Thyroid Diseases

preoperative intra muscular vit D injection

vit D

Assiut university

Vit D Role in Post Thyroidectomy Hypocalcemia

Role of Pre Operative Vit D Administiration in Decrease Incidence of Post Thyroidectomy Hypocalcemia

normal serum calcium level above 8.8 is the target

numbness , tingling or carpopedal spasm are undesirable clinical presentation of hypocalcemia

Mohamed Ramadan

Assiut University

The patients with non-toxic multinodular goiter are assigned to have high intensity focused ultrasound treatment.

The patients with non-toxic multinodular goiter are assigned to have radioactive iodine (i131) treatment.

Non Toxic Multinodular Goiter

High Intensity Focused Ultrasound

Echopulse is a real-time US-guided High-intensity focused ultrasound (HIFU) system, the HIFU session is a noninvasive procedure that involves application of a focused high-energy ultrasound beam for thermal tissue ablation inside the targeted zone, with minimal effect on the surrounding tissue

Echopulse

Radioactive iodine (RAI) is a radioactive form of iodine that for ablation in thyroid disease (i.e. Graves' disease or few thyroid cancer)

Radioactive iodine (Radioidine i131)

Queen Mary Hospital

HIFU Ablation vs Fixed-dose RAI-131 Therapy in Moderate-sized Non-toxic MNG

A Randomized, Open-label, Parallel-group Study to Determine the Efficacy of Sequential High-intensity Focused Ultrasound (HIFU) Ablation Versus Fixed-dose Radioiodine-131 Therapy in Moderate-sized Non-toxic Multinodular Goiter

To compare the absolute change in Thyroid nodule volume (in cm^3) after sequential HIFU treatment and a fixed-dose (370MBq) RAIT after 12 months.

To compare the absolute change in TTV between HIFU and RAIT groups

To compare the change in the largest/dominant nodule dimensions (in cm) between HIFU and RAIT groups

To compare incidence of treatment-related morbidities and hypothyroidism between HIFU and RAIT groups

To compare WHO goiter grade over time between HIFU and RAIT groups

To compare symptom improvement score (0-10) over time between HIFU and RAIT groups

To assess the changes in pressure symptom score (by Visual Analogue Scale, VAS, scoring from 0-10, 0 is for no pressure and 10 is for the maximum pressure feeling as subjects' view) over time between the HIFU and RAIT groups.

To assess the changes in quality of life (QOL) using by "12-Item Short Form Survey (SF-12) (VERSION 2.0)" between the two treatment groups. SF-12 is scoring 70 in total, the higher score represent higher quality of life.

To assess the changes in patient satisfaction (by Visual Analogue Scale, VAS, scoring from 0-10, 10 is for the maximum score representing well satisfaction) between the two treatment groups

To compare the direct and indirect costs between HIFU and RAIT (in dollars)

Dr. Lang Hung Hin, Brian

Clinical Professor

The University of Hong Kong

group 1 is for HIFU treatment, group 2 is for RAI treatment

will receive single dose intramuscular corticosteroid deltoid deposit (as phosphate and betamethasone acetate, 2 mL) for immediate postintubation.

will receive 2 ml saline 0.9% NaCl in deltoid immediately postintubation.

Transient Hypoparathyroidism

single dose of intramuscular depot corticosteroid

phosphate and betamethasone acetate, 2 mL.

saline 0.9% NaCl

Hospital Italiano de Buenos Aires

Steroids in the Postoperative Transient Hypoparathyroidism Total Thyroidectomy

Evaluation of Potential Benefits of Using Steroids in the Postoperative Transient Hypoparathyroidism Total Thyroidectomy

Serial postoperative blood samples will be made to detect hypocalcemia (defined as <8,5 mg/dL)
at 1 hour postoperative from skin closure,
at 6 hours after surgery
24 hours
72 hours

Any negative effects of corticosteroids will be also recorded in the postoperative and during 30 days follow up after surgery.
Major side effects associated with glucocorticoid therapy are:
Gastrointestinal (Gastritis, Peptic ulcer disease, Pancreatitis, Steatohepatitis, Visceral perforation) Dermatologic and soft tissue (Skin thinning and purpura) Cardiovascular (Arrhythmias, Hypertension, Hypotension)

hypoparathyroidism/edema

Vit D Role in Post Thyroidectomy Hypocalcemia

HIFU Ablation vs Fixed-dose RAI-131 Therapy in Moderate-sized Non-toxic MNG

Steroids in the Postoperative Transient Hypoparathyroidism Total Thyroidectomy

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