Background: Goitre includes a heterogenous group of tumours that show considerate variability in histological appearance and biological behavior.1 As thyroid malignancy presents as any other benign condition of thyroid in its early stages, success in treatment of this condition lies largely upon early diagnosis and appropriate management. Hence this study was done to evaluate the prevalence of thyroid malignancy in goiter, their modes of presentation and the incidence of various pathological types.Methods: A hospital-based cross-sectional study involving 275 patients was conducted. Data about the patient's age, sex, clinical presentations and duration of symptoms were collected using a proforma. The functional status of the patient was assessed with thyroid function tests. Anatomy of the gland was assessed by ultrasonogram. Ultrasound guided FNAC was done to assess the cytology. Histopathological evaluation of the thyroidectomy specimen was done.Results: The prevalence of thyroid malignancy was found to be 18.1% with a female preponderance of 94%. The age of presentation was noted to be predominantly between 3rd and 5th decade with a mean age of 42.95 years. Female- male ratio was 15:1. Swelling in front of the neck was the predominant clinical presentation in 82% of patients. Among the thyroid malignancies papillary carcinoma was found to be the commonest malignancy with incidence of 90%.Conclusions: Thyroid malignancy is the commonest endocrine malignancy. Our study revealed a significant prevalence of thyroid malignancy among patients presenting with goiter between 3rd and 5th decade with a female preponderance.

Background: Thyroid cancers are on the rise all over the world. Studies have shown a tripling incidence of thyroid cancer in the United States in the past 35 years. Similar studies from Korea have also shown similar trends of 15 times increase in incidence. This study aims at assessing the recent trends in clinical presentation of thyroid malignancy and the efficacy of ultrasound targeted fine needle aspiration cytology (FNAC) in the diagnosis of thyroid malignancy.Methods: A cross sectional study was conducted involving 275 patients with thyroid disorders treated in the department of General Surgery at Dr. Somervell Memorial CSI Medical College, Trivandrum, India. Chi-square test was done for statistical test of significance and odds ratio for strength of association.Results: In this study group, 89% of the patients presented with swelling in front of the neck as chief complaint both in benign and malignancy. Swelling in front of the neck is the predominant symptom in thyroid malignancy. 52% of patients presented with the described symptoms of more than 6 months duration. The specificity of USG guided FNAC is 90% in diagnosing malignancy in goitre in this study group.Conclusions: The commonest symptom of thyroid malignancy was a painless swelling in the front of the neck. Most common thyroid pathology presenting as thyroid swelling was multinodular goitre. Nearly half of the patients presenting with symptoms more than 6 months had thyroid malignancy. FNAC under ultrasound guidance is an inexpensive accurate and practical investigation for evaluation of thyroid carcinomas.

Background: The usual multiport conventional laparoscopic surgeries (appendicectomy) are now being replaced by single incision laparoscopic surgeries (appendicectomy).In our study various aspects of SILS in comparison with the multiport conventional laparoscopic appendicectomy such as incision site pain, duration of surgery, morbidity and instruments used are discussed, duration of surgery, morbidity and instruments used are discussed.Methods: A single blinded randomized control trial was done on patients presenting with acute appendicitis. Pain numerical scale, use of analgesics, time to return to routine activities, hospital re-admission, complication like port site infection, hernia, intra operative complications rates, conversion rates and duration of surgery were evaluated. Various statistics of pain and other parameters are studied and evaluated. The mean operation time, mean recovery time, post-operative pain were statistically analysed using unpaired t-test. Results: Mean operating time was 44.16 minutes for SILS and 26.88 minutes for laparoscopic appendicectomy. The mean operative pain in scale of 1 to 4 was 1.40 and 0.40 for SILS and for laparoscopic appendicenctomy respectively making SILS more pain free and comfortable for the patient. The mean post-operative recovery time was 3.12 days for SILS and 7.88 days for laparoscopic appendicenctomy giving SILS patients more rapid recovery and resumption of work.  Conclusions: SILS offers better cosmetic outcome, lesser post-operative pain and shorter duration of hospital stay compared to classical 3 port conventional laparoscopic surgery but at the expense of time. Operative difficulties along with time constraint need to be overcome by the surgeon.