Presentation, management and outcome of surgery PF thyroid swellings by ENT and head and neck surgeons at civil hospital Karachi

Objective: to assess the presentation, management and outcome of surgery of thyroid swellings

Design: retrospective study

Place and duration of study: department of Otorhinolaryngology-Head and Neck Surgery, Dow Medical College and Civil Hospital Karachi [CHK], from Jan 2004 to June 2010

Patients and methods: retrospective review of 184 consecutive cases of thyroid swellings admitted and operated, irrespective of age, sex and socioeconomic status. Physiological goiter and previously operated thyroid swellings were excluded from the study. Demographic data, clinical features, investigations, surgical management details and complications were assessed

Result: among 184 cases of thyroid swellings 62.5% were between 21 to 40 years of age, with female preponderance [79.9%]. Majority [71.7%] cases belonged to lower socioeconomic status. Right lobe was involved in 32.60%, left in 15.7% while both lobes were involved in 51.5% cases. Multinodular goiter was seen in 54.8% cases while 39.1% cases had solitary nodule. Total thyroidectomy was performed in 23.3% cases, near total thyroidectomy in 9.8%, subtotal thyroidectomy in 31% and lobectomy [with isthemectomy] in 35.9% cases. In postoperative period, hoarseness was seen in 0.5% cases; while other complications like bleeding due to slipping of ligature, wound infection and hypoparathyroidism was seen in 1.6%, 2.2% and 2.2% cases respectively

Conclusion: with female preponderance and low socioeconomic status, thyroid swellings are mostly seen between the ages of 21 to 40 years. Solitary nodule and multinodular goiter are common findings. Surgical management performed by ENT - Head and Neck surgeon's ranges from total thyroidectomy to lobectomy, gives good results and few complications

Use of antibiotic beads in chronic osteomyelitis: six years experience at civil hospital, Karachi

This series includes 180 patients of Chronic Osteomyelitis who were treated with antibiotic beads from September 1995 to October 2001 in the Dept. of Orthopaedics at Civil Hospital, Karachi. Amongst them were 126 [70%] males and 54 [30%] females, with an age range of 12-52 years. They were followed -up for a minimum period of three years. One hundred and fifty three [85%] cases recovered fully with good functional result. In 18 [10%] patients the result of the treatment was fair as the patient ultimately recovered after initial problems, while in nine [5%] it was poor as the patients had to undergo another surgery. In view of good functional results, and fewer recurrences and complications, we advocate the use of antibiotic beads in the treatment of chronic osteomyelitis of long bones