E-ISSN:2349-4166
P-ISSN:2349-4158

Research Article

Pathological

Public Health Review - International Journal of Public Health Research

2015 Volume 2 Number 1 January-March
Publisherwww.medresearch.in

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

Naik M. R.1, Vudumula V. L.2*
DOI: https://doi.org/10.17511/ijphr.2015.i1.05

1 Naik M. R., Professor, Department of General Surgery, Government Medical College, Ananthapuramu, Andhra Pradesh, India.

2* Vudumula V. L., Assistant Professor, Department of General Surgery, Government Medical College, Ananthapuramu, Andhra Pradesh, India.

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.

Keywords: Hypothyroidism, Ananthapuramu, Thyroid, Goitre

Corresponding Author How to Cite this Article To Browse
Vudumula V. L., Assistant Professor, Department of General Surgery, Government Medical College, Ananthapuramu, Andhra Pradesh, India. Naik MR, Vudumula VL. Clinico pathological study of goitre among women in a tertiary government hospital. Public Health Rev Int J Public Health Res. 2015;2(1):25-29.
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https://publichealth.medresearch.in/index.php/ijphr/article/view/13

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2015-03-08 2015-03-13 2015-03-10 2015-03-30
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
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© 2015 by Naik M. R., Vudumula V. L. and Published by Siddharth Health Research and Social Welfare Society. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

Public Health Review - International Journal of Public Health Research 2015;2(1)25
Naik M. R. et al: Clinico pathological study of goitre among

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 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. 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 selectection was done by convienient sampling and inclusion and exclusion criteria are as follows.

Inclusion criteria: Willing, women diagnosed with goiter.

Exclusion criteria: Unwilling, severe thyroid disorders.

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 2 presents Relation of FNAC and age group. Table 3 presents Biopsy and age group. Table no 4 presents Table 4: Chief complaints among study subjects.

Table 1: Descriptive data on age of study subjects

Mean 36.51
Std. Error of Mean 2.403
Median 32.00
Mode 20
Std. Deviation 14.218
Variance 202.139
Range 45
Minimum 20
Maximum 65
Sum 1278

Mean age of the participants is 36.51

Table : 2 Relation of FNAC and age group

FNAC Age group Total
20-40 40-60 >60
Adenomatous goiter Count 0 1 0 1
% of Total .0% 2.9% .0% 2.9%
Adenomatous goiter
microcystic degeneration 		Count 0 1 0 1
% of Total .0% 2.9% .0% 2.9%
Colloid goiter Count 7 5 1 13
% of Total 20.0% 14.3% 2.9% 37.1%
Nodular colloid goiter Count 3 2 1 6
% of Total 8.6% 5.7% 2.9% 17.1%
Nodular colloid goiter
with cystic degeneration 		Count 2 0 0 2
% of Total 5.7% .0% .0% 5.7%
Nodular colloid goiter
with hemarrhage with cystic degenaration 		Count 1 0 0 1
% of Total 2.9% .0% .0% 2.9%
Nodular goiter Count 3 1 0 4
% of Total 8.6% 2.9% .0% 11.4%
Nodular goiter with cystic degeneration Count 1 0 0 1
% of Total 2.9% .0% .0% 2.9%
follicular adenoma Count 5 1 0 6
% of Total 14.3% 2.9% .0% 17.1%
Count 22 11 2 35

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Naik M. R. et al: Clinico pathological study of goitre among

Table 3: Biopsy and age group

Biopsy Age group Total
20-40 20-40 20-40
Adenoma thyroid Count 1 0 0 1
% of Total 2.9% .0% .0% 2.9%
Adenomatous goiter Count 3 2 0 5
% of Total 8.6% 5.7% .0% 14.3%
Colloid goiter Count 0 1 2 3
% of Total .0% 2.9% 5.7% 8.6%
Colloid goiter with cystic changes Count 1 0 0 1
% of Total 2.9% .0% .0% 2.9%
Hashimotos thyroiditis Count 1 1 0 2
% of Total 2.9% 2.9% .0% 5.7%
Micro follicular adenoma Count 1 2 0 3
% of Total 2.9% 5.7% .0% 8.6%
Mixed folliculal adenoma Count 5 0 0 5
% of Total 14.3% .0% .0% 14.3%
Multy nodular goiter Count 4 1 0 5
% of Total 11.4% 2.9% .0% 14.3%
Multy nodular goiter with fibrosis Count 1 0 0 1
% of Total 2.9% .0% .0% 2.9%
Multy nodular goiter with hashimotos thyroiditis Count 1 0 0 1
% of Total 2.9% .0% .0% 2.9%
Nodular goiter Count 2 2 0 4
% of Total 5.7% 5.7% .0% 11.4%
Nodular goiter with Degenarative changes Count 0 1 0 1
% of Total .0% 2.9% .0% 2.9%
Nodular goiter with cystic changes Count 1 0 0 1
% of Total 2.9% .0% .0% 2.9%
follicular adenoma Count 3 0 0 3
% of Total 8.6% .0% .0% 8.6%
multy nodular goiter with secondary haemarrhage,no malignancy Count 0 1 0 1
% of Total .0% 2.9% .0% 2.9%
Count 22 11 2 35
% of Total 62.9% 31.4% 5.7% 100.0%

Table 4: Chief complaints among study subjects

Complants Age group Total
20-40 20-40 20-40
Swelling neck Count 18 10 2 30
% of Total 51.4% 25.7% 5.7% 82.9%
Difficulty to swallow Count 4 1 0 5
% of Total 11.4% 2.9% .0% 14.3%
Count 22 11 2 35
% of Total 62.9% 31.4% 5.7% 100.0%

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. [6] The patterns of thyroid diseases observed in the current report are comparable with the available world literature. In the study conducted by Handa et al., the incidence of goitres among thyroid nodules was 57.6%, followed by thyroiditis (27.4%), adenomatous goitre (2.3%), follicular/hurthle cell neoplasm (1.4%) and malignant tumors (3.9%), of which papillary carcinoma was the commonest. [5,7] Another Indian study conducted by Andaleeb et al., in 2002 showed 54.7% of multinodular goitre and 27.6% of follicular lesions. [8].

Bandela et al.[9] from Andhra Pradesh reported 10% prevalence of SCH. Gayathri et al.[10] reported 2.8% prevalence of Sub clinical Hypothyroidism. Possible reason for such variability could be the different upper limit cut-offs used for TSH. The patients were between 17 to 90 years of age with a mean age of 41.49 years.

These findings correlate with studies condu cted by Chowdary et al , Hanumanthappa , who suggested occurrence of multinodular goiter in 2 nd and 3 rd decade of life. Our study findings are similar to the findings of Goellner et al, Altavilla et al and Manderkar et al. It was reported that most of the cases one can diagnose number of nodules clinically.

However ultrasonography has an important role in detecting actual number of nodules. This information is very essential for further investigations and necessary management. In 11 patients who have clinically solitary thyroid nodule turned out to be multinodular on USG. 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.

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Naik M. R. et al: Clinico pathological study of goitre among

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