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Article
Thyroiditis in Mosul: a clinico-pathological study

Authors: Bedoor AK. Al-Irhayim بدور عبد القادر الارحيم --- Ahmad F. Lazim احمد لازم
Journal: Annals of the College of Medicine Mosul مجلة طب الموصل ISSN: 00271446 23096217 Year: 2008 Volume: 34 Issue: 2 Pages: 167-175
Publisher: Mosul University جامعة الموصل

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Abstract

Objective: To estimate the relative frequency, as well as specific pathological features of thyroiditis in thyroidectomy specimens in Mosul.
Methods: One hundred (100) cases of histopathologically proved thyroiditis had been evaluated between July 2001 and March 2002. Histopathological examination , serum autoantibody assay, with thyroglobulin immuno-histochemical marker were done. In addition we utilized results of thyroid function tests brought by many patients
Results: Hashimoto's thyroiditis (H.T), 31 cases, F:M ratio 30:1, median age 38 years. Eighty percent of the cases were euthyroid. Focal lymphocytic thyroiditis (FLT) was recognized in 66 cases. It was divided into three grades according to the intensity of the lymphocytic infiltration, all cases showed female preponderance with F:M ratios of 9:1, 23:1 and 1:1 for grades I,II and III respectively with a mean age of 37 years. H.T. and FLT shared positivity for serum autoantibody and the presence of other pathological conditions of the thyroid, namely follicular adenoma, Hurthle cell(H.C.) adenoma and papillary carcinoma. Immunohistochemical stain for thyroglobulin monoclonal antibody marker showed strong reactivity within the atrophic follicles in H.T..The remaining three cases include granulomatous, suppurative and Riedel's types of thyroiditis.
Conclusions: Thyroiditis is a common condition in Mosul with marked female preponderance, and incidence in adulthood. The two main types encountered were H.T and FLT . Hashimoto's thyroiditis invariably shows Hürthle cell metaplasia either in focal or diffuse pattern of growth, particularly the latter. While H.C., if present, are mainly sporadic in FLT. In H.T., thyroid function is related to the type of follicular epithelial cells and the presence or absence of plasma cells.

أجريت هذه الدراسة في مدينة الموصل خلال فترة ثمانية أشهر (تموز 2001إلى آذار 2002) ثم حددت خلالها مائة حالة التهاب في الغدة الدرقية تم فصلها من 298 نموذج استئصال للغدة الدرقية وقد مثلت نسبة الالتهاب حوالي 33,5% من مجموع الحالات الكلي. لقد أجريت دراسة مكثفة للحالات المائة اعتمادا على الفحوص السريرية والمرضية وتحديد الحالة الوظيفية للغدة الدرقية وكذلك فحوصات إضافية شملت وجود الأجسام المضادة في مصل الدم، كذلك فحوصات مناعية كيمياوية ونسيجية على المقاطع النسيجية.بصورة عامة الإناث أكثر عرضة للإصابة من الذكور بنسبة (11,5 إلى 1) وبمتوسط عمري هو 35 سنة لكلا الجنسين. التهاب الغدة الدرقية نوع (هاشيموتو) تم تشخيصه في 31 حالة ونسبة الإناث إلى الذكور (30 إلى 1) ومتوسط العمر كان 38سنة. وظائف الغدة الدرقية كانت طبيعية في 80% من هذه الحالات عند الفحص السريري والمختبري. بعد إجراء الفحص النسيجي تبين أن هناك تغير في نوع الخلايا الطبيعية المبطنة للجرابات الموجودة في الغدة الدرقية وكذلك زيادة في تخلل خلايا اللمف والبلازما في الأنسجة وكذلك وجود أو عدم وجود خلايا البلازما. أما في حالة الالتهاب اللمفي البؤري للغدة الدرقية فقد مثل نسبة 66% من حالات الالتهاب وقد تم تصنيفها إلى ثلاثة مراتب حسب كثافة الخلايا اللمفية. لقد وجد أن هناك غلبة الإناث على الذكور فيما يتعلق بنسبة الإصابة بالمرض وحسب الصنف (9 إلى 1) و (23 إلى 1) و (1 إلى 1) بالنسبة إلى صنف 1و2و3 على التوالي. وقد كان متوسط عمر الإصابة هو 37 عاما. بالإضافة إلى النوعين السابقين من الالتهاب، فقد تم تشخيص ثلاث حالات إضافية من أنواع أخرى هي نوع (التهاب الغدة الدرقية تحت الحاد والالتهاب التقيحي والالتهاب من نوع ريدل) وذلك على شكل حالة واحدة لكل نوع. التهاب الغدة الدرقية بنوعية هاشيموتو والبؤري اشتركا بوجود نتيجة ايجابية للفحوص المناعية على مصل الدم كذلك وجود حالات مرضية مرافقة لكلا النوعين من الالتهاب وهي أورام حميدة وورم خبيث. لقد تبين أيضا وجود زيادة في التفاعل الموجود في المقاطع النسيجية عند إجراء الفحص المناعي الكيمياوي النسيجي على هذه المقاطع خاصة في حالة التهاب هاشيموتو ولكن لم يمثل هذا التفاعل خصوصية لهذا النوع من الالتهاب.

Keywords

Thyroiditis --- thyroid


Article
IS IT SAFE NOT TO LIGATE THE INFERIOR THYROID ARTERY DURING SUBTOTAL THYROIDECTOMY?

Authors: Ahmed D Chiad --- Mazin H Al-Hawaz
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2009 Volume: 15 Issue: 2 Pages: 20-33
Publisher: Basrah University جامعة البصرة

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Abstract

Thyroid surgeries are common operations with an extremely low mortality. It is associated withspecific morbidities which are dramatically decreased due to the rapid progression in operativetechniques which helped to make the thyroid surgery less feared and better understood than itonce was. Inferior thyroid artery is one of the vital structures that require special attention duringoperative technique in order to avoid troublesome and in most cases a preventablecomplications.We conducted this study to assess the: Prevalence and significance of post-operativehypoparathyroidism following thyroid surgery, with or without inferior thyroid artery ligation.Incidence of recurrent laryngeal nerve injury with or without inferior thyroid artery ligation.Intraoperative and post operative bleeding with or without inferior thyroid artery ligation.A prospective observational study was done from June 2005 to June 2008, at Basrah GeneralHospital. One hundred and eight patients underwent subtotal thyroidectomy. Majority of them(90) patients were females. Patients were placed in two groups, Group I had inferior thyroidartery ligation whereas in Group II, inferior thyroid artery was not ligated.Analysis of data reveals that (50%) of patients in group I had hypocalcemia, (16.1%) recurrentlaryngeal nerve injury and (4.83%) hematoma, whereas in group II (47.82%) had hypocalcemia,(8.7%) recurrent laryngeal nerve injury and (2.17%) hematoma.Statistically, there is no significant difference regarding post-operative hypocalcaemia,recurrent laryngeal nerve injury and hematoma formation between truncal ligation and nonligationof inferior thyroid arteries.~ �C


Article
The Prevalence of Papillary Thyroid Microcarcinoma in 489 Cases of Thyroidectomy in Iraqi Patients

Author: Sazan Abdulwahab Mirza AL-Atrooshi*, Nadia H. Ibraheem**, Thukaa T. Yahya ***
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2017 Volume: 16 Issue: 2 Pages: 151-157
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT: BACKGROUND: Thyroid cancer (TC) is considered the most common malignancy of the endocrine system. Papillary Thyroid Microcarcinoma (PTMC) is defined as tumors of less than or equal to 10mm in diameter, it could be non-incidental or incidental. OBJECTIVE: To evaluate the prevalence rate of thyroid papillary microcarcinoma, and to correlate the prevalence rate with different parameters including: age, gender, clinical diagnosis and type of surgery.PATIENTS AND METHODS: The present study, which is a retrospective study, was conducted on 489 cases of thyroidectomy specimens; the study was conducted at the Teaching laboratories of Medical City over a period of one year from February 2015 to Feb. 2016. The incidence of thyroid papillary microcarcinoma was correlated with different parameters including age, sex, clinical presentation, and type of surgery.RESULTS:In this study , cases were divided into: 53(10.83%) cases male, and 436 (89.171%) cases females, with age range 15-68 years and age mean 41.5 years ,regarding histopathological diagnosis ,cases were analyzed as followed: Nodular hyperplasia 354(72.41%) cases. Autoimmune thyroiditis 34(7.0%) cases, thyroid adenoma 28(5.7%) cases, follicular tumors 2 (0.4%) cases, papillary microcarcinoma 28(5.7%) cases, papillary carcinoma 16(3.3%) cases, follicular carcinoma 3(0.6%) cases, medullary carcinoma 1(0.2%) cases, hyperplastic nodule 6(1.2%) cases, toxic goiter 10(2.0%) cases, infections thyroiditis 1(0.2%) case, papillary carcinoma with lymph node involvement 4(0.8%) cases, thyroglossal cyst 1(0.2%) case, parathyroid adenoma 1(0.2%) case. Eight cases of PTMC(3.3%) were below 40 years of age. 20(8.1%) cases were above 40 years. There was a statistical correlation between age and prevalence of TPMC.CONCLUSION: The possibility of thyroid microcarcinoma should always be kept in mind while diagnosing a benign thyroid disease. There was a significant statistical correlation between age and prevalence of thyroid papillary microcarcinoma. .


Article
The frequency of thyroid carcinoma in patients with solitary and multiple nodules utilizing ultrasound guided fine needle aspiration cytology (FNAC): A prospective study(Thyroid carcinoma and U/S guided FNA)

Authors: Qahtan A. Mahdi --- Basim S. Ahmed --- Mohammed A. Kadhim
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2010 Volume: 52 Issue: 2 Pages: 136-140
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Population studies suggest that 3–8% of asymptomatic adults have thyroid nodules. Nodules have a 5–15% prevalence of malignancy. Fine-needle aspiration cytology is the primary and frequently initial tool for assessing the risk of malignancy in thyroid nodules and selecting patients for thyroid surgery. Patients and Methods: This prospective study was done during the period from June 2007 to November 2008. The study includes 141 patients with palpable solitary or multiple thyroid nodules. Only patients with normal or low TSH values were referred for ultrasound examination and ultrasound guided FNAC, which were done using fine needles (G 20).
Results: eleven patients (7.8%) have insufficient or non-diagnostic aspirates and were excluded from the study. Of the remaining 130 patients that were included in our study, only 20 patients had thyroid carcinoma (15.3%). Seventy-nine patients (60.7%) had solitary nodule larger than 10 mm in largest dimension and 51 patients (39.3%) had two or more such nodules. The rate of cancer in males with thyroid nodules was higher than in females. The prevalence of thyroid cancer did not differ between patients with a solitary thyroid nodule (12 of 79 patients, 15.1%) and patients with multiple nodules (8 of 51 patients, 15.7%), the deference is statistically insignificant (P = 0.95). A nodule that is one of several nodules had a lower likelihood of being malignant than did a solitary nodule: (8.9% versus 15.1%) (P < 0.001).
Conclusion: Ultrasound guided FNAC is the primary and frequently initial tool for assessing the risk of malignancy in thyroid nodules. The prevalence of thyroid cancer did not differ between patients with a solitary thyroid nodule and those with multiple thyroid nodules. FNAC have limited role in cytological diagnosis of follicular carcinomas, unless it is confirmed by histopathological diagnosis.


Article
The Effect of Aging on Human Thyroid Gland: (Anatomical and Histological Study)
تأثير تقدم العمر على الغدة الدرقية في الأنسان: دراسة تشريحية ونسيجية

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Abstract

Objectives: To study the effect of aging on human thyroid gland this was investigated anatomically and histologically.Methods: Twenty thyroid glands from twenty normal male cadavers were examined and divided into five groups each group includes four cadavers: Group (A) aged from 20-29 years, Group (B) from 30-39 years, Group (C) from 40-49 years, Group (D) from 50-59 years, Group (E) from 60-70 years.Results: Anatomically a negative correlation between process of aging, weight and length of thyroid lobes was found and the peak of weight and length of thyroid lobes present at group B. Histologically, the present study showed a significant negative correlation between age and number of thyroid follicles, follicular and parafollicular cells, while strong positive correlation was found between age and the number of squamous cells of follicular epithelial lining. The basement membrane, the thickness of interstitial tissue also showed a positive correlation with aging.Conclusions: The weight, length of thyroid gland decreased in approximately proportional level with age. Numbers of thyroid follicles, cuboidal and parafollicular cells are decreased with progressive increase of age. In contrast, the squamous cells are increased with aging process. Key words: thyroid gland, aging, anatomy of thyroid.

الأهداف: لدِراسَة تأثيرِ الشَيْخُوخَة على الغدّةِ الدرقّيةِ في الانسان التي تَحرّتْ بشكل تشريحي ونسيجي.الطرق: عشرون غدّة درقّية أخذت مِنْ عشرون جثه من جنس ذكر فُحِصَت وقُسّمَت إلى خمس مجموعاتِ كُلّ مجموعة تَتضمّنُ أربعة جثثمجموعة (أ) بعمرِ مِنْ 20-29 سَنَوات، مجموعة (ب) مِنْ 30-39 سَنَوات، مجموعة (ج) مِنْ 40-49 سَنَوات، مجموعة (د) مِنْ 50-59 سَنَوات، مجموعة (ي) مِنْ 60-70 سَنَوات.النَتائِج: تشريحيا وجد إرتباط سلبي بين عمليةِ الشَيْخُوخَة وكُلّ مِنْ الوزنِ وطولِ فصوص الغده الدرقّيةِ.وفي هذه الدراسة وجد ان ذروة الوزنَ وطولَ فصوص الغدة الدرقّيةِ كَانَ في المجموعة (ب).اما نسيجيا فهذه الدراسة اظهرت ارتباط سلبي جيد بين العُمرِ وعددِ جريبات الدرقّيه والخلايا الجريبه وجنب الجريبيه, بينما إرتباط إيجابي قوي وُجِدَ بين العُمرِ وعددِ الخلايا الحرشفيه لبطانةِ الجريبات الطلائية. الغشاء القاعديوسمك الانسجه البينية أظهرت علاقه ايجابيه مع العمر.الإستنتاجات: لوزن و طول الغدّةِ الدرقّيةِ يقل معتقدم العمر, كذلك الخلايا الجريبيه المكعبه وجنب الجريبيه تقل مع تقدم العمر مقارنه بازدياد الخلايا الجريبيه المسطحه مع تقدم.


Article
Histological study of thyroid gland in cases of non toxic goiter

Author: Dr. Khalida I. Noel
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2012 Volume: 5 no 2 Issue: 12 Pages: 1438-1445
Publisher: Kerbala University جامعة كربلاء

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Abstract

Background: non toxic goiter is a prevalent thyroid pathology worldwide characterized by unilateral or bilateral thyroid enlargement which arises due to many factors affects the thyroid tissue.Objective: To determine the histological findings observed in non toxic goiter of the resected thyroid tissue in Mosul city.Materials & Methods: Patients were classified according to the preoperative clinical diagnosis into those with non toxic multinodular goiter & those with solitary thyroid nodules, preoperative clinical diagnosis was confirmed by Fine Needle Aspiration Cytology. Postoperatively the thyroid tissue biopsies were collected and fixed in 10% formaline, processed & stained with Haematoxylline & Eosin for histological analysis.Results: non toxic goiter is more common in female than male. Specimens obtained from patients presented with multinodular goiter showed variable sized thyroid follicles, huge follicles were filled with colloid and lined by flattened epithelial cells, most of the nodules were not encapsulated. Specimens obtained from follicular adenoma showed well developed microfollicles with intact fibrous thin capsule. Degenerative changes in the stromal tissue such as haemorrhge , fibrosis & even calcification were present in some of the cases. If hyperthyroidism associated with a discrete swelling it indicates a manifestation of toxic multinodular goiter. Solitary thyroid nodule was observed as a hard, irregular swelling with apparent unusual fixity associated with scanty normal follicular cells together with colloid.Conclusion: Incidence of multinodular goiter in Mosul city is more in female than male & in both sexes it increases between 20 to 50 years of age.


Article
Evaluation of Patients with Thyroid Diseases in Baquba City According to Thyroid Function Tests

Authors: Ahmed M Athab Al-Msari --- Ali Hussein Salih AL-Duleimy --- Imad Ahmed Lateef
Journal: Diyala Journal of Medicine مجلة ديالى الطبية ISSN: 97642219 Year: 2014 Volume: 7 Issue: 1 Pages: 76-79
Publisher: Diyala University جامعة ديالى

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Abstract

Background: Thyroid gland is the largest endocrine gland which is consists of right and left lobes connected by a narrow isthmus, the weight of this gland is 10-20g in normal adult .The function of thyroid gland is to secret T3, T4 under control of TSH. Thyroid hormones help to regulate the body metabolism. Diseases of thyroid are common affecting 5% of population. The disease either change in thyroid hormones secretion or structural changes such as in goiter with or without abnormal thyroid function.Objective: To determine the common causes of thyroid diseases in Diyala province according to thyroid function tests.Patients and Methods: A total number was 2973 patients presented with thyroid diseases at Baquba teaching hospital laboratory unit and private Ibn-alhaitham laboratory sending from specialized doctors, were included in this study 647 male and 2326 females.Results: A total of 2973 patients were included in this study, 2326 (78.24%) were female, and647 (21.76%) were males. According to thyroid diseases the results of percent work demonstrated that 2611(87.82%) patients from total patients 2973 were euthyroid (normal thyroid function), 213patients (7.16%) were hypothyroid and 149 patients (5.01%) were hyperthyroid. Statistical analysis revealed significant differences among them.Conclusion: Thyroid disease one of common endocrine diseases after diabetes mellitus, most thyroid diseases is euthyroid then hypothyroid followed by hyperthyroid. Thyroid diseases was more common in female than male.


Article
Using HPRT gene mutation assay for detection of reasons of thyroid disorders in patients at Al-Zuaaffaranya city

Author: Mithal Abd Al-Kareem Abd Aon
Journal: Iraqi Journal of Biotechnology المجلة العراقية للتقانات الحياتية ISSN: 18154794 Year: 2017 Volume: 16 Issue: 3 Pages: 169-176
Publisher: Baghdad University جامعة بغداد

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Abstract

Thyroid disorders have a multifactorial etiology, and the right combination of genetic, environmental, and endogenous factors are required for the initiation of the disease process. This study was carried out to evaluate some hormonal and genetic parameters of some Iraqi patients from Al Zuaaffaranya city with thyroid disorders in order to find if the exposure to pollutant have a role in the increasement of this disorders, this study consisted of two parts The first part was conducted on 25 patients21( 84%) of them females and 4(16%) were males suffered from thyroid disorders who have been referred to the Department of Radiation, Nuclear Medicine Hospital in Baghdad and 25 healthy control during the period from March to july2015. The age of patients and healthy individuals ranged between (13-60) years. The results showed that the most frequent thyroid disorders among patients were thyroid non-toxic goiter15:25 (60% )and hyperthyroidism 5:25 (20%) while hypothyroidism4:25 (16%) and thyroid cancer 1:25 (4%) in less frequent. Thyroid hormones thyroxin (T4), triiodothyronine (T3), and thyroid stimulating hormone( TSH) levels were determined in all subjects by enzyme linked fluorescent assay (ELFA). T3, T4 and TSH level significantly high p≤(0.01), (1.83±0.144nmol/L, 181.2±54.245 nmol/L, 0.38±0.12 μ IU/ml respectively) In Thyroid toxic goiter(TG), T4, T3 level significantly high p≤0.01(78 ±11.57,1.37±0.06)in hypothyroidism group. The second part of the study include the using of HPRT gene mutation assay as useful biomarkers for the detection of organism's exposure to ionizing radiation .The results of the average mutation frequency for HPRT (Mf-HPRT) gene revealed a significant increase (p<0.05) in patients with thyroid disorders comparing with the control group This indicate a possible exposure to pollutant which may be radiation pollution .


Article
Thyroid Role in Threatened Abortion

Author: Thura jaafar kadhum
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2009 Volume: 2 no.8, 9 Issue: 5 Pages: 568-575
Publisher: Kerbala University جامعة كربلاء

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Abstract


Background: Mild impairment of thyroid function may contribute to disturbed reproductive function.
Objective: To evaluate the role of thyroid hormones in maintaining early pregnancy and their association with the outcome of the threatened abortion.
Materials and methods: The study was carried out in Maternity and pediatric Teaching Hospital in Al-Najaf during period between 1st April to 1st September 2008. The study included 80 pregnant women divided into two groups 50 women with threatened abortion and 30 women with normal pregnancy of comparable age, parity, gestational age and body mass index (BMI). Both groups were subjected to clinical examination, obstetric ultrasound examination and were investigated for hemoglobin, total thyroxine (TT4), total tri-iodothyronine (TT3) and thyroid stimulating hormone (TSH). The group of threatened abortion women divided into two groups where 31 women had a positive outcome (continuation of pregnancy to the third trimester) and 19 women had a negative outcome (pregnancy ended with spontaneous abortion).
Results: There was a significant difference in the level of TT3 and TSH between the control group and the women with threatened abortion (lower TT3 and higher TSH in threatened abortion women) with no significant difference in TT4 between the two groups while TT3and TT4 levels were significantly reduced in the women with negative outcome as compared with the women with a positive outcome while the TSH level was significantly increased in the women with negative outcome. Conclusion: reduced levels of thyroid hormones in early pregnancy may contribute to some cases of spontaneous abortion.
Key words: thyroid hormones, pregnancy, abortion.


Article
EVALUATION OF PROGESTERONE AND ESTRADIOL IN SERA AND TISSUE OF THYROID PATIENT

Author: Husam AK Ahmed حسام عبد الكريم احمد
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2011 Volume: 9 Issue: 3 Pages: 206-208
Publisher: Al-Nahrain University جامعة النهرين

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BackgroundThyroid cancer is more common in subjects with blood group A and O. Estrogenic receptors in some cases of goiter were observed. Obesity is associated with increased risk of thyroid carcinoma possibly by mechanism of production of estrogenic steroids by adipose tissue. ObjectiveThis study was done to determine and compare the progesterone and estradiol in sera and tissue of female patients with various thyroid disorders.MethodsIn this prospective study, Serum and thyroid tissue homogenate were analyzed by measuring progesterone and estradiol in fifty normal healthy women volunteers as a control, in addition to ten patients with malignant thyroid nodules proved by histopathology, and thirty seven patients with benign thyroid nodules from March 2008 to August 2009 in Al-Kadhimiya Teaching Hospital and Al-Dirgham private hospital in Baghdad.ResultsSerum estradiol and progesterone levels for both malignant and benign thyroid nodules patients were less than noticed in healthy control, while tissue estradiol and progesterone levels in malignant thyroid tumor were significantly higher than those in benign thyroid nodules.ConclusionTissue estradiol and progesterone levels can be used in the diagnosis and differentiation between malignant and benign thyroid nodules.Key word: progesterone, estradiol, Thyroid nodules

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