The document discusses goiter classification and goiter control. It classifies goiter into three grades - Grade 0 (impalpable, invisible), Grade I (palpable but not visible), and Grade II (palpable and visible). Goiter control includes four essential components: iodized salt, iodine monitoring, manpower training, and mass communication. Iodized salt is the primary intervention, with salt iodized to contain at least 15 ppm iodine at the consumer level. Iodine monitoring through laboratory testing is also important to track iodine levels in the environment, food, and people. All personnel involved must be properly trained, and mass communication can help create public awareness about goiter

1. GOITRE
Sayli shyam gaikwad
2nd year basic bsc nursing
St Andrews college nursing

2. PREVELANCE OF
GOITRE :

3. CLASSIFICATION OF
GOITER
As per recent WHO publication (1994),
The previous five grades of goiter namely
Grade 0, IA, IB, Grade II and Grade III,
Have been classified into three grades as Grade 0 ,
Grade I , Grade II

4. GRADE 0
–Impalpable
–Invisible

5. GRADE I
-Palpable
-No visible
(swelling visible
only during
swallowing)

6. GRADE II
-Palpable
-Visible (in normal
position of neck)

7. MULTINODULAR
-Palpable
-Visible (along with
nodule)

9. Goitre Control :
–Includes 4 essesntial components:
(i) Iodized salt.
(ii) Iodine monitoring .
(iii) Man power training.
(iv) Mass communication.

10. IODIZED SALT
In india the level of iodization is
fixed under the prevention of food
adulteration act and is not less
than 30 ppm at the production
point , and not less than 15 ppm
of iodine at consumer level.
IDD decided to convert common
salt into iodized salt with the help
of gov. of india .

11. I. Iodized oil (intramuscular ):
a. This iodized oil is given intramuscularly (mostly poppy seed oil
). For controlling goitre .
b. Scientist at the national institution of nutrition , Hyderabad
have now successfully developed a process to produce iodized
oil in safflower or safola oil.
c. 1ml will provide protection for about 4 year.
II. Oral iodized oil :
a. it is expensive than intramuscular injection of iodized oil
b. Sodium iodate tablets can be given
c. It is simpler.

12. IODINE MONITERING
– Countries implementing control programmes require a network of
laboratories for iodine monitoring and surveillance.
– This laboratories are essential for :
a. Iodine excretion determination
b. Determination of iodine in water, oil, food, as part of
epidemiological studies.
c. Determination of iodine in salt for quality control.
d. Neonatal hypothyroidism is a sensitive pointer to environmental
iodine deficiency and can thus be an effective indicator for
monitoring the impact of a programme.

13. MANPOWER TRAINING
–All the engaged people in this
programme should be fully trained I all
aspects of goitre control including
 Legal enforcement
 Public education

14. MASS COMMUNICATION
– Mass communication is a powerful tool for
nutrition education.
– It should be fully used in goitre control work .
– Creation of public awareness is central issue of a
successful public programme.