Cytological and histological correlation of solitary thyroid nodule

To assess the role of fine needle aspiration cytology [FNAc] in the management of solitary thyroid nodule and to correlate the FNA cytodiagnosis with histopathological results of surgically excised specimens of thyroid. It was a retrospective study. This study was carried out at Jinnah Hospital Lahore in the year 2006. In this period patients files and slides were retrieved from record. Both FNA cytolodiagnosis and histopathological results were correlated. Out of these 64 cases, 5 cases were diagnosed malignant on histology. These were 2 cases of papillary carcinoma, 2 cases of Non Hodgkin's lymphoma [NHL] and I case of follicular carcinoma I case of NHL and 2 cases of papillary carcinoma were correctly diagnosed on FNA. 1 case of NHL was misdiagnosed as benign cystic lesion of thyroid on FNA and I case in which cytodiagnosis of hyperplastic colloid nodule/follicular neoplasm was made, turned to be follicular carcinoma on histology. In the remaining 59 benign cases, a wide range of overlap was seen among benign thyroid lesions. Despite, the overlap of the spectrum of cytological features of different thyroid lesions, FNA cytological examination of solitary thyroid nodules is strongly recommended

Typhoid perforation: an experience at Mayo hospital, Lahore

With the view of evaluating our own results with pertinent emphasis on surgical treatment, we conducted this retrospective study. This study consists of 53 cases of typhoid perforation treated in our unit in the last two calendar years from Jan 1997 to dec. 1998. We found that disease remains endemic in poor socioeconomic areas and usual sufferers are young active males[71.7%], with male to female ratio of 2.5:1. The diagnosis of the typhoid perforation should be made on physical examination, prolonged fever 02-03 weeks [62.2%] followed by pain abdomen usually 24-72 hours[68%]. The diagnosis is supported by pneumoperitoneun in 37[68.9%], the serological tests are neither very specific nor readily available in emergency laboratory. The surgical treatment is required in all cases. The majority of the patients had single perforation 39[78%], multiple in 07[14%] and mostly had established severe peritonitis 34[68%]. The single layer repair was performed in 18 [36%], double layer in 21[44%] which carries risk of leakage 01[5.5%] and 02[9.5%] respectively. Resection and anastomosis was performed in 10[20%] cases which resulted in very high morbidity and mortality 03[30%]. Wound infection was the commonest complication, leakage was seen in 06[12%] cases, incidence of leakage was minimum with single layer closure of perforation. The flouroquinolone are far superior with response rate of 92.3% as compared to chloramphenicol 66.6%. Hence single layer closure with aggressive peritoneal lavage under flouroquinolones is recommended. Exteriorization should be preferred choice than resection and anastomosis in high risk cases

Early cholecystectomy safe option in acute cholecystitis

This prospective study comprises of 108 patients. Early cholecystectomy was performed on 54 patients. The results were compared with similar number of patients undergoing elective cholecystectomy for symptomatic gall bladder disease. Diagnosis was based on history, clinical examination and ultrasound scan. The diagnostic accuracy of ultrasonography was similar in both groups. The degree of technical difficulty encountered as evaluated by surgeon and post-operative complications were also comparable. Early cholecystectomy was proved to be associated with advantages like avoidance of complications of acute cholecystitis, saves the patient from recurrent painful attacks and shorter duration of treatment. This comparative study revealed that early cholecystectomy performed by an experienced surgeon is a safe and better option in acute cholecystitis