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  1. Fulltext Inadequate iodine intake among school children in Terengganu-findings from the national iodine deficiency disorder survey 2008
    Lim, Kuang Kuay, Chan, Ying Ying, Ahmad Ali Zainuddin, Teh, Chien Huey, Rusidah Selamat, Kee, Chee Cheong, et al.
    Int J Public Health Res, 2013;3(1):198-203.
    MyJurnal
    Iodine deficiency is still prevalent worldwide and it is the main cause of goiter, thyroid dysfunction and mental retardation. The aim of the study was to determine the iodine status and goiter prevalence among the school children in Terengganu. The representative sample consists of 1163 primary school children aged 8-10 years old randomly selected from urban and rural schools in Terengganu using stratified systematic random sampling technique. Urinary iodine levels in spot urine were determined by in house modified micro-method while goiter assessment was carried out by palpation of thyroid gland. The status of iodine deficiency was determined by the median urinary iodine concentrations (UIC) and total goiter prevalence (TGP) in accordance with the WHO criteria. The result showed the median [inter-quartile range (IQR)] urinary iodine concentrations was 78.7µg/L (50.1µg/L -120.0µg/L) indicating the iodine intake was slightly lower than recommended range of 100 µg/L. The rural school children had a significantly lower Iodine levels (median UIC=72.4µg/L, IQR=46.7µg/L -113.0µg/L) than the urban school children (median UIC=87.7µg/L, IQR=54.5 µg/L - 127.5µg/L). The total goiter prevalence (TGP) was 5.7%. The prevalence of goiter was significantly higher in rural (TGP=6.9%) compared to urban areas (TGP=3.6%). The study revealed that school children in Terengganu showed mild iodine deficiency and the condition is more pronounced in children from rural areas. The findings emphasize the importance of intervention implementation, universal salt iodization to ensure sufficient intake of iodine among the Terengganu school children.
    Matched MeSH terms: Thyroid Diseases
  2. Fulltext Thyroid disorders in the aged
    Peter Michael Barling
    International e-Journal of Science, Medicine & Education, 2013;7(2):4-7.
    MyJurnal
    A review of current information related to the likely incidences of thyroid diseases in the aged population of Malaysia, raising issues such as the need for further epidemiological studies of iodine intake in relation to thyroid diseases within different geographical regions and population subtypes, the need for general country-wide iodization of salt, and the screening of elderly Malaysians for so-called “occult” thyroid diseases.
    Matched MeSH terms: Thyroid Diseases
  3. Fulltext An early single institutional experience in sutureless total thyroidectomy
    Nani Harlina ML, Naqiyah I, Shahrun Niza AS, Jasmi AY, Rohaizak M
    Med J Malaysia, 2012 Apr;67(2):177-80.
    PMID: 22822639 MyJurnal
    Matched MeSH terms: Thyroid Diseases/surgery*
  4. External laryngeal nerve in thyroid surgery: is the nerve stimulator necessary?
    Aina EN, Hisham AN
    Eur J Surg, 2001 Sep;167(9):662-5.
    PMID: 11759734 DOI: 10.1080/11024150152619282
    OBJECTIVE: To find out the incidence and type of external laryngeal nerves during operations on the thyroid, and to assess the role of a nerve stimulator in detecting them.
    DESIGN: Prospective, non-randomised study.
    SETTING: Teaching hospital, Malaysia.
    SUBJECTS: 317 patients who had 447 dissections between early January 1998 and late November 1999.
    MAIN OUTCOME MEASURES:
    Number and type of nerves crossing the cricothyroid space, and the usefulness of the nerve stimulator in finding them.
    RESULTS: The nerve stimulator was used in 206/447 dissections (46%). 392 external laryngeal nerves were seen (88%), of which 196/206 (95%) were detected with the stimulator. However, without the stimulator 196 nerves were detected out of 241 dissections (81%). The stimulator detected 47 (23%) Type I nerves (nerve > 1 cm from the upper edge of superior pole); 86 (42%) Type IIa nerves (nerve < 1 cm from the upper edge of superior pole); and 63 (31%) Type IIb nerves (nerve below upper edge of superior pole). 10 nerves were not detected. When the stimulator was not used the corresponding figures were 32 (13%), 113 (47%), and 51 (21%), and 45 nerves were not seen. If the nerve cannot be found we recommend dissection of capsule close to the medial border of the upper pole of the thyroid to avoid injury to the nerve.
    CONCLUSION: Although the use of the nerve stimulator seems desirable, it confers no added advantage in finding the nerve. In the event of uncertainty about whether a structure is the nerve, the stimulator may help to confirm it. However, exposure of the cricothyroid space is most important for good exposure in searching for the external laryngeal nerve.
    Matched MeSH terms: Thyroid Diseases/surgery*
  5. Fulltext Ultrasound of the cold thyroid nodule
    Alif AK, Meah F
    Med J Malaysia, 1984 Jun;39(2):123-6.
    PMID: 6392839
    Matched MeSH terms: Thyroid Diseases/diagnosis*
  6. Optimization of nuclear medicine procedures for the diagnosis and management of thyroid disorders: report of a research coordination meeting held in Vienna, 15-17 December 1986 under the auspices of the International Atomic Energy Agency
    Ganatra R, Gembicki M, Nofal M
    Nucl Med Commun, 1988 Feb;9(2):131-9.
    PMID: 3386976
    The third and final meeting of a coordinated research programme on the diagnosis and management of thyroid disorders was held in Vienna from 15 to 17 December 1986. The participants were from Czechoslovakia, Egypt, Israel, Malaysia and Thailand. Each participant had studied between 500 and 1000 patients for thyroid function evaluation by performing T3, T4 and TSH radioimmunoassays. Each had also used the newly available supersensitive immunoradiometric (IRMA) assay in a group of patients to compare the efficiency of the new assay with that of the conventional assay. A microcomputer was provided to each participant for data analysis. Internal quality control was studied by establishing precision profiles and external quality control was on the basis of pooled standard sera in different ranges. Recommendation for the strategy suggested T4 RIA as the test of first choice in each category of thyroid function. IRMA TSH was suggested as a second test in borderline cases.
    Matched MeSH terms: Thyroid Diseases/diagnosis*
  7. Fulltext Thyroid-Modulating Activities of Olive and Its Polyphenols: A Systematic Review
    Pang KL, Lumintang JN, Chin KY
    Nutrients, 2021 Feb 06;13(2).
    PMID: 33561976 DOI: 10.3390/nu13020529
    Olive oil, which is commonly used in the Mediterranean diet, is known for its health benefits related to the reduction of the risks of cancer, coronary heart disease, hypertension, and neurodegenerative disease. These unique properties are attributed to the phytochemicals with potent antioxidant activities in olive oil. Olive leaf also harbours similar bioactive compounds. Several studies have reported the effects of olive phenolics, olive oil, and leaf extract in the modulation of thyroid activities. A systematic review of the literature was conducted to identify relevant studies on the effects of olive derivatives on thyroid function. A comprehensive search was conducted in October 2020 using the PubMed, Scopus, and Web of Science databases. Cellular, animal, and human studies reporting the effects of olive derivatives, including olive phenolics, olive oil, and leaf extracts on thyroid function were considered. The literature search found 445 articles on this topic, but only nine articles were included based on the inclusion and exclusion criteria. All included articles were animal studies involving the administration of olive oil, olive leaf extract, or olive pomace residues orally. These olive derivatives were consistently demonstrated to have thyroid-stimulating activities in euthyroid or hypothyroid animals, but their mechanisms of action are unknown. Despite the positive results, validation of the beneficial health effects of olive derivatives in the human population is lacking. In conclusion, olive derivatives, especially olive oil and leaf extract, could stimulate thyroid function. Olive pomace residue is not suitable for pharmaceutical or health supplementation purposes. Therapeutic applications of olive oil and leaf extract, especially in individuals with hypothyroidism, require further validation through human studies.
    Matched MeSH terms: Thyroid Diseases/diet therapy*
  8. Autoimmune antithyroid antibodies with special reference to their presence in human patients in Singapore
    STEIN J, STEIN B, YU M, CHEE M, CHEW BK
    Med J Malaysia, 1963 Dec;18:116-21.
    PMID: 14117279
    Matched MeSH terms: Thyroid Diseases*
  9. Thyroid function, autoantibodies, and HLA tissue typing in children with alopecia areata
    Nanda A, Alsaleh QA, Al-Hasawi F, Al-Muzairai I
    Pediatr Dermatol, 2002 11 20;19(6):486-91.
    PMID: 12437547
    A total of 80 Kuwaiti children with alopecia areata (AA), without clinical evidence of thyroid disease, were screened for the presence of thyroid abnormalities, and 50 unrelated children with AA were tissue typed for human leukocyte antigen (HLA) class I and class II antigens. Thyroid abnormalities were detected in 14 children (17.5%). Among these, 11 children (14%) had thyroid autoantibodies. These observations highlight the significance of screening for thyroid abnormalities in children with chronic, recurrent, and/or extensive disease. The Kuwaiti children with AA were observed to have a significant association with HLA B21 (OR 18.850, 95% CI 4.404-80.677), B40 (OR 6.767, 95% CI 1.818-25.181), and HLA B12 (OR 4.833, 95% CI 1.198-19.505) antigens. These findings differed from those reported elsewhere.
    Matched MeSH terms: Thyroid Diseases/complications; Thyroid Diseases/immunology*
  10. Fulltext Optic neuropathy in thyroid eye disease: A case series
    Salleh NA, Wong HS, Mohd Isa HD
    Korean J Fam Med, 2016 May;37(3):197-201.
    PMID: 27274392 DOI: 10.4082/kjfm.2016.37.3.197
    In patients with thyroid disease, ocular involvement or thyroid ophthalmopathy is common, irrespective of their thyroid status. A common feature of thyroid eye disease is eyelid retraction, which leads to a classical starry gaze (Kocher sign). Treatment with radioactive iodine (RAI) is a known therapy for hyperthyroidism. However, this treatment may lead to or worsen thyroid ophthalmopathy. We report a case series of two patients with thyrotoxicosis, who presented with an atypical and subtle occurrence of thyroid eye disease (TED) soon after RAI therapy. One of the patients was initially diagnosed and treated for dry eyes; however, over a period of time, the patient's vision progressively deteriorated. Clinical and radiological investigations confirmed thyroid ophthalmopathy with low serum thyroid hormone levels. Both patients recovered well after immediate intensive intravenous steroid treatment. These cases highlight the importance of recognizing partial ptosis as one of the presenting signs of active TED among general practitioners and physicians.
    Matched MeSH terms: Thyroid Diseases
  11. Fulltext ANCA-associated vasculitis - revisited, and its association with autoimmune thyroid disease
    Lai Y, Nik Yahya NH, Ong SG
    Med J Malaysia, 2014 Apr;69(2):98-100.
    PMID: 25241822
    Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAV) are a group of uncommon diseases. Given its rarity and multisystem clinical presentation which are usually serious and potentially fatal, prompt recognition and early treatment are of utmost importance. We report a case of AAV that presented with digital infarcts, cutaneous vasculitis, rapidly progressive glomerulonephritis, mononeuritis multiplex, eosinophilia and positive myeloperoxidase (MPO)-ANCA antibody. Apart from renal damage, there was complete recovery in other systems following intravenous cyclophosphamide and high-dose glucocorticoids albeit the response was delayed. This response obviates the need for second-line therapy with newer agent such as rituximab (anti-CD20 monoclonal antibody). We would also like to highlight that this is the first case of AAV that is associated with autoimmune thyroid disease to be reported from Malaysia.
    Matched MeSH terms: Thyroid Diseases
  12. Racial disparity in the prevalence of thyroid disorder during pregnancy
    Sakinah SO, Khalid BA, Aishah AB
    Ann Acad Med Singap, 1993 Jul;22(4):563-6.
    PMID: 8257059
    A study to determine the prevalence of goitre and abnormal thyroid status during pregnancy in Malaysian women was conducted. Two hundred and three women (Malay = 85, Chinese = 47 and Indian = 71) in the third trimester and with no known thyroid disease were studied. There was a marked racial disparity in the prevalence of goitre: Indian 61%, Malay 28% and Chinese 29% (p = 0.001). The serum thyrotropic hormone (TSH) was significantly higher in Indians (median: 1.36 uIU/ml) compared to Malays (1.14 uIU/ml, p = 0.009). The serum albumin was also significantly lower in Indians (mean +/- sd; 36.12 +/- 3.9 mmol/l) compared to Malays (39.3 +/- 4.8 mmol/l) or Chinese (39.1 +/- 5.2) (p < 0.001). Thyroid antibody was detected in 14.6% of these women with no significant racial difference in its prevalence. Three women were found to be thyrotoxic but none were hypothyroid. This study found a high prevalence of goitre among the pregnant Indian women, probably related to the protein malnutrition state. The high prevalence of positive thyroid antibody in our population indicates that a high percentage of women are at risk of developing postpartum thyroiditis.
    Matched MeSH terms: Thyroid Diseases/blood; Thyroid Diseases/diagnosis; Thyroid Diseases/epidemiology*
  13. Salmonella thyroid abscess-two case reports
    Khoo KS, Koh PS, Ng KL
    Gland Surg, 2020 Dec;9(6):2198-2203.
    PMID: 33447571 DOI: 10.21037/gs-20-474
    Acute suppurative thyroiditis account for <1% of thyroid diseases and is uncommon because of the gland's encapsulation, iodine-rich environment, good vascular supply and extensive lymphatic drainage. It has been reported in patients with underlying goiters, thyroid cancers and in immuno-compromised patients. The usual causative organisms are Staphylococci spp. and Streptococci spp. Rarer organisms include Klebsiella spp. and Salmonella spp. Due to its rarity (as there have been only 28 cases of Salmonella thyroid abscess being reported in the literature till 2020), only case reports are available to guide management. We report two cases of thyroid abscess due to Salmonella enteritidis in our institution that may herald the re-emergence of this uncommon infection of the thyroid gland and to raise awareness for all clinicians. Both patients presented with neck swelling, dysphagia and sepsis. Surgical intervention was warranted in both patients due to the severity of the disease and failed medical therapy. Recovery was uneventful following adequate surgical intervention and antibiotic therapy according to the culture and sensitivity report of the pathogen. This case report highlights that both patients were immunocompromised, and they contracted Salmonella thyroid abscess without any gastrointestinal involvement. Thus, a high index of suspicion for Salmonella thyroid abscess in immunocompromised patients can expedite the diagnosis and appropriate management can be commenced such as antibiotic therapy, percutaneous aspiration and surgical drainage in the event of failed medical therapy.
    Matched MeSH terms: Thyroid Diseases
  14. Fulltext Thyroid associated ophthalmopathy - a review
    Mallika PS, Tan AK, Aziz S, Syed Alwi SAR, Chong MS, Vanitha R, et al.
    Malays Fam Physician, 2009;4(1):8-14.
    PMID: 25606151 MyJurnal
    Thyroid associated ophthalmopathy is an autoimmune disorder affecting the orbital and periorbital tissues. Hyperthyroidism is commonly associated with thyroid associated ophthalmopathy, however in 5% to 10% of cases it is euthyroid. Genetic, environmental and endogenous factors play a role in the initiation of the thyroid ophthalmopathy. Smoking has been identified as the strongest risk factor for the development of the disorder. The pathogenesis involves activation of both humoral and cell mediated immunity with subsequent production of gycoaminoglycans, hyaluronic acid resulting in oedema formation, increase extraocular mass and adipogenesis in the orbit. The natural history of the disease progresses from active to inactive fibrotic stage over a period of years. Diagnosis is mainly clinical and almost all patients with ophthalmopathy exhibit some form of thyroid abnormality on further testing. Treatment is based on the clinical severity of the disease. Non-severe cases are managed by supportive measures to reduce the symptomatology and severe cases are treated by either medical or surgical decompression. Rehabilitative surgery is done for quiescent disease to reduce diplopia and improve cosmesis.
    Matched MeSH terms: Thyroid Diseases
  15. Hyperthyroidism in pregnancy
    Zainuddin Z, Shaker AAH
    Family Physician, 2005;13(3):2-4.
    MyJurnal
    Thyroid diseases are common in women, including at the time of pregnancies. Many typical features of hyperthyroidism are common in normal pregnancies and this may delay or mask the diagnosis. Uncontrolled thyrotoxicosis increases the rate of miscarriage, intrauterine growth restriction (IUGR), premature labour and perinatal mortality. Multi-disciplinary efforts are required to achieve optimal control of thyrotoxicosis. Anti-thyroid drugs are safe and should be used with the lowest possible doses. Radioiodine treatment is contraindicated during pregnancy and lactation. Indications of surgery include: compression symptoms, thyroid malignancy, non-compliance to medications or when the patient develop drugs side effects
    Matched MeSH terms: Thyroid Diseases
  16. Fulltext Clinical value of a rapid fully automated thyroid autoantibody assay in the diagnosis and management of graves disease
    Hanita, O., Azura, N.R., Faizal, M.M.Z.
    Medicine & Health, 2012;7(1):24-31.
    MyJurnal
    The most common cause of hyperthyroidism is Graves disease (GD) which is characterised by the presence of autoantibodies which binds to the TSH receptor (TRAb). Recently, a rapid, fully automated electrochemiluminescent immunoassay ElecsysAnti-TSHR for detection of autoantibodies to TSH receptor was made available for routine clinical use. The objective of this study is to evaluate this assay and to determine the sensitivity, specificity and cut-off value. Interassay and total imprecision (CV) were determined at 3.78-7.02 IU/L and 13.5-21.2 IU/L respectively. A total of 124 samples which comprised of 46 GD, seven Hashimoto thyroiditis (HD), 11 non autoimmune nodular goitre (NAG), 2 thyroid cancers (Ca) and 58 normal controls were retrospectively analysed to determine the sensitivity, specificity and cut-off value. Inter-assay CV’s were 2.4% at a concentration of 3.90 IU/L (range: 3.78-7.02 IU/l) and 0.8% at 20.80 IU/L (range:13.5-21.2 IU/l). Total imprecision was 3.8% at a concentration of 3.80 IU/L (range:13.5-21.2 IU/l) and 1.0% at 20.8 IU/L (range:13.5-21.2 IU/l). The ROC analysis of patients with GD, other thyroid disorders and normal controls revealed that the highest sensitivity (94%) and specificity (98%) were seen at cut-off value of 1.69 IU/L. Positive predictive value (PPV) and negative predictive value (NPV) was 95% and 94% respectively. At this derived cut-off value of 1.69 IU/L, we found that the sensitivity of TRAb positivity within the group of 29 newly diagnosed GD patients was 94%. Our results demonstrate that this fully automated assay with testing time of 27 minutes has high sensitivity in detecting GD and high specificity for discriminating other thyroid disease and represent major improvement in the diagnosis and management of patients with thyroid diseases.
    Matched MeSH terms: Thyroid Diseases
  17. Fulltext Depression symptoms level among thyroid disorders patients at Central region of Peninsular Malaysia
    Siti Nur Illiani, J., Azlina, D., Sanisah, S., Ramli, M., Nik Noor Fatnoon, N.A.
    Malaysian Journal of Psychiatry, 2017;26(1):0-0.
    MyJurnal
    Background of Study: Patients with thyroid disorders were found to have
    continued to experience symptoms of depression despite the great of treatment has
    been given to the patient to balance the thyroid hormones. Objective: The aim of
    this study is to determine the level of depression symptoms among various types
    of thyroid disorders patients.

    Methods: A cross sectional study was carried out at
    one of the government hospital at central region of Peninsular Malaysia from
    August to October 2016. Patients were diagnosed as thyroid disorders, Malaysian
    citizen, above 18 years old and did not have any psychiatric disorders were
    included in this study.Depression Anxiety Stress Scale-42 (DASS-42) was
    selected to determine the severity of depression symptoms and interpreted as
    follow: less than 9-no depression, between 10 and 13-mild depression, between
    14-20-moderate depression, between 21 and 27- severe depression and more than
    28-extreme severe depression. Descriptive statistic was analysed by IBM
    Statistical Package for the Social Sciences (SPSS) version 21.0.

    Results: About
    15% (23) out of 153 thyroid patients had varies degree of depression symptoms
    from mild to severe extremely depression. Patients who had hyperthyroid were
    found to have more depressed, followed by hypothyroid and thyroid cancer group.

    Conclusion: These findings would suggest that the depression score was higher in
    the patients who have hyperthyroid. A more detail and thorough study is
    recommended to be done, in order to confirm these findings.
    Matched MeSH terms: Thyroid Diseases
  18. Primary Squamous Cell Carcinoma of the Thyroid Gland
    Ibrahim MI, Jusoh YR, Adam NN, Mohamad I
    Iran J Otorhinolaryngol, 2018 Jan;30(96):65-68.
    PMID: 29387667
    Introduction: Primary squamous cell carcinoma (SCC) of the thyroid gland is one of the rarest types of all reported thyroid malignancies worldwide. It is very aggressive in nature and carries a poor prognosis. The surgical resection with adjuvant radiotherapy and chemotherapy is the most recommended treatment despite its poor reported outcome.

    Case Report: A 74-year-old woman presented with a rapidly progressive neck swelling, with hoarseness and compressive symptoms. Physical examination revealed a multilobulated firm thyroid mass with unilateral vocal cord palsy. Histopathological findings confirmed the diagnosis of SCC while radiological investigations and panendoscopy findings ruled out the possibility of other primary tumors. A surgical intervention was performed; however, the patient eventually succumbed to death prior to undergoing an oncological treatment.

    Conclusion: With no standard consensus to guide the management plan, SCC of the thyroid gland presents a great challenge for the managing team to come up with the best treatment option, due to its unfavorable rate of survival.

    Matched MeSH terms: Thyroid Diseases
  19. Fulltext Salmonella Thyroid Abscess Treated by Serial Aspiration: Case Report and Literature Review
    Vengathajalam S, Retinasekharan S, Mat Lazim N, Abdullah B
    Indian J Otolaryngol Head Neck Surg, 2019 Oct;71(Suppl 1):823-826.
    PMID: 31742073 DOI: 10.1007/s12070-019-01654-6
    Thyroid abscesses are the most rare conditions of the thyroid gland but it could be potentially life threatening. Most patients are immunocompromised or has an underlying chronic thyroid disorder. We report a case of a 58 year-old lady with underlying uncontrolled diabetes mellitus and a long standing uninvestigated goiter who presented with lethargy, a new anterior neck swelling with dysphagia and change of voice. Ultrasound and computed tomography were performed and showed collection with multiple air pockets in the right thyroid lobule extending to the anterior mediastinum. She was started on intravenous antibiotics and underwent serial bedside aspiration. Her symptoms improved and complete resolution was achieved after serial aspirations and antibiotics.
    Matched MeSH terms: Thyroid Diseases
  20. Fulltext Weathering the Crisis: A Case of Thyroid Crisis with Propranolol-Induced Circulatory Collapse Successfully Treated with Therapeutic Plasma Exchange
    Cheah JM, Ng D, Low MY, Foo SH
    J ASEAN Fed Endocr Soc, 2019;34(2):206-209.
    PMID: 33442157 DOI: 10.15605/jafes.034.02.12
    Thyroid crisis is a life-threatening form of thyrotoxicosis characterized by multi-system dysfunction. Therapeutic plasma exchange has been reported to be effective in removing excessive circulating thyroid hormones. We present a 46-year-old female with recently diagnosed Graves' disease associated with thyrotoxic cardiomyopathy admitted for thyroid crisis complicated by propranolol-induced circulatory collapse, acute kidney injury and ischemic hepatitis. The tachyarrhythmia was refractory to conventional therapy. Initiation of TPE resulted in rapid clinical and biochemical stabilization.
    Matched MeSH terms: Thyroid Diseases
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