John, B Jacob (2020) Study of Thyroid Swellings in Tertiary Care Centre. Masters thesis, Sree Mookambika Institute of Medical Sciences, Kulasekharam.
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Abstract
BACKGROUND: Thyroid swellings are not rare and incidence is about 3-4% of adult population. Thyroid is not palpable normally. Swellings in thyroid may be solitary nodule, multiple nodules in single lobe or diffuse swelling. It can be toxic or non toxic. Non toxic can be endemic or sporadic. Endemic is one which more than 10% of population shows thyroid enlargement. Thyroid diseases are one of the commonest endocrine disorders worldwide. Incidence of thyroid disorders are increasing due to increased use of goitrogens and changing food habits. Thyroid diseases are easy to diagnose have easy access to medical treatment and swellings are easily visible to treating doctor. The prevalence of goiter is different according to the geographical region age and sex. In India, it is estimated that 42 million people are affected by thyroid diseases and coastal states like Goa, Gujarat, Kerala and hilly areas like Himalayan regions are endemic for thyroid lesions. Study done by R.Mansoor(2010) of 139 cases maximum fell between 16 and 40 years of age. Colloid goiter was most common among thyroid swelling followed by colloid goiter with cystic degeneration. Thyroid swellings are predominantly present in females of ratio 5:1. Women often develop thyroid enlargement during puberty, pregnancy, lactation and the menopause due to variation of thyroid hormones. Risk for malignancy is more in isolated than diffuse, solid swellings and men more than women. Thyroid swelling whether diffuse or solitary has to be evaluated to rule out neoplasm. USG, FNAC, TFT are the investigations done to determine who needs surgery or can be managed conservatively. FNAC has excellent patient compliance and is readily repeated. Some malignancies are difficult to be diagnosed by cytology alone like follicular carcinoma, papillary carcinoma. So the ultimate test for diagnosis is by HPE of excised thyroid gland. Population of Kulasekharam comes from mixed topography. People are from hilly and immigrants from coastal areas of Kerala. It is a Panchayat under Kanyakumari district. So the food habits also vary. Hence there will be variation in thyroid swellings in this area. More over there is a change in prevalence of goiter in hilly areas. Hence this study is conducted to find out the prevalence of various thyroid swellings in this population. MATERIALS AND METHODS: The study was a cross sectional study that was done at the General Surgery Department and Paediatrics Department at the Sree Mookambika Institute of Medical Sciences, Kulasekharam for a time duration of 18 months on 65 people, who served as a single group. The patients were chosen based on a pre - defined criteria. The study was started after the institutions ethical clearance committee gave ethical clearance to the study. Those who met the criteria were chosen and their legal guardian who accompanied them were given a through information regarding the study and the data that was to be collected .Those cases who were willing to give the informed consent to participate in the study and the data to be collected were enrolled in the study. RESULTS AND OBSERVATIONS: From my study it was found that females were more commonly affected with thyroid disorders than men. Age also had some relation. Most common age group involved was 30-39years. Most common swelling in population was nodular goiter. Most common malignancy encountered was papillary carcinoma thyroid. It was also found that there is an association between SNT and swellings with neoplsia in FNAC with malignancy [p=0.001]. It was also found that there is no relation between diabetes or hypertension on thyroid diseases in population. It was found that even if swelling was found to be benign by USG, FNAC and clinically HPE showed malignancy (3.1%) which strengthens the aspect that any swelling in thyroid should undergo total thyroidectomy and not lobectomy or any conservative measures. CONCLUSION: There is gender preponderance in thyroid swellings to female. Most common swelling in thyroid in the population was nodular goiter. There is an association between SNT and FNAC of swellings showing neoplasia to malignancy. Most common malignancy in study population was papillary carcinoma thyroid. Majority of patients with thyroid swelling were in age group 30-39years. Mean age of patients with thyroid swellings was 42 years. Sensitivity of FNAC for identifying malignancy was 85.71% and that of specificity was 94.11%.
| Item Type: | Thesis (Masters) |
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| Additional Information: | 221711701 |
| Uncontrolled Keywords: | Thyroid Swellings, Tertiary Care Centre. |
| Subjects: | MEDICAL > General Surgery |
| Depositing User: | Subramani R |
| Date Deposited: | 12 Feb 2021 17:56 |
| Last Modified: | 12 Feb 2021 17:56 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/14082 |
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