Purpose This systematic review endeavors to find an effective treatment protocol for subacute thyroiditis (SAT) to minimize side effects, recurrence and long-term hypothyroidism. Materials and Methods We analyzed available original studies on treatment protocols for SAT. A thorough literature search was performed on the following online databases PubMed, Cochrane library nd Google Scholar using appropriate keywords for choosing relevant articles. Two reviewers assessed the methodological quality of selected articles independently using a critical appraisal instrument. The results were analyzed and synthesized qualitatively using the level of evidence method. Results The literature search retrieved a total of 460 publications after abstract screening; out of which 36 articles met the inclusion criteria. After full text screening, 23 articles were further excluded as they were focusing on aspects of SAT other than management, the remaining 15 articles were investigated for both reliability and validity. Thirteen studies provided low-quality evidence, and two randomized control trials (RCT) provided a high quality of evidence. Steroid therapy was found to be the most effective for moderate to severe SAT and provided relief from acute symptoms but was found to not be a risk factor for recurrence. Low initial doses of steroid (15 mg) were preferred over high initial dosage (30–40 mg). Furthermore, a look into the mode of steroid delivery (RCT) revealed that intrathyroidal steroid therapy can potentially become a safer and faster mode of therapy. The duration of tapering was found to be of significance as a short tapering period was linked with greater recurrence rates. Conclusion Low initial doses of steroid along with an extended tapering period may help lower recurrence rates; also, intrathyroidal steroid injections are potentially a better alternative to oral prednisone (PSN) with regard to safety and speed of action. However, the evidence is of moderate quality and further investigation is required.

Background: Homocysteine has been under a lot of speculation since its discovery in 1932. The present study was conducted to assess the role of homocysteine in coronary heart disease. Materials and methods: 76 patients of coronary heart disease of both genders were included. The body mass index was calculated as weight (kg)/height (m)2. Blood pressures were measured. Serum total homocysteine was measured. Serum total and HDL cholesterol were determined with standard methods. Serum creatinine was determined with a modified Jaffe´ method. Results: Out of 76 patients, males were 52 and females were 24. The mean BMI (Kg/m2) was 25.4, SBP (mm Hg) was 154.2, DBP (mm Hg) was 86.4, serum cholesterol (mmol/L) was 6.52, serum HDL (mmol/L) was 1.08, serum creatinine (µmmol/L) was 112.9. Co-morbidities comprise of hypertension in 34, diabetes mellitus in 8, myocardial infarction in 14, stroke in 7 and smoking in 26. The difference was significant (P< 0.05). Crude value was 1.09 and adjusted value was 1.56 in CHD and crude value was 1.88, adjusted value was 1.27, normotensive adjusted value was 6.17 and hypertensive adjusted value was 1.64. Conclusion:A high homocysteine level is common and is strongly associated with the prevalence of coronary heart disease and cerebrovascular disease.

No abstract