Thyroid Goiter Research Articles

Prediction models constructed for Hashimoto’s thyroiditis risk based on clinical and laboratory factors

BackgroundHashimoto’s thyroiditis (HT) frequently occurs among autoimmune diseases and may simultaneously appear with thyroid cancer. However, it is difficult to diagnose HT at an early stage just by clinical symptoms. Thus, it is urgent to integrate multiple clinical and laboratory factors for the early diagnosis and risk prediction of HT.MethodsWe recruited 1,303 participants, including 866 non-HT controls and 437 diagnosed HT patients. 44 HT patients also had thyroid cancer. Firstly, we compared the difference in thyroid goiter degrees between controls and patients. Secondly, we collected 15 factors and analyzed their significant differences between controls and HT patients, including age, body mass index, gender, history of diabetes, degrees of thyroid goiter, UIC, 25-(OH)D, FT3, FT4, TSH, TAG, TC, FPG, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol. Thirdly, logistic regression analysis demonstrated the risk factors for HT. For machine learning modeling of HT and thyroid cancer, we conducted the establishment and evaluation of six models in training and test sets.ResultsThe degrees of thyroid goiter were significantly different among controls, HT patients without cancer (HT-C), and HT patients with thyroid cancer (HT+C). Most factors had significant differences between controls and patients. Logistic regression analysis confirmed diabetes, UIC, FT3, and TSH as important risk factors for HT. The AUC scores of XGBoost, LR, SVM, and MLP models indicated appropriate predictive power for HT. The features were arranged by their importance, among which, 25-(OH)D, FT4, and TSH were the top three high-ranking factors.ConclusionsWe firstly analyzed comprehensive factors of HT patients. The proposed machine learning modeling, combined with multiple factors, are efficient for thyroid diagnosis. These discoveries will extensively promote precise diagnosis, personalized therapies, and reduce unnecessary cost for thyroid diseases.

Surgical Management of 48 Patients with Retrosternal Goiter and Tracheal Stenosis: A Retrospective Clinical Study from a Single Surgical Center

BackgroundBenign retrosternal thyroid goiters can become large enough to compress the trachea and result in tracheomalacia and stenosis. This retrospective study from a single surgical center aimed to study the surgical management of 48 patients with retrosternal goiter and tracheal stenosis diagnosed and treated from January 2017 to December 2021.Material/MethodsAll preoperative contrast-enhanced CT scans showed retrosternal goiter and tracheal stenosis. RG was classified into type I in 28 patients, type II in 12 patients, and type III in 8 patients. TS was classified into grade I in 31 patients, grade II in 11 patients, and grade III in 6 patients. All patients were referred for surgery. Clinicopathologic features and surgical outcomes were recorded.ResultsAll operations were successfully performed. There were 41 patients with transcervical incision, 4 with cervical incision+sternotomy, 2 with cervical incision and thoracoscopic surgery, and 1 with cervical incision and surgery via the subxiphoid approach. Two patients presented recurrent laryngeal nerve injury. One patient showed short-term hand and foot numbness. The patients were pathologically diagnosed as simple nodular goiter (n=27), nodular goiter combined with cystic change (n=6), adenomatous nodular goiter (n=10), and thyroid adenoma (n=5). There was no prominent tumor recurrence or gradual TS remission.ConclusionsThis study has highlighted that patients with retrosternal goiter and tracheal stenosis may have comorbidities and require a multidisciplinary approach to management. The choice of anesthesia, surgical approach, and maintenance of the airway during and after surgery should be individualized.

Ectopic thyroid carcinoma in the mandible with normally located goiterous thyroid gland: A case report.

BackgroundThe presence of ectopic thyroid tissue is a developmental disorder that affects about one per 100,000–300,000 people. It is extraordinarily rare for ectopic thyroid to be out of the lines of its descent. This case is the first to report a cancerous ectopic thyroid in the mandibular bone with a goitrous orthotopic thyroid gland.Case presentation80-year-old female of free medical background presented to our clinic with painless left mandibular swelling that recent increase in size after tooth extraction. Surprisingly the diagnosis of ectopic thyroid tissue with cancerous follicular cells was reached upon histological analysis. The goitrous thyroid gland was found in its expected cervical location, and the patient was euthyroid.ConclusionBecause this diagnosis extremely rare, the possibility of ectopic thyroid carcinoma in cases of a pathological mass in the mandible must always be carefully thought out. A high degree of suspicion is essential as the unusual presentation could take.

The Role of Imaging in the Detection of Non-COVID-19 Pathologies during the Massive Screening of the First Pandemic Wave.

During the COVID-19 pandemic induced by the SARS-CoV-2, numerous chest scans were carried out in order to establish the diagnosis, quantify the extension of lesions but also identify the occurrence of potential pulmonary embolisms. In this perspective, the performed chest scans provided a varied database for a retrospective analysis of non-COVID-19 chest pathologies discovered de novo. The fortuitous discovery of de novo non-COVID-19 lesions was generally not detected by the automated systems for COVID-19 pneumonia developed in parallel during the pandemic and was thus identified on chest CT by the radiologist. The objective is to use the study of the occurrence of non-COVID-19-related chest abnormalities (known and unknown) in a large cohort of patients having suffered from confirmed COVID-19 infection and statistically correlate the clinical data and the occurrence of these abnormalities in order to assess the potential of increased early detection of lesions/alterations. This study was performed on a group of 362 COVID-19-positive patients who were prescribed a CT scan in order to diagnose and predict COVID-19-associated lung disease. Statistical analysis using mean, standard deviation (SD) or median and interquartile range (IQR), logistic regression models and linear regression models were used for data analysis. Results were considered significant at the 5% critical level (p < 0.05). These de novo non-COVID-19 thoracic lesions detected on chest CT showed a significant prevalence in cardiovascular pathologies, with calcifying atheromatous anomalies approaching nearly 35.4% in patients over 65 years of age. The detection of non-COVID-19 pathologies was mostly already known, except for suspicious nodule, thyroid goiter and the ascending thoracic aortic aneurysm. The presence of vertebral compression or signs of pulmonary fibrosis has shown a significant impact on inpatient length of stay. The characteristics of the patients in this sample, both from a demographic and a tomodensitometric point of view on non-COVID-19 pathologies, influenced the length of hospital stay as well as the risk of intra-hospital death. This retrospective study showed that the potential importance of the detection of these non-COVID-19 lesions by the radiologist was essential in the management and the intra-hospital course of the patients.

A man with difficulty dysphagia

A 50-year-old man with history of type II diabetic mellitus attended the emergency department with persistent foreign body sensation after swallowing a drug pill. He also had mild odynophagia. Tracing his history, it was found that he had progressive dysphagia in previous 2 months. There was no coughing or choking immediately after swallowing the pill and speech quality was normal. He denied weight loss in last 6 months. On physical examination, no palpable mass or thyroid goiter was noted. Laboratory data were in acceptable range. A point-of-care ultrasound with a linear probe over the patient’s neck was done. Later, computed tomography was done for confirming the diagnosis.

Combined thoracoscopic and axillary subcutaneous endoscopic thyroidectomy: a novel approach for cervicomediastinal goiters.

After our group described the first remote-access thyroidectomy series in 2000, the procedure has been further developed. Although a thoracoscopic approach with a conventional open cervical incision for thyroid goiters with mediastinal extension has been performed at many institutions, remote-access thyroidectomy for cervicomediastinal goiters has not been established. We have performed combined thoracoscopic and axillary subcutaneous endoscopic thyroidectomies (axillo-thoracic endoscopic thyroidectomies). Here, we describe a novel technique for performing a remote-access thyroidectomy for a cervicomediastinal goiter (CMG). The patients with CMGs who agreed to an axillo-thoracic endoscopic thyroidectomy at one of two hospitals in Japan underwent a remote-access thyroidectomy. We performed the axillo-thoracic endoscopic right or left hemithyroidectomy successfully, but most of the patients did not require the thoracoscopic procedure. None of the patients had complications, and none was converted to an open thyroidectomy. Most thyroid goiters with substernal extension can be removed by the axillary approach, but some cases require a thoracoscopic approach. The novel approach described herein (axillo-thoracic endoscopic thyroidectomy) enables the safe excision of a CMG with high patient satisfaction for selected patients.

Surgical correction of a percutaneous dilatational tracheostomy: A case report.

Introduction and importancePercutaneous dilatational tracheostomy (PDT) has become a routine procedure in intensive care, because of its multiple advantages over surgical tracheostomy (ST).Case presentationWe present the case of a 72-year-old patient with SARS-CoV-2 pneumonia, who received a PDT in the 6th tracheal ring with a lateral puncture of the trachea. This atypical placement of tracheostomy was due to a massive left-pronounced goiter, causing a tracheal shift to the right. To avoid dislocation of the tracheal cannula and prevent recurrent bleeding, surgical revision was decided. After left hemithyroidectomy, oral intubation was temporarily necessary, in order to remove the old tracheostomy. Then suturing of the left lateral tracheal defect and standard ST in the 2nd tracheal cartilage was performed. The patient was successfully weaned and decannulated and his swallowing function remained intact.Clinical discussionIn our case left hemithyroidectomy was necessary, in order to enable an optimal surgical tracheostomy in the 2nd tracheal cartilage. Because mechanical ventilation was carried out proximal to the large tracheal defect after PCT, a secondary closing approach was not an option. The endotracheal cuff was placed above the defect, in order to prevent acute or chronic intraluminal pressure trauma. Postoperative x-ray and bronchoscopy insured the sufficient sealing of the tracheal suturing.ConclusionWe describe an unusual placement of percutaneous dilatational tracheostomy through a thyroid goiter and our approach to perform a correction surgical tracheostomy.

Maintaining the thyroid gland in mutant thyroglobulin–induced hypothyroidism requires thyroid cell proliferation that must continue in adulthood

Congenital hypothyroidism with biallelic thyroglobulin (Tg protein, encoded by the TG gene) mutation is an endoplasmic reticulum (ER) storage disease. Many patients (and animal models) grow an enlarged thyroid (goiter), yet some do not. In adulthood, hypothyroid TGcog/cog mice (bearing a Tg-L2263P mutation) exhibit a large goiter, whereas adult WIC rats bearing the TGrdw/rdw mutation (Tg-G2298R) exhibit a hypoplastic thyroid. Homozygous TG mutation has been linked to thyroid cell death, and cytotoxicity of the Tg-G2298R protein was previously thought to explain the lack of goiter in WIC-TGrdw/rdw rats. However, recent studies revealed that TGcog/cog mice also exhibit widespread ER stress–mediated thyrocyte death, yet under continuous feedback stimulation, thyroid cells proliferate in excess of their demise. Here, to examine the relative proteotoxicity of the Tg-G2298R protein, we have used CRISPR–CRISPR-associated protein 9 technology to generate homozygous TGrdw/rdw knock-in mice in a strain background identical to that of TGcog/cog mice. TGrdw/rdw mice exhibit similar phenotypes of defective Tg protein folding, thyroid histological abnormalities, hypothyroidism, and growth retardation. TGrdw/rdw mice do not show evidence of greater ER stress response or stress-mediated cell death than TGcog/cog mice, and both mouse models exhibit sustained thyrocyte proliferation, with comparable goiter growth. In contrast, in WIC-TGrdw/rdw rats, as a function of aging, the thyrocyte proliferation rate declines precipitously. We conclude that the mutant Tg-G2298R protein is not intrinsically more proteotoxic than Tg-L2263P; rather, aging-dependent difference in maintenance of cell proliferation is the limiting factor, which accounts for the absence of goiter in adult WIC-TGrdw/rdw rats.

A retropharyngeal multinodular goiter: A case report and literature review.

IntroductionThyroid goiter is a benign chronic enlargement of the thyroid gland, which presents as a painless anterior neck mass with occasional extension to the mediastinum. Retropharyngeal goiter is a rare presentation and hardly reported in the literature.Presentation of caseA 70-year-old male presented with a multinodular goiter with a large retropharyngeal component.Clinical findings and investigationsPhysical examination of the head and neck revealed a massive anterior neck mass. Laryngeal endoscopy with a 70-degree rigid endoscope demonstrated a large retropharyngeal mass completely obstructing the view of the larynx. Computed tomography (CT) scan revealed a large multinodular goiter with suprahyoid and retrosternal extension, resulting in displacement of the trachea.Interventions and outcomeThe mass was excised completely under general anesthesia and intubation was done under fiberoptic bronchoscopy guidance. The mass was sent for histological analysis, which confirmed the diagnosis of Hashimoto thyroiditis.ConclusionEventually, upon follow-up at three months post excision, no evidence of recurrence was detected.

Uterine fibroids increase the risk of thyroid goiter and thyroid nodules

Uterine fibroid and benign thyroid disease are both common diseases in women. This study aimed to evaluate whether these diseases are related. We established the uterine fibroid group according to diagnosis and surgery codes using the Korea National Health Insurance data from 2009 to 2020. All women from 20 to 50 years old who underwent uterine myomectomy from 2009 to 2020 were identified. We selected the control group by performing a 1:1 propensity score matching on age at 5-year intervals, socioeconomic status (SES), region, Charlson comorbidity index (CCI), menopause, and year among women who visited a medical institution for a health check-up. Thyroid disease cases were selected using the thyroid disease diagnosis code and thyroid-associated laboratory tests. A total of 181,419 patients were included in the uterine fibroid and control groups. The median age of each group was 40 (range, 35 ~ 44) and 40 (range, 35 ~ 45) years old, respectively. Benign thyroid disease affected 1162 (0.6%) in the uterine fibroid group and 1137 (0.6%) in the control group. Among the benign thyroid diseases, hypothyroidism was the most common in both groups, followed by a nontoxic single thyroid nodule. The uterine fibroid group had a higher risk of thyroid goiter (hazard ratio (HR) 1.169, 95% confidence interval (CI) 1.022–1.338), nontoxic single thyroid nodule (HR 1.268, 95% CI 1.182–1.361), and total thyroid disease (HR 1.078, 95% CI 1.036–1.121) in stratified Cox regression analysis adjusted for age, SES, region, CCI, parity, menopause, hypertension, diabetes, dyslipidemia, systemic lupus erythematosus, irritable bowel syndrome, Crohn’s disease, and endometriosis than the control group. The results suggest that women with uterine fibroids have an increased risk of thyroid goiters and thyroid nodules. Although the mechanism is not well known, estrogen and iodide might be a link between uterine fibroids and thyroid goiters and nodules. Future studies that prospectively follow women with uterine fibroids across a lifetime are needed.

Comparative Analysis of Five Correction Methods for Thyroid Volume by Ultrasound and Their Recommended Reference Values in Chinese Children Aged 8-10 Years.

Considering the influence of body's growth and development on thyroid volume (TVOL), whether five existed corrected methods could be applied to correct TVOL remains unclear, in terms of Chinese children's increased growth and development trends. This study aimed to compare the applicability of five correction methods for TVOL: Body Surface Area corrected Volume (BSAV), Body Mass Indicator corrected Volume (BMIV), Weight and Height corrected Volume Indicator (WHVI), Height corrected Volume Indicator 1 (HVI1) and Height corrected Volume Indicator 2 (HVI2); to establish the reference values for correction methods. The data of Iodine Nutrition and Thyroid Function Survey was used to analyse the differences in TVOL between normal and abnormal thyroid function children. Data of National Iodine Deficiency Disorders Survey were used to compare five correction methods and to establish their reference values. The median urinary iodine concentration of children surveyed were 256.1μg/L in 2009 and 192.6μg/L in 2019, respectively. No significant difference was found in TVOL and thyroid goitre rate between children with normal and abnormal thyroid function. In the determination of goitre, HVI1, HVI2, BSAV and BMIV all showed high agreement with TVOL, while the area under the ROC curve (AUC) of WHVI was relatively low for children aged 8(AUC=0.8993) and 9(AUC=0.8866). Most differences of TVOL between light and heavy weight, short and tall height children can be eliminated by BSAV correction. BSAV was the best method of TVOL correction in this research. Reference values were established for corrected thyroid volumes in Chinese children aged 8-10 years by sex.

Correlation between Ultrasonographic Appearance of Papillary Thyroid Microcarcinoma and BRAF V600E Mutation.

The study was conducted to investigate the correlation between the ultrasonographic appearance of a thyroid nodule and the BRAF V600E mutation. Patients with thyroid nodules (n = 186), for which BRAF V600E testing and cytopathology analysis were performed, and who underwent subsequent surgery for nodule resection were enrolled in this study. For each patient, color Doppler ultrasonography was performed to observe the variables of the nodules. The nodules were then characterized using the thyroid imaging reporting and data system classification TI-RADS. Furthermore, the ultrasonographic appearance of the control group, encompassing patients with nodular thyroid goiters, and the case group, encompassing patients with papillary thyroid microcarcinoma (PTMC), was statically analyzed. Similarly, a statistical analysis of the ultrasonographic appearance of the BRAF V600E-positive and BRAF V600E-negative subgroups was also performed. The accuracy was significantly different for the corresponding values when color Doppler ultrasonography, BRAF V600E testing, or cytopathology alone was used for diagnosis. There were significant differences in the ultrasonographic appearance variables between the control and case groups. Comparing with the BRAF V600E-negative subgroup of the case group, the ultrasonographic appearances of the BRAF V600E-positive subgroup showed less circumscribed and more irregularly shaped nodules, with significantly different aspect ratios of >1. The combination of BRAF V600E testing and color Doppler ultrasonography or cytopathology improved the accuracy of the PTMC diagnose. We found that the ultrasonographic appearance of thyroid nodules was related to PTMC.

Causes of different goiter rates with the same iodine deficiency among the pastoral and agricultural populations of Tibet: a geographical comparison

BackgroundThe residents of both the agricultural and pastoral areas of Tibet share the same iodine deficiency and iodine nutrition, but the rate of thyroid goiter was significantly higher in the agricultural areas than in the pastoral areas. This project sought to determine why the populations in the iodine-deficient pastoral areas show a lower rate of thyroid goiter.MethodsFood frequency questionnaires (FFQs) and 24 h history recalls were adopted to investigate the dietary patterns of the residents of the agricultural and pastoral areas. Meat and milk samples were collected to measure their inorganic iodine, total iodine and thyroid hormone contents using ICP-MS, AsIII-Ce4+ catalytic spectrophotometry and the Siemens’ chemiluminescence method, respectively. The intake of protein, and the microelements, selenium and iron, was calculated according to their content in the food.ResultsThe per capita daily intake of meat, dairy, and cereal in the pastoral areas was 116.7, 216.7, and 433.3 g, respectively, which are significantly higher than those in the agricultural areas (50.0, 72.2, and 375.0 g, respectively) (p < 0.05). The content of thyroid hormone in dried beef and milk in the pastoral areas was 62.6 and 13.5 μg/kg, respectively, which was significantly higher than those in the agricultural areas (25.1 and 4.1 μg/kg, respectively) (p < 0.05). The daily intake of thyroid hormone, protein and microelements, selenium and iron from foods by the residents of the pastoral areas were 10.5 μg, 99.6 g, 30.0 μg and 15.8 mg respectively, which was significantly higher than those in the agricultural areas (1.79 μg, 56.5 g, 23.8 μg and 13.2 mg, respectively) (p < 0.05).ConclusionsThe significantly high intake of the food-borne thyroid hormone by the residents of the pastoral area could be the main reason the residents in the pastoral areas show a lower rate of thyroid goiter than those in the agricultural area. Moreover, the relatively high intake of protein and trace elements, selenium and iron by residents in the pastoral area could be another important factor for reducing the goiter rates.

Importance of proper diet after thyroidectomy in diabetic patients: A short communication

Thyroidectomy is a surgical technique used to treat cancer, noncancerous thyroid enlargement, goiter, and hyperthyroidism. It is a procedure to remove all or sections of the thyroid gland. Most importantly, some common complications are often observed, like weight gain, loss of libido, and vocal cord paresis or paralysis after thyroidectomy. After surgery, diabetic patients are more prone to comorbidities such as kidney disease, eyes health issues, hypertension, obesity, etc. This study highlighted the probable diet and essential home-based nutrition for post thyroidectomy complications. Weight gain is the common complaint of most patients who underwent surgery. Currently, there are insufficient data that do not provide clear conclusions about post-surgery diet plan. However, low carbohydrate, low fat but high veg-protein-rich diet are altogether helpful for weight loss, diabetes, and related complication. More research is needed in the medical nutrition therapies segment to get more dietary options for such patients.

Regulation of Gene Expression by Thyroglobulin

Thyroglobulin (Tg) is a large glycoprotein consisting of 2,768 amino acid residues and the precursor of thyroid hormones (THs). Since abnormalities in Tg function and expression may naturally affect thyroid function, there has been much interest in the mechanisms that regulate the expression and maturation of Tg. By contrast, Tg found in the blood, because of leakage from thyroid follicles, is used as a marker of thyroid goiters and inflammation. However, the precise structure and function of the huge Tg macromolecule are still unclear. Recently, it was shown that Tg at its physiological concentration in follicles dynamically regulates the expression of various thyroid-specific genes responsible for counteracting the effect of TSH. In addition, it was also shown that Tg induces thyroid cell proliferation. Thus, follicular Tg is now recognized as an autocrine negative-feedback regulator tightly controlling follicular function. In this review, we will briefly summarize recent advances of Tg function. Keywords: Thyroid; Thyroglobulin; Thyroid hormones; TSH

BIOCHEMICAL AND CLINICAL CHARACTERIZATION OF IODINE DEFICIENCY DISORDERS IN CENTRAL INDIA

Background: Iodine (I) is a trace element that is required by both humans and animals. It can be found in a variety of chemical forms, including iodine, iodide (I), and iodate (IO3). It is widely distributed across the earth's ecology, with a concentration in the oceans. Iodine entered the natural cycle from the ocean, the atmosphere, and rainfall, as well as from rainfall into streams and rivers. Iodine is absorbed as iodide in human nutrition. Iodine is a necessary micronutrient and a component of thyroid hormones. Fish and seafood have a high iodine level. The amount of iodine in soil and drinking water varies depending on where it comes from. Iodine shortage produces a variety of negative health consequences, which are referred to as iodine deficiency illnesses (IDD). These conditions are caused by a lack of iodine, which causes insufficient thyroid hormone production.&#x0D; Aim: The aim of this study is to characterize the iodine deficiency disorder by biochemical and clinical assessment and to correlate the iodine status with thyroid disorder(s) in adults.&#x0D; Material and Method: The samples for this investigation were taken from patients at the Department of Endocrine Surgery. This study comprised a total of 100 hundred goiter patients, who had their urinary iodine excretion and thyroid hormone levels examined. For all goiter patients, the grading of goitre was established using the WHO/UNICEF/ICCIDD approved criteria. TSH, Free T4, Free T3 by using ELISA Method using commercial kits. Anti-microsomal antibody (AMA) or Thyroperoxidase antibody (TPO-Ab) by using ELISA Method using commercial kits. Anti-thyroglobulin antibody (ATG) estimated by using ELISA Method using commercial kits.&#x0D; Results: The data for each group were presented as Median and inter quarter range (IQR) The median and IQR of Urinary iodine excretion of the hypothyroid, hyperthyroid and Euthyroid goiter subjects were respectively and there was significant difference in the median urinary iodine excretion. The median and IQR of Urinary iodine excretion of the thyroiditis, thyrotoxicosis, cancer of thyroid and benign goiter respectively and there was significant difference in the median urinary iodine excretion.&#x0D; Conclusion: For ages, endemic goitre and cretinism have been recognised as public health issues, and iodine deficiency is thought to be the leading cause of preventable mental retardation. Most countries now include iodine deficiency control as part of their national nutrition policies. To eliminate iodine deficiency, several therapies with high efficacy have been employed, including iodized oil capsules (IOC) and universal salt iodisation (USI). Although some progress has been made, efforts to eliminate this devastating health problem must be hastened. Not only should iodine deficiency be monitored, but so should excessive iodine intake, as this is a problem in various areas, including the camps.&#x0D; Keywords: IDD, Goitre, TSH, IOC, USI, ATG, AMA, T4, T3.

Agronomic performance and fruit quality in greenhouse grown eggplant are interactively modulated by iodine dosage and grafting

Iodine (I) is considered an indispensable trace element for humans due to its capacity to promise a normal functions of thyroid hormones, preventing cretinism, goiter, reproductive failure, and diverse types of brain injury. Vegetable grafting is a technique for securing yield constancy and/or improving fruit quality. The study evaluated the combined effect of I-dosages and grafting onto Solanum torvum rootstock on ‘Birgah’ eggplant. Iodine at 100 or 300 mg L−1 enhanced marketable yield by 28.8% and 8.5%, respectively, compared with the control. Plants grafted onto S. torvum and self-grafted plants increased marketable yield by 53.0% and 45.8%, respectively compared with the ungrafted plants. I-biofortification determined a linear decrease in SSC as I-dosage increased. I-enrichment at 300 and 600 mg L−1 improved fruit dry matter and ascorbic acid compared with the control. The combinations of self-grafting × I-biofortification at 600 mg L−1 and ungrafting × I-biofortification at 600 mg L−1 improved total anthocyanins concentration by 8.5% and 9.1%, respectively, compared with the ungrafting × 0 I-biofortification combination. Exposing ungrafted plants to 600 mg I L−1 resulted in a significantly higher chlorogenic acid content compared to the control. Glycoalkaloids concentration in the fruits was always below the suggested safety value (200 mg 100 g−1 DW). Grafting enhanced proteins, K, Fe and Zn by 22.9%, 7.2%, 20.0% and 2.4%, respectively compared with ungrafting. I concentration in fruit of grafted plants varied from 0.67 mg kg−1 DW at 0 mg I L−1 to 188.67 mg kg−1 DW in plant biofortified with the highest I-dosage. The pulp browning potential was significantly dependent upon I-dosage and grafting with the lowest values found in fruits from grafted plants supplied with 0 or 100 mg I L−1. The present results suggested that I-biofortification at 300 or 600 mg L−1 and grafting, successfully boosted nutritional and functional traits of ‘Birgah’ eggplant, securing satisfactory yield and yield-related traits.

Case Report: Subacute Thyroiditis triggered by Sinovac and Oxford-AstraZeneca vaccine

followed by adenoviral vector) has been widely used and while the incidence of side effects is very low, several adverse effects have been reported. Methods: A 40-year old female patient, with a previous history of thyroid goitre, developed severe neck pain, headache, nausea and fatigue 7-days after receiving second vaccination with Vaxzevria® (Oxford-AstraZeneca). Clinical and laboratory findings, including thyroid function tests and ultrasound of thyroid glands, were performed. Results: Her left thyroid gland was enlarged and multinodular, and severely tender on palpation. She had difficulty in swallowing and had tachycardia but no signs of hyperthyroidism. Laboratory results supported a diagnosis of subacute thyroiditis. She was prescribed NSAID (Ibuprofen 400 mg) and dexamethasone for 3-days and her symptoms resolved. Conclusions: Although this is an extremely rare event, physicians may encounter more cases of this condition due to the extensive vaccination program using this combination of vaccines.

Observational Study on Outcomes after Radioiodine Ablation in Hyperthyroid Patients.

Introduction:Radio-active Iodine (RAI) is a safe, definitive, and cost-effective modality of treatment that is used as the first line of treatment for Graves’ hyperthyroidism by most endocrinologists. Very few reports are available from India, observational follow-up data is needed to determine the meaningful prognostic outcomes of RAI ablation in the Indian population.Aims:To study the outcomes in hyperthyroid patients undergoing RAI ablation.Materials and Methods:This observational cohort study was conducted at Department of Endocrinology at Indraprastha Apollo Hospital, New Delhi. A total of 82 hyperthyroid patients who underwent RAI ablation between June 2014 to June 2018 were enrolled. RAI dose was calculated arbitrarily in most cases; often by an empirical fixed dose based on the goiter size and RAIU. The patients were reviewed at 1, 3 and 6 months post-RAI ablation. During follow-up, along with a detailed clinical examination, free T4, free T3 and TSH were checked.Results:The dose of I-131 varied from 6 mCi to 14 mCi. Most of the patients were given RAI in the dose of 7.1-10 mci. About 63.4% of patients achieved hypothyroidism in 6 months, 6.1% in 1 month, 37.8% in 3 months, and 19.5% in 6 months. Gender, age, etiology of hyperthyroidism, baseline thyroid function, goiter, and ophthalmopathy did not affect outcomes after RAI ablation. Those who were not treated with antithyroid drugs prior to RAI therapy were found to have higher rates of conversion to a hypothyroid state.Conclusion:RAI can be given safely as the first line of treatment in Graves’ disease and antithyroid drug naïve patients respond better to therapy.

Clinico Pathological Analysis of Nodular Goiter: A Retrospective Study

This retrospective study was conducted to evaluate the clinico-pathological pattern of nodular goiter among patients who underwent thyroidectomy. This study included 50 patients following selection criteria. All patients were properly evaluated by history, clinical examination along with blood chemistry, ultrasonography, nuclear scanning and histopathology [fine needle aspiration cytology (FNAC)]. Out of 50 patients 38 were females and 12 were males, the male to female ratio was 1:3.12. Majority of the patients belonged to the age group of 25-40 years. Most of them were in euthyroid state. Among the study patients; tiredness, palpitation, breathing difficulties, swallowing problem, altered appetite and cold preference were the major presenting features. Solitary nodules (60%) were more frequent than multi-nodular goiter (40%). Among the 20 patients having multi-nodular goiter; 18 were nontoxic goiter and 2 cases were diagnosed as carcinoma. On the other hand in 30 patients with solitary nodule; 27 cases were simple nodule and rest 3 cases were carcinoma. Among total study patients 46 were cold nodules and 4 were warm nodules. Histopathological reports of excised tissues revealed that 45 cases were papillary adenoma, 3 cases were papillary carcinoma and 2 cases were follicular carcinoma. The study concluded that solitary thyroid nodules are frequent at the middle age and predominant among females. Most of the patients of thyroid goiter are in euthyroid state and majority of nodules are benign lesions. Papillary adenoma is the most frequent benign nodular tumor followed by papillary carcinoma and then follicular carcinoma.