GMC Hospital

Introduction The Fine Needle Aspiration Cytology (FNAC) is a simple, safe, cost-effective minimally invasive procedure for diagnosing thyroid nodules/swelling. Clinicians usually evaluate thyroid function by estimating T3, T4 and TSH level for therapeutic planning. In this study the importance of FNAC in the diagnosis of thyroid diseases was evaluated and FNAC findings were correlated with clinical features and thyroid profile. Materials and Methods The study was designed as prospective cross-sectional hospital based (laboratory investigation) study for 2 months duration (from 17th July, 2017 to 16th September, 2017). Fifty cases of thyroid swelling attending Pathology Department for FNAC were included in the study. For Each case thyroid profile was done. Result Total 50 patients of thyroid swelling were included in the study, out of which 46 were female (92%) and 4 were male (8%). Male to female ratio was 1:12.5. Mean age was 45.44 ±16.02 years. Out of 50 patients 35 (70%) had diffuse thyroid swelling, 9 (18%) had left lobe and 6 (12%) had right lobe involvement. All the 50 patients with thyroid lesion had a common complaint of neck swelling. Some had associated dysphagia (12 cases, 24%) and/ or dyspnoea (6 cases, 12%), and only 2 had hoarseness of voice. Among 38 cases of non-neoplastic lesions colloid goitre was the commonest comprising 20 cases (52.63%), followed by 11 cases ( 28.95%) lymphocytic thyroiditis, 4 cases (10.53%) of granulomatous thyroiditis and 3 cases (7.89%) of follicular hyperplasia. Among 12 cases of neoplastic lesions papillary carcinoma was the commonest consisting of 7 cases (58.33%), followed by follicular neoplasm (4 cases, 33.33%) and 1 case of Hurthle cell neoplasm. Most of the colloid goitre cases were euthyroid (60%), lymphocytic thyroiditis was commonly associated with hypothyroidism (45.5% cases), and most cases of granulomatous thyroiditis were euthyroid (50%). All the patients with follicular hyperplasia had hyperthyroidism. Most of the cases with papillary carcinoma were in euthyroid (3 of 7, 42.86%) and followed by subclinical hypothyroid state (2cases, 28.57%) and one case of each hypothyroidism and subclinical hyperthyroidism. Follicular neoplasm was commonly associated with euthyroid state (75% cases). One case of Hurthle cell neoplasm had hyperthyroidism. Conclusion Thyroid gland being superficial, it is easy to perform fine needle aspiration. Similar thyroid disease shows variable hormone profile in different patient and different stages of the disease. Hence, FNAC of thyroid lesions in conjunction thyroid hormonal analysis helps in proper assessment and management of patients with thyroid lesion.

Introduction/BackgroundTo evaluate the infra-millimetric resectability rate using the two approaches, the morbidity- mortality rate and the overall survival curves without recurrence.MethodologyFrom January 2015 to December 2017, 82 patients with ovarian cancer classified stage IIIC by FIGO (International Federation of Gynecologists and Obstetricians), were treated in the oncological surgery department of the CPMC (Center Pierre et Marie Curie), randomized into two groups. First group (G1) including patients who underwent primary debulking surgery and group 2 (G2), patients who underwent primary chemotherapy with platinum salt followed by cytoreductive surgery (interval surgery).The anatomo-clinical aspect, the histological type, the intraoperative finding, the procedures performed, the results after surgery, the morbidity and mortality and the survival curves were analysed prospectively.ResultsThe mean age of patients in G1 was 50.05 years (30–80) and in G2 55.90 years (23–80), the majority of patients were classified ASA I in both groups (51, 2%), the mean body mass index (BMI) was 29.16 in the G1 and 27.29 in the G2, the most frequent histological type was serous carcinoma in both groups (69.5%) of patients. The main procedure performed is a total hysterectomy, bilateral adnexectomy, infra colic or infra gastric omentectomy, pelvic and lumbar aortic dissection and resection of any macroscopically visible lesion.In some cases, an associated procedure has been performed such as digestive resection, cholecystectomy, peritonectomy, caudal pancreatectomy. Rate of actions performed in G1: 65.8%; G2: 34.1%. Rate of R0 obtained (41.4%) or 51.5% in G1 and 48.4% in G2. The operative morbidity was 20.7% with a rate of 14.6% in G1 and 6% in G2.ConclusionComplete cytoreductive surgery has become a fundamental principle in surgery for peritoneal carcinomatosis. The gold standard for treating advanced ovarian cancer is complete surgery combined with chemotherapy with platinum salt. The sequence of treatment is still debated, but primary surgery seems to be preferred in terms of recurrence-free survival and overall survival when complete resection (R0) is obtained.DisclosuresPr Chemseddine CHEKMAN: I declare that I have no conflict of interest.Dr Fatiha GOUAREF: I declare that I have no conflict of interest.Pr Kamel BENTABAK: I declare that I have no conflict of interest.Pr Fatiha HADJARRAB: I declare that I have no conflict of interest.Pr Kamel BOUZID: I declare that I have no conflict of interest.

The Journal of Anesthesia & Intensive Care Medicine (JAICM) is a globally accepted journal that aims to publish innovative scientific developments and high quality information on anesthesia and intensive care medicine.

Vital pulp therapy has been known as one of the treatment options to preserve pulp after being exposed by trauma or caries. The procedure of pulp capping relies primarily on the ability of pulpal tissue to heal. A wide array of materials has been used for pulp capping. The aim of this article is to summarize and discuss various pulp capping materials.

This one-year prospective study was carried out at a tertiary care hospital in Ludhiana, Punjab, on patients visiting antenatal OPD (Outpatient Department) in the third trimester with clinical suspicion of IUGR (Intrauterine Growth Retardation) by using high resolution Doppler ultrasound scanner, Model EUB-450, Hitachi. The objective of this study was to evaluate the role of ultrasound in detection of intrauterine growth retardation and to assess and compare different parameters in order to determine best ultrasonic parameter to assess IUGR. The patients included were studied under two groups: Test group of patients suspected to have IUGR on obstetrical examination (n=75) and control group of 148 subjects showing signs of normal foetal development, i.e. not suspected to have IUGR clinically. Four parameters were taken into account namely the Abdominal Circumference (AC), ratio of AC and head circumference (HC:AC), ratio of AC and femur length (FL:AC) and umbilical artery systolic to diastolic ratio (S:D). The sensitivity of ultrasound in detecting IUGR was 86.9%. Umbilical artery flow velocimetry correctly identified 24 of 46 IUGR infants, but on no occasion did this technique detect IUGR, otherwise missed by real time sonography. The sensitivity and specificity of all the four parameters can be summarized as: AC -82.6% and 89.6%, HC: AC -50% and 86.2%, FL:AC -47.8% and 82.7% and umbilical artery S:D ratio -52.1% and 93.1%. Five patients showed absent diastolic flow and three patients showed reversal of diastolic flow. None of the fetus survived in whom there was reversal of flow. We conclude that sonography is a safe, reliable, non-invasive tool in assessment and management of suspected IUGR at or beyond 32 weeks of gestation for obstetrician and the neonatologist.

A full-term male neonate was initially managed for respiratory distress which developed few hours after birth. His initial chest radiograph was normal, and blood culture revealed Group B streptococcal (GBS) sepsis. He subsequently developed progressive right chest opacification that did not improve with medical management. Imaging done few days later revealed right-sided diaphragmatic hernia. The 12-day-old neonate underwent primary repair of the diaphragmatic defect and had an uneventful recovery. This case report intends to highlight this unique association between early onset GBS sepsis and delayed onset of the right congenital diaphragmatic hernia.

Enteric fever is widely prevalent in the tropics. Central nervous system involvement is not rare and reported incidence varies from 5% to 35% [1]. Various well-known neuropsychiatric manifestations include confusional state, encephalopathy, meningism, convulsions and focal neurological deficits. Acute cerebellar ataxia as an isolated neurological complication of enteric fever is very rare and limited to only a few case reports [2]. Here we report a case of enteric fever who presents Acute Cerebellar Ataxia.