RESUMO
Background: The risk of injuring recurrent laryngeal nerves which can result in voice or swallowing problems can be a major complication during thyroid surgeries. Intraoperative injury to RLN can be an issue and can have a detrimental impact on patients’ quality of life. The incidence of injury to recurrent laryngeal nerve worldwide ranges from 0.5 to 20%. To prevent such surgical complications of thyroid, a detailed anatomy of inferior vascular pedicle (inferior thyroid artery) and its relation to adjacent recurrent laryngeal nerve is required. Aim: The aim of the study was, To find out the variable anatomical relationship between inferior thyroid artery and recurrent laryngeal nerve at the base of lateral lobes of thyroid gland. Materials and methods: This descriptive study was conducted for a period of 72 months at the Department of Anatomy, Government Medical College, Omandurar Government Estate, Chennai-2, between January 2015 – January 2021 by dissection method in 60 adult (54 male and 6 female) cadavers (60 – right & 60 – left sides). Results: Results were noted, tabulated and interpreted. It was found that the recurrent laryngeal nerve at the base of thyroid gland which was predominantly posterior on both sides (R-78.33%, L- 100%) to inferior thyroid artery and in 21.66% anterior to ITA on right. Conclusion: The recurrent laryngeal nerve may lie anterior or posterior to inferior thyroid artery. In the present study, the recurrent laryngeal nerve was posterior most commonly on both sides to inferior thyroid artery. On the right, the second common presentation was the recurrent laryngeal nerve lying anterior to inferior thyroid artery.
RESUMO
Background: The prevalence of teenage pregnancy in Assam is higher than the national average as per both NHFS‑4 and NHFS‑5. Four districts in Assam, falling under the NITI‑Aayog Aspiration Districts Transformation program of 2018, namely, Goalpara, Barpeta, Darrang, and Dhubri, have a prevalence of teenage pregnancy at levels higher than the state’s average (12% as per NHFS‑5). Teenage pregnancy affects several health and nutritional indicators. Objectives: The objective of the study was to identify the factors associated with teenage pregnancies in the Aspirational Districts of Assam in both social and public health contexts. Methods: A comparative cross‑sectional study was carried out across these four districts, with sample size of teenage pregnant women as 388 and an equal number of controls. Results: The study presents several factors to be statistically significant, viz., lower level of education of the teenage mothers or their spouses and lesser access to adequate health‑related information by teenage mothers. Furthermore, less number of teenage mothers are aware of contraceptive availability and face objection from spouses to use contraception. A unique factor presented by the study is the higher elopement rate among teenage mothers. Conclusion: Many of the factors upheld by the study are rooted in social and cultural fabric of the communities and could be addressed by mobilizing local institutions like panchayat and religious bodies to act as deterrence to teenage marriages in the communities. Men should also be brought into the fold of discussions on this sensitive subject through information and awareness generation.
RESUMO
Background: We present the findings from the largest hospital-based studies on myasthenia gravis from India, using data collected over a period of 43 years from the Neurology Department in a tertiary referral center in India. Objectives: To study the clinical presentation, age at onset, gender distribution, serological status and thymic pathology in patients with myasthenia gravis. Materials and Methods: A retrospective study was carried out using records of patients with myasthenia gravis from the years 1965 to 2008. Results: Of 841 patients, 836 (611 males and 225 females) had acquired myasthenia (myasthenia gravis) and five congenital myasthenia. The median age at onset was 48 years (males 53 years and females 34 years). The peak age at onset for males was in the sixth and seventh decade and in females, in the third decade. Two hundred and twenty-two (26.31%) patients had ocular and 616 (73.68%) generalized myasthenia. Serological studies were done in 281 patients with myasthenia gravis for Acetylcholine receptor (AchR) antibodies of which 238 (84.70%) were seropositive. The most common histopathology was thymoma and the second most common was thymic hyperplasia. Conclusion: Myasthenia gravis in our study was more common in males (M:F of 2.70:1). There was a single peak of age at onset (males sixth to seventh decade; females third decade). The higher prevalence of thymomas in this series is in all probability related to selection bias as patients with thymic enlargement or more severe disease underwent thymectomy. Thymoma was more common in males; hyperplasia in females.