Strategy and organization of surgical care for patients with thyroid diseases in private medicine

OBJECTIVETo study the pattern of general surgery cases and their management in Bacha Khan Medical Complex Shahmansoor Swabi.METHODSThis descriptive cases-series study was conducted prospectively in general surgery department Bacha Khan Medical Complex Shahmansoor Swabi form jan, 2013 to Dec, 2015. There were 1200 patients in the series who were managed either conservatively or operated upon. All patients with symptoms suggesting a surgical disease and managed as a surgical case were included, while cases that were referred to other departments and those that left against medical advice were excluded.RESULTSMost of the patients had alimentary tract diseases 361(30%) followed by urinary tract diseases 264 (22%),superficial lumps 142 (11.8%), hernia 140 (11.7%), hepato-biliary-pancreatic diseases 116 (9.7%), breast diseases 55 (4.6%), scrotal diseases 41 (3.4%), thyroid diseases 28 (2.3%),salivary gland diseases 15 (1.3%), vascular diseases 8 (0.7%), thoracic diseases 2 (0.2%) and miscellaneous 28 (2.3%). A total of 604 (64.5%) patients were treated as elective cases and333 (35.5%). were treated as emergency cases. As many as 937 (74.08%) patient were treated by operations and 263 (21.92%) patients by conservative treatment, while 41 (3.41%) patients were referred. Seven patients expired, giving a mortality rate of 0.58%.CONCLUSIONThe commonest cause of seeking surgical care was alimentary tract diseases, followed by urinary tract diseases, superficial lumps, hernias, hepato-biliary-pancreatic diseases, breast diseases, scrotal diseases and thyroid diseases. Bacha Khan Medical Complex Shahmansoor Swabi is a newly established hospital catering to the needs of population of district Swabi and adjoining districts and areas.

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Radiation Dose-Response Relationships for Thyroid Nodules and Autoimmune Thyroid Diseases in Hiroshima and Nagasaki Atomic Bomb Survivors 55–58 Years After Radiation Exposure

Yearbook of Endocrinology ◽

10.1016/s0084-3741(08)70117-3 ◽

2007 ◽

Vol 2007 ◽

pp. 230-232

Author(s):

E.L. Mazzaferri

Keyword(s):

Radiation Dose ◽

Radiation Exposure ◽

Dose Response ◽

Thyroid Nodules ◽

Atomic Bomb ◽

Thyroid Diseases ◽

Autoimmune Thyroid Diseases ◽

Autoimmune Thyroid ◽

Atomic Bomb Survivors

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Organization of Surgical Care for Patients with Aneurysmal Subarachnoid Hemorrhage in a Large Region of Russia (According to the Republic Of Tatarstan)

Journal of Neurological Surgery Part B Skull Base ◽

10.1055/s-0034-1370670 ◽

2014 ◽

Vol 75 (S 01) ◽

Author(s):

Valery Danilov ◽

Andrey Alekseev ◽

Michail Volodjkhin ◽

Aleksandr Nemirovsky ◽

Nail Shayakhmetov ◽

...

Keyword(s):

Subarachnoid Hemorrhage ◽

Aneurysmal Subarachnoid Hemorrhage ◽

Surgical Care ◽

Large Region ◽

The Republic

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Vitamin D deficiency and autoimmune thyroid diseases

Experimental and Clinical Endocrinology & Diabetes ◽

10.1055/s-0035-1547749 ◽

2015 ◽

Vol 122 (03) ◽

Author(s):

N Körber-Hafner ◽

C Körber

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Thyroid Diseases ◽

Autoimmune Thyroid Diseases ◽

Autoimmune Thyroid

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Guideline for radioiodine therapy for benign thyroid diseases (version 3)

Nuklearmedizin ◽

10.1055/s-0038-1623919 ◽

2004 ◽

Vol 43 (06) ◽

pp. 217-220 ◽

Cited By ~ 8

Author(s):

J. Dressler ◽

F. Grünwald ◽

B. Leisner ◽

E. Moser ◽

Chr. Reiners ◽

...

Keyword(s):

Radioiodine Therapy ◽

Thyroid Volume ◽

Thyroid Diseases ◽

Antithyroid Drugs ◽

Graves Disease ◽

Co Morbidity ◽

History Of ◽

Individual Decisions ◽

Prophylactic Use ◽

Benign Thyroid

SummaryThe version 3 of the guideline for radioiodine therapy for benign thyroid diseases presents first of all a revision of the version 2. The chapter indication for radioiodine therapy, surgical treatment or antithyroid drugs bases on an interdisciplinary consensus. The manifold criteria for decision making consider the entity of thyroid disease (autonomy, Graves’ disease, goitre, goitre recurrence), the thyroid volume, suspicion of malignancy, cystic nodules, risk of surgery and co-morbidity, history of subtotal thyroidectomy, persistent or recurrent thyrotoxicosis caused by Graves’ disease including known risk factors for relapse, compression of the trachea caused by goitre, requirement of direct therapeutic effect as well as the patient’s preference. Because often some of these criteria are relevant, the guideline offers the necessary flexibility for individual decisions. Further topics are patients’ preparation, counseling, dosage concepts, procedural details, results, side effects and follow-up care. The prophylactic use of glucocorticoids during radioiodine therapy in patients without preexisting ophthalmopathy as well as dosage and duration of glucocorticoid medication in patients with preexisting ophthalmopathy need to be clarified in further studies. The pragmatic recommendations for the combined use of radioiodine and glucocorticoids remained unchanged in the 3rd version.

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Impact of the serum thyroglobulin concentration on the diagnostics of benign and malignant thyroid diseases

Nuklearmedizin ◽

10.1055/s-0038-1632259 ◽

2000 ◽

Vol 39 (05) ◽

pp. 133-138 ◽

Cited By ~ 4

Author(s):

W. Dembowski ◽

H.-J. Schroth ◽

K. Klinger ◽

Th. Rink

Keyword(s):

Hashimoto’S Thyroiditis ◽

Thyroid Volume ◽

Nodular Goiter ◽

Thyroid Diseases ◽

Hashimoto's Thyroiditis ◽

Graves Disease ◽

Normal Range ◽

Serum Thyroglobulin ◽

Diffuse Goiter ◽

Hyperthyroid Patients

Summary Aim of this study is to evaluate new and controversially discussed indications for determining the thyroglobulin (Tg) level in different thyroid diseases to support routine diagnostics. Methods: The following groups were included: 250 healthy subjects without goiter, 50 persons with diffuse goiter, 161 patients with multinodular goiter devoid of functional disorder (108 of them underwent surgery, in 17 cases carcinomas were detected), 60 hyperthyroid patients with autonomously functioning nodular goiter, 150 patients with Hashimoto’s thyroiditis and 30 hyperthyroid patients with Graves’ disease. Results: The upper limit of the normal range of the Tg level was calculated as 30 ng Tg/ml. The evaluation of the collective with diffuse goiter showed that the figure of the Tg level can be expected in a similar magnitude as the thyroid volume in milliliters. Nodular tissue led to far higher Tg values then presumed when considering the respective thyroid volume, with a rather high variance. A formula for a rough prediction of the Tg levels in nodular goiters is described. In ten out of 17 cases with thyroid carcinoma, the Tg was lower than estimated with thyroid and nodular volumes, but two patients showed a Tg exceeding 1000 ng/ml. The collective with functional autonomy had a significantly higher average Tg level than a matched euthyroid group being under suppressive levothyroxine substitution. However, due to the high variance of the Tg values, the autonomy could not consistently be predicted with the Tg level in individual cases. The patients with Hashimoto’s thyroiditis showed slightly decreased Tg levels. In Graves’ disease, a significantly higher average Tg level was observed compared with a matched group with diffuse goiter, but 47% of all Tg values were still in the normal range (< 30 ng/ml). Conclusion: Elevated Tg levels indicate a high probability of thyroid diseases, such as malignancy, autonomy or Graves’ disease. However, as low Tg concentrations cannot exclude the respective disorder, a routine Tg determination seems not to be justified in benign thyroid diseases.

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