Introduction: Thyroid swellings/goiter are still prevalent in north east part of India. Apart from its sub-Himalayan location the areas along the river Brahmaputra suffer from flooding every year and there is also frequent changing of river course, thought to be another reason for iodine depletion in soil of this region(3). Aim: To determine the incidence of thyroid swellings and distribution among different sections of society and geographical areas, and to evaluate the role of FNAC in the diagnosis and management and find out its accuracy by comparing with histopathology. Materials and methods: In the present study, total 212 patients with thyroid swellings attending department of ENT of a state medical college during the period from January 2013 to December 2015 and undergone FNAC at department of Pathology were taken into consideration. Results: Out of 212 cases major fraction (52.83%) were hailed from areas along the Brahmaputra river followed by patients (33.96%) from tea gardens and adjacent areas. Patients belonging to tribal communities constituted 45.28%, whereas patients from tea workers section of society formed the second majority (34.9%). Female male ratio of cases was 5:1. Majority of patients were from 21-40 years age group with mean age of 37.2 years. Cytology results of 212 cases showed colloid goiter 73.58%, adenomatous goiter 8.49%, thyroiditis 9.9%, hurthle cell neoplasm 1.41%, follicular neoplasm 4.24%, papillary carcinoma 1.41%, papillary carcinoma of follicular variant 0.47% and medullary carcinoma in 0.47% cases. Histopathology was possible in 65 cases and compared with FNAC results with accuracy rate of 89.23%. Conclusion: Frequent flooding and changes of river course may be one of the reasons for high prevalence of thyroid swellings and goiter along the Brahmaputra valley apart from its sub-Himalayan location. Consumption polluted drinking water and goitergenous food stuffs may be another reason of high incidence. FNAC is an easy, rapid, reliable, less invasive, low cost technique for diagnosis of thyroid swellings.
Introduction Haemangiomas are common presentation in head and neck, prevalence being 60% followed by 25% and 15% respectively in trunk and limbs. This report studies the efficacy of Polidocanol as sclerosant in the treatment of heamangiomas in head and neck. Materials and Methods The two year prospective study conducted from January 2015 to December 2016 with Polidocanol as sclerosant on 55 patients attending the department of ENT. Intralesional injections of 3 % polidocanol were given at 2 week intervals. Results Out of 55 patients 15 cases did not follow up after the first dose, so results were calculated out of 40 patients. 12 patients showed complete regression & 15 showed regression to half the size. Thus 67.5 % patients showed acceptable results. There were no side effects except hyperpigmentation in 2 patients. There were no cases of recurrence during our study period. Conclusion Sclerotherapy is a promising method of treatment for haemangiomas of head and neck that may obviate the need for surgical intervention.
Introduction Steroid therapy is considered to be the gold standard for sudden sensorineural hearing loss (SSNHL). Delivering steroids by intratympanic injection is more efficient than systemic injections with minimum or no side effects. The present study was aimed to evaluate the efficacy and safety of intratympanic methylprednisolone injections as initial first line therapy for unilateral idiopathic SSNHL and the ease of giving it by otoendoscopy. Materials and Methods A prospective analysis was performed for the patients diagnosed as unilateral idiopathic SSNHL from April 2014 to April 2016 and receiving intratympanic steroids injections as first line therapy. Patients with unilateral sensorineural hearing loss of at least 30 dB at 3 contiguous frequencies occurring within a period of not more than 3 days are only included. All of the intratympanic steroid (ITS) injections were administered as OPD procedures. Each patient was treated by 3 injections given at 3 days interval. Results A total of 22 patients who underwent primary intratympanic steroid (ITS) injection for unilateral SSNHL during the study period were included in the study. The mean age was 42.22 years (+ 9.79) and age ranged from 27 to 68 years. Patients included in our study came within 2nd to 27th day of occurrence of deafness and the mean duration (days) from onset of disease to start of ITS was 7.86 days. The average hearing gain in our study was 44.22 dB. In the present study 11 patients (50%) showed complete hearing improvement and 10 cases (45.45%) had partial and one (4.54%) showed no hearing recovery at 3 weeks follow up period. Conclusion Minimal systemic absorption with minimum or no systemic effects and high percentage of success rate encouraged the surgeons to prefer ITS as primary therapy for idiopathic unilateral SSNHL. It is effective, cheap, well-tolerated and can be performed as OPD procedure.
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