scholarly journals Anatomical Variation of Recurrent Laryngeal Nerve with Inferior Thyroid Artery: A Cross Sectional Study in Bangladeshi People

2021 ◽  
Vol 18 (1) ◽  
pp. 7-12
Author(s):  
Md Rabiul Islam ◽  
Tahmina Begum ◽  
Nazrul Islam ◽  
Md Moshabbirul Islam

Background: Recurrent laryngeal nerve is varied anatomically with inferior thyroid artery. Objective: The purpose of the present study was to observe the anatomical variation of recurrent laryngeal nerve with inferior thyroid artery among Bangladeshi people. Methodology: This comparative cross-sectional study was conducted in the Department of Otolaryngology and Head-Neck surgery at Sylhet MAG Osmani Medical College Hospital, Sylhet, Bangladesh from January 2004 to December 2004 for a period of one (01) year. Patients whose recurrent laryngeal nerve was identified during thyroidectomy due to various pathological conditions of thyroid gland were selected as group I. Again, the dead body which were undergone dissection were designated as group II. All the patients whose recurrent laryngeal nerve and inferior thyroid artery were identified during total, near total, sub-total, hemithyroidectomised or lobectomised were included in this study. Result: A total number of 32 patients were recruited for this study. On the left side nerve was found anteriorly in 2(10.53%), in between in 4(21.05%) and posteriorly in 13(68.42%). On the right side-nerve was found anteriorly in 7(30.43%), in between in 6(26.09%) and posteriorly in 10(43.48%). In this series nerve was seen posterior relation more than other two relations and anterior relation more on right side whereas posterior relation on left side, anterior relation more than in between relation on right side but reverse on left side. In group II On the left side nerve was found anteriorly in 2(6.25%), in between in 6(18.75%) and posteriorly in 24(75%). On the right side-nerve was found anteriorly in 8(25%), in between in 9(28.12%), and posteriorly in 10(46.88%). Conclusion: In conclusion each recurrent laryngeal nerve lies posterior to the inferior thyroid artery in the majority of the occasions whereas the nerve lies anterior to the branches of the inferior thyroid artery less commonly except right side of both study group. Journal of Science Foundation, January 2020;18(1):7-12

Author(s):  
Bathokedeou Amana ◽  
Winga Foma ◽  
Essobozou Pegbessou ◽  
Tchin Darré ◽  
Essohanam Boko ◽  
...  

Introduction Identification of the recurrent laryngeal nerve during thyroid surgeries is recommended to preserve its functionl integrity. This study aims to determine the relationship between the recurrent laryngeal nerves and the inferior thyroid arteries during thyroidectomies, as well as any particularities and intraoperative complications. Materials and Methods Observational cross-sectional study of all culturally Togolese patients who underwent thyroidectomy with nerve dissection in the ENT department of Sylvanus Olympio University Hospital from 1 January 2013 to 30 June 2017, i.e. a period of 4 years 6 months. Results The sex ratio was 0.14 i.e., 7 women for 1 man and the average age of 41.82 years. Tissue nodules and multinodular goiters were the most operated lesions in 40.97% and 33.04%, respectively, with a plunging character in 17 cases. We had 306 cases of nerve dissection but the recurrent laryngeal nerve could not be found in 1 case on the right. It was globally retro-arterial (under the trunk and under the branches of the inferior thyroid artery) in 75.08% of cases with prevalence of the truncal, pre arterial situation in 16.07% and inter-arterial in 3.28% cases. The nerve was non-recurrent (type II pathway) in 1 case on the right. There was no recurrence injury. Parathyroid devascularization (5 cases) was autotransplanted. The surgeon's experience did not have a significant impact on the occurrence of intraoperative complications (p = 0.24). Conclusion This observational cross-sectional anatomical-surgical study supports the existing data on the relationships between the recurrent laryngeal nerve and the inferior thyroid artery by confirming their variability. Nevertheless, it was marked by the predominance of the retro arterial truncal situation of the nerve unlike the literature that most often reports a situation of the nerve under the arterial branches.


2020 ◽  
Vol 8 (2) ◽  
pp. 25
Author(s):  
Mohamed Elghazali Elhasan ◽  
Wael Mohialddin Doush

Background: Until recently, the knowledge of the anatomical variations in the relationship between the recurrent laryngeal nerve (RLN) and the inferior thyroid artery (ITA) combined with visual intraoperative RLN identification are essential for the protection of these life-important structures during surgical exposure and the mobilization of thyroid and parathyroid glands. This leads to the proper treatment of patients and improvement of the surgical techniques.Aim: To describe anatomical variations in the relationship of the recurrent laryngeal nerve to the inferior thyroid artery in the Sudanese population.Patients and methods: Following ethical committee approval, an observational descriptive prospective cross-sectional study in the period between March 2019 and February 2020, for anatomical variations in the relation of the recurrent laryngeal nerve to the inferior thyroid artery in seventy-two cervical sides of thirty-six well-dissected embalmed Sudanese cadavers. The RLN was investigated in three positions: posterior to the ITA main trunk, anterior to the ITA main trunk and between the ITA branches. Then, the results were analyzed according to the gender, age and dissection side.Results: We found that the anatomical variations were more frequent in males (97.2%) than females (2.8%). The age of these variations ranged between 31–45 years which represents (61.1%). On the right side of the neck, the commonest position of the RLN is posterior to the ITA (63.9%) followed by in decreasing order of frequency, the RLNs run between the ITA branches (30.6%) and anterior to the ITA (5.6%). On the left side of the neck, the commonest position of the RLN is posterior to the ITA (69.4%). It passed between the ITA branches in (30.6%) of specimens. There was no anterior location of the RLN to the ITA. Variations in a relationship of the RLN to the ITA on one side is significantly different from the opposite side.Conclusions: Although the risk of potential damage to the RLN during surgical neck procedures involving the thyroid gland and parathyroid glands is well recognized, pre-operative detailed surgeon’s knowledge for these frequent anatomical variations and the usage of the ITA as an anatomical landmark for intraoperative RLN recognition is important. This will lead to a reduction of iatrogenic RLN injury prevalence. Future studies are recommended to compare the findings on this cadaveric study with a larger sample size in the long-term period.  


Author(s):  
Rajnish Raj ◽  
Anuradha Raj ◽  
Rohit Garg

Background: Few studies have reported the role of antidepressants as cataractogenic in humans.Methods: It’s a hospital based descriptive, cross-sectional study. 45 Patients were screened for antidepressant use and diminution of vision, 6 were dropped out. 39 patients with 78 eyes were finally enrolled. They were divided into two goups i.e., Group-I, with cataract (N=53) and Group-II, without cataract (N=25). Three clusters of antidepressants were assessed e.g., SSRI, SNRI and TCA with therapeutic dose (TD) and non-therapeutic dose (NTD) range. Psychiatric illness was diagnosed on DSM-5 and severity of depression on HAM-D. Best corrected visual acuity (BCVA) was converted from Snellen units to logarithm of minimal angle of resolution (log MAR) for statistical analysis. Cataract changes in eyes were seen on slit-lamp and classified on Lens opacities classification system-III (LOCS-III) criteria.Results: A total 78 eyes of thirty-nine (39) patients were evaluated. Thirty (38.46%) and forty-eight (61.53%) eyes belonged to males and females, respectively. Mean age of males (n=7) was 41.8±2.3 years and females (n=32) 40.2±1.0 years. In Group-I, out of (N=53) eyes that developed cataract 33 were females (62.26%) as compared to males 20 (37.7%). Group -II, out of (N=25) eyes, females without cataract were 15 (60%) as compared to males 10 (40%).  Therapeutic dose (TD) of antidepressants (AD) in Group-I had more cataract 37 (69.81%) as compared to non-therapeutic dose (NTD) 16 (30.1%). Most of the eyes with cataract 35 (66.03%) had AD exposure of more than 1 year that was possibly associated with increased risk of cataract development (OR 2.10; 95% CI, 0.79-5.55). Amongst users of antidepressants, SSRI was associated with increased risk of cataract development (OR 2.4; 95% CI, 0.72–7.94) with a female preponderance (OR 1.1; 95% CI, 0.41–2.91). Maximum number of eyes 34 (64.15%) that developed cataract had BCVA of ≥6/12 and minimum of 2 (3.77%) eyes had BCVA of ≤6/36. LOCS-III revealed 38 (71.69%) eyes (71.69%) having peripheral cortical cataract and 15 (28.30%) posterior sub-capsular cataract.Conclusions: There is a possible risk of association of cataract amongst user of antidepressants. The AD use of more than 1 year or longer had increased risk for development of cataract with a female preponderance. The highest risk was observed in the users of SSRI as compared to SNRI and TCA. Treatment exposure with antidepressant was longer for mild depression having more than two episodes.


2020 ◽  
Vol 14 (03) ◽  
pp. 352-359
Author(s):  
Hamda Shazam ◽  
Fouzia Shaikh ◽  
Zaheer Hussain ◽  
M. Mansoor Majeed ◽  
Saba Khan ◽  
...  

Abstract Objectives The present study aimed to investigate osteocalcin levels in saliva of healthy and periodontitis patients and correlate these levels with periodontitis severity. Materials and Methods This cross-sectional study was conducted in a hospital setup. A total of 95 individuals participated in the study with 46 subjects in group I (healthy individuals) and 49 subjects in group II (mild, moderate, and severe chronic periodontitis patients). A detailed assessment of clinical periodontal parameters and alveolar bone loss was made. Unstimulated saliva samples were collected from all study subjects and osteocalcin levels were quantitatively analyzed by sandwich enzyme-linked immunosorbent essay technique. Statistical Analysis One-way analysis of variance, Spearman’s correlation test, and Pearson’s chi-squared test were applied at a significance level of 95%. p-Values less than 0.05 were considered statistically significant. Results The results showed a significant association of qualification with group II (p < 0.02). Bone loss scores were also significantly associated with periodontitis severity (p < 0.01). However, no statistically significant difference was observed between group I and group II in terms of mean salivary osteocalcin levels (p = 0.68). Also, an insignificant correlation was also observed between osteocalcin levels and periodontitis severity (p = 0.13). Conclusion The overall study results showed that there was no significant difference between saliva osteocalcin levels of healthy and periodontitis patients. Also, there was a nonsignificant correlation between osteocalcin levels and periodontitis severity. The findings of the present study support the hypothesis that low osteocalcin levels in saliva might be considered as a poor indicator of periodontal disease progression and severity.


2020 ◽  
Vol 22 (2) ◽  
pp. 60-65
Author(s):  
Muhammad Ali Azad ◽  
AKM Asaduzzaman ◽  
Mohammad Delwar Hossain ◽  
Faysal Bin Mohsin ◽  
Abdullahis Safi

Introduction: Thyroid surgery is a common modality of treatment for both benign and malignant thyroid disorders.Relationship between inferior thyroid artery (ITA) and recurrent laryngeal nerve (RLN) is crucial in preservation of recurrent laryngeal nerve. Thorough anatomical knowledge and meticulous surgery will ensure the integrity of recurrent laryngeal nerve. Objective: The purpose of this study is to observe the anatomical position of recurrent laryngeal nerve in relation to inferior thyroid artery which will eventually lead to identification of recurrent laryngeal nerve peroperatively. Methods: A cross sectional retrospective study was conducted during the time period of 1st January 2013 to 31st December 2015 in Combined Military Hospital, Dhaka among 200 patients who had undergone thyroidectomy. Results: In this series on the right side 71.8% cases RLN was dorsal to ITA, 21.7% cases it was ventral and in 6.5% cases RLN runs in between the branches of ITA. In case of left side 74.5% cases RLN was dorsal to ITA, 22.5% cases it was ventral and in 3% cases RLN runs in between the branches of ITA. Conclusion: Usually RLN runs dorsal to ITA. In left side it is deeper and in case of right side it is more superficial. RLN may pass through the branches of ITA, but it is not very common. Bangladesh J Otorhinolaryngol; October 2016; 22(2): 60-65


Author(s):  
Kritika Upadhyay ◽  
Archana Dhok ◽  
Arpita Jaiswal

Background: Menarche marks the beginning of the reproductive phase in a woman’s life or the onset of puberty Menarche is said to be early when it begins before the age of 8 years in a girl’s life. Early menarche can turn up into many consequences. This can only be controlled by carefully exploring and analyzing the factors causing early menarche. This study aims to assess the impact of changing lifestyle on age of menarche.Methods: It is a prospective cross-sectional study, included 112 subjects in group I (girls had their menarche at the age of <11 years) and 88 subjects in group II (Girls had their menarche at the age between 12-14 years). A self-made questionnaire was used for collecting the data.Results: It is found that  80.32% girls from group I and 47.73% girls from group II consume junk food daily or 2-3 times per week. 66.07% girls from group I and 51.14% girls from group II play indoor games daily or 2-3 times per week. 52.86% girls from group I and 26.14% girls from group II go to hotel once a week and 57.14% girls from group I and 73.86% girls from group II go to hotel occasionally.Conclusions: Girls who are not much interested in playing outdoor games, more frequently go to hotel, eat more junk food and consume more amount of fats in the daily home-made food have a significant lowering in the age of menarche.


2018 ◽  
Vol 18 (01) ◽  
pp. 51-56
Author(s):  
BEHZAD SOHAIL ◽  
ASJAD SHARIF ◽  
AHMED ADNAN ◽  
Rashid Iqbal ◽  
Umer Zahoor

Objective: To evaluate the role of needle diameter in causing postdural puncture headache (PDPH) in patients undergoing elective caesarian section. Study Design: Comparative cross-sectional study. Place and Duration of Study: This study was conducted in Department of Anaesthesia and Intensive care PNS Shifa Karachi over duration of six months. Patients and Methods: It was a cross sectional study of 100 patients, which were divided into two separate groups. Group I and Group II were given spinal anaesthesia with 25 gauge and 27 gauge Quincke needles respectively. In both the groups the patients were randomly selected and were blind to size of the spinal needle used. Results: The data was analyzed using Chi-square test. A P value of <0.05 was considered statistically significant. Two patients in 25-G group and one in 27-G group required additional general anaesthesia because of inadequate spinal anaesthesia. Thus, a total of three patients were excluded from the study. Five out of forty-eight patients in group 1 and one out of forty-nine patients in Group II suffered from post spinal headache. Conclusions: The proportion of patients with post spinal headache with 25 G needle is significantly more than those with 27 G. 


2019 ◽  
Vol 19 (4) ◽  
pp. 414-420
Author(s):  
Payam Mehrian ◽  
Abtin Doroudinia ◽  
Moghadaseh Shams ◽  
Niloufar Alizadeh

Background: Intrathoracic Lymphadenopathy (ITLN) in Human Immunodeficiency Virus (HIV) infected patients may have various etiologies and prognoses. Etiologies of ITLN can be distinguished based on the distribution of enlarged lymph nodes. Sometimes tuberculosis (TB) is the first sign of underlying HIV infection. Objective: We sought to determine ITLN distribution and associated pulmonary findings in TB/HIV co-infection using Computed Tomography (CT) scan. Methods: In this retrospective, observational, cross-sectional study, chest CT scans of 52 patients with TB/HIV co-infection were assessed for enlarged intrathoracic lymph nodes (>10 mm in short axis diameter), lymphadenopathy (LAP) distribution, calcification, conglomeration, the presence of hypodense center and associated pulmonary abnormalities. LAP distribution was compared in TB/HIV co-infection with isolated TB infection. Results: Mediastinal and/or hilar LAP were seen in 53.8% of TB/HIV co-infection patients. In all cases, LAP was multinational. The most frequent stations were right lower paratracheal and subcarinal stations. Lymph node conglomeration, hypodense center and calcification were noted in 25%, 21.4% and 3.5% of patients, respectively. LAP distribution was the same as that in patients with isolated TB infection except for the right hilar, right upper paratracheal and prevascular stations. All patients with mediastinal and/or hilar adenopathy had associated pulmonary abnormalities. Conclusion: All patients with TB/HIV co-infection and mediastinal and/or hilar adenopathy had associated pulmonary abnormalities. Superior mediastinal lymph nodes were less commonly affected in TB/HIV co-infection than isolated TB.


2021 ◽  
pp. 030157422110221
Author(s):  
Jyoti Mishra ◽  
Sudhir Kapoor ◽  
Jitendra Bhagchandani ◽  
Sonahita Agarwal ◽  
Vaibhav Vashishta ◽  
...  

Aim and Objective: To assess the level of awareness among local adult population (orthodontically untreated) regarding orthodontic treatment and procedures. Materials and Methods: A cross-sectional study was planned by accessing 100 subjects comprising of 2 groups (50 male and 50 female). After due ethical clearance, a self-structured questionnaire consisting of 17 questions was given to a group of randomly selected 100 individuals with an age range of 20 to 30 years. Results: The overall awareness of orthodontics as a speciality among both the groups was only 52% to 56%. Statistically insignificant difference was found in the knowledge and awareness of orthodontic treatment among both male and female subjects, that is, Group I and II. Also, those who knew about the orthodontic treatment did not opt for it because of high cost and longer duration involved. Conclusion: More than half of the population is unaware of the scope of orthodontic treatment, and thus, they do not seek any assistance. Hence, more efforts are needed to create awareness about orthodontics and the associated benefits.


2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Emaduldin Seyam ◽  
Emad Moussa Ibrahim ◽  
Ayman Moheb Youseff ◽  
Eissa M. Khalifa ◽  
Enas Hefzy

Objective. The aim of the current study was to laparoscopically investigate the effects of peritoneal nonclosure on the sites, types, and degrees of adhesions developed after primary caesarean section (CS) in women complaining of secondary infertility after first CS delivery. Study Design. This was a cross-sectional study, where 250 women suffering from secondary infertility after their first CS had been recruited. They had been classified into group I (n = 89), where both the visceral and parietal peritoneum had been left opened; group II (n = 75), where only the parietal peritoneum had been closed; and group III (n = 86), where both peritoneal layers had been closed. Laparoscopy had been used to classify those adhesions according to the location, severity, and their adverse impact on the reproductive capacity. Results. Both adnexal and nonadnexal adhesions had been found significantly higher in group I, while adnexal types of adhesions were significantly higher after nonclosure of the visceral peritoneum in group II. Laparoscopic tubal surgery performed included tubo-ovariolysis, fimbrioplasty, and neosalpingostomy. Pregnancy rate was found correlating with the adnexal adhesion location and score. Conclusion. Nonclosure of the peritoneum in CS is associated with more adhesion formation, which might adversely affect the future women reproduction.


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