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World thyroid day 25th May 2025-Thyroid Health Matters: Empower Yourself!

World Thyroid Day 2025: Empowering Thyroid Health for a Vibrant Future

~~Table of Contents (toc)~~

Introduction:

Every year on May 25th, World Thyroid Day is observed worldwide to raise awareness about thyroid-related disorders and promote the importance of thyroid health. In 2023, the theme for World Thyroid Day revolves around empowering individuals to take charge of their thyroid health and ensure a vibrant future.

This article aims to shed light on common thyroid disorders, prevention strategies, treatment options, and the significance of this year’s theme.

Thyroid gland anatomy

Theme of world thyroid day 2023:

Empowering Thyroid Health for a Vibrant Future

World thyroid day 2022 theme

It was: “It’s not you. It’s your thyroid”

Slogan of world thyroid day 2023:

“Thyroid Health Matters: Empower Yourself!”

Common Thyroid Disorders:

The thyroid gland, located in the neck, plays a vital role in regulating various bodily functions. Thyroid disorders occur when the thyroid gland produces an excessive or insufficient amount of thyroid hormones. The two most prevalent thyroid disorders are:

1. Hypothyroidism:

This condition occurs when the thyroid gland fails to produce enough thyroid hormones. Symptoms may include fatigue, weight gain, depression, dry skin, and sensitivity to cold.

2. Hyperthyroidism:

In contrast to hypothyroidism, hyperthyroidism refers to the overproduction of thyroid hormones. Common symptoms include weight loss, rapid heartbeat, anxiety, insomnia, and increased sensitivity to heat.

Prevention Modalities:

While some thyroid disorders may be caused by genetic factors or other underlying conditions, several preventive measures can help maintain a healthy thyroid:

1. Iodine Intake:

Adequate iodine consumption is crucial for proper thyroid function. Including iodine-rich foods such as seafood, dairy products, and iodized salt in your diet can help prevent thyroid disorders.

2. Balanced Diet:

Following a balanced diet with sufficient levels of vitamins, minerals, and antioxidants supports overall thyroid health. Foods like fruits, vegetables, lean proteins, and whole grains should be incorporated into daily meals.

3. Stress Management:

Chronic stress can adversely affect thyroid health. Practicing stress-reduction techniques such as meditation, yoga, or engaging in hobbies can help maintain a healthy thyroid.

Treatment Options:

Treatment for thyroid disorders depends on the specific condition and its severity. Common approaches include:

1. Medication for thyroid disorders:

Thyroid hormone replacement therapy is typically prescribed for individuals with hypothyroidism to restore hormone levels. Anti-thyroid medications, beta-blockers, or radioactive iodine may be used to manage hyperthyroidism.

2. Thyroid surgery:

In cases where medication or other treatments are ineffective, surgical intervention may be necessary. Partial or total thyroidectomy (removal of all or part of the thyroid gland) can be performed to treat thyroid disorders.

3. Radioactive Iodine Therapy:

This treatment involves the administration of radioactive iodine to destroy the overactive thyroid cells responsible for hyperthyroidism.

Conclusion:

World Thyroid Day 2023 focuses on empowering individuals to take proactive steps towards maintaining a healthy thyroid for a vibrant future. By understanding common thyroid disorders, implementing preventive measures, and seeking timely treatment, we can enhance our overall well-being. Remember, “Thyroid Health Matters: Empower Yourself!” Let us join hands to raise awareness, promote early detection, and ensure a brighter future for individuals living with thyroid disorders.

How to give vaccine to Vaccine missed children

Please refer to image above.

Thyroid function test: TFT how to interpret TFT and know these dangerous disease at home

Core Tests

TSH (Thyroid Stimulating Hormone) → most sensitive
Free T4 (FT4) → active hormone
Free T3 (FT3) → useful in hyperthyroidism
± Antibodies:
- Anti-TPO
- TRAb (TSH receptor antibody)

Step 1: Look at TSH first

          TSH
        /  |   \
     Low Normal High

IF TSH LOW → Think Hyperthyroid OR Central Hypothyroid

TSH ↓
  |
  ├── FT4 ↑ / FT3 ↑ → PRIMARY HYPERTHYROIDISM
  │        (e.g. Graves', toxic nodules)
  │
  ├── FT3 ↑ only → T3 TOXICOSIS
  │
  ├── FT4 normal, FT3 normal → SUBCLINICAL HYPERTHYROIDISM
  │
  └── FT4 ↓ → CENTRAL (SECONDARY) HYPOTHYROIDISM
           (pituitary/hypothalamic disease)

Diagnoses

Graves’ disease
Toxic multinodular goiter
T3 toxicosis
Central hypothyroidism

IF TSH HIGH → Think Hypothyroidism

TSH ↑
  |
  ├── FT4 ↓ → PRIMARY HYPOTHYROIDISM
  │        (thyroid gland failure)
  │
  ├── FT4 normal → SUBCLINICAL HYPOTHYROIDISM
  │
  └── FT4 ↑ → RARE:
           - TSH-secreting adenoma
           - Thyroid hormone resistance

Diagnoses

Hashimoto thyroiditis
Iodine deficiency
Post-thyroidectomy
TSH-secreting pituitary adenoma

IF TSH NORMAL → Check FT4/FT3 carefully

TSH normal
  |
  ├── FT4 ↓ → CENTRAL HYPOTHYROIDISM
  │
  ├── FT4 ↑ → TSHOMA / RESISTANCE
  │
  └── FT4 normal → EUTHYROID

SUMMARY FLOWCHART (HIGH-YIELD)

                TSH
         ┌──────┼──────┐
        ↓       N       ↑
        |       |       |
     Check     Check    Check
     FT4/FT3   FT4      FT4
        |       |        |
   ┌────┼───┐   |    ┌───┼────┐
  ↑     N   ↓   |   ↓    N     ↑
Hyper Subclin Central   Primary Subclin Rare
thyroid hyper  hypo     hypo    hypo   causes

SPECIAL PATTERNS (EXAM FAVORITES)

1. Euthyroid Sick Syndrome

TSH: normal/low
FT3: ↓ (early)
FT4: ↓ (late)

👉 Seen in severe illness (ICU patients)

2. Subclinical Disease

Condition	TSH	FT4
Subclinical hyperthyroidism	↓	Normal
Subclinical hypothyroidism	↑	Normal

3. Pregnancy Changes

TSH ↓ (1st trimester)
FT4 slightly ↑ early

4. Drug Effects

Amiodarone → hypo OR hyper
Steroids → ↓ TSH
Lithium → hypothyroidism

MEMORY TRICKS

“TSH runs opposite to thyroid hormones”

↑ TSH = ↓ thyroid function (usually)
↓ TSH = ↑ thyroid function

“Think CENTRAL if TSH doesn’t match FT4”

Low TSH + Low FT4 → pituitary problem
Normal TSH + Low FT4 → pituitary problem

“Subclinical = TSH abnormal, FT4 normal”

QUICK CLINICAL PROTOCOL

Suspected Hypothyroidism

Check TSH
If ↑ → check FT4
If FT4 ↓ → treat
If FT4 normal → monitor / anti-TPO

Suspected Hyperthyroidism

Check TSH
If ↓ → check FT4, FT3
If elevated → confirm cause:
- TRAb → Graves’ disease
- Scan → nodules

Suspected Pituitary Disease

Always check:
- FT4
- TSH (may be misleading)

COMMON PITFALLS

Relying only on TSH in pituitary disease
Ignoring FT3 in hyperthyroidism
Misinterpreting illness-related changes

ULTRA-SHORT REVISION

TSH ↑ + FT4 ↓ → Primary hypothyroid
TSH ↓ + FT4 ↑ → Hyperthyroid
TSH ↑ + FT4 normal → Subclinical hypo
TSH ↓ + FT4 normal → Subclinical hyper
TSH ↓ + FT4 ↓ → Central hypothyroid

Hepatitis Full lecture PPT: Hepatitis introduction, causes, viral hepatitis, treatment of hepatitis and liver function test interpretation

Introduction

Viral hepatitis in children is a primary inflammation of the liver caused by at least five specific hepatotropic viruses (A, B, C, D, and E). While often milder in pediatric patients than in adults, it can progress to acute liver failure or chronic liver disease, particularly with types B and C.

I. Classification and Etiological Profile of Primary Viral Hepatitis

The five main viruses are distinguished by their genomic structure and mode of transmission:

Hepatitis A Virus (HAV): An RNA virus identical to enteroviruses; transmitted primarily via the feco-oral route through contaminated food or water. It never causes chronic infection.
Hepatitis B Virus (HBV): A DNA virus (Dane particle) transmitted parenterally, sexually, or vertically (perinatal). It is the most common cause of acute and chronic hepatitis worldwide.
Hepatitis C Virus (HCV): An RNA virus primarily transmitted via percutaneous blood exposure (IV drug use, transfusions before 1991) and vertically (5-6% risk).
Hepatitis D Virus (HDV): A defective RNA virus that requires co-infection or superinfection with HBV to replicate, as it uses the HBV lipoprotein envelope.
Hepatitis E Virus (HEV): An RNA virus transmitted enterally (water-borne), similar to HAV; it is a major cause of high mortality in pregnant women.

II. High-Yield Incubation Periods and Transmission Routes

Virus	Incubation Period	Main Route of Transmission
HAV	28–42 days	Feco-oral (“The vowels go through the bowels”)
HBV	60–150 days	Parenteral, Sexual, Vertical (Perinatal)
HCV	30–60 days	Parenteral (Blood exposure), Vertical
HDV	60–80 days	Parenteral (Requires HBV co-infection)
HEV	25–60 days	Feco-oral (Often water-borne epidemics)

Exam Point: “The Window Period” In HBV infection, the “window period” occurs when HBsAg has disappeared but Anti-HBs has not yet appeared. During this time, Anti-HBc IgM is the only marker of acute infection.

III. Detailed Clinical Presentation and Extrahepatic Features

Symptoms in children are often non-specific and vary by age:

Prodromal Phase: Fever, malaise, anorexia, nausea, vomiting, and right upper quadrant abdominal pain.
Icteric Phase: Subside of fever and anorexia, followed by jaundice (1–3 days after prodrome), dark urine, and pale stools.
Physical Findings: Tender hepatomegaly is common; splenomegaly occurs in 30% of cases.
HBV Extrahepatic Manifestations: High-yield exam points include serum sickness-like syndrome, polyarteritis nodosa (PAN), and membranous glomerulonephritis.
Chronic Hepatitis: Defined as continuing inflammation for \(\ge\)3–6 months; markers include persistently raised transaminases.

IV. Interpretation of Serological Markers (Crucial for MD Exams)

Diagnostic confirmation relies heavily on serology:

HAV: Diagnosis by Anti-HAV IgM (acute); Anti-HAV IgG indicates past infection and lifelong immunity.
HBV Complex Serology:
- HBsAg: Indicates current infection (acute or chronic).
- Anti-HBs: Indicates immunity (either via vaccine or recovered infection).
- Anti-HBc IgM: Indicates acute/recent infection (useful in the window period).
- Anti-HBc IgG: Indicates past or chronic infection.
- HBeAg: Correlates with high viral replication and high infectivity.
- Anti-HBe: Indicates lower infectivity.
HCV: Screen with Anti-HCV; confirm with HCV RNA PCR (detectable 1–2 weeks post-exposure).

V. Management and Pediatric Treatment Protocols

Treatment is primarily supportive for acute cases, but chronic cases require targeted therapy:

Supportive Care: Bed rest during jaundice, high carbohydrate diet, and avoidance of fats and hepatotoxic drugs (e.g., paracetamol, chlorpromazine).
Chronic HBV: Preferred treatments include Entecavir (\(\ge\)2 years) or Tenofovir (\(\ge\)12 years). Interferon-alfa is also an option for children 1–18 years.
Chronic HCV: Revolutionized by Direct-Acting Antivirals (DAAs). Recommended for all children \(\ge\)3 years. Regimens like Sofosbuvir/Ledipasvir (Harvoni) or Glecaprevir/Pibrentasvir (Mavyret) are highly effective.
Fulminant Hepatitis: Requires ICU admission, management of cerebral edema (Mannitol), and evaluation for liver transplantation.

VI. Prevention and Post-Exposure Prophylaxis (PEP)

Hepatitis A Vaccine: Two-dose series starting at 12 months.
Hepatitis B Vaccine: Routine three-dose series at birth, 1–2 months, and 6 months.
Perinatal HBV PEP: If a mother is HBsAg-positive, the neonate must receive HBIG (0.5 mL) and the first HBV vaccine dose within 12 hours of birth at separate sites.
Hygiene: Improving water supply and personal hygiene is the mainstay for preventing enteral (A and E) types.

High-Yield Laboratory “Rule of Thumb”: In acute viral hepatitis, ALT is typically > AST. If AST is twice as high as ALT, consider other etiologies like alcoholic hepatitis or hemolysis. Very high levels (>1000 U/L) are characteristic of acute viral or toxic injury.

6 Deadly facts About Diabetes: Symptoms, Diagnosis, complications and treatment

Introduction

Diabetes is a chronic medical condition characterized by high levels of blood sugar (glucose). This occurs either because the body doesn’t produce enough insulin (a hormone that regulates blood sugar) or because the cells don’t respond properly to the insulin that is produced. Insulin is necessary for the body to effectively use glucose as a source of energy.

History for diabetes mellitus type 1 and 2:

Symptoms of hyperglycemia
Thirst, dry mouth
Polyuria
Nocturia
Tiredness, fatigue, lethargy
Noticeable change in weight (usually weight loss)
Blurring of vision
Pruritus vulvae, balanitis (genital candidiasis)
Nausea; headache
Hyperphagia; predilection for sweet foods
Mood change, irritability, difficulty in concentrating, apathy
Family history

Physical examination for diabetes mellitus type 1 and 2

BMI
Retinal examination
Orthostatic blood pressure
Foot examination
Peripheral pulses
Insulin injection sites
Peripheral neuropathy

Type 1 Vs Type 2 Diabetes mellitus DM

	Type 1	Type 2
Onset	Sudden	Gradual
Age at onset	Any (mostly young)	Mostly in adults
Body habitus	Thin or normal	Often obese
Ketoacidosis	Common	Rare
Autoantibodies	Usually +	Absent
Endogeneous insulin	Low or absent	Normal, decreased or increased
Concordance in identical twins	~ 50%	~90%
Prevalence	Less prevalent	More prevalent (~90-95% of US diabetics)
Biochemical	C-peptide disappears	C-peptide persists

Mechanism and pathophysiology of Diabetes mellitus

Increased bloog glucose sugar level definition is called when

Normal Blood Glucose

FPG <100 mg/dL (5.6 mmol/L)
Two-hour glucose during OGTT <140 mg/dL (7.8 mmol/L)

Categories of increased risk for diabetes:

•Impaired fasting glucose(IFG)
- FPG between 100 and 125 mg/dL (5.6 to 6.9 mmol/L).
•Impaired glucose tolerance(IGT)
- Two-hour – 75 g OGTT between 140 and 199 mg/L (7.8 to 11.0 mmol/L).
•A1C – Persons with 5.7 to 6.4 percent (39 to 46 mmol/mol

Diagnostic criteria of Diabetes mellitus

1.   A1C ≥6.5 percent
OR
2.    Fasting Plasma Glucose ≥126 mg/dL (7.0 mmol/L)
       (Fasting is defined as no caloric intake for at least eight hours.)
OR
3.    Two-hour plasma glucose ≥200 mg/dL (11.1 mmol/L) during an OGTT.
       (The test should be performed using a glucose load containing the equivalent of 75-gram                    anhydrous glucose dissolved in water.)
OR
4.   In a patient with classic symptoms of hyperglycemia or hyperglycemic crisis, a random                    plasma glucose ≥200 mg/dL (11.1 mmol/L).

1. A1C ≥6.5 percent

2. Fasting Plasma Glucose ≥126 mg/dL (7.0 mmol/L)

(Fasting is defined as no caloric intake for at least eight hours.)

3. Two-hour plasma glucose ≥200 mg/dL (11.1 mmol/L) during an OGTT.

(The test should be performed using a glucose load containing the equivalent of 75-gram anhydrous glucose dissolved in water.)

4. In a patient with classic symptoms of hyperglycemia or hyperglycemic crisis, a random plasma glucose ≥200 mg/dL (11.1 mmol/L).

Advice to patients with Impaired glucose tolerance

Have an increased risk both of progression to type 2 diabetes and of developing macrovascular disease
Advice lifestyle modification reduces the risk of progression in IGT
Monitor annually by measurement of fasting blood glucose
Other cardiovascular risk factors treate aggressively

For Management of Diabetes mellitus Please refer to this link.

https://docs.google.com/presentation/d/e/2PACX-1vSboxNcRaxCiCS5xyX60Z_EGWi1Moh-orL3EKNhw3lfyeIf0Yd1F6dlMVg7UXv3Zw/embed?start=true&loop=true&delayms=15000

Thank you for being here.

Top 6 Treatment Options for Lung cancer in Modern Medicine is Currently Using (and everything about lung cancer)

What is lung cancer?

Lung canceris one form of cancer that begins in lung cells. It is one of the most prevalent cancers and the main reason for cancer-related deaths globally. Lung cancer is also called bronnchogenic carcinoma.

Non-small cell lung cancer (NSCLC) and small cell lung cancer are the two main subtypes of lung cancer. (SCLC). Compared to SCLC, NSCLC is more prevalent and typically develops and spreads more slowly.

What causes lung cancer? Does smoking cause lung cancer?

Smoking is the leading risk factor for lung cancer, although other dangers include radon exposure, air pollution, and exposure to secondhand smoke.

What are the symptoms of lung cancer?

Initilaay the aptient may not be symptomatic.The patient may have constitutional symptoms like weight loss, loss of appetite, decreased energey and weakness. The llung cancer sumptoms include: coughing, chest pain, shortness of breath, and weight loss are all possible signs of lung cancer. The sputum may contain blood in it and cough remains for longer duration of time and is not cured even after treatment for other conditions.

Diagnosis of lung cancer

After patient is suspected of lung cancer, the patient may be needed to be investigated for it. The possible investigations may include complete blood counts, inflammatory markets, imaging studies like chest x ray, contrast or non contrast CT scan of chest, bronchoscopy.

The other disgnostic tests include CT guided needle biopsy, PET or positron emission tomography, bone scan, sputum cytology, thoracocentesis, needle biopsy like FNAC or in some cases even thrascopy may also be needed.

The supportive investigations to rle out the other causes include lunf functions tesst, arterial bood gas ABG analysis, liver function tests etc.

What is the treatment of lung canncer?

Depending on the kind and stage of the cancer, a lung cancer patient may receive surgery, radiation therapy, chemotherapy, targeted therapy, or a combination of these treatments. Early detection through screening can enhance results and raise the likelihood of a successful outcome.

Prevention of lung cancer

Avoiding smoking and exposure to secondhand smoke is important for lung cancer prevention, as is limiting exposure to other risk factors including radon and air pollution.

All lectures and videos linked in one for ease HA CMA Loksewa license and other competitive exams nepal

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World Thyroid Day 2025: Empowering Thyroid Health for a Vibrant Future

Introduction:

Theme of world thyroid day 2023:

World thyroid day 2022 theme

Slogan of world thyroid day 2023:

1. Hypothyroidism:

2. Hyperthyroidism:

Prevention Modalities:

1. Iodine Intake:

2. Balanced Diet:

3. Stress Management:

Treatment Options:

1. Medication for thyroid disorders:

2. Thyroid surgery:

3. Radioactive Iodine Therapy:

Conclusion:

How to give vaccine to Vaccine missed children

Table of Contents

Core Tests

Step 1: Look at TSH first

IF TSH LOW → Think Hyperthyroid OR Central Hypothyroid

Diagnoses

IF TSH HIGH → Think Hypothyroidism

Diagnoses

IF TSH NORMAL → Check FT4/FT3 carefully

SUMMARY FLOWCHART (HIGH-YIELD)

SPECIAL PATTERNS (EXAM FAVORITES)

1. Euthyroid Sick Syndrome

2. Subclinical Disease

3. Pregnancy Changes

4. Drug Effects

MEMORY TRICKS

“TSH runs opposite to thyroid hormones”

“Think CENTRAL if TSH doesn’t match FT4”

“Subclinical = TSH abnormal, FT4 normal”

QUICK CLINICAL PROTOCOL

Suspected Hypothyroidism

Suspected Hyperthyroidism

Suspected Pituitary Disease

COMMON PITFALLS

ULTRA-SHORT REVISION

Table of Contents

Introduction

I. Classification and Etiological Profile of Primary Viral Hepatitis

II. High-Yield Incubation Periods and Transmission Routes

III. Detailed Clinical Presentation and Extrahepatic Features

IV. Interpretation of Serological Markers (Crucial for MD Exams)

V. Management and Pediatric Treatment Protocols

VI. Prevention and Post-Exposure Prophylaxis (PEP)

Table of Contents

Introduction

History for diabetes mellitus type 1 and 2:

Physical examination for diabetes mellitus type 1 and 2

Type 1 Vs Type 2 Diabetes mellitus DM

Mechanism and pathophysiology of Diabetes mellitus

Increased bloog glucose sugar level definition is called when

Categories of increased risk for diabetes:

Diagnostic criteria of Diabetes mellitus

Advice to patients with Impaired glucose tolerance

Table of Contents

What is lung cancer?

What causes lung cancer? Does smoking cause lung cancer?

What are the symptoms of lung cancer?

Diagnosis of lung cancer

What is the treatment of lung canncer?

Prevention of lung cancer

Table of Contents

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