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.
In this article, the inverse source problem is determined by the partition hyperbolic equation under the left end flux tension of the string, where the extra measurement is considered. The approximate solution is obtained in the form of splitting and applying the finite difference method (FDM). Moreover, this problem is ill-posed, dealing with instability of force after adding noise to the additional condition. To stabilize the solution, the regularization matrix is considered. Consequently, it is proved by error estimates between the regularized solution and the exact solution. The numerical results show that the method is efficient and stable.
In this paper we introduce many different Methods of ridge regression to solve multicollinearity problem in linear regression model. These Methods include two types of ordinary ridge regression (ORR1), (ORR2) according to the choice of ridge parameter as well as generalized ridge regression (GRR). These methods were applied on a dataset suffers from a high degree of multicollinearity, then according to the criterion of mean square error (MSE) and coefficient of determination (R2) it was found that (GRR) method performs better than the other two methods.
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The Costing Accounting is one the analytic tools which plays important role by support the management in planning& control and decisions-making ,as it became attendant necessity to establish any project whether industrial ,commercial ,service or agriculture ..etc.
The consolidated accounting system has committed the companies to have their active costing system in which the management can obtain their own data, but we found most of the economic units face problems of applying the costing system because of reasons related to the system design itself or might be related to the requirements of the application success.
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In this work, the modified Lyapunov-Schmidt reduction is used to find a nonlinear Ritz approximation of Fredholm functional defined by the nonhomogeneous Camassa-Holm equation and Benjamin-Bona-Mahony. We introduced the modified Lyapunov-Schmidt reduction for nonhomogeneous problems when the dimension of the null space is equal to two. The nonlinear Ritz approximation for the nonhomogeneous Camassa-Holm equation has been found as a function of codimension twenty-four.
The guarantee of deposits came in most countries as a result of the financial crises faced by the banks, as the role of the guarantee agencies does not end to the point of enabling the depositor to recover his deposit, but rather it is considered necessary to overcome crises and stabilize the banking system.
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... Show MoreOur aim in this paper is to introduce the notation of nearly primary-2-absorbing submodule as generalization of 2-absorbing submodule where a proper submodule of an -module is called nearly primary-2-absorbing submodule if whenever , for , , , implies that either or or . We got many basic, properties, examples and characterizations of this concept. Furthermore, characterizations of nearly primary-2-absorbing submodules in some classes of modules were inserted. Moreover, the behavior of nearly primary-2-absorbing submodule under -epimorphism was studied.