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INTRODUCTION@#Childhood radiation exposure is a known risk factor for thyroid malignancy and dysfunction. However, local data are limited and there is no consensus on the modality and frequency of screening in this high-risk group.@*METHODS@#Retrospective analysis study evaluating patients with childhood radiation exposure in 2006-2016 and minimum of 1-year follow-up.@*RESULTS@#Of the 132 childhood cancer survivors in the study, thyroid malignancy was detected in 2 cases (1.5%) and thyroid nodules in 13 (9.8%). The earliest thyroid malignancy was detected 5 years post-radiotherapy via ultrasound. Of the 84 patients who had screening thyroid function test, 26 (31.0%) were detected with abnormal test results post-radiation, majority being subclinical hypothyroidism.@*CONCLUSION@#Regular screening via clinical examination for thyroid nodules should be performed at least annually. Where feasible and if resources permit, consideration should be given to using ultrasound for thyroid nodule(s) and malignancy screening at 5 years post-radiation therapy. Screening for thyroid dysfunction can be considered from 6-12 months post-radiotherapy.
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Introduction@#Derangement in calcium homeostasis is common in nephrotic syndrome (NS). It is postulated that low serum total calcium and vitamin D levels are due to loss of protein-bound calcium and vitamin D. It is unclear if free calcium and free vitamin D levels are truly low. The guideline is lacking with regards to calcium and vitamin D supplementation in NS. This study aims to examine calcium and vitamin D homeostasis and bone turnover in NS to guide practice in calcium and vitamin D levels supplementation.@*Methodology@#This is a prospective pilot study of ten patients diagnosed with NS, and eight healthy controls. Calcium, vitamin D, and bone turnover-related analytes were assessed at baseline, partial and complete remission in NS patients and in healthy controls.@*Results@#NS patients had low free and total serum calcium, low total 25(OH)D, normal total 1,25(OH)D levels and lack of parathyroid hormone response. With remission of disease, serum calcium and vitamin D metabolites improved. However, nephrotic patients who do not attain complete disease remission continue to have low 25(OH)D level.@*Conclusion@#In this study, the vitamin D and calcium derangement observed at nephrotic syndrome presentation trended towards normalisation in remission. This suggested calcium and vitamin D replacement may not be indicated in early-phase nephrotic syndrome but may be considered in prolonged nephrotic syndrome.
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Vitamin D DeficiencyABSTRACT
Objective To observe the clinical efficacy of ozone injection combined with extracorporeal shock wave in treatment of arthritis of perishoulderr.Methods 120 patients with arthritis of perishoulderr and treated were choiced,they were randomly divided into two groups.Patients in group C were performanced extracorporeal shock wave treatment.Patients in group H were performanced with ozone injection combined with extracorporeal shock wave.Visu-al analogue score(VAS)and rane of motion(ROM)were used to evaluate the therapeutic effect.Results There was no significant difference between the two groups preoperation.Then significant difference of VAS in the two groups for 1week,1 month,3 months and 6 months after treatment showed respectively as (4.56 ±0.27)points vs.(2.49 ± 0.25)points,t =43.57,(3.96 ±0.23)points vs.(1.86 ±0.29)points,t =43.95,(3.36 ±0.20)points vs.(1.79 ± 0.25)points,t =36.51,(3.98 ±0.23)points vs.(2.09 ±0.27)points,t =41.29,P <0.05;The ROM data were respectively(55 ±18)points vs.(67 ±16)points,t =3.86,(60 ±20)points vs.(72 ±18)points,t =3.45,(56 ±19) points vs.(78 ±15),t =7.04,(46 ±18)points vs.(77 ±14)points,t =10.53,P <0.05.Patients feeled pain eased significantly in group H was significantly higher than group C in 6 month postoperativeiy.(χ2 =38.90,P <0.01;χ2 =8.91,P <0.05).Conclusion There is significant effect in patients with arthritis of perishoulderr treated by com-bined ozone injection with extracorporeal shock wave.