Open Access Case Series

Minimally Invasive Open Thyroidectomy: A Safer Approach in the Era of Minimally Invasive Surgery-A Case Series

Devajit Chowlek Shyam, Ranjit Chowlek Shyam

Asian Journal of Research and Reports in Endocrinology, Page 1-7

Complications related to the conventional thyroidectomy like the long scar in front of the neck, paraesthesia, hyperesthesia, voice changes, and dysphagia is still the matter of concern with conventional thyroidectomy (CT). Due to all these complications, minimally invasive surgery of head and neck is becoming popular nowadays. Advantages of minimally invasive thyroidectomy surgery (MITS) over CT cosmesis, less post-operative pain, shorter hospital stay and better functional outcomes (in terms of voice and swallowing).  A thyroidectomy performed with incision of less than 3.5 cm, without endoscope is term as the minimally invasive open Thyroidectomy (MIOT) or minimally invasive or non-endoscopic thyroidectomy (MINET). Since Dec 2011 we performed seven MIOT. All patients were female aged between 16-40 years. All seven patients had unilateral thyroid swelling and the size ranging from 3.3 × 2.8 to 4×4 cm.  In the first three patients,  we made an incision of 3.5 cm but thereafter we reduced the length of the incision to 2.5 cm. Operating time was ranging from 107 minutes to 56 mins. Except for the superficial thermal burn at the skin edge, no other complications were encountered in our series. Hospital stay was between 1 -2 days. VAS score was 1 in all patients except the first patient who sustained a thermal injury. She had a VAS score of 2. We used a simple four parameters score: Excellent, Good, Fair and poor. Except for this patient all patient has very minimal pain and good remarks for the cosmetic outcome. With the improvement in our surgical techniques, our incision length, and duration of surgery reduced in subsequent cases. Minimally Invasive thyroidectomy is a safe procedure and as it does not require any special equipment and training it can be done in any centers irrespective of hospital infrastructure.

Open Access Case Study

Neonatal Diabetes Mellitus: A Case Report and Literature Review

B. G. Mande, A. S. Batina, O. J. Alworong’a, D. N. Ngbonda

Asian Journal of Research and Reports in Endocrinology, Page 1-4

Aims: To report a case of a neonatal diabetes mellitus observed in the Nouveau Village de Pédiatrie, Democratic Republic of Congo, between June 2014 and June 2018.

Cases Presentation: Neonate diabetes is a rare disease. It occurs to 1 newborn over 300000. Two forms are described: the transient and the definitive neonatal diabetes mellitus. We report a case of a male and term newborn, hospitalised for a neonatal infection, who had hyperglycemia. Therapeutic implications are discussed in the light of literature findings.

Conclusion:  Neonatal diabetes is a rare phenomenon but alert signs must be known. Screening of blood glycemia disorders should be systematic in sick newborn for early detection and successful treatment.

Open Access Original Research Article

The Importance of Laboratory Investigation of Thyroid Hormones in Various Thyroid Dysfunctions in Enugu South Eastern Nigeria

N. Okafor Edwin, O. U. Odurukwe, A. Meka Ijeoma, H. O. Obianyido, E. Chukwukelu Ekene, I. C. Ikegwonu, M. Nkonyo

Asian Journal of Research and Reports in Endocrinology, Page 1-9

Background: Thyroid disorder remains the disease of major public health importance in Nigeria. Clinical diagnosis in thyroid dysfunction is limited; hence diagnosis and management are dependent on accurate laboratory measurements and interpretation of results.

Objective: The present study was designed to evaluate the importance of serum total triiodothyronine (tT3), total thyroxine (tT4), Free triiodothyronine (fT3) and Free thyroxine (fT4) as reliable indicators to assess thyroid dysfunctions in Enugu Southeastern Nigeria.

Materials and Methods: The study was conducted at Department of Chemical Pathology (Endocrine unit) University of Nigeria Teaching Hospital (UNTH) Enugu, from 2015 - 2017.  It comprised of a total of 1182 participants. 336 patients (110 males, 226 females; age range 20-75 years) with hypothyroidism, 336 patients (100 males, 236 females; age range 20-75 years) with hyperthyroidism and 510 healthy subjects (200 males, 310 females; age range 20-75 years) with detailed medical history.  After due consent, chest x-ray was done. Blood samples for serum analysis of tT3, tT4, fT4, fT3 and thyrotropin (TSH) were collected between 8 to 10 am using Enzyme Linked Immunosorbent Assay (ELISA) method. The Pearson correlation between tT3, tT4, fT3, fT4 and TSH was determined to identify the valuable indicator for thyroid function besides TSH.

Result: The correlations of tT3 and fT3 with TSH were statistically significant in healthy population  P = .003,  .015 and   r-values  were .130 and -.108) respectively. The correlations of fT3 and fT4 with TSH were statistically significant in patients with hypothyroidism and (P <.0001) and r-values were -.480 and -.307 respectively. The correlation of tT3, fT3 and tT4 with TSH were statistically significant in patients with hyperthyroidism and (P<0001) and  r-values were -.459, - .337 and -.313 respectively.

Conclusion: TSH, tT3 and fT3 are the indicators of thyroid function in healthy population, TSH fT3,fT4 in hypothyroidism. TSH, tT3 and  tTin hyperthyroidism.

Open Access Original Research Article

Cardio-Metabolic Risk Profile of a Diabetic Population in the Ho Municipality

Sylvester Yao Lokpo, William K. B. A. Owiredu, Percival Agordoh, Eric Agboli, Louisa Naa Akunsah Amoo, Mark Noagbe, George Yiadom Osei, Romeo Asumbasiya Aduko, Gifty Nkansah, Prosper Mensah

Asian Journal of Research and Reports in Endocrinology, Page 1-11

Background: This study aimed to determine the burden of cardio-metabolic risk factors among type 2 diabetes clients undergoing clinical management at the Ho Municipal Hospital in the Volta Region of Ghana.

Methodology: A hospital-based, cross-sectional study was conducted among sixty-two (62) individuals presenting with type 2 diabetes at the Diabetic Clinic from November 2017 to February 2018. The participants aged between 20-60 years were purposively recruited. Demographic data was captured using a semi-structured questionnaire. Anthropometric, haemodynamic and other laboratory variables were obtained using standard methods.

Results: The prevalence of hypertension and prehypertension was 16.1% and 51.6% respectively. About 33.8% of respondents were overweight and 17.7% obese. Raised Total Cholesterol (TC), Triglycerides (TG), Low-Density Lipoprotein cholesterol (LDL-C), Very Low-Density Lipoprotein cholesterol (VLDL-C), and low High-Density Lipoprotein cholesterol (HDL-C) were 69.4%, 35.5%, 72.6%, 3.2%, and 17.7% respectively. Obesity was higher among the females (24.3%) compared to their male counterparts (8.0%). There was a significant association of waist circumference (central adiposity) with systolic blood pressure and atherogenic lipid parameters among study participants.

Conclusion: The burden of cardio-metabolic risk factors is high among type 2 diabetes individuals at the Ho Municipal Hospital. Overweight, prehypertension and raised LDL-C were the predominant risk factors. The cardio-metabolic dysregulation may be mediated by adiposity and dyslipidaemia. We recommend that individuals with high risk profiles are identified for rigorous management to delay or prevent any fatal outcome. 

Open Access Original Research Article

Disease of the Thyroid Gland: A Histopathological Perspective

Innocent Emmanuel, Mansur Ramalan Aliyu, Adam Ochigbo, Philip Akpa, Jagshak Barnabas Mandong, Barnabas Mafala Mandong

Asian Journal of Research and Reports in Endocrinology, Page 1-9

The thyroid is affected primarily by disease conditions which are variously classified and are not uncommon worldwide. They could lead to enlargement of the thyroid gland thereby earning the designation “goiter”. Globally, iodine deficiency has been identified as a major cause of goiter. This was a descriptive retrospective study of consecutive cases of thyroid specimen analyzed at the Histopathology Department of the Jos University Teaching Hospital, Jos, Nigeria, between January 2008 and December 2017. The aim of this work is to study thyroid disorders histologically, relating these findings to age and sex, and comparing same with previous reports.

The Hospital’s Medical records and the Histopathology Departments served as sources for extraction of patient’s data which included age, sex, and histological diagnosis. Archival slides were reviewed to confirm the diagnosis of the thyroid lesion.

Three hundred and eleven (311) cases of thyroid disease were diagnosed histologically at the Jos University Teaching Hospital during the study period. These lesions were broadly classified into developmental anomalies, hyperplasias, immune/inflammatory diseases, and neoplasm. They accounted for 1.9% (6 cases), 81.3% (253 cases), 3.9% (12 cases), and 12.9% (40 cases) of all cases respectively. The age range of the study population was 1 year to 70 years, with a mean age of 41.2±12.0 SD, and peak incidence at 30 years to 39 years. There were 25 males and 286 females making a male female (M/F) ratio of 1:10.2.

Thyroid disorders are essentially a female disease in our environment occurring commonly in the third and fourth decade of life.