Objectives: Diabetes mellitus and thyroid dysfunction are the two most common endocrinopathies seen in general population. The study was done to determine whether there is any co-occurence of thyroid hormonal status alternating in newly diagnosed type 2 diabetes mellitus. Patients and Methods:This Cross-sectional study which was carried out at National Institute of Nuclear Medicine and Allied Sciences and outpatient Department (OPD) of Endocrinology of Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka during the period January 2015 to July 2016. A total of 98 newly diagnosed type 2 diabetic patients (Group I) and 98 healthy individuals (Group II) were enrolled in this study purposively. After taking written consent, history of the study subjects was taken and clinical checkup was done. Age of the subjects of both the group were 30 years and above. Glycemic status of both the group was assessed by measuring fasting blood sugar, blood sugar two hours after 75 gm oral glucose and blood for HbA1C. Patients with type 1 and other form of diabetes mellitus and any condition that may impair glycemic control were excluded from the study. Thyroid hormonal status of both the group was evaluated by measuring patients' serum TSH by Immunoradiometric Assay (IRMA) and serum FT3 and serum FT4 by Radioimmunoassay (RIA) method in NINMAS. All the data were digitized and analyzed using SPSS -22.0 software. Results:In this study, mean age of the patients was 46.0 ± 9.7 years and 45.5 ± 7.7 years in group I and group II respectively. Male female ratio was 1:1.45 in group I and 1:1.08 in group II. Fasting blood sugar, blood sugar two hours after 75 gm oral glucose and HbA1c were significantly higher in group I than that of group II. Mean TSH, FT3 and FT4 were 2.37 ± 3.86 mIU/L, 6.35 ± 2.41 pmol/L and 15.79 ± 5.41 pmol/L respectively in group I whereas 2.28 ± 2.67 mIU/L, 6.59 ± 1.83 pmol/L and 16.25 ± 3.46 pmol/L respectively in group II. But there was no statistical significant difference between group I and group II. In group I, sixteen patients had thyroid disorder (seven had hyperthyroidism and nine had hypothyroidism). In group II, five patients had thyroid disorder (two had hyperthyroidism and three had hypothyroidism). The difference was statistically significant. Fasting blood sugar positively correlated with TSH, FT3 and FT4 in group I, similarly HbA1c correlated with TSH and FT4 but not with FT3 in group I. Conclusion:Thyroid disorder was 16.3% in newly diagnosed type 2 diabetic patients and 5.1% in normal individuals.

Ectopic thyroid gland is uncommon in our routine clinical practice and among them dual ectopic thyroid appears to be rarer. We report an unusual case of two different locations of ectopic thyroid tissues in the lingual and left submandibular regions of a 12 years old girl who presented with painless, nodular left upper neck swelling. Provisionally, the patient was diagnosed by high resolution ultrasound (HRUS) of neck and confirmed by radionuclide thyroid scan. Thyroid scintigraphy with 99mTc-pertechnetate is highly sensitive but minimally invasive procedure to detect and image the ectopic thyroid tissue with fairly good specificity and negligible radiation exposure. Bangladesh J. Nuclear Med. 23(1&2): 67-69, 2020

ABSTRCT

<p><strong>Objective:</strong> The modified fixed doses of radioactive iodine (RAI) in different types of hyperthyroidism had been practiced at National Institute of Nuclear Medicine &amp; Allied Science (NINMAS) according to Society of Nuclear Medicine Bangladesh (SNMB) protocol since 2002 which was upgraded in 2015. The objective of the study was to observe the treatment outcome in modified fixed dose on previous protocol. Patients and Methods: In the present study the outcome of radioiodine therapy of hyperthyroid patients was retrospectively evaluated in 1349 consecutive primary hyperthyroid patients treated from January 2010 to December 2014 at NINMAS. Diagnosis of hyperthyroidism was done by thyroid function test; thyroid stimulating hormone (TSH), free triiodothyronine (FT3)   &amp; free thyroxine (FT4), 99m Technetium scan, thyroid radioiodine uptake and ultrasound imaging of thyroid gland. All patients received a fixed dose (8-29 m Ci) of radioactive iodine (RAI) depending on types of hyperthyroidism, visual assessment of gland size and severity of disease at diagnosis. They were followed up at 2 months of therapy, then every three months intervals for first year and thereafter 6 monthly up to 5 years or as needed during fluctuation of thyroid function.</p><p><strong>Results:</strong> Among the study population, 832 patients had diffuse toxic goiter (Graves’ disease), 369 patients were diagnosed as toxic multinodular goiter and 148 patients with single toxic nodule. At one year follow-up, permanent hypothyroidism occurred in 61.62% of patients and the cumulative incidence of hypothyroidism progressively increased up to 79.25% after 5 years. Cure or success of RAI therapy was considered as attainment of euthyroid state or hypothyroid state. About 11.26 % patients received more than single dose.</p><p><strong>Conclusion:</strong> Fixed dose RAI therapy is very much cost effective mode of treatment for primary hyperthyroidism with ~89% success by giving single dose.</p><p>Bangladesh J. Nuclear Med. 20(1): 37-40, January 2017</p>