Comparison between radioiodine therapeutic and diagnostic whole body scans in postoperative differentiated thyroid carcinoma patients correlation with serum thyroglobulin levels

Purpose: It has been reported that high image quality and high sensitivity can be achieved by the I-131 post therapy scan. We aim to demonstrate through our clinical experience the efficacy of I-131 therapeutic whole body scans [WBSs] compared to diagnostic scans in detecting lesions and to appraise whether the differentiated thyroid carcinoma patient has to undergo postoperative radioiodine therapy based on the diagnostic scan and/or thyroglobulin level

Method: 263 patients [193 females, 70 males, 19-67 years old] with well differentiated thyroid carcinoma [208 papillary, 55 follicular] underwent postoperative diagnostic radioiodine scan. All patients [263] were imaged 48 hours after receiving a diagnostic I-131 dose of 111-185 MBq [3-5 mCi]. Two hundred seven [207] with a postoperative thyroid ablation and I-131 uptake above 2% received an 1110-4440 MBq [30-120 mCi] therapeutic I-131 dose and were imaged 72 hours thereafter. Images from both scans, diagnostic and therapeutic, were compared for the presence and the intensity of thyroid cancer lesions [recurrences and metastases] and correlated to the serum thyroglobulin level

Results : Compared to negative diagnostic WBSs [25 patients] and those with high serum thyroglobulin level [110 patients], therapeutic scans revealed positive lesions in 19/25 patients [76%]. Almost all lesions [104/ 110] were detected and more clearly defined in the therapeutic scan than the diagnostic scan. Sensitivity was calculated to be 96% for therapeutic WBS and 88% for diagnostic WBS, respectively. Only 7/207 patients [3.4%] who received a high therapeutic dose [4440 MBq] showed a greater lesion uptake in the diagnostic scan than the therapeutic scan

Conclusion: The findings indicate that therapeutic scans are more effective than diagnostic scans for follow-up studies in differentiated thyroid carcinoma patients undergoing postoperative radioiodine treatment. Despite recording a negative diagnostic scan, postoperative radioiodine therapy still had to be performed for those patients with high serum thyroglobulin levels

Reasons for extractions in patients seen in Pak field hospital level Darfur, Sudan

This cross sectional study was conducted at Pak Field Hospital Level 3 Darfur Sudan from Jan 2011 till May 2012 to find out the reasons for extractions of teeth in UNAMID troops. 1500 patients, from various countries were interviewed and examined. Percentage of six common reasons [caries and its sequel, periodontal problems, impactions, prosthetic, orthodontic and other causes] were calculated by SPSS version 16, as whole, separate for male, female and for individual countries. Results showed that Overall 41.2% of the teeth were extracted due to advanced dental caries whereas 34.8% due to periodontal disease, 12.04% due to impactions, 4.4% for prosthetic purposes, 4.3% for orthodontic and 3.2% for other reasons. Advanced caries was the primary cause for extractions in male while impactions and orthodontic causes were the main reasons. Highest numbers of teeth were extracted due to advanced caries in patients from Nigeria [43.5%] and due to periodontal reason from patientsof Bangladesh [37.1%] and Nepal [37%]

Ameloblastomas - seven years clinical audit

To determine the pattern and presentations of ameloblastoma in patients reporting to Armed Forces Institute of Dentistry [AFID], a descriptive study was undertaken from June 2002 to June 2009. A total number of 34 Ameloblastoma patients who were treated at the institute were analyzed. Their mode of presentation, site involved, various age groups and gender distributions, histological patterns, clinical and radiological features, treatment offered and follow up was recorded. The age range was from 15 to 65 years with mean age of 37.6 years. Out of 34 patients, 24 [70.6%] were males and 10 [29.4%] were females. Majority of tumours, 28 [82.3%] were present in mandible and the most common site was angle of the mandible 13[38.2%]. Clinically most common feature was swelling without pain and was experienced by 19 [55.9%] patients. Radiographically, there were 19 [55.9%] patients with multilocular radiolucency and 11 [32.4%] patients with unicystic appearance while 4 [11.8%] patients had typical honeycomb appearance. The most common histological pattern was follicular, seen in 21 [61.8%] patients. Enucleation with curettage was carried out in most of the cases 11 [32.4%], marginal resection was done in 10 [29.4%] cases, segmental resection was performed in 7 [20.6%] patients and radical resection with reconstruction was done in 6 [17.6%] patients. Ameloblastoma is one of the most common odontogenic tumour mostly occur in lower jaw. It is locally invasive and have high rate of recurrence therefore early diagnosis, complete excision with safe margins followed by reconstruction and long term follow up is required for psychological and emotional well being of the patient