European Journal of Molecular & Clinical Medicine

To determine the incidence of non-alcoholic fatty liver disease in patients with thyroid dysfunction.
Materials & method: A cross-sectional study was conducted on 100 patients attending the out-patient and in-patient department of general medicine. Ethical committee clearance was obtained.A detailed history was taken with reference to the onset, duration, and progression of the symptoms, anorexia, malaise, fatigue, weight loss, constipation, reflux, nausea, hematemesis, vomiting, pain in abdomen, itching, melena, fullness of abdomen, alcohol intake and amount, long-term diseases like diabetes mellitus, hypertension,  iron storage disorders, celiac disease, TPN, history of jejuno-ileal bypass, abetalipoproteinemia, disorders of copper metabolism, personal history and habits, family history, drug history, and such other relevant history.CBC, thyroid profile, liver function test, kidney function test, RBS, PPBS, FBS, lipid profile, blood urea, creatinine, HbA1c, total protein, albumin, globulin, A:G ratio and ultrasonography.
Results: In our study, elevated ALT and AST was reported among 40% and 37% of study subjects respectively. The incidence of non-alcoholic fatty liver disease (NAFLD) among the subjects having thyroid dysfunction was 36%.Univariate and multivariate analysis revealed that thyroid dysfunction and age > 50 years were independent risk factor of NAFLD.
Conclusion: Overall, our study suggests that thyroid function is associated with NAFLD.This is an important finding because it opens a discussionif the adequacy of the TSH level to a lower reference couldprevent the emergence of NAFLD.

Aim: Histopathological study of neoplastic lesions of thyroid in a tertiary care centre. Methods: This retrospective study was carried out in the Department of Pathology. The material for this study consisted of thyroidectomy specimens including lobectomy, partial thyroidectomy, subtotal thyroidectomy and total thyroidectomy. Every patient was preoperatively assessed by FNAC. Detailed information regarding age, gender, clinical details(hypothyroid, hyperthyroid and euthyroid), relevant investigations like Fine Needle Aspiration Cytology, USG reports, thyroid scan and operative findings were obtained from histopathological report forms.
Results: 80% cases were found to be females and 20% cases were males with a female: male ratio of 4:1. Among total of 100 neoplastic lesions, 27 cases were adenomas 21 cases of follicular adenoma and 6 cases of Hurthle cell adenoma were diagnosed accounting for 21% and 6% respectively of all neoplastic thyroid lesions. The age of the studied benign thyroid neoplastic lesions ranged from 11 years to 67 years with a mean age of 37.95 years and the relative peak age of incidence was seen in 20-30 years age group (28%). The young age group (≤20 years) and the elderly age group above 60 years constituted 9% and 5% of cases respectively. Malignant thyroid lesions accounted for 73% (n=73) of all neoplastic lesions. Papillary carcinoma was the commonest malignant tumor in this study seen in 60(82.19%) of all malignant lesions. Of these cases, 10(16.67%) were males and 50 (83.33%) were females with a female: male ratio 5:1. Most of the patients (n=18; 30%) were between 20-30 years of age. 8 cases of follicular carcinoma and 4 cases of medullary carcinoma were encountered in this study, comprising of 8% and 4% of all malignant neoplasms respectively. No case of anaplastic carcinoma were seen in our study.
Conclusion: Thus in conclusion, females accounted for 80% of patients with neoplastic thyroid lesions and the incidence peaked at a younger age. Papillary carcinoma was the most frequent thyroid cancer accounting for 60% of thyroid cancers and follicular adenoma was the common benign tumor

It determined the frequency, dimensions, treatment, and results of the COVID-19 pandemic in children who had endocrine problems and diabetes.
Methods: A worldwide network of endocrine societies was sent an internet survey in the form of a cross-sectional questionnaire. The professional and practice characteristics of respondents, the size of their clinics, the nation in which they practiced medicine, and the influence that COVID-19 had on endocrine illnesses were explored.
Results: The study was completed by respondents from 134 pediatric endocrine institutions located in 51 different countries and across all seven continents. The majority of pediatric endocrinology clinics have made adjustments to their standard checkups as well as their educational programming. More than twenty percent of clinics reported experiencing a lack of availability of crucial supplies or drugs. Patients diagnosed with diabetes and COVID-19 needed therapy in an intensive care unit. It has been clearly stated that pediatric patients with endocrine abnormalities have alterations in their biopsychosocial functioning as well as their behaviors.
Conclusions: This extensive worldwide study was carried out during the COVID-19 pandemic, and its findings underscore the fact that diabetes is more difficult to control than any other juvenile endocrine illness, and it also carries a higher risk of morbidity. It is necessary to acknowledge and treat the psychological anguish that has been caused by COVID-19. Every patient ought to have easy access to medical supplies, and it is essential that they maintain frequent interaction with the medical staff who are responsible for their treatment

Background:Thyroid gland is one of the vital endocrine organs and thyroid disorders are the most common endocrine disorders. The prevalence of thyroid disease in India is huge. Thyroid lesions usually present as goitrous enlargement and nodules. Non-neoplastic lesions are more common than the neoplastic lesions.
Materials and Methods: The present study was conducted both retrospective and prospectively and included 100 non-neoplastic thyroid specimens received to the department. The clinical details were noted, specimens were fixed in formalin and H&E sections were studied.
Results: Most of the patients were in the age group of third decade of life constituting about 57% of all the cases. There is female preponderance in the study overall, with female to male ratio of 2.4:1. In this study, the commonest non-neoplastic thyroid lesion observed was nodular goitre which accounted for 56%, followed by colloid goitre, 33%. Hashimoto’s thyroiditis is the commonest inflammatory lesion (5%) and 1 case of thyroglossal cyst diagnosed.
Conclusion: The present study was conducted to evaluate the spectrum of distribution of non-neoplastic thyroid lesions in the institute as these show higher incidence than the neoplastic lesions.

The aim of this study is tocompare the prevalence of various thyroid disorders between T1DM and T2DM populations. Present study is conducted at Amaltas Institute of Medical Sciences, Dewas, M.P.
Result: Out of 132 diabetic patients, 8.33% (11/132) were suffering from T1DM and 91.67% (121/132) from T2DM.Hyperthyroidism was  the  most prevalent  disorder  in  T1DM patients, occurring in up to 18.18% of the total T1DM population [9.09% were having primary hyperthyroidism and 9.09% were having T3 toxicosis syndromes]. Males and females are equally affected (Both 9.09%). In T2DM patients, primary hypothyroidism was the most prevalent disorder, occurring in up to 7.44% of the total diabetic population, followed by subclinical hypothyroidism in 5.79%, subclinical hyperthyroidism in 4.13%, hyperthyroidism in 0.83%, and nonthyroid dysfunction in 0.83% patients.
Conclusion: The prevalence of hypothyroidism in the male population was 8% (4/50),subclinical hypothyroidism 4% (2/50),subclinical hyperthyroidism as 4% (2/50) and patients suffering from nonthyroid illness as 2% (1/50). The values in female population were as follows: the prevalence of hypothyroidism was 7.04% (5/71) that of subclinical hypothyroidism was 7.04% (5/71), hyperthyroidism 1.40% (1/71) and subclinical hyperthyroidism was 4.22% (3/71).

Aim: To analyse the cardio vascular changes in newly detected hypothyroid patients.
Material and methods: This cross sectional study was conducted among patients attending the medicine OPD over a period of one year and total number of 50 patients was taken. In the present study for the measurement of TSH, T4, T3 radio-immuno assay was employed. ECG was recorded in all patients, in all the 12 leads, at a paper speed of 25mm per sec. at normal standardisation, PR interval of >0.2 seconds was taken as prolonged, QRS complexes of less than 5mm in limb leads and less than 10mm in chest leads was taken as low voltage complexes. In all the patients in the study, echocardiogram was done on 2-D MODE and Doppler. Each case was specifically screened for cardiovascular manifestations like pericardial effusion, ventricular dysfunction.
Results: Most common signs on general physical examination was skin changes (58%) followed by oedema (52%) and delayed ankle jerk (34%). No abnormality was detected among 54% of the subjects. ST & T wave change and sinus bradycardia was reported among 12% of the subjects. Low voltage complex was revealed in 10% of the subjects. Pericardial Effusion (PE) was present among 13 (26%) subjects.
Conclusion: Cardiovascular symptoms are less commonly associated with newly detected hypothyroidism. The occurrence of pericardial effusion in hypothyroidism is significantly related to the duration of disease, hence the need for early diagnosis of hypothyroidism.

Background: The aim is to study the serum electrolyte levels in thyroid patients
attending a tertiary care hospital.
Materials and Methods: Thyroid hormones plays vital role in maintaining body's
metabolism, BMR, thermoregulation and hemodynamic status and present study was
prospective study done in the patients attending TRR Medical College & Hospital. The
study was conducted over duration of 2 years from December 2019 to June 2021. All the
patients in the age group of 18- 40 years were taken in the study. Total 100 patients
were included in the study (50 cases, 50 controls) to study the evaluation of serum
electrolytes on thyroid patients.
Results: In the present study, with respect to association of cases and controls with age,
no significant causation was seen. In this study thyroid patients have no association with
age, with not much mean difference in age of cases (32.11 years) and controls (30.02)
years. Thyroid cases were found to be more females (90%) as compared to males (10%),
but the association of sex with disease is not significant. This further concludes that
though females are commonly affected with thyroid disorders, but their association is
by chance and not significant. All serum electrolytes (Na+, K+, Cl-), TSH shows a
positive relationship it signifies that as TSH increases in patient the level of these
electrolytes also increases, but this relationship of TSH with all the electrolytes was not
significant (p>0.05).

Introduction: Elevated anti-thyroid peroxidase (Anti-TPO) antibodies and thyroid
stimulating hormone (TSH) levels in hypothyroidism have been linked to the alter the
vitamin B12 metabolic pathway thereby imparting the anemia. Thyroid peroxidase is
an important enzyme responsible during organification of iodide for synthesis of
thyroid hormone. Antibodies to TPO are formed as a part of autoimmune response of
body causing autoimmune thyroiditis in patients. Antibodies to thyroid peroxidase
(TPO) are clinically useful markers of thyroid autoimmunity
Objectives: Present study aims to correlate the thyroid stimulating hormone and antithyroid
peroxidase expression in Anti-TPO positive patients with the anemia.
Methods:60 patients who were anti-TPO positive and hypothyroid were recruited in
present study.TSH level, anti-TPO antibodies level and haemogram was analysed
among all patients.
Results: There was a positive correlation between the haemoglobin and TSH level (r=
0.09580). There was a negative correlation between the Haemoglobin and Anti-TPO
expression (r= -0.2086).
Conclusion: Present study revealed a correlation of anemia with TSH level and Anti-
TPO expression which have the diagnostic value. Anti-TPO positive hypothyroid
patients have risk of developing anaemia.

Introduction: Vitamin D belongs to a group of fat-soluble secosteroids which helps in increasing intestinal absorption of calcium, iron, magnesium, phosphate, and zinc. In humans, vitamin D3 (also known as cholecalciferol) and vitamin D2 (ergocalciferol) are important compounds. Cholecalciferol and ergocalciferol can be ingested from the diet and from supplements.
Materials and Methods: This was a prospective observational study of postmenopausal women attending gynaec OPD department of Obstetrics and Gynecology, Kakatiya Medical College and MGM hospital, Warangal from1^st October 2021 to 30^th September 2022 (1 year). Apparently healthy postmenopausal women without any prolonged medical illness like diabetes, thyroid, hepato-renal disease, malignancy, or without any surgical illness were selected. Besides patients on HRT, steroids, bisphosphonates or any drugs affecting bone metabolism, smokers and alcoholics were excluded.
Results: Out of total 206 postmenopausal women attending gynaec OPD during the study period, only 122 women were found eligible for study after satisfying inclusion-exclusion criteria. We divided these postmenopausal women according to their age into five years age-groups, starting from 50 years to 70 years of age. Most common age-group was 55-60 years accounting for 49% followed by 50-55 years age-group making 41%, thus together adding up to 90% of study population. This shows the authenticity of study population. Mean age of study group was 56.9 years.
Conclusion: There is high prevalence of vitamin D deficiency among Indian postmenopausal women, but our study shows no correlation between hypovitaminosis D and fasting blood sugar. Besides, the cut-off level for vitamin D deficiency should be reviewed in Indian population looking at the scenario of adequate sunlight exposure, to prevent it from overtreatment and also for dietary modification. The role of bioavailable 25(OH) vitamin D should be ascertained.

Background: Thyroid diseases are endemic in India with around 42 million people suffering from them.
Hashimoto’s thyroiditis is the most common autoimmune pathology of the thyroid gland. Papillary
carcinoma thyroid is the most common thyroid cancer. The objective of this article is to study coexistence
of Hashimoto’s thyroiditis with papillary thyroid cancer.
Methods: Our study was prospective study carried out on 123 patients in the age group 14-65 in the
department of surgery Sree Gokulam Medical college and research foundation Venjaramoodu during the
period November 2011 to February 2013.A history was taken followed by clinical examination. They
were then investigated by thyroid function test, ultrasound neck X-ray neck, X-ray chest, indirect
laryngoscopy, fine needle aspiration cytology (FNAC) and anti-thyroid antibody tests. The patients were
taken up for surgery and histopathology reports were correlated with the findings of FNAC and antithyroid
antibodies.
Results: Out of the 123 patients who enrolled. For our study 115 were females. All patients presented
with a swelling in the neck. FNAC showed 70(56.9%) colloid goitre, 14(11.4%) had Hashimoto’s
thyroiditis, 11(8.9%) follicular neoplasm and 4(3.3%) papillary thyroid cancer. 60(48.8%) of patients of
123 had abnormal Anti- TPO antibodies and 70(56.9%) had positive Anti- thyroglobulin antibody. Of
the 123 patients 38(30.89%) had thyroiditis. 19(15.44%) patients had papillary thyroid cancer and 5(4%)
had papillary thyroid cancer and thyroiditis at the same time. All patients with papillary carcinoma
thyroid and thyroiditis were females.
Conclusion: In a country like India were thyroid diseases are endemic, benign thyroid diseases are very
common. Papillary thyroid cancer is the most common thyroid cancer and according to our study has a
26.3% coexistence with Hashimoto’s thyroiditis which is the commonest auto immune thyroid disease.
From this study we conclude that careful workup and surgery are recommended when dealing with
patients with thyroiditis especially women.

During the third week of gestation, the thyroid gland begins to form on the floor of the rudimentary pharynx. The thyroglossal duct carries the gland from its origin at the foramen caecum at the base of the tongue to its eventual resting place in the neck. These cysts of the thyroglossal duct and the unusual ectopic position of thyroid tissue at the base of the tongue (lingual thyroid) are both explained by this anatomical trait. Synthesis of thyroid hormone typically starts during the 11th week of pregnancy.
Thyroid follicular cells form the follicles seen in a fully developed thyroid gland, and the colloid they release is a proteinaceous fluid rich in thyroglobulin.⁹

The complication of the Thyroid is endless, affecting the lifestyle due to the effect on direct neurological disturbances. Mainly, depression and anxiety are closely linked with hypothyroidism. In this work, initially, we clinically describe Thyroid and its classification. Then we disseminate the genetic causes and the methods involved in diagnosing hypothyroidism. Finally, the effects of different treatments on curing chronic illness have been discussed.

INTRODUCTION: The neck is a part of the body that has many vital structures in a relatively small region with complex anatomy. Various pathologies of the neck may present as neck swellings. The mass may be first noticed by the patient, other individual or by the physician as an incidental finding during physical examination. With the improvement of CT imaging techniques, shorter examination time, higher resolution imaging, Multidetector CT is particularly useful in evaluation of neck masses. AIM OF STUDY: To assess the role of MDCT in neck masses for characterization of nature of lesion (benign or malignant) and organ of origin and to Correlate with tissue diagnosis wherever possible. MATERIALS AND METHODS: Patients presenting with clinical suspicion of neck masses and referred for MDCT neck to the Department of Radio-diagnosis and Imaging, DMCH, Ludhiana were included in this study. RESULTS: 18.9% patients were in 31-40 years age group. Mean age for malignant lesions was 58.3 years. Most common space involved was visceral space (48.9%) and the most common diagnosis was benign thyroid nodule(s) (30%). Many of malignant lesions showed ill-defined margins (68.18%), necrosis (62.5%), heterogeneous enhancement (68.2%), bony infiltration (20.8%), obliteration of fat planes (8.3%), metastasis (45.8%), involvement of adjacent neck spaces (37.5%), vascular involvement in form of internal jugular vein thrombosis (8.3%) of cases. In diagnosing malignant lesions, CT had a sensitivity of 95.83%, specificity of 96.30%, positive predictive value of 92.00%, negative predictive value of 98.11% and accuracy of 96.15%. CONCLUSION: MDCT has high accuracy for characterization of a lesion as benign or malignant. It provides the best possible contrast of soft tissue (with the choice of appropriate delay, contrast agent volume, flow rate and scanning time), visualization of vascular structures, extent of lesion, bone and airway details, thus helps in making diagnosis and deciding further course of management.

Maternal hypothyroidism, is a deficiency of the transfer of thyroid hormones from the mother to the
fetus. This study was designed to investigate the effect of induced hypothyroidism in female rats during
gestation (G), lactation (L) and gestation and lactation (G+L) on thyroid and testicular functions of
their male offspring at puberty. The hypothyroidism state was induced by administration of
propylthiouracil (PTU) (0.2) mg/kg b.w/day orally to three pregnant female rats’ groups during
different physiological state as follows: gestational group (treated from day 6 till parturition),
lactational group ( treated from parturition till weaning) and gestational and lactational (treated from
day 6 of parturition till weaning), in addition, to pregnant control group which received distilled water
(D.W) only. All offspring were weaned at 30 days age and six male offspring of each group were
chosen randomly and left without treatment until puberty (60 days) postnatal. Blood samples were
collected to the measurement of serum level of some hormones including thyroid stimulating hormone
(TSH), thyroxin (T4), triidothyronine (T3), testosterone (T), luteinizing hormone (LH), and folliclestimulating
hormone (FSH). Thyroid glands and testes were removed for histopathology study. The
results of hormonal analysis revealed a significant (P≤0.05) increase of TSH concentration in G and L
groups and a significant (P≤0.05) decrease of T4 in all treatment groups while a significant decrease in
T3 was recorded in the G group compared with the control group. Histopathological results showed
histological changes in both thyroid glands and testes in G, L, and G+L groups. The present study
concluded that the different maternal hypothyroidism periods have a nearly different impacts on
offspring male rat, where the G group was the most affected than others.

Maternal hypothyroidism, is a deficiency of the transfer of thyroid hormones from the mother to the fetus. This study was designed to investigate the effect of induced hypothyroidism in female rats during gestation (G), lactation (L) and gestation and lactation (G+L) on thyroid and testicular functions of their male offspring at puberty. The hypothyroidism state was induced by administration of propylthiouracil (PTU) (0.2) mg/kg b.w/day orally to three pregnant female rats’ groups during different physiological state as follows: gestational group (treated from day 6 till parturition), lactational group ( treated from parturition till weaning) and gestational and lactational (treated from day 6 of parturition till weaning), in addition, to pregnant control group which received distilled water (D.W) only. All offspring were weaned at 30 days age and six male offspring of each group were chosen randomly and left without treatment until puberty (60 days) postnatal. Blood samples were collected to the measurement of serum level of some hormones including thyroid stimulating hormone (TSH), thyroxin (T4), triidothyronine (T3), testosterone (T), luteinizing hormone (LH), and follicle-stimulating hormone (FSH). Thyroid glands and testes were removed for histopathology study. The results of hormonal analysis revealed a significant (P≤0.05) increase of TSH concentration in G and L groups and a significant (P≤0.05) decrease of T4 in all treatment groups while a significant decrease in T3 was recorded in the G group compared with the control group. Histopathological results showed histological changes in both thyroid glands and testes in G, L, and G+L groups. The present study concluded that the different maternal hypothyroidism periods have a nearly different impacts on offspring male rat, where the G group was the most affected than others.

Thyroid lesions are one of the common conditions encountered in clinical practice. The diseases of thyroid are of great importance because most of them are amenable to medical or surgical treatment. Often it is difficult to make an accurate diagnosis by clinical evaluation alone. Hence Fine Needle Aspiration Cytology (FNAC) study of such lesions along with clinical evaluation is emphasized in order to aid towards accurate diagnosis. A uniform reporting system for thyroid FNA will facilitate effective communication among cytopathologists, endocrinologists, surgeons, radiologists, and other health care providers. Also, it will facilitate cytologic-histologic correlation for thyroid diseases, facilitate research into the epidemiology, molecular biology, pathology and diagnosis of thyroid diseases, particularly neoplasia and allow easy and reliable sharing of data from different laboratories for national and international collaborative studies. The present study aims at diagnosing various thyroid diseases based upon cytomorphological features in FNAC.