Thyroid function is usually normal in differentiated thyroid carcinoma. We describe a case of a female patient who had metastatic follicular thyroid carcinoma (FTC) to the spine and lungs, who was clinically euthyroid but had very low free tetraiodothyronine (fT4) and normal thyroid stimulating hormone (TSH). Free triiodothyronine (fT3) and total T3 (TT3) were normal. Levothyroxine treatment increased fT4 marginally but caused a two- to three-fold rise in fT3 and TT3 along with suppressed TSH. This is likely due to hyperconversion of T4 to T3 from elevation in D2 deiodinase activity in the tumor. This phenomenon has been reported to occur in about 20% of metastatic FTC.
Primary hyperparathyroidism in children and adolescents is rare and often symptomatic at presentation. A 15-year-old bo presented with bilateral genu valgum for two years. Biochemical results were consistent with primary hyperparathyroidism Calcium levels normalized two months after removal of a left inferior parathyroid adenoma.
Oil palm shell (OPS) is an agricultural solid waste from the extraction process of palm oil. All these wastes from industry pose serious disposal issues for the environment. This research aims to promote the replacement of conventional coarse aggregates with eco-friendly OPS aggregate which offers several advantages, such as being lightweight, renewable, and domestically available. This paper evaluates the mechanical and thermal performances of renewable OPS lightweight concrete (LWC) reinforced with various type of synthetic polypropylene (SPP) fibers. Monofilament polypropylene (MPS) and barchip polypropylene straight (BPS) were added to concrete at different volume fractions (singly and hybrid) of 0%, 0.1%, 0.3% and 0.4%. All specimens were mixed by using a new mixing method with a time saving of up to 14.3% compared to conventional mixing methods. The effects of SPP fibers on the mechanical properties were investigated by compressive strength, splitting tensile strength and residual strength. The strength of the oil palm shell lightweight concrete hybrid 0.4% (OPSLWC-HYB-0.4%) mixture achieved the highest compressive strength of 29 MPa at 28 days. The inclusion of 0.3% of BPS showed a positive outcome with the lowest thermal conductivity value at 0.55 W/m °C. Therefore, the results revealed that incorporation of BPS fiber enhanced the performance of thermal conductivity tests as compared to inclusion of MPS fiber. Hence, renewable OPS LWC was proven to be a highly recommended environmentally friendly aggregate as an alternative solution to replace natural aggregates used in the concrete industry.