Background: Patients with chronic kidney disease have multiple alterations of thyroid hormone metabolism in the absence of concurrent thyroid disease. These may include elevated basal TSH values, which may transiently increase to greater than 10 mU/liter, blunted TSH response to TRH, diminished or absent TSH diurnal rhythm, altered TSH glycosylation, and impaired TSH and TRH clearance rates. In addition, serum total and free T3 and T4 values may be reduced, free rT3 levels are elevated while total values are normal, serum binding protein concentrations may be altered, and disease-specific inhibitors reduce serum T4 binding .
Objective:. To assess the prevalence of hypothyroidism and u/s abnormalities of thyroid gland in patients with chronic kidney disease at different levels of estimated glomerular filtration rate (eGFR) and their association with age , sex and duration of chronic renal failure . cross sectional study.
Patients and Method: a cross sectional study total of 50 patients who seek medical advice in Baghdad teaching hospital (29 male , 21 female) , the mean of their age was 60, with established chronic kidney disease were categorized into five groups according to the stages of chronic kidney disease . Full clinical, biochemical ( includes blood urea , serum creatinine , total T3, total T4 , TSH ) , thyroid ultrasonography studies were performed to all patients in this study. Risk factors such as hypertension, diabetes mellitus, smoking and family history of CKD were also recorded. Type of treatment of CKD whether conservative or renal replacement therapy (in form of peritoneal or hemodialysis) were also.
Results:- From a total of 50 patients with chronic kidney disease (CKD ), eight patients had hypothyroidism (16 %) , three patients from stage 4 CKD and five patients from stage 5 CKD . Twelve patients from study sample had abnormalities in thyroid ultrasonography (24%) , one patient from stage 2 CKD , three patients from stage 3 CKD ,three patients from stage 4 CKD and five patients from stage 5 CKD . Thyroid ultrasound abnormalities includes six patients with simple goiter and six patients with multinodular goiter .From those eight patients with hypothyroidism , six patients were males (75%) and two patients were females (25%) .Regarding 12 patients with thyroid u/s abnormalities , five patients were male (41.6%) and seven patients were female (58.4%).Statistical analysis showed a significant association between drop in GFR and drop in thyroid function, from 13 patients in stage 4 CKD , three patients (23.07%) had hypothyroidism , and from 23 patients in stage 5 CKD , five patients (21.739%) had hypothyroidism .
Conclusion:- reduced glomerular filtration rate was associated with an increased prevalence of hypothyroidism, with many subclinical cases. Future studies are needed to determine the potential adverse effects of subclinical and clinical hypothyroidism in persons with chronic kidney disease.
Die vorliegende Forschung handelt es um die Satzfelder, besonders das Mittelfeld des Satzes im deutschen und Arabischen. Diese Forschung wurde mit der Satzdefinition, Satzglieder begonnen, damit wir diese klar werden und dann werden die Felder des Satzes gut gekannt. Der erste Abschnitt schlieβt auch den Mittelfeld des Satzes und, wie man das Feld erkennen und bestimmen kann. Die Forschung untersucht auch. Ob es in der arabischen Sprache den selben Struktur wie im Deutschen gibt, z.B Bildung des Satzes sowie Satzfelder bezügllich das Mittelfeld.
Der zweite Abschnitt handelt sich um den arabischen Teil und behandelt die Wortarten im Arabischen sowie den Satz als auch Satzarten (Nominal- Verbal- Halbsatz).
Danach befinden
... Show More... Show MoreThe present paper deals with medical terms translation and its relationship with the medical text of Arabic and Spanish. Medical translation is the process of transferring texts related to the field of health and medicine to achieve an accurate effective translation from the source language text to the equivalent target language text. The most prominent medical translations are from English to Arabic as most of the syllabuses in Arab countries are taught in English.
Translation is an innovative work intended to render the original text in the source language into the target language with the highest level of linguistic and intellec
The charge density distributions (CDD) and the elastic electron scattering form
factors F(q) of the ground state for some odd mass nuclei in the 2s 1d shell, such
as K Mg Al Si 19 25 27 29 , , , and P 31
have been calculated based on the use of
occupation numbers of the states and the single particle wave functions of the
harmonic oscillator potential with size parameters chosen to reproduce the observed
root mean square charge radii for all considered nuclei. It is found that introducing
additional parameters, namely; 1 , and , 2 which reflect the difference of the
occupation numbers of the states from the prediction of the simple shell model leads
to very good agreement between the calculated an
Abstract
Objective of this research focused on testing the impact of internal corporate governance instruments in the management of working capital and the reflection of each of them on the Firm performance. For this purpose, four main hypotheses was formulated, the first, pointed out its results to a significant effect for each of corporate major shareholders ownership and Board of Directors size on the net working capital and their association with a positive relation. The second, explained a significant effect of net working capital on the economic value added, and their link inverse relationship, while the third, explored a significant effect for each of the corporate major shareholders ownershi
... Show MoreThe charge density distributions (CDD) and the elastic electron scattering form
factors F(q) of the ground state for some odd mass nuclei in the 2s 1d shell, such
as K Mg Al Si 19 25 27 29 , , , and P 31
have been calculated based on the use of
occupation numbers of the states and the single particle wave functions of the
harmonic oscillator potential with size parameters chosen to reproduce the observed
root mean square charge radii for all considered nuclei. It is found that introducing
additional parameters, namely; 1 , and , 2 which reflect the difference of the
occupation numbers of the states from the prediction of the simple shell model leads
to very good agreement between the calculated an
In this paper, estimation of system reliability of the multi-components in stress-strength model R(s,k) is considered, when the stress and strength are independent random variables and follows the Exponentiated Weibull Distribution (EWD) with known first shape parameter θ and, the second shape parameter α is unknown using different estimation methods. Comparisons among the proposed estimators through Monte Carlo simulation technique were made depend on mean squared error (MSE) criteria