CONTINUOUS DISRUPTION OF PARLIAMENT
Parliament has adjourned with out any business for 11 days. Finance Minister has said he does not know how to resolve the impasse created by the oppositions demand for a JPC to probe to the 2 G spectrum scandal,and the UPA government's stubborn refusal. The people if India disappointed at the valuable loss of time and money caused by the stalling of parliamentary proceedings. The Loksabha speaker is constantly trying to restore order in the House. The opposition parties are obstructing parliament in every session .
The people of India congratulate the Congress MPs including Sonia Gandhi have signed a letter saying they do not want honorarium. They are serious about the” no work no pay” .People cannot understand why doesn't the UPA government agree to a JPC inquiry in to the spectrum scam.
Prof.John Kurakar
Monday, November 29, 2010
INDIRA GANDHI NATIONAL OPEN UNIVERSITY TO FOCUS SKILL DEVELOPMENT CENTRES
INDIRA GANDHI NATIONAL OPEN UNIVERSITY TO
FOCUS SKILL DEVELOPMENT CENTERS
Indira Gandhi National open University will launch 5,ooo skill development centers across the country,using facilities lying idle with various institutions, as the commonwealths largest open university explores new frontiers to facilitate learning in a global development perspective.
Indira Gandhi National Open University to conduct a students satisfaction survey as pratised by some leading universities abroad.
Prof. John Kurakar
FOCUS SKILL DEVELOPMENT CENTERS
Indira Gandhi National open University will launch 5,ooo skill development centers across the country,using facilities lying idle with various institutions, as the commonwealths largest open university explores new frontiers to facilitate learning in a global development perspective.
Indira Gandhi National Open University to conduct a students satisfaction survey as pratised by some leading universities abroad.
Prof. John Kurakar
CLIMATE CHANGE CONFERENCE
CLIMATE CHANGE CONFERENCE
Climate change conference will begin Monday th November,2o1o in Cancun,Mexico. The main focus could be on foresting issues and reducing emissions from deforestation and forest degradation.15,ooo delegates are expected to attend the conference.
The Mexican government is committed to ensuring that participants mobilization and energy consumption during the conference results in the smallest environmental impact. The Mexican authorities is to ensure that a large amount of the energy used during the conference comes from renewable sources, hence minimizing as much as possible the release of green houses gas emissions in to the atmosphere.
The Mexican government is engaged in supplying energy through a system of photovoltaic cells with en estimated out put of 13o kw. The installation of a wind power generator with a 1.5 MW capacity will contribute to Cancun's electric out put through an additional renewable source.
Regarding transportation delegation of participating countries will be provided with hybrid vehicles for their transfers during the conference.
Around 1o,ooo trees and bushes will be planted in Cancun. This will contribute both carbon capture and sequestration.
Prof. John Kurakar
Climate change conference will begin Monday th November,2o1o in Cancun,Mexico. The main focus could be on foresting issues and reducing emissions from deforestation and forest degradation.15,ooo delegates are expected to attend the conference.
The Mexican government is committed to ensuring that participants mobilization and energy consumption during the conference results in the smallest environmental impact. The Mexican authorities is to ensure that a large amount of the energy used during the conference comes from renewable sources, hence minimizing as much as possible the release of green houses gas emissions in to the atmosphere.
The Mexican government is engaged in supplying energy through a system of photovoltaic cells with en estimated out put of 13o kw. The installation of a wind power generator with a 1.5 MW capacity will contribute to Cancun's electric out put through an additional renewable source.
Regarding transportation delegation of participating countries will be provided with hybrid vehicles for their transfers during the conference.
Around 1o,ooo trees and bushes will be planted in Cancun. This will contribute both carbon capture and sequestration.
Prof. John Kurakar
SHINING INDIA-- SHAMING INDIA
![](https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjbMCvOYNNZQe2bOyzKFNQgae1yDEoRUCKFI5uV9gEA46Kvqkcm5Qi2tgq9oqxSE7c6qcx4waXOGj5xDmH623sACgFqApOkXRUiQGTOGqUIau-uW_OqNg6y7YfuO136trLeuy9f-PR9_Po/s1600/shining+india.jpg)
The shining India won 64 medals including 14 gold,to be ranked sixth in the Asian Games. Somdev Devvarman won two gold medals along with AC Ashwini. Kabaddi continued to be the foundation for Indian performance,as it delivered a double gold. Commonwealth Games India won 101 medals including 38 gold to finish second behind Australia. As the Indian flag went up 101 times.
CWG corruption led shame to India. Many agencies started investigations. India Shaming eclipsed India's momentary hours of shining. The Adarsh scam showed how former defence officers were defenceless befoe greed. 2 G Spectrom scam is another one. The CVC,the CAG and the CBI put together investigate the himalayan corruptions. To day,we need a second freedom movement against corruption.
Prof.John Kurakar
Sunday, November 28, 2010
GUANGSHOU-2010 SPECTACULAR END TO 16thASIAN GAMES
GUANGSHOU-2010
SPECTACULAR END TO 16thASIAN GAMES
It was a spectacular climax to the 16th Asian Games.Closing ceremony was on Saturday th November,.The torch tower and flame glowing in all its glory on the cauldron standing in front of the eight huge sil-bot television screens depicting the silent features of the 45 nations,the 610 metre Canton tower looking down majestically on one side,fire works lighting up the sky,the beautifully decorated and colourfully lit boats on sail on the river on one side,the city lit up nicely in the back ground. It was another spell binding performance with emphasis on dance and music.
It was a commendable effort by the strong Indian contingent of 626 athletes to come up with a decent performance of 64 medals including 14 gold to be ranked sixth in the Asian Games. Overall,it was a healthy improvement from the 5 medals won in the last edition for India.57 medals won in Delhi in 1982,when the team had won 13 gold medals.
India had won 15 gold medals in 5 in the inaugural edition that featured 489 athletes from 11 nations.
The Chinese won 199 gold medals ina total 6 won with a contingent of 960
FINAL MEDALS TALLY-
1-China 199-G 119-S 98-B T-416
2-South korea 76-G 65-S 91-B T-232
3-Japan 48-G 74-S 94-B T-216
4-Iran 2o-G 14-S 25-B T-59
5-Kazakhstan 18-G 23-S 38-B T-79
6-India 14-G 17-S 33-B T-64
Prof.John Kurakar
Save Pampa Clean Pampa
Clean Pampa-Save Pampa
The Pampa Parirakshana Samithy (PPS) is a voluntary non-government organisation which has been working relentlessly since 1993 to protect the Holy River Pampa and to save it from degradation and destruction.
The PPS was formally inaugurated at a large public gathering at Kozhencherry on 14th May, 1994, and since then it has been working to study the problems faced by the river and seeking solutions to those problems. PPS have been interacting continuously with the public from different strata of society and working along with organizations like Centre for Earth Sciences Studies (CESS), Centre for Water Resources Development and Management (CWRDM) and the Kerala State Pollution Control Board
PPS took shape when the local inhabitants and environmentalists decided to protest against indiscriminate sand mining of river basins in Kerala.
- As a result of continuous mining of sand from the Pampa river, the seabed level has fallen to three metres below the mean sea level (MSL)
- The water table in all the wells in the Pampa river valley has fallen significantly, as a result of which there is acute shortage of drinking water just a few months after the monsoon rains.
- Mining has also weakened the foundations of pillars of several bridges across these rivers.
- The snake boat race during Onam Festival which used to be an annual sport attracting thousands of tourists, had to be cancelled many years as the river did not have sufficient water.
- The Biggest achievement of PPS so far is the Approval of PAMPA ACTION PLAN from The Government of India
Prof.John Kurakar
ACTION PLAN FOR TO PROTECT PAMBA
The Kerala State Bio-diversity Board is keen to declare the Pampa river an important biodiversity zone. Board chirman was delivering the keynote address at a workshop on' biodiversity conservation of Pampa' organised by the Pampa Parirakshana Samithi. The Chirman said an eco-friendly action plan was the immediate need for biodiversity conservation of the pampa.
He said protection of river banks growing indigenous flora was of the view that river conservation could be effective nd transparent only with the active involvement of the public and local self-government institutions.
Prof. John Kurakar
He said protection of river banks growing indigenous flora was of the view that river conservation could be effective nd transparent only with the active involvement of the public and local self-government institutions.
Prof. John Kurakar
PAKISTAN MUST KEEP ITS PROMISES
Pakistan has not fulfilled its promises of bringing to book the perpetrators of the November 26,2008 Mumbai terror attacks. Union Home Minister P. Chidambaram said on Friday, the second anniversary of the tragedy.
Prof. John Kurakar
The Minister expressed the hope that" Pakistan would realize its responsibility as a nation and government and fulfill its promises to bring the justice, those who perpetrated the attacks.
" Our neighbour Pakistan made many promises to us that they will bring to jistice the masterminds, controllers and handlers of the 26/11 tragedy. They have not done so,sofar. They promised they will arrest all the seven persons whose names handed over to them. They have not done that so far.. They promised, they will provide voice samples of the persons whose name are handed over. They have not done so far.
India has no ambitions except to live inpeace and harmony. India wants all her neighbours to grow at the same rate at which India grows. India wishes prosperity for all the people of south Asia.
Saluting ombale, Mr Chidambaram said it was his sarifice that led the police to capture Kasab aive. If Kasab had died, there would be no conclusive link to Pakistan, and that the terror attack ws mounted from Pakistani soil.
Union Home Minister on Friday 26th November paid tribute to the policemen who were killed during the 26th November terror attack at Mumbai two years ago.
Prof. John Kurakar
Saturday, November 27, 2010
URI SEEK BAN ON ENDOSULFAN
URI Environment wing urged to the Union government to ban on Endosulfan in Nation wide. Prof. John Kurakar presented a paper on" Endosulfan" more than hundred members of URI pledging their support. Prof G. Jacob presided over the function. Dr Ashraf Kadackal inaugurated the URI Interfaith Youth camp at Fathima public school at Punalur on 27th November,2010. Prof P.K Varghese Dr Kottuckal Sreedhar, Prof. Geroge Mathew Thiruvalla, Dr Samuel Nellikade, Mr Binu Cheriyan, Mr Alexander Jacob, Mr K.K Joy, Mr Nazarudeen were spoke on the occasion.
Group discussion began at 2 pm. The four group leaders presented their report on the public meeting at 2. 30p.m. The URI members presented some cultural programmes like group song, Role plays, and Recitation on the cultural section at 3 pm. The annual general body elected new office bearers of association. The Valedictory function held at at 3.3o pm.
Prof.John Kurakar
Group discussion began at 2 pm. The four group leaders presented their report on the public meeting at 2. 30p.m. The URI members presented some cultural programmes like group song, Role plays, and Recitation on the cultural section at 3 pm. The annual general body elected new office bearers of association. The Valedictory function held at at 3.3o pm.
Prof.John Kurakar
Friday, November 26, 2010
ENDOSULFANPACKAGE FOR ENDOSULFAN VICTIMS Kerala chief minister on Tuesday 22nd,November,2010 ,announced a comprehensive package for relief and remediation of victims of the Endosulfan pesticide in the state.The package includes higher pensions,special education,housing,drinking water supply, rehabilitation,training and employment. Chief Minister made the announcement after a conference of officials,people's representatives and non-governmental organisations convened to discuss the plight of the victims and review the relief measures taken so far. The cabinet would decide on an immediate moratorium on recovery of loans and further measures. The government had identified the next kin of 486 persons whose deaths hd been caused by Endosulfan, for payment of a solatium of Rs 50,000 each. Action would also be taken to provide land for the landless and house for the home less. ACTION COMMITTEE FOR PESTICIDE- FREE KASARAGOD The Endosulfan action Committee, an umbrella organisation of 12 organisations working for relief and remediation of Endosulfan victims in Kasaragod district has urged the government to provide Rs 10 lakh each to relatives of the deceased and declare the border district as pesticide free. The organisation demand compensation of Rs 10 lakh and Rs 5000 as family pension to the kin of the deceaced. The organisation has come out against the socio- economic and health survey,which was carried out in 11 panchayats in 48 hours. The committee said there are 8000-9000 victims. The plantation corporation,which holds 4,696 hectares of land,one third of the district, had been spraying pesticide on its land for over 24 hours. KERALA STATE SEEK CENTRE GOVERNMENT RS 100 CRORE RELIEF FOR ENDOSULFAN VICTIMS The Kerala cabinet on Wednesday decided to provide free ration to the victims of Endosulfan in the state and approach the centre for assistance to form a special relief fund for them. Chief minister said Rs 100 crore would be sought as urgent assistance from the centre. An all- party delegation would go to Delhi to meet Prime Minister Manmohan Singh and request a ban on the manufacture and use of Endosulfan in the country. ENDOSULFAN- AN EFFECTIVE PESTICIDE Agriculture scientist M.S Swaminathan has its decision to ban the use of Endosulfan across the state. Dr Swaminathan said there was no need for any new commission to study the health impact ofthe use of Endosulfan. He said that Endosulfan was an effective pesticide. Prof. John Kurakar
UNITED NATIONS SECURITY COUNCIL PERMANENT SEAT IS INDIA'S RIGHT The united Arab Emirates on Monday ,22nd November came in strong support of India's quest for a permanent seat in a reformed United Nations Security Council,with president Sheikh Khalifa Bin Zayed Al Vahayan telling his Indian counter part Pratibha Patil that this was New Delhi's right. UAE president stated that UAE would certainly support India,which had the right to be a permanent member of a reformed Un Security Council. UAE has emerged as India's largest trading exchange in the first half of 2010,with $43 billion bilateral trade,and oil imports by India accounting for $ five billion. Prof. John KurakarUNITED NATIONS SECURITY COUNCIL PERMANENT SEAT IS INDIA'S RIGHT The united Arab Emirates on Monday ,22nd November came in strong support of India's quest for a permanent seat in a reformed United Nations Security Council,with president Sheikh Khalifa Bin Zayed Al Vahayan telling his Indian counter part Pratibha Patil that this was New Delhi's right. UAE president stated that UAE would certainly support India,which had the right to be a permanent member of a reformed Un Security Council. UAE has emerged as India's largest trading exchange in the first half of 2010,with $43 billion bilateral trade,and oil imports by India accounting for $ five billion. Prof. John Kurakar
PARLIAMENT APPROVED RIGHT TO FREE EDUCATION BILL
THE PARLIAMENT APPROVED RIGHT TO FREE EDUCATION BILL
The parliament has adopted ‘ the Right of children to Free and compulsory Education Bill, 2009 which envisages providing free and compulsory education to children in the 6-14 age group with the Lok sabha approving it by voice vote on Tuesday 4th August 2009. The Rajya Sabha passed the Bill on July 20. Human Resource Development Minister Kapil Sibal termed the center’s move a’ national enterprise that would help shape India’s future” the legislation would ensure every child’s right to education and the obligation of the government to impart it. The law would ensure that the child got free, compulsory and quality education by qualified teachers.
The curriculum would be less rigorous and it would ensure all- round development of children, while 25 percent of seats in every private school would be allocated for children from disadvantaged groups including differently abled children at entry level, as far as minority institutions were concerned up to 50 percent of those seats could be offered to students from their communities. Every 100 children attending elementary school only 12 reach the graduation level, in
Europe it was 50-70 students reaching college from elementary level and global average is 27. The centre wanted to increase India’s average to 15 by 2012 and 30-35 by 2020.
Prof John KurakarPA
The parliament has adopted ‘ the Right of children to Free and compulsory Education Bill, 2009 which envisages providing free and compulsory education to children in the 6-14 age group with the Lok sabha approving it by voice vote on Tuesday 4th August 2009. The Rajya Sabha passed the Bill on July 20. Human Resource Development Minister Kapil Sibal termed the center’s move a’ national enterprise that would help shape India’s future” the legislation would ensure every child’s right to education and the obligation of the government to impart it. The law would ensure that the child got free, compulsory and quality education by qualified teachers.
The curriculum would be less rigorous and it would ensure all- round development of children, while 25 percent of seats in every private school would be allocated for children from disadvantaged groups including differently abled children at entry level, as far as minority institutions were concerned up to 50 percent of those seats could be offered to students from their communities. Every 100 children attending elementary school only 12 reach the graduation level, in
Europe it was 50-70 students reaching college from elementary level and global average is 27. The centre wanted to increase India’s average to 15 by 2012 and 30-35 by 2020.
Prof John KurakarPA
Thursday, November 25, 2010
THYROID GLAND
THYROID GLAND
Dr K.P. Paulose
Like liver,heart,Kidney and brain,thyroid is an organ,which has a specific role. All human beings have thyroid and normal thyroid weights 15-25 grams. It is located in front of the neck,just below the voice box and it has the shape of a butterfly.
Thyroid Gland structure |
Thyroid gland belongs to the group endocrine glands’,including pituitary gland in the brain, parathyroid glands embedded in the thyroid glands, pancreas in the abdomen and sex glands like ovary in females and testes in males. They are called endocrine glands because their secretions called’ hormone directly pushed to circulation; with out the help of ducts. In males the thyroid cartilage in front of the neck is easily visible on swallowing and the gland is situated below the thyroid cartilage. The thyroid cartilage is otherwise called Adam’s apple.
Thyroid gland starts functioning even before birth and two hormones it secretes,namely T3 and T4 are very vital for physical and mental growth of all human beings. Thyroid is the only organ,which secretes hormones with the help of iodine.
Tri-iodo thyronine is called T3 and tetraiodo thyronine is called T4 because these hormones contain 3 and 4 atoms of iodine in each molecule. The hormone secretion of thyroid gland is under the influence of a trophic hormone secreted by the master gland of the body called pituitary,labelled as TSH or Thyroid stimulating hormone. Pituitary gland situated in the base of the brain is called the master gland because it secretes many other trophic hormones which influence endocrine glands like adrenals, ovaries and testes. Four small glands called para thyroid glands which secrete a hormone called” Parathormone” (PTH) necessary for calcium metabolism/ bone growth are also embedded in the thyroid gland. Sometimes during thyroid surgery these parathyroid glands are accidentally removed resulting in “hypocalcaemia”{low calcium level in blood).
Thyroid hormones: They are called T3 and T4 and these two hormones are required at every minute by every organ,every tissue and every cell in the body. They control various metabolic activities in the body, which are essential for energy,growth and development. They should be secreted by thyroid in specific quantities and if the gland produces them less than or more than the requirement, it leads to certain complications. They need to be diagnosed and treated in time. Some special cells of the thyroid gland also secrete a hormone called’ calcitonin’ which brings down calcium level in the blood.
Thyroid hormones are necessary for the development of feudal brain and lack of these hormones either in the mother or in the foetus leads a poor development of the brain of the child.
The role of iodine in Thyroid: Iodine plays an important role in thyroid function because the thyroid hormones are made up of iodine. Iodine deficiency or excess leads to thyroid disorders. Iodine is obtained from the diet and the dietary content depends on the iodine content in the soil and water in a particular location. Thus, supplementation of iodine in salt or bread is suggested as a therapy to compensate iodine deficiency in iodine deficient ares. In India,30-40% of the areas is known to be iodine deficient(low iodine in water).
Daily requirement of iodine is about 100-150 mcg, which is derived from water, vegetables and fish. Iodine is an essential component of both thyroid hormones. T3 is more potent than T4. Poor iodine content in water as in Sub Himalayan regions, Andesmountainous areas( South America) leads to goiter in people living there( endemic goiter) and cretinism (poor development of children). This is the reason why iodized salts are recommended for daily use to prevent such goiters.
What is a thyroid disorder?
There are basically two types of thyroid disorders:
1.Abnormal size and structure of the gland (goitre with or without nodules)
Goitre may or may not have an associated thyroid dysfunction.
Nodules may be single or multiple. Cancerous growth may present as nodules. Painful thyroid gland enlargement may be seen in inflammatory conditions( Thyroiditis). The term goitre means only an enlargement of thyroid which is benign.
2.Abnormal function of the gland. (Under or over function and it may happen even with out a goitre).
Though both causes concern, they require different diagnostic tests and evaluation. Under function of thyroid leading to low production of thyroid hormone is called Hypothyroidism (Myxedema) and over function of thyroid leading to increased production of thyroid hormones is called Hyperthyroidism ( Graves
Disease). Transient hyper function may be seen Thyroiditis.
Goitre:
Enlarged thyroid gland is called goitre and the enlarged gland may or may not have nodules (lumps) in them. A nodule is the enlargement of a part of the gland. In certain individuals more than one nodule may be present and the size of the goitre at times could be 100 times that of the weight and size of the normal gland. When there are multiple nodules it is called “multi nodular goitre” and single nodules are called” solitary nodular goitre” Many say after looking at your enlarged thyroid.” You have got thyroid, so show it to a doctor” It is not that you get thyroid enlargement overnight. But any abnormal swelling or enlargement should be shown to a doctor because it could be”Cancer”. They recommend certain studies like ultrasound scanning needle aspiration etc. to rule out malignancy(Cancer)
About 150 million people in India are at risk of developing benign goitre. Because of iodine deficiency, 54 million Indians are suffering from goitre and 6.6 million are having mild neurological defects, 2.2 million overt cretins are there in India. Even in Kerala, there are pockets of endemic goitre especially in the hilly districts of Kottayam and Idukki.
In primary hyperthyroidism(due to primary disease of thyroid) T3 T4 values are increased with low TSH while in Primary Hypothyroidism T3 T4 vales are low with high TSH (See Table). It is called primary because pituitary diseases(hypo function or hypo-function as in pituitary tumors) can also produce hyperthyroidism/hypothyroidism( secondary thyroid disorders) and in these patients although the symptoms may be the same as primary laboratory values are different.
Normally the thyroid hormones circulated in blood are in the bound form (bound with proteins,more than 99% with a small fraction in the free form. In pregnancy the binding proteins are otherwise increased and hence Free T3 and Free T4 estimation is done to assess the thyroid function.
LAB RESULTS
Hyperthyroidism (primary)
Hypothyroidism(primary)
Pituitary Hyperthyroidism
Hypopituitarism
Thyroid Dysfunction
Like any other organ, thyroid too has functional abnormalities. They lead to:
· Low thyroid hormone production or hypothyroidism or
· Excess thyroid hormones production or hyperthyroidism
These disorders can be diagnosed within 2-3 hours using simple laboratory blood tests. Once diagnosed they can be brought to perfect normalcy using certain drugs within a week or a month.
Testing for thyroid function: When you in for your family doctor all relevant complaints, the doctor suspects the possibility of thyroid dysfunction. To confirm or rule out a thyroid disorder, he sends you to a laboratory to get some basic thyroid tests done called T3,T4 and TSH. These tests, if done, will reveal the exact concentration of the hormones circulating in the blood and a definitive diagnostic conclusion can be arrived at.
Hyperthyroidisma
The major role of the thyroid gland is to produce two thyroid hormones T3 and T4, which control the growth and metabolic rate. These hormones have their influence on every tissue, every organ and every cell in the body and their levels in blood are important in keeping the metabolic normalcy, If thyroid over functions, it will secrete more hormones(more than the required quantities) and additional load of thyroid hormones will stimulate and promote certain unwanted metabolic events resulting in certain signs and symptoms and such a patient is known to have hyperthyroidism. Once diagnosed these patients are given medicines which reduce the output of hormones by thyroid and bring normalcy within weeks to months of beginning of therapy. The tremors in treatment for hyperthyroidism, however,is not as easy as that of hypothyroidism and you should consult your clinician to know the merits and limitations of various modes of treatment for hyperthyroidism.
Symptoms of hyperthyroidism:
Due to increased metabolic activities one may experience nervousness, irritability, thinning of skin,fine brittle hair,muscular weakness, hands,increased bowel movements,increased her rate,loss of weight and in women a delayed or scanty menstrual periods. Enlarged thyroid gland and protruding eyeballs are also noticed in some patients.
Treatment of hyperthyroidism is of 3 types
a-Drugs like nermercazole to block the excess secretion of thyroid hormones (Tablet forms)
B)Surgery-removal of a significant portion of the hyperactive gland- subtotal thyroidectorny- so that the excess secreation can prevented.
c- Radioactive iodine- oral administration
This facility is available only in specialised centres handling radioisotopes. An isotope of iodine(1-131) which emits radiation is administered to the patient orally in liquid or capsule form. This iodine will go to the thyroid gland and the radiations emitted will destroy the excessively acting thyroid cells. This procedure will be cheaper than surgery in private institutions. Radiations may be allfa,beta or gramma. Although 1-131 emits Beta and grama radiations,the Beta radiations are the one which destroy the overactive thyroid cells.
Hypothyroidism
When the production of thyroid hormone decreases below the body’s need,it results in certain signs and symptoms, a clinical condition called hypothyroidism. In such patients, the laboratory tests indicate a below normal T3, a below normal T4 very high TSH levels.
When hypothyroidism occurs with puffiness of face without any obvious thyroid enlargement it is called myxedema. Hypothyroidism can also occur in goitre with multiple nodules (multi nodulaar goitre)
The importance of estimation of free T3 and T4 in pregnancy is mentioned before.
What causes Hypothyroidism?
The most common cause of hypothyroidism is chronic autoimmune Thyroiditis (Hashmoto’s Thyroiditis), a condition characterized by inflammation and damage to the thyroid tissue. The gland partly or completely fails to synthesis the required quantities of thyroid hormones. Other causes of hypothyroidism include:
· Surgical removal of the thyroid gland either for hyperthyroidism or thyroid Cancer.
· * Radioactive iodine treatment
· A deficiency in dietary iodine consumption(cretinism)
· Genetic thyroid absence or function failure or defect in hormone synthesis.
The signs and symptoms of Hypo-thyrodism:
The symptoms of hypothyroidism are mainly dependent on the amount of decrease in thyroid hormone and duration of time that the decreased level has been present. For most patients, the symptoms are mild and can often be confused with menopause or stress. The symptoms may include-
· Fatigue and muscle swelling or cramps
· Weight gain
· Dry skin and cold intolerance
· Coarseness or loss of hair
· Depression
Hoarseness
· Goitre enlarged thyroid causing a lump in the neck
· Constipation
· Memory and mental important
· Infertility or miscarriages
Pregnancy and Hypothyroidism:
Thyroid disorders can sometimes cause unexplained infertility or miscarriages particularly early in pregnancy. Therefore,thyroid function tests are often done as a routine part of evaluating a patient,who may have problems with pregnancy. Untreated hypothyroidism is known to give disturbances in sex and fertility in men also.
During pregnancy, the requirements of thyroid hormone may increase, and should be monitored closely in the first and second trimester. Both the mother and fetus require optimum hormone levels and,in a hypothyroid pregnant patient,the dose monitoring should be done with extra care and more frequently. It is known that the deficiency of thyroid hormones can cause irreversible damage to both physical and mental growth of the fetus.
Body weight and Thyroid:
What we eat should be converted into energy for a normal life. In hypothyroidism,the energy conversion is reduced. Hence,fat accumulation and weight increase are very common in hypothyroid patients’ However,once diagnosed and treated, the supplemented thyroid hormone tunes up the metabolic pathways and reduces weight to normal. Similarly in hyperthyroidism, loss of weight occurs.
Excess secretion of TSH by the pituitary gland as in pituitary tumours also results in hyperthyroidism which is called secondary hyperthyroidism (mentioned before)
Secondary Hypothyroidism
Since thyroid cells are stimulated by TSH, the failure of pituitary to synthesis desired quantity of TSH too results in a deficiency of thyroid hormones. This group of patients will have all the signs and symptoms of hypothyroidism but will not have an elevated TSH level.
Thyroiditis:
As in the case of other organs inflammation of thyroid gland can occur which is called Thyroiditis ( you have heard about Tonsillitis, Appendicitis, Neuritis etc}. Thyroiditis may be acute due to bacterial infection or sub acute Thyroiditiis, the thyroid gland is painful and tender.. patients will complain of pain in front of the neck and may have associated symptoms of hyperthyroidism.
There is another type of Thyroiditis called autoimmune Thyroiditis which may be painless, but will cause irregular firm enlargement of thyroid( chronic thyroiditis and may produce hypothyroidism.
Antibodies against one’s own thyroid cells are produced in the body(autoimmune antibodies) which acts on thyroid cells resulting in hypo function of the thyroid. These antibodies are called anti microsomal antibodies. Sometime antibodies may present without disturbing the thyroid function. The presence of these antibodies in a pregnant woman may lead to the development of post partum Thyroiditis(within 6months of deliver) characterized by painful enlargement of thyroid gland and hyperthyroidism.
Treatment of Hypothyroidism: is by replacement therapy with Thyroxine (T4). T4 will be converted to T3 in the tissues and T3 is the potent hormone. T4 is available as 100mcg/50mcg/25mcg. Tablets which are very cheap. Dose may vary up to 300 mcg, and this can be safely given in pregnancy also. One has to monitor T4/T3/TSH during treatment. For most of the patients, the drug has to be continued for life.
Ultrasound Scan and Isotope Scan:
Ultrasound Scan of neck will give us some idea regarding the anatomy of thyroid gland whether it is enlarged, whether the nodules are cystic(containing fluid) or solid etc.
ultra sound scanning |
Radioisotope scan involus the administration of a radioisotope orally (iodine) or intravenously( Technetium) which concentrates in the thyroid and can delineate the functioning areas. Nodules which concentrate more radioisotope (Iodine/Technetium) are called are called cold nodules. Cancer is more common (10%) in single cold nodules.
Fine needle aspiration Cytology: is an outpatient procedure which involves striking a needle to the thyroid and aspirating fluid from the gland. This fluid will be sent for hypo-pathological examination to exclude malignancy. This is a simple procedure followed universally and has no complications.
Diagnostic Tests in Thyroid Diseases:
The most effective and efficient way to diagnose thyroid dysfunction is by measuring the blood levels of T3,T4 and TSH. These tests are done using specialized technologies like Chemiluminescence (CLIA), Radio Immunoassay (RIA) and ELISA etc. Additional tests,which may be helpful in determining the etiology of thyroid dysfunction.
Thyroid antibodies- anti microsomal(AMA) or anti thyroglobulin (AT) antibodies
Thyroid isotope scan and/or sonogram
Thyroid biopsy(Fine Needle Aspiration Cytology)
Free T3
Free T4
Cancer thyroid
Thyroid cancer accounts for only 0.4% all cancer deaths and for about 5 deaths per million population in USA each year. Thyroid cancer is reported to be more in Kerala as compared to other states,may be because of the radiation produced by the radioactive elements in the monazite sand found in the coastal areas.
Thyroid cancer can occur in children, or in elderly people. The diagnosis is by FNAC or by biopsy. Spread to other organs may some times occur especially lymph nodes and lung. The treatment is complete removal of thyroid gland and adjoining lymph nodes if thyroid gland and adjoining lymph nodes if they are involved. Most of the thyroid metastasis to other regions can be treated by high doses of radioactive iodine. Patient has be to isolated and kept in the isolation ward for 5-7 days to avoid radiation exposure to other people in the household or community. There is one type of cancer called medullary carcinoma throid which can occur in families. Many surgeons advise removal of thyroid in patients with thyroid nodule to prevent malignancy in future. Once the thyroid gland is removed, patients have to be on replacement thyroid medications for life.
Who should be tested?
Some individuals are more likely than others to be a thyroid patient. These include patients with
· High cholesterol
· Have lost or gained more than 2 kilos in 2-3 months
· Who feel exhausted, fatigued and Weak
· Too low or too high heart beat rates
· Irregular heart rate
Why women more often hve Thyroid Failure?
In every five thyroid patients, four are women. Child bearing and associated hormonal, immunological and other stresses in them make them to be more prone to thyroid dysfunction.
Diseases associated with Thyroid dysfunction?
It is known that majority of the patients with autoimmune disorders have an association with thyroid disorders and patients with chronic Thyroiditis have higher incidence of other autoimmune disease,such as:
*Vitiligo
*Rheumatoid Arthritis
*Addison's disease(adrenal gland low function)
*Diabetes Mellitus
*Pernicious anaemia (B12 Deficiency anemia)
10% of patients with type I Diabetes Mellitus develop chronic Thyroiditis in their life time,which may change their insulin requirements. It is therefore important for diabetic patients to be checked for goiter and have their TSH levels monitored regularly. Some patients suffering from depression may have primary hypothyroidism. In addition,patients on Lithium may develop goitre and hypothyroidism.
What are free thyroid hormones?
T3 and T4 once secreted from thyroid gland join the blood stream and then travel to the target tissues in the bound forms. In the ccirculation,there are 3 thyroid hormone binding proteins viz, thyroxine binding prealbumin (TBPA) also known as trans-thyretin,and albumin. It is known that more than 99.95% of hormone circulate in the bound from while only less than 0.05% are available in the free form. Research has proved that it is the “ free thyroid hormone moiety” which is metabolically active and therefore for the last two decades,new technologies have been persuaded to get free thyroid hormone measurements. Ideally speaking, FT3,FT4 and TSH should be a better alternative than conventional TFT ( total T3,total T4 and total TSH)
Conclusion
Thyroid gland enlargement is a very common phenomenon in women in Kerala. 99% are benign enlargement. The incidence of malignancy thyroid is very rare 3-6 new cases//1,00,000 population. So many diagnostic tests are available to assess the function of thyroid as well as the pathological basis of the gland enlargement. Radioisotope tests are contraindicated in pregnancy. Patients who are on thyroid drugs should not stop it without the consent of the treating doctor.
Tuesday, November 23, 2010
TRIBUTE TO FILM ACTOR SANTHA DEVI
She was the winner several awards,including the national honour for the best supporting actress for her best performance in’Yamanam and the life time achievement award of the Kerala Sangeeta Nataka Akademi smarakom, a drama directed by Vasu Pradeep, was her first play. She made her debut in cinema 53 years ago in Minnaminungu, directed by Ramu Karyat. She had entered the silver screen on inspiration by her husband, Abdul khader.
She had handled memorable roles in television serials, such as Manasi and Minnukettu. She was among the leding woman actors in Kerala who took the glory of theatre art to its zenith surmounting social stigma.
The state bid a tearful adieu to vetern film and theatre artiste Santha Devi who was cremated at the mavoor Road crenatorium with state honours on Sunday 21 st November. The people from all walks of life, including ministers,film and theatre artistes and cultural leaders,paid their last respect to the actor whose body was kept at town Hall,Kozhikodu
Chief Minister described Santha Devi as an actor with a novel talent and said her contribution to the stage and cinema would be remembered. She had come on the scene at a time when the women kept away from the stage and screen and had proved her acting genius by donning powerful dedicated to the stage.
Prof.John Kurakar
QUIT SMOKING
CHRONIC OBSTRUCTIVE PULMONARY DISEASE(COPD)
According to the World Health Organizations global estimates 210 million people have COPD. The rate of morbidity and mortality will increase over the next 20 years.
COPD- is a condition where airway loses its elasticity and become rigid. As a result, there is airflow limitation in and out of the lungs, there by compromising oxygen supply to the whole body. As a result, the person becomes breathless,coughs up and expectorates, troubling himself and his loved ones for years before dying a painful death.
Tobacco smoking is the main culprit behind the cruel damage. An exponental increase in cigarette smoking in the Indian subcontinent has increased the prevalence of COPD. The premature death among chronic respiratory patients is up to six times higher than in the rest of the population.
If you kiss a cigaratte, it reciprocates by biting your lungs. So those who smoke quit today Remember, lighting up a cigarette would darken your life permanently.”The theme for the world COPD Day 2010, the year of the lung measure your lung health- Ask your doctor about spirometry.
Prof.John Kurakar
KURAKAR CENTER & MAHATMA RESIDENCE ASSOCIATION
The center of the Mahatma Residence Association is at Kurakar Center,Kottarkara. Third annual meeting was held at Kurakar Tourist Home auditorium on 21st November,2010. Prof.JohnKurakar, president Kerala Kavya Kala Sahithy was the chief gust on the annual function. Mr Sathyasheelan,president,Residence Association presided.Mr Samuel welcomed the gatherings.Mr Scaria presented the annual report. Dr Gangadharan Nair, secretary, Federation of Residence Association delivered keynote address.Mr V.Philip,Mrs Lovely Alexander,Mr T.G George ,Dr Williams George were felicitated. Mr Scaria proposed vote of thanks. Association elected a new office-bears of the year 2011.
Kurakar Center
INTERNATIONAL EXPERTS DEMANDED AN IMMEDIATE BAN ON PRODUCTION AND USE OF ENDOSULFAN IN INDIA
An international group of academics and experts working on environmental and developmental issues had demanded an immediate ban on production and use of Endosulfan in India. In a letter to Prime Minister Manmohan singh, they urged that India should join the global consenus on the ban Endosulfan and provide adequate compensation to the Endosulfan victims.
They noted that India was the only country to have opposed the recommendation of the peristent organic pollutents Review Committee of the stockholm convention in favour of the global ban on the pesticide.
They said 60 countries had banned this lethal chemical. India has more convencing reason to ban the pesticide and suport an international ban. The Mortality and grusome morbidity in Kasaragod district, resulting from two dacades of aerial spraying of Endosulfan in the cashew plantations,are compelling enough for India to stand for the ban of this lethal chemical. The tragic congenital deformities,widespread prvalence of cancer, blindness among children,mental growth retrdation, hydrocephalus ( enlargement of head) etc.
They noted the Endosulfan tragedy has been repeated in the Belthengady taluk of Dakshina Kannada district in Karnataka. Twenty years of Endosulfan spraying two times a year, by the Karnataka cashew corporation had affected a large number of people.
Jurist V.R KrishnaIyer has in a letter,appealed to president to take steps to get the maufacture and sale of Endosulfan banned” Healthy life and Endosulfan cannot go to together and are incompatible, he said”I pray thee ban Endosulfan in any form, in any manner, in any chemical composition and make it a crime evidence to manufactureit, to posses it, to store or sell it or consumeit”
Prof. John Kurakar
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