RESUMO
The liver is one of the most frequently damaged organs and remains the most common cause of death following blunt abdominal trauma.During the last century, the management of blunt force trauma to the liver has changed from observation and expectant management in the early part of the 1900s to mainly operative intervention, to the current practice of selective operative and non operative management.Currently, a non operative management constitutes the treatment of choice in patients with hemodynamic stability.The objective of this study is to examine the outcomes of blunt hepatic trauma, and compare surgical and nonsurgical treatment on patients admitted with hemodynamic stability and with no obvious indications of laparotomy.Methods: A retrospective study of the patients presented with blunt liver trauma was performed from 2016-2017.Variables analyzed included demographic data, cause of injury, grade of injury, associated injuries, vitals, haemoglobin values,number of blood transfusion, mode of treatment and complications.Clinical parameters, GCS were recorded in all the patients. ultrasonography and CT scan were also done. Patients with unstable hemodynamics who responded to fluid challenge and with stable hemodynamics were included in conservative management of liver trauma.Results: A total of 55 patients were analyzed. 5 patients had sustained severe injuries. Mean pulse rate in conservative group was 92 beats/min.Mean blood pressure inconservative group was 110/70 mmHg . Conservative treatment was followed in 50 patients with surgery undertaken in 6 of the patients from this group due to failure of conservative treatment. Mean duration of hospital stay in conservative and operative groups are respectively 17 and 19 days. P value is significant (0.04).Conclusions:A non-operative approach results in lower complications, a lesser need for blood transfusions and a lower mortality rate.Failure of conservative treatment did not show a higher incidence of complications or mortality.
RESUMO
Introduction:Solitary thyroid nodule is a common clinical entity encountered in routine clinical practice. Excising all thyroid lesions is impracticable and associated with risk [1, 2]. A routine use of FNAC in assessment of thyroid lesion has reduced number of patients subjected to thyroidectomy for benign lesion.Objective:Present study was undertaken to know distribution of lesion according to age and sex and also to evaluate efficacy of FNAC in diagnosis of clinically obvious and palpablesolitary thyroid nodule.Material and methodology :This study include 25 cases, for the purpose of inclusion in this study a STN defined as a single swelling involving either lobe of thyroid or isthmus of thyroid gland.Result: from25 cases of FNAC’s of thyroid lesion maximum cases were benign 21 (84%) malignant cases were 2(8%) and 2 cases was suspicious (8%).Conclusion:With 92% accuracy rate and is a single best investigation for preoperative evaluation for STN to differentiate betweenbenign and malignant nodules.