Evaluation of a Scoring System for predicting the risk of malignancy in thyroid nodules using Clinical, Laboratory and Sonological data

INTRODUCTION: Many patients present to the surgical department with a thyroid nodule. However not all require surgery and only 5-6% of these are malignant. There are many methods to diagnose and predict malignancy in thyroid nodules. This study throws light on the usefulness of combining clinical, radiological and laboratory investigations into a single scoring system which is used to predict the risk of malignancy in thyroid nodules thereby helping the surgeon to make appropriate decisions regarding the operative management and follow up of the patient. AIMS AND OBJECTIVES: To evaluate a scoring system using clinical, laboratory and sonological data for predicting the risk of malignancy in patients with thyroid nodules, in a tertiary care centre in South India, which caters mostly for an economically underprivileged population. MATERIALS AND METHODS: This prospective observational study involved 50 patients admitted in MMC, Chennai with thyroid nodules. Analysis of a scoring system was done which combined clinical findings, radiological features and laboratory findings such as TSH level and FNAC report. The final scores were compared with the post-operative histopathology of the patient and the risk of malignancy was predicted. OBSERVATION AND RESULTS: The scoring system had a maximum score of 26. The observed score ranged from 3 to 19. The mean score was 11. All the malignant cases observed in our study had a score greater than 11. The incidence of thyroid carcinoma for scores of 1 to 11 was 0%, 12 to 13 was 20%, 14 to 18 was 75% and ≥19 was 100%. The average risk of malignancy for a score ≤11 was 0% and for a score >11 was 54.166%.The sensitivity and specificity of the scoring system was 70.2% and 100% respectively. The positive and negative predictive value for the scoring system was 100% and 43.83% respectively.The greater risk of malignancy demonstrated for patients above a score of 11 was statistically significant (p < 0.0001, χ2 = 14.965, df = 1). The risk of malignancy increased with increasing scores and was found to be 100% for a score ≥16. CONCLUSION: This scoring system has proved to be accurate in predicting the risk of malignancy in patients with thyroid nodules by combining various parameters derived from the patient’s history, clinical examination and simple, cost-effective investigations like thyroid function test, ultrasonogram and FNAC. Each of these factors has variable reliability, but their combination has proven to be a better predictor of malignancy. It can be routinely introduced in every hospital for pre-operative assessment of patients presenting with thyroid nodules, thus helping the surgeon to make rational and individualized decision while treating such patients

Kerjasama Antarsektor Dalam Program Pertanian Padi Organik Untuk Mewujudkan Pembangunan Berkelanjutan (Sustainable Development) (Studi Di Desa Sukorejo Kecamatan Sambirejo Kabupaten Sragen)

: Sragen District has implemented the organic rice farm in Sukorejo Village, Sambirejo Sub-district as a follow up of “Go Organic 2010” that be a national agenda of Agriculture Ministry. The organic rice farm program has complex components to support sustainable development, so it needs cross sector partnership to fill it up. This research aims to know the cross sector partnership on the organic rice farm program in Sukorejo Village, Sambirejo Sub-district, Sragen District to achieve sustainable development. This research uses descriptive qualitative research. The commitment and communication become main factor to achieves the success of cross sector partnership. The cross sector partnership is consolidation of the relation among sector which has no hierarchy to combine different competency and resource to complete not being substitution of organic rice farm program. The cross sector partnership on organic rice farm program brings a result which is based on the principle of sustainable development. This partnership becomes a role model agricultural development in other areas

Single Phase PV Microinverter based on Interleaved Flyback Inverter

In this paper, topology of a Grid connected solar microinverter is proposed. The DC power obtained from the solar panel is converted into a rectified AC signal. This conversion is realized by an Active Clamped Flyback Converter. A full-bridge inverter which switched at a high frequency converts this rectified AC into sinusoidal AC of power frequency and this also controls the power flow direction to the grid. The topology is designed and simulated in PSIM software. The designed output values are verified with the simulated result. DOI: 10.17762/ijritcc2321-8169.150517

Structural and magnetic properties of nanocrystalline BaFe12O19 synthesized by microwave-hydrothermal method

Nanocrystalline BaFe12O19 powders were prepared by microwave-hydrothermal method at 200 °C/45 min. The as-synthesized powders were characterized by using X-ray diffraction (XRD), thermogravimetry (TG) and differential thermal analysis (DTA). The present powders were densified at different temperatures, i.e., 750, 850, 900 and 950 °C for 1 h using microwave sintering method. The phase formation and morphology studies were carried out using XRD and field emission scanning electron microscopy (FE-SEM). The average grain sizes of the sintered samples were found to be in the range of 185–490 nm. The magnetic properties such as saturation magnetization and coercive field of sintered samples were calculated based on magnetization curves. A possible relation between the magnetic hysteresis curves and the microstructure of the sintered samples was investigated

Myths and taboos in dentistry

Background: India, a developing country, faces many challenges in rendering health needs to its countrymen. The influence of culture is seen in every discipline of health and medical practices, and dentistry is no exception. This study was performed to investigate the existence of myths and taboos in dentistry, to assess the variation of these myths across various demographic aspects and socio-economic status, to co-relate the existence of myths with the oral health of the subject and to impart education to the people regarding abolishing the myth as that will be a hindrance towards a healthy life in patients.  Methods: The study had a cross-sectional design, used a structured questionnaire and was conducted to assess the existence of dental myths and taboos and to determine its correlation with the OHIS index of the patients. Statistical analysis software SPSS V 16.0 was used. Descriptive &amp; inferential statistical analysis was performed on categorical and continuous data. Chi-square, independent sample T tests and ANOVA test were used to compare the distribution of caries and OHI-S between different groups. P value less than 0.05 (p&lt;0.05) was considered to be significant. Socioeconomic status was also calculated.Results: In the present study it was found that the there was almost an equal distribution of prevalence of myths in the educated as well as uneducated patients .Also the ratio of existence of myths was found higher in females as compared to males.Conclusions: Existence of myths and taboos regarding dental health has started decreasing among the urban population due to the widespread of awareness regarding dentistry.But still there is prevalence of some myths in the patients having primary education as compared to patients having secondary and tertiary education. If community is educated about proper prevention and cure, the myths relating dental concepts will vanish from the society and over all dental health status of the community will improve

An observational comparative study of intraocular pressure changes in post-operative cataract patients treated with dexamethasone, difluprednate and prednisolone in a tertiary care centre

Background: Cataract is opacity of lens which is treated surgically. Topical corticosteroids are routinely used in the treatment of post-operative inflammation following cataract surgery. This study aims to compare the intraocular pressure changes caused by various topical steroids (prednisolone, dexamethasone and difluprednate) in post cataract patients. To compare compliance and to detect any significant adverse effects.Methods: Patients admitted in ophthalmology department for cataract surgery operated by phacoemulsification were taken as subjects. Total number of patients enrolled in the study were 354. Subjects were separated into 3 groups depending on topical steroids which were prescribed after surgery: group 1 - difluprednate, group 2 -dexamethasone and group 3 - prednisolone. Changes in intraocular pressure (IOP) of patients were measured by ophthalmology department preoperatively and postoperatively after 1st, 2nd, 3rd, 4th week of surgery. These data were collected and analysed. Adverse effects, Compliance of patients and number of bottles of drug used after surgery were also noted.Results: On comparing IOP, there was significant variation (p&lt;0.027) between 3 drugs after one week of drug administration. When group 1 was compared with group 2 or group 3 there was no significant difference Average cost of difluprednate is about 3 times higher than the cost of dexamethasone or prednisolone.Conclusions: All the three topical steroids cause a rise in intraocular pressure in post cataract patients. But in group 1 (difluprednate) there was a rise in IOP up to three weeks after surgery but after 3rd week IOP remained stable. Adverse effects were seen more in group 2 and group 3.

Educational intervention to improve knowledge, attitude and practice of pharmacovigilance among nursing staff in tertiary care hospital

Background: The present study was planned to assess the knowledge, attitude and practice among nursing staff and to evaluate the effect of educational intervention.Methods: The questionnaire related with knowledge, attitude and practice (KAP) were given to nursing staff before and after the educational intervention in a tertiary care hospital. The data obtained were subjected to statistical analysis.Results: The training given in different sessions has improved KAP among nursing staff. Ninety six percent of them responded correctly regarding who can report ADR as compared to pre training session (69%). Regarding pharmacovigilance as purpose of safe use of medicines was responded by 71% after training as compared to 54% before training. In questions related to PvPI, 94% of nursing staff responded correctly about the scale to be used for causality assessment in comparison to 79% before training. Majority of them were of opinion that only unknown and serious ADR should be reported whereas after training they answered that all the ADR should be reported. A significant improvement has been noticed in questions related to attitude and practice.Conclusions: The educational intervention to improve KAP among nursing staff has resulted in significant improvement

An observational comparative study of intraocular pressure changes in post-operative cataract patients treated with dexamethasone and difluprednate

Background: Cataract is the leading cause of blindness worldwide. Treatment of cataract is surgical. Topical corticosteroids are routinely used in the treatment of post-operative inflammation following cataract surgery. This study aims to compare the intraocular pressure changes caused by topical steroids (dexamethasone and difluprednate) and to detect adverse effects.Methods: All patients operated by phacoemulsification in ophthalmology Department of SMIMER Surat were taken as subjects. Depending on topical steroids prescribed after surgery, subjects were separated into 2 groups, group 1 - difluprednate and group 2 - dexamethasone. Changes in intra-ocular pressure (IOP) of patients were collected from the data available pre-operative, 1st ,2nd ,3rd ,4th week after surgery and were analyzed. Other parameters whose data were collected are-adverse effects and compliance of patients.Results: In group 1 preoperative mean IOP was 15.5. At the end of 1st week, the mean IOP was significantly increased to 15.8. There was equal rise in IOP during 3rd week and 4th week which means that after 3rd week IOP remains stable. In group 2 preoperative mean IOP was 15.4. At the end of 1st, 2nd, 3rd and 4th there was significant increase in IOP as compared to preoperative mean IOP. Adverse effects were reported more in group 2.Conclusions: In group 1 there was a rise in IOP up to three weeks but after 3rd week IOP remained stable. In group 2 rise in IOP was seen throughout 4 weeks of treatment. Adverse effects seen more in group 2. Compliance of patients was better in group 1