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This systematic review endeavors to find an effective treatment protocol for subacute thyroiditis (SAT) to minimize side effects, recurrence and long-term hypothyroidism.We analyzed available original studies on treatment protocols for SAT. A thorough literature search was performed on the following online databases PubMed, Cochrane library nd Google Scholar using appropriate keywords for choosing relevant articles. Two reviewers assessed the methodological quality of selected articles independently using a critical appraisal instrument. The results were analyzed and synthesized qualitatively using the level of evidence method.The literature search retrieved a total of 460 publications after abstract screening; out of which 36 articles met the inclusion criteria. After full text screening, 23 articles were further excluded as they were focusing on aspects of SAT other than management, the remaining 15 articles were investigated for both reliability and validity. Thirteen studies provided low-quality evidence, and two randomized control trials (RCT) provided a high quality of evidence. Steroid therapy was found to be the most effective for moderate to severe SAT and provided relief from acute symptoms but was found to not be a risk factor for recurrence. Low initial doses of steroid (15 mg) were preferred over high initial dosage (30-40 mg). Furthermore, a look into the mode of steroid delivery (RCT) revealed that intrathyroidal steroid therapy can potentially become a safer and faster mode of therapy. The duration of tapering was found to be of significance as a short tapering period was linked with greater recurrence rates.Low initial doses of steroid along with an extended tapering period may help lower recurrence rates; also, intrathyroidal steroid injections are potentially a better alternative to oral prednisone (PSN) with regard to safety and speed of action. However, the evidence is of moderate quality and further investigation is required.

Temozolomide has been the most used chemotherapeutic drug for glioblastoma and various CNS malignancies. Although myelosuppression has the most severe adverse effect, central diabetes insipidus (CDI) has been found as an infrequent side effect. CDI is characterized by decreased antidiuretic hormone secretion from posterior pituitary, thereby the inability to concentrate the urine with variable degrees of polyuria and compensatory polydipsia. Following a comprehensive literature search of several databases from 1990 to October 2020, which were limited to the English language, patient data were analyzed to demonstrate the risk factors, severity, reversibility of the disease, and overall survival. Total nine cases found who developed CDI following TMZ treatment. All patients manifest hyperosmolar symptoms like polyuria and polydipsia within 3 to 12 weeks following temozolomide initiation. Clinical and laboratory features, therapeutic response to exogenous desmopressin, and clinical course have been summarized.