scholarly journals Patterns of Surgically Treated Thyroid Disease: A Two Years Review at St. Paul Hospital Millennium medical Collage, Addis Ababa, Ethiopia

1970 ◽  
Vol 30 (1) ◽  
Author(s):  
Yisihak Suga ◽  
Engida Abebe
Keyword(s):  
Thyroid Disease ◽  
Medical Records ◽  
Addis Ababa ◽  
Endocrine System ◽  
Nodular Goiter ◽  
Follicular Neoplasm ◽  
Medical College ◽  
Common Diagnosis ◽  
Diffuse Goiter ◽  
The Common

BACKGROUND: Thyroid disease is a common disorder of the endocrine system worldwide. It is a common problem in developing countries, including Ethiopia. The aim of this study was to determine the burden and the pattern of thyroid disease in St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia.METHODS: A retrospective review of patients’ medical records over a two-year period, January 2013-december 2014, was done. OR log books, and individual patient medical records was used for the review. Data was analyzed with SPSS version 20.RESULTS: A total of 2201 general surgical operations were done in a two-year period. Of these, 250(11%) were for thyroid surgery. Records of 222(88.8%) patients were found and used for analysis. Females accounted for 91.4% with F: M ratio of 10.7:1. The common mode of presentations were anterior neck swelling (91.4%) and toxic (29.7%) and pressure symptoms(19.4%). The common physical findings identified were multi nodular goiter (57.2%), diffuse goiter (23.9%) and solitary nodule (5.8%). FNAC showed that Nodular colloid goiter was common diagnosis (68.5%). Neoplasms accounted for 15.9% of the diagnosis; of this follicular neoplasm make (54%) and papillary cancer (20%). Functionally, hyperthyroid goiter 28.8% and euthyroid goiters (64 %). Transient hypocalcaemia (3.2%) and hoarseness of voice (1.8%) were the commonest complications. There was no postoperative mortality.CONCLUSION: Hyperthyroidism and neoplasms make significant proportions of the patients. Follicular neoplasm is the commonest tumor. Morbidity and mortality rates are comparable to the literature. 

scholarly journals Ectopic pregnancy managed medically at St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia

2021 ◽  
Vol 14 (3) ◽  
pp. 85-88
Author(s):  
Jok Thikuiy Gang ◽  
Sisay Kirba Kea ◽  
Samson Gebremedhin
Keyword(s):  
Ectopic Pregnancy ◽  
Medical Records ◽  
Selection Criteria ◽  
Surgical Intervention ◽  
Addis Ababa ◽  
Safe Alternative ◽  
Medical College ◽  
Endometrial Cavity ◽  
Emergency Surgical Intervention ◽  
Ectopic Pregnancies

Background: Ectopic pregnancy, a pregnancy in which the embryo implants outside the endometrial cavity, is an important cause of maternal mortality, especially in developing countries. It can be managed medically using methotrexate. In Ethiopia, limited evidence exists regarding the treatment outcome of this approach.Methods: This retrospective study was conducted based on medical records of ectopic pregnancies managed medically using methotrexate. The data of women who had unruptured ectopic pregnancy and who were managed medically in the study period at St. Paul’s Hospital Millennium Medical College were included. Data were extracted from patients’ medical records and analysed using SPSS software.Results: During the 5-year period 2015 to 2019, 81 women with unruptured ectopic pregnancy were managed medically using methotrexate with 93.8% (n=76) success. Methotrexate was administered intramuscularly to all patients in either single dose or multiple doses. Five out of the 81 patients underwent surgical intervention for either ectopic rupture or persistent ectopic mass. There were no fatal complications.Conclusion: Methotrexate is a successful and safe alternative to surgical management of unruptured ectopic pregnancy in our settings. It should be given a trial in patients who meet the selection criteria in a setting ready for emergency surgical intervention and blood transfusions.

scholarly journals Magnitude of Abdominal Wound Dehiscence and Associated Factors of Patients Who Underwent Abdominal Operation at St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Berhanetsehay Teklewold ◽  
Dut Pioth ◽  
Tadele Dana
Keyword(s):  
Medical Records ◽  
Addis Ababa ◽  
Age Groups ◽  
Wound Dehiscence ◽  
Complete Healing ◽  
Sub Saharan Africa ◽  
Abdominal Wound ◽  
Related Factors ◽  
Medical College ◽  
Abdominal Wound Dehiscence

Background. Abdominal wound dehiscence (AWD) is the separation of different layers of an abdominal wound before complete healing has taken place. It is a major cause of postoperative morbidity and mortality in sub-Saharan Africa including Ethiopia, and little is known about its prevalence and related factors in the study area. Objectives. The aim of this study is to assess the magnitude of abdominal wound dehiscence and related factors on patients operated at St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia. Methods. A hospital-based retrospective review of the chart was carried out by using the data covering three years (September 2014–September 2017) period. Data were collected from hospital medical records of sampled patients such as operation room logbooks and individual patient medical records. The collected data were checked for consistency, coded, and entered into SPSS version 20 for data processing and analysis. Descriptive analysis was conducted, and tables and graphs and summary statistics were used to depict data. Results. A total of 41 patients developed abdominal wound dehiscence from among 4137 patients who underwent abdominal laparotomy in the hospital. Among the patients, 51.2% were in the age range of 41 and above with mean age 29.8 (SD = 1.21) and 70.7% of them were male. Abdominal wound dehiscence was more common in emergency patients (90%) and vertical incision was the most common type of incision. Over half (58.5%) of the wound dehiscence occurred within 6–10 postoperative days. The majority (95.2%) of dehisced patients underwent relaparotomy for the management of the wound dehiscence, and 48.8% of them were treated with tension suture during the second operation of abdominal closure. Four of the patients (9.7%) died after the management of the second operation. Conclusion. The current study revealed that the overall magnitude of abdominal wound dehiscence in the study area was 0.99%. Most of the dehiscence has occurred in male patients, and older age groups were highly affected than the younger ones. Emergency admission is the most common form of admission identified in the study, and this signifies appropriate preoperative preparation of patients for an optimal outcome. However, regarding the management outcome, 9.8% of patients died in our study within the institution after the second operation which is the high mortality rate.

scholarly journals THYROID MALIGNANCY IN MULTI NODULAR GOITER;

2013 ◽  
Vol 20 (04) ◽  
pp. 587-590
Author(s):  
KASHIF NADEEM ◽  
NAVEED AKHTAR ◽  
JAVED MIRDAD TARAR
Keyword(s):  
Retrospective Study ◽  
General Surgery ◽  
Thyroid Disease ◽  
Multinodular Goiter ◽  
Nodular Goiter ◽  
Benign Disease ◽  
Thyroid Malignancy ◽  
Medical College ◽  
History Of ◽  
Suspicious Nodule

Objectives: To assess the incidence of malignancy in patients with Multinodular goiter in southern Punjab. Study design:A retrospective study. Place & Duration of study: Department of General Surgery, Sheikh Zayed Medical College & Hospital Rahim YarKhan, from April 2010 to May 2012. Patients and Methods: All patients were presented in OPD with history of Multinodular goiter onclinical examination or USG neck. FNAC of any dominant nodule or suspicious nodule on USG neck was performed. All patients wereoperated & total thyroidectomies were done in all patients irrespective of the age. We sent all specimens for histopathological examinationand reports were collected from department. The whole information collected was entered in a pre designed proforma. Results: During 2years period, total 141 patients of thyroid disease were seen in OPD out of which 98 patients have Multinodular goiter. Histopathology ofthese patients showed 10 malignancies & 88 benign. Most of the patients that turned out to be malignant belong to 41-50 years agegroup. 7 patients were female and 3 were male. Among the malignancies 50% were papillary, 30% were follicular, and 10% wereanaplastic carcinoma & lymphomas each. Conclusions: Multinodular goiter (MNG) is the commonest indication of thyroidectomy iniodine deficient areas of Pakistan. This study concludes that don’t consider MNG as a benign disease anymore until proved otherwise.

scholarly journals Prevalence of nodular goiter in patients with breast diseases

2020 ◽  
Vol 5 (2) ◽  
pp. 91-95
Author(s):  
Gurushantappa Yalagachin ◽  
◽  
Nishanth Lakshmikantha ◽  
Sanjay B. Mashal ◽  
◽  
...  
Keyword(s):  
Thyroid Disease ◽  
Nodular Goiter ◽  
Breast Disease ◽  
Thyroid Diseases ◽  
Breast Diseases ◽  
Benign Breast Diseases ◽  
Thyroid Screening ◽  
Diffuse Goiter ◽  
Malignant Breast ◽  
Thyroid Profile

Introduction. Various studies have reported conflicting results regarding the relationship between breast and thyroid diseases. The exact pathogenesis behind this association is not clear. The aim of this study was to determine the prevalence of thyroid disease in patients presenting with breast diseases and to examine whether thyroid screening is required in patients with breast diseases. Methodology. All patients attending the department of General Surgery in our institution with breast diseases during the period from December 2015 to September 2017 were enrolled for the study. A thorough clinical examination which included an examination of the neck was done. Thyroid profile and ultrasonography neck were performed in all patients and the pathology in all radiologically diagnosed cases of nodular goiter was confirmed by cytology. Results. We had 128 patients with breast diseases enrolled in the study of which 62 (48%) patients had malignant breast disease and 66 (52%) patients had benign breast disease. None of the patients in our study had a palpable thyroid nodule or a diffuse goiter. Of the 61 patients having malignant breast diseases, 26 (42.6%) patients had a radiologically detected thyroid disease and among the 64 patients with benign breast diseases, 10 (15.6%) had radiologically detected thyroid diseases. Conclusions. In our study the prevalence of nodular goiter was higher in patients with malignant breast diseases than patients with benign breast diseases. However, this prevalence or clinical relevance is not significant enough to warrant screening for thyroid disease in patients with breast diseases.

scholarly journals Heterogenous Morphologic forms of Goiter in Autoimmune thyroid disease: An Insight based on a Prospective Surgical series of 88 cases

2014 ◽  
Vol 6 (2) ◽  
pp. 71-76
Author(s):  
Bhargav PRK
Keyword(s):  
Prospective Study ◽  
Thyroid Disease ◽  
Autoimmune Thyroid Disease ◽  
Ex Vivo ◽  
Nodular Goiter ◽  
Endocrine Surgery ◽  
Autoimmune Thyroid ◽  
Diffuse Goiter ◽  
A Prospective Study ◽  
Surgery Department

ABSTRACT Two commonest forms of autoimmune thyroid disease (AITD) are Graves' disease (GD) and Hashimoto's thyroiditis (HT) with a diffuse goiter. The nature of goiter apart from clinical presentation is crucial in the management of AITD. But, the goiter is not always diffuse, leading to diagnostic confusion. In this context, we conducted a prospective study on the goiter morphology in AITD. This is a prospective study conducted in Endocrine Surgery department of a teritiary care teaching hospital in South India over a period of 1 year. The cohort is a surgical series of 88 cases of AITD (GD = 53; HT = 35). Morphology of all the ex vivo specimens were studied, documented and correlated with clinical and radiological forms of goiter. Sex ratio was M:F = 74:14. Mean age for GD = 30.7 years (17-46) and HT = 38.2 years (31-52). In GD, the morphology was diffuse = 34; Unilateral hyperplasia (ULH) = 9; atrophic = 4; nodular = 5 and Marine Lenhart syndrome = 1. In HT, diffuse = 16; ULH = 10 and nodular goiter = 9. The correlation between the radiology and goitrous morphology was statistically significant and more concordant than clinico-morphological correlation. Autoimmune thyroid disease has heterogenous goitrous forms. Macroscopic morphological evaluation of goiter complements the clinicoradiological-pathological diagnosis of AITD leading to optimal diagnosis, counseling, follow-up. How to cite this article Bhargav PRK. Heterogenous Morphologic forms of Goiter in Autoimmune thyroid disease: An Insight based on a Prospective Surgical series of 88 cases. World J Endoc Surg 2014;6(2):71-76.

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

2000 ◽  
Vol 39 (05) ◽  
pp. 133-138 ◽  
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.

Side Effects of Chemotherapy and Cancer Treatment in Tertiary Care Teaching Hospital

2016 ◽  
Vol 2 (1) ◽  
pp. 62-78
Author(s):  
. Hemraj ◽  
Raj Kumar ◽  
Sourabh Kosey ◽  
Amit Sharma ◽  
Nalini Negi
Keyword(s):  
Side Effects ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Informational Needs ◽  
Cross Sectional ◽  
Clinical Pharmacists ◽  
Medical College ◽  
Related Information ◽  
The Common ◽  
Chemotherapy Patients

To determine the most common physical side effects experienced by local chemotherapy patients. Their perceptions of these side effects and informational needs from clinical pharmacists were also evaluated. This was a single center, observational cross-sectional study conducted at department of General Surgery, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab. A face to face interview was conducted. Information collected included chemotherapy related side effects after last chemotherapy experience, the most worrisome side effects, overlooked by healthcare professionals and the preferred method, amount and source of receiving related information. In this study, hundred patients were enrolled out of them 48 were male and 52 were female. When differential calculations was done, common side effects or adverse effects of chemotherapy in the patients of breast, lung cancer, Ovarian Cancer, Colon cancer, Prostate cancer, Lymphoma Cancer, Cervix cancer where there is much irregular medicine intake 57.4% may be due to common problem of joint pain reported by all the patients under study, with the consecutive problem of nausea and vomiting. The high prevalence of chemotherapy related side effects among local patients is a major concern and findings of their perceptions and informational needs may serve as a valuable guide for clinical pharmacists and physicians to help in side effect management. This study shows the common problems reported by the patients when they are suffering from cancer condition, according to their incidence perceptions as experienced by the patient, this will allow the physician and clinical pharmacist to effectively counsel and manage the common symptoms as reported prior to its occurrence in the patient, so that withdrawal can be checked.

Comparison of Heffner Criteria and Light Criteria in Differentiating Exudative and Transudative Pleural Effusion

2020 ◽  
Vol 22 (3) ◽  
pp. 141-145
Author(s):  
Krishna Chandra Devkota ◽  
S Hamal ◽  
PP Panta
Keyword(s):  
Pleural Effusion ◽  
Cross Sectional Study ◽  
Pleural Space ◽  
Sectional Study ◽  
Inclusion Criteria ◽  
Cross Sectional ◽  
Medical College ◽  
The Common ◽  
The Mean ◽  
Exudative Pleural Effusion

Pleural effusion is present when there is >15ml of fluid is accumulated in the pleural space. It can be divided into two types; exudative and transudative pleural effusion. Tuberculosis and parapneumonic effusion are the common cause of exudative pleural effusion whereas heart failure accounts for most of the cases of transudative pleural effusion. This study was a hospital based cross sectional study performed at Nepal Medical College during the period of January 2016-December 2016. A total of 50 patients who fulfilled the inclusion criteria were enrolled. Pleural effusion was confirmed by clinical examination and radiology. After confirmation of pleural effusion, pleural fluid was aspirated and was analysed for protein, LDH, cholesterol. The Heffner criteria was compared with Light criteria to classify exudative or transudative pleural effusion. Among 50 patients, 30 were male and 20 were female. The mean age of patient was 45.4±21.85 years. The sensitivity and specificity of using Light criteria to detect the two type of pleural effusion was 100% and 90.9%, whereas using Heffner criteria was 94.87%, 100% respectively(P<0.01). There are variety of causes for development of pleural effusion and no one criteria is definite to differentiate between exudative or transudative effusion. In this study Light criteria was more sensitive whereas Heffner criteria was more specific to classify exudative pleural effusion. Hence a combination of criteria might be useful in case where there is difficulty to identify the cause of pleural effusion.

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