Type Of Goiter Research Articles

Factors predicting the use of the backward upward rightward pressure maneuver in thyroid surgery: a single-center retrospective cohort study

BackgroundThe purpose of this study was to evaluate the predictability of utilizing the backward upward rightward pressure (BURP) maneuver and the efficacy of related tests in patients with a challenging airway and a Mallampati score of 2 or higher who underwent scheduled elective thyroid surgery.MethodsPatient files were scanned for 300 adult patients who had undergone thyroid surgery under general anesthesia. The information included their medical history of thyroid disease, previous thyroid surgery, and evaluation tests for difficult intubation such as Mallampati score, maximum mouth opening, ease of intubation, thyroid goitre grade, and whether the BURP maneuver was performed. Patients who had a history of difficult intubation or a Cormack Lehane score less than 2 were excluded. Additionally, the patients were divided into two groups: one group underwent the BURP maneuver (n = 78) and the other did not (n = 56).ResultsStatistically significant differences in the maximum mouth openings and thyroid goitre grade were observed between the groups according to the preoperative evaluation. Furthermore, significant differences were noted between the groups in terms of the ease of intubation, intubation time, Cormack–Lehane score, and number of intubation attempts.ConclusionThere may be a correlation between the maximum mouth opening and thyroid goitre grade in predicting the use of the BURP maneuver. It is important to keep in mind, however, that difficult intubation may occur in some uncommon types of goiter, such as retrosternal goiter, even if the thyroid gland size is small. Therefore, it may be useful to consider performing the BURP maneuver.

Manajemen Anestesi Operasi Total Thyroidectomy Pada Pasien Struma Multinodosa: Laporan Kasus

Goiter is an enlargement that occurs in the thyroid gland. Goiter can be classified based on physiology (euthyroidism, hypothyroidism, and hyperthyroisdism), morphology (diffuse and nodular goiter) and clinically (toxic and non-toxic goiter). Multinodular goiter is an enlargement of the thyroid gland with multiple nodules in which the thyroid gland follicles experience changes both morphologically and functionally. The characteristics of nontoxic multinodose goiter are slow, continuous and expanding growth. Surgery is one treatment for most types of goiter. The operation is performed under general anesthesia. Operative procedures performed on the head and neck are high-risk operations that can cause brain damage and result in death. Therefore, it’s necessary to prepare an anesthesia plan as well as appropriate pre-operative, intra-operative and post-operative management to avoid complications that may occur. Mrs. BP, 65 years old, came with complaints that a lump had appeared in his neck since approximately 2 years ago and had grown to approximately 5 cm in the last 1 year. In 2003 the patient underwent partial thyroidectomy under general anesthesia. This case report aims to look at anesthetic management in patients with multinodose goiter, where appropriate anesthetic management also determines the success and prognosis of surgical procedures in these patients.

An uncommon and distinctive type of goiter to recognize: about 5 cases

An uncommon and distinctive type of goiter to recognize: about 5 cases

A rare case report of accessory thyroid in the superior mediastinum in the form of multinodular goiter

Retrosternal expansion of a goiter is one of the most common types of mass in the upper mediastinum. Although there is no clear definition of retrosternal, substernal, or mediastinal goiter in the literature, it usually refers to an extension of thyroid tissue from the cervical part that continues to the anterior mediastinum of the aortic arch. One of the interesting features of these cervical mediastinal lesions is that they may not be continuous. Such goiter types classically present with compression symptoms such as dyspnea, dysphonia, dysphagia, or sleep apnea, and less frequently, these masses can compress neurovascular structures, leading to superior vena cava (SVC) syndrome and Horner’s syndrome. In our case report, A 47-year-old female from North Karnataka presented to the hospital with history of dyspnea, dysphonia, and dysphagia persisting for the last 3 years. After careful examination and investigation, a diagnosis of thymoma was made initially. However, upon biopsy of the excised tumor, unexpected finding was revealed, it was identified as a multinodular goiter (MNG) rather than a thymoma.

Ectopic thyroid mass separately present in mediastinum and not a retrosternal extension: a rare case report

Retrosternal extension of goiter is one of the most common types of masses in the superior mediastinum. These types of goiters classically present with compressive symptoms such as dyspnoea, dysphonia, dysphagia, or sleep apnea. Surgical treatment with a total thyroidectomy and complete removal of the intrathoracic portion of thyroid is the gold standard treatment. These cervico-mediastinal lesions at times may not be continuous, and a sternotomy may be required for complete and safe excision of the mediastinal mass to achieve decompression of the surrounding structures and preventing the hemorrhagic complications if attempted from cervical incision.

Gambaran Kejadian Struma di RSU Negara Tahun 2019-2020

ABSTRACT
 Introduction: A goiter, also called a goiter, is a swelling of the neck due to enlargement of the thyroid gland due to thyroid gland disorders, which can be in the form of dysfunction or changes in the arrangement of the gland and its morphology can be in the form of diffuse or nodus Based on the results of research conducted, it is estimated that around 200 million people worldwide suffer from goiter. The results of research on goiter in Indonesia, show the prevalence of the total goiter rate (TGR) from 9.8% in 1998 to 11.1% in 2003. is still a public health problem in Indonesia and data on the incidence of goiters in Indonesia is still minimal. This study aims to obtain a description of the goiter based on age, gender, type of therapy.
 Method: This study used a retrospective descriptive study, the sample used was the State Hospital patient with goiter who met the criteria, the sample collection method used medical records which were then processed using the SPSS program, then presented in a table form.
 Result: Female patients were the most suffering from goiter (68.3%) in this study. The highest incidence of goiters in this study was the type of toxic goiter, namely 25 people (61%).
 Conclusion: The highest incidence of goiter in the type of toxic goiter, female sex, age 45-54 years, and most types of operative therapy.
 
 Keyword: Struma, Struma Nodusa, Goiter

Goiter size changes as an indicator of response to treatment following selenium intake, and its correlation with goiter type

Introduction: Goiter is a common problem in the world; however, it is more prevalent in countries with iodine deficiency. Goiter has different etiologies while one of them is Hashimoto’s thyroiditis. Selenium is a trace element that has different important effects in the body. It has also some effects in the thyroid. Objectives: This study aimed to evaluate the effect of selenium intake on goiter size and the correlation with goiter type. Patients and Methods: In prospective observational study, 20 patients with Hashimoto’s goiter and 40 patients with non-Hashimoto’s goiter were evaluated for thyroid sizes. The nodule sizes were else evaluated. After the first evaluation, daily selenium supplement (200 mg) was prescribed for all patients for six months. After this time, the sizes of goiter and nodules were measured again. Results: Results showed that the size of both goiter lobes in both Hashimoto’s and non-Hashimoto’s groups was significantly reduced before and after selenium intake (P<0.001). The reduction rate in left lobe size in patients with Hashimoto’s goiter was 50.73% and in nonHashimoto’s goiter patients was 20.89% (P<0.001). The reduction rate in right lobe size in patients with Hashimoto’s goiter was 53.37% and in non-Hashimoto’s goiter was 20.46 (P<0.001). Conclusion: We conclude that administration of selenium is effective in reducing the size of the goiter.

ANALYSIS OF MULTIVARIATE GOITRES: RETROSPECTIVE STUDY IN A TERITIARY CARE CENTRE

Objectives : To evaluate demographic profile, risk factors, clinical presentation, pathological features of thyroid swellings diagnosed and managed at our tertiary care hospital. The purpose of the study was to compare the following parameters pre and post surgery. The following parameters were noted Type of Goitre, clinical symptoms, Biochemical status (thyroid profile), surgical complications, post-op status-comparison between FNAC and histopathological report. Materials and Methods : A total of 127 cases of thyroid swellings on examination from March 2018 to May 2020 in BLDE(DU) Shri BM Patil Medical College Hospital and Research Centre, Vijayapura were included. The medical records were retrieved, studied and analysed retrospectively with regards to type of goiters, clinical symptoms, Biochemical status (thyroid profile), at the time of presentation and surgical complications. Histopathological details were analyzed. Results : The most number of cases were noted in 41-60yrs age group, with female predominance, solitary nodules being most common. Hemithyroidectomy being the predominantly done surgery and nodular goitre was seen in the final histopathogical report in most of the cases. Conclusions : In our study we concluded that USG and FNAC findings of the thyroid goiters had higher sensitivity and specificity in detecting thyroid tumors but it has low sensitivity for follicular carcinoma as observed in our study, discrepancy between FNAC and HPR.

Impact of anti-thyroid peroxidase and anti-thyroglobulin antibodies on the gestational outcome of euthyroid pregnancies: A retrospective study.

Thyroglobulin (anti-TG) and/or thyroid peroxidase (anti-TPO) autoantibodies are associated with higher rates of poor gestational outcomes. To demonstrate the impact of anti-TPO and anti-TG autoantibodies on the gestational outcomes of euthyroid pregnant women with a history of poor gestational outcome and thyroid gland disorders. This retrospective study included totally 75 euthyroid pregnant, 30 of women with high thyroid autoantibodies (Anti-TPO/Thyroglobulin-positive group) and 45 of them without autoantibodies (control group). We could not demonstrate significant differences between two groups in terms of risk factors/co-morbidities, obstetric complications, gestational outcomes, and birth data (p> 0.05). However, enhanced miscarriage rates were observed among the Anti-TPO/Thyroglobulin-positive and control groups without significance (36.7% and 17.8% respectively, p= 0.116). High neonatal intensive care unit (NICU) admission rates were found for control and Anti-TPO/Thyroglobulin-positive groups (16.2% and 21.1%, respectively) (p= 0.720). Clinically, we compared the two groups in terms of the existence and the types of goiter (diffuse and nodular), and demonstrated that nodular goiter was statistically more frequent in the control group (40.0% vs. 8.7%, p= 0.015). Alongside, relatively high hereditary thrombophilia and type-2 diabetes mellitus rates were found in the Anti-TPO/Thyroglobulin-positive group (20.0% and 20.0%). Thyroid autoantibody positivity is likely a risk factor for early pregnancy loss and NICU admission.

The correlation between iodine nutrition and autoimmunity among hyperthyroid goiter patients in tertiary care hospital of Tamil Nadu

Background: Iodine is a trace element that is essential for the formation of thyroid hormones. It is essential for the human life’s growth and development. The thyroid gland size and functions affected by deficient or excessive intake of iodine. Iodine excess intake was found to associating with iodine-induced hyperthyroidism (IIH) and autoimmune thyroiditis. Aims and Objectives: The present study was to find the hyperthyroid goiter patient nutritional status by urinary iodine excretion (UIE) measurement and correlate them with thyroid hormone and thyroid autoantibodies. Materials and Methods: In this study, 100 adult hyperthyroid goiter ssubjects and 100 apparently normal adult subjects were conveniently recruited in this study.Urinary iodine estimation and serum TSH, fT4, fT3, AMA, and ATG were estimated,which were estimated for case and control groups. Results: The hyperthyroid goiter patient mean UIE concentration was 278.98 μg/L and 68% of excess UIE which was found. There was significant difference in the UIE between the hyperthyroid goiter patient and control (P<0.001). The following types of goiter, based on palpation, were identified among the 100 hyperthyroid patients: Grade I – 4 %, Grade II – 63%, and Grade III – 33%. There were elevated serum AMA levelswith positive correlation of excess iodine for hyperthyroid goiter patient. Conclusion: In this study, there were excess UIEs among patients; hence, these associated complications, namely, benign goiter (14%), thyroiditis (43%), cancer of thyroid (4%), and thyrotoxicosis (39%) were observed.

Total Insights on Goiter in Children: A Mini-review

Background: Thyroid disorder is one of the main endocrine problems in childhood. In children with thyroid disorders, goiter is common. Objectives: In this mini-review, the authors aimed to present total insights on goiter in children. Methods: This is a mini-review about total insights on goiter in children. This review included articles assessing goiter in children. Web of Science, PubMed, and Google Scholar were investigated to find appropriate articles regarding goiter in children from 1988 to 2021. The keywords were thyroid, goiter, hyperthyroidism, hypothyroidism, and thyroid nodule. The authors included all study types assessing the pathophysiology, evaluation, and treatment of goiter in childhood. Results: Through taking the medical history and performing a physical examination, clinicians can differentiate types of goiter, including diffuse or nodular toxic or non-toxic, which can present themselves in euthyroid, hypothyroid, and hyperthyroid states. When taking a medical history, clinicians have to ask patients about their food intake, place of residence, and nutrient deficiencies to abstain from goitrogens. Diverse treatment methods are required for goiter in euthyroidism, hypophyroidism, and hyperthyroidism. In patients with euthyroidism, whenever there is iodine deficiency, a history of irradiation to the neck, or Hashimoto’s disease, suppressive therapy is needed. Both clinical and subclinical hypothyroidism need levothyroxine. Besides, in hyperthyroidism, antithyroid drugs, iodine therapy, or surgery are needed. Both clinical and subclinical hypothyroidism need levothyroxine. Conclusions: In hyperthyroidism, antithyroid drugs, iodine therapy, or surgery are needed. Based on the importance of managing goiter in children, clinicians have to consider food intake, vitamin deficiency, and iodine status in these patients.

Goiter surgery recommendations in sub-Saharan Africa in humanitarian cooperation.

BackgroundThe standard treatment for endemic goiter is usually total thyroidectomy. In low‐ and middle‐income countries, the management of thyroid disease, which is commonplace in fully developed countries, is not always possible. The purpose of this study is to establish a treatment algorithm to calculate the extent of thyroidectomy based on the risk factors of each patient.MethodsThis is a retrospective observational study conducted during the period between 2017 and 2019. A total of 287 patients with thyroid pathology were treated in Maragua Hospital (Kenya). The results of surgical treatment were analyzed after the implementation of an individualized treatment protocol.ResultsOne hundred and sixty patients with different types of goiter underwent surgery: solitary nodule (54.4%), multi‐nodular goiter (30.6%), diffuse goiter (10.6%), and intrathoracic goiter (3.8%). The techniques used were hemithyroidectomy (78.8%), Dunhill thyroidectomy (9.4%), bilateral subtotal thyroidectomy (6.9%), and total thyroidectomy (3.1%). There was no mortality. The surgical morbidity rate was 16% (only one major complication (3b)). Two cases of dysphonia were resolved in the first week. There were three cases of symptomatic hypocalcaemia, two of which resolved in the first week and the other of which was definitive. The follow‐up at 6 months was 67%. The cancer rate found in the resection specimens was 5%.DiscussionThe implementation of individualized surgical protocols for thyroid surgery in sub‐Saharan Africa can improve outcomes. The cooperation projects can increase access to complex surgical treatment for patients with limited resources in low‐ and middle‐income countries.

Prevalence and predictors of thyroid cancer among thyroid nodules: a retrospective cohort study of 1,000 patients.

Thyroid cancer is increasing in incidence globally due either to early detection (overestimation) or true increment. A recent debate concerns multinodular goitre (MNG) or toxic goitres which have classically been considered at a lower risk for cancer. In this study, we enrolled retrospectively all patients with nodular goitre treated at our tertiary hospital and analysed their data with the aim of detecting the rate of cancer among different types of nodular goitre. We also studied predictors of incidental malignancy among thyroidectomies. A predilection for solitary thyroid nodules (STNs) was found in women of younger age, with STNs tending to be larger in comparison with MNG in the same age group. However, both types of nodules were at equal risk of harbouring malignancy. Thyroid Imaging Reporting and Data System (TI-RADS) and Bethesda scores were the only dependent predictors of malignancy within thyroid nodules. The authors recommend management of both STNs and MNG using the same algorithm.

Patterns of Laryngeal Nerves Injuries Following Thyroid Surgery in Al-Imamein Al-Kadhmein Medical City

Background: Morbidity after thyroid surgery related to injuries to parathyroid, recurrent laryngeal nerve (RLN) and external branch of superior laryngeal nerve (EBSLN), mostly due to unawareness of the anatomical variations and lack of meticulous dissection added to that patient comorbidity and type of goiter. Objective: To assess the incidence of nerves injuries (RLN and EBSLN) and evaluation of the risk factors for nerves injuries. Methods: A prospective study included 250 patients admitted to the General Surgical Unit at Al-Imamein Al-kadhimein Medical City from the first of October 2014 to the end of October 2017. Evaluation of nerves injuries (RLN and EBSLN) with regard to thyroid pathology, types of resection, age and gender. Thyroidectomies were done by different surgical teams. Patients with recurrent goiter, prior cervical surgery and preexisting vocal cord paralysis were excluded. Vocal cords assessment was done preoperatively, intraoperatively at time of extubation and postoperatively. Patients with injury to the RLN were managed accordingly and followed up by serial examination for 6-12 month, while patients with symptoms of EBSLN injuries were followed depending just on clinical feature due to lack of diagnostic facilities. Results: There were 78 (31.2%), 172 (68.8%) male and females subsequently. The age range was (18-70) years and mean±SD was (44±11.9). Multinodular goiter was the main presentation in (168 patients), while thyroiditis was the least (6 patients). Injury to RLN was reported in 8 (3.2%) patients, 3 had unilateral and 5 had bilateral. Permanent damage documented in 2 patients. There was a significant RLN injury association with malignancy and total thyroidectomy. EBSLN injury have been reported in 55 patients (22%), it was transient in 43 patients and permanent in 12 patients. Conclusion: Nerve damage after thyroidectomy is not uncommon and affect significantly on quality of life. Careful dissection and awareness of anatomical variation is essential. Majority of injuries were transient and recovered spontaneously. Immediate intervention is not recommended unless airway compromisation ensure. Keywords: RLN, EBSLN, thyroidectomy Citation: Jaber SMA, Abdulhassan BA, Hussien HK, Al-Helfy SH. Patterns of laryngeal nerves injuries following thyroid surgery in Al-Imamein Al-Kadhmein Medical City. Iraqi JMS. 2021; 19(1): 10-17. doi: 10.22578/IJMS.19.1.2

Altered methylarginine levels after surgery in subjects with multinodular goiter.

Thyroid disorders are important risk factor for cardiovascular diseases. Levels of methylarginines such as asymmetric dimethyl arginine (ADMA), L-monomethyl arginine (L-NMMA), symmetric dimethyl arginine (SDMA) are increase in cardiovascular diseases. Multinodular goiter (MNG) is the most common type of goiter in adults. To date, no study has been conducted to determine the levels of methylarginine in euthyroid MNG patients. Our aim in this study is to compare levels of methylarginines and related metabolites in the preoperative, postoperative MNG patients and controls. Serum ADMA, SDMA, L-NMMA, homoarginine (hArg), arginine and citrulline concentrations were measured by liquid chromatography-tandem mass spectrometry (LC-MS/MS). ADMA (p<0.001), L-NMMA (p=0.002), l-arginine (p=0.006) and citrulline (p<0.001) levels were statistically significantly higher in preop group than postop group. ADMA (p=0.003), L-NMMA (p=0.003) levels were statistically significantly higher and SDMA/ADMA (p<0.001), hArg/ADMA (p<0.001) levels were statistically significantly lower in preop group than control group. The levels of methylarginines and related metabolites altered in the euthyroid MNG patients compared to the control group, and more importantly, there were significant differences between the preop and postop groups. Therefore, these metabolites can be useful in the diagnosis and prognosis of thyroid disorders, even if thyroid hormone levels are normal.

Nucleocytoplasmic correlation in thyrocytes in case of nodular types of goiter with recurrent and non recurrent course

The term «nodular» or «adenomatous» goiter is used concerning thyroid gland diseases of a various morphological structure. The disease is extremely widespread among the population especially in the regions with iodine deficiency. Fine-needle aspiration puncture biopsy under USD control with the cytological examination of punctate is a «gold» standard to diagnose thyroid nodes before surgery. Though this method differs from that of histological one, it enables us to give an idea concerning thyroid pathology occurring in a certain patient. Of course, postsurgical histological examination is the most accurate method of studying the thyroid tissue, but diagnostics of the pathology before surgery is more important for the choice of an adequate surgery with the purpose to minimize the risk of recurrence.The objective of the study was to determine nucleocytoplasmic correlation in the thyrocytes in the case of nodular types of goiter with recurrent and non-recurrent course and to compare findings obtained from histological and cytological specimens.Material and Methods. The histopathological method was used to examine the samples of postoperative recurrent nodular goiter, primary nodular goiter with a quick growth of nodes confirmed by ultrasonography findings, and primary nodular goiter with a slow growth of thyroid nodes diagnosed by means of USD, and thyroid tissue without pathology.Results. The area of nuclei in thyrocytes in the mean trends didn’t differ between study groups in any variant of pairwise comparison. The nucleocytoplasmic correlation was found to be statistically lower in all the main groups than that in with normal thyroid tissue in both histopathological preparations and in smears from thyroid punctures. Thus, in the group with relapse of nodular goiter it was 1,36 times as less, nodular goiter with quick growth - 1.28 and 1.22 times, respectively, and in the group with nodular goiter with slow growth - 1.46 and 1,05 times, respectively, compared with healthy thyroid tissue.Conclusions. The investigation determined that similar regularity occurs both in histological specimens and punctate smears from the thyroid gland – nucleocytoplasmic correlation in the thyroid cells decreases gradually in a line – the tissue of the normal thyroid gland, nodular/adenomatous goiter with slow growth, nodular/adenomatous goiter with quick growth, and relapse of nodular/adenomatous goiter. Though, quantitative data between histological and cytopathological specimens differ, the changes are of a constant character and enable to recommend histological and cytopathlogical examinations as quite equal.

An overview of retrosternal goiter.

Goiters tend to grow slowly and steadily over many years, occasionally reaching the mediastinum and extending through the thoracic inlet into the visceral compartment. In most cases, retrosternal goiters originate from the cervical portion of the thyroid. The incidence of retrosternal goiters varies considerably, ranging from 0.2 to 45% of all thyroidectomies, depending on the criteria used to define this type of goiter. Symptoms are generally related to the compressive nature of the mass on the adjacent structures, and most patients report some form of respiratory manifestation associated with the goiter. A diagnostic assessment usually includes an evaluation of thyroid function, chest radiography, and computed tomography. Fine-needle aspiration biopsy should be avoided in substernal areas of the goiter due to limited visibility and location of vital structures in this region. Treatment of retrosternal goiters is surgical, as medical therapy is generally unsuccessful in these cases.

SURGICAL TECHNIQUE OPTIONS IN THYROID OPERATIONS

The article highlights the analysis of 552 surgical interventions on different types of goiter performed on at the clinical base of the Department of Surgery No. 1, Ukrainian Medical Stomatological Academy (Poltava). The study included 491 women (88.9%) and 61 men (11.1%). Diffuse toxic goitre was diagnosed in 48 (8.7%) individuals, thyrotoxic adenoma occurred in 8 cases (1.5%), unilateral nodular goitre in 162 (29.3%), multinodular goitre in 334 (60.4%) patients. 20 (3.6%) patients were operated on relapsed goitre. The large size of the goitre, the adhesive process, and the cervical-retrosternal location of the thyroid gland complicate operating situation and often require innovative surgical decisions. Original methods for preventing the damage to the laryngeal nerves and thyroid glands, which are successfully used in non-standard surgical situations, as well as a method of mobilizing the thyroid gland in cervical and thoracic goitre. Complications during surgery were avoided by using extrafascial techniques for manipulating on the thyroid gland, using reliable controlled haemostasis and accuracy during the operation. The main factor to prevent specific intraoperative complications during surgery on the thyroid gland is a reasonable combination of the latest technology and the experience of the surgeon. Postoperative transitory hypoparathyroidism on days 7-8 was observed in 9 (1.6%) patients with normalization of clinical manifestations and calcium levels; 6 (1.1%) complained of hoarseness and weakening of the voice for 3 weeks. Most of these complications occurred in the first half of the period that was analyzed. These variants for performing surgery in difficult situations have enabled to improve the results of surgical treatment.

A comparative study between harmonic scalpel hemostasis and conventional hemostasis in total thyroidectomy

Background: Thyroidectomy is the most commonly performed procedure in endocrine surgery. Since the thyroid gland is highly vascular, therefore, rapid and absolute hemostasis is extremely required. Conventional thyroidectomy is commonly used with acceptable outcomes, however, it is time‑consuming and resulted in significant intraoperative blood loss with the possible risk of postoperative hemorrhage, injury to parathyroid glands and laryngeal nerves. The advent of focus harmonic devices was encouraging for improving safety, effectiveness, and reduction of operative time, especially in thyroid surgery. Aim of this study: The purpose of this study was to analyze the effectiveness and surgical outcomes of using ultrasonic harmonic scalpel for thyroid surgery compared to conventional techniques.Methods: This was a prospective, randomized study in which 60 patients with various types of goiters presented for thyroidectomy. The patients were divided into two comparable groups. Group A (30 patients) included patients who had focus harmonic thyroidectomy and Group B (30 patients) included patients who underwent conventional thyroidectomy.Results: Focus harmonic thyroidectomy showed a significant reduction in operative time, intraoperative blood loss, volume of postoperative fluid drainage and meantime for hospital stay compared with conventional thyroidectomy. There were no significant differences in the incidence of postoperative hypocalcemia, seroma, hematoma, wound infection and laryngeal nerve injury between both groups.Conclusions: Focus harmonic thyroidectomy was a safe, effective, faster, and appealing alternative to conventional technique since it reduced the operative time, intraoperative blood loss, postoperative drainage and hospital stay with comparable postoperative complications.

A Cross-sectional study assessing the Prevalence ofIodine Deficiency Disorders among school children aged6 to 12 years in Tumakuru district of Karnataka

Background Iodine deficiency disorders IDD constitute a major public health problem in India. Deficiency of iodine can cause physical and mental retardation cretinism abortions stillbirth deaf mutism squint amp various types of goitre. Methodology A community ndash based cross section survey was undertaken during the February-March 2019 in Tumakuru district of Karnataka to find out prevalence of goitre estimate urinary iodine excretion in 6-12 years old school children and household salt iodine concentrations. 2875 school children aged 6-12 years were examined for goitre. Urine samples of 270 childrenwere collected for estimation of urinary iodine using Sandell-Kolthoff method. Household salt samples of the 540 selected children from schools were analyzed for its iodine content by standard iodometric titration method. Results The overall prevalence of Goitre was found to be 9.5 among children examined. The median urinary iodine excretion UIE was 104 mugL. All the household salt samples were adequately iodized having Iodine content of gt15ppm. Conclusion Considering prevalence of goitre in 6-12 years children Tumakuru district is lsquoendemicrsquo for IDD. But as inferred from median UIE obtained IDD is not a public health problem of significance. Household level salt is adequately iodized as per NIDDCP recommendations