INTRODUCTIONOneof the important gland of endocrine system is thyroid gland.
In 17thand 20th century researchers understand the anatomy, function andits diseases .It is the first gland which develops first in embryo. This glandsecrete hormones which perform different functions in the body. Pituitaryregulate the thyroid gland secretion. It is located down in the front of neckand weigh 25 grams. The gland consist of two pear shaped lobes where the rightlobe is large than left.
This gland has capsule which is covered by envelope ofpretracheal fascia thick posteriorly and attached to upper tracheal ring andcricoid cartilage. This attachment is responsible for moving during swallowingof gland up and down with larynx (Khatawkar & Awati, 2015). The relation of thyroid and otherbody function was studied by experimental thyroidectomy and internal secretoryfunction was formulated by king after 9 years (Majid & Siddique, 2009).Thyroidhormones play important role in all normal body functions including liver.These hormones also play role in the regulating of the basal metabolic rate ofhepatocyte. For normal function of the body normal serum level of thyroidhormones are necessary. The normal serum vales of T3and T4 are 80-180 ng/dl,4.
6-12 ug/dl respectively (Yousef et al.,2017). It is well established that thyroid hormone status correlates with bodyweight and energy expenditure (Mullur, Liu, & Brent, 2014).Thyroidfunction test is perform for the estimation of thyroid hormones T3 (Serum Triiodothyronine) and T4 (Serumthyroxine) which are secreted by thyroid gland. Thyroid hormonesare needed for normal growth of the body as well as for metabolisms anddevelopment. The thyroid gland transports diet actively from blood whichconsist of iodine through iodide pump in cell membrane which is calledsodium-iodide symporter. Iodine and tyrosines combine in thyroglobulin whichare mediated by thyroperoxidase to form T3 or T4. This process are controlledby thyroid stimulating hormones (TSH) which is secreted by pituitary gland.
Thyroglobulin as co-secreted with thyroid hormones and in the blood bound tothe thyroid hormones binding protein. And some little amount of free fractionis available for the uptake by cell. The secreted thyroid hormones consist of90% T4 and 10% T3 (Mortimer, 2011). Thepathophysiology of thyroid diseases is related to the three hormones TSH, T3and T4.
The most important chemical marker of thyroid function is TSH.Hyperthyroidism is the result when the low level of TSH profile, whereas highvalue leads to hypothyroidism (Attaullah, Haq, & Muska, 2016). The most common disorders ofthyroid gland are Hyperthyroidism and Hypothyroidism. It can be treated byhormones therapy (Hannemann et al., 2010).Mostcommon cause of hypothyroidism is a decrease intake of iodine in the diet dueto this body cannot synthesized thyroxine. Another cause of hypothyroidisms isthe autoimmune condition called Hashimoto’s thyroiditis. Hypothyroidism can createnumber of symptoms like tiredness, sensitivity to cold, weight gain and dryskin (KUMAR, RASOOL, AHMED, & MAKHIJA,2016).
Hyperthyroidismis mostly caused by Graves’ disease, followed by toxic multinodular goiter,other cause of hyperthyroidism included an autonomously functioning thyroidadenoma, or thyroiditis (Peter, 2009). Subclinical thyroid dysfunction isa risk factor for developing symptomatic thyroid disease (Helfand, 2004).Thyroidabnormalities affect a considerable portion of the population. However, theprevalence and the pattern of thyroid disorders depend on ethnic andgeographical factors and especially on iodine intake (Bjoro et al., 2000).
In2003 study shows that Global total goiter prevalence (TGP) in the generalpopulation was 16 %. A total of 37 % (285 million) school-age children wereestimated to have an insufficient iodine intake, ranging from 10 % in the WHORegion of the Americas to 60 % in the European Region (Andersson, Takkouche, Egli, Allen,& Benoist, 2005).Thyroiddisorders are a widespread endocrinological problem, but data on its prevalencein India is scanty (Deokar, Nagdeote, Lanje, &Basutkar, 2016). South Asianpopulation has a particularly high prevalence of thyroid disorders mainly dueto iodine deficiency and goitrogen use. April 2007 the prevalence of hypothyroidism (5 %), Graves’ disease (0.6%), gestational transient thyrotoxicosis (6 %), and thyroid autoimmunity (TAI-12 %).
This study collected from Mumbai (India) (Nambiar etal., 2011).Thyroiddiseases are increasing globally but are growing more rapidly in Asia (Attaullah et al., 2016). Form Jan – Dec 2007, the prevalenceof thyroid disorder 14 % of hyperthyroidism and 17 % of hyperthyroidism ineastern Nepal and thyroid disorder is 17 % in western Nepal (Risal, Maharjan, Koju, Makaju, , 2010). In2001 the data collected from various studies showed that 42 millions of Indianpeople have thyroid disorders. Hypothyroidism, hyperthyroidism, goiter andiodine deficiency disorders, Hashimoto’s thyroiditis, and thyroid cancer. (Unnikrishnan & Menon, 2011).
Thereis no data available for prevalence of thyroid disorders in the generalpopulation living in no mountainous regions of Pakistan. February 2011, somedata collected from different areas of Pakistan shows that Median age of theparticipant was 34 years, (50 %) were males.(29 %) subjects presented withgoiter(Jawa et al., 2015). January2013 to December2014, study of Thyroid Dysfunction in Punjab was detected in 15% of patients: 9 % hypothyroidism and 6 % hyperthyroidism.
In increasing ordersubclinical hypothyroidism, overt hypothyroidism, overt hyperthyroidism, andsubclinical hyperthyroidism were found in (5 %), (4 %), (4 %), and (3 %)patients, respectively (Batool, Elahi, Saleem, & Ashraf,2017). From2003 to 2009, the thyroid cancer found in Baluchistan that leading thyroidcancer is papillary carcinoma which accounts for 71 (82 %) cases. Follicularcarcinoma has been reported in 6 (7 %) cases while 10 (12 %) cases presentedwith mixed papillary and follicular carcinoma (Iftikhar et al., 2011).FromJanuary 2009 to December 2015, Data collected from Lyari general hospital andAbbasi Shaheed hospital in Sindh. A total of 367 patients had thyroiddisorders. The prevalence of sub-clinical thyroid disorders was (9 %). 265 (7%) had sub-clinical hypothyroidism and 102 (3 %) had overt or subclinicalhyperthyroidism (A.
S. Rahman et al., 2017). Studyfrom Khyber Pakhtunkhwa was conducted from 07-2010 to 07-2011 at cardiologydepartment of Hayatabad medical complex, Peshawar.
According to this study outof 753 patients, there were 431 (57 %) male and 322 (43 %) female patients.Subclinical thyroid disease was found in 46 (6 %) patients including 26 (4 %)males and 20 (3 %) females. Subclinical hypothyroidism was found in 30 (4 %)patients of CHF including 19 (3 %) males and 11 (2 %) females. Subclinicalhyperthyroidism was found in 16 (2 %) patients with Congestive heart failure (CHF) including 7 (1 %) males and 9(1 %) females. Majority of subclinical hypothyroid (67 %) and subclinicalhyperthyroid (81 %) patients were <60 years of age (ULLAH, 2013).
Differentresearchers perform different studies in Brick factory workers. August 2011 toJune 2012, the data collected from brick factory workers in South India. Inwhich 4002 workers participated in this study. The prevalence of chest symptomsamongst males and females was 10 % and 8 %, respectively (Thomas et al., 2014).Anotherstudy performed among brick factory workers in rural Southern India to checkthe status of musculoskeletal disorders.
The data collected from 2007-08,Majority of the workers (87 %) experienced some kind of pain, with (51 %)having pain during work. A total of 65 % of them have moderate or severe formof pain (Inbaraj et al., 2013).FromApril to May 2011, cross sectional study performed among Brick factory workersin rural districts of Pakistan to find out the status of respiratory symptomsand illness. In which 335 workers have participated. The study shows 22 %workers have chronic cough while 21 % reported chronic phlegm. 14 % had morethan two attacks of shortness breath with wheezing.
17 % workers have reportedchronic bronchitis while 8.2 % reported asthma (Shaikh et al., 2012).FromOctober, 1st to November, 30th 2007, Comparative cross sectional studyperformed all over Pakistan. The prevalence of Chronic Obstructive PulmonaryDisease among Brick factory Workers in which 407 kiln workers and 407 non kilnworkers have participated.
(57% v/s 6 %) had cough, (33 % v/s 3 %) have sputum and (14 % v/s 1 %) havedyspnea (A. RAHMAN, SAEED, & ALI).Differentresearchers performed different studies related to different diseases amongbrick factories workers as mention above. But there is no previous study aboutthyroid function among brick factory workers. Objective:Theobjective of this research is to assess the thyroid function among brickfactory workers and the population expose to the factory smoke.