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

Frequency of HBs Ag and anti-HCV in trauma patients

This study was carried out to determine the frequency of Hepatitis B and C Viral infection in patients undergoing emergency surgical operations after trauma, and to evaluate the associated risk factors. Descriptive Study. This study was conducted at General Surgical, Orthopaedic and Paediatric Surgery Department of Ghulam Muhammad Mahar Medical College Hospital Sukkur from May-2011 to April-2012. All the patients who were admitted in the Surgical and orthopaedic department for emergency surgical operations followed by trauma were included in the study. The patients were screened for HBsAg and Anti-HCV using immunochromatography [ICT] method. Those who were weak positive by ICT were further confirmed by Enzyme Linked Immunosorbent Assay [ELISA]. 592 patients were admitted in Surgical and orthopaedic department during a period of last one year for emergency operations after trauma and were screened for HBsAg and Anti-HCV. Out of these 592 patients 472 [79.7%] were males and 120 [20.27%] were females. Mean age of these patients was 40 years. After screening, 33 [5.57%] patients were found HBsAg positive and 117 [19.76%] were Anti-HCV positive, while 09 [1.5%] were positive for both. Hepatitis-B was found in 21 [2.3%] males and 12 [1.3%] females, while Hepatitis-C was predominantly found in 68 [7.44%] males and 49 [5.36%] female patients. Parenteral injections by Quacks, previous surgery, blood transfusion and shaving by barbers were found to be the risk factors. High frequency of HBs Ag and Anti-HCV was found in trauma patients undergoing emergency surgery. Our message is that "Prevention is better than cure". So it is essential to prevent the spread of Hepatitis B and C by screening every patient before surgery and counseling of patients

Treatment outcome of enteric fever in children at tertiary care hospital Sukkur Pakistan

Enteric fever [Typhoid fever] is widely recognized as a major public health problem in developing countries. To evaluate the treatment outcome of enteric fever in children. Retrospective descriptive study. This study was conducted at the Paediatric department, Ghulam Muhammad Mahar Medical College Hospital Sukkur from January 2009 to December 2011. This was a retrospective study, included all patients of enteric fever, of both sex and age ranged from 6m to 13 years. All enteric patients were confirmed by serological test Typhidot IgM or IgM and IgG positive. The data was collected from case record for demography and treatment outcome. A total of 360 patients were diagnosed to have enteric fever during this period. Mean age of presentation was 6.47 years and 166 [46.12%] patients were <5 years whereas 194 [53.88%] were > 5 years of age. Male: Female ratio was 2:1. Serological test typhidot IgM was positive in 290 [80.5%] and both [IgM + IgG] were positive in 70 [19.45%] of cases. Raised ALT was seen in 90[25%] of cases. Complications were seen in 52 [14.4%] of cases, hepatitis 10 [2.77%], hepatic abscess 3 [0.83%] intestinal hemorrhage 8 [2.22%], peritonitis 4 [1.11%] intestinal perforation 4 [1.11%], cholecystitis 6 [1.66%], paralytic ileus 3 [0.83%] enteric encephalopathy 3 [0.83%], meningitis 1 [0.27%]. Two patients expired [0.55%], one was enteric encephalopathy and other intestinal perforation with peritonitis. enteric fever remains a major cause of morbidity and mortality in our part of country. Major complications found in our cases were hepatitis, hepatic abscess, intestinal hemorrhage, intestinal perforation, peritonitis, cholecystitis, enteric encephalopathy, meningitis, osteomyelitis, septic arthritis