Safety and Effectiveness of Total Thyroidectomy and Its Comparison with Subtotal Thyroidectomy and Other Thyroid Surgeries: A Systematic Review

Diseases associated with the thyroid gland are one of the most frequently seen endocrine disorders across the globe. Total thyroidectomy is currently the preferred treatment for many thyroid diseases. Controversies exist among surgeons regarding safety of total thyroidectomy due to the risk associated with it like postoperative hypoparathyroidism or recurrent laryngeal nerve damage. Since, in the recent years, the incidence of thyroidectomy is in increasing trend in south Indian population, this review aims to study the available data regarding the appropriateness and safety of total thyroidectomy and compares it with subtotal thyroidectomy and other thyroid surgeries. This is a retrospective comprehensive review of various articles and publications regarding total and partial thyroidectomy performed across the world. Many retrospective studies and few prospective studies suggest that the incidence of transient hypocalcemia is higher after total thyroidectomy than after subtotal thyroidectomy, but the incidence of other complications including recurrent laryngeal nerve palsy and postoperative hematoma is not significantly different between the two procedures. Hence in our review we found that total thyroidectomy is safe and cost effective with low complication rates and provides little significant advantage of being safer procedure compared to subtotal thyroidectomy

Histo-morphometric Analysis of an Idiopathic 'Kink' in the Transverse Colon

Presence of kinked transverse colon is not a very common phenomenon. Its presence may not cause physiological disturbance. However, at times when it requires endoscopy, the abrupt looped course of the transverse colon might set a risk of entrapment of the device, which in turn might lead to severe complications and undue discomfort to the patient. An idiopathic kink in the transverse colon of an adult male cadaver was noted and its morphometric and histopathological analysis was performed. The exact location and gross morphometric measurements of the kinks in the transverse colon was recorded. Small pieces of the colon at the regions of kinks were removed, processed, and stained with Haemetoxylin and Eosin, Alcian Blue- Periodic Acid Schiff (PAS) stain and Masson Trichrome stain for histopathological examination. Transverse colon presented with an abrupt loop towards its splenic end by the presence of proximal and distal kinks. Histopathological features of the mucosa at the areas of kink showed foci of surface erosions composed of parallelly placed tubular glands lined by columnar cells, interspersed by goblet cells. Submucosa was oedematous with few congested vessels. Presence of such unusual kink and the loop together may be the cause for forceful forward push of the device introduced into it during colonoscopy and might result in the damage of its mucosa

Additional circular intercostal space created by bifurcation of the left 3rd rib and its costal cartilage: a case report

Abstract Introduction In the thorax there are normally 11 pairs of intercostal spaces: the spaces between adjacent ribs. The intercostal spaces contain intercostal muscles, intercostal nerves and vessels. Case presentation During a routine dissection for undergraduate medical students, we observed a variation involving the left 3rd rib and 3rd costal cartilage in the cadaver of a man of Indian ethnicity aged about 65 years. The left 3rd rib and its costal cartilage were bifurcated at their costochondral junction enclosing a small circular additional intercostal space. Muscle tissue covered by deep fascia was present in this circular intercostal space. The muscle in the circular intercostal space received its nerve supply from a branch of the 2nd intercostal nerve. Conclusions Knowledge of such variations is helpful to surgeons operating on the anterior thoracic wall involving ribs and intercostal spaces. Knowing the possibility of the presence of an additional space between normal intercostal spaces can guide a surgeon through to a successful surgery.</p

Measurement of Stress-Strain Response of A Rammed Earth Prism In Compression Using Fiber Bragg Grating Sensors

A comparative study of strain response and mechanical properties of rammed earth prisms, has been made using Fiber Bragg Grating (FBG) sensors (optical) and clip-on extensometer (electro-mechanical). The aim of this study is to address the merits and demerits of traditional extensometer vis-à-vis FBG sensor; a uni-axial compression test has been performed on a rammed earth prism to validate its structural properties from the stress - strain curves obtained by two different methods of measurement. An array of FBG sensors on a single fiber with varying Bragg wavelengths (..B), has been used to spatially resolve the strains along the height of the specimen. It is interesting to note from the obtained stress-strain curves that the initial tangent modulus obtained using the FBG sensor is lower compared to that obtained using clip-on extensometer. The results also indicate that the strains measured by both FBG and extensometer sensor follow the same trend and both the sensors register the maximum strain value at the same time

Bilateral Vascular Variations at the Renal Hilum: A Case Report

Imaging technology with its advancement in the field of urology is the boon for the patients who require minimally invasive approaches for various kidney disorders. These approaches require a precise knowledge of the normal and variant anatomy of vascular structures at the hilum of the kidney in terms of their pattern of arrangement and division. The present paper describes a bilateral anomalous arrangement of the structures at the renal hilum as well as their peculiar branching pattern which is of clinical and surgical relevance. Multiple branching of the renal vessels was observed in both kidneys due to which the hila were congested. The right renal artery immediately after its origin divided into 2 branches. The upper branch represented an aberrant artery whereas the lower branch gave 5 divisions. The left renal artery also divided into 2 branches much before the hilum as anterior and posterior divisions. The anterior branch took an arched course and gave 6 branches. The posterior branch gave 3 terminal branches before entering the renal substance. In addition to anomalous hilar structures, normal architecture of both kidneys was altered and the hilum of the left kidney was found on its anterior surface

Unusually Looped and Muzzled Branches of Right Coronary Artery

Coronary artery disease (CAD) is the major cause of death in developed countries as it accounts on an average for 1 of every 5 deaths. Morphological variations of coronary arterial system is one of the causative factor for CAD. Anatomical knowledge of all possible variant patterns of coronary arterial system is imperative in the diagnostic and therapeutic approach of CAD. We report here a rare branching pattern of right coronary artery (RCA). The origin of RCA was normal but the course and branching pattern of it were atypical. RCA was not occupying its usual position in atrioventricular (coronary) sulcus and its course was incomplete. It gave a ventricular branch to right ventricle, which presented an unusual looping pattern. It terminated as right marginal artery following its muzzled appearance within the musculature of the ventricle

A Study to Assess the Barriers And Facilitators of Blood Donation Among University Students Of South India

Introduction: Donated blood is very crucial and life-saving for those who require large volumes of blood in any medical emergency. Many blood donation camps are routinely organized to fill this void of demand and supply. In a university campus associated with a hospital, it is important that student volunteers should contribute towards the increase in demand for blood during times of crisis. This makes it imperative to understand their perception of this noble cause. Methods: A descriptive cross-sectional study was conducted among 354 volunteers of a university campus using convenience sampling. The primary outcome was to assess the factors that influence voluntary blood donation among the volunteers. The adjusted association was performed using logistic regression. R Console was used for statistical analysis. Odds ratios and p-value &lt; 0.05 with 95% confidence intervals were calculated to determine the level of significance. Results: A total of 354 responses were received and analysed. Among these, 38.98%, (n=138) participants had donated blood at least once. Factors that were significantly associated with blood donation were gender, being a member of an NGO, frequency of volunteering activities, fear of needles, and belief that they would acquire the disease during blood donation. Conclusion: The majority of the participants had good knowledge of blood donation, but their attitude and practice did not fall along the same lines. The study also highlighted that attitude towards donating blood is high among the participants who are associated with the NGOs or participate in voluntary activities. Voluntary work induces a ‘sense of giving something to the society which appears to be facilitating factor and an effective measure to encourage blood donation among youth

Scholars Journal of Medical Case Reports ISSN 2347-9507 (Print) Incomplete duplicated (bifid) left ureter -A case report

Abstract: The ureter is subjected to natural variation such as duplication. The partial duplication forming bifidity is one of its rare congenital anomalies. We report here a case of unilateral left bifid ureter encountered during cadaveric dissection. The bifidity in the present case was at its greater extent and in the form of Y shaped with superior and inferior segments. Proximally, both the segments arose from the renal hilum. At pelvic brim, superior segment crossed the inferior segment superficially from medial to lateral. Both the segments united in the lesser pelvis at the level of bifurcation of internal iliac artery, about 1.5 inches above its opening into urinary bladder. Bifid ureter may be associated with the renal stones and other pathological conditions like gonadal dysgenesis. Knowledge of bifid ureter with the extent of bifidity is important during diagnostic approaches of associated disorders. Since the ureter is closely related to neighbouring vessels and organs, its detailed anatomy is essential in surgical and radiological interventional approaches

Inhabitation of an accessory renal artery in a cratered hilum of a malrotated kidney

Structural variations of the kidney and its abnormal vascular architecture make the kidney unsuitable for transplantation. We report here a case of malrotated left kidney with cratered hilum and presence of an accessory renal artery. A lumbar vein was seen to loop under the accessory renal artery on the way of its termination into the left renal vein. The kidney appeared to have failed to rotate from its fetal position. Thus, the hilum was placed ventrally. The hilum was crater-like in shape, wide, and allowed passage of the hilar structures. The shape of the kidney itself had undergone slight modification as it appeared more ovoid than its typical bean shape. The poles, but not the surface or borders were distinguishable. The variations described in the current observation are of a unique pattern of congenital malformation having surgical, urological, and radiological implications