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
The Gram stain is a fundamental technique in microbiology used to classify bacteria based on their cell wall structure. It provides a quick and simple method to distinguish between Gram-positive and Gram-negative bacteria, which have different susceptibilities to antibiotics
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
CDSCO and Phamacovigilance {Regulatory body in India}NEHA GUPTA
The Central Drugs Standard Control Organization (CDSCO) is India's national regulatory body for pharmaceuticals and medical devices. Operating under the Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India, the CDSCO is responsible for approving new drugs, conducting clinical trials, setting standards for drugs, controlling the quality of imported drugs, and coordinating the activities of State Drug Control Organizations by providing expert advice.
Pharmacovigilance, on the other hand, is the science and activities related to the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problems. The primary aim of pharmacovigilance is to ensure the safety and efficacy of medicines, thereby protecting public health.
In India, pharmacovigilance activities are monitored by the Pharmacovigilance Programme of India (PvPI), which works closely with CDSCO to collect, analyze, and act upon data regarding adverse drug reactions (ADRs). Together, they play a critical role in ensuring that the benefits of drugs outweigh their risks, maintaining high standards of patient safety, and promoting the rational use of medicines.
International Journal of Pharmaceutical Science Invention (IJPSI)
1. International Journal of Pharmaceutical Science Invention
ISSN (Online): 2319 – 6718, ISSN (Print): 2319 – 670X
www.ijpsi.org Volume 2 Issue 8‖ August 2013 ‖ PP.14-18
www.ijpsi.org 14 | P a g e
The Effect of L –Thyroxine on Metabolic Parameters in Newly
Diagnosed Primary Hypothyroidism
Dr N.Ajay Kumar1 ,
Dr M Shanthi 2
, Dr R. Parameswari,3
ABSTRACT: Objective: Thyroid hormones regulate the basal metabolic rates of most of the cell. This
hospital based study was done to evaluate the metabolic changes induced in newly diagnosed hypothyroid
patients and the benefits of early intervention in the same.Methodology: The study included 30 patients
randomly selected from the department of endocrinology. Serum T3,T4,TSH, kidney function, total cholesterol
levels were measured using standard kits. The same patients were revaluated after treatment with L-Thyroxine
at the end of 6 months. Results: Hypothyroid patients showed decreases in Hb, increase in total cholesterol,
serum uric acid and creatinine level compared to euthyroid patients. After 6 months of thyroxine treatment, Hb
showed a significant increase (p<0.005), serum cholesterol(p<0.001),and serum uric acid level(p<0.001)
showed a significant decrease, where as the serum creatinine level showed no significance(p<0.350).
CONCLUSION: This shows that early intervention with thyroid replacement therapy resulted in reversible
change in the metabolic parameters
KEYWORDS: hypothyroidism, anemia, levothyroxine, bilirubin, creatinine, uric acids.
I. INTRODUCTION:
Hypothyroidism was first described in the year 1874 by Gull under the name of myxedema. The active
principle of thyroid extract, thyroxin was isolated by Kendall in 1914.Hypothyroidism is a clinical syndrome
characterized by the clinical and biochemical manifestation of thyroid hormone deficiency in the target tissue,
leading to generalized slowing of all metabolic processes.The thyroid gland synthesizes and release T3 and
T4.The Biological active hormones T31
and T4 Play a significant role in the growth, development and function
of all major tissues. Thyroid hormones regulate the basal metabolic rate of all cells which also include
hepatocytes. Liver in turn metabolizes the thyroid hormones and in turn regulates their endocrine effects2
.
Normal circulating levels of the thyroid hormone are required for hepatic circulation and normal bilirubin
metabolism3
. Thyroid hormone synthesis and secretion is regulated by the negative feedback system that
involves the hypothalamus, pituitary and the thyroid gland4
.Thyroid dysfunction may perturb the liver function
and vice versa.Various animal experiments or drug induced hypothyroidism have shown to decrease GFR on
long standing5,6
.Primary hypothyroidism is due to abnormality in thyroid gland itself, secondary hypothyroidism
may be due deficiency of TSH. In central hypothyroidism, the TSH secretions is not sufficient to stimulate the
thyroid gland. Basal TSH values in central hypothyroidism are low, normal or slightly elevated. The incidence
of hypothyroidism depends on different environmental and various geographic factors, they include dietary
iodine deficiency (most common), genetic variation in population. Iodine deficiency remains the main cause of
hypothyroidism throughout the world. Auto immune disorders remains the other cause.
Hypothyroidism is the most common hormonal deficiency, the diagnosis can be made quickly,
confirmed or excluded and the treatment is straight ward with excellent prognosis. Thyroid hormone deficiency
affects virtually every tissue in the body. The clinical finding is slowing of physical and mental activity.
Pathologically, there is accumulation of glycosaminoglycans which is related to loss of inhibitory effects of
thyroid hormones on the synthesis of hyaluronate , fibronectin and collagen by fibroblasts.Long standing
hypothyroidism can cause reversible changes in the metabolic parameters such as increase in serum uric acid,
serum creatinine levels, abnormal lipid profile and low levels of Hb %.The present study was carried out to
determine the changes produced by thyroid hormone deficiency on metabolic parameters and the efficacy of
drug treatment on the same.
II. MATERIALS AND METHODS
It was a open label, single centre, randomized prospective study carried out in the Outpatient
Department of Endocrinology, Govt. Rajaji hospital, Madurai,for a period of 6 months ( July-December 2011)
after obtaining approval from the Institutional Ethical Committee, Ref no:6087/E4/3/2011
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COLLABORATING DEPARTMENTS:
Institute of Pharmacology,
Department of Endocrinology,
Department of Biochemistry.
SELECTION OF CASES:
30 Patients (male & female) who fulfilled the following inclusion criteria were enrolled for the study.
Inclusion criteria:
1. Newly Diagnosed Hypothyroid patients with elevated TSH.
2. Both male and females above 18yrs.
Exclusion criteria:
Pregnant, Breast feeding women and Patients with other chronic ailments like Chronic Arterial Disease(CAD),
Deep Venous Thrombosis(DVT) etc, were excluded from study.
III. METHODOLOGY:
Institutional review board approval was obtained prior to the initiation of the study. The study group,
consisting of 30 patients, who satisfied the inclusion and exclusion criteria, were selected from the outpatient
department of Endocrinology in Tertiary care teaching hospital. They were informed verbally and in writing by
the investigator about the nature, significance, implication and risks of the study prior to enrollment. All terms
were explained by the investigator in a language and in terms that were easy to understand by the patient.
Informed consent was obtained from all patients personally and signed by both the patient and the investigator.
The details of the investigator (name, phone number, and contact address) were given to each and every patient,
to enable them to contact for any ailments at anytime during the study period. Newly diagnosed hypothyroid
patients with elevated TSH were selected for the study.The impact of hypothyroidism on various metabolic
parameters such as Hb%, lipids, serum uric acid level, serum creatinine and serum cholestrol were measured at
the beginning of the study.The patients were then treated with the requird dose of l-Thyroxine in the out patient
clinic for a period of six months .At the end of six months the same parameters were measured,tabulated
compared and analysed statistically using one way anova test.
IV. RESULTS
The study population is of 30 newly diagnosed patients with primary hypothyroidism from the out
patients departments of the hospital. All patients included were screened for T3, T4, TSH, Hb , total
cholesterol, serum uric acid and serum creatinine level.. A significant difference was observed in levels of TSH,
T 3 and T4 in euthyroid and the hypothyroid patients. This study shows an increase in serum creatinine with a
mean of 1.119 , increase in serum uric acid with a mean of 7.358 and increase in serum cholesterol with a mean
of levels 226.19 along with decrease in Hb levels with a mean of 9.503 . These patients were treated with L-
thyroxine and the same patients were evaluated at the end of six months The changes in the metabolic
parameters were found to be reversible after thyroxine replacement therapy. In the present study the Hb showed
a mean increase from 9.503 to 10.823 and statistically significant (p<0.005), the mean serum cholesterol levels
decreased from 226.19 to 186.71 (p<0.001) statistically highly significant ,the mean uric acid levels decreased
from 7.358 to 5.797 (p< 0.001) statistically highly significant and the serum creatinine decreased 1.119 to 0.948
(p< 0.350) not statistically significant.
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V. DISCUSSION:
Hypothyroidism is a clinical syndrome resulting from deficiency of thyroid hormones, leading to
generalized slowing of all metabolic process6
. Hypothyroidism in infants and children results in growth and
mental development retardation7
. The prevalence of hypothyroidism varies in different part of the region but
generally higher among females8
.The metabolic disturbance associated with hypothyroidism include anemia,
hyperlipidemia, increases in serum creatinine and uric acid levels. Thyroid hormones are involved in
haemoglobin synthesis in the adults and maturation of haemoglobin in the fetus 9
and by affecting hematopoietic
process, hypothyroidism results in anemia through slowing the oxygen metabolism 10
. The anemia in patients
with hypothyroidism varies between 20-65% 11
indicating a high correlation between hypothyroidism and
anemia. The current study showed that all the patients had a significant improvement in the mean values of Hb
(p<0.005) after treatment with l- thyroxine. Besides the incidence of anemia was found to be greater in women
than men , this higher association may be linked to menorrhagia12
. The standard administration of levothyroxine
is able to reduce TSH level as well as improve the anemic status.
Although the association between hypothyroidism and dyslipidemia is still lacking, most reports have
documented relationship between hypothyroidism and reversible dyslipidemia. Hypothyroid patients have
increased levels of Total Cholesterol and Low Density Lipoprotein C 13
. Indeed, hypothyroidism is a common
cause of secondary dyslipidemia 14,15
. Although decreased thyroid function is accompanied by reduced activity
of HMG-CoA reductase, TC and LDL-C levels are increased in patients with overt hypothyroidism 16
. This is
due to the decreased LDL-receptor activity, resulting in decreased catabolism of LDL and IDL 17,18
. Moreover, a
decrease in LPL activity is found in overt hypothyroidism, decreasing the clearance of TG-rich lipoproteins 19
.
Therefore, overt hypothyroid patients may also present with elevated TG levels associated with increased levels
of VLDL and occasionally fasting chylomicronemia 20
. Hypothyroid patients have increased lipoprotein (a)21
levels ,which are associated with increased CVD risk22
. In addition, an increase in carotid intima media
thickness (CIMT) has been observed in hypothyroid patients 23
. Administration of substitution therapy with L-
thyroxine significantly improves lipid metabolism abnormalities. A period of 4-6 weeks of thyroxin replacement
therapy is usually needed to correct dyslipidemia in overt hypothyroidism. A study in newly-diagnosed
hypothyroid patients (n=60) showed a decrease in serum TC and LDL-C levels after thyroxine treatment A
more dramatic reduction of TC levels has been observed in hypothyroid patients with higher baseline TSH
levels 24
. Thyroid failure is associated with increased levels of creatininekinase (CK) 25
. Statin therapy may
substantially increase levels of CK. A study examined the effects of accidentally starting statin therapy in
patients with undiagnosed hypothyroidism (n=9) 26
. These patients had significantly higher CK levels (1095
U/L) compared with untreated hypothyroid patients matched for freeT4 levels (n=18; CK=395; p<0.05) 27
.
Therefore, it is imperative to firstly correct thyroid dysfunction with thyroxine substitution therapy and then
treat the underlying dyslipidemia with statins.
Mild thyroid hormone deficiency per se is responsible for reversible endothelial dysfunction and
reduced nitric oxide availability, which act as promoters of atherosclerosis 28.
Accordingly, Mizuma et al.
recently described the presence of an iodothyronine deiodinase in human vascular smooth muscle (VSM) cells
29
. Although the target genes for T3 action in VSM cells remain unknown, it could be speculated that, as
described in cardiac myocytes, they are involved in the modulation of sarcoplasmic reticulum and sarcolemmal
ion flux and VSM contractility. Indeed, the presence of an iodothyronine deiodinase suggests that VSM cells,
which are in physiologic cross-talk with endothelium, may be a target for thyroid hormone action and lends
support to the hypothesis of a direct involvement of thyroid hormone deficiency in IMT thickening. The fact
that L-T4 replacement therapy was able to improve both the atherogenic lipoprotein profile and intima-media
thickening suggests that lipid infiltration of arterial wall may represent a major mechanism underlying IMT
increase in this selected subset of patients.Long standing hypothyroidism can also cause a significant reversible
change in renal function such as a decrease in sodium resorption in the proximal tubules, impairment in the
concentrating and diluting capacities of the distal tubules, a decrease in urinary urate excreation , and a decrease
in the renal blood flow and the glomerular filtration rate. The increase in uric acid concentration in hypothyroid
state may be either due to increased in production or due to decrease in renal clearance of uric acid. Though the
observed decrease in renal function was not so severe in this study , a recent case report illustrated how
hypothyroid induced renal dysfunction may lead to adverse clinical consequences in patients taking medications
cleared by the kidneys. With thyroxine replacement therapy a significant decrease in serum uric level was
observed to that of serum creatinine levels. Other scattered studies and case reports also demonstrate an
improvement in the renal status of patients with treatment of hypothyroidism. Histological changes in nephrons,
especially basement membrane thickening have been demonstrated in hypothyroid rats and humans30
. Some of
these functions include decrease in GFR and renal blood flow. The cause of the decrease in renal blood flow and
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GFR is believed to be due to the generalized hypodynamic state of the circulatory system in
hypothyroid patients. This decrement in GFR is readily reversible upon correction of thyroid hormone
deficiency 31
.Thyroid hormones has a role in the maturation of the RAAS system. Plasma level of renin are low
in hypothyroidism in contrast to hyperthyroidism. The study confirm association of hypothyroidism with
elevated uric acid and creatinine which may be due to a decrease in GFR levels and alteration in the RAAS
system. Thyroid hormones induce relaxation of blood vessels resulting in a reduction in vascular resistance and
in increase in serum levels of rennin activity and angiotensin concentration there by increase in GFR. The study
concluded that there is a significant decrease in the total cholesterol levels (p< 0.001) and the serum uric acid
levels (p<0.001) where as there is a significant increase in the Hb level (p<0.005), the decrease in the serum
creatinine level though was not statistically significant (p< 0.350).All the findings in the current study help us to
understand the complex interaction between the thyroid gland and major organ systems. It also denotes the
importance of early intervention of hypothyroidism which will help in the prevention of long term complication
like CVD and decrease in mortality. Hence a multi system approach is indeed needed to treat patients suffering
from hypothyroidism.
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