Multinodular goiter; frequency of malignancy

The object of this study was to determine the frequency and type of thyroid carcinoma in Multi nodular goiter [MNG] after surgical resection on histopathological basis. Multi nodular goiter [MNG] is one of the common presentations of various thyroid diseases. Thyroid nodules have been reported to be found in 4% to 7% of the population on neck palpation. Although in comparison to solitary nodule, the risk of malignancy in MNG is low but certain studies are showing significant risk. This prospective, observational study was carried out in the surgical unit I of Ghulam Mohammad Mahar Medical college hospital sukkur from 2007 to 2012. 94 cases with clinical diagnosis of MNG were analyzed during this period. All the patients were admitted through opd with routine investigations plus investigations specific to thyroid including thyroid profile, thyroid scan, FNAC of dominant nodule before being subjected to surgery. All FNACs were carried out at agha khan university hospital Karachi. Histopathology of operated specimen was the main criteria for malignancy. Among the 94 cases which were included in this study, 9 [9.5%] cases containing foci of malignancy. Incidence of malignancy commonly occurs in females, papillary carcinoma is being the commonest entity. The incidence of malignancy in MNG in this study is 9.5% that is quite high. So people should be educated and encouraged to attend the thyroid clinics for proper evaluation and early diagnosis of Malignancy

Effects of combined interferon alpha and ribavirin therapy on thyroid functions in patients with chronic hepatitis C attending hepatitis centre Ghulam Mohammad Medical College Hospital Sukkur

To determine the frequency of thyroid dysfunction in patients of chronic hepatitis C during treatment with interferon alpha-2b and ribavirin therapy. A cohort study. Hepatitis Centre Ghulam Mohammad Mahar Medical College Hospital, Sukkur, from February 2009 to January 2010. One hundred and sixty seven non-cirrhotic chronic hepatitis C patients were grouped into treatment group [n=107] and control group [n=60] awaiting treatment. Baseline serum [s.] Alanine Transferase [ALT] and S. Aspartate Transferase [AST] were measured by IFCC method. Serum Thyroid Stimulating Hormone [S. TSH], serum free thyroxine [S. Free T4] and serum total triiodothyronine [S.T3] level were determined by chemiluminescence. Study group patients underwent 24 weeks IFN and ribavirin therapy and were followed-up for thyroid dysfunction at weeks 0, 12 and 24. Control group patients underwent the same tests at weeks 0, 12 and 24. Statistical analysis was done on SPSS 15. Out of 107 patients of treatment group, 20 patients [18.69%] developed thyroid dysfunction. Females were at higher risk with Relative Risk [RR] of 11.25 and Attributable Risk [AR] of 91%. Hypothyroidism was more common than hyperthyroidism. Interferon-alpha and ribavirin therapy induces thyroid dysfunction in chronic hepatitis C patients. Hypothyroidism was more common. Females are at a higher risk of developing thyroid dysfunction

Comparison of oral and intravenous proton pump inhibitor in patients with high risk bleeding peptic ulcers

To compare the efficacy of oral omeprazole vs intravenous omeprazole in decreasing risk of re-bleeding in peptic ulcer patients. This prospective, randomized, controlled clinical trial was conducted at Ghulam Mohammad Mahar Medical College Hospital, Sukkur, Pakistan from January 2010 to December 2011. One hindered and six patients with high risk peptic ulcer were randomized to receive either oral omeprazole [80mg BID for 3 days] or IV omeprazole [80mg bolus and 8mg/hour infusion for 3 days] followed by omeprazole [20mg each day for 30 days]. All patients underwent upper endoscopy and endoscopic therapy within 24 hours. Seventeen patients were excluded from the study. Forty four patients were randomly allocated into oral omeprazole group and 41 to IV omeprazole group. Both groups were similar for factors affecting the outcome. Bleeding reoccurred in five patients of oral omeprazole group and four patients in IV omeprazole group [11.4% vs 9.8%]. The mean hospital stay and blood transfusion were not different in both groups. Oral omeprazole and IV omeprazole had equal effects on prevention of re-bleeding after endoscopic therapy in patients with high risk bleeding peptic ulcers

Occupational exposure to blood and body fluids amongst health care workers in a teaching hospital of the Sukkur, Sindh

Health care workers [HCWs] are at risk of infection with blood-borne viruses in the course of their work. Over 90% of these infections are occurring in low-income countries and most are preventable. However, the situation in the teaching hospitals has always been thought to be much better than the public health facilities in other hospitals. The focus of the study was on assessing the exposure frequency amongst HCWs in a teaching hospital in the Sukkur. Cross-Sectional Study. This study was conducted at Ghulam Mohammad Mahar Medical College Hospital, Sukkur, Sindh from November 2011 to December 2011. A cross-sectional survey amongst HCWs involved in collecting blood samples and administering injections in all wards of the hospital was conducted. Selection of study participants was by simple random sampling. A pre-tested questionnaire was administered by unlinked, anonymous method. Total sample studied was 70. The proportion of HCWs experiencing exposure to blood body fluid splash [BBF] and needle stick injury [NSI] during last one week was 47.1% and 31.43%, respectively. The incidence density of BBF exposure was 537.14 per 100 person years and that of NSI episodes was 228.57 per 100 person years. The reasons for not using personal protective equipment [PPE] ranged from busy schedule [37.14%], non use of PPE by co-workers [67.14%], emergencies [91.43%] risk that patients may get offended by PPE use by HCWs [27.14%] to discomfort while using PPE [24.29%]. All components of PPE were available as per only 34.24 percent. The high level of occupational exposure to blood and body fluids and consequent risk of infection amongst a group of HCWs in the Teaching Hospital highlights the urgent need for interventions to enhance to the occupational safety of workers