RESUMO
FNAC (Fine Needle Aspiration Cytology) is an essential tool in the preoperative diagnosis and preoperative planning for surgery of solitary thyroid nodules. It is a cost effective procedure that provides specific diagnosis rapidly with minimal complication. The purpose of the study was to evaluate the accuracy of Fine Needle Aspiration Cytology as a diagnostic tool in detecting malignancy in case of solitary thyroid nodule by correlating the preoperative fine needle aspiration cytology (USG Guided) findings with post-operative histopathology findings of the excised specimen in a sub Himalayan tertiary medical college & hospital.METHODSIt was a cross sectional hospital based study conducted on 30 patients in the period from April 2015 to March 2016 after acceptance from West Bengal University of Health Sciences and approval from ethical committee. All admitted patients having solitary thyroid nodule (confirmed clinically & ultrasonographically), biochemically euthyroid and giving consent for surgery were included in this study. Patients who are medically unfit for surgery, biochemically hypo- or hyper-thyroid and not giving consent for surgery were excluded from the study.RESULTSThe sensitivity, specificity, accuracy, positive predictive value and negative predictive value of FNAC for diagnosis of neoplastic solitary thyroid nodule were 75%, 94.44%, 86.67%, 90% and 85%. Commonest malignancy detected was papillary carcinoma in 9 patients.CONCLUSIONSIt is evident from our study that USG guided FNAC should be regarded as the investigation of choice and first line investigation in evaluation of cases with solitary thyroid nodule due to its simplicity, high diagnostic accuracy, easy to perform procedure and absence of significant complications.
RESUMO
PURPOSE: This study aimed to investigate the safety and efficacy of trabeculectomy with intraoperative mitomycin C (MMC) in the management of eyes with neovascular glaucoma (NVG). METHODS: Fifteen eyes of 14 patients with NVG were included in the study. NVG was secondary to central retinal vein occlusion (3 eyes), hemiretinal vein occlusion (2 eyes), proliferative diabetic retinopathy (8 eyes), branch retinal vein occlusion (1 eye) and idiopathic (1 eye). Preoperative retinal ablation was performed in eyes with evidence of posterior segment ischaemia. Following this, all eyes underwent trabeculectomy with intraoperative MMC (0.4 mg/ml for 3 minutes). Clinical outcome assessment included visual acuity, intraocular pressure (IOP), bleb appearance, identification of complications and antiglaucoma medications required to control IOP. RESULTS: The mean IOP decreased from 38.6 +/- 12.9 mmHg (range, 15-64 mmHg) to 17.4 +/- 9.33 mmHg (range, 4-34 mmHg) (P = 0.001). Preoperative visual acuity ranged from light perception to 6/9 in the affected eye. Thirteen (86.6%) of 15 eyes improved vision or retained preoperative vision, one (6.7%) eye lost light perception and one (6.7%) eye developed tractional retinal detachment two years after trabeculectomy. Ten (66.7%) of 15 eyes were classified as surgical success with a mean follow-up of 28.6 +/- 26.3 months (range, 2-82 months). None of the patients developed choroidal haemorrhage, hypotony maculopathy, late onset bleb leak or endophthalmitis. CONCLUSION: Trabeculectomy with intraoperative MMC is a good treatment modality in the management of eyes with NVG.