No abstract

There is no doubt that the success of minimally invasive parathyroidectomy (MIP) has changed the whole treatment of patients with primary hyperparathyroidism, especially the approach towards traditional bilateral neck exploration. A single adenoma is the most common cause of primary hyperparathyroidism and its removal results in cure. Hence, it is worth the effort to localise and excise the single adenoma using modern technologies such as highquality sestamibi scans and to confirm complete excision using rapid intra operative parathormone (IOPTH) assays. The objective of the study was to evaluate the feasibility of rapid IOPTH assay in successfully facilitating minimally invasive parathyroid excision. This research involved the retrospective study of seven patients, who underwent MIP at Sagar Hospital in Bengaluru, India, for parathyroid adenoma. All patients with evidence of unifocal disease on sestamibi scanning and cervical ultrasonography, underwent MIP via 2-3 cm lateral incision. Blood samples for measurement of IOPTH were taken at the time of induction of anaesthesia and 10 min after the adenoma excision. Reduction of parathormone (PTH) levels of more than 50 % in the postexcision sample was taken as evidence for complete extirpation of parathyroid adenoma. A solitary adenoma was identified in all the seven patients. After MIP, IOPTH levels fell in six of the seven patients.Following the surgery, all the cases were followed up for a period of 1 month. During this time, except for one patient, six patients remained asymptomatic and blood tests revealed normal serum calcium levels. A histopathological examination confirmed the diagnosis of parathyroid adenoma in six of the seven patients. After accurate preoperative localisation of the adenoma in patients with primary hyperparathyroidism, MIP with IOPTH measurement offers a safe and successful outcome.

Aim: Psoriasis is associated with a variety of psychological problems including poor self-esteem, sexual dysfunction, anxiety and depressive disorder, suicidal ideation and significant cognitive impairment. The aim of the study is to evaluate the frequency of cognitive impairment in patients with psoriasis. Method: 200 subjects were included for the study. The tools used in the study were Standard Mini-Mental Status Examination (SMMSE) and Brief Cognitive Rating Scale (BCRS) for assessing cognitive functions. The results obtained were analyzed using the Chi-square test and student test. Results: Patients with psoriasis had cognitive deficits in the domain of attention, concentration and total scores of SMMSE and BCRS.

Background: Psoriasis is associated with a variety of psychological problems including poor self-esteem, sexual dysfunction, anxiety and depressive disorder and suicidal ideation. There are reports that patients with psoriasis may have significant psychiatric morbidity. The objective of the study is to evaluate the frequency of psychiatric disorders, frequency and nature of psychiatric symptoms in patients with psoriasis.Methods: 100 patients with psoriasis were evaluated and included for the study. Comprehensive Psychopathological Rating Scale (CPRS) is used for assessment of psychiatric symptoms and MINI Plus for assessing psychiatric disorders. Chi-square test was used to compare the proportions.Results: Patients with psoriasis had high frequency of psychiatric morbidity and was found to be 42%.Conclusions: Patients with psoriasis have more psychopathology and higher psychiatric morbidity which may further imply justifiable consultation liaison psychiatry in other speciality fields like Dermatology.

Introduction: Tuberculous lymphadenitis is one of the common cause of Paediatric lymphadenopathy in India. This study was aimed to assess the usefulness of Fine needle aspiration cytology of lymph nodes as a diagnostic tool in suspected Tuberculosis and to observe the cyto morphological changes for better understanding of immune response. Material and methods: This was a cross sectional observational study conducted between the year 2016 to 2018 at Melmaruvathur tertiary care hospital. Children up to 14 years with suspected Tuberculosis symptoms and chronic lymphadenopathy irrespective of the sizes of nodes were subjected to Fine needle aspiration cytological study. Cyto smears morphology were observed and analysed. Results: A total of 81 cases were studied and the predominant age group affected were between five to ten years (n=46; 56.8%). 42 patients were female (51.9%) and 39 were male (48. 1%).Most of them had cervical nodes and 44% of nodes were less than 1 cm size. Out of 81 cases, 32 (39.5%) were diagnosed as nonspecific adenitis and 46 cases (56.8%) as granulomatous lymphadenitis. Among the size of the nodes, 57% of small nodes, 65% of medium sized nodes and 100% of large nodes showed granulomatous adenitis. Among sexes, female preponderance (63.1%) for granulomatous adenitis and male predominance (62.5%) for nonspecific adenitis were observed. Conclusion: Fine needle aspiration cytological study of paediatric lymphadenopathy is a useful diagnostic indicator in suspected Tuberculosis even for small size nodes and can be recommended if clinically warranted.