Background:In the preoperative decision-making of the thyroid swellings, fine needle aspiration cytology (FNAC) is becoming an ever more vital tool.Objectives:To compare the advantage of preoperative FNAC of thyroid swellings with postoperative histopathology to reach a consensus protocol as a simple procedure for diagnosis and optimal management of thyroid swellings.Materials and Methods:A prospective study of preoperative FNAC was carried out on 178 incidental thyroid swellings attending a tertiary care centre in Kishanganj, Bihar. Evidence-based surgical interventions were done, irrespective of FNAC findings and diagnosis was confirmed by histopathological examination (HPE) postoperatively in all the cases.Results:In the FNAC, preponderance of the cases (75.84%) was colloid goitre followed by granulomatous thyroiditis; follicular carcinoma was noted in 7.30 percent and anaplastic carcinoma in 3.37 percent of cases. Histopathological examination showed colloid goitre predominantly (76.97%), followed by follicular carcinoma (8.99%). The overall prevalence of malignancy was 11.24 percent diagnosed by HPE and 9.55 percent by FNAC. In our FNAC series sensitivity of was 90 percent while specificity was 100 percent; accuracy was 98.88 percent. Predictive value of a positive test and negative tests was 100 percent and 98.75 percent respectively.Conclusion:The study highlights that FNAC should be treated as a first-line diagnostic test for thyroid swellings to guide the management though this is not a substitute for HPE as a need to improve primary healthcare in India.

Foreign bodies are a common occurrence in children that may be either accidental or self-induced as a matter of habit. Various materials have been reported as foreign bodies like metal, plastic toy parts, food matters, etc. Button batteries have been reported as foreign bodies in the nose and are especially relevant, due to their early chemical disintegration in contact with mucosal surface; hence, need emergency surgical intervention to avoid complications like septal necrosis and perforation. Here, we report four cases of button batteries in the nose at various stages of presentation with their sequelae along with a review of literature.

The clinical efficacy of glycopyrrolate, a synthetic anticholinergic drug, for premedication was compared in a double-blind study with that of atropine or hyoscine in patients anaesthetized with diethyl ether. The antisialogogue actions of the three drugs were similar. Glycopyrrolate produced less tachycardia, pyrexia and blurred vision than atropine, and its sedative effect was less than that of hyoscine.

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