Day 1 :
- Thyroid disorders |Endocrinology: Male and Female Reproductive Health
Department of Nuclear Medicine Radiology, Faculty of medicine, Vajira hospital, Navamindradhiraj University
Title: Outcome of using equation for prediction of 24-hour thyroid uptake, first and second therapeutic doses calculation in Graves’ disease patients
Piyarat Parklug is nuclear medicine radiologist at Faculty of Medicine, Vajira hospital, Navamindradhiraj university for over 20 years. She is the director and instructor of nuclear medicine department of the Vajira hospital for over 10 years. Her research interest are focused on radioactive iodine treatment of hyperthyroid and Bone mineral density. She is an advisor of the nuclear medicine research in Navamindradhiraj university. She is the coordinator of drone in emergency medicine project.
Background: The Radioactive Iodine Thyroid Uptake (RAIU) is used in calculation the I-131 treatment dose for Graves’ disease. The duration time for the standard RAIU is 24-hours, then the patient is required to visit hospital in 2 consecutive days. Equation is the alternative method which applies 3-hours RAIU to predict 24-hours RAIU. Thus, we can reduce duration of the study time.
Objective: The study aims to evaluate the correlation between the I-131 treatment doses that calculated by Predictive 24-hours RAIU (P24U) from equation and treatment dose that calculated by actual 24-hour RAIU. The study was performed in both the first and the second Therapeutic Doses (TD) in Graves’ disease.
Methods: A retrospective study was performed in Graves’ disease patients who underwent thyroid uptake and radioactive iodine treatment. Two groups were identified as the first and the second therapeutic doses. For each group, predictive value of 24-hours RAIU was calculated the equation. The equation is 24-hour RAIU = 32.5 + (0.702 × 3-hour RAIU). The TD and PTD were calculated and compared.
Results: The patients with the first therapeutic doses are 92 and the second therapeutic doses are 36. The first therapeutic dose, the correlation between 24U and P24U is 0.902 and the second therapeutic doses, the correlation between 24U and P24U is 0.806. The correlations between TD and PTD in the first and second therapeutic doses are 0.954 and 0.953 respectively. The mean difference between TD and PTD of the first and second therapeutic doses are less than 1 millicuries (-0.3 to -0.5), there is no statistically significant difference in both groups.
Conclusions: The equation is an alternative method to calculate I-131 dose for Graves’ disease patients in the first and second therapeutic doses.
Counselling Psychologist & Nutritionist
Title: The Positive Magic of Kolam – The Traditional Therapeutic Art
Sripriya Shaji is a Doctorate in Counseling Psychology and also a Nutritionist and Art therapist. Nutritional Psychology is her passion and she is the pioneer in the subject in South India. She has the work experience over 2 decades. Her scientific publications have figured in 12 International and National Journals. And also presented in several conferences. She is the founder of Srisha Counselling, Kozhikode which is affiliated to World Mental Health Federation. She works with Individuals, groups and organizations to amplify their authencity and empower them to become a better version of themselves. She have also co-founded Community Nutrition Forum, Kerala a community relentlessly works towards eradicating “Nutritional illiteracy” Also, a renowned speaker and her signature topics are Women empowerment through nutritional psychology, Wellness and self-care, Managing anxiety and stress, Prioritising mental health through good nutrition, Healthy periods. She is also a columnist in a international magazine 'Mind matters' and has penned good number of health care articles in other magazines. She has delivered more than 500 health talks for general public at various community health programs.
Polycystic ovary syndrome (PCOS) is the most common endocrine disease affecting women in reproductive age group globally. It is associated with dyslipidemia, insulin resistance, atherosclerotic diseases and is one of the leading cause for anovulatory infertility. Women with PCOS also present with severe anxiety, anger, mood disorders, low self-esteem and depression. As the causes for PCOS is multiple and complex, it demands several therapeutic strategies for effective management.
Art therapy in the form of Kolam, a traditional art of India was studied for its effectiveness as an additional therapeutic modality in PCOS. Kolam is a traditional decorative art of drawing geometrical lines, curves and loops around a grid pattern of dots by holding pinch of rice flour, chalk powder, white stone powder or color powders with three fingers. It is usually drawn by women on the floor who stretch their body where several physical postures in which yoga
exercises like malasana (squat), utkatasana (chair pose) and vajrasana (thunderbolt pose) are hidden. Many research studies had pointed out that the practice of Yoga which is an ancient Indian exercise called asanas had brought significant improvement in several metabolic disorders.
The chief purpose of drawing kolam is to exercise both mind and body simultaneously. The art of kolam helps in directing the attention of mind exclusively towards a satisfying creation and sustain that concentration without any distractions. It helps in venting out their emotions in a healthier way without any usual verbal outbursts. It thereby helps them to regain their confidence which boost their self-esteem.
As women face several physical and mental health related issues in PCOS, art therapy in the form of kolam where exercises for body and mind are properly blended can be implemented as an additional therapeutic tool.
Department of radiology, faculty of Medicine Vajira hospital, Navamindradhiraj University
Title: Comparison of diagnostic accuracy of K-TIRADS and EU-TIRADS guidelines in detection of thyroid malignancy from ultrasound
Naruporn Marukatat is diagnostic radiologist at Faculty of Medicine, Vajira hospital, Navamindradhiraj university for over 25 years. She was a visiting fellow in the Breast Health Center, Mallinckrodt Institute of Radiology, Washington School of Medicine, St. Louis, U.S.A., 2001. She is an instructor of radiology and was director of diagnostic radiology, department of radiology at Vajira hospital during 2011-2020. Her research interest is focused on ultrasound head and neck, superficial organ and breast imaging. She is an expert in breast and superficial organ intervention.
Background: This retrospective study compared the diagnostic accuracy of histopathologically proven thyroid nodules between the Korean Thyroid Imaging Reporting and Data System (K-TIRADS) and the European Thyroid Imaging Reporting and Data System (EU-TIRADS) guidelines for the management of thyroid nodules characterized by ultrasonography. For thyroid nodules resected from 2018 to 2021 at our institution, static ultrasound images of each nodule were reviews and stratify into both systems. Agreement between above two classifications was compared based on histopathological results.
Results: A total 403 thyroid nodules from 213 patients were evaluated. Each nodule was characterized by ultrasonography and stratified into K-TIRADS and EU-TIRADS classifications. The diagnostic accuracy was as follows: K-TIRADS sensitivity 85.3% (95% CI, 78.7–91.9) specificity 76.8% (95% CI, 72.1–81.7), positive predictive value 57.8% (95% CI, 50.1–65.4) negative predictive value 93.4% (95% CI, 90.3–96.5); EU-TIRADS sensitivity 86.2% (95% CI, 79.7–92.7), specificity 75.5% (95% CI, 70.6–80.4), positive predictive value 56.6% (95% CI, 49.1–64.2), negative predictive value 93.7% (95% CI, 90.6–96.8). Excellent agreement in risk stratifications between both systems was found (kappa 0.86).
Conclusions: Ultrasound thyroid nodules categorized by either by K-TIRADS or EU-TIRADS are useful to predicting malignancy and perform risk stratification with similar results. This study confirmed that both K-TIRADS and EU-TIRADS have high diagnostic accuracy and both guidelines may be used as an effective tool for management planning of patients with thyroid nodules in daily clinical practice.
Department of Otolaryngology, Faculty of Medicine, Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand.
Title: Incidence and Associating Factors of Post-Thyroid-Lobectomy Hypothyroidism in Thai Patients at Vajira Hospital: A Retroprospective Review.
Chayada Chanasriyotin is Otolaryngologist at Faculty of Medicine, Vajira hospital, Navamindradhiraj university for over 12 years. She was a facial plastic research fellowship in the facial plastic Division, Otolaryngology Head and Neck surgery at Stanford University 2017-2018. She is an instructor at Faculty of medicine, Navamindradhiraj University. She is an advisor of the Otolaryngology research in Navamindradhiraj university. Her research interest is focused on head and neck surgery. She is an expert in thyroid and facial plastic surgery.
Background: A retrospective review of 80 patients who had undergone hemithyroidectomy from 2017 to 2022 at Vajira Hospital. Patients were analyzed for age, sex, weight, height, BMI, underlying medical problems, pre- and postoperative levels of thyroid stimulating hormone (TSH), histologic diagnosis, weight of resected tissue, histologic evidence of thyroiditis, and lag time to diagnosis of hypothyroidism. Kaplan-Meier survival and log rank test was performed.
Results: Of these 80 patients, 38 (47.5%) became hypothyroid post surgery. Using Kaplan-Meier survival analysis, we found probabilities of hypothyroidism at 3, 6, 12 months to be 40%, 44.4% and 49.8%, respectively. Eighteen hypothyroid patients (22.5%) needed supplemental thyroxine within 3 months post surgery while 2 patients (2.5%) required the supplement at 6 months and 2 more patients (2.5%) did so at 12 months. Sixteen patients (20%) developed hypothyroidism but did not require supplemental thyroxine. The remaining 42 patients (52.5%) were euthyroid. No significant difference was seen between the two groups with respect to age, sex, weight, BMI, comorbidities, TSH levels, histology, lag time of diagnosis, or weight of resected gland (p>0.05).
Conclusions: We conclude that hypothyroidism after hemithyroidectomy is a common occurrence. It is recommended to follow patients closely for at least 1 year post surgery. Monitoring should include scheduled serial serum TSH draws.
Department of Orthopaedics, Faculty of Medicine, Vajira hospital, Navamindradhiraj University, Thailand
Title: Associating Factors of Osteoporosis in post-menopausal women at Vajira Hospital, Thailand
Wetchayan Chansarn is a musculoskeletal oncology orthopaedist at Faculty of Medicine, Vajira hospital, Navamindradhiraj university. He is the instructor of Orthopaedics department of the Vajira hospital for over 3 years. His research interest focuses on bone and soft tissue cancer treatment and metabolic bone disease. He is a Committee of Musculoskeletal Oncology and a Committee of Metabolic Bone Disease and Orthogeriatics of Royal College of Orthopaedics Surgeon Thailand.
Background and objective: Prevalence of postmenopausal osteoporosis is increasing. Osteoporosis increases the chance of fractures which increased morbidity and mortality rates. This study aims to study 3 risk factors for osteoporosis; age, body mass index, age at menopause. Methods: This cross-sectional study in postmenopausal women was evaluated for bone mineral density using Dual energy X-ray absorptiometry at nuclear medicine department in Vajira Hospital from January 2021 to December 2021. A total of 1,201 women were enrolled, 494 with osteoporosis and 707 without osteoporosis. We use criteria for the diagnosis of osteoporosis according to WHO criteria. The baseline data and risk factors; age, body mass index (BMI), and menopause age, were collected from DXA. Results: From total 1,201 populations, the mean age was 69.81 + 9.11, mean menopausal age was 48.34 + 5.69 and mean BMI was 24.98 + 4.78. In the Adjust Odds ratio analysis, the age groups 60-69, 70-79 and 80 more at risk of developing osteoporosis than 1.830, 2.687 and 6.028 times, respectively, compared to the reference age group of 50-59 years old. The underweight group and normal group have higher risk of developing osteoporosis were 5.467, 2.002 times, respectively, compared to the reference overweight group. The later menopause age in every 1 year, the lower risk of osteoporosis by 2.3 percent. Conclusion: Advance age, low BMI and menopausal age are statistically significant associated factors with the occurrence of osteoporosis in postmenopausal women.