Open Access Editorial

Open Access Original Research Article

Total and Near-total Thyroidectomy is Better Than Subtotal Thyroidecomy for the Treatment of Bilateral Bening Multinodular Goiter; A Prospective Analysis

Salman Yousuf Guraya FRCS, Abdu Hassan Al-Zobydi

Journal of Advances in Medicine and Medical Research, Page 1-6
DOI: 10.9734/BJMMR/2011/156

Objective: To analyze the safety and effectiveness of total thyroidectomy in the surgical management of bilateral benign multinodular goiter. Materials and Methods: A prospective review of patients with bilateral benign multinodular goiter undergoing subtotal thyroidectomy (Group 1), and near-total thyroidectomy and total thyroidectomy (Group 2) during 5-year period was undertaken. Patients’ demographics, indications for surgery, type of operation performed, final histological diagnosis and complications were recorded. Transient and permanent complications regarding hypoparathyroidism and recurrent laryngeal nerve paralysis were analyzed for each surgical procedure. Results: Out of a total of 207 patients, recurrence of benign multinodular goiter was recorded in 27 (30%) cases in group 1 while there was no recurrence in group 2 (p < 0.01). Completion thyroidectomies were performed in 31 (34%) patients in group 1 whereas none was required in group 2 (p < 0.01). Incidental thyroid malignancy was found to be 18% (n= 38/207) in this study which necessitated completion thyroidectomy in group 1 patients. Permanent hypoparathyroidism was documented in 4(4%) and 3(1.8%) and transient hypoparathyroidism in 5 (6%) and 4 (2.8%) cases in groups 1 and 2, respectively; p value not significant. Permanent hypoparathyroidism and transient RLN palsy were recorded in 9 (29%) and 8 (25%) patients, respectively in those patients who underwent second thyroid surgery (P < 0.05).  Conclusion: Total or near-total thyroidectomy is effective and safe for the surgical treatment of bilateral multinodular goiter to prevent recurrence and to eliminate the need for completion thyroidectomy in case of final diagnosis of incidental thyroid malignancy.

Open Access Original Research Article

Risk Factors of Viral Hepatitis B among Egyptian Blood Donors

H. I. Awadalla, M. H. Ragab, M. A. Osman, N. A. Nassar

Journal of Advances in Medicine and Medical Research, Page 7-13
DOI: 10.9734/BJMMR/2011/127

Background: Surveillance of infectious disease markers in the blood donor population is important in recognizing trends in prevalence and incidence of transfusion related infections in asymptomatic volunteer blood donors. Subjects & Methods: It is a community base cross sectional study. Subjects of study are volunteers to donate blood. Samples were collected from blood donors and questionnaire was designed to collect the risk factors data. The prevalence of hepatitis B surface antigen (HBsAg) among 1,000 apparently healthy blood donors was determined. Objective: To estimate the prevalence of virus B hepatic infection and to illustrate the various socio-economic, demographic and medical factors related to infection with HBV among apparently healthy individuals. Results: The prevalence rate of HBV was 5%. Conclusion: This study provides comprehensive and reliable information on the possible risk factors affecting spread of Hepatitis B.

Open Access Original Research Article

Effect of Combined Leaf Extracts of Vernonia amygdalina (Bitter Leaf) and Gongronema latifolium (Utazi) on the Pancreatic β-Cells of Streptozotocin-Induced Diabetic Rats

Mfon I. Akpaso, Item J. Atangwho, Amabe Akpantah, Victor A. Fischer, Anozeng O. Igiri, Patrick E. Ebong

Journal of Advances in Medicine and Medical Research, Page 24-34
DOI: 10.9734/BJMMR/2011/215

The study evaluated the effect of combined extracts of Vernonia amygdalina (VA) and Gongronema latifolium (GL) on the pancreas of streptozotocin (STZ) induced diabetic Wistar rats. Thirty-two (32) albino rats were divided equally into 4 groups. Groups A and B which served as normal (NC) and diabetic (DC) controls respectively, received placebo treatment. The diabetic test groups C and D were respectively treated with combined extracts of VA and GL (200mg/kg b. w., p. o.) and insulin, (humulin 5 IU/kg, s.c.) for 28 days. Thereafter, the animals were sacrificed and blood and pancreas were collected for serum glucose and histological evaluation, respectively. Changes in animal weight were also measured within the period. From the results it was revealed that both the combined extracts and humulin significantly increased the animals’ body weight (p<0.05) from -10.5% reduction in the DC, to 7.6% and 8.9% respectively. In the same order, serum glucose significantly decreased (p<0.05) by 12.49% and 14.96% after the 28-day treatment compared to DC. The extent of reversal of hyperglycemia in the extract treated animals compared well with the insulin treated group. The biochemical results were corroborated with results of histological evaluations: The pancreatic β-cells of DC animals which were distorted and degenerated with shrunken cell mass as against prominent islet cells with normal exocrine pancreas of NC animals became rapidly proliferated upon intervention with the combined extracts, suggesting a possible regeneration of the islet cells. On the otherhand, intervention with humulin did not produce observable differences in the cyto-architecture of the pancreatic islets compared to the diabetic control, confirming an extra-pancreatic mechanism of insulin.

Open Access Review Article

A Silent Tsunami on Indian Road: A Comprehensive Analysis of Epidemiological Aspects of Road Traffic Accidents

P. Mondal, Abhishek Kumar, U. D. Bhangale, Dinesh Tyagi

Journal of Advances in Medicine and Medical Research, Page 14-23
DOI: 10.9734/BJMMR/2011/106

This paper aims to critically analyze the epidemiology of road traffic accident in India. It is noteworthy to mention that India already accounts for about 9.5% of the total 1.2 million fatal accidents in the world. In 2009, for every 4.14 minute and 1.13 minute one death and one injury took place in India from road accident, respectively. Between 1970 and 2009 the number of accidents has quadrupled (1.1 lakh in 1970 to 4.22 lakh in 2009) with nearly 6.5 fold increase in injuries (0.7 lakh in 1970 to 4.67 lakh in 2009) and nearly 9.5 fold increase in fatalities (0.14 lakh in 1970 to 1.27 lakh in 2009). During the period of 2004 to 2009, road accident rate, injury rate and casualty rate per 105 population have been increased by 8.5%, 4.7% and 29.8%, respectively. In 2009, total 1,08,409 male and 18,487 female died in road accident. It was also observed that in last five years (2005 to 2009) average 84.9% male and 15.1 % female died in road accident. In 2009, total 90,298 people, out of total 1,26,896 accident victims died from age group of (5-44 Yrs), which is the most productive age group for nation. Average percentage share of last five years (2005-2009) for the age groups (Up to 14 Yrs), (15–29 Yrs), (30–44 Yrs), (45–59 Yrs), and (Above 60 Yrs) were 6.35, 29.84, 35.05, 20.97 and 7.79, respectively. The month-wise distribution of ‘Road Accidents’ has also shown more accidents during May (38,928) and June (36,234) sharing 9.2% and 8.6% respectively. Maximum ‘Road Accidents’ (68,835) were reported during 3 p.m. to 6 p.m (16.3%), 64,191 cases during 9 a.m. to 12 noon (15.2%), and least number (28,984) of these accidents (6.9%) was reported during 1200 to 3 AM in the night. The cause-wise number of persons killed in road accidents indicates that almost three-fourths of the accidents were due to driver’s fault.