Prevalence of hyperthyroidism and its impact on quality of life among students

Authors’ Contributions 1, 2, 3 Conception & study design 1, 2, 4, 5 Data Collection & Processing 1, 2, 4, 5 Data Analysis and/or interpretation 1, 2, 4, 5 Drafting of Manuscript 3 Critical Review Acknowledgement The authors are thankful to Dr. Imran ulHaq, who is treating many patients of hyperthyroidism in South City Hospital, Karachi. The first author is an example of successful treatment of hyperthyroidism during the time of this experiment. The authors have strongly recommended the participants with this disease to get treatment from Dr. Imran ulHaq. Article info. Received: March 30, 2020 Accepted: September 25, 2020 Funding Source: Nil Conflict of Interest: Nil Cite this article: Shaffique S, Anwer H, Asif HM, Haq I, Akram M. Prevalence of hyperthyroidism and its impact on quality of life among students of The Islamia University of Bahawalpur Pakistan. RADS J Pharm Pharm Sci. 2020; 8(2):85-90. *Address of Correspondence Author: shifa.shafiquee@gmail.com Aim: Population based studies on prevalence of hyperthyroidism and its impact on quality of life, with variability of weight, height and distribution, their associated symptoms are limited. Knowledge and awareness about the prevalence of hyperthyroidism and their associated symptoms and its treatment option is necessary for the patient education and evaluation of underlying causative factors of this disease. Methodology: Apopulation-based study was conducted from October 2018 to May 2019 to determine the prevalence of hyperthyroidism and its impact on quality of life among the students of The Islamia University Bahawalpur. Questioner were developed and distributed among the consenting participants. Thirty-six males and one hundred and six females were included in this study. Results: Our study concluded that prevalence of hyperthyroidism is n=10(6.6%) and its prevalence ishigher in middle class families. Hyperthyroidism has a positive link with family history and previous history as shown in the results i.e. n=8 (5.3%) with family history and n=5 (3.3%) linked with previoushistory. It is the leading cause of morbidity and its prevalence is raised day by day. We studied that hyperthyroidism produces following effects on quality of life; n=10 (6.6%) participants were presented with loss of concentration in work / studies=10 (6.6%) with body ache, n=8 (5.3%) with social isolation, n=10 (6.6%) with mental health changes, n=6 (4%) with a history of previous treatment, n=8 (5.3%) with need of repeated checkups. Conclusion: It is concluded from present study that the hypehyperthyroidism significantly affects the quality of life and it is positively linked with the family history and history.


I N T R O D U C T I O N
Hyperthyroidism is defined as a condition in which the thyroid produces an excessive amount of thyroxin [1][2][3]. Hyperthyroidism can hasten your metabolism, causing sudden loss of weight, a feeling of rapid or irregular heartbeat enlargement of thyroid, heat intolerance, diarrhea, sweating, hand tremors, nervousness or irritability [4][5][6]. Hyperthyroidism is due complex relation between genetic predisposition and environmental triggers such as amount of iodine intake and extent of smoking [7][8][9]. This diseased condition is also defined by suppressed serum level of TSH and increased concentrations of the thyroid hormone I.e. thyroxin and/or triiodothyronine [10][11][12]. Regardless of its cause I.e. Graves' disease or nodular toxic goiter, hyperthyroidism is linked with conditions such as: Atrial fibrillation, Stroke Pulmonary embolism, Hypercoagulopathy. These conditions could lead to an increased mortality rate [13][14]. The types of hyperthyroidism are Toxic multi-nodular goiter, Thyroid adenoma, Hyperthyroidism in pregnancy, Iodine-induced hyperthyroidism, Hyperthyroidism in aging, Atrial fibrillation with hyperthyroidism, and Diabetes mellitus with hyperthyroidism [15][16][17]. Sometimes, simple goiters become multi-nodular over 10-20 years [18,19]. These nodules grow at irregular rates and become toxic and secrete thyroid hormone 'freely', thereby control TSH dependent growth and function in the resting gland [20,21]. Very large goiter may cause stridor, difficulty in swallowing and superior vena cava obstruction. Grave's disease, the most typical form of hyperthyroidism, is an autoimmune disease in which antibodies called thyroid-stimulating immune-globulins (TSIs) form against the TSH receptor in the thyroid gland [22][23][24]. These antibodies attach with the same membrane receptors that attach TSH and generate continual stimulation of the CAMP system of the cells, with resultant spread of hyperthyroidism [24,25]. The aim of cross sectional survey is to educate the females and males to give awareness about their treatment options, due to poor knowledge and misunderstanding among males and females and to find the prevalence of this disease and its impact on quality of life of people and this survey is conducted to collect the unbiased data from specific number of population and to develop sensible decisions based on analyzed results.

M E T H O D O L O G Y
The presentcross-sectionalsurvey was carried out from October 2018 to May 2019, after consent from ethical committee of The Islamia University Bahawalpur.
Standard questionnaires were developed and distributed in consenting females and males total 150 participants were chosen for study. The participants were guaranteed that their data remain confidential and will be used only for research goal. Participants were guided to complete the questioner attentively. The questioner were prepared with reference to previous papers with slight modifications [26][27][28][29].

DevelopmentofQuestionnaire:
The first part of questioner accommodates personal information i.e. Name,father or husband name, age, sex, marital status, date, contact number, patient ID, address.
The second part of questioner accommodates patient's history about Hyperthyroidism present/absent, BMI, BMR, Social status, residence. Patient previous history, family history and history of experience of recurrence in past. The third part of questioner accommodates associated symptoms of hyperthyroidism i.e., heartbeat, fatigue, nervousness, weak memory, voice changes, hair fall, mood changes, blurry or double vision, eye red, dry, swollen, tremors of extremities, weight changes, goiter, diabetes associated with hyperthyroidism, any history of irregular, skipped, shorter or lighter, longer periods, blood pressure, and appetite. The fourth part of questioner accommodates impact of hyperthyroidism on daily life i.e. loss of concentration in work/studies, body ache, social isolation, need repeated checkups, mental health, limited physical activity, general health, sexual life, holidays, any history of taking drugs, alcohol, any history of smoking, any history of previous treatment and medications.

Distribution of Questionnaires
The questionnaire was developed and distributed in consenting females and males. A total of 150 participants were chosen for study. The participants were guaranteed that their data will use only for research goal. Part0020 icipants were guided to complete the questioner attentively.

D I S C U S S I O N
Hyperthyroidism is the endocrinological disorder that involves various organs of the body and leads to serious clinical manifestation [30,31].Hyperthyroidism is the main cause of morbidity which affects the quality of life, globally the incidence of the disease increases with passage of the time so it is the need of the hour to find out the factors responsible for the association and causation [32,33]. We conducted a short cross sectional study October 2018 -May 2019 for prevalence of hyperthyroidism and its impact on quality of life with various parameters to compute the linkage between association and the causation [34].
In our study, the results revealed that hyperthyroidism has positive link with family history as shown n=8 (

C O N C L U S I O N
The prevalence of hyperthyroidism in our study-based result is 6.6%. We concluded from our study that hyperthyroidism is positively linked with family history and previous history and due to this chance of developing hyperthyroidism increases in a person who has any family history/previous history. It also affects the quality of life and it is the leading cause of morbidity. Our study also concluded that if once in a lifetime a person develops hyperthyroidism then chances of recurrence of disease increased to 50% and prevalence of hyperthyroidism is more in middle class family i.e. n=128(85.3%). The prevalence of hyperthyroidism is n=10(6.6%) this shows that prevalence of hyperthyroidism is significant. So, treatment option should be planned and educate the people to improve the quality of life with underlying disease I.e. regular checkup, observation of symptoms and to get proper treatment as directed by the physician.

R E C O M M E N D A T I O N
We concluded from the present study the prevalence of hypothyroidism is 6.6% and its impact on quality of life. As our sample size was small and our crosssectional study was limited. So, we recommend that the study should be conducted on the standard level with a big sample size so we could get more knowledge about this disease and its prevalence. In this way we could aware the people more accurately about this disease. Also, a better medicinal system should be introduced for the treatment ofhyperthyroidism andan alternativesystem of medicine i.e. homoeopathic system of medicine should be introduced for the treatment of hyperthyroidism.