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Outcome of Analysis of Thymectomy Operation In Myasthenia Gravis Patient With Or Without Adjuvant Therapy

Sharfuddin Ahmed1*, Magfur Rahman

Abstract Introduction: One of the autoimmune disease is Myasthenia gravis. Myasthenia gravis is an autoimmune disease characterized by a fluctuating weakness of voluntary muscles. The weakness of myasthenic patients is due to an antibodymediated autoimmune attack against acetylcholine receptor at neuromuscular junction. Normally impulses travel down the nerve and nerve endings release a substance called acetylcholine. Acetylcholine binds or attaches to receptor on the muscle and makes the muscle contract. Objective: To Diagnose the Myasthenia gravis patients prevent the autoimmune disease process with help of adjuvant therapy. Materials and Methods: Study design: Cross sectional observational study. Place of study: This study was carried out in the Department of Cardiac Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. Study population: Patients diagnosed as Myasthenia Gravis admitted to the Department of Cardiac Surgery, BSMMU were selected for the criteria. Period of study: July 2018 to December 2020. Sampling method: purposive sampling. Sample Size (n): Twenty-Five (25). Grouping: Patients were divided into group: Group A: patients without plasmapheresis or immunoglobulin therapy (n=15). Group B: patients with plasmapheresis or immunoglobulin therapy, or with both plasmapheresis and immunoglobulin therapy (both Pre-Operative and Post-Operative) (n=10). Results: In this study, twenty-five patients aged 20-50 years admitted in department of Cardiac Surgery, BSMMU who underwent Thymectomy and full filled inclusion and exclusion criteria were selected for the study Sample into two groups. Group-A (n-15) Consist of the patients who underwent thymectomy without adjuvant therapy and Group-B (n=10) consists of patients underwent thymectomy with adjuvant therapy during analysis, p-value (0.05) consider as significant. patients having thymectomy without adjuvant therapy shared lower incidence of Complication and thymectomy with adjuvant therapy of Complication more. Conclusion: Extended thymectomy seems to be an effective treatment for MG, with low surgical morbidity. This single-centre study showed that the majority of patients benefited from the thymectomy, with tremendous clinical improvements and drug reduction post-operatively. Among 25 study subjects 10(40%) were complete remission after 12 months. Improvement and complete remission were statistically higher in without plasmapheresis/ immunoglobulin therapy or adjuvant therapy compare to patient with plasmapheresis/immunoglobulin therapy (p<0.05) or adjuvant therapy.