Thyroidectomy Related Complications in Post-Thyroid Lobectomy (Unilateral) in Addition to Thyroid Isthmusectomy

Objective: To identify thyroidectomy related complications in post-thyroid lobectomy (unilateral) in addition to isthmusectomy. Study Design: Cross-sectional study Place and Duration: Department of ENT, Islamic International Medical College, Islamabad from 1st April 2019 to 31st March 2020. Methods: Sixty patients were enrolled. These patients were those who have to undergo complete thyroidectomy post unilateral-thyroid lobectomy in addition to isthmusectomy. The age pf the patients was 16-72 years. Each patient’s demographic, clinical as well as surgical details were recorded and calcium tests were run. Results: There were 34 females and 26 males in this study. The mean age of the enrolled patients was 41.12±5.9 years. The mean BMI calculated of the patients was 25.4±2.5 kg/m2. Hypocalcaemia (transient) was identified 10% whereas 3.3% got seroma and 1.6% each suffered from transient voice hoarseness and hematoma in neck. Conclusion: Transient hypocalcaemia is the most frequent complication followed with seroma and hematoma. Keywords: Completion Thyroidectomy, Thyroid lobectomy, Thyroidectomy

Reliability study of Visual Infusion Phlebitis Score Portuguese European version

Phlebitis is the most frequent complication associated with the use of Short Peripheral Catheters. The Visual Infusion Phlebitis Scale is a tool used to access the catheter insertions site and surrounding area, providing a score. The goal of this study was to translate and culturally adapt the VIP scale to European Portuguese in order to achieve a reliability score. Intra and inter-observer reliability studies were performed. The study was conducted at one Portuguese Hospital in a sample of 23 participants. The reliability score was assessed using Kendall's Tau = 0.925, Spearman's Rho = 0.926 and Cohen Kappa = 0.918.

A multidisciplinary approach to the management of inflammatory bowel diseases: surgical complications — how not to miss by therapist

The article deals with a condition that is complex for diagnostic search — inflammatory bowel diseases (IBD). Frequent complication of IBD by acute surgical manifestations, the possibility of the onset of diseases from surgical lesions determines the practical need for physicians to be aware of the management of IBD with complicated pathology. The article presents a clinical case — the complication of ulcerative colitis by multiple colonic perforations, which were not detected in time. The diagnostic search allowed us to find out intraoperatively the causes of acute surgical manifestations, to diagnose complications, and the prescribed ade­quate postoperative treatment stabilized the patient’s state.

AB0442 CLINICAL FEATURES OF POLYMYOSITIS AND DERMATOMYOSITIS PATIENTS WITH SEVERE DYSPHAGIA

Background:Polymyositis (PM) and dermatomyositis (DM) are autoimmune inflammatory diseases characterized by proximal myositis. Dysphagia has been reported to develop in 35 to 62% of PM/DM patients and known as poor prognosis factor.Objectives:The purpose of this study is to determine the clinical characteristics of PM/DM patients who present with deglutition disorder.Methods:Consecutive patients with PM/DM who visited National Hospital Organization Tokyo Medical Center between April 2010 and January 2021 are included in this study. We compared clinical features between the patients with and without dysphagia. The diagnosis of dysphagia was based on videofluorography swallow study, and dysphagia requiring gastrostomy was defined as severe dysphagia. The clinical characteristics compared in this study were following: age of onset, levels of serum creatine kinase (CK) and lactate dehydrogenase(LDH), sense of dysphagia, manual muscle test (MMT) score, and complication of malignancy or interstitial pneumonia.Results:A total of 73 patients with PM/DM were identified. Among them, 12 patients were diagnosed with dysphagia, and 5 patients developed severe dysphagia. Patients with dysphagia had the following characteristics compared to patients without dysphagia: higher levels of serum LDH (833.7 ± 500.1 U/L vs 471.9 ± 321.0 U/L, p = 0.0088), higher levels of serum CK at initial examination (6070.3 ± 7184.8 IU/L vs 1534.7 ± 2978.8 IU/L, p = 0.0086) and more frequent sense of dysphagia (90.9% vs 10.6%, p< 0.0001), lower MMT score(3.18 ± 1.07 vs 4.31 ± 0.75, p = 0.0017). In addition to those, patients with severe dysphagia presented older age of onset (mean age 69.4 ± 12.0 vs 51.7 ± 14.8, p = 0.014), more frequent complication of malignancy (80.0% vs 14.8%, p= 0.0048) and less frequent complication of interstitial pneumonia (0.0% vs 55.5%, p= 0.023).Conclusion:These results indicate that dysphagia develops frequently in PM/DM patients with higher levels of serum LDH or CK, sense of dysphagia and low MMT score. Among them, patients with elderly onset or malignancy are at risk for sever dysphagia, and should be treated carefully.Disclosure of Interests:None declared.

A Central Role for Ischemia and OCTA Metrics to Follow DR Progression

Diabetic retinopathy (DR) is a frequent complication of diabetes and through its vision-threatening complications, i [...]

Frequency of Positive PCR test and Complications in Nasopharyngeal Swabs of Suspected Patients and Contacts of COVID-19 Tested at Allied Hospital Faisalabad

Background: COVID-19 is a severe respiratory disease, started in China. For diagnosis, we need swabs from different regions of respiratory tract. Nasopharyngeal swab is the preferred method. Rt-PCR for Corona virus is the gold standard lab test for diagnosis. Objective: To determine frequency of positive PCR tests and complications in total number of nasopharyngeal samples taken at ENT department of Allied Hospital, Faisalabad Pakistan. Study Design: Descriptive cross-sectional study. Settings: ENT department, Allied Hospital, Faisalabad Pakistan. Duration: 1st May 2020 to 31st August 2020. Methodology: Nasopharyngeal swabs of suspected cases, their contacts, and healthcare workers were taken at ENT department of Allied Hospital. All samples were sent to BSL-LAB. The complication related to procedure were also noted. The result was labelled as detected and non-detected. Results: Total sample taken were 2909 out of which 627 (22%) cases were positive for Corona virus while 2282 (78%) were negative. Pain was most frequent complication (68%) followed by blood staining of swab (31%) and epistaxis (1%). Conclusion: Frequency of positive corona virus case presenting to allied Hospital is 22%. Nasopharyngeal swabs are a safe and effective method of sampling in suspected Corona Virus cases. Pain during the procedure is the most frequent complication.

A new simple endoscopic incision therapy for refractory benign oesophageal anastomotic stricture

Oesophageal anastomotic stricture is a frequent complication after esophagectomy. In most cases, endoscopic bougination or balloon dilation usually resolves anastomotic stricture. However, some refractory oesophageal strictures remain difficult to treat and cause significant morbidity. Recently, successful treatment using endoscopic incisional therapy has been reported in several cases. We report a case of refractory benign oesophageal anastomotic stricture after oesophagectomy. A 72-year-old man underwent three consecutive bouginations. However, he developed progressive stricture. Stricture was successfully treated with an endoscopic knife incision. We performed only three incisions without a cutting method, which was new compared with previous reports. A new simple endoscopic incision technique is effective and safe for stricture management. In conclusion, endoscopic incisional therapy may be recommended as a salvage treatment for properly selected patients with refractory benign stricture who do not respond to conventional therapy.