ABSTRACT
Thyroid diseases particularly nodular lesions are among the most common diseases of human. Approximately 5% of the populations have palpable thyroid nodules which are detected in the routine Autopsy. Nearly 95% of thyroid nodules are benign wherease malignant nodules include 5% of them. Fine needle aspiration [FNA] has been recognized as a simple, inexpensive and available procedure for rapid diagnosis. The objective of this study was to determine the value of FNA in thyroid diagnosis. In this retrospective research, 536 patients with thyroid nodules reffered for FNA or hospitalized for thyroid surgery in Imam Reza Hospital from March 2002 until March 2005 were studied. Individual and laboratory data were gathered in a questionnaire and analyzed by descriptive statistics. This study included 107 men and 429 women and the average age of patients was 40 years. Out of 536 patients 12.7% had malignant, 70.3% benign and 8.6% yield suspicious results and 2.4% of FNAs were insufficient. Comparing the results of FNA and biopsy, FNA had the specificity of 89.5%, sensitivity of 91.5%, and accuracy of 93.7%; negative and positive predictive values were 80.9% and 95.5% respectively. These results reemphasized that, FNA is a simple and non invasive procedure and if performed carefully and evaluated by an expert pathologist is of high sensitivity and specificity
ABSTRACT
TCD is an expensive diagnostic investigation for patients and health insurance companies. Based on the therapeutic view, cost-effectiveness of transcranial doppler [TCD] is important in patients with cerebrovascular disease. This descriptive study was conducted in Neurosonology Center, Ghaem Hospital, Mashhad, within 2006-2007. Indication of TCD was made by neurologists previously. 200 TCD on 166 patients was performed by neurosonologists based on the standard protocol with AKAI device, France and 2MHz probe. The effect of TCD results on changing the dose and type of medicine and neurosurgical consultation of the patients was recorded. Data was analyzed with descriptive statistics and frequency distribution tables. 166 patients [64 males and 80 females] with mean age of 53.4 years were investigated. Abnormal results were found in 27.5% of TCD. Performance of 3D TCD [15%] had influence on therapeutic decisions of the patients. Among this later group, 83% were patients with subarachnoid hemorrhage and 17% had high risk cardiac source of embolism or sever carotid stenosis with recurrent cererbral ischemic events. The cost of 200 TCD in non-private center was evaluated to be about 10 million thomans. Due to high expenses and low percentage of therapeutic influences, performance of TCD is recommended in a restricted group of patients. However TCD is a safe and non-invasive test for assessment of main cerebral arteries, which provide useful information