A Clinical Study on Gallbladder Polyp.

There are different types of gallbladder polyps having variable morphology and nature. Symptoms are vague and mostly diagnosed incidentally on abdominal ultrasound. Risk factors are many. Indications of surgery are not clearly understood due to lack of clinical evidence. This study was carried out to analyze the management of gallbladder polyp in our settings and review of available evidence. Patients who underwent clip less mini laparoscopic cholecystectomy for gallbladder polyp were included. Clinical data including short history, age, gender, parity, lab tests, ultrasound report and macroscopy were recorded during surgery. Histopathology reports collected later. Total of 112 patients with mean age 42.6 years (range 22-82), 74 of whom were female. Most of them (46.42%) were asymptomatic. Single polyp was in 69, multiple in 32 and polyp with stone in 8 patients. Sessile polyp was 74.10%. Average polyp size was 7.6mm. Cholesterol polyp was in 82 patients. Four out of 5 malignant polyps were single and sessile. Abdominal ultrasound is the mainstay of diagnosis of gallbladder polyp but size, location, morphology, number and presence of associated gallstone has to be mentioned. Symptomatic gallbladder polyp benefited from surgery. Polyps more than 6mm, single and sessile morphology above the age 50 should undergo cholecystectomy.

Thyroid Dysfunction and Autoimmunity in First Trimester of Pregnancy, Single Center Experience in Bangladesh.

Study on thyroid function and thyroid autoantibody status in pregnancy considering the trimester specific range, is scarce in Bangladesh. This cross sectional study done in Bangabandhu Sheikh Mujib Medical University, Bangladesh from August 2012 to June 2013 encompassed 186 pregnant women of first trimester for study of thyroid function (TSH, FT4) and anti-thyroid antibodies (anti-TPO, anti-TG). Age of the subjects was 25.4±4.9 years (mean±SD), median gestational age was 9 weeks. Applying the trimester-specific normal reference range set by American Thyroid Association (ATA), 48(25.8%) of the women were found to have thyroid dysfunction; 40(21.5%) subclinical hypothyroid (SCH), 1(0.5%) overt hypothyroid (OH) and 7(3.8%) hyperthyroid; 40(21.5%) women had goiter. If non-pregnant adult normal rage is used, 22 of SCH women as per ATA criteria will be labeled as normal and 19 normal women as per ATA cut off will be labeled as hyperthyroid. There was statistically significant disparity for functional status defined by these two references cut off value (p<0.001). 29(15.6%) women had thyroid autoimmunity and the autoantibody positivity was more frequent in women with thyroid dysfunction than euthyroid women (22.92% vs. 13.04%, p<0.001). Even though universal screening for thyroid dysfunction is not yet a recommendation, it should be considered in our population.