Cytodiagnosis of anaplastic thyroid carcinoma with osteoclast-like giant cells − A case report with a review of the literature

xlomafota13 shared this article with you from Inoreader Cytodiagnosis of anaplastic thyroid carcinoma with osteoclast-like giant cells − A case report with a review of the literature Via Thyroid Res Pract Padmanaban Krishnan Govindaraman, Selvaraj Balakumar, Anthuvan Jeyarani Lawrence Thyroid Research and Practice 2021 18(1):40-44 Anaplastic thyroid carcinoma (ATC) accounts for 5%–10% of primary thyroid malignancies. Cytodiagnosis of osteoclast-like giant cells (OLGCs) variant of ATC is very rare with only few cases reported in literature. We report a case of ATC with OLGC variant in an 85-year-old female who presented with swelling in the right lobe of thyroid and scalp nodule, which on radiological evaluation and subsequent fine-needle aspiration biopsy (FNAB) was diagnosed as ATC having numerous OLGC with metastases in skull bones. Cytologically, thyroid aspirate revealed sheets of epithelioid neoplastic cells admixed with many OLGC. Aspirate from the scalp nodule showed neoplastic cells with follicular differentiation. She also had radiological evidence of lung metastasis. Such a presentation of this rare variant being diagnosed by FNAB is rarely reported in literature and highlights the importance of this simple procedure in diagnosing and planning management of this rare condition. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Thyroid disorders in arsenic prevalent area

xlomafota13 shared this article with you from Inoreader Thyroid disorders in arsenic prevalent area in Bangladesh Via Thyroid Res Pract Mohammad Moin Shahid, Khadiza Begum, Kaniz Rahman, Hosnea Ara, Sharmin Ferdousi, Richmond Ronald Gomes Thyroid Research and Practice 2021 18(1):19-22 Background and Objectives: Due to geographical position and geological nature, Bangladesh (BD) has been the worst affected country in the world by arsenic contamination. The aim of this study was to highlight the association of chronic arsenic intoxication with thyroid disorders (TDs). Materials and Methods: This cross-sectional study was conducted from March 2019 to February 2020 at Ad-din Women's Medical College and Hospital. One thousand one hundred and thirty-seven patients were randomly selected, who visited the outpatient departments of medicine faculty with thyroid-stimulating hormone test report. Rest of the thyroid function tests were done if required. Considering the arsenic level in irrigation and drinking water, 64 districts of BD were divided into two regions "arsenic prevalent area" and "less arsenic prevalent area" and patients hailing from those areas were divided as Group 1 and Group 2, respectively. All patients were subjected to history taking and physical examination. Chi-square test and one-way ANOVA test were used to compare the variables. Results: Prevalence of TD were significantly higher in Group 1 (60.14%; P = 0.001) and so was the prevalence of goiter (19%;P = 0.021). Older (31.17 ± 9.81;P = 0.001) and female patients (94.92%;P = 0.001) were more prone to develop TD. Conclusion: It will require more studies at larger scale for better understanding of the association of thyroid disorders with chronic arsenic intoxication. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A case of acute liver injury induced by methimazole

xlomafota13 shared this article with you from Inoreader A case of acute liver injury induced by methimazole Via Thyroid Res Pract Karthika Niveditha, Arun S Menon, Harish Kumar, Malini Eapen, Rajesh Gopalakrishna Thyroid Research and Practice 2021 18(1):34-36 Antithyroid drugs, methimazole, and propylthiouracil have been reported to cause hepatotoxicity. We report the case of a patient with methimazole induced liver injury who presented within a few weeks of commencement of the drug. She presented with a cholestatic picture and responded well to discontinuation of the drug and administration of steroids. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Long-term hypocalcemia prediction post thyroidectomy

xlomafota13 shared this article with you from Inoreader Long-term hypocalcemia prediction post thyroidectomy Via Thyroid Res Pract Deepak Janardhan, Sandeep Suresh, PG Balagopal, Nebu Abraham George, KM Jagathnath Krishna Thyroid Research and Practice 2021 18(1):14-18 Introduction: Hypocalcemia is a common sequela of total thyroidectomy and is usually transient (30%), only a few develop permanent hypoparathyroidism. Till date, no effective risk stratification score to predict hypocalcemia is available that can predict postoperative hypocalcemia. Materials and Methods: This was a prospective observational study including all patients who underwent total or completion thyroidectomy with initial parathormone (PTH) within the normal range in our institution during a 1 year period. Postoperative 6th h PTH fall was noted in all patients and cutoff point for the prediction of long-term hypocalcemia (LTHP) was determined using a paired t-test. Results: Postoperatively, calcium supplementation was initiated in 52% of patients. In 7.6% of patients who had a fall in PTH to more than 80% of preoperative value, calcium supplementation could not be tapered even after 3 months postoperatively. About 66% of patients <20 years of age developed hypocalcemia in the postoperative period. Patients who developed delayed hypocalcemia with initial normal calcium levels had fall in PTH of at least 45%. For individuals below 20 years, a PTH fall of 56% or more required calcium supplementation. The various variables studied failed to attain statistical significance. Conclusions: More than 82% fall in 6th h postoperative PTH predicts long-term hypocalcemia. Post total thyroidectomy, adolescent individuals are at a higher risk of developing hypocalcemia; hence, early calcium supplementation is recommended based on fall in PTH. Weighted score to predict LTHP could not be developed, as none of the risk factors evaluated were statistically significant. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Long-term hypocalcemia prediction post thyroidectomy

xlomafota13 shared this article with you from Inoreader Long-term hypocalcemia prediction post thyroidectomy Via Thyroid Res Pract Deepak Janardhan, Sandeep Suresh, PG Balagopal, Nebu Abraham George, KM Jagathnath Krishna Thyroid Research and Practice 2021 18(1):14-18 Introduction: Hypocalcemia is a common sequela of total thyroidectomy and is usually transient (30%), only a few develop permanent hypoparathyroidism. Till date, no effective risk stratification score to predict hypocalcemia is available that can predict postoperative hypocalcemia. Materials and Methods: This was a prospective observational study including all patients who underwent total or completion thyroidectomy with initial parathormone (PTH) within the normal range in our institution during a 1 year period. Postoperative 6th h PTH fall was noted in all patients and cutoff point for the prediction of long-term hypocalcemia (LTHP) was determined using a paired t-test. Results: Postoperatively, calcium supplementation was initiated in 52% of patients. In 7.6% of patients who had a fall in PTH to more than 80% of preoperative value, calcium supplementation could not be tapered even after 3 months postoperatively. About 66% of patients <20 years of age developed hypocalcemia in the postoperative period. Patients who developed delayed hypocalcemia with initial normal calcium levels had fall in PTH of at least 45%. For individuals below 20 years, a PTH fall of 56% or more required calcium supplementation. The various variables studied failed to attain statistical significance. Conclusions: More than 82% fall in 6th h postoperative PTH predicts long-term hypocalcemia. Post total thyroidectomy, adolescent individuals are at a higher risk of developing hypocalcemia; hence, early calcium supplementation is recommended based on fall in PTH. Weighted score to predict LTHP could not be developed, as none of the risk factors evaluated were statistically significant. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Acute suppurative thyroiditis: An unusual complication

xlomafota13 shared this article with you from Inoreader Acute suppurative thyroiditis: An unusual complication Via Thyroid Res Pract Dipratim Das, Partha Chakraborty, Madhurima Ganguly, Pankaj Kumar Halder Thyroid Research and Practice 2021 18(1):37-39 Acute thyroiditis is rare and usually subsides with medical therapy. An abscess arising due to it is even rarer. Sometimes, surgical drainage is required to control ongoing infection and sepsis. We report a case of a 4-year-old girl who had acute suppurative thyroiditis. The swelling was not resolving after 9 days of administering intravenous antibiotics and eventually compressing the esophagus and trachea which was relieved leading to a speedy recovery on emergency surgical drainage. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Effect of metformin therapy on thyroid-stimulating hormone levels in women with polycystic ovarian syndrome

xlomafota13 shared this article with you from Inoreader Effect of metformin therapy on thyroid-stimulating hormone levels in women with polycystic ovarian syndrome Via Thyroid Res Pract Vinay Dhanpal, Mala Dharmalingam, Pramila Kalra Thyroid Research and Practice 2021 18(1):6-10 Introduction: Metformin has been shown to decrease thyroid-stimulating hormone (TSH) levels without effect on total T4 and total T3 levels, especially in patients with underlying thyroid dysfunction. The Aim of the Study: To evaluate the effect of metformin therapy on TSH levels in polycystic ovarian syndrome (PCOS) patients who were euthyroid with or without treatment. Design of the Study Nonrandomized prospective intervention trial. Materials and Methods: The study included all euthyroid PCOS patients of the reproductive age group diagnosed according to the modified Rotterdam criteria and the patients were divided into two groups. The first group was put on lifestyle modification alone (Group-I), whereas the second group was put on lifestyle modification and metformin therapy (Group-II). In both groups of patients, TSH, total T4, and total T3 levels were done at baseline and after 3 months of follow-up. Results: A total of 105 patients with PCOS were nonrandomly assigned to Group I (n = 53) and Group II (n = 52). The baseline parameters (age, body mass index, TSH, and Homeostatic Model Assessment for Insulin Resistance) were similar. Thirty-six patients in Group I and 39 in Group II were followed up for 3 months. The change in TSH levels in both groups was not significant at follow-up (Group I [2.56 ± 0.87 vs. 3.01 ± 1.54; P = 0.102] and Group II [2.90 ± 0.81 vs. 2.76 ± 1.26;P = 0.503]). In a subgroup analysis in patients who had thyroid dysfunction, there was a significant decrease in TSH levels in Group II (3.10 ± 0.54 vs. 2.57 ± 0.50;P = 0.031). Conclusion: Metformin significantly decreased TSH levels in women with PCOS with underlying thyroid dysfunction, while it did not show any effect on women without underlying thyroid dysfunction. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Primary hypothyroidism on follow-up in a cohort of Indian patients with subacute thyroiditis

xlomafota13 shared this article with you from Inoreader Primary hypothyroidism on follow-up in a cohort of Indian patients with subacute thyroiditis Via Thyroid Res Pract Pramila Kalra, KM Prasanna Kumar Thyroid Research and Practice 2021 18(1):1-5 Objectives: Subacute thyroiditis (SAT) is a temporary dysfunction of the thyroid gland and is commonly due to its viral infection. Permanent hypothyroidism after recovery from SAT has been reported in various studies. Methodology: This was a prospective study conducted in two tertiary care centers in South India to follow-up these cases for the development of permanent primary hypothyroidism at 1-year follow-up after recovery from SAT. Results: The total number of cases followed up was 146, including 103 females (70.5%) and 43 males (29.5%). Females' mean age was 33.03 ± 11.7 years, and males' mean age was 40.17 ± 11.84 years. Seven patients reported the second attack of thyroiditis. The mean thyroid-stimulating hormone (TSH) recorded at baseline was 0.042 ± 0.056 µIU/ml. Permanent hypothyroidism was seen in 19.86% of the cases at a 1-year follow-up and was found to be higher in patients with lower TSH at baseline. The females and males were affected at a younger age as compared to other studies. The incidence of permanent hypothyroidism was found to be higher as compared to some but lesser compared to a few others. The iodine supplementation could also be one of the postulates for this higher incidence of hypothyroidism. The severity of thyrotoxicosis was a significant determinant of the future development of hypothyroidism. Conclusions: The patients with SAT need to be followed up for the development of permanent hypothyroidism. The prevalence of hypothyroidism at 1 year was 19.86% after an attack of thyroiditis. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Treatment approach to isolated common peroneal nerve palsy by mechanism of injury: Systematic review and meta-analysis of individual participants' data

xlomafota13 shared this article with you from Inoreader Treatment approach to isolated common peroneal nerve palsy by mechanism of injury: Systematic review and meta-analysis of individual participants' data Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Oct 30:S1748-6815(21)00483-6. doi: 10.1016/j.bjps.2021.09.040. Online ahead of print. ABSTRACT BACKGROUND: We reviewed the individual participant data of patients who sustained isolated common peroneal nerve (CPN) injuries resulting in foot drop. Functional results were compared between eight interventions for CPN palsies to determine step-wise treatment approaches for the underlying mechanisms of nerve injury. METHODS: PubMed, Embase, Cochrane Library, Web of Science, Scopus, and CINAHL databases were searched. PRISMA-IPD and Cochrane guidelines were followed in the data search. Eligible patients sustained isolated CPN injuries resulting in their foot drop. Patients were stratified by mechanisms of nerve injury, ages, duration of motor symptoms, and nerve defect/zone of injury sizes, and were compared by functional results (poor = 0, fair = 1, good = 2, excellent = 3), using meta-regression be tween interventions. Interventions evaluated were primary neurorrhaphy, neurolysis, nerve grafts, partial nerve transfer, neuromusculotendinous transfer, tendon transfer, ankle-foot orthosis (AFO), and arthrodesis. RESULTS: One hundred and forty-four studies included 1284 patients published from 1985 through 2020. Transection/Cut: Excellent functional results following tendon transfer (OR: 126, 95%CI: 6.9, 2279.7, p=0.001), compared to AFO. Rupture/Avulsion: Excellent functional results following tendon transfer (OR: 73985359, 95%CI: 73985359, 73985359, p<0.001), nerve graft (OR: 4465917, 95%CI: 1288542, 15478276, p<0.001), and neuromusculotendinous transfer (OR: 42277348, 95%CI: 3001397, 595514030, p<0.001), compared to AFO. Traction/Stretch: Good functional results following tendon transfer (OR: 4.1, 95%CI: 1.17, 14.38, p=0.028), compared to AFO. Entrapment: Excellent functional results following neurolysis (OR: 4.6, 95%CI: 1.3, 16.6, p=0.019), compared to AFO. < p>CONCLUSIONS: Functional results may be optimized for treatments by the mechanism of nerve injury. Transection/Cut and Traction/Stretch had the best functional results following tendon transfer. Rupture/Avulsion had the best functional results following tendon transfer, nerve graft, or neuromusculotendinous transfer. Entrapment had the best functional results following neurolysis. PMID:34801427 | DOI:10.1016/j.bjps.2021.09.040 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Adult False Vocal Cord Cavernous Lymphangioma Presenting with Hemoptysis: A Case Report

xlomafota13 shared this article with you from Inoreader Adult False Vocal Cord Cavernous Lymphangioma Presenting with Hemoptysis: A Case Report Via ear nose throat Ear Nose Throat J. 2021 Nov 20:1455613211047131. doi: 10.1177/01455613211047131. Online ahead of print. ABSTRACT Lymphangiomas are rare benign tumors of the lymphatic system, most often found at birth and before the age of 2 years. The head and neck region are the most frequent locations for lymphangioma. Involvement of the adult larynx in isolation is rare, and only a few cases have been reported so far. We report the case of a patient with a left false vocal cord reddish t umor presenting with hemoptysis and voice cracking. The surgical excision of mass was performed by direct laryngoscopy-assisted CO2 laser. The histopathological report revealed the diagnosis as cavernous lymphangioma. After a follow-up of 1 year, the patient is free of recurrence with all laryngeal functions being normal. PMID:34802262 | DOI:10.1177/01455613211047131 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The role of vein grafts in reconstructive head and neck microsurgery

xlomafota13 shared this article with you from Inoreader The role of vein grafts in reconstructive head and neck microsurgery Via Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial Braz J Otorhinolaryngol. 2021 Oct 26:S1808-8694(21)00175-0. doi: 10.1016/j.bjorl.2021.09.004. Online ahead of print. ABSTRACT OBJECTIVE: Free tissue transfer is widely used for head and neck reconstruction. In certain circumstances, vein grafting is required to elongate free flap pedicles to connect them to appropriate recipient vessels. Because of controversy regarding the use of interposition vein grafts in free tissue reconstruction, this paper reports vein graft indications, techniques, safety, and outcomes for head and neck microvascular surgery. METHODS: Twenty-six patients (23 men and 3 women) who underwent interposition vein grafting concurrent with free tissue transfer were included in this study. The most common reason for head and neck reconstruction with vein graft was tumor recurrence, followed by flap salvage. The interposition vein grafts were applied in two manners as temporary arteriovenous (A-V) loop and conduit to extend the length of the free flap for venous drainage. RESULTS: The most common reconstructions were anterolateral thigh flaps (15 cases), followed by vastus lateralis myocutaneous (3 cases) and radial forearm (2 cases) flaps. The common recipient vessels were superior thyroid artery, superficial temporal artery and external jugular vein. The free flap loss rate was 7.7% with vein grafts and 4.9 without vein grafts (p = 0.380). The free flap complication rate was 50.0% and 16.8% in patients with and without vein grafts, respectively (p < 0.001). Radiation therapy, chemotherapy, prior neck dissection, and prior free flap transfer were more common in the vein graft group (all p < 0.001). The hospital stay was significantly longer for the vein graft group than for the non-vein graft group (29.5 vs. 19.0 days; p = 0.001). CONCLUSION: Overall free flap survival rates of 92.3% and 95.1% in the vein and non-vein graft groups, respectively - indicating the reliability of the vein grafts in challenging head and neck reconstructions, particularly in salvage cases and patients with multiple reconstructions. LEVEL OF EVIDENCE: Level 3. PMID:34802968 | DOI:10.1016/j.bjorl.2021.09.004 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.