Management of differentiated thyroid carcinoma.

The study was done to determine the clinical, radiological and histopathological characteristics along with the management outcome of differentiated thyroid carcinoma. This Retrospective study included sixty patients with differentiated thyroid carcinoma presented to Department of Otolaryngology and Head-Neck Surgery at Dhaka Medical College Hospital and Apollo Hospitals Dhaka from June 2006 to December 2008. The data of each patient included age, sex, presenting symptoms and signs, provisional diagnosis, preoperative investigations, operation notes, histopathological examination and state at follow up. This study included 28 males and 32 females. The mean age was 42.7 years. Maximum patients presented at 4th decade. The commonest presentation was thyroid swelling followed by lateral neck swelling. Detailed clinical assessment before operative treatment has been done for all patients. Fifty five patients (91.66%) presented with single nodule. Distant metastasis was found in 2 cases. All patients underwent fine needle aspiration cytology which was conclusive in 38 patients (63.33%). All the sixty patients underwent surgical excision; either total thyroidectomy or completion thyroidectomy. Neck dissection was performed in 8 patients. All patients received postoperative radio-iodine. Fifty one cases were papillary carcinoma and 9 cases were follicular carcinoma. Except for one case with local recurrence the remaining cases were disease free on follow up (up to 10-40 months). One patient died with bone metastasis 2 years after operation. Of all thyroid cancers, majority cases are papillary cancer (85%). In contrast to other cancers, thyroid cancer is almost always curable. Most thyroid cancers grow slowly and are associated with a very favorable prognosis. Early diagnosis and treatment of the same is strongly advisable.

Determinants of night blindness in Bangladesh.

A cross-sectional study was conducted to evaluate the effect of a community-based health education intervention programme and to study the determinants of night blindness in Bangladesh. The intervention programme was implemented to reduce the morbidity of nutritional blindness (night blindness) in the northern part of Bangladesh (Ranjpure district) during 1986-1989. A baseline study in 1986 covered 2010 households with a total population of 11,600, and the evaluation study in 1989 covered 2011 households with a total population of 10,456. Prevalence of night blindness was studied among children aged < 9 years in these households. The prevalence of night blindness per 1000 children was reduced significantly during the intervention period from 50.7 in 1986 to 26.7 in 1989. However, the post-intervention prevalence varied significantly between areas. Multivariate analyses showed that consumption of fish, meat, milk or eggs, dark green leaf vegetables, yellow fruits and vitamin A capsules were significant predictors of night blindness. In addition, family income, mother's literacy, family size and area of residence exhibited strong and statistically significant associations with night blindness in the 1989 cross-sectional study. The prevalence of night blindness was highest among 4-6 year old girls and 7-8 year old boys. The sex difference was, however, not statistically significant.

PIP: A community-based health education intervention program was implemented over the period 1986-89 in the northern Bangladesh district of Ranjpure in hopes of reducing the level of morbidity due to nutritional blindness. This cross-sectional study reports findings from an evaluation of the effects of the program and the determinants of night blindness in the country. The baseline study in 1986 assessed the prevalence of night blindness among children under 9 years old in 2010 households with a total population of 11,600. The evaluation study of 1989 covered comparably aged individuals in 2011 households with a total population of 10,456. The data indicate that the prevalence of night blindness was reduced from 50.7% to 26.7% over the period, but post-intervention prevalences varied significantly between areas. Where fish, meat, milk or eggs, dark green leaf vegetables, yellow fruits, and vitamin A capsules were consumed in comparatively larger quantities, the prevalence of night blindness was significantly lower. Likewise, higher family income, higher mother's literacy, and smaller family size were associated with lower prevalence of night blindness in the 1989 cross-sectional study. Area of residence was strong and statistically significant as a determinant factor. Finally, the prevalence of night blindness was highest among 4-6 year old girls and 7-8 year old boys, yet the sex difference was not statistically significant.