Background: As the half-life of intact parathyroid hormone (iPTH) is very low, it reflects parathyroid insufficiency within minutes to hours after total thyroidectomy. Therefore, iPTH level assessment in the postopera...Background: As the half-life of intact parathyroid hormone (iPTH) is very low, it reflects parathyroid insufficiency within minutes to hours after total thyroidectomy. Therefore, iPTH level assessment in the postoperative period can be used to predict the development of hypocalcaemia. The optimal time point to measure serum iPTH is important for the accurate prediction of hypocalcaemia. Aim: This paper aims to evaluate the ability of iPTH as an early predictive marker of hypocalcaemia and determine which time iPTH is more able to predict postoperative hypocalcaemia. Method: This prospective observational study was conducted in the Department of Otolaryngology-Head & Neck Surgery, BSMMU, Dhaka, from July 2020 to December 2021, with 67 patients who underwent total thyroidectomy. iPTH levels were measured on the day before the operation and at 1 hour, 4 hours, and 24 hours after the operation. S.calcium levels were measured on the day before the operation and 1<sup>st</sup> postoperative day. All the data were compiled and sorted properly and were analyzed statistically. Results: Postoperative hypocalcaemia developed in 18 cases, with an incidence of 26.9%. Pearson correlation showed a significant correlation between postoperative iPTH at 1 hr, 4 h, and 24 hr with 1st postoperative calcium value. The Receiver operating characteristic (ROC) curve was processed for the postoperative iPTH at 1 hr, 4 h, and 24 hr. The sensitivity, specificity, cut-off value, and mean AUC found 93.9%, 94.4%, ≤14.0, 0.988;95.9%, 94.4%, ≤09.5, 0.993 and 91.8%, 94.4%, ≤11.0, 0.993 respectively. Conclusion: iPTH can be used as an early predictor of post-thy-roidectomy hypocalcaemia. 4 hr iPTH showed more sensitivity and specificity for a cut-off value near the laboratory reference range.展开更多
Thyroidectomy is a complete or partial surgical removal of the thyroid gland. The aim was to review the particularities of thyroid surgery in children, to review our operative indications and our working method as wel...Thyroidectomy is a complete or partial surgical removal of the thyroid gland. The aim was to review the particularities of thyroid surgery in children, to review our operative indications and our working method as well as the results by comparing them with the data in the literature. This was a retrospective study covering a sixteen-year period from January 2003 to December 2018. We collated 29 patient records from 3 to 15 years of age. The epidemiological aspect, the indication and the operative gesture, the anatomopathological result were studied. Data were processed using Epi Info version 3.5.4 and Microsoft Excel 2010. Our study shows that thyroid surgery in children accounted for 2% of all thyroidectomies performed (1350 cases). Females were most affected, with a sex ratio of 0.16. The mean age was 12 years, with extremes of 3 and 15 years. Three indication groups: Graves’ disease 62%, heteromulti nodular goiter (HMNG) 28%, thyroid nodule 10%. Thyroid surgery was total in 65.5% of cases;subtotal thyroidectomy in 20.7%. Partial thyroidectomy was performed in 13.7% of cases. We dissected 54 recurrent nerves, and the parathyroids were controlled. Drainage was systematic. We noted one complication (3.4%). It involved immediate postoperative dyspnea requiring a life-saving tracheotomy, and decanulation was performed 48 hours after surgery.展开更多
文摘Background: As the half-life of intact parathyroid hormone (iPTH) is very low, it reflects parathyroid insufficiency within minutes to hours after total thyroidectomy. Therefore, iPTH level assessment in the postoperative period can be used to predict the development of hypocalcaemia. The optimal time point to measure serum iPTH is important for the accurate prediction of hypocalcaemia. Aim: This paper aims to evaluate the ability of iPTH as an early predictive marker of hypocalcaemia and determine which time iPTH is more able to predict postoperative hypocalcaemia. Method: This prospective observational study was conducted in the Department of Otolaryngology-Head & Neck Surgery, BSMMU, Dhaka, from July 2020 to December 2021, with 67 patients who underwent total thyroidectomy. iPTH levels were measured on the day before the operation and at 1 hour, 4 hours, and 24 hours after the operation. S.calcium levels were measured on the day before the operation and 1<sup>st</sup> postoperative day. All the data were compiled and sorted properly and were analyzed statistically. Results: Postoperative hypocalcaemia developed in 18 cases, with an incidence of 26.9%. Pearson correlation showed a significant correlation between postoperative iPTH at 1 hr, 4 h, and 24 hr with 1st postoperative calcium value. The Receiver operating characteristic (ROC) curve was processed for the postoperative iPTH at 1 hr, 4 h, and 24 hr. The sensitivity, specificity, cut-off value, and mean AUC found 93.9%, 94.4%, ≤14.0, 0.988;95.9%, 94.4%, ≤09.5, 0.993 and 91.8%, 94.4%, ≤11.0, 0.993 respectively. Conclusion: iPTH can be used as an early predictor of post-thy-roidectomy hypocalcaemia. 4 hr iPTH showed more sensitivity and specificity for a cut-off value near the laboratory reference range.
文摘Thyroidectomy is a complete or partial surgical removal of the thyroid gland. The aim was to review the particularities of thyroid surgery in children, to review our operative indications and our working method as well as the results by comparing them with the data in the literature. This was a retrospective study covering a sixteen-year period from January 2003 to December 2018. We collated 29 patient records from 3 to 15 years of age. The epidemiological aspect, the indication and the operative gesture, the anatomopathological result were studied. Data were processed using Epi Info version 3.5.4 and Microsoft Excel 2010. Our study shows that thyroid surgery in children accounted for 2% of all thyroidectomies performed (1350 cases). Females were most affected, with a sex ratio of 0.16. The mean age was 12 years, with extremes of 3 and 15 years. Three indication groups: Graves’ disease 62%, heteromulti nodular goiter (HMNG) 28%, thyroid nodule 10%. Thyroid surgery was total in 65.5% of cases;subtotal thyroidectomy in 20.7%. Partial thyroidectomy was performed in 13.7% of cases. We dissected 54 recurrent nerves, and the parathyroids were controlled. Drainage was systematic. We noted one complication (3.4%). It involved immediate postoperative dyspnea requiring a life-saving tracheotomy, and decanulation was performed 48 hours after surgery.
