BACKGROUNDSubtotal thyroidectomy is the preferred procedure currently done in our institution for multinodular goitre. However, many surgeons prefer near-total thyroidectomy for this condition as the recurrence of Multinodular goitre is less with this procedure. The main advantage of subtotal thyroidectomy is that the post-operative complications like hypothyroidism, hypocalcaemia and recurrent laryngeal nerve palsy are found to be less with this procedure. In this study, we assess the hypothesis that Subtotal thyroidectomy is not associated with increased risk of recurrence as compared to Near-total thyroidectomy and Total thyroidectomy in cases of benign thyroid disease, multinodular goitre. MATERIALS AND METHODSWe conducted a retrospective study among patients who underwent subtotal thyroidectomy in Govt. Medical College, Calicut during a 5-year period from 2008 to 2012. We collected data from the record library and contacted them through letter. A total of 108 patients were included. Then, detailed history taking, physical examination and relevant investigations were done. RESULTSPostoperative USG and FNAC showed 3 cases of recurrence, that is 2.8%. Postoperative functional status shows that 21% remained euthyroid and about 79% were hypothyroid. No cases of hypocalcaemia or recurrent laryngeal nerve palsy were reported. CONCLUSIONThere is no increased risk among these subjects considering recurrence, but had advantage of lesser complications. So it concludes that subtotal thyroidectomy is a better procedure for benign thyroid diseases compared to total thyroidectomy and is not with increased risk of recurrence.
Background: Diabetic patients will develop diabetic foot ulcerations of which 14-20% will go on to amputation. By this study we aimed to investigate the effectiveness of clinical scoring system predicting the outcome of diabetic foot and also to know whether neuropathy or vasculopathy predominated in these patients.Methods: Patients with Type 2 diabetic ulcers are selected, and the ulcer was graded according to Wagner’s grading. The vasculopathy and Neuropathy were assessed by Doppler study and monofilament tests respectively. The patients were grouped based on the grade of ulcer and presence or absence of neuropathy and vasculopathy. These patients were followed up for a duration of 1 year.Results: The patients belonging up to group 6 had better outcome(healing) on conservative management and those in group 8 and group 9 had a bad outcome (amputations). 66% of patients had neuropathy predominance.Conclusions: Even though clinical scoring system could predict the outcome, statistically it is not found to be significant. Neuropathy was the more predominant factor among the patients with diabetic foot.
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