BACKGROUNDThe main post-operative complications of thyroidectomy are temporary hypocalcaemia (20%), permanent hypocalcaemia (4%), transient vocal cord palsy (1-2%) and permanent vocal cord palsy (0.5-1%). These complications are less with experienced surgeons using capsular dissection technique. The technique of capsular dissection can be done with the conventional technique or using other energy sources. Our study aims to find the outcome of capsular dissection using monopolar cautery. We wanted to study the outcome of capsular dissection technique, using monopolar cautery, during thyroid surgery, with regard to complications, bleeding and time taken for the procedure. METHODSThis is a retrospective study conducted in the Department of Surgery, Government Medical College, Thrissur. Details of patients undergoing thyroidectomy by capsular dissection technique, using monopolar cautery, during the period 2012 to 2015 were collected. Collected data was subjected to statistical analysis with the help of SPSS Ver. 21.0. Basic statistical methods like percentage analysis is used for analysis of data. RESULTS115 patients who underwent thyroidectomy for varying indications during the period and satisfying the inclusion criteria were included in the study. All patients were operated under general anaesthesia. All surgeries were done by the same surgeon, by capsular dissection technique using monopolar cautery. Average time duration was 79 minutes for total and 60 minutes for hemi-thyroidectomy. Blood loss was less than 30 ml. in all patients. There was no mortality. Overall complication rate was 5.2%. Transient hypocalcaemia was 3.4%, temporary hoarseness was 2.2% and wound haematoma was 0.8%. CONCLUSIONSCapsular dissection using monopolar cautery in thyroidectomy is safe and effective. This technique is less time consuming, causes only minimal bleeding and has lower complication rate.
BACKGROUND Gastric perforation is a common surgical emergency. Majority is due to benign ulcers, but rarely it may be cancer perforation. Usually it is on the anterior surface of the stomach. Only rarely we get perforation on the posterior surface. Pre-pyloric area is a common location of stomach perforation. Surgical options like primary closure or omental patch repair are favoured in the literature as these options carry good results as well as low mortality in an emergency setting. Traditionally it is said that gastric perforation carries high incidence of malignancy so should either be resected or at least a biopsy is essential before closure. The objectives of this study were-1. To identify the most common location of gastric perforations. 2. To identify the total incidence of malignancy. 3. To determine the rate of malignancy in different locations. 4. To evaluate the need for intraoperative biopsy. 5. To identify the best treatment options for these patients. MATERIALS AND METHODS This is a retrospective cohort study. Patients operated for gastric perforations during the period 2013-2016 were identified and details collected from data base. The collected data was subjected to statistical analysis with the help of SPSS Version 21.0. RESULTS Results of the analysis are presented in the form of tables and graphs. CONCLUSION Most common location of gastric perforation is pre-pyloric region. Incidence of malignancy is less in pre-pyloric perforation (1.3%). Malignancy incidence is more in other locations in stomach (24%). Intra operative biopsy is essential, since malignant perforation was detected in all locations, especially in locations other than pre-pyloric region of stomach. Gastrectomy in the setting of perforated stomach carries high mortality.
Periodontitis is a chronic inflammatory disease, highly prevalent almost around 10-15% of adults. Periodontitis is a group of chronic, progressive bacterial infections causing inflammation and destruction of supporting structures of teeth and has multiple factors affecting the quality of an individual's life. Diabetes is also a chronic inflammatory disease. Both diseases share a common platform in disease pathogenesis, a periodontal abscess is the sixth complication of diabetes, and there is clear evidence showing the relationship between periodontitis and diabetes Overall no clear evidence and studies which correlate diabetes and periodontal parameters. This study aims to compare blood sugar levels with demographic data age, gender and to assess the association between periodontal severity with diabetic status. Results: Periodontal severity was found to be greater in both male and female with diabetic Mellitus. 39 out of 52 subjects have generalized chronic periodontitis, and 13 was found to have localized chronic periodontitis. The age group of (50-70) years had high severity of clinical attachment loss. No significant difference between male and female on periodontal severity was found. Conclusion: This study concludes the age group of 50-60 years more prevalent among diabetes with periodontitis. The male is more affected by diabetes and periodontitis. The association between periodontal severity (CAL, PD) increases with an increase in blood sugar level was statistically significant.
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