Open Access Case Report

Ventriculoperitoneal Shunt Migration through the Anus in a Child: Case Report and Management Algorithm

Baba Alhaji Bin Alhassan, Kwasi Agyen-Mensah, G. A. Rahman, C. S. J. D. Makafui

Journal of Advances in Medicine and Medical Research, Page 53-57
DOI: 10.9734/jammr/2020/v32i330382

Aims: Ventriculoperitoneal (VP) shunt placement is one of the commonest procedures undertaken by neurosurgeons to manage patients with hydrocephalus. Although shunt migration through bowel and exteriorization per anus is rare, it’s associated with about 15% mortality.

Presentation of Case: We present a six year old boy with shunt migration through the bowel and exteriorization per anus.

Discussion: The risk factors as well as management algorithm of such cases are discussed in this manuscript.

Conclusion: Although this presentation is rare, early recognition and intervention is key. It is important to stratify patients as symptomatic or asymptomatic and manage them accordingly.

Open Access Case Report

Bilateral Anophthalmia: Literature, Review and Case Report

L. E. Yaguo Ide, B. A. Alex-Hart, A. R. Nte

Journal of Advances in Medicine and Medical Research, Page 106-110
DOI: 10.9734/jammr/2020/v32i330389

Introduction: Anophthalmia which is the congenital absence of the eyes could be bilateral or congenital, it occurs globally although it is rare. It is usually in association with other systemic congenital abnormalities.

Case Report: A case of a female baby delivered at a primary health center in Port Harcourt, Nigeria who had bilateral anophthalmia is reported here along with review of literature Magnetic Resonant Imaging (MRI) of brain and orbit was used to confirm the diagnosis which showed absence of both globes, with hypoplasia of the orbits as well as the extraocular muscles, the optic nerves could not be differentiated from the visualized intra-orbital structures. All other systems were essentially normal. This is an exceptional case in Port Harcourt, Nigeria, as literature search shows that no other case has been reported in Port Harcourt. She is currently being followed up at the paediatric, ophthalmology and ENT clinics of the University of Port Harcourt teaching hospital.

Open Access Systematic Review Article

Evaluation of the Different Methods for Fixation of Sagittal Ramus Split Osteotomy of the Mandibular Ramus in Relation to Stability for Mandibular Advancement: A Systematic Review

Luiza Roberta Bin, Natasha Magro Érnica, Eleonor Álvaro Garbin Junior, Geraldo Griza, Ricardo Conci, Letícia Nadal

Journal of Advances in Medicine and Medical Research, Page 111-121
DOI: 10.9734/jammr/2020/v32i330390

Aims: The purpose of this study was to perform a systematic review of the literature on the different fixation methods available for sagittal ramus split osteotomy associated with mandibular advancement tested in vitro to evaluate stability of each method.

Study Design: Systematic review.

Methodology: Following the PRISMA model for systematic reviews, a query was made in the PubMed, Bireme and Cochrane Library databases, identifying articles that reported the different fixation methods for sagittal ramus split osteotomy for mandibular advancement.

Results: A total of 352 articles were identified, 11 papers of which, after evaluation in relation to the inclusion and exclusion criteria, were systematically reviewed.

Conclusion: Sagittal ramus split osteotomy is a technique performed for the treatment of mandibular discrepancies in which the methods for fixation of the segments are quite varied. In view of the biomechanical studies, the hybrid technique is the most indicated method, while miniplates with monocortical screws present less stability.

Open Access Original Research Article

Interprofessional Undergraduate Analytical Study on Anger Management

Htay Lwin, Sim Khye Shen, Ch’ng Shi Yunn, Yasheera Vasudevan, Nan Nitra Than, Htoo Htoo Kyaw Soe, Adinegara Lutfi Abas, Mila Nu Nu Htay

Journal of Advances in Medicine and Medical Research, Page 1-10
DOI: 10.9734/jammr/2020/v32i330377

Introduction: Anger has been defined in many ways from “a negative, phenomenological (or internal) feeling state” to “a basic emotion in which the function is to provide the organism with motivated capacities to overcome obstacles”. Anger has been the subject of many discourses and its vehemence in many religions and cultures. The study aimed to determine the ability of anger management among different gender and factors associated with anger management.

Methods: This is a cross-sectional prospective study. The validated ‘Quality of Life’ questionnaire from University of Washington, Seattle Washington, United Sates of America and Novaco Anger Scale from Mental Health America of Northern Kentucky & Southwest Ohio (WHOQOL-BREF) were used for students’ perception on anger management. Quantitative data were analyzed using Epi Info Version. 7 Software.

Results: The total of 358 students participated in this study. There is a significant association between anger management among different ethnicity.

Conclusion: Gender was not a significant factor in anger management, it was probably due to equal opportunity among male and female in acquiring education, application for scholarships and usage of education facilities. Gender equality had a big impact in enhancing the good anger management properties.

Open Access Original Research Article

C-reactive Protein is an Independent Predictor of Left Ventricular Mass in Offspring of Hypertensive Subjects in Nigeria

O. M. Akinlade, A. A. Akintunde, F. T. Akinlade, O. A. Adeyemi, J. O. Akande, Y. A. Ayoola, O. G. Opadijo, A. B. O. Omotoso

Journal of Advances in Medicine and Medical Research, Page 11-21
DOI: 10.9734/jammr/2020/v32i330378

Offspring of hypertensive parents have been shown to be at increased risk of developing systemic hypertension and adverse cardiovascular events later in life. The pathological antecedents of this are thought to be alterations in the structure and function of left ventricle. However, it is currently unclear if these abnormalities are due to genetic factors or a result of higher biomarker levels such as highly sensitive C reactive protein (hsCRP). An improved understanding of the associations of hsCRP with left ventricular structure may offer additional insight. Therefore, this study aims at determining the correlation of left ventricular mass with hsCRP among offspring of hypertensive parents compared with controls.

Methodology: A cross sectional Hospital based study, with 100 subjects and 100 controls. A questionnaire was administered to obtain relevant history, physical examination, blood tests, ECG, Echocardiography were done for the two groups. The results were analysed using SPSS 20. 
Results: The left ventricular mass and mass index was significantly elevated in the subjects compared with the control group. The median hsCRP was significantly higher in the subjects [1.85 (0.28-10.20) vs. 1.34 (0.17-8.49) mg/L: P < 0.010]. It progressively increases significantly as the number of parent with hypertension increases [1.34 (0.17-8.49), 2.00(0.28-9.66) and 2.54(0.91-10.20) mg/L P < 0.001] from zero, to single and both parent respectively. There was a significant correlation between hsCRP levels, blood pressure, left ventricular mass and left ventricular mass index (R = 0.165, 0.316, 0.274: P = 0.021, 0.004, 0.014) respectively.

Conclusion: The study shows that offspring of hypertensive parents had higher echocardiographic left ventricular mass, left ventricular mass index and hsCRP levels compared with controls and this hsCRP increases as the number of parents with hypertension increases. Blood pressure and left ventricular mass index increase with increasing Plasma hsCRP: This may suggest possible role of hsCRP in the development of hypertension and cardiac remodeling.

Open Access Original Research Article

Prevalence and Socio-demographic Determinants of Stunting among School Age Children (SAC) in Gombe State, Nigeria

Mela Danjin, Solomon O. Adewoye, Henry O. Sawyerr

Journal of Advances in Medicine and Medical Research, Page 22-34
DOI: 10.9734/jammr/2020/v32i330379

Background: As one of the key indicators of malnutrition, stunting has been considered to be a very vital proxy for not only chronic nutritional deficit but for long term socioeconomic deprivation among children and the society at large.

Objective: This study was aimed at determining the prevalence of stunting and its association with socio-demographic factors among school children in Gombe state, Nigeria.

Methodology: The study employed a cross sectional survey design to assess school children aged 6 to 15 years in 12 public and 6 private schools from six selected Local Government Areas (LGAs) of the state. Data were collected on a structured pro forma from March to June, 2019. Analysis of the data was done using IBM SPSS version 21 and Chi square statistics was used to compare proportions, while alpha level of significance was set at 0.05.

Results: The mean age of the children was 9.96±2.26 and the overall prevalence of stunting among them was 22.5%. Children in public schools were found to be more stunted (χ2=20.342,   df= 1, P=0.000) and more than twice at risk (OR=2.598, CI=1.699-3.974) of stunting than their counterpart in private schools (27.3% vs. 12.6%). Low academic performance was significantly associated with high prevalence of stunting (28.4% vs. 20.9% & 18.0%) among the subjects (χ2 = 7.443, df = 2, p=0.024). Other factors that were associated with stunting include; class of pupil, age group, LGA, tribe, religion, occupation of father, occupation of mother, SES and level of education of mother.

Conclusion: It is quite evident from the findings of this study that stunting is quite prevalent among school children in Gombe state. Hence, it is recommended that a multi-sectoral approach to addressing the problem be instituted by government and all stakeholders.

Open Access Original Research Article

Post-operative Paediatric Pain Assessment and Management at a Tertiary Health Facility, Southern Nigeria: Surgeons’ Perspectives and Practice

G. K. Eke, P. E. Okoro

Journal of Advances in Medicine and Medical Research, Page 35-42
DOI: 10.9734/jammr/2020/v32i330380

Introduction: Whereas advances in perioperative care of children continue to be made with increasing evidence-based practice for postoperative analgesia, inadequate relief of postoperative pain resulting in significant morbidity and mortality is still being reported.

Objective: To appraise surgeons' perspectives and practice of paediatric post-operative pain assessment and management at a tertiary health facility in southern Nigeria.

Methods: In this cross-sectional survey carried out between September and December 2019, a semi-structured and self-administered questionnaire was distributed to surgeons/trainees in departments/units where paediatric patients undergo both major and minor surgeries. Their perspectives and practice of postoperative pain assessment and management were analysed using SPSS version 20.0.

Results: Seventy-nine respondents completed the survey, including 19(24%) consultants, 32(40.5%) senior registrars, and 22(27.9%) junior registrars. Two-third of respondents (n=51, 64.6%) had more than 10 years working experience post-graduation. Involving parents/caregivers to assess postoperative pain was the most common strategy used by respondents (n=69, 87.3%), and most of them (n=67, 84.8%) do not make use of any pain assessment tools. 

Non-pharmacologic strategies for postoperative pain management were applied/prescribed sometimes (n=20, 25%) or rarely (n=20, 25%). Paracetamol and NSAIDs were the commonest non-opioid analgesics used while pentazocine was the commonly used opioid. Many respondents (n=66, 83.5%) had never prescribed morphine for postoperative analgesia in children. Seventeen percent of respondents do not prescribe postoperative analgesia to newborns.

Conclusion: Findings of this study show that the practice in our institution falls short of the recommended multimodal approach to paediatric postoperative pain care. Development of standard protocols and training of providers of postoperative care are recommended.

Open Access Original Research Article

Bacteriological Profile of Chronic Osteomyelitis with Special Reference to Antibiotic Resistance Mechanisms/Patterns – A Cross-sectional Prospective Study from Tertiary Care Hospital in Central India

Aparna Pandey, Prachi Shaw, Aamir Johar

Journal of Advances in Medicine and Medical Research, Page 43-52
DOI: 10.9734/jammr/2020/v32i330381

Objective: Chronic osteomyelitis is the infection and inflammation of the bone. Inappropriate use of antibiotics and multidrug resistance has raised the morbidity and mortality rate in chronic osteomyelitis. This study aims to determine the bacterial profile and antimicrobial susceptibility patterns of chronic osteomyelitis with special mention to various resistant mechanisms.

Methods: The study is a prospective design. Hundred (100) clinically diagnosed cases of chronic osteomyelitis of all age group and both sex admitted in a tertiary care hospital at central India, in one year were included. Samples like pus, sinus discharge or exudates were collected aseptically and sent for microbiological investigation. Antimicrobial susceptibility of bacterial isolates to the commonly used antibiotics was done by using modified Kirby Bauer disc diffusion method.

Results: The aerobic bacteriological study of chronic osteomyelitis showed Staphylococcus aureus is being continued to be major etiological agent followed by Pseudomonas aeruginosa and Staphylococcus epidermidis. Gram-positive isolates were sensitive to linezolid, teicoplanin while gram-negative isolates were sensitive to colistin, ciprofloxacin in the majority. The disease occurs mostly due to traumatic injuries commonly affecting the middle age group. In present study prevalence of methicillin-resistant Staphylococci aureus and β Lactamase producing (ESBL, Amp-C and MBL) gram-negative bacilli is found to be on the higher side.

Conclusion: It has been the major cause of morbidity for a long time. The emerging multidrug-resistant strain is a major concern for the treatment. Identification of causative isolates and using a judicious selection of antibiotics will help the clinician in starting the empirical treatment accordingly would limit the multidrug resistance strains in the hospital as well as the community.

Open Access Original Research Article

Descriptive Study of School Feeding Practices in Nigerian Children and the Risk of Dental Caries

Joycelyn O. Eigbobo, Nneka K. Onyejaka

Journal of Advances in Medicine and Medical Research, Page 58-68
DOI: 10.9734/jammr/2020/v32i330383

Background: Nutrition is important in development, growth and maintenance of overall well being of an individual and plays a significant role in children’s cognitive, behavioural and emotional development. Poor diets may initiate or exacerbate chronic diseases including dental caries which has dietary fermentable carbohydrates as one of its aetiologies.

Objectives: To describe the school feeding practice in Nigerian schools and relate the contents  of their lunch boxes to risk of having dental caries and determine the relationship between socioeconomic factors and the content of lunch boxes.

Study Design: This was a descriptive cross sectional study.

Methodology: Multistage sampling technique was used in selecting participants from 12 schools in Southern Nigeria. Information on socio-demographic characteristics and contents of lunch boxes were elicited using structured questionnaires. The contents of lunch boxes were categorized as balanced (cooked meals with vegetables or fruits), overloaded (one cooked meal and snacks) and unbalanced-over loaded (no lunchbox, or greater than one snacks). Information elicited were analyzed using SPSS version 22 and the level of significance was set at <0.05.

Results: There were 152 (49.8%) males and 153 (50.2%) females with a mean age of 10.1 (+2.2) years who participated in the study. One hundred and fifty two (49.8%) pupils brought lunch boxes to school. The category of meals taken during lunch breaks was mostly [157 (51.5%)] unbalanced-overloaded. There were statistically significant associations between the mothers’ occupation (<0.001), number of siblings (p<0.001), type of school (p=0.001) and the presence of lunch boxes. There was also statistically significant association between the types of schools and contents of lunch packs. Multivariate regression analysis showed that age (OR=0.116, CI=0.030-0.447; p=0.002) and number of siblings (OR=0.286; CI=0.097-0.841; p=0.023) were significant predictors of bringing lunch box to school.

Conclusion: Type of school, age of the children, their mothers’ social class/occupation and family size were significantly associated with possessing lunch packs. Their lunch meals were majorly confectioneries thus a high risk to dental caries.

Open Access Original Research Article

P-wave and QT Interval Dispersion Analysis in Children with End Stage Renal Disease on Regular Hemodialysis

Mai Attia, Shimaa El-Nemr, Hend Abd-Elnabi, Amr Zoair

Journal of Advances in Medicine and Medical Research, Page 69-77
DOI: 10.9734/jammr/2020/v32i330384

Objectives: The consequences of hemodialysis on P-wave dispersion and QT dispersion have not been unequivocally documented and understood and may be complex. To investigate homogeneity disorders of atrial conduction and ventricular repolarization and tendency to develop various arrhythmias by demonstrating the effects of hemodialysis in children with end stage renal disease through assessment of P-wave dispersion and QT dispersion (By electrocardiograghy).

Methods: Twenty end stage renal disease patients on conventional hemodialysis for at least 12 months and twenty healthy, age and sex matched volunteers were included. Patients underwent echocardiography to exclude any abnormalities of cardiac valves or muscle. A 12-lead electrocardiogram was undertaken in order to measure minimal and maximal (P wave and QT interval) durations, P wave dispersion and QT dispersion.

Results: In patient group, males were 13, females were 7 with mean age of 11.9 ± 3.4 years, mean P wave dispersion and QT dispersion were significantly longer than control group. P wave dispersion was significantly shorter after dialysis (mean= 34 ± 13.1 ms) than before dialysis (mean=42.4 ± 14 ms), whereas QT dispersion was longer after dialysis (59 ± 19 ms) than before dialysis (55.5 ± 17 ms) but the differences in QT dispersion was not significant. Also, there was no correlation between neither P wave dispersion nor QT dispersion and the electrolytes.

Conclusion: P wave dispersion and QT dispersion was found to be higher in end stage renal disease children on regular hemodialysis than healthy control subjects, indicating heterogeneity disorders of atrial conduction and ventricular repolarization in these patients and tendency to develop various arrhythmias.

Open Access Original Research Article

Normative Orthodontic Treatment Need of Nigerian Adolescents – A Comparative Study of Three Major Ethnic Groups

S. S. Etim, E. A. Aikins, C. O. Onyeaso

Journal of Advances in Medicine and Medical Research, Page 78-87
DOI: 10.9734/jammr/2020/v32i330385

Objective: This study was carried out to assess and compare the normative orthodontic treatment need of adolescents aged 12 to 16 years from the three major ethnic groups in Nigeria.

Methods: The study population comprised one thousand, four hundred and forty-nine (1449) adolescents selected from nine public schools within nine Local Government Areas from three (3) selected states (Lagos, Kano, Imo) in Nigeria. Randomization based on multistage sampling technique was used to determine the selected participants. Consent and assent forms were duly completed and signed by parents and participants respectively. Participants’ parents were from the same ethnic group. Oral examination of the participants was done and their normative treatment need assessed following the standard protocols of Index of Complexity, Outcome and Need. (ICON) Data collected were analyzed using Statistical Package for Social Science version 20.0. Descriptive, as well as parametric (ANOVA) and non-parametric (Chi-square) statistical analyses were conducted.

Results: Normative (objective) orthodontic treatment need was observed in 27.7%, 31.5% and 42.8% of Igbo, Hausa and Yoruba adolescents, respectively. The mean ICON scores recorded were for Hausa, 33.0±16.1 (SD), 32.1 ± 16.6 (SD) for Igbo and 34.8 ± 16.2 (SD) for the Yoruba, with a statistically significant difference noted among the groups. The mean scores were 33.9 ± 16.2 for males and 32.8 ± 16.4 for females while the combined population mean was 33.4 ±16.3. The males had more orthodontic treatment need than the females in the combined population.

Conclusion: Yoruba adolescents statistically had the greatest normative orthodontic treatment need while Igbo adolescents had the least among the three major Nigerian tribes.

Open Access Original Research Article

Causes of Hospitalization and Predictors of Mortality among Adult HIV Positive Patients at the Benue State University Teaching Hospital, Makurdi

Patrick Ojojarumi Echekwube, Emmanuel Uzodimma Iwuozo, Helen Sagay

Journal of Advances in Medicine and Medical Research, Page 88-97
DOI: 10.9734/jammr/2020/v32i330387

Introduction: HIV/AIDS is one of the leading causes of morbidity and mortality worldwide. In Africa, opportunistic infections are the leading causes of morbidity among HIV patients and there is need to establish the causes of morbidity and/or mortality among the patients in our environment.

Methods: This was a retrospective study in which the case files of adult HIV positive patients admitted from January 2018 to December 2018 were retrieved. Their socio-demographic profile, HIV stage at admission, outcomes and other relevant information were extracted. The Center for Disease Control staging for HIV was used for the study.

Results: A total of 94 patients were enrolled into the study. At admission, most of the patients, 57(61%) were in CDC Stage B while the remaining patients were in stage C. Pulmonary tuberculosis was responsible for most of the admissions.

The total number of deaths were 27 giving a mortality ratio of 28.7%; 9 (33%) of them were in stage B and the remaining 18 (67%) were in stage C. The predictors of mortality were male sex, short duration of admission, substance use and referral from non-specialist centres.

Conclusion: The major disease cause of morbidity among PLHIV in Makurdi is Pulmonary Tuberculosis. Male sex, substance use, referral from non-specialist centres and short duration of admission were significant predictors of mortality. All stakeholders involved in HIV care should intensify efforts at early HIV diagnosis, scale up HAART where necessary and implement task shifting at non-specialist centres to improve treatment outcomes.

Open Access Original Research Article

Factors Influencing Viral Load Non-suppression among People Living with HIV (PLHIV) in Borno State, Nigeria: A Case of Umaru Shehu Ultra-Modern Hospital

Fadoju Sunkanmi, Yunana Paul, Dickson Peter, Affiah Nsikan, Jasini Joseph, Emmanuel Opada, Udenenwu Henry, John Jonah, Kyeshir Tapshak, Ndifreke James

Journal of Advances in Medicine and Medical Research, Page 98-105
DOI: 10.9734/jammr/2020/v32i330388

Background: The 2019 National AIDS Indicator and Impact Survey (NAIIS) report showed that the prevalence of HIV in North East Nigeria is 1.1%. Despite the increasing number of patients on ART in Nigeria, there is inadequate information about clients with virologic failure and its different determinants among PLHIVs enrolled into care in resource-limited and security challenged settings like Borno state.

Objectives: To evaluate the suppression rate and the associated factors for non-suppression of Viral Load (VL) at a HIV/AIDS comprehensive service delivery site in Borno State.

Methods: A case study conducted using routinely received Viral Load (VL) test results in Umaru Shehu Ultra-Modern Hospital, Borno State. Six (6) VL data from 402 patients on HIV anti-retroviral therapy (ART). Data collected using standard tools and Lafiya Information Management System (LAMIS) used for data extraction and STATA 14 used for analysis. Logistic regression was employed to identify various factors associated with viral Load non-suppression (virologic failure) in the selected facility in the State.

Results: From the 402 patients; 279 (69.40%) were females while the remaining 123(30.60%) were males. Overall virologic failure/non-suppression rate was 16.33%. 19.2% of the patients age 25-29 were virally unsuppressed. The odds of virologic failure decreased with age, with children aged 5-9 years (OR= 1.97, 95%CI = 0.02-169.913) and adults (OR= 3.33, 95%CI = 0.064-171.66) registering the highest odds. Last clinical stage (OR= 1.54, 95%CI = 0.499-4.76) and Body mass Index (OR= 1.4, 95%CI = 0.5-4.33) increased the odds of virologic failure.

Conclusions: Demographic, economic and clinical data study increased the odds of virologic failure. Second line and third line ART regimens were protective against virologic failure. The study recommends close monitoring and regular follow up on patients by the case managers/care givers/treatment supporter and intensified patients' adherence support for repeat testers after suspected failure of the drug.

Open Access Original Research Article

Effects of Ginkgo Biloba Extract and Troxerutin on the Hippocampus of Adult Albino Rats after Induction of Diabetes Mellitus

Radwa Ismail, Amal Mahdy, Mona Attia, Fotna Eskander

Journal of Advances in Medicine and Medical Research, Page 122-138
DOI: 10.9734/jammr/2020/v32i330391

This study aimed to assess the effects of Ginkgo Biloba Extract and Troxerutin on the hippocampus of induced diabetes mellitus in adult albino rats using histological methods.50 adult male albino rats were divided into three groups; Group I (Control); Group II (diabetic): subdivided into Subgroup IIa (T1DM)), Subgroup IIb (T1DM+GBE), Subgroup IIc (T1DM+ troxerutin); Group III: subdivided into Subgroup IIIa (GBE) and Subgroup IIIb (troxerutin). The brain was removed and the cerebral hemisphere was coronally cut at the hippocampal level and used for light microscopic study (H&E staining and PCNA immunostaining). There was a statistically insignificant improvement in animal weights in subgroup IIb and subgroup IIc. Subgroup IIb showed a statistically significant reduction of blood glucose levels while the subgroup IIc showed insignificant reduction of blood glucose levels. Diabetes disturbed the light microscopic structure of the hippocampus. In subgroup IIb and subgroup IIc the hippocampus retained an apparently normal appearance and the stratum pyramidale exhibited the pyramidal cells with rounded vesicular nuclei and acidophilic cytoplasm. Diabetic hippocampal sections revealed negative PCNA immunoreactivity in all layers of DG. In subgroup IIb and subgroup IIc, hippocampal sections showed positive immunoreactivity.

Open Access Original Research Article

Aspiration Cytology for Thyroid Lump in Remote Areas of Sindh

Santosh Kumar Sidhwani, Prem Shankar, Haresh Chand, Ali Mala, Yameena Noman Khan, Jabbar Ahmed Qureshi

Journal of Advances in Medicine and Medical Research, Page 139-145
DOI: 10.9734/jammr/2020/v32i330392

Background: Scandinavian countries were the first to use fine needle aspiration cytology (FNAC) as a diagnostic tool in the 1930. Fine needle aspiration cytology is a diagnostic approach, which helps the clinicians in diagnosis of the various lesions. Most common sites which can be targeted include breast lumps, lymph nodes, thyroid masses and other palpable swellings. The most common lesion encountered is thyroid nodule. In current cross sectional study we tried to find frequency of different thyroid lesions by fine needle aspiration cytology in different rural areas of Sindh.

Methodology and Results: 158 samples were recruited from the Vital Laboratory Larkana with different pathological midline neck (thyroid) swelling during 2014 and 2015 by non-probability consecutive sampling. 125 (79.1%) were females and 33 (20.9%) were males with a ratio of 4:1. Majority of case were of 20-39 years of age (52.5%). Most of the cases were diagnosed with nodular goiter (88.6%) followed by colloid goiter (4.4%). In present study we failed to find any association of diagnosis with gender (p =0.211) and age (p =0.553).

Conclusion: So in this study we concluded that large number of thyroid lesions present with nodular goiter at the age of 20-39 years. The frequency is increased for these lesions due to different risk factors.