RESUMO
Background: Volumetric evaluation of thyroid gland volume [TGV] is one of the criteria determining the iodine status of a population. TGV is the product of 3 dimension of each lobe: Anterio-posterior [AP] x medio-lateral [ML] x and craniocaudal [CC] x correction factor
Objectives: To determine the effect of serum TSH on thyroid dimensions of each lobe and to measure the amount of effect of per unit increase in serum TSH on thyroid dimensions of each lobe in euthyroids
Study Design: It was a cross-sectional study
Setting: The study was conducted at Ziauddin University Hospital, Clifton, Karachi. Methodology: Healthy participants aged 21 years and above were included through convenient sampling. Serum Thyroid stimulating hormone was evaluated and ultrasound of thyroid gland TG of 192 euthyroid participants was performed. Spearman correlation and regression analysis was applied to evaluate the relationship between TSH and TG dimensions
Results: Relationship of increase in serum TSH with decrease in light lobe AP dimension was most significant. [r= -0.142 P-Value=0.001] and CC dimension least significant [r= -0.0098 P-Value=0.001]. Where as in the left lobe AP dimension decreases significantly with increase serum TSH [r= -0.147 P-value=0.001]. 11.7% of total variation in AP dimension, 3.5% of total variation in ML dimension and 6.5% of total variation in CC dimension in right lobe thyroid are because of serum TSH. While 9.5% of the total variation in AP dimension in left lobe is also due to serum TSH
Conclusion: Negative and significant correlation between serum TSH and thyroid dimensions was observed. Serum TSH inversely and significantly affects all the dimensions of the right lobe and only one dimension in the left lobe
RESUMO
Spinal anaesthesia is the most common and widely practiced regional anaesthesia. It is used for various surgeries involving lower abdomen and lower limbs. However Spinal anesthesia also has some drawbacks and one of its well recognized complications is Post dural puncture headache [PDPH]
Aims and Objectives: the objective of this research was to identify different factors significantly influencing PDPH in over patient population
Material and Method: it was a single blinded, cross-sectional study carried out from January 2008 to December 2009, at the department of anesthesiology, Shaikh Zayed Hospital, Lahore. Patients admitted for any surgical procedure involving the region below the umbilicus and requiring spinal anesthesia for it, were included in our study. Every patient was given spinal anesthesia between L2-L3 or L3-L4 space, using the drug Bupivacaine [upto 2ml of 0.75% concentration] with the Quincke needle of a size 22G, 23G or 25G depending on the availability. All patients were blinded to the size of needle being utilized
Results: we studied 227 patients aged 17-90 years. Needle 22G was used on 52 patients [22.9%], 23G on 128 patients [56.4%] and 25G on 47 patients [20.7%]. Frequency of PDPH was 13/52 [25%] in patients receiving 22G needle, 14/128[11%] in 23G and 4/47[8%]in 25G.This relation was statistically significant with a P value of 0.024 .PDPH occurred in 11% of males and in 24% of females. P value for this difference was also significant [0.019]. All the other variables studied did not have a significant P value
Conclusion: PDPH is more common in females. 25-Gauge Quincke needle has definite advantage over 22-gauge and 23 -Gauge needles as far as frequency of PDPH is concerned. Level of expertise, duration of surgery , number of attempts and occurrence of a hypotensive episode have no significant effect on the frequency of PDPH