Noncompliance with hospital visits for surgical procedures can be predicted from noncompliance with other healthcare encounters. Surgical procedures for previously noncompliant patients should be booked at the end of the operating room day, when the cancellation is least likely to interfere with operating room flow.
Thymic tumors represent 0.2-1.5 % of all malignancies with an incidence of 0.15 per 100,000 population. Thymic tumors are most common tumors of the anterior mediastinum accounting for 20 % of all mediastinal tumors and 50 % of all anterior mediastinal tumors. Over 90 % of all thymic tumors occur in anterior mediastinum, remainder occurring in neck or other mediastinal areas especially aortopulmonary window and retro cardiac area which are common sites for ectopic thymic tissues and possible explanation for failure in some cases of simple thymectomy to improve Myasthenia Gravis(MG). The aim of this review is to discuss histologic classification, diagnostic features, evaluation, management and prognosis of thymic tumors.
Water is a most precious natural resource and vitally important for agricultural development and day-today living. In order to use such a precious natural resource economically, drip irrigation would be a possible solution which minimizes the losses of water and fertilizer as well as increase the yield of crops. The present study was conducted in four panchayat samities (out of six) in Bikaner district of Rajasthan on the basis of highest area and large number of beneficiary farmers under drip irrigation system. From the selected four panchayat samities, a total of 234 respondent farmers having drip irrigation system were selected randomly for the study purpose. The data were collected by personal interview method with the help of interview schedule. The collected data were classified, tabulated and statistically analyzed. The findings revealed that majority of the respondents (64.53%) were in middle age group, belonging to other backward and general caste (85.47%), agriculture work as their main occupation (72.22%), educated can read and write up to primary and middle levels (55.99%), member of one or more organizations (56.84%), having medium land holding
Hypocalcemia is the most common complication after total thyroidectomy. The aim of this study was to determine the predictors of postoperative hypocalcemia requiring augmentation of routine calcium supplementation. Prospectively collected data of 61 patients who underwent total thyroidectomy from December 2018 to June 2019 was considered for the study. All patients received calcium and vitamin D supplementation after the surgery. In the postoperative period, serum calcium and parathormone (PTH) levels were monitored. The need of additional oral or intravenous (i.v.) calcium supplementation was evaluated as an outcome measure. This cohort comprised 61 patients with median age of 46 years (range 16-80 years) and 49 (80%) females. Central compartment clearance (CCC) was done in 32 patients. Escalation to increased oral and intravenous calcium was required in 15 patients (24.6%) and 2 patients (3.3%), respectively. Serum parathormone level of 11.5 pg/ml on postoperative day 1 predicted the requirement of additional calcium with a sensitivity of 82.4% and specificity of 77.3%. On univariate analysis, serum PTH (p < 0.001), CCC (p = 0.018), and intraoperative parathyroid gland congestion (p = 0.021) predicted the need for escalation of calcium supplementation. On multivariate analysis, only serum PTH showed a significant impact on the need for augmentation of calcium supplementation (p = 0.003). The need for calcium dose augmentation after total thyroidectomy was significantly associated with CCC, parathyroid gland congestion, and serum PTH levels. Intraoperative identification of parathyroid gland congestion and postoperative serum PTH levels is effective in predicting postoperative hypocalcemia with implications on time and cost.
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