Correlation analysis of serum thyroglobulin,thyroid-stimulating hormone levels,and thyroid-cancer risk in thyroid nodule surgery

BACKGROUND Thyroglobulin(Tg)is one of the markers of thyroid cancer,and its concentration may be elevated in patients with malignant thyroid tumors.Thyroid-stimulating hormone(TSH)is secreted by the pituitary gland,which has a significant impact on thyroid gland function.Excessively high or low TSH levels may be associated with an increased risk of thyroid cancer.Thus,in-depth studies on the association of serum Tg and TSH levels with thyroid cancer risk in patients with thyroid nodules are warranted.This can help determine whether Tg and TSH levels can predict the degree of malignancy of thyroid nodules,which can in turn guide doctors in making accurate diagnoses and treatment decisions.Furthermore,such studies can provide more accurate diagnostic methods for thyroid nodules and help patients become aware of the presence of thyroid cancer as early as possible,thereby improving the success rate of treatment and prognosis.AIM To investigate the association of serum Tg and TSH levels with the risk of thyroid cancer in patients undergoing thyroid nodule surgery.METHODS The clinical data and laboratory examination results of 130 patients who underwent thyroid nodule surgery were retrospectively analyzed.Furthermore,their preoperative serum Tg and TSH levels were recorded.Histopathological examination conducted during follow-up revealed the presence of thyroid cancer.Correlation analysis were used to analyze the association of Tg and TSH levels with the risk of thyroid cancer.RESULTS Of the 130 patients,60 were diagnosed with thyroid cancer.Statistical analysis revealed a significant positive correlation between serum Tg levels and the risk of thyroid cancer(P<0.05).This suggests that high serum Tg levels are associated with an increased risk of thyroid cancer.However,no significant correlation was observed between serum TSH levels and the risk of thyroid cancer(P>0.05).CONCLUSION In patients who underwent thyroid nodule surgery,serum Tg levels exhibited a significant correlation with the risk of thyroid cancer but serum TSH levels did not.These findings suggest that serum Tg can serve as an important biomarker for assessing the risk of thyroid cancer in these patients.

Post Thyroidectomy Assessment of Intact Parathyroid Hormone for Early Prediction of Hypocalcaemia

Background: As the half-life of intact parathyroid hormone (iPTH) is very low, it reflects parathyroid insufficiency within minutes to hours after total thyroidectomy. Therefore, iPTH level assessment in the postoperative period can be used to predict the development of hypocalcaemia. The optimal time point to measure serum iPTH is important for the accurate prediction of hypocalcaemia. Aim: This paper aims to evaluate the ability of iPTH as an early predictive marker of hypocalcaemia and determine which time iPTH is more able to predict postoperative hypocalcaemia. Method: This prospective observational study was conducted in the Department of Otolaryngology-Head & Neck Surgery, BSMMU, Dhaka, from July 2020 to December 2021, with 67 patients who underwent total thyroidectomy. iPTH levels were measured on the day before the operation and at 1 hour, 4 hours, and 24 hours after the operation. S.calcium levels were measured on the day before the operation and 1st postoperative day. All the data were compiled and sorted properly and were analyzed statistically. Results: Postoperative hypocalcaemia developed in 18 cases, with an incidence of 26.9%. Pearson correlation showed a significant correlation between postoperative iPTH at 1 hr, 4 h, and 24 hr with 1st postoperative calcium value. The Receiver operating characteristic (ROC) curve was processed for the postoperative iPTH at 1 hr, 4 h, and 24 hr. The sensitivity, specificity, cut-off value, and mean AUC found 93.9%, 94.4%, ≤14.0, 0.988;95.9%, 94.4%, ≤09.5, 0.993 and 91.8%, 94.4%, ≤11.0, 0.993 respectively. Conclusion: iPTH can be used as an early predictor of post-thy-roidectomy hypocalcaemia. 4 hr iPTH showed more sensitivity and specificity for a cut-off value near the laboratory reference range.

SOOJI CHIM (Koryo hand acupuncture) for perimenopausal insomnia:Evidence from actigraphy and serum hormone testing

Objective:This study is conducted to determine the effects of SOOJI CHIM(Koryo hand acupuncture,KHA)therapy on sleep structures and perimenopause symptoms among insomniacs.Methods:Totally 49 participants who met the inclusion criteria were enrolled in a two-arm randomized,placebo controlled,patients-blind trial,with 24 cases allocated to a real-KHA group and 25 cases allocated to a sham-KHA group.Patients in each group received corresponding treatment every other day,three times a week for total eight weeks.Both actigraphy and testing of serum hormones level reflected by biological markers such as follicle-stimulating hormone(FSH),luteinizing hormone(LH)and estradiol(E2)were performed at pre-and post-treatment.Additionally,the scores of Pittsburgh sleep quality index(PSQI)was used for assessing the subjective sleep experience of insomniacs.Meanwhile,adverse effects were monitored and recorded.Results:After eight-week treatment,the global scores of PSQI declined significantly(P<0.05)in the realKHA group but not in the sham-KHA group(P>0.05).According to the outcomes of actigraphy,a striking increase was observed in both sleep efficiency(SE)and total sleep time(TST)in the real-KHA group(both P<0.05)but not in the sham-KHA group(P>0.05).However,no significant changes of sleep awakenings(SA)in both groups was found after treatment(both P>0.05).Meanwhile,FSH and LH in the real-KHA group decreased markedly after intervention(both P<0.05)while those indicators only slightly changed in the sham-KHA group(P>0.05).The fluctuation of E2 levels were not significant in both groups(both P>0.05).No serious adverse event was reported in either real-or sham-KHA group.Conclusion:KHA may be a potential alternative therapy for improving perimenopausal insomnia via down regulating the levels of FSH and LH.

A Study on Various Symptoms of Ohronic Hepatitis Treated with Radix Astragali and Its Regulative Effect to Levels of Serum Hormone

Sixty-seven cases of chronic hepatitis were treated with Radix Astragali. After treatment(2-month course) . the clinical improvement rate in 38 cases ot the Stagnation of the Liver-Qi and Defi-ciency of the Spleen type was 92. 1%. and in 26 cases of the Deficiency of Liver Yin and Kidney Yin typewas 88. 5% , more effective than in the control group (P<O. 05) . The regulative effect to the levels ofserum hormone was observed in the patients of the Stagnation of the Liver-Qi and Deficiency of the Spleentype treated with this medicine. The results showed that the levels of serum triiodothyronine, estradiol(female) and testosterone (male) were increased after treatment (1. 40 1. 38 ng/dl, 129. 30 1. 23 pg/ml and 496. 24 1. 47 ng/dl) . Pretreatment levels were 1. 22 1. 49 ng/dl, 104. 60 1. 45 pg/ml and 398.17 1. 55 ng/dl respectively (P<O. 05) . however, the level ot serum prolactin (2. 75 4. 46 ng/ml) waslower after treatment than before treatment (3. 20 3. 82 ng/ml, P<O. 05) . No obvious changes were ob-served in the levels of serum follicle stimulating hormone. luteinizing hormone, thyroid stimulating hor-mone, thyroxine, triiodothyronine uptake ratio and cortisol after treatment.

Effect of modified laparoscopic salpingectomy on ovarian reserve:Changes in the serum antimüllerian hormone levels

Objective:To retrospectively estimate the impact of modified laparoscopic salpingectomy on the ovarian reserve in infertile women.Methods:There were 74 infertile women undergone modified laparoscopic salpingectomy from June 2016 to January 2017,and their levels of serum antimüllerian hormone,basal follicle-stimulating hormone and estradiol were reviewed retrospectively.Results:No significant change was detected in serum antimüllerian hormone at 3 months after surgery compared to preoperative level(p=0.857).Similar changes were observed for the basal follicle-stimulating hormone(p=0.102)and estradiol(p=0.233)level.Conclusions:Our results revealed that modified laparoscopic salpingectomy might be a valuable treatment for hydrosalpinx before in vitro fertilization.

Effect of thyroid hormone on serum NO concentration and iNOS activity of intestinal mucosa in septic rats

Objective To investigate the effect of exogenous thyroid hormone on serum NO and iNOS activity of intestinal mucosa in septic rats. Methods Septic model was established by cecal ligation puncture (CLP) in male SD rats. Triiodothyronine ( T3 ) was administered intraperitoneally to correct the low T3 syndrome of septic rats. Blood was collected to examine serum NO and thyroid hormone concentration. Intestinal mucosa iNOS activity was assayed using immunochemical stain. Results Mortality rate in the prevention group was significantly lower than the septic group (Log rank = 3. 85, P 【 0.05). Serum NO concentration was significantly lower in the prevention group (F=19.6,F【0.01). The degree of inflammatory injury of intestinal mucosa was much milder in the prevention group than in the septic group (x2 = 5.303,P【0. 05). Mucosa iNOS activity was also significantly lower in the prevention group (x2 = 4. 876, P【0. 01). Conclusion Thyroid hormone protects the intestinal mucosa barrier inhibiting the expression of

Recurrent acute pancreatitis as an initial presentation of primary hyperparathyroidism:A case report

BACKGROUND With 4.9 to 35 instances per 100000 cases,hyperparathyroidism is one of the rarest causes of acute pancreatitis.The major cause of primary hyperparathyroidism is a parathyroid adenoma,which can manifest clinically in various ways.CASE SUMMARY We discuss the unusual case of a 13-year-old boy with recurrent pancreatitis as the initial presentation of primary hyperparathyroidism.The cause of his recurrent pancreatitis remained unknown,and the patient had multiple admissions with acute pancreatitis over 3 years.His diagnosis was delayed due to the initial normal levels of parathyroid hormone,which were later reported elevated in a subsequent episode where ultrasound neck and thyroid scintigraphy revealed a parathyroid adenoma as the underlying cause.After the diagnosis was made,he underwent surgical resection of the adenoma.CONCLUSION This case study stresses the importance of considering uncommon causes for recurrent pancreatitis.

The relationship between concentration of growth hormone in serum and microangiopathy in patients with diabetes mellitus.

Objective To study the relationship between growth hormone (GH) and microangiopathy in patients with diabetes mellitus in order to elucidate pathogenesis on microangiopathy in diabetics. Methods GH and insulin (INS) were detected by radioimmunoassay, and blood sugar (BS) was detected by oxydase method. Results 138 NIDDM diabetics were examined. The concentration of serum GH in diabetics without microangiopathy (2.3±1.2 μg/L) was higher than in normal people (1.0±1.2 μg/L) and GH in diabetics with microangiopathy (5.74±1.94 μg/L) was higher than in diabetics without microangiopathy. The differences were significant ( P <0.01). As the history of diabetes went on, the level of GH in serum increased, and the incidence of microangiopathy increased too. The correlation of GH in serum with BS was parallel. The correlation of GH in serum with INS was not apparent. 27 IDDM diabetics were examined, their level of GH in serum (6.8±3.4 μg/L) was higher than that of NIDDM diabetics (4.6±1.8 μg/L). They were all patients with microangiopathy. Conclusion The rise of GH in serum may be an important pathogeny that causes microangiopathy in diabetics.

Alterations and clinical significance of serum thyroid hormone levels in patients with acute exacerbation of chronic obstructive pulmonary disease

Objective To observe the alterations of serum thyroid hormone levels in acute exacerbation of chronic obstructive pulmonary disease(AECOPD)patients without thyroid disease and therefore to investigate the association between serum thyroid hormone levels and the severity and prognosis of AECOPD.Methods Serum thyroid hormone levels including TT4,TT3,TSH,FT4 and

Suicide attempt of an overt hypothyroid patient with levothyroxine:A case report

Rationale: Levothyroxine is the most commonly used agent in thyroid hormone replacement therapy. Although there are many hypothyroid patients who use levothyroxine as a treatment, high level of thyroid stimulating hormone is found in a limited number of levothyroxine overdose cases worldwide.Patient concern: A 34-year-old male patient taking 4.5 mg levothyroxine for suicide. Diagnosis: Overdose of levothyroxine. Interventions: The patient was admitted to the intensive care unit for follow-up treatment. Cardiac rithym and vital parameters of patient were closely monitored. Outcomes: The patient discharged without any life-threatening complications. Lessons: Patient with initial high thyroid stimulating hormone levels may not be in hyperthyroidism crisis by levothyroxine poisoning.