Profile of Multi Nodular Goitre in Krishna Delta

Department of Surgery, Katuri Medical College and Hospital, Guntur-5222019, Andhra Pradesh, India. _________________________________________________________________________________________________________________________ ABSTRACT Krishna river flows over a distance of more than 700 (seven hundred) kms covering three states i.e.; Maharashtra, Karnataka and Andhra Pradesh. Thus the water content in addition to flora and fauna vary from soil to soil. As a result there is an increased incidence of flourosis and also iodine deficiency. This is very much reflected in clinical spectrum of the denizens. Thus the multinodular goitre is of common occurrence in this land. Therefore a prospective study of multinodular goiter (MNG) of 132 patients admitted with nodular thyroid swelling from july 2011 to August 2013 in the Department of general Surgery, Katuri Medical College, Guntur was undertaken. Out of this sample, majority 87% were females, within the age group of 41 – 50 years. The main complaint was swelling in front of the neck, with a duration of 1 month to 10 years. Concomitent family history was taken in 21% of the whole lot. Futhur more 71% had colloid goiter on FNAC. Both these factors substantiate the deficiency of iodine in the water. Pressure symtoms were elicited in 26% of cases. Toxic symptoms and signs were seen in 15% of the steady group. Thus 108(82%) subjects had near total thyroidectomy and rest 24(18%) underwent subtotal thyroidectomy. The complication rate was 17% in the total group, which was acceptable. The occurrence of iodine deficiency in general and female preponderance in particular leaves a doubt of hormonal factor as well.