Background: Incidental parathyroidectomy with subsequent hypoparathyroidism and postoperative hypocalcemia is thought to be one of the common complications of thyroidectomy. Current literature reports wide discrepancy in incidence and risk factors.Objectives: The aim of our study was to evaluate the incidence and risk factors of incidental parathyroidectomy in thyroid surgery.Methods: A retrospective study included 270 patients who had thyroid surgery that was performed over two years from January 2017 to December 2018 in two tertiary care hospitals. Preoperative and postoperative records were assessed. Factors such as gender, diagnosis, type of surgery, and usage of surgical loupes during the procedure were evaluated and were compared to find the association with incidental parathyroidectomy in thyroid surgery.Results: Incidental parathyroidectomy was noticed in 62 (23%) surgical specimens during histopathologic examination. There was no significant association between incidental parathyroidectomy and sex of patient, use of surgical loupes, pathology of thyroid disease, or neck dissection.Conclusion: Although the risk of incidental parathyroidectomy is inevitable, careful dissection and meticulous intraoperative identification of parathyroid gland during thyroidectomy can reduce the incidence of incidental parathyroidectomy, thereby minimizing the risk of postoperative hypoparathyroidism and hypocalcemia.

ObjectiveAnticonvulsants are increasingly being used in the symptomatic management of several neuropathic pain disorders. The present observational study was designed to evaluate the efficacy, tolerability, and quality of life (QoL) of carbamazepine use for 12 weeks in patients with painful diabetic neuropathy, in Pakistan.MethodsThis was a 12-week, multicenter, open-label, uncontrolled trial in adult type 2 diabetic patients (aged 18–65 years) suffering from clinically confirmed neuropathic pain (Douleur Neuropathique en 4 [DN4] score ≥4). Change in neuropathic pain at week 12 compared with baseline was assessed using the Brief Pain Inventory Scale–Short Form (pain severity score and pain interference score). QoL was determined by the American Chronic Pain Association QoL scale. Safety was assessed based on patient reported adverse events (AEs) and serious AEs.ResultsOf the total 500 screened patients, 452 enrolled and completed the study. The mean (± standard deviation [SD]) pain interference score decreased from 4.5±2.0 at baseline to 3.1±1.9 at week 12 (P<0.001). The mean (± SD) pain severity score decreased from 5.8±2.0 at baseline to 3.6±2.2 at week 12 (P<0.001). There was a decrease of ≥30% in the pain severity score between visits. The mean (± SD) QoL scale score improved from 5.9±1.6 at baseline to 8.0±1.7 at week 12. A total of ten (2.2%) patients reported AEs during the study period. No patient discontinued the study due to AEs.ConclusionIn this real-life experience study, carbamazepine, when prescribed for 12 weeks to adult diabetic patients suffering from neuropathic pain, showed pain-relief effect, with reduced mean pain severity and mean pain interference scores and with improved QoL and good tolerability profile.

Background: Nodular goitre is prevalent in adult population. Usually it is multinodular goitre but a discrete swelling has to be evaluated for risk of neoplasia. Special dilemma is for diagnosis of follicular adenomas and follicular carcinomas. Objective: To investigate solitary thyroid nodule and its association with malignancy. Materials and Methods: This prospective study of 145 patients from January 2015 to December 2016, carried out in referral hospital of Saudi Arabia. Only those cases with solitary thyroid nodule were included in the study and then incidence of malignancy evaluated. Sex incidence, age groups along with routine investigations followed by ultrasonography and FNAC carried out in all patients. Thyroid function tests were mandatory before subjecting patients for treatment. Results: Predominantly (68%) solitary nodule was found in Right lobe of thyroid gland in comparison to left lobe (25%) and in isthmus (07%). Out of these 145 patients, 88.27% were benign while 8.3% malignant and 3.45% were suspicious. Suspicious turned out to be 2.1% benign and 1.4% malignant on biopsy. Nodular goitre (65%) dominated in benign group, followed by Hashimoto’s thyroiditis (3%). In neoplastic group, follicular carcinoma (52%) took top slot and papillary neoplasm (23%) on second place. Female to male ratio was 4:1. Age range was from 19 years to 64 years. FNAC was main stay of investigation along with ultrasound neck. Conclusion: A significant percentage of malignancy is present in solitary thyroid nodule. So its early diagnosis and proper treatment should be ultimate goal to reduce the mortality of the disease.

No abstract