Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.
Department of Diabetic Foot Care, Bangladesh Diabetic Wound and Foot Care Hospital, Dhaka, Bangladesh.
Front Endocrinol (Lausanne). 2024 Jan 8;14:1322335. doi: 10.3389/fendo.2023.1322335. eCollection 2023.
Thyroid disorders are common clinical conditions globally. The objective of the present study was to evaluate the physicians' approach to the diagnosis and treatment of thyroid disorders in Bangladesh.
The present nationally representative cross-sectional study was conducted among 662 physicians of different levels (general practitioners as well as specialists) from different hospitals in Bangladesh from January to June 2023. A self-administered semi-structured questionnaire including information about demographics and practice patterns for the diagnosis and management of thyroid disorders was used for data collection. Descriptive statistics were used to analyze the data.
The American Thyroid Association (ATA) guidelines were the most commonly followed guidelines for the diagnosis and management of thyroid disorders (60%), followed by the American Association of Clinical Endocrinologists (AACE) guidelines (18%) and the European Thyroid Association (ETA) guidelines (9%). Serum TSH, free T3 and free T4 levels were the most frequently used diagnostic tests for the evaluation and follow-ups of both hypothyroid and hyperthyroid states in adults, pregnant women and children, followed by total T3 and total T4 levels. Other tests, such as anti-TPO antibody, anti-TG antibody, anti-TPO, ultrasound scan of the thyroid gland, etc., were rarely used by the participating physicians. Levothyroxine at a dose of 25 to 50 mcg and carbimazole at a dose of 30 to 45 mg were the most frequently used drugs for hypothyroid and hyperthyroid patients, respectively. Almost 65% of the physicians suggested routine thyroid function tests before surgery. In addition, more than 90% of the physicians agreed that thyroid screening for pregnancy, neonates, school children and adults would be mandatory.
The majority of the physicians participating in our study followed relevant guidelines for the diagnosis and management of thyroid disorders in Bangladesh. However, there are still some gaps to be improved, as a good number of physicians did not follow specific guidelines for these disorders.
甲状腺疾病是全球常见的临床病症。本研究的目的是评估孟加拉国医生在诊断和治疗甲状腺疾病方面的方法。
本研究为 2023 年 1 月至 6 月期间在孟加拉国不同医院的 662 名不同级别（全科医生和专科医生）医生中进行的一项全国代表性横断面研究。使用了一份自我管理的半结构式问卷，其中包括有关甲状腺疾病诊断和管理的人口统计学和实践模式信息。使用描述性统计数据对数据进行分析。
美国甲状腺协会（ATA）指南是最常遵循的甲状腺疾病诊断和管理指南（60%），其次是美国临床内分泌医师协会（AACE）指南（18%）和欧洲甲状腺协会（ETA）指南（9%）。血清 TSH、游离 T3 和游离 T4 水平是评估和随访成人、孕妇和儿童甲状腺功能减退和甲状腺功能亢进状态最常用的诊断测试，其次是总 T3 和总 T4 水平。参与研究的医生很少使用其他测试，如抗 TPO 抗体、抗 TG 抗体、抗 TPO、甲状腺超声扫描等。左旋甲状腺素剂量为 25-50mcg，卡比马唑剂量为 30-45mg，分别是甲状腺功能减退和甲状腺功能亢进患者最常使用的药物。近 65%的医生建议在手术前常规进行甲状腺功能检查。此外，超过 90%的医生认为对孕妇、新生儿、学童和成人进行甲状腺筛查是强制性的。
参与我们研究的大多数医生遵循了孟加拉国甲状腺疾病诊断和管理的相关指南。然而，仍有一些需要改进的地方，因为相当多的医生没有遵循这些疾病的具体指南。
