Incidence of thyroid IMA artery in our population

To find out the incidence of thyroid ima artery in our population. An exploratory study. This study was conducted in a private hospital and Nishtar Hospital Multan. Study was conducted from 15 Jan to 25 September 2012. All the patients with the goiter and who were euthyroid presenting to the Nishatr Hospital and private hospital [Khursheed Rafiq Hospital] in Multan were included in study.Patients with tumors and huge retrostemal goiter were excluded from the study.During surgery of thyroid, meticulous dissection was done to identify the thyroid ima artery and incidence was recorded. A total no of 87 patients were included in the study. Out these 7 were excluded due to the huge goiter with difficult surgery. Out of remaining 80 pts, 65 [80%] were females on 15 [20%] were females, [ratio of female to male 4.3: l].The mean age of the patients was 45 years [from 70 years to 20 years] The thyroid ima artery was found in 4 pts only [5%].All the patients were females It means that incidence of this artery in females is more than males.It may be due to the more incidence of goiter in females [80%] than males as this study was conducted only patients suffering from goiter. In both patients this artery was supplying the isthmus of the thyroid gland. This was of adequate size. Inferior thyroid artery was also present in both cases. The incidence of thyroid ima artery was recorded to be 4% in our population

Frequency of thyroid carcinoma in multinodular goitre

To determine the frequency of carcinoma in thyroidectomies for multinodular goitre [MNG]. This was a prospective descriptive study, conducted in department of general surgery, Nishtar Medical College, Multan [NMC] from July 1998 to December 2004. Only 255 patients with confirmed multinodular goitre were considered in the study. All were from either sex and above the age of 12 years. Out of 255 patients, 213 were female and 42 males with female to male ratio of 5:1. The patients with swelling in front of neck were 180 [70.58%], with symptoms of thyrotoxicosis 30 [11.76%], with dysphagia 21 [8.23%], with dyspnoea 15 [5.88%] and with hoarseness of voice 9 [3.52%]. Thyroid carcinoma was reported in 21 patients [8.23%]. Papillary carcinoma was the most common 57.14% and Follicular carcinoma was 28.57%. Papillary to follicular ratio was 2:1. Risk of malignancy in Multinodular goitre should not be underestimated. It should be considered for surgery, especially if it has very hard nodules and / or dominant nodules are present in multinodular goitre

Comparative study of fistulectomy vs fistulotomy in treatment of fistula-in-ano regarding postoperative complications and long term results

Fistula is defined as chronic granulating tract connecting two epithelial lined surfaces. These surfaces may be cutaneous or mucosal. An anal fistula is a track with an internal opening in the mucosa of the anal canal or retctum. To compare fistulectomy vs fistulotomy regarding postoperative complications and long term results. All patients having fistula-in-ano of low variety were treated with to procedures, fistulectomy and fistulotomy. These patients were divided into two groups. In one group fistulectomy was done and in other group fistulotomy was done. Out of patients operated for perianal fistula of low variety, 60 were males and 20 were females. The male to female ratio was 3:1. The patients of perianal fistula present with different symptoms. Patients present with discharge were 28, with pain and perianal abscess were 38 and with perianal itching were 14. The patients of perianal fistula belong to the different categories, the 50 belong to poor group, 20 belong to middle class and 10 belong to rich group. In this study, 40 patients were operated by fistulotomy, pain was present in I patient. In another 40 patients who were operated by fistulectomy pain was present in 2 patients. It has been concluded that complete removal of fistulous tract and minimal postoperative complications are the keys to be success in fistula surgery