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Health related quality of life (HRQOL) is a multidimensional concept that encompasses the patient's perceptions of his or her physical, emotional, social, and cognitive functions. Despite DTC patients' long survival, HRQOL has been shown to be lower than in the general population. There is a scarcity of data on HRQOL in thyroid cancer in the Indian population and especially goiter endemic area. As a result, the authors conducted a health-related quality of life survey in patients managed at their center in Northern India's Sub-Himalayan region using two widely accepted questionnaires. Adults with differentiated thyroid cancer who had surgery with or without radio-iodine ablation and had recovered for at least 6 months were assessed using health quality of life surveys, the QLQ-C30 and QLQ-THY34 of the European Organization for Research and Treatment of Cancer Quality of Life Group. The survey was completed by 57 adults with a mean age of 45.64 ± 15.64 years. The average time between the survey and treatment was 13.3 ± 10.8 months. After surgery, the QLQ-C30 found a significant reduction in insomnia, appetite loss, constipation, diarrhea, and financial difficulties, whereas radio-iodine ablation significantly improved global health status. The QLQ-THY34 found a significant increase in symptoms such as voice concerns, hair problems, dry mouth, shoulder functioning, tingling, and worrying after surgery, with a significant improvement in swallowing and job impact symptoms. The surgical extent had no impact. The quality of life for people with differentiated thyroid cancer in goiter-endemic areas is similar to that of other areas. However, the limited number of subjects in the study warrants further large sample size longitudinal study to understand the exact Health-related quality of life in thyroid cancer in endemic area. [ABSTRACT FROM AUTHOR]

Introduction: Iodine deficiency disorders (IDD) have remained an unresolved public health problem in India. In this survey, we have estimated the prevalence of IDD among 6-12 years of school children in rural areas of north Karnataka, India and estimated the prevalence of low iodine content (<15 ppm) in salt at the household level and urine iodine excretion in this population. Material and Methods: In this cross-sectional survey, we recruited 16,827 children between 6 and 12 years of age through multistage sampling from six districts. Goitre was examined clinically for all children. Household-level salt iodine estimation and urinary iodine estimation were carried out among a subset of the participants. Results: Overall prevalence of goitre was 17.1% (95% CI: 16.5, 17.7). Out of this, 76.7% (n = 2116) had Grade-1 goitre, and 23.7% (n = 656) had Grade-2 goitre. The prevalence of goitre was higher among females (17.9%, vs. male 16.4%, P < 0.05). The prevalence of low iodine content (<15 ppm) in salt was 48.5% (95%CI: 46.7, 50.3). The overall median iodine excretion in urine was 85 µg/L (IQR: 60-150 µg/L). In total, 37.2% (n = 601) had mild iodine deficiency, 5.2% (n = 84) had moderate deficiency, and 10.1% (n = 163) had severe deficiency. All parameters showed high inter- and intradistrict variations. Conclusion: North Karnataka has a high goitre prevalence. Low use of iodized salt can be a major reason for the high prevalence of the condition. Ensuring the availability of iodized salt in this region and periodic surveillance to measure the impact of the programme should be the priority in this region. [ABSTRACT FROM AUTHOR]

This article examines how Dr. Robert McCarrison's goitre research in British India in the early twentieth century established his credentials as a medical researcher. It argues that the recognition that McCarrison achieved in this field had more to do with the fact that his research was conducted in a colonial non-Western locale. McCarrison resisted the Iodine Deficiency Disease explanation for goitre and critiqued successful public health initiatives conducted in the USA and Switzerland that involved distributing iodised salt or iodine supplements to populations to prevent goitre outbreaks. Thus, he created a path dependency in British India for himself and other British researchers, as well as his junior and affiliated Indian researchers, which impeded effective public health initiatives to prevent goitre outbreaks in India. [ABSTRACT FROM AUTHOR]

Background and Purpose: Pressure symptoms are usually uncommon in multinodular goitre (MNG). Imaging modalities fail to define the functional air flow dynamics of the upper airway. The airway-related changes due to MNG can be understood using a Pulmonary function test (PFT). To address this lacuna, this study was conducted to compare the pulmonary function profile of patients undergoing total thyroidectomy with benign MNGs using a pre-operative and post-operative pulmonary function test using Spirometry and assessing if surgery had an impact on airway status with varying volumes of thyroid gland measured with ultrasound Methods: The study was conducted in a tertiary care centre in South India between 2019-2020. Twenty-five patients with MNG undergoing total thyroidectomy were included in the study population. PFT (Spirometry -- Lung volume & Flow volume loop) was performed preoperatively and was compared with post-operative PFT after 6 weeks of surgery. The desired variables -- Forced Vital Capacity (FVC), Forced expiratory volume in 1 second (FEV1), FEV1 ratio & Peak expiratory flow rate (PEFR) were analysed & interpreted to ascertain changes in respective values attributable to surgery. Results: Mean (MEDIAN)thyroid gland volume(cc) of 25 participants in our study was 50.28 ±50.03. Statistically significant improvement was observed in the FVC (Preoperative mean 2.16 ± 0.59 to post-operative mean 2.43 ± 0.78), FEV1 (1.79 ± 0.53 to 2.07 ± 0.69), PEFR (356.8 ± 101.4 to 388 ± 99.4). However, the change in FEV1/FVC ratio (0.83 ± 0.05 to 0.84 ± 0.05) did not approach statistical significance. The study showed that in patients without restrictive lung disease, there is a statistically significant improvement in airflow dynamics following total thyroidectomy, irrespective of the volume of the gland. Conclusion: Alleviating upper airway obstruction is an important facet of surgical intervention for thyroid disease. Early surgery to prevent progressive worsening of the degree of obstruction should be considered, irrespective of the volume of the thyroid gland for patients with intrathoracic goitre and in cervical MNG with pre-existing airway compromise. [ABSTRACT FROM AUTHOR]

Background: Routine evaluation of Iodine Deficiency Disorders (IDDs) is done through a national program called National Iodine Deficiency Disorder Control Program (NIDDCP). The aim of this study is to determine the goiter prevalence, to estimate salt Iodine and urinary Iodine levels. Materials and Methods: An institution-based cross-sectional study was conducted among 2700 school children across seven taluks of Chikmagalur. A total of 2700 children aged 6 to 12 years were selected from 30 clusters by multistage sampling method. The iodometric titration method and Sandell–Kolthoff method were used for the estimation of salt and urinary Iodine, respectively. Descriptive and Inferential statistics were used. Results: The prevalence of goiter was 13.0%. About 153 (28.3%) salt samples had inadequate iodine content (<15 ppm). Median Urinary Iodine Excretion was 126 μg/L. Conclusion: Chikmagalur district is still at risk of a significant public health problem which needs timely interventions and appropriate measures to prevent further consequences due to IDDs. [ABSTRACT FROM AUTHOR]

Background: Iodine deficiency is a major public health problem, which leads to impaired neurodevelopment, particularly in early life and is the single most preventable cause of mental retardation and brain damage in children and fortunately, it is preventable. Aims: To estimate the prevalence of goitre among school children in Kodagu District and to estimate the urine iodine excretion and salt iodine content in a subsample. Patients and Methods: A cross-sectional study was conducted among school children of 6-12 years in the Kodagu district. Sampling was done by population proportionate to size cluster sampling method with 2700 study participants, 540 salt samples and 270 urine samples. Results: Out of 2700 study participants, the prevalence of goitre was 15.50%. Students of Madikeri Taluk, rural area students, 11-year-old students, Consumption of Goitrogens among students show significant association with goitre after multivariate logistic regression analysis. Urinary iodine excretion test shows 0.36%, 1.80% and 12.99% of the participants had severe, moderate and mild iodine deficiency, respectively. Conclusion: The prevalence of goitre was high indicating that it is an endemic area. Activities such as periodic surveys, provision of iodised salt and intensified monitoring and further evaluation of the IDD programme is obligatory to reduce the goitre rate. [ABSTRACT FROM AUTHOR]

Fine-needle aspiration cytology is considered the gold standard screening test in the evaluation of a thyroid nodule. We studied whether cell block cytology can be used in addition to conventional smears for the evaluation of tissue from fine-needle aspirations or fluid aspirations and also compared it with histopathological diagnosis. Aims: The primary aim of this study was to know the utility of cell blocks in the diagnosis of thyroid lesions. Settings and Design: This was a prospective observational study conducted from June 2018 to September 2020 at a tertiary Care Hospital in Eastern India. Ethical approval was obtained from the Ethics Committee of the institution. Patients above 18 years who presented with goiter were included in the study. Thirty patients were enrolled in the study after informed consent. Methods and Material: Smears prepared from the aspirates were stained with Leishman-Giemsa (LG) and Pap stain. The remnant from the needle hub was transferred to a sterile container. Cell blocks were prepared from the remnants. Smears were scored based on cell obscuration by blood, cellularity, cell degeneration, and cell architecture. The results were compared with histopathology. Statistical Analysis Used: Data were recorded using Microsoft Excel. Descriptive statistics, frequency, and proportion were used to describe demographic variables. Results: The majority of the patients (23.3%) were in their third decade of life, followed by 16.7% of the patients in their fourth and fifth decades. The patient age ranged from 25 to 80 years, with a mean age of 50.83 years and a standard deviation of 16.72. The largest number of patients were females accounting for 80% (24/30) of the total participants. The majority of the patients (36.7%) (11/30) had thyroid gland enlargement for a period of 15 days to three months. 14% of the participants were not able to recall its duration. The majority (60%) (18/30) had left lobe lesions, followed by 33.3% (10/30) who had right lobe lesions, and 6.7% (2/30) who had bilateral lobe swelling. The mean size of the lesion was 2.84 cm. 50% were found to be Bethesda II lesions, while 13.3% were Bethesda IV, and 36.7% were found to be Bethesda VI lesions. The cell block score (7) was found to be better compared to Fine Needle Aspiration Cytology (FNAC) (4.7). Tissue Coagulum Clot and Clot Scrape methods were found to yield better results compared to the Cytocentrifuge method. The P value was found to be significant (<0.001). Conclusions: Cell blocks were found to improve the cell morphology compared to FNAC alone and can be used as an adjunct to FNAC in the diagnosis of various thyroid lesions. [ABSTRACT FROM AUTHOR]

The mineral iodine is required by our body to make thyroid hormones which, in turn, control the body's metabolism and other important functions like bone and brain development in infants. Deficiency in iodine leads to a wide range of health issues in individuals collectively known as Iodine Deficiency Disorders (IDDs) which become more prevalent when the daily requirements are not met properly. Due to its geographical location in an intense goiter belt, the Indian population is prone to IDDs. According to World Health Organization (WHO), school-aged children, adolescents and pregnant mothers are at a high risk of the adverse effects of IDDs. The present paper focuses on the prevalence of TGR (total goiter rate) and UIE (urinary iodine excretion) level and household consumption of iodine salt among school-aged children in the world and in India with special reference to West Bengal. [ABSTRACT FROM AUTHOR]

Objective: Hyperthyrotropinemia (HT) or reduced thyroid function in Down syndrome (DS) is not uncommon, causes range from glandular dysgenesis to altered hypothalamopituitary axis. In the present study, we have compared hypothyroid Indian children with and without DS (NDS), especially focusing on family history, goiter, and biochemical features. Methods: We conducted this retrospective observational study from previous medical records of children with DS (1-17 years) having an elevated TSH (≥5 mIU/L) who were consecutively referred for with HT to Endocrinology OPD of a tertiary care hospital in India. Records from hypothyroid children (1-17 years) without Down Syndrome (NDS) were evaluated as controls. Free thyroxine (FT4), anti-thyroid peroxidase (TPO) antibody were measured and congenital hypothyroidism was excluded in all subjects. Results: Thirty-four DS cases [median age 8 years (IQR: 2-14), M: F = 13:21] and 34 controls [median age 10.5 years (IQR: 7-13.25), M: F = 13:21] were comparable in terms of age and sex, Median age of presentation was significantly earlier in case of DS vs NDS [7 years vs. 10 years]. DS children had significantly less family history of thyroid disorders compared to NDS [14.7% vs 64.7%]. Goiter was significantly less common in patients with DS [DS - 32.25% vs. NDS - 73.5%, P = 0.001]. Anti-TPO antibody positivity was significantly less common in patients with DS [DS- 41% vs. NDS- 73.5%, P = 0.014]. Conclusion: There is a significant difference in presentation in hypothyroid children with DS compared to NDS. DS children with hypothyroidism compared to NDS, had earlier presentation, lower incidence of traceable family history, goiter, and anti-TPO-antibody positivity. [ABSTRACT FROM AUTHOR]

Nodular goitre is the most common endocrine disease requiring surgical thyroidectomy for its cure. Though surgical exploration is routinely performed through conventional open-neck approach, a wide range of minimal access and minimally invasive endoscopic techniques (gasless and with gas) have been attempted in the past two decades. In this context, we report the feasibility and safety of an innovative transoral endoscopic thyroidectomy technique, which marks a paradigm shift in the endocrine surgery. This is a prospective study conducted at a tertiary care endocrine surgery department in Southern India from May 2016 to November 2018. We employed a novel transoral, lower vestibular route for endoscopic thyroidectomy. All the clinical, investigative, operative, pathological and post-operative data were collected from our prospectively filled proformas. Statistical analysis was performed with SPSS 20.0 version. Descriptive analysis was done. Out of the 604 goitre cases operated during the study period, 123 (20.4%) were operated by this technique. Hemithyroidectomy was performed in 104 and total thyroidectomy in 19 cases respectively. Mean operative time was 124 ± 18 min (100–220). There was extended subcutaneous emphysema on to upper chest in one case. Otherwise, the post-operative course was uneventful with no major morbidity, hypocalcemia, or recurrent laryngeal nerve palsy. All the cases had benign histopathology. We conclude that this novel transoral vestibular route thyroidectomy is a comparably optimal approach for nodular thyroid goitres, especially in benign cases. [ABSTRACT FROM AUTHOR]

Background: In India, iodine deficiency (ID) still remains a serious concern even after five decades of enormous efforts. ID during the preconception period of adolescent girls may negatively affect future neonates, resulting in neonatal hypothyroidism. Hence, the present study was conducted to assess the prevalence of goiter and associated factors among adolescent girls in a poor socioeconomic district of Rajasthan. Methodology: A cross-sectional study was conducted during January–March 2015 in Tonk district of Rajasthan. A total of 1912 adolescent girls were selected from thirty schools using population proportionate to size sampling. Adolescent girls were clinically examined for thyroid using palpation method. Casual urine (n = 344) and salt samples (n = 370) were collected from a subgroup of girls for the estimation of urinary iodine concentration (UIC) and iodine content in salt, respectively. Results: The overall goiter prevalence was 15.3% (95% confidence interval 13.6%–16.9%) and the median UIC was 266 μg/l (interquartile range: 150–300 μg/l) among 1912 adolescent girls (age, 15.7 ± 1.4 years). Around 16.8% of the families of adolescent girls were consuming salt with inadequate iodine (<15 ppm). Goiter prevalence was statistically significantly different with respect to age groups (P = 0.03). There was no statistically significant difference in goiter prevalence with respect to iodine content of salt (P = 0.98) and UIC (P = 0.41). The median UIC increased with an increase in consumption of iodine content of salt from inadequacy to adequacy (P = 0.15). Conclusion: Adolescent girls, residing in an underdeveloped district, are in the transition phase from mild ID (goiter prevalence 15.3%) to iodine sufficiency (median UIC 266 μg/l). [ABSTRACT FROM AUTHOR]

The demand for cosmetic procedures is stronger than ever and women who comprise the majority of patients with thyroid tumours drive this demand the world over. The goal of endoscopic thyroidectomy (ET) is to avoid visible scarring on the neck without compromising treatment safety and efficacy. At our institute, we are performing ET since 2014. The size limitation for ET usually ranges from 4 to 6 cm; however, being in an endemic goitre region, most of our patients usually present with long-standing goitres and majority are larger than the recommended size for ET. However, the patient's demand for better cosmesis is only increasing. The aim of this study is to analyse our initial experience of endoscopic thyroidectomy and various approaches used and determine the feasibility in Indian patients. [ABSTRACT FROM AUTHOR]

Background: Iodine deficiency is a preventable cause of brain damage. Aims &Objectives : The present study was conducted to determine the prevalence of goiter in school going children clinically, to assess the iodine status (urinary iodine excretion) of school children, and to assess the iodine content of the salt consumed by the population. Materials and Methods: It is school based cross-sectional study, conducted in Mandla district of Madhya Pradesh state in central India in 2016. The study participants were school children in 6-12 years of age. Probability-proportional-to-size cluster sampling was used. Palpation method was used to identify the presence of goiter. Urine samples were collected and median urinary iodine excretion was found. The salt samples were also collected from the households and local market to determine the iodinization status. Results: A total of 2700 school children were studied. The total goitre rate was 0.74%. Among those clinically palpable goiter 15(75%) were girls. The prevalence of goitre higher among girls was statically significant with p=0.025. All the cases of clinically palpable goiter belonged to caste other than general with p<0.001. The median urinary iodine excretion of 270 urine samples of school children was 184 ^g/l. The prevalence of iodine deficiency disorders using urinary iodine excretion as indicator in the present study was 22.9% Seven percent of the samples had median urinary iodine The normal iodine content i.e more than the 15 ppm iodine was present in 84% of samples collected from households. Conclusion: The children of Mandla district of Madhya Pradesh had low prevalence of goiter. However, there is significant burden of goiter among backward classes. [ABSTRACT FROM AUTHOR]

Background and Objectives: Iodine deficiency disorders (IDD) has been a major public health challenge for the Indian subcontinent over many years. Our study was conducted in Tikamgarh district of Madhya Pradesh, an iodine deficiency disorders-endemic district, with the objective to estimate total goitre rate and iodine nutrition status.Methods and Study Design: A cross-sectional study with 30 cluster sampling was conducted between June to July 2016 among school-going children in the age group of 6-12 years. Ninety children from each school (30x90=2700) were selected for the assessment of Goitre. Total 540 salt samples and 270 urine samples were collected to estimate salt iodine content from their house-hold and urine iodine excretion (UIE) respectively. A total of 150 households and 30 shopkeepers were interviewed to understand the awareness level for salt iodization.Results: Goitre rate in Tikamgarh district was 1.9% with prevalence of grade I & II was 1.7% and 0.2% respectively. The median UIE level was 200 mcg/L. The 20% the population had iodine deficiency, 28.9% population had adequate iodine nutrition and 51.1% population had either more than adequate level of iodine. The 72.4% of the population consume adequately iodized salt (>=15 ppm).Conclusions: Our study concludes that Tikamgarh district is non-endemic for IDDs against the earlier classification as an IDD-endemic district. About 20% population has 'iodine deficiency' and approximately 51.1% population has 'more than adequate iodine intake'. We recommend stringent programme monitoring, undertake periodic assessment of IDD and explore manifestations of excess iodine intake (>=300 mcg/L) such as Iodine-induced hyperthyroidism in future. [ABSTRACT FROM AUTHOR]

Background: Iodine Deficiency Disorder is major public health problem causing increased perinatal mortality, mental retardation and goiter and all these morbidities are preventable. Most effective and inexpensive mode to prevent IDD is consumption of iodized salt. Objectives: To estimate the proportion of households using adequately iodized salt in Begusarai district, to assess the knowledge of households on consumption and storage of salt and to estimate Total Goitre Rate (TGR). Material and Methods: Community- based cross sectional study carried out on 412 household from 30 cluster in Begusarai district using cluster sampling technique. Children (6-12 years) were examined clinically for goitre status and sample of household salt was collected for testing iodine content. Iodine content estimation was done both quantitatively by titration and qualitatively by MBI kit. Statistical analysis was performed using SPSS version 22. Result: The respondents were mainly female (92.8%) of mean age 34 years. Three- fifth (61.6%) participants used packaged crushed salt for cooking purpose, followed by packaged crystal (30.5%). Only 12.1 % of the respondents gave affirmative answer for presence of label and logo. Storage of salt in container with lid was 78.5%. The proportion of household using adequately iodized salt was 78%. The sensitivity MBI kit was 61% and the Total goiter rate was 9.3%. Conclusion: The Begusarai district falls in mild public health problem for IDD as TGR is more than 5% and even after many decades of effort towards achieving an adequately salt iodization of more than 90%, it is 79% only. [ABSTRACT FROM AUTHOR]

Background: National survey documented that none of the Indian state is free from iodine deficiency (ID). Hence, the study was conducted with the objective to assess prevalence of goiter and associated factors among pregnant mothers (PMs) in a backward district of Indian state, Rajasthan. Methods: A cross‑sectional survey was conducted during January to March 2015. Multistage random sampling was utilized to select PMs. A total of 1,183 villages were enlisted with their respective population, and 30 villages were selected using population proportionate to size sampling. Subjects were included from a cluster till the numbers reached to 17. PMs were clinically examined for goiter by palpation method. Casual urine (n = 226) and salt samples (n = 220), were collected from a subgroup of subjects, and iodine concentrations were analyzed by using wet digestion and iodometric titration methods, respectively. Results: The prevalence of goiter was found to be 14.2% (95% CI; 11.2–17.2). Goiter prevalence did not significantly differ with respect to trimesters of pregnancy (P = 0.09), iodine content in salt (P = 0.8), and urinary iodine concentrations (UIC, P = 0.69). The median UIC was 174 μg/L (IQR; 116–300 μg/L), which indicated adequate iodine intake. There was higher prevalence of goiter in PMs consuming salt with inadequate iodine than those with adequate, which was not significant (P = 0.8). Goiter prevalence was also insignificantly higher among PMs with UIC <150 μg/L than those with UIC ≥150 μg/L (P = 0.69). Conclusion: The study population is in transition phase from mild ID (goiter prevalence 14.1%) to sufficiency (median UIC 174 μg/L). [ABSTRACT FROM AUTHOR]

Background: Iodine deficiency is a major nutritional problem in India. Fortification of edible salt with Iodine is a good strategy being implemented by the government to bring down the goitre prevalence. Type of edible salt used by people in different parts of the country varies considerably. Hence in this study an endeavor was made to know the usage pattern of edible salt and the awareness & usage of iodized salt among the resident population in the field practice area of the Urban Health Centre attached to a Medical College. Methods: After obtaining approval from the Institutional Ethical Committee, a cross-sectional study of all the households was conducted in the field practice area of ASRAM Medical College, Eluru. The data was collected by using a predesigned, pretested & semi-structured questionnaire over a period of two months. Collected data was compiled in M.S. Excel 2013 and analyzed in PASW Version 23 (trial version). Results: Study population consisted 2591 residents, 1300 (50.2p.c) males & 1291 (49.8p.c) females. In the study population, 89.7p.c respondents had the knowledge of Iodized salt, but only 20.4p.c were using it for cooking purpose and only 12.8p.c were consuming <5gram salt per day. Conclusion: Knowledge of Iodized salt was relatively good but hardly 20p.c were using it for cooking purpose. There is an urgent need for behavior change communication in the community towards Iodized salt consumption. [ABSTRACT FROM AUTHOR]

Introduction: Hypothyroidism is a common functional disorder of the thyroid gland. Despite extensive research, data on this subject are lacking from the northeastern part of India, which falls in the Sub-Himalayan goitrogenic belt. Therefore, we decided to study the profile of hypothyroidism in Assam, a northeastern state with the following objectives: to determine the prevalence of hypothyroidism and to describe the various modes of clinical presentation. Materials and Methods: The study was conducted at a clinic-cum-radioimmunoassay laboratory in Guwahati, Assam, from January to November 2011. Two thousand and four hundred fifty-six patients referred to our center from different parts of Assam were evaluated clinically and their thyroid profile was estimated. Antithyroid peroxidase (TPO) antibody was estimated in 1950 patients. Results: The prevalence of overt hypothyroidism was 10.9% (n = 267) and that of subclinical hypothyroidism was 13.1% (n = 321). Male:female ratio was 1:3. Among the cases of overt hypothyroidism, 247 (92.51%) were adult hypothyroids, 15 (5.62%) juvenile hypothyroids, and 5 (1.87%) cretins. The common presenting features of hypothyroidism were weakness (98%), lethargy (95%), dry and coarse skin (87%), and body ache (85%). Uncommon modes of presentation were pleural and pericardial effusion, low body weight, frequent motions, and palpitations. Postthyroidectomy and drug-induced hypothyroidism accounted for 2.38% cases each and postpartum hypothyroidism for 3.74% cases. Thirteen percent cases presented with goiter. The prevalence of anti-TPO antibody in the study population was 8.41%. Conclusion: Hypothyroidsm is no longer a rarity, and Assam is no exception to this phenomenon. A population-based epidemiological study of thyroid disorders in Northeast India is an urgent need. [ABSTRACT FROM AUTHOR]

Iodine deficiency disorders (IDDs) have been recognized as one of the major nutritional disorders throughout the world affecting 200 million people who are at risk and another 71 million suffering from goiter and other IDDs. These groups of disorders can affect every stage of life, but most vulnerable age group is between 6 and 12 years and these disorders together constitute the single largest preventable cause of brain damage leading to learning disabilities and psychomotor impairment. The existence of endemic goiter in an extensive belt along the southern slopes of the Himalayas, Alps, and Andes has long been described, but consistently high prevalence of IDDs outside the endemic zones and failure to attain goals set by the National Iodine Deficiency Disorder Control Program questions the strategy and achievements till date. Therefore, the present article is an attempt to critically examine the program since inception in India. [ABSTRACT FROM AUTHOR]

Introduction: Iodine deficiency disorder remains one of the major public health problems, despite it being easily preventable. Initially thought as the disorder of Himalayan goiter belt, the disorder has been found to have a pan-India presence. The study was planned with the aim to assess the prevalence of goiter among 6-12 years school-going children and to identify levels of iodine in salt consumed at the household level in the study area. Materials and Methods: The study was conducted among 3955 school-going (2162 children from Rajouri and 1793 children from Poonch) children age 6-12 years in Rajouri and Poonch districts of Jammu Province. The children were examined clinically to detect and grade the goiter. Salt samples were collected from subsample (n = 400) to estimate iodine content in the salt. Results: The prevalence of goiter in the study population was found to be 18.87% and 9.70% in Rajouri and Poonch districts, respectively. Goiter prevalence was higher in 9-12 years age group as compared to 6-9 years age group and the difference in goiter prevalence in males of these two age groups was statistically significant (P = 0.02). Estimation of iodine content of the salt samples revealed that all of them (100%) had adequate iodine content. Conclusion: Despite the implementation of Universal Iodization Program and adequate content of iodine in salt consumed by the families, the goiter prevalence in both the districts is high. The future research should focus on identifying the reasons for this high prevalence. [ABSTRACT FROM AUTHOR]

In the present 100 Patients of swelling or mass in head and meek 40 were male and 60 were female Highest prevalence of lymph node lesion 20(50%) in males and 25 (41.6%) in females but thyroid lesion were more in females 18(30%) and in males 5(15.5%) salivary lesion 10(25%) in males 11(18.3%) in females soft tissue lesion 5(12.5%) in males 6(10%) females in the study of lymph node FNAC study tuberculosis lymphadenitis 8(40%) in males 9(36%) in males reactive lymphadenitis 4(20%) in males 5(20%) females supportive lymph were3(15%) in males 4(16%) in females metastasis ware 5(25%) in much and 7(28%) in females in the FNAC study of thyroid lesions benign nodular goiter 2(40%) in males 5(27.7%) in females follicular lesion was 1(20%) in males 2(11%) in females but Hashinoto thyroiditis was observed only in females 8(44.4%) only malignant thyroid were 2(40%) in males 5(45.4%) in females suppurative lymph were 3(15%) in males 4(16%) in females metastasis ware 5(25%) in much and 7(28%) in muco-epidermis carcinoma 3(30%) in males 2(18.1%) in females chronic sailadentis 3(30%) in males 4(36.3%) in females in the FNAC study of sobt tissue lipane were 3(60%) in males 2(33.3%) in females haemangioma 2(40%) in males, 3(50%) in females basal cell carcinoma observed only in females 1(16.6%). This study will certainly help the pathologist to rule out first time of investigation rapidly pain less without Anesthesia without hospitalization of patient. [ABSTRACT FROM AUTHOR]

The present study is a Cross-Sectional Study and was conducted in Post-graduate department of Community Medicine, Govt. Medical College, Srinagar between Feb. 2012 and Jan. 2013. The sample size of 1,041 was estimated. The study was conducted to estimate the effect of relationship of salt iodine level and prevalence of goiter among women of reproductive age group in two districts of Kashmir valley, district Srinagar and district Ganderbal, which were selected randomly. A frame of the blocks and villages in the two districts and their population was formed. From each district 10 % of the blocks were selected using simple random sampling. From each block, 5 % of the villages were selected using simple random sampling. A door to door survey was conducted in the selected villages and all the women in the reproductive age group (15-49 years) identified and examined clinically for goiter after taking informed consent. Salt samples (one teaspoonful) from every household were taken and assessed for iodine content on spot and the iodine content of salt was assessed qualitatively by spot testing kits. The results of the present study have indicated that iodine deficiency continues to be a health problem. Almost the whole population consumes powdered salt but the storage and cooking practices diminish the iodine content of salt and results in decreased intake. Thus the need of the hour is to make people aware about proper storage and cooking practices. Women in the reproductive age group especially need to be made aware about the importance of consumption of adequately iodized salt because of the wide range of ill effects of iodine deficiency on the developing fetus and the growing child. In addition monitoring of iodine content of salt at distributor level should be done. [ABSTRACT FROM AUTHOR]

Globally, 1.9 billion individuals have inadequate iodine nutrition, of whom 285 million are school-aged children. Universal salt iodization is the favored preventive strategy for iodine deficiency disorders (IDD), the single largest cause of preventable mental retardation. Two thousand and twenty estimates show nearly 1 billion people do not consume iodized salt. When at least 90% of households consume adequately iodized salt (≥15 ppm), a country is said to have attained USI. Only 23 countries had household coverage of 90% or higher. India has a household coverage of 76.3%. One 67 million people are at risk of IDD, 54 million suffer from goiter, and 2 million from cretinism. Yearly, 9 million pregnant women and 8 million newborns are at risk. Nagaland, with the second highest coverage of iodized salt in India, the study aims to assess the state-specific approach, track various mitigating measures that effectively sustained the gains of the program.

Objectives: Fine needle aspiration cytology (FNAC/FNA) is the primary investigation for thyroid nodules. Fine needle capillary cytology (FNCC/FNC) is an alternative technique not commonly used, though it is easy to perform. Both the techniques have their own advantages and disadvantages. This study aims to compare these two cytological techniques for better specimen and cytological diagnosis. Methods: This prospective study was conducted on 50 patients attending the FR Muller Medical College Hospital from May 2006 to April 2008. The patients with thyroid nodules (diagnosed by palpation) were subjected to both the cytological techniques; FNA and FNC. The specimen and results were compared and then correlated with the final histopathological findings wherever surgical specimens were available (38 cases). Results: The mean age of the patients was 39.16 with a female predominance. The majority of cases were diagnosed to have nodular goiters. The FNC technique yielded 88% diagnostic superiority and adequate specimens compared to 94% by FNA. Sensitivity was 50% for FNC and 100% for FNA while specificity was 100% for both techniques; accuracy score was 97.4% for FNC and 100% for FNA in predicting malignancy. While sensitivity was 75% for FNC and 100% for FNA; specificity was 100% for both techniques, and accuracy score was 97.4% for FNC and 100% for FNA in the prediction of neoplasia. Conclusion: The results indicated that there was no significant difference between the two techniques; if done in tandem can give better and accurate cytological diagnosis. In highly cellular lesions, in which abundant material was obtained, FNC was more likely to be diagnostically superior, but FNA can diagnose most of the lesions. In less cellular lesions, FNA is more likely to be diagnostically superior to FNC. [ABSTRACT FROM AUTHOR]

Objective: To review the studies on iodine nutrition of pregnant women in India. Methods: A systematic review of published literature assessing the iodine nutrition status of pregnant women in India was performed. Percentage households using adequately iodised salt, Urinary Iodine (UI) concentration, Total Goitre Rate (TGR) and serum Thyroid Stimulating Hormone (TSH) were the indicators studied. The cut off values for iodine nutrition sufficiency for the studied indicators as defined by WHO/UNICEF/ICCIDD guidelines were used. For studies which provided data only as per old cut-offs, the new estimates were imputed. Results: Five out of nine studies were community based studies. The percentage of pregnant women consuming adequately iodised salt ranged from 59.5% to 95%. Median UI concentration value ranged from 95 µg/L to 178 µg/L and in only one study pregnant women had median UI concentration greater than 150 µg/L. TGR was reported in 5 studies, ranging from 1.9% to 45%. Conclusions: Review of available studies from India shows a significant iodine deficiency in pregnant women. There is a need to conduct national level representative survey to better quantify the iodine nutrition of pregnant women in India. [ABSTRACT FROM AUTHOR]

Research Question: What is the situation of Iodine Deficiency Disorders (IDD) and salt consumption in Porbandar district? Objectives: To assess the magnitude of IDD in Porbandar district and also assess the salt consumption patterns in the region. Design: Cross Sectional Study. Setting: Primary schools in rural areas. Study Tools: Clinical examination of study population for goiter, laboratory assessment of urine samples of study population. Participants: Study was conducted among 2700 school children in the age group of 6-12 years from 30 clusters. Urine samples were collected from 10% of selected children and salt samples from 20% of the selected children. Results: An overall goiter prevalence of 8.8% was observed in the region. Girls had a prevalence of 9.6% and boys had 8.0%. The median urinary iodine excretion in the region was 65 μg/l. 61.9% of children had biochemical iodine deficiency with 25.2%, 14.8% and 21.9% having severe, moderate and mild iodine deficiency respectively. In Porbandar district, only 72.4% households consume salt with Iodine content of more than 15 ppm. Conclusion: Iodine Deficiency is a public health problem in the Porbandar district. [ABSTRACT FROM AUTHOR]

Background: Iodine deficiency disorder (IDD) creates major public health problems in India, including Gujarat. The Bharuch district is a known iodine deficiency endemic area. This study was conducted to estimate the prevalence of goiter in primary school children; to determine the median urinary iodine concentration; to assess the level of iodine in salt samples at the household and retail shop levels; and to study the profile of salt sold at retail shops. Methods: This study was carried out by using the 30-cluster survey method in the primary schools of the rural areas in Bharuch district. A total of 70 students, including five boys and five girls from the first to seventh classes, who were present in class on the day of the visit were selected randomly for goiter examination from each village. Urine samples were collected from one boy and one girl from each class in each cluster. From each community, a maximum of two boys and two girls from each standard in the same age group were examined and also salt samples were tested from their households. From each village, one retail shop was visited and the salt purchased from those shops was immediately tested for iodine with spot kits. Results: We found a goiter prevalence of 23.2% (grade 1 - 17.4% and grade 2 - 5.8%). As the age increased, the goiter prevalence decreased except in nine-year-olds. The median urinary iodine excretion level was 110 μg/L. An Iodine level > 15 ppm was found in 93% of the salt samples tested at the household level. Conclusion: The present study showed moderate goiter prevalence in primary school children in the Bharuch district of Gujarat and an inadequate iodine content of salt at some household levels. [ABSTRACT FROM AUTHOR]

Introduction: Goiter is a common problem in southern Punjab and thyroid surgery is frequently performed in surgical units of BVH Bahawalpur. Fine Needle Aspiration Cytology is the investigation of choice in detection of carcinoma thyroid. It is simple and quick to perform and can be readily repeated. Objectives: The aim of the study was to find out the diagnostic accuracy of FNAC in thyroid nodules. Study Design: Cross sectional study. Period: June 2009 to November 2009. Setting: Department of Surgery, BVH Bahawalpur. Methods: Fifty patients of goiter of age ranging from 16to60 years, irrespective of gender, presenting with a thyroid nodule and undergoing surgery were included in the study at Department of Surgery, BVH Bahawalpur. Information of each patient was collected on a structural Performa and then analyzed on SPSS to assess the sensitivity and specificity of the FNAC. Results: the sensitivity and specificity of FNAC was 72.2% and 97.8% respectively. Conclusions: FNAC should be performed in all cases of thyroid nodules because of its high sensitivity and specificity to diagnose the benign as well as the malignant lesions of thyroid. [ABSTRACT FROM AUTHOR]

Objective: To review the studies on iodine nutrition of pregnant women in India. Methods: A systematic review of published literature assessing the iodine nutrition status of pregnant women in India was performed. Percentage households using adequately iodised salt, Urinary Iodine (UI) concentration, Total Goitre Rate (TGR) and serum Thyroid Stimulating Hormone (TSH) were the indicators studied. The cut off values for iodine nutrition sufficiency for the studied indicators as defined by WHO/UNICEF/ICCIDD guidelines were used. For studies which provided data only as per old cut-offs, the new estimates were imputed. Results: Five out of nine studies were community based studies. The percentage of pregnant women consuming adequately iodised salt ranged from 59.5% to 95%. Median UI concentration value ranged from 95 µg/L to 178 µg/L and in only one study pregnant women had median UI concentration greater than 150 µg/L. TGR was reported in 5 studies, ranging from 1.9% to 45%. Conclusions: Review of available studies from India shows a significant iodine deficiency in pregnant women. There is a need to conduct national level representative survey to better quantify the iodine nutrition of pregnant women in India. [ABSTRACT FROM AUTHOR]

Objective: To compare prevalence of goitre in primary school children; to determine median urinary iodine concentration in children; and, to assess level of salt iodization at retail trader level. Design: 30 cluster survey study. Settings: Primary schools of Kutch district, Gujarat, India. Methods: Total 70 students including five boys and five girls from 1st to 7th standard, present in class on the day of visit were selected randomly for Goitre examination ( n=2100). Urine sample was collected from one boy and one girl from each standard in each cluster. From the community, 28 children, including two boys and two girls from each standard in the same age group were examined, and salt samples were tested from their households. From each village, one retail shop was visited and various salts available were purchased and tested for iodine on the spot with spot kit. Results: Goitre prevalence of 11.2% was found among primary school children (grade 1-8.6% and grade 2-2.6%). As the age increased, the Goitre prevalence also increased except in age group of 8 years. Median urinary iodine excretion level was 110 μg/L. Iodine level more than 15 ppm was found in 92.3% salts samples tested at the household level. Conclusion: Present study showed mild goitre prevalence in primary school children in Kutch district of Gujarat [ABSTRACT FROM AUTHOR]

Background & objectives: Despite years of salt iodization, goitre continues to be a major public health problem worldwide. We examined the prevalence of goitre in the post-iodization phase and the relationship of goitre with micronutrient status and thyroid autoimmunity in school children of Chandigarh, north India. Methods: Two phase study; in the first phase, 2148 children of 6 to 16 yr were screened for goitre by two independent observers as per the WHO grading system. In the second phase, a case-control study, 191 children with goitre and 165 children without goitre were compared with respect to urinary iodine, iodine content of salt, serum levels of T3, T4, TSH, anti-TPO (thyroid peroxidase) antibody, haemoglobin, ferritin and selenium. Results: Prevalence of goitre in the studied subjects was 15.1 per cent (13.9% in 6 to 12 yr and 17.7% in 13 to 16 yr age group, P= 0.03). Median urinary iodine excretion in both the groups was sufficient and comparable (137 and 130 µg/l). 3.2 per cent children with goitre and 2.4 per cent without goitre had hypothyroidism (subclinical and clinical) and only one child with goitre had subclinical hyperthyroidism. Nine (4.9%) children in the goitre group and 3 (1.9%) in control group had anti-TPO antibody positivity. The median serum selenium levels were not different in both the groups (181.9 and 193.5 µg/l). Seventy one (37.4%) of the goitrous children had anaemia (haemoglobin <12 g/dl) as compared to 41 (24.8%) of the control group (P<0.01). More number of goitrous children (39, 20.6%) were depleted of tissue iron stores (serum ferritin <12 µg/l) as compared to controls (11, 6.4%; P<0.001). Serum ferritin level negatively correlated with the presence of goitre (r = -0.22, P=0.008) and had an OR of 2.8 (CI 1.20 - 6.37, P=0.017). Interpretation & conclusions: There was a high prevalence of goitre in young children despite iodine repletion and low thyroid autoimmunity. The concurrent iron deficiency correlated with the presence of goiter. However, the cause and effect relationship between iron deficiency state and goitre requires further elucidation. [ABSTRACT FROM AUTHOR]

Iodine deficiency (ID) is the world's single most important preventable cause of brain damage and mental retardation. Iodine deficiency disorders (IDDs) is a public health problem in 130 countries, affecting 13% of the world population. The simplest solution to prevent the IDD is to consume iodized common salt every day. In India, significant progress has been achieved toward elimination of IDD, in the last 30 years. Satisfactory levels of urinary iodine excretion and iodine content of salt have been documented by the research surveys conducted by research scientists. The results indicate that we are progressing toward elimination of IDD. IDD is due to a nutritional deficiency, which is prima rily that of iodine, in soil and water. IDD is known to re-appear if the IDD Control Program is not sustained. To ensure that the population continues to have intake of adequate amount of iodine, there is a need of i) periodic surveys to assess the magnitude of the IDD with respect to impact of iodized salt (IS) intervention; ii) strengthening the health and nutrition education activities to create demand for IS and iii) development of a monitoring information system (MIS) for ensuring that the adequately IS is available to the beneficiaries. [ABSTRACT FROM AUTHOR]

We assessed the iodine nutrition of upper socioeconomic strata school children from Delhi to identify its association with goiter, thyroid autoimmunity or thyroid function. After informed consent of parents, all assenting students (n=997) from one randomly selected section of each class from five private schools representing all the zones of Delhi) were evaluated for goiter, urinary iodine excretion, thyroid function and antibody status. Median urinary iodine was 35.28µg/dL. Goiter was present in 123 (12.3%) and positive anti-TPO antibodies in 17 (2.6%). Increased urinary iodine was associated with thyroid dysfunction, though not with goiter. [ABSTRACT FROM AUTHOR]

Abstract: Objective: This study was planned to obtain normative data of thyroid functions in school-age children from different regions of India. Design and methods: Students from 36 schools involving 13 states across four geographical zones of India were evaluated for goiter. Subjects who consented, underwent evaluation for serum FT3, FT4, TSH, anti-TPO antibodies and thyroid ultrasound. From this, a “reference population” was obtained by excluding those with personal or family history of thyroid disease, use of thyroid medications, goiter, hypoechogenicity or nodularity on ultrasound or positive anti-thyroid antibodies. Results: Of 24,685 students clinically evaluated, 8665 formed part of the study. The reference population comprised 5343 subjects. The mean, median, 3rd and 97th percentiles of FT3, FT4 and TSH for each year (6–17 years) were obtained. Conclusions: This community based study in Indian school-age children provides reference intervals for thyroid hormones and evidence against narrowing the TSH reference range. [Copyright &y& Elsevier]

Introduction: Iodine deficiency disorders (IDD) create major public health problems in India, including Gujarat. Panchmahal district is known for endemic iodine deficiency. The present study was conducted to (1) estimate the prevalence of goiter in primary school children, (2) determine median urinary iodine concentration, (3) assess the level of iodine in salt samples at the household and retail shop level, and (4) profile of salt sold at retail shops in Panchmahal district, Gujarat. Methods: A total of 70 students including five boys and five girls from 1st to 7th standard who were present on the day of the first visit were selected randomly for goiter examination from each village. Urine samples were collected from one boy and one girl from each standard in each cluster. From the community, at least 28 students, including two boys and two girls from each standard in the same age group, were examined, and salt samples were tested from their households. A total of 2100 students were examined in schools and 928 students were examined in the selected villages. From each village, one retail shop was visited, and salts purchased from those shops were immediately tested for iodine with spot kits. Results: Among young primary school children, goiter prevalence was 23.35% (grade 1-18.35%, grade 2-5.0%). As the ages increase, goiter prevalence also increases except for 9-year-olds. The median urinary iodine excretion level was 110 µg/L. An iodine level >15 ppm was found in 78.3% of the salt samples tested at household level. Conclusion: The present study showed considerable goiter prevalence in primary school children in Panchmahal district of Gujarat and an inadequate iodine content of salt at the household level. [ABSTRACT FROM AUTHOR]

The article presents a study which determined factors associated with the prevalence of goiter in selected areas of Siddharthnagar District in Eastern Uttar Pradesh, India. It describes goiter surveys done on a representative population sample size as well as testing of iodine (I) and thiocyanate (SCN) contents of 210 salt samples from the selected study areas. Results show that consumption of inadequate amounts of goitrogenic/anti-thyroidal substances in iodized salts and cyanogenic plant foods are possible reasons for goiter prevalence in the area.

Background: To determine the prevalence of goiter and to study the factors influencing goiter among people of the rural community in Karnataka state, a community based study. Setting and Study Design: A cross sectional study was carried out to find out the prevalence of goiter in a rural community of Belgaum district. The study was conducted by house-to-house survey for a period of one month. Materials and Methods: Two villages (Handiganur and Gundwad) were selected randomly from Belgaum and Raibag taluks of Belgaum district. All the family members in each household were examined for the presence of goiter using WHO criteria. Iodine content of the salt sample obtained from each household was estimated by using spot testing kits. Information regarding the determinants of goiter was collected and recorded in a pre tested proforma. Data collected was analyzed using SPSS statistical packages. Results: The prevalence of goiter among rural population was found to be 16.6%. Goiter of grade 1 was 15.7% and that of grade 2 was 0.9%. Prevalence among males and females were 7.2% and 21.8%, respectively. The prevalence of goiter was highest among adolescents. Estimation of iodine content in the salt sample revealed that 50% of samples had adequate iodine content (≥15 ppm). Multiple Logistic Regression Analysis revealed that females of the age group 10-49 years were independently associated with goiter. Conclusion: Prevalence of goiter was relatively high and therefore constituted a public health problem in this region. [ABSTRACT FROM AUTHOR]

Background & objectives: The present investigation was undertaken to study the iodine nutritional status of school children of Imphal east district in Manipur where endemic goitre persists during post-salt iodization phase along with the investigation of the factors responsible for the occurrence of goitre endemicity. Methods: A total of 1.286 children (6-12 yr) were clinically examined for goitre from study areas of imphal east district. A total of 160 urine samples were collected and analyzed to measure urinary iodine and thiocyanate levels. Iodine content was measured in 140 salt samples and 16 drinking water samples. Results: Overall goitre prevalence was about 30 per cent (grade 1-24.7%; grade 2-5.3%) and median urinary. iodine level was 17.25 µ/dl. The mean urinary thiocyanate level was 1.073 ± 0.39 mg/dl. Iodine/thiocyanate ratio (µg/mg) was in the ranges from 15.65 to 22.34. The mean iodine content in drinking water samples was 2.92 ± 1.75 µg/l and 97.8 per cent of edible salts had iodine level above 15 ppm at the consumption point. Interpretation & conclusion: Our findings showed that in spite of no biochemical iodine deficiency, iodine deficiency disorders (IDD) is a serious public health problem in Imphal east district of Manipur. The consumption pattern of certain plant foods containing thiocyanate (or its precursors) was relatively high that interfere with thyroid hormone synthesis resulting in the excretion of more iodine. Thus, the existing dietary supplies of thiocyanate in relation to iodine may be a possible aetiological factor for the persistence of endemic goitre in the study region during post salt iodization period. [ABSTRACT FROM AUTHOR]

Research question: What is the current status of Iodine Deficiency Disorders (IDD) in the state of Jharkhand? Objectives: (1) To determine the status of iodine deficiency in the state. (2) To determine the availability and cost of adequately iodized salt at the retail shops. (3) To study the perceptions of the community regarding iodine deficiency, salt and iodized salt. Design: A cross-sectional community-based survey. Study setting: Thirty clusters selected through the probability proportion to size (PPS) sampling in the state of Jharkhand. Study participants: Children aged 6.12 years, households, retail shopkeepers and opinion leaders. Study tool: Quantitative and qualitative methodology using a pretested questionnaire and focus group discussion used to carry out the community-based survey. Results: Total goiter rate (TGR) was 0.9%. Median urinary iodine level was 173.2µg/L. The proportion of individuals with urinary iodine levels less than 100 and 50µg/L were 26.4% and 10%, respectively. Slightly less than two-thirds (64.2%) of the households were found to be consuming adequately iodized salt as measured by titration (greater than 15 ppm). Iodized salt was available across the state and the cost varied between Re. 1 and Rs. 8 per kilogram. A common belief among the community was that iodized salt is equivalent to refined packet salt that is further equivalent to expensive salt. Conclusion: The results of the present survey show that the iodine nutrition in the state of Jharkhand is optimal. Considering that the consumption of adequately iodized salt should increase from 64.2% to the goal of more than 90%, sustained efforts are required in this place to consolidate the current coverage of adequately iodized salt and increase it to greater than 90%. [ABSTRACT FROM AUTHOR]

The present work was undertaken to evaluate the prevalence of goiter, state of iodine nutrition of the population, distribution of iodine through edible salt, bioavailability of iodine, consumption of common goitrogenic food that generally interfere with iodine nutrition in Naugarh sub-division of Siddharthnagar district in Uttar Pradesh, India. Setting: Five areas were selected from 5 Community Development (CD) Blocks taking one from each by purposive sampling method. In each area, Primary and Junior high schools were selected by simple random sampling to get representative target population. Methods: Clinical goiter survey was conducted in 1663 school-aged children from both sexes (6-12 yrs), along with the biochemical analysis of iodine (I) and thiocyanate (SCN) in 200 urine samples, iodine content in 175 edible salt samples and 20 water samples collected from the selected study areas. Results: The studied region is severely affected by Iodine deficiency disorders (IDD) as goiter prevalence is 30.2% (grade1: 27.1%; grade 2:3.1%). Median urinary iodine level was 96 µg/L indicating biochemical iodine deficiency. The mean urinary thiocyanate was 0.810±0.490 mg/dL and mean of I/SCN ratios in all the studied areas were above the critical level of 7. However, 22% of the individual had I/SCN ratio ≤7 indicating their susceptibility for the development of goiter. Only 12.6% of the salt samples had adequate iodine i.e., ≥15ppm while iodine content in drinking water varied between 7.5-10.7 µg/L. Conclusion: Iodine deficiency is the primary cause, however the consumption of cyanogenic food may have important role for the persistence of IDD in the studied region during post salt iodization phase. [ABSTRACT FROM AUTHOR]

This article is a study on iodine nutritional status among 1627 school children aged 6–12 years, along with biochemical analysis of iodine of 200 urine samples, 50 drinking water samples and 175 salt samples carried out in certain randomly selected areas of the district Howrah in Gangetic West Bengal. Results indicate that the entire region is clinically goitre endemic having goitre prevalence 38%; however the median urinary iodine level was 25 μg/dl indicating no biochemical iodine deficiency, 70% salt samples had a recommended level of iodine and the region was found to be environmentally iodine sufficient. Consumption of dietary goitrogen and hard drinking water may have the possible role for the persistence of endemic goitre in the region. [ABSTRACT FROM PUBLISHER]

Research Question: What is the situation of iodine deficiency disorder (IDD) and salt consumption in Jammu region? Hypothesis: The prevalence of IDD has decreased markedly as a result of medical as well as socio-economic factors. Objective: To assess the magnitude of IDD in Jammu region and also assess the salt consumption patterns in the region. Design: Cross-sectional study. Setting: Primary schools in both urban and rural areas. Study Tools: Clinical examination of study population for goiter, laboratory assessment of casual urine sample for urinary iodine estimation of I2 content of salt samples collected from sub-samples of study population. Participants: School children in the age group of 6-12 years were selected for study using WHO 30-cluster methodology, urine samples were collected from 15% of selected children and salt samples from 5% of sub-sample. Ethical Concern: No ethical issues were involved. Results: An overall goiter prevalence of 11.98% was observed in the region. Females had a prevalence of 16.1% and males 10.1%. The median urinary iodine excretion in the region was 96.5 µg/l (range: 29.0-190.0 µg/l). Forty-nine percent of subjects had biochemical iodine deficiency with 6.7% having moderate and 42.53% mild iodine deficiency. In Jammu region, 74.47% of households consume powdered salt with 98.17% powdered salt samples having an I2 content of greater than 15 ppm. Conclusion: Iodine deficiency remains a public health problem in the region, though the region seems to be in a state of nutritional transition from iodine deficiency to iodine sufficiency. [ABSTRACT FROM AUTHOR]

Background: In 2002, the percentage of households consuming iodized salt in the state of Uttar Pradesh (UP) in India dropped to as low as 6%. This implied that 3.5 million newborns in this non-salt producing state, with 180 million population, were at risk of brain damage unless universal accessibility and consumption of iodized salt was ensured and sustained.Objectives: Urgent measures were introduced in 3 phases in the statefor accelerating procurement, distribution and consumption of iodized salt.Methods: In the first phase, a study on mapping of salt wholesalers and understanding the salt trading system--including understanding the knowledge, attitudes, and practices of salt traders was undertaken to accelerate efforts to influence availability, marketing, and accessibility of iodized salt. The study revealed that a total of only 344 primary wholesalers supplied salt to the entire state. Of these, 126 wholesalers marketed 80% of salt and were located in only 15 of the total 70 districts of the state. This finding became a very strong basis for the program in phase II, which focused on the critical group of wholesalers and set up a system to frequently interact with them. The salt wholesalers were equipped with Salt Testing Kits (STKs) to ensure adequate iodine content in the salt procured by them and adherence to the legal ban on the sale of non-iodized salt for human consumption. Simultaneously, a "child-to-community" approach was launched through involvement of middle and high school children to create demand and monitor consumption of iodized salt at the household level. Over 217,000 salt samples (about 26,000 samples per quarter) were brought in by school children and tested for iodine content.Results: The school activities resulted not only in influencing consumption of iodized salt, but also galvanized the entire chain linking consumers, retailers, and wholesalers. In less than 2 years, salt procured with nil iodine decreased from 38% to 15.3%, and salt marketed with adequate iodine level increased from 28.6% to 64.9%. School data revealed an increase in consumption of iodized salt from 6% to 46.7%. In phase 3, additional standardized activities at the school level were included and the program was taken to scale in the state.Conclusion: The findings revealed that identification and inclusion of salt wholesalers-not only the salt manufacturers-was important for achieving a rapid positive shift in iodized salt marketing and consumption practices. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to analyse the incidence of carcinoma thyroids in toxic multinodular goiters (MNG) and the pathological pattern of these cancer nodules. Methods: This is a retrospective review of 2344 patients, operated for MNG over a period of 10 years from January 1993 to December 2002 at Lourdes Hospital, Kochi, Kerala, India. Results: We operated on 2344 patients for MNG, out of whom 160 patients presented to us in a toxic state and the remaining 2184 in a non-toxic state. Of the patients operated for MNG 4.5% were found to have associated thyroid cancer. The incidence of thyroid cancer in toxic MNG patients was 26.25% whereas in non-toxic MNG patients it was 2.5%. All the malignant nodules detected were papillary cancers of the thyroid and relatively large nodules (range 0.6 cm−4.1 cm) were found in toxic MNG compared to non-toxic MNG. Conclusion: Patients with toxic MNG showed a very high incidence of coexisting thyroid cancer. Thyroid cancers can coexist in toxic MNG despite the suppression of thyroid stimulating hormone (TSH). The coexisting thyroid cancer size is larger in toxic MNG than euthyroid MNG. A total thyroidectomy is the treatment recommended for toxic MNG in an endemic area. [ABSTRACT FROM AUTHOR]

In 2000, India revoked the ban on production and sale of non-iodised salt. We conducted a study in the north 24 parganas district in the state of West Bengal to assess the prevalence of goitre, status of urinary iodine excretion (UIE) level and to estimate iodine content of salts at the household level. We surveyed 363 school children aged eight to ten years selected using a multistage cluster sampling technique. We estimated goitre prevalence and urinary iodine excretion (UIE) using methods and criteria recommended by the World Health Organization. We estimated the iodine content of salt samples collected from the households of the study subjects using spot iodine testing kit. Of the 363 children, 73 (20%) had goitre. The median UIE was 160 µg/l (normal: ≥ 100 µg/l) and only 6% children had a level below 50 µg/l. Only 253 of 363 salt samples (70%) were sufficiently iodised. The combination of high goitre prevalence with normal median urinary excretion indicates that the North 24 Parganas district is in transition from iodine deficient to iodine sufficient state. However, the persistence of non-iodised salt consumption indicates that an intensification of universal salt iodisation program is needed. [ABSTRACT FROM AUTHOR]

The shape of the thyroid gland, its extension as the pyramidal lobe (PL) and attachments of the levator glandulae thyroideae (LGT) were studied in 410 male and 160 female adults from the Chandigarh zone in northwest India during medicolegal autopsies performed in the department. Whereas the measurements of the gland were recorded in 210 subjects, the weights were taken only in 160 instances. The shapes of the glands were: lateral lobes (LL) with isthmus (50.2%), horseshoe-shaped gland (36.8%), gland with separate lobes (7.9%) and irregularly shaped gland (5.1%). No sexual dimorphism was seen in the incidence of various shapes of the gland. The incidence of the PL and LGT was 28.9% and 19.5%, respectively. Neither a PL nor LGT was present in irregularly shaped glands. The mean weight of the gland was 15.01±7.69 g in males and 13.16±5.64 g in females. Sexual and age-wise differences in weights were found to be statistically insignificant. A survey involving 152 subjects in 2 villages in Chandigarh showed that it is an iodine sufficient zone. The size and weight of thyroid glands in adults of the two genders were found to be smaller than in western Caucasian and Japanese subjects. [ABSTRACT FROM AUTHOR]

This study was done to assess goitre prevalence, thyroid functional status and cause of residual goitre among school children in the postsalt iodization phase in India. A cross-sectional study in which, 14 762 school children in the age group of 6–18 years, from different States and Union territories of India, were evaluated for goitre prevalence, urinary iodine and thiocyanate excretion, functional status of the thyroid as well as serological and cytopathological markers for thyroid autoimmunity. Urinary iodine (wet ashing method), urinary thiocyanate (colourimetric method), serum thyroxine [in-house radioimmunoassay (RIA)], serum TSH (IRMA), antithyroid microsomal and antithyroglobulin antibodies (haemagglutination method) were estimated. Fine-needle aspiration cytology was performed in all goitrous subjects giving consent. The overall goitre prevalence was 23% (27·1% girls; 17·8% boys, P < 0·001). Subjects belonging to poor socio-economic strata had significantly higher goitre prevalence. Median urinary iodine excretion (UIE) in goitrous subjects (2·53 µmol/l) was significantly higher than in controls (2·24 µmol/l; P < 0·001). Levels of UIE observed among goitrous subjects showed no relationship with the presence or absence of thyroid dysfunction or with thyroid antibody status. High titres (≥ 1 : 1600) of TMA were present more often in goitrous subjects (6·08%) than nongoitrous controls (0·34%; P < 0·001) and in girls (7·3%) than boys (2·35%; P < 0·001). TMA positivity were significantly more among goitrous subjects with thyroid dysfunction than in euthyroid subjects. Significantly higher median urinary thiocyanate (USCN) excretion was observed in goitrous subjects (0·75 mg/dl) compared to controls (0·64 mg/dl; P < 0·001) and goitrous girls compared to goitrous boys. USCN excretion of goitrous subjects and controls showed no relationship with functional or thyroid antibody status in various groups. Persistent, albeit reduced prevalence of goitre, despite adequate iodine prophylaxis, suggests existence of additional factors in goitrogenesis in India. Thyroid autoimmunity can explain only a part of the goitre prevalence. The role of goitrogens in residual goitre prevalence is brought forth. [ABSTRACT FROM AUTHOR]

Despite India's substantial progress in human development since its independence in 1947, 5-7% of its children have vitamin A deficiency disorders in selected geographic areas, 53% have iron deficiency anemia, and 9 % have goiter. Three micronutrients--vitamin A, iron, and iodine--are among the most important of all the nutrients needed by the body because they are vital for developing normal learning and cognitive functions, immunity, work capacity, and reproductive health. The body cannot synthesize them, so they must be made available through the diet. Deficiencies of these three micronutrients are known to have devastating effects on health. [ABSTRACT FROM AUTHOR]

In the post-salt iodization phase, a study on iodine nutriture status was conducted in Tripura of North East India. The clinical variable of the study was goiter and the biochemical variables were urinary iodine and thiocyanate. Random sampling methodology was followed for selecting the study areas in the State. In each study area, the studied population consisted of school children of both sexes in the age group 6-15 years. The total study areas were 22 and the total number of the population was 10,801. The total number of urine samples were analysed for iodine and thiocyanate were 1,032 (about 10%). The total goiter rate was 21.63%. Population of most of the studied areas had no biochemical iodine deficiency as evidenced by median urinary iodine excretion levels. However, the per capita consumption of iodine of about 40% population was inadequate. A large number of cyanogenic plants (SCN precursors) are used as common vegetables. This study ensures that the existing goiter prevalence in the region could possibly due to non-uniform adequate iodine supply along with the thiocyanate load. [ABSTRACT FROM AUTHOR]