Objective: To determine the clinicopathological profile of patient with solitary thyroid nodule presented to opd at a tertiary care hospital Pakistan Study Design: Cross sectional study Settings: Department of Diabetes and endocrinology, Hayatabad Medical Complex, Peshawar Materials & Methods: Patients with confirmed diagnosis of a solitary thyroid nodule through imaging or clinical examination were included. Patients with a history of thyroidectomy or thyroid cancer, those with multiple thyroid nodules were excluded. Results: The mean age of the patients in the study was 48.7 years (SD = 2.11). In terms of gender, 42.4% were female, while 57.6% were male. Swelling with dysphagia was reported by 25.6% of patients, swelling with pain by 20.8%, and swelling with fever by 1.6%. The distribution of thyroid nodule location revealed that 50.4% were in the left lobe, 48% in the right lobe, and a small percentage (1.6%) were bilateral. The ultrasonography findings of the patients revealed diverse characteristics of thyroid nodules. The most common were hypoechoic nodules, present in 38.4% of cases. Isoechoic nodules were observed in 26.4%, while mixed echogenicity was noted in 17.6% of patients. A smaller proportion, 9.6%, exhibited thyroid nodules with cystic components. A significant proportion, 57.6%, yielded benign results, while 22.4% were categorized as suspicious. Practical Implication: Understanding the clinicopathological profile of patients with solitary thyroid nodules presenting at a tertiary care hospital in Pakistan can aid in refining diagnostic and treatment strategies, ultimately improving patient outcomes and reducing unnecessary interventions. Conclusion: In conclusion, our study on the clinicopathological profile of patients with solitary thyroid nodules at a tertiary care hospital reveals a diverse presentation of clinical and ultrasonographic features. Keywords: Solitary thyroid nodule, Clinicopathological profile, Ultrasonography, Fine-Needle Aspiration, Thyroid Disorders

Clinicopathological Profile of Patient with Solitary Thyroid Nodule Presented to OPD at a Tertiary Care Hospital Pakistan

Diabetes mellitus (DM) and thyroid disorders are both caused by endocrine abnormalities, and both have been shown to have a reciprocal influence and frequently coexist. Hence, the current study aims to detect the thyroid functions markers among patients with Type 2 diabetes (T2DM). In this research study, 90 enrolled participants aged 40 to 60 years were taken as samples for the study. There were 66 with T2DM and 24 who were non diabetic healthy individual. All individuals were investigated in terms of age, gender, diabetes duration, glycemic control (HbA1c), fasting blood glucose (FBG), diabetic complications, Body mass index (BMI), waist circumference (WC), and family history of DM. Samples were to assess serum thyroid hormones (TSH, FT3 and FT4), HbA1c, FBG, and insulin levels. The study's findings showed higher glucose incidence, hyperinsulinemia and higher insulin resistance (IR) in diabetic patients. Additionally, it has been noted that T2DM patients have low TSH concentrations and elevated blood concentrations of FT4 and FT3 than controls. Moreover, there was a highly significant correlation between serum FT4 and FT3 with values of FBG, insulin and IR. Also, a significant association between WC with insulin and Homa – Ir was noted. In conclusion, the diabetic patients showed significant relations with thyroid functions status.

/pdf/evaluation-of-thyroid-function-markers-in-type-2-diabetic-e69vo19s.pdf

Evaluation of thyroid function markers in type 2 diabetic patients in relation to insulin resistance

Objectives: To correlate the screening ability of ultrasound-based TIRADS with the FNAC-based Bethesda system when the latter is kept as a gold standard.
Material and Methods: A cross-sectional study was conducted in the Histopathology department, Rehman Medical Institute, Peshawar 15th June 2022- 14th June 2023. A total of 363 patients from any age group of either gender diagnosed with thyroid nodules were included in the trial. All the participants underwent ultrasound followed by ultrasound-guided fine needle aspiration of thyroid nodules. TIRADS and Bethesda grading was done for each participant. Demographics and grading scores were recorded. Keeping Bethesda scoring as gold standard diagnostic performance of TIRADS grading was calculated.
Results: Mean age of the patients was 46.68 ± 12.28 years with a female-to-male ratio of 2.3:1.  TIRADS grading revealed 210 (69.8%) from TIRADS 2 while 70(82.4%), 12(50%), and 09(23.7%) patients were from TIRADS 3, 4 and 5 categories respectively. Bethesda grades were 301(82.9%), 21(5.8%), 09(2.5%), 28(7.7%), and 04(1.1%) from Bethesda 2, 3, 4, 5, and 6 categories respectively. The sensitivity of the TIRADS was 93.8%, specificity 89.1%, positive predictive value 45%, negative predictive value 99.3%, and a diagnostic accuracy of 89.5%.
Conclusion: TIRADS grading has a high diagnostic ability when Bethesda scoring is kept as the gold standard. It can be used effectively in segregating benign from malignant nodules and is recommended for screening patients presenting with thyroid nodules.
Keywords: Biopsy, Fine-Needle, Sensitivity and Specificity, Thyroid Nodule

The correlation between bethesda system and ultrasound-based tirads for reporting thyroid cytopathology

Introdução: A redução dos níveis séricos de testosterona com a idade podem se associar com o aumento da gordura corporal e a piora de parâmetros endócrinos-metabólicos, culminando com um quadro de síndrome metabólica juntamente com hipogonadismo. Objetivo: O presente estudo teve como objetivo avaliar os aspectos clínicos, epidemiológicos e fisiopatológicos da síndrome metabólica decorrente do hipogonadismo de início tardio, alicerçando a construção do conhecimento com base em relatos de casos e no conhecimento sedimentado na literatura. Materiais e Métodos: Trata-se de uma revisão integrativa de literatura acerca das características clinicas gerais sobre a síndrome metabólica induzida pelo redução dos níveis de testosterona. Utilizou-se a estratégia PICO para a elaboração da pergunta norteadora. Ademais, realizou-se o cruzamento dos descritores “Síndrome Metabólica”; “Hipogonadismo Tardio”; “Transtornos Gonadais”, nas bases de dados National Library of Medicine (PubMed MEDLINE), Scientific Eletronic Library Online (SCIELO), Ebscohost, Google Scholar e Biblioteca Virtual de Saúde (BVS). Resultados e Discussão: Uma parcela significativa dos artigos demonstrou que existe a associação entre os baixos níveis de testosterona, característicos do hipogonadismo de início tardio, e o desenvolvimento da síndrome metabólica, sobretudo, em pacientes com idade entre 30 e 50 anos. Acerca do manejo da junção entre essas condições endócrinas, este deve ser planejado e individualizado para ofertar o melhor prognóstico do paciente. Conclusão: A bidirecionalidade entre os mecanismos fisiopatológicos das doenças é de extrema importância para a compreensão integrativa entre elas, assim como dos aspectos que envolvem a terapêutica, sendo fundamental para que os pacientes possam receber os melhores cuidados. 

pdf/o-desenvolvimento-da-sindrome-metabolica-em-pacientes-com-n8n99j29xo.pdf

O desenvolvimento da Síndrome Metabólica em pacientes com Hipogonadismo de início tardio

Solitary nodules are a typical thyroid disease appearance. Solitary thyroid nodules are little swellings that are ordinarily impalpable glands. Solitary thyroid nodules are typically benign. With a mean age of 35 years, ladies are more likely than males to develop cancer (10–20%). An endocrine gland called the thyroid is located in the lower front and sides of the neck. Its primary purpose is to regulate basal metabolic rate. It also promotes somatic and psychic growth and is crucial for calcium metabolism. The identification, examination, and treatment of thyroid nodules can be difficult. These lumps frequently develop near the thyroid gland's border and are enormous in size, causing them to feel or seem like a lump in front of the neck. A multitude of variables, including age, sex, food, iodine deficiency, and even therapeutic and ambient radiation exposure, affect the occurrence of these nodules in a given population. This study was conducted in hospital of Dera Ismail Khan, KPK,Pakistan to determine the prevalence of solitary thyroid nodules in patinets admitted in the hospital. The results indicates that females between the ages of 26 and 30 are more likely to have thyroid nodules. Swelling at the front of the lower neck is the most frequent presenting ailment. The majority of patients presented between 6 months and 3 years after the edoema first appeared. The sensitivity and specificity of FNAC in the current investigation were 92% and 98%, respectively, while sensitivity and specificity of USG were 70 and 90%, respectively. Histopathology verified all malignant tumours on FNAC, demonstrating its superiority. USG and FNAC aids in proper management planning as a result, preventing the need for additional surgery. Keywords: Solitary thyroid nodule; Thyroid neoplasm; Neck swelling; Body mass index; Pakistan

/pdf/prevalence-of-solitary-thyroid-nodule-in-patients-admitted-1q9iaxgg.pdf

Prevalence of Solitary Thyroid Nodule in Patients Admitted in Hospital of Dera Ismail Khan, KPK, Pakistan

Numerous physiological and pathological processes must be controlled for the thyroid gland to function properly. Research utilising both animal models and human subjects has demonstrated that thyroid hormones regulate cellular processes that are crucial for most age-related diseases. Furthermore, both hyperthyroidism and hypothyroidism have been associated to the onset of several kinds of diabetes, proving the intricacy of the molecular processes regulated by thyroid hormones. In this article, we provide a summary of the most recent thyroid hormone-related findings in the field of diabetes research. We contend that despite the difficulty in developing thyromimetics due to their inefficiency and potential toxicity, therapies based on the use of modulators of thyroid hormone activity may be therapeutically beneficial in some kinds of diabetes.

Diabetes: Insights into Thyroid Hormones

Obesity, a clinical condition that is on the rise internationally and is highly associated to lower testosterone levels in males, is the most strongly linked clinical condition. In addition to this, it is one of the most reliable signs that a guy may require testosterone replacement medication. When it comes to obesity, the severity of the condition can determine whether the hypothalamic-pituitary-testicular axis (HPT) is suppressed. Moderate obesity, on the other hand, is typically characterized by lower levels of sex hormone binding globulin. Even though there is a connection in both directions between hypogonadism and obesity, the effect of adiposity on testosterone levels is much more significant than the impact that testosterone has on adiposity. The relationship between hypogonadism and obesity is complex and multifaceted. There are various components, both causal and correlative, on both sides of the contact, which can be thought of as a connection that goes in both directions. The number of people who are overweight or obese is increasing at an epidemic rate. In a manner quite like this, we have begun to observe a significant increase in the frequency of male hypogonadism. We are just now starting to get a better understanding of how these two ailments might interact with one another and make each other worse, as well as how treating one of these conditions can help in the treatment of the other.

/pdf/male-hypogonadism-and-obesity-an-insight-lji5ge2q.pdf

Male Hypogonadism and Obesity: An Insight

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Papers

Prevalence of Solitary Thyroid Nodule in Patients Admitted in Hospital of Dera Ismail Khan, KPK, Pakistan

Diabetes: Insights into Thyroid Hormones

Male Hypogonadism and Obesity: An Insight