TO EVALUATE ROLE OF MORPHOLOGICAL CRITERIA ON USG AND ELASTOGRAPHY IN DIFFERENTIATING BENIGN AND MALIGNANT THYROID LESION

2021 ◽  
pp. 40-42
Author(s):  
Ashok Kumar Verma ◽  
Rakesh Kumar Verma ◽  
Rashmi Rashmi ◽  
Neha Kumari
Keyword(s):  
Gold Standard ◽  
Prospective Observational Study ◽  
Thyroid Nodules ◽  
Nodular Goiter ◽  
Thyroid Lesion ◽  
Diagnostic Reliability ◽  
Medical College ◽  
Morphological Criteria ◽  
Autopsy Data

Introduction: Thyroid nodules are common and are commonly benign. The reported prevalence of nodular thyroid disease depends on the population studied and the methods used to detect nodules. Numerous studies suggest a prevalence of 2-6% with palpation, 19-35% with ultrasound, and 8-65% in autopsy data. Aims and objectives: To evaluate diagnostic reliability of ultrasound morphological criteria (ACR-TIRADS system) and elastographyin differentiating benign from malignant thyroid nodules in patients using cytopathology or histopathology as gold standard. Materials and methods: Prospective observational study, Patients visiting LLR (Hallet) Hospital with clinically suspicious thyroid nodule, LLR (Hallet) Hospital, GSVM Medical College, Jan 2019 to Oct 2020. Result: Showing distribution of composition of nodules in our study subjects Maximum nodules have mixed solid cystic composition . Showing distribution of echogenicity of nodules in our study subjects. Maximum nodules in our study have to hyperechoic echogenicity. Showing distribution of margin of nodules in our study subjects. Maximum nodules in our study have ill dened margin. Conclusion: In conclusion, no single investigation was found to be 100% sensitive or specic in diagnosing malignancy in nodular goiter but a good clinical, FNAC and USG examinations are complimentary to each other in predicting malignancy and avoid unnecessary or inadequate surgery.

scholarly journals Role of oral inositol supplementation in women with polycystic ovarian syndrome

2021 ◽  
Vol 10 (12) ◽  
pp. 4493
Author(s):  
Najma Malik ◽  
Navneet Dubey
Keyword(s):  
Insulin Resistance ◽  
Prospective Observational Study ◽  
Oocyte Quality ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Medical College ◽  
Good Medicine ◽  
Ovarian Syndrome ◽  
Rotterdam Criteria

Background: PCOS is one of the most common endocrine disorder in women of reproductive age, it affects about 5-10% of women of reproductive age. It is characterized by chronic anovulation, hyperandrogenism, and insulin resistance. 30-40% of PCOS women have impaired glucose tolerance.Methods: This was prospective observational study carried out on 100 patients of PCOS visiting outpatient Department of Obstetrics and Gynecology, BRD Medical College, Gorakhpur from 1st July 2018 to 30th June 2019. Patients were diagnosed as PCOS on basis of Rotterdam criteria. In these 100 patients, oral inositol 2 gm twice daily was given for 3 months to 6 months depending upon the response of the patient and patients were examined every 4 week for menstrual regularity, acne improvement, hirsutism, spontaneous ovulation and pregnancy.Results: With inositol supplementation, menstrual abnormality corrected in 80% cases, 45% cases having acne improved. Ovulation occurred in 75.5% cases and 66.6% cases conceived with inositol supplementation.Conclusions: Insulin resistance is the basic pathophysiology for PCOS hence inositol supplementation is supposed to be very good medicine for management of PCOS to improve insulin sensitivity. Inositol leads to improvement in regularity of menstrual cycle, insulin resistance, hyperandrogenic features like hirsutism, acne, restores ovulation and improves oocyte quality.

scholarly journals MULTINODULAR GOITER;

2013 ◽  
Vol 20 (06) ◽  
pp. 1035-1041
Author(s):  
ZULFIQAR ALI BHATTI, ◽  
JAVED AHMED PHULPOTO, ◽  
NOOR AHMED SHAIKH,
Keyword(s):  
Multinodular Goiter ◽  
Prospective Observational Study ◽  
Thyroid Nodules ◽  
Significant Risk ◽  
Nodular Goiter ◽  
University Hospital ◽  
Risk Of Malignancy ◽  
The Common ◽  
Thyroid Profile ◽  
Surgical Unit

Objective: The object of this study was to determine the frequency and type of thyroid carcinoma in Multi nodular goiter(MNG) after surgical resection on histopathological basis. Introduction: Multi nodular goiter (MNG) is one of the common presentationsof various thyroid diseases. Thyroid nodules have been reported to be found in 4% to 7% of the population on neck palpation. Although incomparison to solitary nodule, the risk of malignancy in MNG is low but certain studies are showing significant risk. Material andmethods: This prospective, observational study was carried out in the surgical unit I of Ghulam Mohammad Mahar Medical collegehospital sukkur from 2007 to 2012. 94 cases with clinical diagnosis of MNG were analyzed during this period. All the patients wereadmitted through opd with routine investigations plus investigations specific to thyroid including thyroid profile, thyroid scan, FNAC ofdominant nodule before being subjected to surgery. All FNACs were carried out at agha khan university hospital Karachi. Histopathologyof operated specimen was the main criteria for malignancy. Results: Among the 94 cases which were included in this study, 9 (9.5%)cases containing foci of malignancy. Incidence of malignancy commonly occurs in females, papillary carcinoma is being the commonestentity. Conclusions: The incidence of malignancy in MNG in this study is 9.5% that is quite high. So people should be educated andencouraged to attend the thyroid clinics for proper evaluation and early diagnosis of Malignancy.

scholarly journals Role of ACR-TIRADS in risk stratification of thyroid nodules

2019 ◽  
Vol 7 (4) ◽  
pp. 1039
Author(s):  
Jayashree Mohanty ◽  
Sanket . ◽  
Pooja Mishra
Keyword(s):  
Classification System ◽  
Thyroid Nodules ◽  
Needle Aspiration ◽  
P Value ◽  
Diagnostic Reliability ◽  
Increasing Trend ◽  
Risk Of Malignancy ◽  
Echogenic Foci ◽  
Ultrasound Features

Background: This study was performed to prospectively investigate the diagnostic reliability of the daily use of ACR-TIRADS classification system, in differentiating between a benign and a malignant lesion.Methods: In this prospective observational study, 50 patients with thyroid nodules underwent ultrasound examination and fine needle aspiration. The ultrasound studies were evaluated according to the ACR-TIRADS greyscale characteristics of composition, echogenicity, margins, shape, and echogenic foci. Each feature in a particular USG characteristic was scored and ACR-TIRADS categorization done from 1 to 5. This was compared to FNAC/histopathology findings and risk of malignancy was calculated for each feature and ACR-TIRADS category.Results: Of the 50 nodules included in the study, 38 were found to be benign and 12 were found to be malignant. Risk of malignancy for all ultrasound features showed an increasing trend with higher scored feature. Risk of malignancy for various features were as follows: Composition-cystic (0%), spongiform (0%), solid-cystic (0%) and solid (36%); echogenicity-anechoic(0%), hyperechoic (4%), isoechoic (11%), hypoechoic (47%) and markedly hypoechoic (100%); shape-wider-than-tall (21%) and taller-than-wide (66%); margins-smooth (18%), illdefined (0%), lobulated/irregular (38%) and extrathyroid extension (100%); echogenic foci-none (13%), large comet-tail artefacts (0%), macrocalcification (42%), rim calcification (50%) and punctate echogenic foci (50%). Amongst ACR-TIRADS(TR) categories TR1, TR2 and TR3 had 0% risk while TR4 had 30% and TR5 had 56% risk of malignancy with p value of 0.001.Conclusions: ACR-TIRADS is a high specific, accurate classification system for categorizing the thyroid nodules based on ultrasound features, for assessing the risk of malignancy.

scholarly journals The role of fine-needle aspiration biopsy and post-operative histology in the evaluation of thyroid nodules

2021 ◽  
Vol 17 (4) ◽  
pp. 315-321
Author(s):  
E. Xhardo ◽  
D. Xhemalaj ◽  
F. Agaçi ◽  
P. Kapisyzi
Keyword(s):  
Fine Needle Aspiration ◽  
Diagnostic Tool ◽  
Gold Standard ◽  
Thyroid Nodules ◽  
Fine Needle Aspiration Biopsy ◽  
Needle Aspiration ◽  
Aspiration Biopsy ◽  
Fine Needle ◽  
Needle Aspiration Biopsy

Thyroid nodules present a serious problem, and mostly they do not carry neoplastic characteristics. Thus, they do not need to be surgically treated. The risk of malignancy varies from 5 to 15 %. Steps to diagnose malignancy should include a careful clinical evaluation, laboratory tests, a thyroid ultrasound exam and a fine-needle aspiration biopsy. Fine-needle aspiration biopsy (FNAB) is the most important diagnostic tool in the assessment of thyroid nodules. Today it is considered the gold standard for malignancy diagnosis in thyroid cancer. In this review we evaluate the role of FNAB and post-operative cytology in the evaluation of thyroid nodules. FNA results are classified as diagnostic (satisfactory) or nondiagnostic (unsatisfactory). Unsatisfactory smears (5–10 %) result from hypocellular specimens usually caused by cystic fluid, bloody smears, or suboptimal preparation. Diagnostic smears are conventionally subclassified into benign, indeterminate, or malignant categories. Benign cytology (60–70 %) is negative for malignancy, and includes cysts, colloid nodule, or Hashimoto thyroiditis. Malignant cytology (5 %) is almost always positive for malignancy, and includes primary thyroid tumors or nonthyroid metastatic cancers. Indeterminate or suspicious specimens (10–20 %) include atypical changes, Hurthle cells or follicular neoplasms. The new Bethesda Cytologic Classification has a 6-category classification, subdividing indeterminate further by risk factors. Considering the increasing worldwide incidence of thyroid microadenomas, recently it is recommended to undergo FNAB under ultrasound guidance even in small (< 1cm) nodules if they are correlated with suspicious ultrasonographic features or suspicious neck lymph nodes. FNAB is a cheap and reliable diagnostic tool that can be used in the selection candidates for surgery and pre-operative diagnosis of thyroid carcinomas. It was concluded that FNAB is the gold standard in the evaluation of thyroid nodules and can prevent many unnecessary surgeries. False-negative FNA cytology remains a concern for clinicians treating patients with thyroid nodules. Post-operative histology give the definitive diagnosis and studies confirm that it has a significant discordance between pre-operative cytology and post-operative histology in patients with thyroid nodule. Cytopathologists should strengthen their criteria for the identification of adenomatous hyperplasia, thyroiditis, cystic lesions or suspicious thyroid nodules to avoid misdiagnoses.

scholarly journals Role of hysterolaparoscopy in evaluation and management of infertility

2021 ◽  
Vol 10 (9) ◽  
pp. 3413
Author(s):  
Urmila Karya ◽  
Neha Singh ◽  
Komal Rastogi
Keyword(s):  
Observational Study ◽  
Prospective Observational Study ◽  
Endometrial Polyp ◽  
Male Factor ◽  
Secondary Infertility ◽  
Medical College ◽  
Hormone Profile ◽  
Obstetrics And Gynaecology ◽  
Tubal Pathology

Background: This study was conducted to evaluate the role of hysteron-laparoscopy in evaluation and management of infertility.Methods: Prospective observational study was conducted in department of obstetrics and gynaecology, LLRM medical college, SVBP hospital Meerut from May 2019 to June 2020. It included 58 women aged 22-40 years with primary and secondary infertility with normal hormone profile without male factor infertility.Results: Out of total 58 cases for infertility evaluated, primary infertility were 42 (72.41%) and secondary infertility were 67 (27.59%). In hysteroscopy deep seated ostium (12.06%), followed by endometrial polyp (6.89%) ,intrauterine synechiae (6.89%) were the most common pathologies while common abnormalities in laparoscopy were tubal pathology (20.68%), endometriosis (15.51%), and PCOD (12.06%) .Some of the diagnosed pathologies were dealt surgically in same sitting.Conclusions: Hystero-laparoscopy is a feasible and acceptable procedure and it can be used as “one time approach” in the assessment of female infertility caused due to pelvic and uterine pathology. It helps in diagnosis of certain factors causing infertility, which cannot be diagnosed by any other method such as by USG, HSG and reveals whether surgery is possible and if so the nature of surgery most suited for patient which can be performed in the same sitting.

scholarly journals Role of diagnostic hysteroscopy in evaluation of postmenopausal bleeding

2019 ◽  
Vol 8 (11) ◽  
pp. 4182
Author(s):  
Nisha Solanki ◽  
Prashant Suryarao ◽  
Aditi Bhatnagar
Keyword(s):  
Predictive Value ◽  
Gold Standard ◽  
Abnormal Uterine Bleeding ◽  
Transvaginal Sonography ◽  
Postmenopausal Bleeding ◽  
Medical College ◽  
Diagnostic Hysteroscopy ◽  
Sensitivity Specificity ◽  
Follicular Activity

Background: Postmenopausal bleeding is defined as permanent cessation of menstruation resulting from the loss of ovarian follicular activity. Incidence of abnormal uterine bleeding is 10% to 15% in postmenopausal bleeding. For evaluation of postmenopausal bleeding earlier dilatation and curettage was considered as gold standard which is a blind procedure, transvaginal sonography has improved the accuracy of endometrial morphology. Now the focus has shifted to hysteroscopic guided biopsy which is gold standard for evaluating postmenopausal bleeding it also has benefit of see and treat modality. The objective of this study was to study the significance of hysteroscopy in diagnosis of etiopathological factors of postmenopausal bleeding. To correlate the diagnosis by TVS, hysteroscopy and histopathological diagnosis.Methods: The study was conducted at Dr. D. Y. Patil Medical College and Hospital from June 2016 to September 2018. A total of 30 cases were evaluated. The commencement of the study was followed by approval of the institutional ethical committee.Results: In our study, 83.34% of patients with postmenopausal bleeding where in age group menopause is >55 years. 66.67% are overweight with BMI of 25-29.9. We evaluated the ET <4 mm, 4-12 mm, >12 mm thickness, 53.33% were between 4-12 mm of ET. In our study endometrial hyperplasia shows 30% in hysteroscopy, on HPE shows 33.33%, in atrophic endometrium 20% on HPE is also 20%, polyp shows 6.67% in both hysteroscopy and HPE, sub mucous myoma on both hysteroscopy and HPE shows 3.33% and Ca endometrium shows 3.33% in both hysteroscopy and HPE.Conclusions: Study of total 30 cases were conducted, by using Bettochi Office hysteroscope (2.9 mm). Sensitivity, specificity, positive predictive value and negative predictive value of hysteroscopy was calculated in each group of patients.

scholarly journals SERIAL CRP EVALUATION FOR THE DIAGNOSIS OF NEONATAL SEPSIS: A PROSPECTIVE OBSERVATIONAL STUDY.

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Ved Prakash Gupta ◽  
Rizwan Haider ◽  
Binit Singh
Keyword(s):  
Birth Weight ◽  
Observational Study ◽  
Neonatal Sepsis ◽  
Prospective Observational Study ◽  
Clinical Presentation ◽  
Medical College ◽  
Study Population ◽  
Turbidimetric Immunoassay ◽  
Rule Out

Aim: to evaluate the role of serial CRP evaluation in the diagnosis of neonatal sepsis. Materials and Methods: The present prospective observational study was conducted in the Department of Pediatrics, Darbhanga Medical College and Hospital, Bihar for the period of 1 year.  A total of 97 neonates suspected of sepsis having birth-weight >1,500 g constituted the study population. CRP was measured from the serum by quantitative turbidimetric immunoassay. The CRP 1 level was measured at the time of clinical presentation; CRP 2 and CRP 3 were measured at 24 and 48 hours respectively. Results: In the present study out of total 97 subjects, there were 59 (60.8%) males and 38 (39.2%) females. CRP was found positive in 60 cases. In the present study, lethargy (100%), decreased activity (100%), poor feeding (94.7%), poor cry (94.7%), tachypnea (89.5%), hypotonia (47.4%), hypothermia (31.6%), convulsion (26.5%), prolonged CFT (21.1%) and fever (10.5%) were the various symptoms observed. Conclusion: Serial CRP measurements are useful in the diagnosis of neonatal sepsis. CRP 3 level may virtually rule out or rule in the diagnosis of neonatal sepsis, and has very good correlation with blood culture. Keywords: CRP, Sepsis, Neonates

scholarly journals Role of intranasal fluticasone furoate spray in modifying quality of life of children with adenoid hypertrophy

2020 ◽  
Vol 24 (1) ◽  
pp. 22-28
Author(s):  
Md Mazharul Islam ◽  
AKM Rezaul Karim ◽  
Md Ahsanul Habib ◽  
Nafisa Zaman ◽  
Md Tanvir Hasan
Keyword(s):  
Nasal Spray ◽  
Prospective Observational Study ◽  
Clinical Symptoms ◽  
Adenoid Hypertrophy ◽  
Fluticasone Furoate ◽  
College Hospital ◽  
Medical College ◽  
Pediatric Age Group

Introduction: Symptoms of adenoid hypertrophy is commonly seen among the pediatric age group. Since the surgical approach for this on immunity is controversial, the study was planned out to appraise the outcome of intranasal Fluticasone Furoate spray use. Objective:To find out the efficacy of Fluticasone Furoate nasal spray in reducing clinical symptoms due to enlarged adenoid. Methods: The prospective observational study was conducted in the Rangpur Medical College Hospital between April 2017 to August 2017 among 64 patients aged 4-15 years. Improvement on clinical symptoms was assessed by the structured OSA-18 questionnaire. Results: At the end of 4 weeks, statistically significant improvement (p < 0.001) was observed in nearly all the domains of among the 64 participants. The average total score showed improvement from 60.95 to 46.37. Conclusion:The use of fluticasone furoate nasal spray considered to be useful in reducing clinical symptoms of adenoid hypertrophy among children. Bangladesh J Otorhinolaryngol; April 2018; 24(1): 22-28

scholarly journals The role of formative objective structured clinical examinations on students’ performance in clinical years

2021 ◽  
Vol 9 (8) ◽  
pp. 2231
Author(s):  
Misbah Riaz ◽  
Fazal Hussain ◽  
Mah Muneer Khan
Keyword(s):  
Medical Students ◽  
Gold Standard ◽  
Medical Curriculum ◽  
Medical Assessment ◽  
Chi Square ◽  
Medical College ◽  
Chi Square Test ◽  
Objective Structured Clinical Examinations ◽  
The Subject

Background: Objective structured clinical examinations are the gold standard of modern medical assessment for students. The aim of our study was to determine the effect of formative OSCEs on students’ performance in summative OSCEs in final year medical exams.Methods: This observational study was conducted at surgical B Unit, MTI, Khyber teaching hospital, Peshawar from January to December 2019. A total of 297 consecutive students of final year MBBS, studying in Khyber medical college were included in the study. Students who had repeated the year were excluded. Examination scores of formative OSCEs taken in the ward and the subsequent summative OSCEs taken in the subject of surgery were analyzed to determine the effect on summative OSCE performance. Data was analyzed using SPSS 23. Chi square test was used and p>0.05 was taken as statistically significant.Results: Out of 297 students, 188 (63.3%) were males and 109 (36.7%) were females. Of these, 243 (81.8%) students appeared in the formative OSCEs whereas 54 (18.2%) students did not appear in the formative OSCEs. The result of the subsequent summative OSCEs showed that those students who appeared in formative OSCEs showed a better performance in summative OSCEs (p<0.001) with majority of students (53.5%) having scores above 80%.Conclusions: Formative OSCEs enhance students’ performance in summative OSCEs. Repetitive formative OSCE sessions along with regular feedback should be incorporated in the medical curriculum for better performance of medical students in their final year undergraduate exams.  

ROLE OF LIPID PROFILE IN OVARIAN CARCINOMA PATIENTS

2019 ◽  
Vol 3 (8) ◽  
Author(s):  
Dr. Manisha ◽  
Dr. Ruchi Jindal
Keyword(s):  
Ovarian Cancer ◽  
Lipid Profile ◽  
Cancer Patients ◽  
Ovarian Tumor ◽  
Ovarian Cancer Risk ◽  
Low Level ◽  
Medical College ◽  
Group I ◽  
History Of

Background: The term "ovarian cancer" includes several different types of cancer that  arise from cells of the ovary, most commonly, tumors arise from the epithelium or lining cells of the ovary.  Ovarian cancer risk is positively associated with higher consumption of dietary cholesterol and eggs, and inversely associated with a higher intake of vegetables. High consumption of fats may increase circulating estrogen levels, thus increasing the possibility of cell damage and proliferation that is responsible for cancerous growth. Material & Methods: The present study was conducted at Geetanjali Medical College and Hospital, Udaipur (Rajasthan). Total  100 cases (females) attending the obstetrics and gynecology department for some gynecological and other problem  were selected for this study between the age of 40-60 years, who were attending cancer centre at GEETANJALI MEDICAL COLLEGE AND  HOSPITAL, Udaipur (Rajasthan).                GROUP I: - It consisted of healthy females control subjects (n=50) .By routine examination and tests, we ensured that all the subjects were healthy and there were no signs and symptoms or history of ovarian tumor and diseases GROUP II: - It consisted of ovarian cancer females subjects (n=50) with a history of ovarian tumor. Results:   Higher level of cholesterol, LDL, VLDL and low level of HDL are found in ovarian cancer patients. Conclusion: The present study we highlights the importance and role of serum lipid profile in diagnosis, prognosis and recurrence of the disease. The study shows that serum level of cholesterol, LDL, VLDL was elevated in  patients of ovarian cancer while low level of HDL are found in ovarian cancer patients. Key words: lipid profile, ovarian cancer.

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