RESUMO
Introduction: Varicose veins of the lower extremities are one of the most common peripheral vascular diseases. A variety of treatments methods have emerged as an alternative to traditional surgery but are limited by their need for equipment and expertise which increases the cost of treatment making it unviable especially in rural India. Thus traditional surgery still forms the mainstay of treatment. Aims: To evaluate and compare the outcomes in patients undergoing Trendelenberg’s procedure with stripping and without stripping of varicose veins. Materials and methods: The study comprised of 50 patients who were admitted with varicose veins. They were allocated into two groups of 25 each where they either underwent Trendelenberg’s procedure with stripping or without stripping of varicose veins. The patients were followed up for six months to assess the efficacy of the procedure as per the parameters of the study. Results were analyzed using SPSS software. Percentages and proportions were used for qualitative data; mean and standard deviation were used for quantitative data. Chisquare test and student t test were applied where appropriate. Results: In the group undergoing stripping, 28% (7 of 25) patients developed hematoma, post operative pain scores on day 0,3,7 and 10 were 3.8±0.9, 2.6±0.7, 1.1±0.6 and 0.2±0.4 respectively. Mean post operative ambulation was achieved on 3.88 days and recurrence at 6 months was seen in 12% (3 of 25) patients. In the group undergoing ligation alone, 4% (1 of 25) patients developed hematoma, post operative pain scores on day 0,3,7 and 10 were 3.0±0.8, 1.6±0.8, 0.8±0.5 and 0.1±0.3 respectively. Mean post op ambulation was achieved on 2.16 days and recurrence at 6 months was seen in 20% (5 of 25) patients. Conclusions: With lesser rates of hematoma formation, better post operative pain scores and quicker ambulation in patients undergong ligation of veins alone, we conclude that Trendelenberg’s procedure without stripping is a better procedure than Trendelenberg’s procedure with stripping of veins in the treatment of varicose veins.
RESUMO
Background: Incidence of thyroid nodules varies according to the methods of diagnosis, 4-7% by palpation and 17-67% by high resolution ultrasound. The gold standard of diagnosis for thyroid nodules is fine needle aspiration (FNA); however, fine needle aspiration cytology (FNAC) alone is insufficient to detect cancer because of inadequate cytology (5-15%) and in cases of follicular neoplasm (15-25%) where only surgery is diagnostically conclusive. Therefore, other factors in addition to FNA should be considered to predict malignancy. This study was done to evaluate the association between elevated pre-operative thyroglobulin levels and histopathologically proven thyroid carcinoma.Methods: This retrospective study was conducted in Bowring and Lady Curzon Hospital, from December 2017 to November 2018. All patients above 18 years, undergoing total thyroidectomy, with normal antithyroglobulin levels and with indeterminate thyroid nodules or disease on FNAC were included. Patients proven to have malignancy by FNAC, who underwent hemithyroidectomy and patients with thyroglossal cyst or ectopic thyroid swellings were excluded.Results: A total of 50 patients were included. The Fischer’s exact test shows significant value of 0.037 and also the two-tailed test showed a p value <0.05, hence it is significant to conclude that the mean value of thyroglobulin levels among histopathologically proven malignant thyroid cancers is significantly higher compared to the benign thyroid disease.Conclusions: In addition to thyroid-stimulating hormone, thyroid nodules with elevated thyroglobulin levels were independently associated with the presence of thyroid cancer; therefore, the evaluation of pre-operative thyroglobulin level in patients with indeterminate FNAC might give additional information to predict malignancy.