ABSTRACT
To compare quality of scar after subcuticular stitches between Polypropylene [Prolene], a non-absorbable suture, with Polyglactin 910 [Vicryl], an absorbable suture after thyroid surgery. Randomized controlled trail [RCT]. Department of Surgery Combined Military Hospital and Military Hospital Rawalpindi from 1 Jan 2007 to 31 Dec 2007. Sixty patients undergoing elective thyroid surgery were included and randomly divided into two groups using random number tables. Informed written consent was obtained from each patient. The neck wound was closed by subcuticular suturing technique and the suture material was used according to the sampling technique. The patients were followed up in OPD on 10[th] post operative day and twelve weeks after surgery for the quality of scar. After 10 days, 1 patient in each of the Polypropylene group [3.3%] and Polyglactin 910 group [3.3%] had a bad scar [p = 1.000]. After twelve weeks of surgery, 2 patients in the Polypropylene group [6.7%] and 3 patients in the Polyglactin 910 group [10.0%] had bad scars [p = 1.000]. There is no significant difference between the frequency of bad scar formation in the Polypropylene and Polyglactin 910 group. It is thus recommended that absorbable Polyglactin 910 sutures should be used for wound closure after thyroid surgery as it does not require suture removal and thus prevents patient anxiety and discomfort and also saves surgeon and staff's time
ABSTRACT
To compare the frequency of hypocalcaemia in thyroid surgery after ligation of inferior thyroid artery trunk and ligation of Inferior thyroid artery branches at gland surface. Quasi experimental comparative study. Department of Surgery, Combined Military Hospital Rawalpindi, from February 2008 to August 2008. The patients were assigned to two equal groups, Group 'A' and Group 'B'. Estimation of serum calcium [Ca] levels was done before surgery in both the groups. In group 'A' patients underwent thyroid surgery with ligation of inferior thyroid artery [ITA] trunk, while in group 'B' terminal branches of ITA were ligated on gland capsule. Following the surgery serum calcium levels was measured 6 hours after surgery. Afterwards levels of serum calcium were checked daily for three days. The two groups were compared for the frequency of transient hypocalcaemia. Four patients in group A [13.3%] developed transient hypocalcaemia [serum corrected Ca < 2.0mmol], while in group B three patients [10%] developed transient hypocalcaemia. Fishers Exact test was applied and this difference was found statistically insignificant at p=1.0. Over all frequency of transient hypocalcaemia in this study was 11.6%. Ligation of ITA trunk does not increase the risk of hypocalcaemia in thyroid surgery.
ABSTRACT
To determine the diagnostic accuracy of fine needle aspiration cytology [FNAC] in cervical lymphadenopathy using histopathologic examination of the excised lymph node as gold standard. Cross sectional study. Combined Military Hospital Rawalpindi in collaboration with Armed Forces Institute of Pathology [AFIP] Rawalpindi, from January 2007 to January 2008. A total of 70 patients suffering from cervical lymphadenopathy were selected. After obtaining informed consent FNAC was obtained from the lymph node. Afterwards same lymph node was removed under local anesthesia for histopathology. All specimens were sent to AFIP for histopathology reporting. Sensitivity, specificity, positive and negative predictive values and diagnostic efficacy for both the modalities were calculated. Data was analyzed using SPSS version 10. Mean and standard deviation for age and gender were calculated. Mean age of the patients was 38.14 +/- 16.88 year. FNAC findings showed a sensitivity of 79.5%, specificity 47.61%, positive predictive value 78%, negative predictive value 50% and diagnostic efficacy 70%. FNAC appears well established method of diagnosis, as its results compared favorably in many respects with those obtained from traditional surgical biopsy.