How are Thyroid Disorder Investigated and Treated?
The thyroid gland is an endocrine gland in your neck. It makes two hormones that are secreted into the blood: thyroxine (T4) and triiodothyronine (T3). These hormones are necessary for all the cells in your body to work normally.
Thyroid disorders are very common and tend mainly to occur in women, although anybody - men, teenagers, children and babies, too - can be affected. About one in 20 people has some kind of thyroid disorder, which may be temporary or permanent.
The thyroid gland lies in the front of your neck in a position just below your Adam’s apple. It is made up of two lobes - the right lobe and the left lobe, each about the size of a plum cut in half - and these two lobes are joined by a small bridge of thyroid tissue called the isthmus. The two lobes lie on either side of your wind-pipe.
What does my thyroid gland do?
The thyroid makes two hormones that it secretes into the blood stream. One is called thyroxine; this hormone contains four atoms of iodine and is often called T4. The other is called triiodothyronine, which contains three atoms of iodine and is often called T3. In the cells and tissues of the body the T4 is converted to T3. It is the T3, derived from T4 or secreted as T3 from the thyroid gland, which is biologically active and influences the activity of all the cells and tissues of your body.
What can go wrong with my thyroid?
- Hypothyroidism (underactive thyroid) - not enough thyroxine is produced for the body’s needs.
- Hyperthyroidism (overactive thyroid) - too much thyroxine is produced for the body’s needs.
- Hypothyroidism is the most common disorder.
Types of thyroid disease
There are many types of thyroid disease. However, the main conditions present in most thyroid illnesses are hypothyroidism (thyroid under activity) and hyperthyroidism (thyroid over activity).
Thyroid nodules and thyroid cancer
Thyroid nodules are common and treatable but should always be investigated since a small proportion of them are cancerous. The majority of thyroid cancers have a favourable prognostic and require a multidisciplinary approach (endocrinologist, surgeon, nuclear medicine specialist and sometimes oncologist). In the past years there has been a rise in the number of thyroid cancers being identified. There has been no change however, in the mortality rate.
Symptoms of thyroid disease
Signs and symptoms of hypothyroid and hyperthyroid conditions include:
- weak slow heart beat
- muscular weakness and constant fatigue
- sensitivity to cold
- thick puffy skin and/or dry skin
- slowed mental processes and poor memory
- goitre (increased size of the thyroid)
- menstrual disorder
- weight gain
- rapid forceful heartbeat
- muscular weakness
- weight loss in spite of increased appetite
- restlessness, anxiety and sleeplessness
- profuse sweating and heat intolerance
- eye changes
- goitre (increased size of the thyroid)
How is my thyroid gland controlled?
There has to be some sort of mechanism that regulates very carefully the amount of T4 and T3 secreted by your thyroid gland so that the right - the normal - amounts are manufactured and delivered into the blood stream. The mechanism is very similar to that which regulates the central heating in a house where there is a thermostat in, say, the living room, which is set to a particular temperature and which activates the gas- or oil-fired furnace, or boiler that heats the hot water. In the case of the thyroid the ‘thermostat’ consists of a little gland, called the pituitary gland that lies underneath your brain in your skull. The pituitary senses the level of thyroid hormones in your blood stream, just as the thermostat in your living room senses the temperature. Under normal circumstances, if the level drops just a little below normal, the pituitary reacts by secreting a hormone called the thyroid stimulating hormone, also known as TSH, and this hormone activates the thyroid gland to put out more T4 and T3.
Conversely, when the thyroid hormone levels rise above normal the ‘thermostat’ senses this and the pituitary stops secreting TSH so that the thyroid gland stops working so hard and the secretion of T4 and T3 is reduced.
Stigma of Mental Health
One in four of us will experience a mental health problem every year - that means that, right now, one of your friends, colleagues or loved ones is going through it.
But too many people with mental health problems are made to feel worthless or isolated. The way you act towards someone with a mental illness can change their life: by opening up to mental health you can make a real difference.
Mental health is as genuine as any other aspect of a person’s health. When an individual is experiencing thought or behavior patterns that negatively impact their quality of life, it is appropriate to address them, just as any other health concern should be addressed. People with mental illnesses are able to recover, but usually only when the problem is confronted and dealt with directly.
Concern over being stigmatized may be a leading reason why people do not seek out help for issues of mental health. If that is the case, as it indeed seems to be, then perhaps it is time to ask ourselves "why?" After all, some mental health problems are physiological and some are cognitively rooted, but all benefit from treatment.
Depression is the most common mental health disorder and instances of it are rising across the globe. Driven by a lack of confidence in psychiatric remedies, most people prefer to trust the self-healing ability of the human body.
Types of problems
Anxiety disorders happen when someone has feelings of anxiety that are very strong or last for a long time.
Bipolar disorder is characterised by the experience of swings between low mood and high, manic mood, usually with more normal phases in between.
Depression is characterised by the persistence of feelings of sadness or misery.
Eating disorders can occur when someone has a relationship with food that they find difficult.
Obsessive compulsive disorder (OCD) is an anxiety disorder where unwanted thoughts, urges and repetitive activities become an obstacle to living life as someone wants to..
Someone might have a personality disorder if their personality traits cause regular, long-term problems in the way they cope with life..
Schizophrenia is a mental illness that occurs when the parts of the brain that are responsible for emotion and sensation stop working properly.
How we think and act
It's too easy to dismiss mental health problems as something that happen to other people. But it can happen to any of us, and the way we all think and act makes a real difference.
Too many people can be left in situations where they feel isolated, ashamed and worthless. Without our support, they can lose what they care about most: their family and friends, their job, their home, their energy for life.
When you're going through a mental health problem, you need your friends, loved ones and colleagues more than ever.
You can be the difference.
Public stigma over help-seeking
The public stigma attached to having a mental illness is not the only type of stigma that inhibits the decision to seek therapy. There is also a public stigma associated with seeking professional services, separate from the public stigma associated with mental illness. With this stigma, what one suffers from is less important than the simple behaviour of seeking psychological help, whether that is for a chronic, diagnosable mental disorder or for processing the death of a loved one. Simply seeking professional psychological help appears to carry its own mark of disgrace. Research indicates that people tend to stigmatise clients more than they stigmatise non-clients.
In scenario-based research, individuals described as depressed and having sought help were rated more emotionally unstable, less interesting, and less confident than those described as depressed and not seeking help. In addition, those who have sought help are more likely to report being stigmatised by others than those who have not.
These are compelling findings. Public stigma regarding mental illness and seeking profession help has a significant impact on those who suffer from problems that could be treated. However, there is a growing awareness of a potent stigma that might be more directly related to negative experiences with mental illness and help-seeking.
In contrast to the outward, other-oriented focus of public stigma, self-stigma has been described as an internal form of stigma, wherein one labels oneself as unacceptable because of having a mental health concern. We originally conceived of self-stigma as the specific threat to one’s sense of self, including esteem, regard and confidence, that seeking psychological help might pose. We hypothesised that the more a person saw psychological help as a threat to their sense of worth, confidence or self-regard, the less likely they would be to seek out that help.
The distinction between the public and self-stigma associated with seeking professional help allows for a more nuanced assessment of what people feel about their own psychological concerns and their treatment. Although perception of public stigma is likely to be related to self-stigma for many individuals, this does not have to be the case for everyone. Individuals might perceive the possibility of public stigma for seeking help (perhaps accurately), and yet have little or no internalisation of that stigma. For example, people might have less self-stigma due to previous experiences with therapy or knowing someone who benefited from therapy. Thus, they might perceive a general public stigma toward help-seeking, but know from personal experience that seeking help is beneficial and have less concern about it personally.
Cervical cancer is the most common type of gynaecological cancer worldwide. It is also known to be the fifth leading cause of all cancer deaths. Cervical cancer affects nearly 16,000 of women every year. Cervical cancer symptoms do, and can mimic signs of Uterine cancer, endometriosis and other female problems; these are just a few.
Cancer of the cervix is a very common kind of cancer disease in women. This disease occurs when cancer (malignant) cells are found in the tissues of the cervix -- the opening of the uterus (womb). The cervix connects the uterus to the vagina (birth canal).
Cancer of the cervix usually grows slowly over a period of time. Before cancer develops, cervical tissues change and cells that are not normal begin to appear (called dysplasia).
It is a very slow growing process and type of cancer and so therefore; it can sometimes nearly take up to several years before any noticeable signs or cervical cancer symptoms starts to show.
Early symptoms of cervical cancer can, and do vary, but are usually similar in nature.
Cervical cancer is caused by certain types of the human papilloma virus (HPV). HPV is a common sexually transmitted viral infection affecting an estimated 80% of sexually active women at some point in their lives. Most HPV infections clear by themselves but some high risk types can cause cell changes on the cervix that may lead to cervical cancer 10 to 20 years after infection.
There are more than 100 types of HPV infections, but only about 40 of these are linked to cervical cancer. While infection with HPV can cause conditions such as genital warts, it often causes no symptoms. Many women are therefore unaware they have contracted the virus.
What are the symptoms of cervical cancer?
During the early stages of cervical cancer there are often no symptoms at all but the most common symptom experienced is abnormal vaginal bleeding. This bleeding may occur between periods, following sexual intercourse or after the menopause. Menstrual bleeding may also be heavier.
Other symptoms that may occur include:
- Unusual vaginal discharge
- Pain in the pelvic area
- Excessive tiredness
- Lower back pain.
Normally, a pap smear can, and should show any abnormal cells or dysplasia (abnormal cell changes in the cervix); but finding the abnormal cells does not actually mean that you do have cancer.
All cancers are given a ‘stage’. The stage indicates the size of the tumour and the extent of its spread throughout the body. Cervical cancers may be given the following stages:
Abnormal cells are found in the first layer of cells lining the cervix.
The cancer is found only in the tissues of the cervix.
The cancer has spread beyond the cervix to the vaginea and tissues next to the cervix.
The cancer has spread throughout the pelvic area. It may involve the lower portion of the vagina, the ureters and surrounding lymph nodes.
The cancer has spread beyond the pelvic area to other parts of the body.
How is cervical cancer treated?
Treatments for cancer of the cervix depend on the stage of disease, the size of the tumor, age, overall physical condition and a woman’s desire to have children. There are three kinds of treatment for women with cancer of the cervix: surgery (removing the cancer in an operation), radiation therapy (using high-dose X-rays or other high-energy rays to kill cancer cells) and chemotherapy (using drugs to kill cancer cells).
Ivy Group of hospitals is one of the largest tertiary care healthcare delivery network operating in Punjab. Presently, it has 6 operational Multi Super Speciality hospitals at Mohali, Khanna, Nawanshahr, Hoshiarpur, Amritsar and Panchkula. The Panchkula facility is the latest addition in the bouquet. It got operational in the month of May, 2016. There are 2 more hospitals at Bathinda & Jalandhar are in pipe line.
At present, the total bed capacity across all the facilities is 915; Mohali (205), Khanna (80), Nawanshahr (120), Hoshiarpur (160) ,Amritsar (200) and Panchkula(150). The 2 new planned hospitals would add another 300 beds (approximately) taking the total bed capacity to 1200+ beds.
Across the group, we have 25+ Super Specialty departments, 125+ Consultants, 1500+ Paramedical & Nursing Staff, 5000+ Complex Surgeries performed annually & more than 1.50 Lakh patients are being treated annually.
We are empanelled with all the leading Health Insurance Companies (through their respective TPAs), 100+(to be changed) Public & Private Corporate, ECHS, State Governments of Haryana & Himachal Pradesh etc.