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Bhardwaj Y, Singh B, Bhadoria P, Malhotra R, Tarafdar S, Bisht K. Computed tomography angiographic study of surgical anatomy of thyroid arteries: Clinical implications in neck dissection. World J Radiol 2023; 15:182-190. [PMID: 37424736 PMCID: PMC10324493 DOI: 10.4329/wjr.v15.i6.182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 04/27/2023] [Accepted: 05/30/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND The course and variations of thyroid arteries must be understood by surgeons to prevent bleeding during operative procedures of the thyroid gland. There is limited scientific literature regarding the radiological anatomy of thyroid arteries in this geographical area, the Garhwal region of Sub-Himalayan belt, which is considered to be the endemic belt of goiter. Computed tomography angiography provides a three-dimensional orientation of the vascular and surgical anatomy of the entire cervical region.
AIM To estimate the proportion of variation in origin of thyroid arteries using Computed Tomography Angiography.
METHODS Using Computed Tomography Angiography, the presence and origin of the superior thyroid artery, inferior thyroid artery, and thyroid ima artery were observed and assessed.
RESULTS Out of total 210 subjects, superior thyroid artery was seen to be emerging from external carotid artery in 77.1% cases. The artery was found to be originating at the level of bifurcation of common carotid artery in 14.3% cases, whereas in 8.6% cases, it emerged as a direct branch of the common carotid artery. Similarly, the inferior thyroid artery was observed to be emerging from thyrocervical trunk, subclavian artery and vertebral artery in 95.7% cases, 3.3% and 1% cases, respectively. Thyroid ima artery was also reported in a subject, arising from the brachiocephalic trunk.
CONCLUSION To avoid vascular injuries, excessive and uncontrollable bleeding, intra-operative difficulties, and post-operative issues, it is imperative for surgeons to be aware of the course and variations of thyroid arteries
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Affiliation(s)
- Yashu Bhardwaj
- Department of Anatomy, All India Institute of Medical Sciences, Rishikesh 249203, Uttarakhand, India
| | - Brijendra Singh
- Department of Anatomy, All India Institute of Medical Sciences, Rishikesh 249203, Uttarakhand, India
| | - Pooja Bhadoria
- Department of Anatomy, All India Institute of Medical Sciences, Rishikesh 249203, Uttarakhand, India
| | - Rashmi Malhotra
- Department of Anatomy, All India Institute of Medical Sciences, Rishikesh 249203, Uttarakhand, India
| | - Swarnava Tarafdar
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Rishikesh 249203, Uttarakhand, India
| | - Kanchan Bisht
- Department of Anatomy, All India Institute of Medical Sciences, Rishikesh 249203, Uttarakhand, India
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Wassie MM, Smithers LG, Zhou SJ. Association Between Newborn Thyroid-Stimulating-Hormone Concentration and Neurodevelopment and Growth: a Systematic Review. Biol Trace Elem Res 2022; 200:473-487. [PMID: 33686634 DOI: 10.1007/s12011-021-02665-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 03/02/2021] [Indexed: 10/22/2022]
Abstract
Iodine nutrition during pregnancy can affect newborn thyroid-stimulating-hormone concentration (TSH). Associations of newborn TSH with the neurodevelopment and growth of children are inconsistent. The aim of the study was to systematically review the literature on the associations between newborn TSH and childhood neurodevelopment and growth. Databases including PubMed, Scopus, CINAHL, Embase, PsycINFO, WHO, and Iodine Global Network were searched for eligible studies. Seventeen studies were included. Neurodevelopment was assessed using different tools in children aged 1-12 years of age. The associations between newborn TSH and cognitive development were negative in studies from iodine deficient populations, while a null association was found in studies from iodine sufficient populations. A null association between TSH and psychomotor development was observed regardless of iodine status of the study populations. There was no evidence of an association between newborn TSH and child anthropometry, but evidence of negative association was found between newborn TSH and birthweight. Although the associations between newborn TSH and neurodevelopment may differ based on the iodine status of populations, most of the included studies did not adjust for the key confounders and had a small sample size. Quality data-linkage studies that utilize newborn TSH data from newborn screening with adequate adjustment for potential confounders are warranted to better understand the relationship between newborn TSH and neurodevelopment and growth in children. CRD42020152878.
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Affiliation(s)
- Molla Mesele Wassie
- Department of Food and Nutrition, School of Agriculture Food and Wine, The University of Adelaide, PMB1, Glen Osmond, 5064, SA, Australia
- Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Lisa Gaye Smithers
- School of Public Health, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
- Robinson Research Institute, School of Paediatrics and Reproductive Health, The University of Adelaide, Adelaide, Australia
| | - Shao Jia Zhou
- Department of Food and Nutrition, School of Agriculture Food and Wine, The University of Adelaide, PMB1, Glen Osmond, 5064, SA, Australia.
- Robinson Research Institute, School of Paediatrics and Reproductive Health, The University of Adelaide, Adelaide, Australia.
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Gaurav K, Yadav S, Kumar S, Mishra A, Godbole MM, Singh U, Mishra SK. Assessment of iodine nutrition of schoolchildren in Gonda, India, indicates improvement and effectivity of salt iodisation. Public Health Nutr 2021; 24:6211-6217. [PMID: 33966669 PMCID: PMC11148573 DOI: 10.1017/s1368980021001956] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To study the total goitre rate (TGR), urinary iodine concentration (UIC) and salt iodine content among schoolchildren in a previously endemic area for severe iodine deficiency disorder (IDD). DESIGN Cross-sectional epidemiological study. SETTING The study was carried out in the Gonda district (sub-Himalayan region) of North India. PARTICIPANTS Nine hundred and seventy-seven schoolchildren (6-12 years) were studied for parameters such as height, weight, UIC and salt iodine content. Thyroid volume (TV) was measured by ultrasonography to estimate TGR. RESULTS The overall TGR in the study population was 2·8 % (95 % CI 1·8, 3·8). No significant difference in TGR was observed between boys and girls (3·5 % v. 1·9 %, P = 0·2). There was a non-significant trend of increasing TGR with age (P = 0·05). Median UIC was 157·1 μg/l (interquartile range: 94·5-244·9). At the time of the study, 97 % of salt sample were iodised and nearly 86 % of salt samples had iodine content higher than or equal to 15 part per million. Overall, TGR was significantly lower (2·8 % v. 31·0 %, P < 0·001), and median UIC was significantly higher (157·1 v. 100·0 μg/l, P < 0·05) than that reported in the same area in 2009. CONCLUSIONS A marked improvement was seen in overall iodine nutrition in the Gonda district after three and a half decades of Universal Salt Iodisation (USI). To sustainably control IDD, USI and other programmes, such as health education, must be continuously implemented along with putting mechanisms to monitor the programme at regular intervals in place.
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Affiliation(s)
- Kushagra Gaurav
- Department of Endocrine Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, Lucknow226 014, India
| | - Subhash Yadav
- Department of Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Sheo Kumar
- Department of Radiodiagnosis, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Anjali Mishra
- Department of Endocrine Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, Lucknow226 014, India
| | - Madan M Godbole
- Department of Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Uttam Singh
- Department of Biostatistics & Health Informatics, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Saroj K Mishra
- Department of Endocrine Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, Lucknow226 014, India
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Associations between newborn thyroid-stimulating hormone concentration and neurodevelopment and growth of children at 18 months. Br J Nutr 2021; 126:1478-1488. [PMID: 33494842 DOI: 10.1017/s0007114521000325] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The study aimed to assess the associations between newborn thyroid-stimulating hormone (TSH) concentration, a marker of iodine nutrition in early life, and childhood neurodevelopment and growth using data collected from two pregnancy studies, one in a borderline iodine-deficient setting (DHA to Optimize Mother Infant Outcome (DOMInO) Study) and one in an iodine-sufficient setting (Pregnancy Iodine and Neurodevelopment in Kids (PINK) Study). TSH data were obtained from routine newborn screening. Neurodevelopment was assessed at 18 months using the Bayley Scales of Infant and Toddler Development, third edition (Bayley-III). Weight, height and head circumference were measured at 18 months. In total, 1467 children were included in the analysis. Comparing the highest with the lowest TSH quartile, the mean differences (MD) in the Bayley-III scores ranged from -2·0 (95 % CI -4·7, 0·7) to -2·2 (95 % CI -5·8, 1·3) points in DOMInO and 1·0 (95 % CI -1·6, 3·6) to 2·0 (95 % CI -0·4, 4·4) points in PINK in the cognitive, language and motor scales; the MD in the anthropometric z scores ranged from -0·01 (95 % CI -0·5, 0·5) to -0·5 (95 % CI -0·9, -0·1) in both studies. A 1 mIU/l increase in TSH was associated with -0·3 (95 % CI -0·9, 0·2) point and 0·2 (95 % CI -0·3, 0·7) point changes in the mean cognitive score in the DOMInO and PINK, respectively. A null association between TSH and growth was also observed in both studies. Longitudinal studies that utilise newborn TSH data and examine neurodevelopmental outcomes at later ages are warranted, as neurodevelopmental assessments in older children are more predictive of later achievement.
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Kumar D, Raina SK, Chauhan R, Kumar P, Sharma S, Goel C. Assessing Adequacy of Iodine Intake among Children from 6 Months to 15 Years of Age from Hilly Terrains of North India. Indian J Endocrinol Metab 2021; 25:43-47. [PMID: 34386393 PMCID: PMC8323626 DOI: 10.4103/ijem.ijem_38_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 02/15/2021] [Accepted: 03/12/2021] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Routine outcome-based monitoring is required to assess the status of consumption of iodized salt as USI strategy. OBJECTIVE To assess the extent of recent iodine intake among children from 6 to 15 years of age in the hilly terrain of northern states of India. METHODS A school-based cross-sectional observational study among 227 children attending school was done for assessment of socio-demographic, dietary, salt consumption and urinary iodine concentration (UIC). RESULTS Mean age of children was about 6 years and 87.7% were consuming salt of >30 and none with <15 ppm iodine content. Median UIC was 138.0 μg/L. Among those assessed, 37.9% had adequate level of UIC, whereas about 20% and 40% participants had less (<99.0 μg/L) and more than adequate to excessive (≥200 μg/L) levels of UIC. Insignificant difference (p = 0.07) was observed for mean log UIC between cabbage eaters (2.3) and non-eaters (1.9) consuming salt >5 grams/day. CONCLUSION Recent iodine intake among children observed to be inadequate and effect of cruciferous food items on UIC needs to be studied despite high coverage of iodized salt among children.
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Affiliation(s)
- Dinesh Kumar
- Community Medicine, Dr. Rajendra Prasad Government Medical College, Kangra at Tanda, Himachal Pradesh, India
| | - Sunil K. Raina
- Community Medicine, Dr. Rajendra Prasad Government Medical College, Kangra at Tanda, Himachal Pradesh, India
| | - Raman Chauhan
- Community Medicine, Dr. Rajendra Prasad Government Medical College, Kangra at Tanda, Himachal Pradesh, India
| | - Parveen Kumar
- Community Medicine, Dr. Rajendra Prasad Government Medical College, Kangra at Tanda, Himachal Pradesh, India
| | - Sushant Sharma
- Community Medicine, Dr. Rajendra Prasad Government Medical College, Kangra at Tanda, Himachal Pradesh, India
| | - Chirag Goel
- Department of Health Research, Model Rural Health Research Unit, Una, Himachal Pradesh, India
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Current iodine nutrition status in Poland (2017): is the Polish model of obligatory iodine prophylaxis able to eliminate iodine deficiency in the population? Public Health Nutr 2020; 23:2467-2477. [PMID: 32476639 DOI: 10.1017/s1368980020000403] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE The monitoring of the populations' iodine status is an essential part of successful programmes of iodine deficiency elimination. The current study aimed at the evaluation of current iodine nutrition in school children, pregnant and lactating women as a marker of the effectiveness and sustainability of mandatory iodine prophylaxis in Poland. DESIGN The following iodine nutrition indicators were used: urinary iodine concentration (UIC) (all participants) and serum thyroglobulin (pregnant and lactating women). SETTING The study was conducted in 2017 within the National Health Programme in five regions of Poland. PARTICIPANTS The research included 300 pregnant women, 100 lactating women and 1000 school children (aged 6-12 years). RESULTS In pregnant women, median UIC was 111·6 µg/l; there was no significant difference in median UIC according to the region of residence. In 8 % of pregnant women, thyroglobulin level was >40 ng/ml (median thyroglobulin 13·3 ng/ml). In lactating women, median UIC was 68·0 µg/l. A significant inter-regional difference was noted (P = 0·0143). In 18 % of breastfeeding women, thyroglobulin level was >40 ng/ml (median thyroglobulin 18·5 ng/ml). According to the WHO criteria, the investigated sample of pregnant and lactating women was iodine-deficient. Median UIC in school children was 119·8 µg/l (with significant inter-regional variation; P = 0·0000), which is consistent with iodine sufficiency. Ninety-four children (9·4 %) had UIC < 50 µg/l. CONCLUSIONS Mandatory iodisation of household salt in Poland has led to a sustainable optimisation of iodine status in the general population. However, it has failed to assure adequate iodine nutrition during pregnancy and lactation.
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Wassie MM, Middleton P, Zhou SJ. Agreement between markers of population iodine status in classifying iodine status of populations: a systematic review. Am J Clin Nutr 2019; 110:949-958. [PMID: 31268129 DOI: 10.1093/ajcn/nqz118] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 05/10/2019] [Accepted: 05/24/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Population iodine deficiency is indicated by >3% of the population with newborn thyroid-stimulating hormone (TSH) concentration >5 mIU/L, median urinary iodine concentration (MUIC) <100 µg/L, or >5% prevalence of goiter in school-age children. However, the agreement between these population markers has not been systematically investigated. OBJECTIVE To assess the agreement between TSH, MUIC, and goiter as markers of population iodine status. METHODS We performed a systematic search for studies published on PubMed, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, and PsycINFO up to 29 October, 2018. Studies assessing iodine status in the population using the TSH marker and either MUIC or goiter prevalence in school-age children were included. The agreement between markers in classifying iodine status of the population was assessed. The sensitivity and specificity of the TSH marker was determined against MUIC and goiter prevalence as the reference markers. RESULTS Of 17,435 records identified by the search strategy, 57 eligible studies were included in the review. The agreement between markers in classifying the iodine status of populations into the same category was 65% for TSH and MUIC, and 83% for TSH and goiter prevalence. The TSH marker had a sensitivity of 0.75 and specificity of 0.53 when compared with MUIC, and 0.86 and 0.50 when compared with goiter prevalence. CONCLUSIONS The TSH marker has a better agreement with goiter prevalence than MUIC when classifying the iodine status of populations. Re-evaluation of the current criteria for classifying the iodine status of populations using the TSH marker is warranted. This systematic review was registered at PROSPERO (http://www.crd.york.ac.uk/prospero/) as CRD42018091247.
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Affiliation(s)
- Molla Mesele Wassie
- School of Agriculture Food and Wine, Faculty of Sciences, The University of Adelaide, Adelaide, Australia.,Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Philippa Middleton
- Robinson Research Institute, School of Paediatrics and Reproductive Health, The University of Adelaide, Adelaide, Australia.,South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Shao Jia Zhou
- School of Agriculture Food and Wine, Faculty of Sciences, The University of Adelaide, Adelaide, Australia.,Robinson Research Institute, School of Paediatrics and Reproductive Health, The University of Adelaide, Adelaide, Australia
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Shetty A, Rao CR, Kamath A, Sp V, Reddy T SK. Goiter Prevalence and Interrelated Components from Coastal Karnataka. Indian J Pediatr 2019; 86:159-164. [PMID: 30105567 DOI: 10.1007/s12098-018-2757-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Accepted: 07/24/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To assess prevalence of goiter and associated factors among school going children in Udupi district. METHODS A school based cross-sectional survey was conducted among 6-12 year old children. A sample of 30 villages was selected from the entire district by probability proportionate to size. One school was then randomly selected from each of the 30 villages. Goiter was assessed clinically and was graded as per the recommended criteria of World Health Organization (WHO)/ United Nations Children's Fund (UNICEF)/ International Council for the Control of Iodine Deficiency Disorders (ICCIDD). Salt and urine samples were collected from a subsample for iodine estimation. RESULTS A total of 2703 children were examined. The mean (±SD) age of the participants was 9.6 y (±1.9). The overall prevalence of goiter in Udupi district was found to be 9.3% with 7.0% and 2.3% having grade 1 and grade 2 goiter respectively. Prevalence of goiter was significantly higher among females [153(11.1%)] as compared to males [98(7.4%)] (p = 0.001). Of the 543 salt samples analyzed, 379 (69.8%) salt samples had adequate salt iodine content (> 15 ppm); while among the children with goiter 32 (8.4%) had inadequate salt iodine. Median iodine value was 202.12 mcg/l among the 270 urine samples tested for iodine levels. CONCLUSION Goiter prevalence at 9.3% in the coastal district contributes to the endemicity of the public health problem. The district had adequate iodine nutrition based on median urinary iodine levels. Hence, other contributing factors for the persistence of endemic goiter need to be explored.
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Affiliation(s)
- Avinash Shetty
- Department of Community Medicine, Kasturba Medical College (KMC), Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Chythra R Rao
- Department of Community Medicine, Kasturba Medical College (KMC), Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India.
| | - Asha Kamath
- Department of Statistics, PSPH, MAHE, Manipal, Karnataka, India
| | - Vibha Sp
- Department of Community Medicine, Kasturba Medical College (KMC), Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Sravan Kumar Reddy T
- Department of Community Medicine, Kasturba Medical College (KMC), Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
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Abstract
Micronutrients play an important role in the proper growth and development of the human body and its deficiency affects the health contributing to low productivity and vicious cycle of malnutrition, underdevelopment as well as poverty. Micronutrient deficiency is a public health problem affecting more than one-fourth of the global population. Several programmes have been launched over the years in India to improve nutrition and health status of the population; however, a large portion of the population is still affected by micronutrient deficiency. Anaemia, the most common form of micronutrient deficiency affects almost 50 to 60 per cent preschool children and women, while vitamin A deficiency and iodine-deficiency disorders (IDD) have improved over the years. This review focuses on the current scenario of micronutrient (anaemia, vitamin A, iodine, vitamin B12, folate, ferritin, zinc, copper and vitamin C) status in the country covering national surveys as well as recent studies carried out.
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Affiliation(s)
- Zaozianlungliu Gonmei
- Centre for Promotion of Nutrition Research and Training with Special Focus on North East, Tribal & Inaccessible Population, Division of Nutrition, Indian Council of Medical Research (Campus II), Tuberculosis Association of India Building, New Delhi, India
| | - G.S. Toteja
- Centre for Promotion of Nutrition Research and Training with Special Focus on North East, Tribal & Inaccessible Population, Division of Nutrition, Indian Council of Medical Research (Campus II), Tuberculosis Association of India Building, New Delhi, India
- ICMR-Desert Medicine Research Centre, Jodhpur, India
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