Iodine and Human Health: Bhutan's Iodine Fortification Program

Lhendup, Karma

doi:10.1002/9780470370124.ch12

Cited by 1 publication

(2 citation statements)

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“…Nevertheless, goiter can still be seen in older people in remote villages of Bhutan 18 and it could be one of the contributing causes for higher number of benign cases in our study.…”

Section: Discussionmentioning

confidence: 63%

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Application of the Bethesda system for reporting thyroid cytopathology for classification of thyroid nodules: A clinical and cytopathological characteristics in Bhutanese population

Choden¹,

Wangmo²,

Maharjan

2021

Diagnostic Cytopathology

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Introduction:The existence of baseline data on the spectrum of thyroid nodules in Bhutanese patients is unknown. Fine-needle aspiration cytology (FNAC) is regarded as the gold standard diagnostic test for pre-op assessment of thyroid lesions. Materials and Methods:We conducted a retrospective study, involving 765 patients who underwent FNAC of the thyroid gland, at Jigme Dorji Wangchuck National Referral Hospital, Thimphu, between January-2018 to December-2020. We aimed to assess the cytomorphological spectrum of thyroid nodules, classify them as per The Bethesda system for reporting thyroid cytopathology (TBSRTC), assess risk of malignancy (ROM), and evaluate the accuracy of FNAC in diagnosing thyroid malignancy.Results: Colloid nodule (37.4%) and papillary thyroid carcinoma (4.2%) constituted the majority of benign and malignant cytological diagnoses, respectively. According to TBSRTC, majority of the cases (82.0%) fell under the Bethesda II category.Bethesda III was the least common (1.4%) category. As compared to histopathological diagnosis; the sensitivity, specificity, positive and the negative predictive values of FNAC in diagnosing thyroid malignancy were 90.0%, 93.3%, 93.10%, and 90.32% respectively. The ROM increased concurrently with the grade of the Bethesda category and was more or less close to the ROM reference range, published in the TBSRTC. Conclusion:Benign thyroid nodules (82.0%) constituted a majority of thyroid nodules in Bhutanese patients. FNAC was found to be reliable in detecting thyroid malignancy. From the literature, TBSRTC was found to be a more convenient method for reporting thyroid cytology. Henceforth, as most institutes, we plan to implement TBSRTC for reporting thyroid cytopathology. K E Y W O R D Sfine-needle aspiration cytology, the Bethesda system, thyroid malignancy, thyroid nodule | INTRODUCTIONThyroid gland is the largest endocrine organ in the human body that is affected by both neoplastic and non-neoplastic diseases, leading to diffuse and/or nodular enlargement. Depending on the screening approaches, the prevalence of thyroid nodules ranges from 20% to 60%. 1,2 Although non-neoplastic lesions are relatively more common, thyroid malignancy is the most serious clinical condition behind a

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“…Nevertheless, goiter can still be seen in older people in remote villages of Bhutan 18 and it could be one of the contributing causes for higher number of benign cases in our study.…”

Section: Discussionmentioning

confidence: 63%

“…13 Similar to previous reports, 3,[14][15][16] benign cases (82.0%) were more common in our study. Although Bhutan falls in the iodine-deficient belt of the Himalayas, 17,18 Bhutan achieved its goal of iodine deficiency disorder elimination in 2003.…”

Section: Discussionmentioning

confidence: 99%