https://www.clinsurggroup.us/journals/international-journal-of-clinical-endocrinology-and-metabolism A Peertechz Open Access Journal en-us 11 Mar, 2026 https://www.clinsurggroup.us/articles/IJCEM-12-167.php Objectives: To examine the association between thyroid nodular formation and histopathological outcomes in an iodine-sufficient region, we retrospectively reviewed histopathological findings from surgically excised thyroid specimens collected over three years (2021–2023) at Henry Dunant Hospital in the metropolitan area of Athens. Histological diagnoses, along with patient anthropometric characteristics and thyroid morphological parameters, were analysed to evaluate malignancy risk and enhance prognostic assessment. Methods: Histopathological reports from 192 patients (138 men and 54 women) were retrospectively reviewed. Patients were categorised into three age groups: Group A (&lt;40 years: 42 men, 14 women), Group B (40–69 years: 87 men, 35 women), and Group C (≥69 years: 9 men, 5 women). Correlations were performed between anthropometric characteristics and thyroid morphological parameters, including gland weight, gland dimensions, and the number of nodules per lobe. Results: An age-related increase in thyroid gland weight was observed, which was more pronounced in the female population (p &lt; 0.027). Multinodular goitre was present in more than 80% of patients across all age groups. In women aged 40–49 years, a significantly larger nodule diameter was observed in the right thyroid lobe. In contrast, an increase in the number of nodules was noted exclusively in the left lobe of men aged ≥69 years. The prevalence of a solitary thyroid nodule was similar in men aged &lt;40 and 40–69 years (23.8% and 24.1%, respectively), while women showed a higher prevalence in the &lt;40-year age group (42.9%). No statistically significant sex-related differences were observed in the incidence of papillary or follicular thyroid carcinoma. However, papillary carcinoma predominated over follicular carcinoma in both sexes within the &lt;40 and 40–69 age groups. Metastatic disease was more frequently observed in men aged 40–69 years. Medullary carcinoma was identified exclusively in men, with a prevalence of 2.3% in the 40–69-year age group. Follicular adenoma was the most common histopathological diagnosis across all age groups. Conclusions: Consistent with previous reports, follicular adenoma was the most frequent histopathological finding in patients with multinodular goitre, while papillary carcinoma represented the predominant thyroid cancer subtype. Thyroid gland weight increased with age, particularly among women, but this increase was not associated with a higher risk of malignancy. Further studies are required to confirm these findings and better define their implications for long-term clinical outcomes. 25 Jun, 2025 https://www.clinsurggroup.us/articles/IJCEM-11-166.php Diabetes mellitus, particularly type 2 diabetes, continues to pose a significant global health burden, with increasing prevalence, healthcare costs, and long-term complications. Conventional treatments, including insulin therapy and oral hypoglycemic agents, although effective, often come with limitations such as side effects, high costs, and reduced patient compliance. In this context, herbal antidiabetic preparations have gained growing attention as alternative and complementary therapeutic options, driven by traditional medicinal knowledge and an increasing body of scientific evidence. This review explores the efficacy, mechanisms of action, and therapeutic potential of various herbal formulations in the management of diabetes, while also identifying gaps in current research and proposing future directions. A wide range of medicinal plants, including Momordica charantia (bitter melon), Gymnema sylvestre, Trigonella foenum-graecum (fenugreek), Cinnamomum verum (cinnamon), and Berberis aristata, have demonstrated hypoglycemic activity in both experimental and clinical studies. These herbs contain bioactive constituents such as charantin, gymnemic acids, berberine, trigonelline, and cinnamaldehyde, which act through multiple mechanisms. These include enhancing insulin secretion, regenerating pancreatic beta cells, improving insulin sensitivity, inhibiting intestinal glucose absorption, and exerting antioxidant and anti-inflammatory effects. Unlike synthetic drugs that typically target a single pathway, herbal preparations often provide a multifaceted approach, making them particularly suitable for the complex pathophysiology of diabetes. Despite these promising results, the clinical adoption of herbal antidiabetic therapies remains limited due to several challenges. These include variability in phytochemical content based on geographical and processing factors, lack of standardized formulations, and insufficient large-scale randomized controlled trials with inconsistent methodologies and small sample sizes. Moreover, concerns regarding safety, potential herb-drug interactions, and regulatory inconsistencies further hinder their widespread integration into mainstream healthcare. While preclinical evidence is robust, the translation of findings into clinically approved treatments necessitates rigorous evaluation, including toxicity studies, pharmacokinetic profiling, and long-term efficacy trials. Recent advances in biotechnology, phytochemistry, and computational biology have opened new avenues for enhancing the reliability and efficacy of herbal medicine. Standardization of active ingredients, use of nanotechnology for improved bioavailability, and integration of systems biology approaches such as metabolomics and network pharmacology are transforming the field. Furthermore, the development of herbal-drug combination therapies, precision herbal medicine tailored to individual genetic profiles, and the incorporation of herbal remedies into public health strategies represent important future directions. In conclusion, herbal antidiabetic preparations offer a promising, accessible, and culturally acceptable alternative for managing diabetes, especially in regions with limited access to modern medical care. However, realizing their full potential requires a multidisciplinary effort to bridge traditional knowledge with modern scientific validation. By addressing current limitations and investing in high-quality research and regulatory frameworks, herbal medicines can become an integral part of evidence-based diabetes management and prevention strategies globally, including multi-center randomized trials and pharmacovigilance mechanisms. 07 May, 2025 https://www.clinsurggroup.us/articles/IJCEM-11-165.php Background: NAFLD is a growing menace globally, with an estimated global prevalence of 25.2%. It affects 10 to 24 percent of the general population in various countries. The reported global prevalence rate of non-obese NAFLD varies widely, ranging from 3% to almost 30%. Asian studies also report that NASH is frequently found in non-obese NAFLD. In Bangladesh, about one-third of the population is affected by NAFLD. Aim: The purpose of this study was to evaluate the metabolic profile of NAFLD in non-obese patients attending a tertiary care hospital. Materials and methods: This cross-sectional study was conducted in department of medicine and department of gastroenterology and hepatology at Rajshahi Medical College Hospital, Rajshahi from January 2022 to June 2022. Total 100 patients were enrolled by purposive sampling technique. Results: Among 100 patients, mean age was 40.82 years with female predominance (53%). Most of the patients were normotensive (77%) and non-diabetic (55%) and non-smoker (52%) but 57% had hypothyroidism. The body mass index in male was 21.32 ± 1.3 (SD) kg/m2 and body mass index female was 20.5 ± 2.15 (SD) kg/m2. The waist circumference in male was 76.572 ± 5.395 (SD) cm and in female was 74.512 ± 5.523 (SD) cm. Among the respondents 30% had Fasting Blood glucose > 5.5 mmol/L and 40% had Blood glucose 2 h after breakfast > 11.1 mmol/L. Majority of the respondents fasting lipid profile showed cholesterol level ≥ 200 mg/dl in 73%, triglyceride level ≥ 200 mg/dl in 72%, LDL ≥ 130 mg/dl in 58% and HDL level ≤ 40 mg/dl was 51% patients. Among the respondents 60% had TSH > 5 mIU /L and 57% had Free T4 < 0> 40 U/L, 56% had alanine aminotransferase (ALT) > 40 U/L and 46% had gamma-glutamyl transferase (GGT) > 30 U/L. Majority of respondents 36% had Grade 1 fatty liver followed in decreasing order by 34% had Grade 3 fatty liver and 30% had Grade 2 fatty liver. Conclusion: Non-obese NAFLD is likely a different entity than obese NAFLD, with its unique genetic predisposition. This study found that components of metabolic syndrome were quite frequent among study population. More than half of the study population had altered level of Liver function enzyme, hypothyroidism and dyslipidemia and approximately 45% of patients had diabetes mellitus. 05 Apr, 2025 https://www.clinsurggroup.us/articles/IJCEM-11-164.php Intrahepatocyte triglyceride buildup and concurrent immune system activation, followed by histological alterations, tissue destruction, and clinical manifestations, are signs of Non-alcoholic Fatty Liver Disease (NAFLD). One promising method of treating diabetes is cell-based therapy. In regenerative medicine, Mesenchymal Stem Cells (MSCs), which can be isolated from various tissue sources, such as bone marrow, adipose tissue, umbilical cord, and mobilized peripheral blood, have gained increasing significance . Mesenchymal Stem Cell (MSC)-derived Extracellular Vesicles (EVs) (MSC-EVs) are novel cell-free carriers with minimal immunogenicity that might inhibit harmful immune responses in tissues that are inflamed. EVs may reduce inflammation in liver conditions. Advancement in the clinical translation of EVs necessitates enhanced interdisciplinary collaboration between EV researchers, nanomedicine specialists, regulatory agencies, and clinical institutions is required. However, further in vitro and in vivo studies are required for better understanding cross talk between EVs and immune cells to clarify the potency and mechanisms of action of this novel potential therapeutic tool. 28 Mar, 2025 https://www.clinsurggroup.us/articles/IJCEM-11-163.php Free triiodothyronine toxicosis is a rare condition, expressed by isolated triiodothyronine concentration elevation, resulting in an overt hypermetabolic state. Diagnosis and treatment are particularly important in young populations during puberty, with intensive intellectual and physical development. We present a case of monozygotic adolescent male twins, with cardiovascular symptoms, along with anxiety, hypersensitivity and insomnia. The free triiodothyronine toxicosis in the absence of anti-thyroid antibodies. Successful treatment with symptom relief and laboratory results normalization was achieved after 8 weeks of anti-thyroid medication with beta-blocker addition. The described condition may be an early stage of developing disease, so further follow-up is obligatory. Because the case presents an atypical population for the disorder, with brothers additionally being monozygotic twins, genetic factors should be taken into consideration in the event of disease progression. 12 Nov, 2024 https://www.clinsurggroup.us/articles/IJCEM-10-162.php Bone fractures due to decreased Bone Mineral Density (BMD) in men with hypogonadism are an important issue in decreasing quality of life. Moreover, Testosterone (TT) plays a crucial role in maintaining BMD, but the relationship between TT levels and osteoporosis development has been conflicting. Nonetheless, Testosterone Replacement Therapy (TRT) seems to be beneficial, especially in men with hypogonadism and osteopenia or osteoporosis. 24 Sep, 2024 https://www.clinsurggroup.us/articles/IJCEM-10-161.php A retrospective hospital-based study was conducted at the Pediatric Endocrine Division, King Khalid University Hospital (KKUH), King Saud University, Riyadh, Saudi Arabia, during the period July 1983 and June 2017. Methods: Medical records of patients who were diagnosed with DSD were retrospectively reviewed. Data included the etiological diagnosis, clinical history, physical examination, results of laboratory and radiological investigations, medical and surgical options offered, and results of follow-up. Laparoscopy or laparotomy with gonadal biopsies was done when appropriate. Results: During the period under review, a total of 203 patients with Disorders of Sex Development (DSDs) were evaluated. Their ages ranged between one day and 13 years. Hundred- thirty-nine (68.5%) patients were genetic females (46 XX). Congenital Adrenal Hyperplasia (CAH) is the most common, in 137(98.5%) patients. Conclusion: Disorders of sex development are a group of heterogeneous conditions with variable aetiologias. Many patients with DSD have a good quality of life and lead a near-normal life, though some have not. The severity of the disorder, initial evaluation and follow-up by a specialized multidisciplinary team, good psychological support, and proper education were important. Finally, sex assignments should be made early after a thorough investigation. 04 Jul, 2024 https://www.clinsurggroup.us/articles/IJCEM-10-160.php Abstract: There is a lack of studies analyzing Severe Insulin Resistance (SIR) forms, especially from clinical aspects. The main objective of this research was to assess the relationship between micro- and macrovascular complications and the death rate of patients with SIR. Methods: It was a partially prospective case-control study of 120 participants with T2DM. Patients with doses of insulin >1 IU/kg/day were considered to have SIR (case group), with an insulin requirement of &lt;1 IU/kg/day - control group. Statistical analyses were performed. Results: Regarding microvascular complications, an association was found between insulin doses and the rate of Diabetic Nephropathy (DN) in the case group compared with the control group (138 vs. 170 IU/day), p = 0.002. Men with T2DM and SIR were more likely to present with myocardial infarction than women (39.3% vs. 13.3%); p = 0.036. Subjects of the case group with lower eGDR (2.44 vs. 1.35) (or higher insulin resistance) were more likely to suffer a stroke, p = 0.003. Case group males were more likely than females to undergo coronary artery bypass graft surgery (21.4% vs. 3.3%); p = 0.048. Higher mortality was observed in the case group of patients with lower eGDR (1.01 vs. 1.85); p = 0.031. Conclusion: As for microvascular outcomes, the rate of DP and DR was similar in both control and case groups. Only the rate of DN in the case group was associated with higher insulin doses. Macrovascular complications such as stroke, myocardial infarction, and bypass surgery were related to the male gender and SIR, as well as higher mortality according to eGDR. 29 Jun, 2024 https://www.clinsurggroup.us/articles/IJCEM-10-159.php This article provides an overview of the recent advancements in thyroid hormone therapy for treating hypothyroidism and other thyroid disorders. The traditional thyroid hormone replacement therapy using levothyroxine has been effective, but recent advancements have led to a more individualized approach to treatment. The article discusses the development of new formulations and dosages of thyroid hormone replacement therapy, as well as the exploration of new combination therapies using both levothyroxine and liothyronine. Additionally, recent developments in the guidelines for thyroid hormone replacement therapy have emphasized the need for individualized treatment based on the patient’s specific needs and physiology. The article also highlights recent advancements in thyroid hormone therapy for depression, cardiovascular disease, and non-thyroidal illness syndrome. Overall, the article shows that recent advancements in thyroid hormone therapy have provided clinicians with more options for treating patients with thyroid disorders, improving their lives. 20 Oct, 2023 https://www.clinsurggroup.us/articles/IJCEM-9-158.php Many cytokines play a role in the pathogenesis of Type 1 Diabetes (T1D), and gene polymorphisms could possibly contribute to the disease’s genetic predisposition because they can affect cytokine production or function. The purpose of this study was to investigate the role of the gene polymorphisms TGF-β1 (+869T/C), (+915G/C), IL-10 {-1082 G/A), (-819 C/T), and (-592 A/C), and IL-6 (-174 G/C) in hereditary vulnerability to T1D. The Polymerase Chain Reaction with Sequence-Specific Primers (PCR-SSP) was used to analyze the polymorphisms. According to their genotypes, individuals were divided into the low-, high-, or intermediate-producer phenotypes predicted for these cytokines polymorphisms. Our findings revealed that the production of TGF-β1 was significantly higher in control than in T1D participants whereas the IL-6 genotype with low IL-6 production was significantly increased in the cases compared to the control. A significant association was evident between TGF-β1 and IL-6 low production and the incidence of T1D, thereby confirming the importance of TGF-β1 and IL-6 polymorphism as a genetic factor contributing to the incidence of T1D. By contrast, the involvement of IL-10 in the incidence of T1D was not as clear. Although some evidence supports a relationship, no statistically significant association has been verified between IL-10 and T1D. This type of measurement could be beneficial in determining the susceptibility and severity of the T1D condition while also taking into consideration the prediction of T1D incidence. 19 Jan, 2023 https://www.clinsurggroup.us/articles/IJCEM-9-157.php Background: Fatty acids of the omega-3/omega-6 groups are used especially in cases of pregnancy, lactation, and malnutrition. In recent decades, pediatrics has been trying to find out whether the use of omega-3/omega-6 has effects on human growth and neurodevelopment. Aims: Check the state of the art on the use of omega-3/omega-6 type fatty acids in the diet, in adolescent and adult populations. Materials and methods: A total of 72 original articles on the topic of human growth and nutrition in pediatrics have been selected on PubMed through September 2022. Results: In literature, the use of omega-3/omega-6, with greater prevalence in the former group than the latter group, appears to be most effective in hypertension hypothesis, dyslipidemia, and high C-reactive protein values, cardiovascular risk, and neuropathic pain, while appearing to have less impact on neurodegenerative (except in multiple sclerosis) and mental disorders (except in depression). Interesting benefits can be detected when combining omega-3/omega-6 with spirulina algae, chitosan, probiotics, vitamin D, fiber and plant extracts. Conclusion: Significant evidence emerges on the importance of omega-3 and omega-6 fatty acid supplementation, but important structural shortcomings of research designs still emerge from the published studies; moreover, many studies assume that fatty acid supplementation can have a curative effect on already active diseases, when in fact such prescriptions should be considered as adjuvant therapies to prevent or promote symptomatic regression, precisely because of their anti-inflammatory, antioxidant and immunomodulating virtues. However, there is no concrete and robust evidence of the positive impact on psychological well-being. Future research that can resolve the critical issues highlighted is hoped to promote a better approach to the topic of omega-3/omega-6 supplementation in human health. 18 Jan, 2023 https://www.clinsurggroup.us/articles/IJCEM-9-156.php Seobuk Hospital is a hospital directly operated by the Seoul Metropolitan Government and has mainly served as a tuberculosis hospital. It is a Seoul city governmental public hospital which primarily provides inpatients and out patients treatment to the elderly, many of them suffering from dementia patients and the marginalized, such as the homeless and the disabled. From March 2nd, 2020, to May 31th, 2022 Seobuk hospital was appointed to treat COVID-19 patients that required stationary treatment. South Korea’s COVID-19 mortality rate has below 0.1% while in other countries such as the United States and in Europe the mortality rate varies between 1 and 2 %. We believe that it is due to the quarantine system which was put in place right from the start of the COVID-19 pandemic in Febuary 2020. Patients testing positive for COVID-19 were hospitalized free of charge and they were hospitalized usually in early period (2 - 3 days after COVID -19 testing) of COVID-19 disease. In this paper we analyzed the disease patterns of patients hospitalized with COVID-19 using the data from the 4,531 patients charts which received treatment in Seobuk hospital between March 2nd, 2020 and May 31st, 2022 by looking at their clinical features and medication history and medications for treatment. The key element of the guideline of our treatment was to administer Veklury (Remdesivir) or Paxlovid despite its high cost in the early period of the COVID-19 disease when oxygen saturation dropped below 94%. Nowadays we administer Veklury and Paxlovid right after COVID-19 is daignosed free of charge for the proper patient. It is believed that the current quarantine system in South Korea which allows patients to be treated with Veklury (Remdesivir) in hospitals at the initial stage of the infection and with an early Paxlovid administration in home treatment has contributed to lowering the death rate in South Korea. 22 Dec, 2022 https://www.clinsurggroup.us/articles/IJCEM-8-155.php β-Thalassemia Major (TM) is a form of beta-thalassemias. TM complications include, among others, osteoporosis, whose frequency, among TM patients, varies from 13.6% to 50%. The overall etiological mechanisms of TM-related osteoporosis remain unclarified. The primary approach to osteoporosis in patients with TM is the management of TM and its complications and the use of antiresorptive agents, such as Bisphosphonates (BPs), as the first line-drug of treatment. In this article, we present the case of 45 years old-woman with TM and severe osteoporosis, with multiple fractures, albeit the assumption of BPs for many years. The anti-fracture efficacy and safety of BPs are not well-established in TM patients. Data suggest that etidronate and zoledronic acid should be considered as first-line agents in the management of TM- associated osteoporosis. Regarding Teriparatide (TP), there are only a few case reports published about its use in TM patients. It is also noticed that, at the dismission of TP therapy, its benefits are rapidly lost. Finally, regarding romosozumab, our patient presents a significant cardiovascular risk due to the presence of insulin-treated Diabetes Mellitus (DM) and TM-related cardiomyopathy, suggesting we avoid this drug. This case report shows that the therapy of osteoporosis in patients with TM remains an open problem. TM patients often present multiple comorbidities which create limitations to osteoporosis’s treatment. Moreover, these comoboridites are often unavoidable risk factors for osteoporosis. 24 Sep, 2022 https://www.clinsurggroup.us/articles/IJCEM-8-154.php People with diabetes are at increased risk of infection and are worried about biological agents such as bacteria. Particularly, foot infections, urinary tract infections, pneumonia, and skin diseases are due to bacterial infections that make diabetic patients suffer from clinical difficulties. Although antibiotics, one of the bacterial therapies, have been used, the emergence of multidrug-resistant bacteria is now in demand for alternative therapies. Although, many studies reported that antibiotic-resistant for bacterial infections and their rate have increased significantly in the diabetic patient population. Still, there is no report that directly compares the prevalence of antibiotic-resistant infections in diabetes types. In this review, we described the diverse types of diabetes with their bacterial infection and the reported resistance. Generally, diabetic patients are susceptible to vancomycin-resistant enterococcal infections, extended-spectrum β-lactamase-producing intestinal bacteria, carbapenem-resistant intestinal bacteria, and unfermented gram-negative bacilli. Thus, early detection of diabetes and prompt treatment are important to control chronic infections in diabetic patients. 24 Sep, 2021 https://www.clinsurggroup.us/articles/IJCEM-7-153.php Vildagliptin is an oral anti-hyperglycaemic agent, commonly called an anti-diabetic medication that belongs to the family of medications known as Dipeptidyl Peptidase-4 (DPP-4) inhibitors. It is a medicine that is used to treat Type 2 Diabetes Mellitus [1]. 26 Dec, 2020 https://www.clinsurggroup.us/articles/IJCEM-6-152.php Background: Metformin use has been associated with a decreased risk of cancer and improvement in overall cancer survival rates. However, scant data available regarding metformin’s role in the risk of Gastrointestinal (GI) malignancies in patients with type II diabetes. Our study aimed to conduct a meta-analysis to evaluate the association of metformin use and GI cancer risk. Methods: We conducted electronic search by two independent investigators using the PubMed and Cochrane library databases. Studies were assessed for design and quality, and a meta-analysis was conducted to quantify the effect of metformin on the odds of developing specific GI malignancies. The final papers that met our prespecified inclusion criteria included 4 case-control studies that address metformin’s effect on pancreatic cancer, and 4 case-control studies that address metformin’s effect on colorectal cancer in patients with type II DM.  Results: Of 2258 articles screened, 8 eligible studies were identified comprising 483,561 participants diagnosed with DM. Our analysis showed that metformin use was not associated with a significant effect on the odds of developing pancreatic cancer (OR .98; 95% CI 0.82-1.17, P=0. 83). Metformin use was associated with significantly lower odds of having Colorectal Cancer (CRC); (OR 0.84; 95% CI 0.81-0.87, p &lt; 0.01). Sufficient data were not available to conduct analyses on the impact of metformin dose and duration. Conclusion: Our findings suggest that metformin could be a useful neoadjuvant agent for CRC cancer and as a possible preventive therapy for other inflammatory conditions related to colorectal pathologies such as adenomatous polyps and inflammatory bowel disease. Further research is warranted to elucidate the role of metformin on the risk of developing pancreatic cancer, given the complex nature of the organ’s regulation on insulin production.  26 Nov, 2020 https://www.clinsurggroup.us/articles/IJCEM-6-151.php Coronavirus disease 2019 (COVID-19) pandemic has become a global threat to public health, risk factors of COVID-19 is in urgent need in this fight. We collected data and clinical records from 123 COVID-19 patients at Wuhan Union hospital, China. Of 123 patients enrolled, 6 died in hospital and the other 117 survived. It is noteworthy that lipid levels, especially HDL-c, significantly differed between survivors and non-survivors. We suppose that HDL-c might also be a risk factor of COVID-19. Medical staff should pay more attention to the lipid levels of COVID-19 infected patients. 05 Nov, 2020 https://www.clinsurggroup.us/articles/IJCEM-6-150.php The effects of infection with SARS-CoV-2 on host health are complex and major differences in the severity of the disease are observed. The best choices, nevertheless, are prevention and management. The main functions of genomic metabolic processes regulated by various physiological mechanisms are defined by the metabolic health of a person. Disordered genomic metabolic processes and a reduction in metabolic health are triggered by disruption of these mechanisms. Weaknesses health is the main risk factor for extreme COVID-19. It is probable that potential physiological changes induced by metabolic syndrome and T2D will overcap with COVID-19, potentially exacerbating the course of the disease. Although chronic diabetes hyperglycaemia contributes to harm that can exacerbate the path of the disease in COVID-19, recent research indicates that in patients with COVID-19 and T2D, dysregulated glucose by itself is counterproductive. To regulate the host inflammatory response, to reduce tissue susceptibility to inflammatory damage signals and to maintain physiological function during the extreme and critical phase of infection, glycaemic control is essential. 08 Sep, 2020 https://www.clinsurggroup.us/articles/IJCEM-6-149.php Aim: The aim of this study is to compare the risk factors, management and pregnancy outcome between the Gestational Diabetes Mellitus (GDM) patients who were diagnosed at early and late stage of pregnancy. Methods: We randomly selected 250 newly detected GDM patients and examined them. They were divided into two groups considering the gestational age at the time of diagnosis: early group (13 to 28 weeks) and late group (after 28 weeks). Results: Data of 150 cases from early group and 100 cases from late group were analyzed. Incidence of nulliparous GDM patient (24% vs 36%, P – 0.04),weight at the time of GDM diagnosis (66.0 ± 11.067 vs 69.93 ± 9.865, P - 0.004) were significantly higher in late group and so was the excess body weight from ideal body weight (14.13 ± 10.147 vs 17.94 ± 8.535, P - 0.002). Prevalence of pre pregnancy obese/ overweight patients (68.7% vs 80.0%, P - 0.047), maternal H/O of DM (45.3% vs 32%, p - 0.035) and H/O unexplained fetal loss (24% vs 10%, p - 0.005) were higher in early group. There were no significant differences of blood sugar values (SMBG) between the groups except fasting blood sugar at 2nd visit (F2) (5.557 ± 1.045 vs 5.167 ± 0.960, P - 0.01). Conclusion: This study suggests that range of screening should be broader to detect high risk and undiagnosed GDM mothers. Beside that it has also showed that only early diagnosis and intervention will not be enough to prevent the complications if the patients fails to understand and participate in GDM management. 03 Aug, 2020 https://www.clinsurggroup.us/articles/IJCEM-6-148.php The sudden onset of a viral pandemic has led to an urgent situation in which health professionals are looking for something “out of the box” to remedy the crisis. This article describes a novel intervention that is extremely easy and science-based: Earthing or electrically grounding your body to the Earth. COVID-19 has ushered in a plethora of medical claims concerning the use of natural products to prevent and/or treat the pathogen. 29 Jun, 2020 https://www.clinsurggroup.us/articles/IJCEM-6-147.php The presence of the thyroglossal duct cyst (TDC) within the thyroid gland is of rare occurrence as only 16 cases have been documented to date. It is even rare for the intrathyroidal TDC to present as infective thyroiditis as only one case has been reported in the scientific literature. We report a case of intrathyroidal TDC which presented as recurrent episodes of thyroiditis in a 13-year-old female. Diagnostic work-up, management, and review of pertinent scientific literature is also presented. To the best of our knowledge, this is the second case of intrathyroidal TDC which has presented as chronic recurrent thyroiditis. It is the first case of the intrathyroidal TDC with chronic thyroiditis reported in the pediatric age group. 06 Jun, 2020 https://www.clinsurggroup.us/articles/IJCEM-6-146.php Metabolic health is defined as physical conditions that involve metabolic functions and its associated health impacts. Metabolism is the process occurring in the cells in order to get energy and remove waste products. Understanding of metabolism is the basis of improving metabolic health and prevention of metabolic health problems and its associated complications. Metabolism includes catabolism and anabolism. 06 Jun, 2020 https://www.clinsurggroup.us/articles/IJCEM-6-145.php Primary hyperparathyroidism (PHPT) is an endocrinological disease with parathormone (PTH) and calcium elevation. It is the most common form of hypercalcemia in the community. In this review, the definition, diagnosis, differential diagnosis and treatment of hyperparathyroidism are described. 24 Feb, 2020 https://www.clinsurggroup.us/articles/IJCEM-6-144.php Fibrodysplasia Ossificans Progressiva is a rare (incidence-one in two million people3) and disabling genetic condition, diagnosis of which is generally based on presence of congenital abnormality of great toes, progressive heterotopic ossification and the classical pattern of disease progression and radiological findings. Our case, a 29year old male presented with deformity of bilateral great toes since childhood, multiple hard swellings all over body leading to painful restriction of joint mobility and limitation of routine activities. Radiograph and bone scan revealed multiple sites of heterotopic ossifications. 28 Jan, 2020 https://www.clinsurggroup.us/articles/IJCEM-6-143.php Post prandial hypoglycemia refers to low blood glucose levels in the post meal period. In absence of any gastro-intestinal abnormality or surgery, other less common conditions need consideration. Extended glucose tolerance test helps confirm the diagnosis. The timing of hypoglycemia post meals and the corresponding insulin and C-peptide values help in understanding its pathophysiology. Hyperinsulinemia in Insulin resistance can also rarely present initially with post meal hypoglycemia. Frequent low glycemic index meals along with alpha-glucosidase inhibitors help alleviating the symptoms. We report this case for its rarity and clinical relevance. 13 Jan, 2020 https://www.clinsurggroup.us/articles/IJCEM-6-142.php Assisted reproductive techniques have been developed for infertility related problems and to offer more treatment options with increased infertility rates. The aim of the study was to investigate the effect of Luteinizing hormone β receptor (LHβR) gene variants on outcome of In Vitro Fertilization (IVF). This study included 69 cases (29 cases with failured of IVF treatment in IVF Center of Ondokuz Mayis University Hospital by comparing with 30 healthy pregnant cases). DNA isolated from all the cases and LHβ gene was analyzed by next generation DNA sequencing method. 12 Nov, 2019 https://www.clinsurggroup.us/articles/IJCEM-5-141.php Hypertension in pediatric patients,unlike adults, is mostly secondary to systemic disorders which may be renal,cardiovascular or endocrine, among others.Apparent mineralocorticoid excess (AME) is one such cause of hypertension. 09 Sep, 2019 https://www.clinsurggroup.us/articles/IJCEM-5-140.php Thyroid cancer can be largely classifi ed as well-differentiated, poorly differentiated, medullary and anaplastic. Differentiated thyroid cancer (DTC) includes follicular and papillary subtypes, with the incidence of papillary thyroid cancer (PTC) on the rise. 16 Jul, 2019 https://www.clinsurggroup.us/articles/IJCEM-5-139.php Periodic fl accid paralysis is related to loss of tone and power transiently and which occurs repeatedly over time. Etiologies like channelopathies, myasthenia gravis and thyroid disorders are common. There have been case reports of thyroid disorders leading to periodic paralysis. The pathophysiology attributed to it is the increased uptake of potassium by the cells in the thyrotoxic state. Thyrotoxicosis is also an uncommon cause for distal renal tubular acidosis. 09 Jul, 2019 https://www.clinsurggroup.us/articles/IJCEM-5-138.php A deep understanding of the cardiopulmonary and hemodynamic changes from acute immediate to chronic long-term in the patients undergoing TIPSS is essential for providing a base for timely intervention to decrease the associated morbidity and mortality in the patients post TIPSS . The hemodynamic status of patients has shown a specifi c pattern of alternations in the different time periods post TIPSS. Most of the hemodynamic parameters which increases immediately after TIPSS i.e. including the CO, MAP, PcWP, RAP seems to normalize within 2 months to 1 year duration, 13 Jun, 2019 https://www.clinsurggroup.us/articles/IJCEM-5-137.php Type A Insulin Resistance Syndrome is due to heterozygous mutations in the insulin receptor (INSR) gene or its signaling pathway. We present a premenarcheal 14 year-old girl with normal BMI, severe hirsutism, acanthosis nigricans, clitoral hypertrophy, deep voice, enlarged polycystic ovaries, severe hyperinsulinemia and biochemical hyperandrogenism. We identified a novel heterozygous missense variant in the tyrosine kinase domain of INSR (p.Leu1150Pro) and an heterozygous missense variant in SH2B adapter protein 1 involved in the insulin pathway (p.Ala663Val). Interestingly, the patients’ mother and brother had the same INSR mutation although of a milder phenotype, reason why their IR went undiagnosed. 02 May, 2019 https://www.clinsurggroup.us/articles/IJCEM-5-136.php Myxedema coma is a rare clinical condition that represents severe hypothyroidism decompensation usually occurs in patient with long-standing undiagnosed hypothyroidism and is usually precipitated by infection and discontinuation of supplements treatment. Clinical symptoms are a mental decreased status, hypothermia, bradycardia, hypotension, hypoglycemia and hypoventilation. Thyroid hormone measurement allows the diagnosis. Protocols with rapid intravenous high doses of thyroid hormone, warming and mechanical ventilation may improve the prognosis. The purpose of the present article is to describe a fatal case of myxedema coma in elderly-woman occurring in the context of immunodeficiency. 29 Mar, 2019 https://www.clinsurggroup.us/articles/IJCEM-5-135.php Background: Ovarian hyperstimulation syndrome (OHSS) is a rare but serious complication of ovarian stimulation occurring during assisted reproduction technologies (ART). It is characterized by increased vascular permeability and hypercoagulable states resulting in strokes and peripheral ischemia. Acute myocardial infarction and cardiac thrombosis, however, have been rarely reported complications of OHSS. Methods: A literature search was performed for reports on myocardial infarction and cardiac thrombosis associated with ovarian stimulation with a summary of their clinical characteristics. Results: A total of twelve published cases were reviewed with 5 out of 12 (41.67%) of the reported cases were 35 years of age or older. Myocardial infarction was reported in 10 out of the 12 cases (83.3%). Two of the cases were pregnant at presentation (16.67%). The mean duration between starting ovarian stimulation medications and clinical presentation was 23 days. Chest pain was the most common presenting symptom (66.67%), 2 cases presented with stroke (16.67%) and 2 cases presented with abdominal distention (16.67%). A total of 8 patients underwent coronary angiography with 2 of these cases were treated with percutaneous coronary intervention. No mortality reported in any of the twelve cases. 12 Feb, 2019 https://www.clinsurggroup.us/articles/IJCEM-5-134.php Diabetes Mellitus is a group of metabolic disorders associated with microvascular and macrovascular complications. The rapidly increasing prevalence and incidence of this disease is causing a major worldwide health problem. Maturity onset diabetes of the young (MODY) is a rare monogenic form of diabetes resulting from mutation in a single gene. There are 13 types of MODY genes identified currently. The two main types of MODY is caused by mutations in the hepatocyte nuclear factor 1A and glycolytic enzyme glucokinase (GCK). Genetic testing is the gold standard for diagnosing MODY. It is essential to identify the MODY subtype to determine the management and treatment options. 11 Feb, 2019 https://www.clinsurggroup.us/articles/IJCEM-5-133.php Background: Diabetes increases the risk of periodontal disease. Integrating periodontal care with the treatment of type 2 diabetes (T2DM) may facilitate the management of both diseases. Aim of the study: To evaluate the periodontal status at two years in patients with T2DM and assess glycated hemoglobin (HbA1c) according to the severity and extension of periodontitis. Methods: This is a descriptive cohort study. Full-mouth periodontal evaluation was performed and blood samples were obtained to analyze HbA1c at baseline, 3, 12 and 24 months. Clinical attachment level, probing depth, bleeding on probing and oral hygiene were measured. We analyzed mean HbA1c according to severity and extension of periodontitis. 18 Dec, 2018 https://www.clinsurggroup.us/articles/IJCEM-4-132.php A 50 year old man was referred to us with inadequate control of blood pressure for last few years. He was being treated as a case of essential hypertension on a four drug regime. Subsequent work up led to the diagnosis of primary hyper parathyroidism due to left inferior parathyroid adenoma. 06 Dec, 2018 https://www.clinsurggroup.us/articles/IJCEM-4-131.php Diabetes is a major public health issue affecting millions of people in the United States and worldwide. In the United States alone, about 30.3 million people (9.4% of the population) have diabetes [1]. Worldwide, a staggering 422 million have diabetes according to 2014 estimates [2]. Diabetes complications over years of exposure include cardiovascular disease -- stroke and myocardial infarction -- and microvascular disorders -- kidney failure, blindness and amputation [3]. Acute and potentially fatal complications of diabetes include hyperglycemic crises, specifically diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) [4]. 30 Oct, 2018 https://www.clinsurggroup.us/articles/IJCEM-4-130.php Case 1: A 65- year-old man was accidentally injured by wooden hammer on his top of head on 34 years before. He was suffered from vomiting, diarrhea and hypotension, and the laboratory examination revealed increased CRP level, hyponatremia and decreased plasma cortisol and ACTH levels, suggesting isolated ACTH deficiency and Crohn disease diagnosed by colonoscopic biopsy, and finally transferred to University Hospital. LH-RH, TRH, CRH and GHRP stimulation tests showed normal response of plasma pituitary hormones except for no response of plasma ACTH and cortisol levels by CRH stimulation. ACTH stimulation test showed no response of plasma cortisol levels although hydrocotisone replacement therapy had already been started. MRI imaging showed bottom of anterior lobe was crushed and pituitary gland was atrophied, which suggested brain might be injured by any strong trauma. 29 Oct, 2018 https://www.clinsurggroup.us/articles/IJCEM-4-129.php Turner syndrome (TS) is characterized by short statute and ovarian dysgenesis in females with one X chromosome and partial or complete absence of the second X. It has an estimated birth prevalence of 1/2000 to 1/5000 female live births [1]. There is a global growth delay in TS characterized by slight intrauterine growth retardation, delayed growth during infancy and childhood, and lack of a pubertal growth spurt [2]. 11 Jul, 2018 https://www.chemisgroup.us/articles/IJCEM-4-129.pdf Diabetes mellitus (DM) is widely recognized as the major cause of blindness and diabetic retinopathy (DR) being the most frequently cited as the underlying pathophysiologic mechanism. This makes DR, among all ocular manifestations of diabetes, the focus of most diagnostic as well as therapeutic interventions. However, diabetic neurotrophic keratopathy, is a common ocular complication of diabetes that is caused by corneal nerve fiber damage, is a diagnostic entity that generated a lot of attention recently in the ophthalmology community for being largely unrecognized, underdiagnosed and generally not treated, rendering a large number of the growing population susceptible to this serious ocular complication. This is largely because of the challenge in diagnosis and management of diabetic neurotrophic keratopathy. 07 Dec, 2017 https://www.clinsurggroup.us/articles/IJCEM-3-128.php The profi le of primary hyperparathyroidism (PHPT) changed profoundly over the course of the twentieth century. The highly symptomatic forms reported in the 1960s have progressively been replaced by forms with few symptoms and in some cases totally asymptomatic forms. 11 Nov, 2017 https://www.clinsurggroup.us/articles/IJCEM-3-127.php Diabetic retinopathy is a major cause of blindness in the United States. With rise of the epidemic of obesity and diabetes in the USA and around the globe, serious and common diabetic complications are evolving as a major public health problem, particularly among minority populations. 01 Nov, 2017 https://www.clinsurggroup.us/articles/IJCEM-3-126.php Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age. The pathogenesis has not been fully deciphered. PCOS is associated with insulin resistance (IR), menstrual irregularities, cardiovascular disease, obesity, hirsutism, infertility, and endometrial cancer. The use of D-chiro-inositol (DCI) for the treatment of IR in PCOS has been controversial with contradictory data being published. Our objective is to evaluate the effect of DCI combined with myo-inositol (MI), and metformin on the metabolic outcomes of PCOS in a Lebanese women cohort. 19 Sep, 2017 https://www.clinsurggroup.us/articles/IJCEM-3-125.php Objectives: S100A8/A9 expression has been linked to carcinogenesis and infl ammation. We hypothesized that S100A8/A9 protein serum levels are a useful stratifi cation marker for patients with pancreatic ductal adenocarcinoma (PDAC), intraductal papillary mucinous neoplasm (IPMN) or chronic pancreatitis (CP). 08 Jul, 2017 https://www.clinsurggroup.us/articles/IJCEM-3-124.php Background: Dipeptidyl peptidase-IV (DDP-IV) Inhibitors may represent single anti-diabetic drugs, the multiple actions of which may translate into demonstrable therapeutic benefi ts in diabetes. 05 Jul, 2017 https://www.clinsurggroup.us/articles/IJCEM-3-123.php F-18 fl uorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) is widely accepted modality in order to evaluate the cancer patientsfor staging, restaging and treatment response evaluation. 20 Mar, 2017 https://www.clinsurggroup.us/articles/IJCEM-3-122.php Purpose: Parasitic diseases can involve central nervous system presenting with various manifestation. However, parasitic infection of pituitary is very rare, unexpected and can be missed diagnosis with tumor. 17 Mar, 2017 https://www.clinsurggroup.us/articles/IJCEM-3-121.php Background: Glycemic control remains the major therapeutic objective for prevention of target organ damage and other complications arising from diabetes. 30 Dec, 2016 https://www.clinsurggroup.us/articles/IJCEM-2-120.php Objective: The study was planned to investigate the effect of Eruca sativa seeds’ oil (ESSO) and Raphanus sativus seeds’ oil (RSSO) on impaired glucose tolerance, lipid profi le and oxidative stress in streptozotocin-induced diabetic albino rats. 30 Dec, 2016 https://www.clinsurggroup.us/articles/IJCEM-2-119.php Background: Sarcoidosis is a systemic infl ammatory disease characterized by non-caseating epitheloid granulomas; whereas it usually involves the lungs and lymph nodes, genitourinary involvement is extremely rare. 30 Dec, 2016 https://www.clinsurggroup.us/articles/IJCEM-2-118.php Introduction: Less hygienic use of blood glucose monitoring equipment such as blood glucose meters, lancets, fi nger stick devices or other diabetes-care equipment such as syringes or insulin pens by self-administration often exposes the diabetic patient to Hepatitis B infection. This study evaluates hepatitis B vaccination among individuals with diabetes. 11 Nov, 2016 https://www.clinsurggroup.us/articles/IJCEM-2-117.php Anemia due to iron deficiency is commonly associated with rickets, but rarely myelofibrosis was seen in infants with rickets in the hypocalcaemic phase. The aim of this review is to elucidate the mechanism of development of myelofibrosis in rickets. We reviewed the literature in PubMed with keywords myelofibrosis, hypocalcemia and anemia. The cases diagnosed as myelofibrosis in infants with evidence of rickets were studied. Hypocalcemia as it occurred in all the cases reported, it suggests that an association exists between myelofibrosis and hypocalcemia possibly as a consequence of a disturbed vitamin D metabolism. We could not find another evidence to support a direct relation between low calcium per se and myelofibrosis. Vitamin D with its multiple metabolites and whose levels in our sunny communities are getting lower and lower with more associated diseases being discovered still needs to be considered. 15 Oct, 2016 https://www.clinsurggroup.us/Clinical-Endocrinology-Metabolism/IJCEM-2-116.php Introduction: Pheochromocytoma is an adrenal gland tumour, which usually produces catecholamines. The classical triad of clinical symptoms consists of palpitations, headaches and profuse sweating. Other symptoms include: hypertension, anxiety, pallor, nausea, weakness. However, it can be asymptomatic. Because of unspecific symptoms the diagnosis of this rare neuroendocrine tumor can be missed or delayed. In differential diagnosis other entities should be considered: essential hypertension, anxiety attack, hyperthyroidism, hypogonadism, hypoglycemia, renal artery stenosis, intracranial lesion, autonomic epilepsy, carcinoid syndrome, use of cocaine or amphetamine. 22 Jul, 2016 https://www.clinsurggroup.us/Clinical-Endocrinology-Metabolism/IJCEM-2-115.php Gynecomastia, referred to enlargement of the male’s breast tissue is a common finding in boys during childhood. Although most cases are benign and self-limited, it may be a sign of an underlying systemic disease or even drug induced. Rarely, it may represent male breast cancer. Understanding its pathogenesis is crucial to distinguish a normal developmental variant from pathological cases. This review will highlight the pathophysiology, etiology, diagnosis and various medical and surgical therapies. 10 Jun, 2016 https://www.clinsurggroup.us/Clinical-Endocrinology-Metabolism/IJCEM-2-114.php Introduction: Congenital hypothyroidism with muscular pseudohypertrophy or Kocher-Debre-Semelaigne syndrome is the result of long standing untreated moderate to severe hypothyroidism. The pathogenesis of this muscular pseudohypertrophy is unknown and it is usually noted in the muscles of the extremities, limb girdle, trunk, hand and feet but is most evident in the muscles of the lower limb giving the child a Herculean appearance. This is in contrast to the thyroid myopathy due to hypothyroidism in older age group patients which results in muscle atrophy and wasting. 21 Apr, 2016 https://www.clinsurggroup.us/Clinical-Endocrinology-Metabolism/IJCEM-2-113.php Introduction: Congenital generalized lipodystrophy or Berardinelli-Seip syndrome is a rare autosomal recessive multisystem disorder characterized by the near absence of subcutaneous and visceral adipose tissue from birth or early infancy with severe insulin resistance. It is caused by mutations in the gene for AGPAT-2 on chromosome 9 or BSCL-2/Seipin on chromosome 11 resulting in triglyceride-depleted adipocytes. BSCL-2/Seipin is a cell autonomous regulator of lipolysis essential for adipocyte differentiation. 23 Mar, 2016 https://www.clinsurggroup.us/Clinical-Endocrinology-Metabolism/IJCEM-2-112.php Thyroid hormones are important for early brain development. During pregnancy, both maternal and foetal thyroid hormones contribute to foetal brain development. Maternal Graves’ can lead to transplacental transfer of antibodies that cause neonatal thyrotoxicosis. Neonatal thyrotoxicosis is rare and a high index of suspicion is needed to diagnose it. Neonatal thyrotoxicosis has significant risk of morbidity and mortality and early recognition is warranted. Babies who are at risk following birth should be identified early while avoiding the need for unnecessary blood tests or prolonged hospital admission. There are no published consensus guidelines to date as to how these babies should be managed and followed up. The purpose of this guideline is to describe the importance of risk stratification and subsequent management of babies born to mothers with a history of Graves’ disease. 09 Dec, 2015 https://www.clinsurggroup.us/articles/IJCEM-1-111.php Plants are rich in antioxidants which play an essential role in disease prevention. Amaranthus viridis linn. Is a common medicinal plant, spread throughout the world is used in traditional ayurvedic medicine. The present study was aimed to examine the protective effect of partially purified alkaloids (PPA) from Amaranthus viridis against hydrogen peroxide induced oxidative damage in human erythrocytes in vitro conditons. 20 Nov, 2015 https://www.clinsurggroup.us/articles/IJCEM-1-110.php Synthesis, storage, secretion, delivery, and utilization of thyroid hormones are dependent upon specific enzymatic activity; inherited disorders may cause thyroid disease. 14 Oct, 2015 https://www.clinsurggroup.us/articles/IJCEM-1-109.php Purpose: Recently, there have been an increasing number of studies indicating that Florine-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) is a sensitive method in the evaluation of thyroid cancer. This retrospective study aims to assess the value of FDG PET/CT in the evaluation of thyroid cancer and determine the association between serum thyroglobulin (Tg) levels and FDG PET/CT. 14 Oct, 2015 https://www.clinsurggroup.us/articles/IJCEM-1-108.php We present a 40 year old lady who was previously reviewed in a different center with a neck swelling and a clinical and biochemical picture of post-partum thyroiditis. She underwent a fine-needle aspiration (FNA) biopsy of a hypoechoic isthmus nodule that was reported as being a follicular neoplasm and diagnostic surgery was recommended. 03 Oct, 2015 https://www.clinsurggroup.us/articles/IJCEM-1-107.php C-type natriuretic peptide (CNP) is one of the three most important members of the human natriuretic peptide family, sharing with them a highly conserved 17-aminoacid ring structure, essential to elicit its biological actions by binding to its specific receptor NPR-B. CNP acts in a paracrine or autocrine way and it is cleared from plasma circulation by the NPR-C receptor. This is one of the reasons why its plasma levels are usually low. 03 Sep, 2015 https://www.clinsurggroup.us/articles/IJCEM-1-106.php Hypercholesterolemia is patho-physiological condition of metabolism caused by incessant increase in blood cholesterol levels and might be a possible risk factor for many cardiovascular and its associated diseases. Due to adverse effects and cost inefficiency of medications curing hypercholesterolemic disorders, medicinal plants are providing a cost efficient alternative to reduce the risk factors. Present review is providing data of 22 important medicinal plants species possessing antihypercholesterolemic activity and their active phyto-constituents. It would provide a ready reckoner for the research related to increased cholesterol level in blood. Further efforts should be made to implement these plant based drugs in clinical trials. 15 Jul, 2015 https://www.clinsurggroup.us/Clinical-Endocrinology-Metabolism/IJCEM-1-105.php Objective: To study the clinical and laboratory characteristics of children suffering from congenital hypothyroidism in China. Method: 455 cases of congenital hypothyroidism infants were collected from 5 articles were published in 4 china medical journals. Different screening methods were adopted, like enzyme immunoassay assay and filter paper dried blood biotin-avidin enzyme notation to test TSH, FT3、FT. All the collected children treated by oral thyroxin tablets for long period and regular follow-up was done. Clinical follow up for any signs of hypothyroidism and also detection of I.Q of those children. 15 Jul, 2015 https://www.clinsurggroup.us/Clinical-Endocrinology-Metabolism/IJCEM-1-104.php Aim: To determine the prevalence and phenotypic characteristics of diabetes subtypes based on glutamic acid decarboxylase autoantibodies (GADA) status in those newly presented diabetic to the Al-Faiha Specialized Diabetes, Endocrine and Metabolism Center (FDEMC) in Basrah, Southern Iraq. 25 Jun, 2015 https://www.clinsurggroup.us/Clinical-Endocrinology-Metabolism/IJCEM-1-103.php Primary hypothyroidism is one of the most common endocrine disorders. TCM and Ayurveda are the two giant ancient systems of medicine flourished in China and Indian sub-continent respectively. The term like hypothyroidism is not mentioned in both classical literatures of TCM and Ayurveda but the features nearest to hypothyroidism are described in both. In TCM the disorders like Xulao (consumptive disease), Xusun (wasting) and Yinbing (thyroid swelling) can be closely correlated with hypothyroidism while in Ayurveda the disorder Galaganda (enlarged thyroid gland) is the nearest one. According to TCM the pathogenesis of hypothyroidism lies in liver depression as well as spleen and kidney yang deficiency while Ayurveda believes it is due to imbalance of Tridosha (three bodily humours) and treatment is directed accordingly. 24 May, 2015 https://www.clinsurggroup.us/Clinical-Endocrinology-Metabolism/IJCEM-1-102.php A 42-year-old woman was referred to us for evaluation of a suspicious mass in her left thyroid gland. She had experienced left anterior neck pain and odynophagia for a few weeks. Ultrasonography (US) demonstrated a heterogenous and hypoechoic mass with bright internal hyperechoic foci and a partial surrounding halo involving the posterior aspect of the left thyroid lobe (Figure 1). Computed tomography (CT) of the neck with contrast enhancement demonstrated a soft tissue mass with internal air between the left back side of the thyroid and esophagus (Figure 2). Barium swallow pharyngoesophagography showed a barium-filled sac protruding from the left anterolateral wall of the cervical esophagus (Figure 3). 22 May, 2015 https://www.clinsurggroup.us/Clinical-Endocrinology-Metabolism/IJCEM-1-101.php Methods: A cross-sectional study, collected from the Pilgrimages with diabetes during the Hajj season. Baseline characteristics were collected by a formal interview and the measurements were self-reported. The primary outcome was to evaluate the patients' Hajj readiness and the association of the previous Hajj performance on this outcome. Results: Of the 262 patients with diabetes participated, 72.9% have type 2, mean age of 53.1 years; mean duration of diabetes is 9.23 years.