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.

Background. Difference in scar formation at different sites, in different directions at the same site, but with changes in the elasticity of skin with age, sex, and race or in some pathological conditions, is well known to clinicians. The inappropriate collagen syntheses and delayed or lack of epithelialization are known to induce scar formation with negligible elasticity at the site of damage. Changes in the elasticity of scars may be due to an unequal distribution of dermal collagen (C) and elastic (E) fibers.Materials and Methods. Spearman correlation coefficients (r) of collagen and elastic fibers in horizontal (H) and in vertical (V) directions (variables CV, CH, EV, and EH) were measured from the respective quantitative fraction data in 320 skin samples from 32 human cadavers collected at five selected sites over extremities.Results. Spearman’s correlation analysis revealed the statistically significant (p<0.01) strong positive correlation betweenCHandCVin all the areas, that is, shoulder joint area (r=0.66), wrist (r=0.75), forearm (r=0.75), and thigh (r=0.80), except at the ankle (r=0.26,p=0.14) region. Similarly, positive correlation betweenEHandEVhas been observed at the forearm (r=0.65, moderate) and thigh (r=0.42, low) regions. However, a significant moderate negative correlation was observed betweenCVandEVat the forearm (r=-0.51) and betweenCHandEHat the thigh region (r=-0.65).Conclusion. Significant differences of correlations of collagen and elastic fibers in different directions from different areas of extremities were noted. This may be one of the possible anatomical reasons of scar behavior in different areas and different directions of the same area.

Murlimanju BV, et al. Anat Cell Biol. 2014 Sep;47(3):202-206. http://dx.doi.org/10.5115/acb.2014.47.3.202

Background: To evaluate the haemostatic potential of human bone marrow-derived mesenchymal stromal cells (BM-MSCs) in carbon tetrachloride (CCl₄) induced liver cirrhosis in Wistar rats. Methods: This was an experimental study. Liver cirrhosis was induced in adult female Wistar rats using CCl₄. Rats were randomly divided into 6 groups with ten rats in each group: group 1 (normal control group), group 2 (received only CCl₄), group 3 (CCl₄ + low dose BM-MSCs), group 4 (CCl₄ + high dose BM-MSCs), group 5 (CCl₄ + silymarin), group 6 (CCl₄ + high dose BM-MSCs + silymarin). Thirty days after the treatment, blood samples were collected for liver enzyme level analysis, prothrombin time test and plasma fibrinogen estimations. The rats were then sacrificed, livers were excised and used for histopathological and scanning electron microscopy (SEM) study. Results: BM-MSCs and the combination treatment of high dose BM-MSCs and silymarin effectively decreased the prothrombin time and increased plasma fibrinogen concentration in rats with CCl₄ induced liver cirrhosis. BM-MSCs treatment produces significant anti-fibrotic effect which was supported by the liver enzyme level analysis, histopathology and SEM study. Conclusions: Results indicate that treatment of BM-MSCs in combination with silymarin had a better haemostatic effect when compared to the administration of BM-MSCs alone.

Background. Descriptive evaluation of nerve variations plays a pivotal role in the usefulness of clinical or surgical practice, as an anatomical variation often sets a risk of nerve palsy syndrome. Ulnar nerve (UN) is one amongst the major nerves involved in neuropathy. In the present anatomical study, variations related to ulnar nerve have been identified and its potential clinical implications discussed. Materials and Method. We examined 50 upper limb dissected specimens for possible ulnar nerve variations. Careful observation for any aberrant formation and/or communication in relation to UN has been carried out. Results. Four out of 50 limbs (8%) presented with variations related to ulnar nerve. Amongst them, in two cases abnormal communication with neighboring nerve was identified and variation in the formation of UN was noted in remaining two limbs. Conclusion. An unusual relation of UN with its neighboring nerves, thus muscles, and its aberrant formation might jeopardize the normal sensori-motor behavior. Knowledge about anatomical variations of the UN is therefore important for the clinicians in understanding the severity of ulnar nerve neuropathy related complications.