Clinico-histopathological Assessment of Patients Undergoing Thyroidectomy

Objective: To determine the clinical presentation and histopathological evaluation of patients undergoing thyroidectomies at tertiary care Hospital. Methodology: This cross-sectional study was done at department of general surgery of LUMHS/Jamshoro. Duration of the study was 1 year from October 2017 to September 2018. All the cases with a diagnosis of thyroid disorder and underwent thyroidectomy were selected and above 25 years of the age were included. All the surgeries were carried out by senior surgeons along with the cooperation of the ENT surgeons. After surgeries specimens of all the cases were sent to the diagnostic laboratory for the histological assessment. Data was collected via self-made proforma. Results: Of 58 patients majority i.e. 43.10% were found with age group of 35-44 years. Females found in the majority 63.80%. The swelling was noted among all of the cases, followed by pain, difficulty in swallowing, difficulty in breathing and others 8.62%, 10.34%, 20.68% and 25.68% respectively. Adenomatous goiter was the most common histopathological finding in 82.75% cases, papillary carcinoma was found 8.62%, follicular carcinoma was only in one case and anaplastic carcinoma was also in 1 case. Conclusion: Swelling, difficulty in swallowing and difficulty in breathing were the most common clinical features. Adenomatous goiter was the most common histological finding and papillary carcinoma was the commonest malignancy.

Download Full-text

GOITRE;

The Professional Medical Journal ◽

10.29309/tpmj/2019.26.03.3247 ◽

2019 ◽

Vol 26 (03) ◽

Author(s):

Shahnawaz Leghari ◽

Gulshan Ali Memon ◽

Habib-ur-Rehman Khan Toor

Keyword(s):

Chinese Text ◽

Tertiary Care ◽

Malignant Neoplasm ◽

Follicular Carcinoma ◽

Cross Sectional Study ◽

Anaplastic Carcinoma ◽

Care Hospital ◽

College Hospital ◽

Cross Sectional ◽

Triple Assessment

Background: The entity of goitre is as old as mankind itself and has been recorded historically in Chinese text as back as 2700 B.C. Indeed in context to WHO adage, every thyroid nodule should be considered malignant until proven otherwise, needs triple assessment. The histopathology is very mandatory to have definitive diagnosis. Objectives: of this study was to determine the frequency of malignancy in patients presented with goitre at our institution. Study Design: Descriptive cross sectional study. Period: January 2015 to December 2017. Setting: Department of Surgical Unit 1 People’s Medical College Hospital Nawabshah tertiary care hospital were plotted in this study, through non probability consecutive methods. Material and Methods: 160 patients having goitre underwent for various thyroid surgeries with reported histopathology. Results: In a total of 160 patients, 79.4%, 6.9%, 2.5%, and 11.3% were simple, toxic, inflammatory and malignant neoplasm respectively. Conclusions: Study revealed 11.25% frequency of thyroid malignancy in patient presented with goiters. Among these papillary carcinoma was 8.1%, follicular carcinoma was 1.9% and anaplastic carcinoma was 1.3%.

Download Full-text

Pattern of Primary Thyroid Malignancy in a Tertiary Care Hospital

Journal of Dhaka Medical College ◽

10.3329/jdmc.v27i2.45829 ◽

2020 ◽

Vol 27 (2) ◽

pp. 161-174

Author(s):

Mohammad Asraful Islam ◽

Rashedul Islam ◽

Debnath Talukder ◽

AHM Noor E As Sayeed ◽

SK Nurul Fattah Rumi ◽

...

Keyword(s):

Thyroid Cancer ◽

Papillary Carcinoma ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Follicular Carcinoma ◽

Medullary Carcinoma ◽

Anaplastic Carcinoma ◽

Care Hospital ◽

Thyroid Malignancy ◽

Follicular Variant

Background: Among the endocrine malignancies thyroid cancer is the most common. It constitutes a heterogeneous group of malignancies ranking it as the fifth most common cancer worldwide. On health as well as health system it has severe implication. Thyroid cancer incidence is rising most rapidly worldwide. Different thyroid malignancy requires different management strategy. Proper addressing and prompt management of different thyroid malignancies can lessen the suffering. Objective: The study aimed to evaluate the pattern of primary thyroid malignancy in a tertiary care hospital. Methods: The study was a hospital based descriptive cross sectional study and was conducted in Dhaka Medical College Hospital, Dhaka for one-year period following approval of this protocol. Patients suffering from primary thyroid carcinoma admitted in or attending the outpatient department (OPD) in the department of Otolaryngology and Head-Neck Surgery was approached for inclusion in the study. Written informed consent was taken from the subject and ethical issues were ensured. A total of 50 individual suffering from primary thyroid carcinoma calculated by sample size formula was selected by inclusion and exclusion criteria and data was collected by interview using a semi-structured questionnaire and by personal document analysis. Collected data was analyzed by the SPSS 20 for windows. This study reflects the pattern of primary thyroid malignancy in a tertiary care hospital in Bangladesh. Results: Mean age of the participants was 32.7 years with SD ± 13.8 years, Minimum age was 17 years and maximum age was 70 years. Majority of the patients (46%) were in the age group of 31- 40 years. Among the participants, 70% were female and 30% were male. The majority of the patients belong to Dhaka and Rangpur divisions (26% & 22% respectively) of which maximum patients were from rural area (70%). By occupation, maximum (22%) of the study subjects were businessman, maximum study subjects were below SSC (24%) and maximum patients (42%) had relatively low income per month. Half of the participants had habit of tobacco. All patients (100%) had presented with palpable thyroid swelling. Among the total participants 54% had lymphadenopathy, 10% had dysphagia, 4% had hoarseness of voice and 4% had lumpiness in throat. Only 2% of patients had the symptom of dyspnoea. No palpable lymph nodes were found in 46% followed by Single node lymphadenopathy 26%, multiple nodules in one side in 18%, bilateral lymphadenopathy 8% and 20% participants had Central compartment lymphadenopathy. USG findings of thyroid revealed Single solid nodule in 22.0%, Single cystic nodule in 16.0%, multiple mixed (solid + cystic) nodules in 62.0% cases. FNAC findings revealed Anaplastic carcinoma in 2.0%, Follicular neoplasm in 16.0% and Follicular variant of papillary carcinoma in 8.0%. Papillary carcinoma found in maximum 70.0% cases. No lymphoma found whereas medullary carcinoma found in 4.0% cases. Histopathological findings confirmed Anaplastic carcinoma in 4.0%, Follicular carcinoma in 16.0%, Follicular variant of papillary carcinoma in 8.0% and Papillary carcinoma 68.0% cases. By histopathological examination no lymphoma found whereas medullary carcinoma found in 4.0% cases. Only 24% participants had hypertension and 76% had DM as co-morbid diseases. Distant metastasis of carcinoma was not present in any of the participants. Conclusion: In this study, middle age group and female sex prevalent thyroid cancer. Geographical distribution also has an important role. Business, low educational level, low socioeconomic status and tobacco smoking are found the most important risk factors. Histopathologically papillary carcinoma was predominant followed by follicular carcinoma, follicular variant of papillary carcinoma, anaplastic carcinoma and medullary carcinoma. No lymphoma found. J Dhaka Medical College, Vol. 27, No.2, October, 2018, Page 161-174

Download Full-text

Turn Around Time for Clinical Biochemistry Laboratory: A Vital and Effective Parameter for Patient Care

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/46385.14517 ◽

2021 ◽

Author(s):

Mitul Navinchandra Chhatriwala ◽

Dharmik Savjibhai Patel ◽

Divyal Patel ◽

Hitesh N Shah

Keyword(s):

Clinical Biochemistry ◽

Tertiary Care ◽

Cross Sectional Study ◽

Care Hospital ◽

Sample Collection ◽

Diagnostic Laboratory ◽

Cross Sectional ◽

Entire Interval ◽

Turn Around Time ◽

Analytical Errors

Introduction: Clinical laboratories are judged by its validity, reliability, genuineness or authenticity and its timeliness in reports generating. Repetitively, patients and physicians complain about the time taken by the laboratory for the investigation. The total Turn Around Time (TAT) for laboratory tests includes the entire interval from the order of the test to the awareness of the result by the clinicians. The evaluation and improvement of TAT is crucial for the management of laboratory quality and the satisfaction of patients. Aim: To observe the TAT of common biochemical investigations, to identify reasons for increased TAT and to formulate a plan to rectify increased TAT. Materials and Methods: A hospital based cross-sectional study was conducted at the Clinical Biochemistry Section of the Central Diagnostic Laboratory of Tertiary Care Hospital. TAT data from April 2014 to September 2015 were included in the study. The laboratory technicians and the resident doctors of biochemistry recorded the reasons for the delay of those specimens exceeding the TAT. Data were analysed with the help of statistical software Epi Info 7. Results: The total number of samples received in the biochemistry laboratory were 1,85,658. Out of this, Out Patient Department (OPD) samples were 1,35,022 and Intensive Care Unit (ICU) samples were 50,636. Pre-analytical errors were observed in 670 of ICU samples, which was 1.32% of total samples received and it was higher than the post-analytical errors. In the pre-analytical phase, the most common cause was inaccurate procedures of sample collection. Conclusion: This study demonstrates that the main culprit of increased TAT was delay in the sample transportation and Haemolysed samples. TAT minimisation is a constant procedure for any facility. Every laboratory needs to develop a decent approach for reducing the TAT.

Download Full-text

Prevalence of Thyroid Disorder in Pregnant Women Visiting a Tertiary Care Teaching Hospital: A Descriptive Cross-sectional Study

Journal of Nepal Medical Association ◽

10.31729/jnma.5529 ◽

2020 ◽

Vol 59 (233) ◽

Author(s):

Gita Khakurel ◽

Chandrima Karki ◽

Sanat Chalise

Keyword(s):

Pregnant Women ◽

Teaching Hospital ◽

Tertiary Care ◽

Cross Sectional Study ◽

Thyroid Disorders ◽

Care Hospital ◽

Thyroid Disorder ◽

Sectional Study ◽

Cross Sectional ◽

Management Of Complications

Introduction: The function of the thyroid gland is altered during pregnancy. Thyroid disorders during pregnancy are associated with serious maternal and fetal outcomes. Universal screening for thyroid disorders is recommended in the first trimester of pregnancy. This study aims to determine the prevalence of thyroid disorder during pregnancy in women attending a tertiary care hospital. Methods: A descriptive cross-sectional study was conducted in the Department of Obstetrics and Gynaecology of Kathmandu Medical College and Teaching Hospital from March 2020 to August 2020 after obtaining ethical approval from the Institutional Review committee with reference number 20032020. The pregnant women >18 years of age, irrespective of their gestational age and gravida status, were included in the study by convenience sampling method. The participants were screened by estimation of thyroid function test. Data were collected, and statistical analysis was done in Statistical Packages for Social Services version 20.0. Results: A total of 329 pregnant women were included in this study. The prevalence of thyroid disorders in the present study is 24.62 %. The most common thyroid disorder observed was subclinical hypothyroidism comprising 65 (19.75 %) cases followed by overt hypothyroidism 8 (2.43%) cases. Conclusions: There is a high prevalence of thyroid disorders during pregnancy in our settings. Timely screening of pregnant women helps in the early diagnosis and management of complications related to thyroid disorders.

Download Full-text

Histopathological Spectrum of Non-Neoplastic and Neoplastic Lesions of Thyroid: A Descriptive Cross-sectional Study

Journal of Nepal Medical Association ◽

10.31729/jnma.5038 ◽

2020 ◽

Vol 58 (231) ◽

Author(s):

Dilasma Ghartimagar ◽

Arnab Ghosh ◽

Manish Kiran Shrestha ◽

Sushma Thapa ◽

Om Prakash Talwar

Keyword(s):

Thyroid Gland ◽

Papillary Carcinoma ◽

Follicular Carcinoma ◽

Cross Sectional Study ◽

Anaplastic Carcinoma ◽

Sectional Study ◽

Cross Sectional ◽

Female Ratio ◽

Neoplastic Lesions ◽

Thyroid Lesions

Introduction: Thyroid gland lesions are the most common endocrine disorders encountered globally. Diseases of the thyroid gland present with either an alteration of hormone secretion or as an enlargement of the thyroid gland. The objective of the study is to find the frequency of different thyroid lesions. Methods: A descriptive cross-sectional study was conducted at Manipal Teaching Hospital, Pokhara from Jan 2005 to Jan 2020. Ethical approval was taken from the Institutional Review Committee (Ref: 330). Patients who had undergone thyroidectomy procedures for both non-neoplastic and neoplastic thyroid lesions were enrolled. Convenient sampling was done. IBM Statistical Package for Social Sciences version 21 and Microsoft Excel were used. Results: Out of 345 thyroidectomy specimens, 246 (71.3%) cases of non-neoplastic lesions, and 99 (28.69%) cases of neoplastic lesions were present. There were 54 males and 291 females with a male to female ratio of 1:5.4. The age ranged from 9 to 76 years with a mean age of 43.67 years. In non-neoplastic lesions, the predominant lesion was the colloid goiter with 205 (83.33%) cases followed by Grave’s disease and lymphocytic thyroiditis with 14 (5.69%) cases each. In neoplastic lesions, papillary carcinoma was the commonest lesion with 56 (56.56%) cases followed by follicular carcinoma with 14 (14.14%) cases and follicular adenoma with 13 (13.13%) cases. There were also 9 (9.09%) cases of anaplastic carcinoma in neoplastic lesions. Conclusions: Colloid goiter and papillary carcinoma was the most commonly encountered non-neoplastic and neoplastic lesion with a female predominance. Rare tumors like anaplastic carcinoma, papillary carcinoma, and follicular carcinoma with anaplastic transformation were also encountered.

Download Full-text

Morphological Spectrum of Lesions Seen in Thyroidectomy Specimens At A Tertiary Care Institute

Esculapio ◽

10.51273/esc20.2516314 ◽

2020 ◽

Vol 16 (03, july 2020-Septmber 2020) ◽

Author(s):

Iram Nadeem ◽

Samra Sameen ◽

Sahar Iqbal ◽

Tazeen Anis

Keyword(s):

Papillary Carcinoma ◽

Tertiary Care ◽

Follicular Adenoma ◽

Follicular Carcinoma ◽

Medullary Carcinoma ◽

Anaplastic Carcinoma ◽

Cell Adenoma ◽

Care Institute ◽

Hyalinizing Trabecular Tumor ◽

Neoplastic Lesions

Objective: To determine the morphological spectrum of thyroid lesions encountered in thyroidectomy specimens at a tertiary care institute. Methods: It was a retrospective study conducted in Pathology Department, Allama Iqbal Medical College, Lahore. A retrospective manual collection of data was done from record registers, for the years 2012 & 2013. Results: A total of 307 cases were retrieved with age range of 16-70 years. Amongst them, 47 were males and 260 were females. Non neoplastic conditions outnumbered the neoplastic lesions as 229(75%) cases were of colloid goiter. Hashimoto thyroiditis was present in 12(3.9%) specimens and associated hyperplastic changes were seen in 15(4.9%) cases. There were 19(6.2%) cases of papillary carcinoma, 3(0.9%) cases of follicular carcinoma, 3(0.9%) cases of medullary carcinoma, 1(0.3 %) case of insular carcinoma and 2(0.6%) anaplastic carcinoma. Papillary microcarcinoma was seen in 4(1.3 %) cases and medullary microcarcinoma in 1(0.3%) case. Follicular adenoma comprised 29(9.4%) cases and Hurthle cell adenoma 3(0.9%) cases. Study data also showed 1(0.3%) rare case of hyalinizing trabecular tumor. Conclusion: Non neoplastic thyroid diseases are more common as compared to neoplastic lesions. Papillary carcinoma is most common thyroid malignancy encountered in our setting. Key Words: Thyroidectomy, Colloid goiter, papillary carcinoma

Download Full-text

A study of prevalence of thyroid disorders in type 2 diabetic patients in tertiary care hospital

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20184240 ◽

2018 ◽

Vol 5 (6) ◽

pp. 1383

Author(s):

K. Sankar Reddy ◽

E. Pragnanjali ◽

M. Dorsanamma ◽

M. V. Nagabushana

Keyword(s):

Subclinical Hypothyroidism ◽

Tertiary Care ◽

Diabetic Patients ◽

Thyroid Disorders ◽

Care Hospital ◽

Thyroid Disorder ◽

Type 2 Diabetic Patients ◽

Cross Sectional ◽

Duration Of Diabetes ◽

Low T3

Background: Insulin and thyroid being intimately involved in cellular metabolism, excess or deficit of one of these hormones leads to abnormality of the other. Association between type 1diabetes and hypothyroidism may be autoimmune. Association of poorly controlled diabetes and thyroid results in a low T3 state and loss of TSH response to TRH. The objective of the present endeavor is to study the thyroid functions in diabetics and to know the spectrum of thyroid dysfunction in DM.Methods: It is a prospective cross-sectional study of 100 diabetic patients admitted in medical wards in a duration of 6 months from November 2017 to May 2018 of both sexes in between age group of 30-80years. All these patients underwent thyroid profile tests. Detailed history and examination done on these patients.Results: Out of total 100 patients included in the study, thyroid disorder was present in 29%. Hypothyroidism in 1 patient, sub clinical hypothyroidism in 15 patients, hyperthyroidism was present in 13 patients. Females (36%) had high incidence than males (22%). Elderly people had higher incidence of subclinical hypothyroidism (18.2%), clinical features of hyperthyroidism present in 8 patients, Poor hypoglycemic control seen in hyperthyroid individuals (55.5%). Duration of diabetes had no relation with incidence of thyroid disorders.Conclusions: Prevalence of thyroid disorders in diabetic patients was 29%. Elderly population had more incidence. Subclinical hypothyroidism more common than other conditions. It was more common in females than in males. There is no relation in between duration of diabetes and thyroid disorder. Severe complications were noted in patients with sub clinical hypothyroidism.

Download Full-text