CLINICAL PROFILE AND MANAGEMENT OF PATIENTS WITH MULTINODULAR GOITRE. (ONE YEAR MULTIDISCIPLINARY STUDY).

Abstract

Objective: To determine the clinical profile and management of patients with multinodular goiter (MNG). Patients and Methods: A total of fifty patients clinically presented as multinodular goiter were recruited and in included in the cross sectional descriptive study conducted from January 2019 to December 2019 in a multidisciplinary manner at Liaquat University Hospital Hyderabad. Total fifty cases were selected from the in-patients admitted in the Medicine, Surgery and ENT wards with clinical presentation of multinodular goitre. The inclusion criteria of the study were the patients with enlargement of thyroid gland, with more than one nodule palpable or enlarged thyroid gland with nodular surface. Both toxic and nontoxic multinodular goitres were included in the study. All patients were investigated for thyroid profile before surgery and submitted for USG guided FNAC of the thyroid swelling and underwent surgery and all the excised thyroid specimen were sent for histopathological examination whereas the frequency / percentages (%) and means ±SD computed for study variables. Results: During one year study period total fifty patients with MNG were recruited and studied had mean age ± SD identified as 37.73±7.74 (yrs) with female gender predominance 37 (74%). Regarding residence the urban and rural population was identified as 20 (40%) and 30 (60%) while the swelling was recorded as gradual, rapid, pain and painless as 45 (90%), 05 (10%), 06 (12%) and 44 (88%). The FNAC was declared as colloidal goiter, Hashimoto's Thyroiditis and follicular neoplasm as 41 (82%), 05 (10%) and 04 (8.0%) whereas the surgical complications observed were transient hypoparathyroidism, temporary Recurrent laryngeal nerve palsy and wound infection 06 (12%), 02 (4.0%) and 03 (6.0%) respectively. Conclusion: MNG is the commonest thyroid disease among our population presented as swelling in front of neck with. FNAC is appropriate diagnostic tool and the cosmetic purpose was identified as main indication for surgical intervention. Total thyroidectomy remains good option for MNG as recurrence of goiter can be avoided and chance of malignancy is also can be prevented.