Dual ectopic thyroid: a case report with review of literature

The ectopic thyroid gland is a rare entity which is mostly found along the line of descent of the thyroid gland. Most of the patients present with midline swelling and usually seek medical attention. Dual ectopic thyroid gland is even rarer. The clinical examination and different imaging modalities establish its diagnosis. Radionuclide studies are highly sensitive and specific in demonstrating the functional tissues in patients with ectopic thyroid, thereby guiding further management. The authors reported a case of ectopic thyroid gland in a girl with midline neck management. The authors reported a case of ectopic thyroid gland in a girl with midline neck swelling initially, subsequently lost to follow-up. She again presented with enlarged swelling after a period of three years with dual ectopic thyroid in the neck region on thyroid scan. Thyroid scintigraphy demonstrated that progression in the size of ectopic glands was due to neglect in treatment

Cardiorespiratory compromise under conscious sedation sedation during upper gastrointestinal endoscopy

To compare the cardiorespiratory effects of benzodiazepine and midazolam used for sedation in patients undergoing upper gastrointestinal endoscopy with cardiorespiratory changes in the non-sedated patients. Comparative, randomized, single blind study. Department of Medicine at Government Medical College and Hospital, Chandigarh, India, from January to July 2000.A total of 252 adult patients without previous cardiorespiratory co-morbidity, undergoing upper gastrointestinal endoscopy were recruited. They were randomly allocated in to group I [placebo with saline administration], group II [diazepam administered] and group III [midazolam administered]. The pulse rate, blood pressure, ECG and peripheral oxygen saturation [SpO2] was noted at baseline, after pre-medication, during endoscopy and postendoscopy. Statistical analysis was done by paired t-test, Chi-square test and ANOVA as applicable. There was no difference in baseline record of the three groups. Significant fall in SpO2 was noted in all the groups, more marked in the sedated one during endoscopy. Tachycardia developed in all the three groups and settled within 5 minutes of endoscopy. Blood pressure remained more stable in the sedated group. ECG changes included atrial and ventricular premature contraction in all the three groups. Endoscopy is a safe procedure where cardiorespiratory complication are minimized in non-sedated patients when appropriately selected