Clinico pathological study of goitre among women in a tertiary government hospital

Introduction: Diseases of the thyroid gland are one of the commonest endocrine disorders in India as well as in the world. It is estimated that nearly 42 million people in India suffer from thyroid diseases. They may be diffuse or nodular, benign or malignant, euthyroid or hyperthyroid in status. The spectrum of thyroid diseases includes simple goitre, thyroiditis, adenoma, carcinoma, multinodular goiter, hypo or hperthyroidism and Graves' disease. It is postulated that the incidence of thyroid nodule increases with age, in women, in people with iodine deficiency, and after radiation exposure. 
Materials & Methods: Study done in Government General Hospital Ananthapuramu. Cross sectional descriptive study. Study subjects were included based on inclusion criteria who have given consent for the study. 
Results: A total of 35 women were enrolled for this study. Mean age of the study subjects is 36.51 years. A report suggests a prevalence of 2-6% with palpation, 19-35% with ultrasound, and 8-65% in autopsy data while a prevalence of 4-7% has been estimated in another. 
Conclusion: The prevalence of goitre is different according to the geographical region, age and sex. Majority of the study subjects had Swelling of neck. Among Biopsy reports majority were diagnosed as Multy nodular goiter. We recommend further detailed study in this area to explore further details for the benefit og general population.


Introduction
Diseases of the thyroid gland are one of the commonest endocrine disorders in India as well as in the world. It is estimated that nearly 42 million people in India suffer from thyroid diseases. [1] They may be diffuse or nodular, benign or malignant, euthyroid or hyperthyroid in status. The spectrum of thyroid diseases includes simple goitre, thyroiditis, adenoma, carcinoma, multinodular goiter, hypo or hperthyroidism and Graves' disease. It is postulated that the incidence of thyroid nodule increases with age, in women, in people with iodine deficiency, and after radiation exposure. A report suggests a prevalence of 2-6% with palpation, 19-35% with ultrasound, and 8-65% in autopsy data [ 2 ] while a prevalence of 4-7% has been estimated in another [3 ] The prevalence of goitre is different according to the geographical region, age and sex. [4] Thyroid nodules are common clinical findings and have a reported prevalence of 4% to 7% in the adult population. Thyroid swellings are four times more common in females. FNAC has now supplanted most of the other tests for pre-operative evaluation of thyroid nodules. Thyroid surgeries are most common surgeries especially in the female population. Nearly more than 40%of the postoperative thyroid surgery patients experience significant postoperative pain with pain score above 4 reflecting inadequate analgesia considered independent risk factor. The present study was undertaken to study clinical pathology of goitre among women in a tertiary government hospital.

Materials & Methods
Study was conducted in Government General Hospital Ananthapuramu. Cross sectional descriptive study. Study subjects were included based on inclusion criteria who have given consent for the study. The study period was from January to July 2014. A total of 35 women mean age of 36.51 years were enrolled for this study after obtaining free, written, voluntary informed consent. The study was approved by institutional ethical committee. Participants

Research Article
Public Health Review: International Journal of Public health Research Available online at: www.publichealthreview.in 26 | P a g e selectection was done by convienient sampling and inclusion and exclusion criteria are as follows.
Inclusion criteria: Willing, women diagnosed with goiter.
Data analysis: Data was analyzed by SPSS 20.0. Data was expressed in frequency and percentage.

Results
Results are presented in table no 1 to table no 4. Table no 1 presents Descriptive data on age of study subjects. Table no 4  presents Table 2: Chief complaints among study subjects. Table 4 presents Biopsy and age group.

Discussion
India has the world's largest goitre belt in the sub-Himalayan region [5]. It has been estimated that 12% of adult population in India have a palpable goitre. [ Fine needle aspiration cytology is the most important investigation for multinodular goiter. Pre operative evaluation with ultrasound and FNAC can minimize the extent of surgery to be performed. Most of the times multinodular goiter turned out to be a benign pathology. Histopathological examination of the resected specimen proved useful to exclude malignancy.

Conclusion
The prevalence of goitre is different according to the geographical region, age and sex. Majority of the study subjects had Swelling of neck. Among Biopsy reports majority were diagnosed as Multy nodular goiter. We recommend further detailed study in this area to explore further details for the benefit og general population.