<p>Different devices and techniques have been developed to retrieve fractured instruments during the endodontic procedures. This case report describes the management of a broken instrument, which was accidentally broken during cleaning and shaping of the root canal in right 2^nd molar tooth. A # 25 stainless steel K-file was separated in mesiobuccal canal of the treated tooth. At first, a radiograph was taken to confirm the level of separation of the instrument. The instrument was found to be separated at the apical 3^rd of the mesial canal and then file bypass technique was performed. Calcium hydroxide dressing was given for 7 days followed by obturation with guttapercha cone and zinc oxide eugenol sealer in lateral condensation technique. It can be concluded that bypass technique can be considered as simple and effective technique for the management of broken instrument into the root canal.</p>

Thyroid uptake and scintigraphy using Tc-99m pertechnetate has proven to be more advantageous than with I-131 iodide, since the images have better quality, the procedure is faster and the patient is submitted to a lower radiation dose. Tc-99m has been used worldwide to study the thyroid function because of a number of advantages such as short half-life, short biological half-life, short effective half-life, short retention in gland and no Beta (β-) radiation, providing low dose to gland (10,000 times less than that of I-131), low cost and readily availability. Otherwise, I-131 with its high radiation burden (1-3 rad/mCi) has long half-life and causes Beta (β-) particle emission. Its main gamma photon has high energy (364 keV) which also causes poor image quality.

<p><strong>Background:</strong> Nodular goiter is mostly a benign thyroid tumor. A change of frequency of nodular goiter in areas with sufficient iodine intake has been documented in several reports. However, contrary to common belief it may also be associated with autoimmunity is being observed recently by many investigators.</p><p><strong>Objectives:</strong> To observe association between thyroid autoimmunity and nodular goiter.</p><p><strong> Methods:</strong> This cross sectional study included two hundred cases and one hundred controls. Clinically suspected nodular thyroid patients were confirmed by USG. Selection of healthy control was done after exclusion of nodule clinically and by USG. Data were collected through a structured questionnaire.</p><p><strong>Results:</strong> Frequency of positive anti-thyroid antibodies was significantly higher in nodular goiter cases, when anti-TPO and anti-TG considered together (42.5% vs. 25.0%; χ²=8.792, p=0.003) as well as individually (anti-TPO: 37.0% vs. 20.0%; χ²=8.955, p=0.004 and anti-TG: 31.0% vs. 9.0%; χ²=17.861, p&lt;0.001) in the patients with nodular goiter than that of control. Conversely, there was no statistical difference between STN and MNG for antibody status when considered together (41.lvs. 42.5%; χ²=0.093; p=0.769) or separately (for anti-TPO: 34.2% vs. 38.6%; χ²=0.374, p=0.648 and anti TG: 27.4% vs. 33.1%; χ²=0.698, p=0.431). Also there was no statistical disparity for frequency of positivity of the two antibodies in STN (p=0.359) and MNG (p=0.167).</p><p><strong>Conclusion:</strong> Significant number of nodular goiter cases was positive for anti-thyroid antibodies.</p>

Background and objective: Childhood obesity plays major role in the pathogenesis of various cardiovascular and metabolic diseases. Serum adiponectin has been found to be associated with several cardiometabolic risk factors. The study investigated the serum adiponectin levels and its relationship with obesity and cardiometabolic risk factors in Bangladeshi obese children. Material and methods: Overweight or obese children, between 6-18 years of age, attending the obesity clinic of the Department of Endocrinology, BSMMU were enrolled. Waist circumference (WC) and blood pressure (BP) were measured and blood samples were taken for estimation of glucose, insulin, lipid profile and adiponectin. Fasting plasma glucose (FPG), serum insulin and lipid profile were estimated by automated analyzer. Insulin resistance (HOMA-IR) was calculated from fasting insulin and fasting plasma glucose values. Serum adiponectin (total) was measured by ELISA method using DRG ELISA kit, Germany. Results:A total of 78 overweight or obese children of 6-18-year of age were enrolled. The mean (±SD) age of the study population was 12.22 ± 2.56 years and the mean BMI was 28.79 ± 4.54 kg/m2. Mean (±SD) serum adiponectin was 36.93 ± 17.85 µg/ml in 78 overweight/obese children. One way ANOVA showed no significant (P= 0.582) difference of adiponectin levels among children with overweight and different grades of obesity. There was no significant correlation between adiponectin and measures of generalized (r=0.035, p=0.763) or central (r=0.098, p=0.392) obesity. Also, no significant correlation was found between serum adiponectin level and any of cardiovascular risk factors of obesity or metabolic health. Conclusion: The study showed high serum adiponectin level in obese Bangladeshi children. Also, no association was found between serum adiponectin levels with grades of obesity and cardiometabolic risk factors among obese children of Bangladesh. IMC J Med Sci. 2023; 17(2):009. DOI: https://doi.org/10.55010/imcjms.17.019 *Correspondence: Palash Chandra Sutradhar, Department of Medicine, Sir Salimullah Medical College Mitford Hospital, Kotwali, Dhaka-1000, Bangladesh. Email: palashdmc@gmail.com