Comparison of percutaneous ultrasound guided needed aspiration and open surgical drainage in management of puerperal breast abscess.

, less morbidity and will allow the patient to carry on breast feeding. Aims & Objective: The aim of this study is to compare the management of puerperal breast abscess by percutaneous ultrasound guided needle aspiration versus open surgical drainage with special attention to resolution and complications. Material and Methods: In this interventional study, 70 puerperal breast abscess cases were randomly divided and undergone either percutaneous ultrasound guided niddle aspiration (Group A) or open surgical drainage (Group B) and results were compared. Results: Failure rate for aspiration therapy was17.14% with 06 patients requiring conversion to open surgical drainage after aspiration and were excluded from study. The resolution time was less in aspiration group. Painful and cumbersome daily changes of dressing, mammry fistula in 3 patients with ugly scar were the main drawback of open surgical drainage as compared to aspiration. However, there was high failure rate of aspiration therapy in abscesses presenting later than 5 days (45.83%) and those with >5 cm size (55.55%) on ultrasonography. Conclusion: Percutaneous ultrasound guided needle aspiration has acceptable failure rate and is an effective alternative to open surgical drainage of puerperal breast abscess especially for those present early and of small size.

Comparison between total and subtotal thyroidectomy in Graves’ disease.

Objective: To compare the results of total thyroidectomy and subtotal thyroidectomy amongst the surgically treated patients with Graves’ Disease. Material and Method: This study includes 50 patients of Graves’ disease out of which 27 patients underwent for total thyroidectomy and 23 underwent for subtotal thyroidectomy. Comparison done in regards to postoperative complication between total and subtotal thyroidectomy in terms of advantages and disadvantages. Results: Incidence of transient or permanent recurrent laryngeal nerve palsy and hypocalcemia were high amongst the patients operated for total than subtotal thyroidectomy. Thyroid function tests were normal in all patients after total thyroidectomy with hormone replacement therapy and 17.39% of patients had hypothyroidism after subtotal thyroidectomy. Recurrence rate was nil and 21.73% respectively in total and subtotal thyroidectomy. One patient of subtotal thyroidectomy had occult carcinoma in histopatholical examination which required revision of surgery. Conclusion: Total thyroidectomy is superior to subtotal thyroidectomy based on the considerable surgical risk and lack of recurrence in total thyroidectomy as well as the risk of occult carcinoma and questionable ability of the subtotal thyroidectomy to maintain the euthyoid state.