Role of elastography strain ratio and TIRADS score in predicting malignant thyroid nodule

ABSTRACT Objective: Ultrasonography (US) is the most accurate and cost-effective imaging method in diagnosis of thyroid nodules. A practical thyroid imaging reporting and data system (TIRADS) for thyroid nodules has been proposed to classify nodules of the thyroid gland to solve the problem of nodule selection for fine needle aspiration cytology (FNAC). Real-time elastography and strain ratio (SR) is a method used to assess the stiffness and predict the malignancy of thyroid nodules. The objective of this study was to assess the role of elastography and SR and the TIRADS scoring system in discriminating malignant from benign thyroid nodules. Materials and methods: From 2015 to 2018 at Cairo University Hospital, a series of 409 patients with thyroid nodules was referred to undergo thyroid ultrasound. Categorization of each nodule according to the TIRADS ranged from 1 to 5. The qualitative elastography score and semiquantitative SR of the nodules were evaluated. Final diagnosis was done by either post-thyroidectomy histopathological examination or US-guided FNAC. Results: Our study included 409 patients with thyroid nodules. Their mean age was 39 ± 10 SD; 36 were males and 373 were females. There were 22 malignant nodules and 387 benign nodules. There were statistical differences between benign and malignant nodules regarding TIRADS classification, SR, anteroposterior/transverse ratio, degree of echogenicity, border, presence of calcification, and absence of halo sign (P < 0.001). The elastic properties of thyroid nodules proved to be a good discriminator between malignant and benign nodules (P- < 0.001) at a cut off value of > 2.32 with 95.2% sensitivity and 86.5% specificity. For every unit increase in SR, the risk of malignancy increased by nearly 2 times. Patients with irregular borders had nearly 17 times increased risk of malignancy than those with regular borders. Conclusion: Elastography and SR proved to be of high significant value in discriminating benign from malignant nodules, so we recommend adding it to the TIRADS classification.

Effects of aluminum on rat cerebellar cortex and the possible protective role of Nigella sativa: a light and electron microscopic study

Aluminum [AL] is toxic to the central nervous system, and Nigella sativa [NS] reduces lipid peroxidation by its antioxidant activity. To investigate the effects of AL treatment on rat cerebellar cortex and the possible protective role of NS. Twenty-five adult male albino rats were divided into five groups: a control group, an NS-treated group, which received NS oil [1ml/kg] orally for 1.5 months, an AL-treated group, which received AL chloride daily [320mg/kg] for 1.5 months, an AL+NS group, which received NS with AL for 1.5 months at the same previous doses, and a withdrawal group, which received AL at the same previous dose for 1.5 months and was left for withdrawal for 1.5 months. Specimens of the cerebellar cortex were processed for light microscopic, electron microscopic, and immunohistochemical study. Morphometric and statistical analysis was carried out. The NS-treated group was very similar to the control group. After the administration of AL, the cerebellum showed a significant reduction in the number of Purkinje cells, which appeared irregular with a darkly stained cytoplasm. The ultrastructure showed Purkinje cells with cytoplasmic vacuolation, dilatation of Golgi cisternae, and mitochondria with dilated cristae. Granule cells showed mitochondria with destroyed cristae. The immune reaction for caspase-3 was intense compared with that of the control group. Administration of NS with AL showed an observable protection against these changes. The withdrawal group showed Purkinje cells that were irregular and darkly stained and their ultrastrucure showed mitochondria with destroyed cristae, but these changes were less marked than those in the AL-treated group. NS may play a protective role against AL-induced cerebellar toxicity in humans

Effects of honey on carbon tetrachloride - induced kidney injury in adult male albino mice: light and electron microscopic study

In the recent years, extensive research work has been focused on the use of natural antioxidants against the toxic oxidative materials to ameliorate their toxic and cell damaging effects. In people who had died after exposure to CC14, kidney failure was frequently reported as the main cause of death. Honey is one of the natural antioxidants. So, the present work aimed at the morphological and morphometric evaluation of the efficacy of honey on the carbon tetrachloride-induced kidney injury.Thirty adult male albino Sprague-Dawley mice were divided into three groups, each group consisted of 10 mice. Control group [group I] received olive oil subcutaneously [S.C.]; CCL4 group [group II] were injected S.C. with 0.3% CCL4 dissolved in olive oil in a daily dose of 5ml/kg B. W. for 4 weeks. CCL4 + Honey group [group III] recieved both CCL4 and honey simultaneously daily for 4 weeks. The honey mixed with water and was given orally by gastric tube. The kidney specimens were processed for both light and electron microscopic examinations. Morphometric studies were also carried out. At L.M. level; carbon tetrachloride - induced degenerative changes in kidney cortex involved both corpuscles and tubules as well as inflammatory mononuclear cellular infiltration. By E.M.; thick interrupted glomerular basement membrane Morphometry showed significant changes of glomerulus, corpuscles and tubules. Honey effects were at L.M.; improvement of degenerative changes and inflammatory infiltration. At E.M; improvement of corpuscular and tubular changes. Morphometry showed better significant changes of glomerulus, corpuscles and tubules. Processed honey significantly reduced degenerative changes induced by CCL4 in the renal cortex on simultaneous administration

Maternal risk factors in young Egyptian mothers of down syndrome

We investigated the possible maternal risk factors that may increase the incidence of Down syndrome [DS] in young Egyptian mothers [younger than 35 years] especially methylene tetrahydrofolate reductase [MTHFR] enzyme C677T polymorphism. The study included 200 mothers of karyotypically ascertained non-disjunction DS attending Genetics clinic, Children's hospital, Ain Shams University [100 mothers were < 35 years and 100 mothers =/> 35 years]. 50 mothers of none-DS children served as a control group. For all cases, history was taken laying stress on: Parental ages at conception, maternal grandparent's ages at conception of mother, DS birth order, history of oral contraceptive use 6 months before conception, genital infection, vitamin supplementation and smoking or exposure to irradiation. MTHFR C677T mutational analysis was done to twenty DS mothers with ages