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

Toe salvage procedure for the recurrent chondromyxoid fibroma

The treatment options for recurrent chondromyxoid fibroma of the toe range from total amputation to salvaging a functional toe. There is no globally accepted treatment protocol available for this tumour because of its rarer incidence and lack of population based data. Here we suggest performing a staged approach, which involves en block resection initially and maintenance of metatarsophalangeal space by using a kirshner wire with the bone cement. If there is no sign of malignancy in the histopathology, we recommend performing interposition arthroplasty at the metatarsophalangeal joint with the tricortical iliac crest graft. The kirshner wire should be kept which incorporates the iliac graft and the soft tissue, which is being interposed at the metatarsal head. This will cause pseudoarthrosis and also decreases the chances of having chronic pain. We believe that this staged approach which leads to toe salvage is the best suitable treatment option for the recurrent chondromyxoid fibroma. This will prevent amputation of the toe and will give cosmetic success to the patient

TOE SALVAGE PROCEDURE FOR THE RECURRENT CHONDROMYXOID FIBROMA

The treatment options for recurrent chondromyxoid fibroma of the toe range from total amputation to salvaging a functional toe. There is no globally accepted treatment protocol available for this tumour because of its rarer incidence and lack of population based data. Here we suggest performing a staged approach, which involves en block resection initially and maintenance of metatarsophalangeal space by using a kirshner wire with the bone cement. If there is no sign of malignancy in the histopathology, we recommend performing interposition arthroplasty at the metatarsophalangeal joint with the tricortical iliac crest graft. The kirshner wire should be kept which incorporates the iliac graft and the soft tissue, which is being interposed at the metatarsal head. This will cause pseudoarthrosis and also decreases the chances of having chronic pain. We believe that this staged approach which leads to toe salvage is the best suitable treatment option for the recurrent chondromyxoid fibroma. This will prevent amputation of the toe and will give cosmetic success to the patien

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

The dimensions of the corpus callosum of the cerebrum

AimsTo determine the dimensions of the human corpus callosum and its parts. The objective was also to know its location in the cerebral hemisphere of South Indians. Methods Twenty mid-sagittal sections from formalin fixed human cadaveric brain specimens were used for this study and the parameters recorded were: distances from frontal pole to occipital pole (AB), inferior surface to the superior surface of the brain (CD), frontal pole of brain to genu (AG), occipital pole of cerebrum to corpus callosum splenium (BS), from splenium of corpus callosum to superior colliculus (Ls-SC) and inferior colliculus (Ls-IC), genu to fornix (GF), outer curvature O (G-S) and inner curvature I (G-S) from genu to splenium, the entire outer curvature (OUTCR) and inner curvature (INCUR) from beginning of corpus callosum rostrum to the splenium end. We did also measure the thicknesses of its splenium (S), isthmus (I), body (T), genu (G) and rostrum (R). ResultsStatistical analysis using correlation study showed significance between A-B and B-S, O (G-S) and INCUR, O (G-S) and OUTCR, A-G and R, T and I. Highly significant correlations were found between C-D and Ls-IC, O (G-S) and I (G-S), I (G-S) and G-F, G-F, and G. Very highly significant correlations were seen between I (G-S) and INCUR, Ls-SC, and Ls-IC, T and S. ConclusionThis morphometric study on the corpus callosum provides data that could be valuable in the diagnosis of lesions of the corpus callosum. The data are of particular relevance to neurologists and radiologists

High origin of the deep femoral artery: a case report and literature review Origem alta da artéria femoral profunda: relato de caso e revisão da literatura

Arterial variations of the femoral triangle are rarely reported in the literature. In the present article, we have reported a case of high origin of the deep femoral artery, which was originating just lower to the inguinal ligament. It was also observed that the lateral circumflex femoral artery arose directly from the femoral artery instead from the deep femoral artery. We have discussed the anatomy, embryological basis, and clinical implications of these variations along with relevant literature review. The importance of knowledge about these variations in therapeutic and diagnostic interventions is discussed.<br>Variações arteriais no triângulo femoral têm sido pouco relatadas na literatura. No presente artigo, relatou-se um caso de origem alta da artéria femoral profunda, que estava se originando pouco abaixo do ligamento inguinal. Também foi observado que a artéria femoral circunflexa originava-se diretamente da artéria femoral, ao invés de ser originada da artéria femoral profunda. Discutiu-se sobre anatomia, base embriológica e implicações clínicas dessas variações junto com uma revisão da literatura pertinente. A importância do conhecimento sobre essas variações no quadro das intervenções diagnósticas e terapêuticas é discutida