Analytical study of thyrotoxicosis

Lakshmi Devi, R (2010) Analytical study of thyrotoxicosis. Masters thesis, Tirunelveli Medical College, Tirunelveli.

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Abstract

INTRODUCTION: Thyroid gland was first documented by Italians of the renaissance period. The term Thyroid (Greek – Thyreoeides, shield shaped) is attributed to Thomas warton. Goitre is derived from the Latin word Gutter which means “Throat.” The most notable thyroid surgeons were Emil Theodar Kocher (1841 – 1917) and Theodor Billroth (1829-1894). Emil Theodor Kocher of Berne is regarded by many as “Father of Thyroid Surgery”. In 1909, Kocher received the nobel prize for Medicine in recognition for his works on physiology, pathology & surgery of thyroid gland. Bernard Courtois discovered iodine in the ash of burnt sea weed. The first accounts of thyroid surgery dates back to Roger frugardi in 1170. Thyrotoxicosis is a syndrome which is caused by excessive secretion of Thyroid hormones. Hyperthyroidism is hyperfunctioning of thyroid with elevated levels of thyroid hormones. AIM OF STUDY: 1. Review the data regarding prevalence of thyrotoxicosis and its association with standard variables. 2. Discuss the various clinical presentations of thyrotoxicosis. 3. Discussion of etiopathogenesis in Thyrotoxicosis. 4. Discussion of various treatment Modalities. 5. Evaluate a cost effective treatment for a country like ours. 6. Discuss the complication of treatment and follow up. MATERIALS AND METHODS: This is a prospective study of randomly selected patients who presented with hyperthyroid symptoms, of toxic goitre who were diagnosed and treated at Dept. of General surgery TVMCH during the period of June 2007 to November 2009. Each patient’s symptoms and signs were entered in proforma with detailed clinical examination in relation to thyroid. All the patients were subjected to basic investigations like Complete haemogram, Blood – Urea, sugar, creatinine, chest x-ray. Thyroid profile, x-ray neck and ECG were taken for the cases. Radio-Isotope study was not done since facilities are not available in our hospital. Since RI ablation therapy is not available in our hospital, our patients were treated with either Antithyroid drugs or surgery. Surgery was the modality of treatment offered to all the patients. Out of 50 cases surgery was done for only 45 cases and for remaining 5 Cases surgery was deferred due to various reasons and these patients were treated with Antithyroid drugs only. The 45 Patients who were planned for surgery were put on antithyroid drugs as part of pre-op preparations to euthyroid state and to prevent thyrotoxic crisis. They were monitored by daily sleeping pulse chart, periodic weight monitoring and by symptomatic improval. Surgery was done after bringing the patient to euthyroid state pre operatively with antithyroid drugs. CONCLUSION: In this study, a comprehensive account of History, anatomy, physiology, with a detailed account of clinico-pathological aspects, presentations and various modalities of treatment of thyrotoxicosis have been dealt with 50 cases of thyrotoxicosis. From the evidence it is clear that after adequate control of toxicity with anit-thyroid drugs, surgery is the modality of treatment that can be safely offered to patients with thyrotoxicosis in our hospital. This present study confirms the observation made by the reputed authors and emphasize the importance of perfect and sufficient pre operative preparation, meticulous surgical technique, detailed knowledge about anatomy of thyroid, parathyroid and associated nerves to assure complete remission with negligible morbidity and nil mortality.

Item Type: Thesis (Masters)
Uncontrolled Keywords: thyrotoxicosis, Analytical study.
Subjects: MEDICAL > General Surgery
Depositing User: Devi S
Date Deposited: 09 Jun 2018 17:21
Last Modified: 13 Jan 2020 14:17
URI: http://repository-tnmgrmu.ac.in/id/eprint/8355

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