A Comprehensive Approach to Thyroid Swellings: Clinical, Sonological, Cytological and Histopathological Correlation

ABSTRACT Objectives This study was conducted with the aim of clinicopathological evaluation of thyroid swellings. Setting Tertiary referral centre, Davangere, Karnataka, India. Design Retrospective study. Materials and methods Clinical details, sonological reports, laboratory reports were retrieved from the records for the 110 patients with thyroid swellings who were included in our study, between May 2009 and April 2013 and the data was analyzed. Cytological smears in all patients and histopathology slides in operated patients were retrieved and studied. Results The highest incidence (37.4%) of thyroid swellings were found in age group of 21 to 30 years. The youngest patient being 10 years. Females (90%) predominated in this study, male to female ratio being 1:9. Majority of patients (35%) came with complaints of swelling of duration less than 6 months. Among 110 patients, 36.36% of them were treated conservatively, out of which 7 cases (17.5%) were hyperthyroid, 10 cases (25%) were hypothyroid and 23 cases (57.5%) were euthyroid and the remaining 63.63% of them underwent surgery. Of the 110 patients subjected to FNAC, 16 patients (14.54%) were neoplastic and 94 patients (85.45%) were non-neoplastic. Upon correlation with the histopathology report, the sensitivity of FNAC was 78.57%, specificity was 91.07%, with a positive predictive value of 68.75% and negative predictive value of 94.44%. Diagnostic accuracy of FNAC is 88.50%. Conclusion FNAC and USG are valuable tools in assessing the need for surgical intervention in thyroid swellings. USG guided aspiration will further enhance the cytological yield and diagnostic accuracy. How to cite this article Santosh UP, Sunil Kumar KB, Trupthi MC, Boobalan S. A Comprehensive Approach to Thyroid Swellings: Clinical, Sonological, Cytological and Histopathological Correlation. Int J Otorhinolaryngol Clin 2014;6(1):5-8.

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Ocular Cysticercosis — A Profile

Tropical Doctor ◽

10.1177/004947550303300327 ◽

2003 ◽

Vol 33 (3) ◽

pp. 185-188 ◽

Cited By ~ 9

Author(s):

Anuradha Chowdhary ◽

Rajlakshmi Bansal ◽

Kirti Singh ◽

Varinder Singh

Keyword(s):

Retrospective Study ◽

Medical Treatment ◽

Surgical Excision ◽

North India ◽

Age Group ◽

Common Site ◽

Referral Centre ◽

Tertiary Referral ◽

Tertiary Referral Centre ◽

Ocular Cysticercosis

A retrospective study was conducted on all histopathologically proven cases of ocular cysticercosis spanning a decade in a tertiary referral centre of North India. The symptomatology, presentation, complications and treatment therapies of 18 of these patients are discussed. The most common age group to be affected was 11–20 years (50%), while the most common site involved was subconjunctival (78%), followed by lid (11%). Spontaneous extrusion was documented in three cases. Medical treatment with albendazole under the cover of corticosteroids was found to be a useful adjunct to surgical excision.

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Diagnostic accuracy of urinary protein-to-creatinine ratio in a tertiary referral centre

Archives of Disease in Childhood - Fetal and Neonatal Edition ◽

10.1136/adc.2011.300163.17 ◽

2011 ◽

Vol 96 (Supplement 1) ◽

pp. Fa101-Fa102

Author(s):

S. J. Wang ◽

J. Myers

Keyword(s):

Diagnostic Accuracy ◽

Urinary Protein ◽

Creatinine Ratio ◽

Referral Centre ◽

Tertiary Referral ◽

Tertiary Referral Centre

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AB117. SOH21AS062. Surgical intervention in epistaxis—a retrospective review from a tertiary referral centre

Mesentery and Peritoneum ◽

10.21037/map-21-ab117 ◽

2021 ◽

Vol 5 ◽

pp. AB117-AB117

Author(s):

Lisa Marie O’Byrne ◽

Andreea Maria Nae ◽

Seng Guan Khoo

Keyword(s):

Retrospective Review ◽

Surgical Intervention ◽

Referral Centre ◽

Tertiary Referral ◽

Tertiary Referral Centre

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Growth of Focal Nodular Hyperplasia is Not a Reason for Surgical Intervention, but Patients Should be Referred to a Tertiary Referral Centre

World Journal of Surgery ◽

10.1007/s00268-017-4335-6 ◽

2017 ◽

Vol 42 (5) ◽

pp. 1506-1513 ◽

Cited By ~ 2

Author(s):

Mirelle E. E. Bröker ◽

Anne J. Klompenhouwer ◽

Marcia P. Gaspersz ◽

Annick M. E. Alleleyn ◽

Roy S. Dwarkasing ◽

...

Keyword(s):

Focal Nodular Hyperplasia ◽

Surgical Intervention ◽

Referral Centre ◽

Tertiary Referral ◽

Tertiary Referral Centre ◽

Nodular Hyperplasia

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OP0200 PATIENTS WITH HYPERMOBILITY RELATED DISORDERS HAVE A SIGNIFICANT NUMBER OF ORTHOPAEDIC INTERVENTIONS ON MULTIPLE SITES AND AT A YOUNG AGE: DATA FROM A TERTIARY REFERRAL CENTRE

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.1486 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 125-125

Author(s):

S. Wright ◽

P. Mehta ◽

J. Parry ◽

H. Kazkaz

Keyword(s):

Chronic Pain ◽

Pain Management ◽

Surgical Procedures ◽

Surgical Intervention ◽

Young Age ◽

Genetic Mutations ◽

Referral Centre ◽

Tertiary Referral ◽

Beighton Score ◽

Tertiary Referral Centre

Background:Mechanisms of pain associated with joint hypermobility are poorly understood and include nociceptive pain from structural joint changes along with soft tissue injuries linked to impaired proprioception; central sensitisation associated with chronic pain and muscle weakness alongside deconditioning. Anxiety and depression are also thought to play a role in patients presenting with pain and hypermobility. We have observed an increase in the rate of orthopaedic surgical procedures undertaken in patients attending the hypermobility clinics compared to those attending the general rheumatology and chronic pain clinics. There is limited published data regarding orthopaedic interventions in patients with hypermobility related disorders especially those with confirmed genetic mutations.Objectives:We aimed to evaluate the characteristics of patients in our hypermobility cohort focusing on those who had received prior surgical intervention in order to understand the underlying mechanism behind their presentations.Methods:A retrospective review of medical records was conducted of patients attending a hypermobility clinic at our tertiary referral centre, University College London Hospital, between January 2018 and December 2018.Results:There were 350 patients (300 females, 50 males) with a mean age of 36 years (range 18-71 years). 63% had a diagnosis of Hypermobility Spectrum Disorder or Hypermobility Syndrome and 37% had a type of Ehlers-Danlos Syndromes (EDS) (hypermobile, classical, vascular or other rare type). 46 patients (13%) had documented genetic mutations. 83 patients (24%) had undergone orthopaedic interventions including 9 who had EDS with confirmed genetic mutations. 54% of patients who had surgical intervention were under the age of 40. The total number of surgical procedures in the cohort was 227 (equating to 0.6485 interventions per patient). Of those requiring operative intervention, the average number of interventions per patient was 2.73. One third of patients had surgery on two or more joint groups, including 8 patients (2%) who had surgery in four or more joint groups. Knees (24%) and hips (23%) were the most common sites for operative intervention with 9% having surgery on their shoulders. 29% of pts had significant hypermobility with a Beighton score of 7 and above but there was no correlation between Beighton score and number of surgical procedures. Only 2% of cases were referred from an orthopaedic team thereby excluding a referral bias.Conclusion:Patients with hypermobility related disorders have a significant number of orthopaedic surgical procedures on multiple sites and at a young age, with indication of mechanical pathology playing an important role in their symptoms. The Beighton score does not appear to be a reliable predictor of surgical intervention. This is not surprising given that the score only covers 5 joint areas and excludes common surgical sites such as the hips and shoulders. Early diagnosis and a holistic non-operative approach combining physiotherapy and chronic pain management is essential to reduce the need for multiple surgical procedures.References:[1]Chopra P, Tinkle B, Hamonet C, Brock I, Gompel A, Bulbena A, et al. Pain management in the Ehlers-Danlos syndromes. Am J Med Genet C Semin Med Genet [Internet]. 2017 [cited 2020 Jan 27];175(1):212–9. Available from:http://www.ncbi.nlm.nih.gov/pubmed/28186390[2]Shirley ED, Demaio M, Bodurtha J. Ehlers-danlos syndrome in orthopaedics: etiology, diagnosis, and treatment implications. Sports Health [Internet]. 2012 Sep [cited 2019 Jan 30];4(5):394–403. Available from:http://www.ncbi.nlm.nih.gov/pubmed/23016112Disclosure of Interests:None declared

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The Use of Modified Checklist for Autism in Toddlers (Malay Version) in Differentiating Between Autism Spectrum Disorders and Other Developmental Behavioural Disorders

Malaysian Journal of Paediatrics and Child Health ◽

10.51407/mjpch.v25i1.39 ◽

2019 ◽

Vol 25 (1) ◽

pp. 6-12

Author(s):

Doris Sie Chong Lau ◽

Juriza Ismail ◽

Zarina Latiff ◽

Raja Juanita Raja Lope

Keyword(s):

Screening Tool ◽

Autism Spectrum ◽

Age Group ◽

Behavioural Disorders ◽

Referral Centre ◽

Tertiary Referral ◽

Tertiary Referral Centre ◽

Younger Age ◽

Spectrum Disorders ◽

Child Development Centre

Objective: The present study examined the sensitivity and specificity of M-CHAT-Malay version [M-CHAT(MV)] to discriminate ASD from other developmental-behavioural disorders. Methods: This study was carried out in the Child Development Centre at a tertiary referral centre. Parents of 130 children aged 18–60 months, referred for developmental-behavioural disorders were asked to complete M-CHAT(MV). A child was considered to have ASD if they failed any 3 of the 23 total items or 2 or more of the 6 critical items. Results: Looking at the total items, M-CHAT(MV) has a good sensitivity (88.9%) to differentiate between ASD and other developmental-behavioural disorders, although specificity was only 47.8%. However, the critical items only has sensitivity of 71.4% and specificity of 77.6%. Sensitivity for children aged 49–60 months old was lower (80.0%) compared to those in the younger age group (100.0% and 90.3% for those aged 25-36 months and 37–48 months respectively). Based on the ROC curve, the optimal criteria to detect ASD was failing 1 out of 6 critical items or 3 out of 23 total items. Conclusion: M-CHAT(MV) is a good screening tool in differentiating ASD from other developmental-behavioural disorders although the critical items’ criteria may need to be lowered to improve its sensitivity in selected cohorts.

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EP09.09: The importance of malformation counting method in patients with more malformed organs for the diagnostic accuracy in the tertiary referral centre

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.15606 ◽

2015 ◽

Vol 46 ◽

pp. 215-215

Author(s):

N. Vecek ◽

A. Veček ◽

T. Zupic

Keyword(s):

Diagnostic Accuracy ◽

Counting Method ◽

Referral Centre ◽

Tertiary Referral ◽

Tertiary Referral Centre

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HIRSCHSPRUNG’S DISEASE: OUR INSTITUTIONAL EXPERIENCE

10.36106/ijar/7907605 ◽

2021 ◽

pp. 68-71

Author(s):

Arka Chatterjee ◽

Neeraj Tuteja ◽

Ramesh Chand Tanger ◽

Pradeep Gupta ◽

Arvind Kumar Shukla

Keyword(s):

Hirschsprung's Disease ◽

Hirschsprung’S Disease ◽

Tertiary Care ◽

Abdominal Distension ◽

Western India ◽

Age Group ◽

Referral Centre ◽

Tertiary Referral ◽

Tertiary Referral Centre ◽

Multiple Biopsies

BACKGROUND: Hirschsprung's disease is one of the most important causes of functional intestinal obstruction in the paediatric age group. The clinical characteristics of patients with Hirschsprung's disease at a tertiary referral centre were studied over a 22-month period. Aims and Objectives: To study the demography, including Age, Sex, various clinical presentations, types, segment involved, surgery, complications and survival in patients with Hirschsprung's disease at a tertiary care referral centre in Rajasthan, India. Materials and methods: This was a prospective observational study between October 2018 and June 2020, over 22 months, at tertiary referral centre in North-Western India. Clinical data were tabulated, various presentations of the disease were studied, intra-operative ndings were noted and post-operative course was studied. Results: 82 cases of Hirschsprung disease were admitted, of which 66 were male and 16 were female. Of these, 10 presented in the neonatal age group, 25 during infancy (1 month to 1 year of age) and the rest – 47 patients presented beyond infancy. The commonest symptoms in infants and older children was chronic constipation, whereas delayed passage of meconium, abdominal distension and bilious vomiting were among the common symptoms in neonates. The patients underwent exploratory laparotomy with multiple biopsies and diversion colostomies. 43 patients underwent the denitive procedure. In all the 43 patients, Martin's modication of Duhamel's procedure, was the surgery performed. Complications included persistence of constipation, enterocolitis, and a few cases of anastomotic leak.

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