Accuracy of a new sonographic classification system in differentiating benign from malignant solid thyroid nodules

Objective: To determine diagnostic accuracy of sonographic criteria in differentiating benign from malignant solid thyroid nodule by using new sonographic classification system

Study Design: Cross sectional validation study

Place and Duration of Study: Department of Radiology, Combined Military Hospital Multan from Oct 2014 to Mar 2015

Material and Methods: A total of 150 consecutive cases of either sex ranging in age from 19-60 years with palpable thyroid nodules referred for diagnostic workup were subjected to ultrasound [US] examination for assessment of solid thyroid nodules and it was followed by US-guided fine-needle aspiration [FNA] of all solid thyroid nodules. Each of the biopsied nodule was subsequently placed into one of five categories on the basis of sonographic features i.e. [malignant] [suspicious for malignancy] [borderline] probably benign] and [benign]. Evaluation of accuracy of sonographic diagnosis for solid thyroid nodule was done by comparing results of fine needle aspiration biopsy [FNAB]

Results: The mean age of the patients [n=150] was 42.34 +/- 4.78 years; seventy three percent [n=109] were females and twenty seven percent [n=41] were males. Frequency of thyroid nodules [on FNAB as gold standard] was revealed as 20.7% [n=31] malignant and 79.3% [n=119] benign, accuracy of a new sonographic classification system in differentiating benign from malignant solid thyroid nodules, keeping FNAB as gold standard showed 18.7% [n=28] true positive, 4.7% [n=7] false positive, 2% [n=3] false negative and 74.6% [n=112] true negative

Ultrasound finding has sensitivity of 90.3%, specificity of 94.12% and diagnostic accuracy of 93.3%

Conclusion: Accuracy of a new sonographic classification system in differentiating benign from malignant solid thyroid nodules, while keeping FNAB as gold standard was high and is recommended for diagnosis of malignant solid thyroid nodules

Maternal obesity: a global health problem and it's implications on maternal and fetal health

To compare maternal complications and labor outcome in obese and non-obese women. It is a retrospective comparative study conducted at the Department of obstetrics and gynecology, Unit 1, Civil Hospital, Karachi from December 2008 to December 2009. A sample size of 220 gravid women is selected by Non Probability Convenience sampling technique. In these 110 obese women as cases was compared with 110 non-obese women as controls, booked at <20 weeks of gestation. Data were collected regarding maternal complication, mode of delivery and neonatal outcome by trained medical officers. Data were entered and analyzed by SPSS version 11.0 through descriptive analysis, chi-square test and independent sample t test. The p-value of <0.05 was considered significant. Pregnancy induced hypertension was present in 9 [8.2%] women in control group and 21 [19.1%] in cases [p=0.01]. Gestational diabetes was seen in one [0.9%] in control compared to 8 [7.3%] in obese women [p=0.01]. Obese women were found to be at increased risk of caesarean section [17 [15.5%] Vs. 39 [35.4%], p=0.002]. Apgar score at 1 and 10 minute were lower in cases compared to controls [p=0.0001]. Obese women are at increased risk of pregnancy induced obesity and associated with an increased risk of hypertension, gestational diabetes mellitus, thromboembolic disease and urinary tract infection

Factors associated with relapsed tuberculosis in males and females: a comparative study

Tuberculosis [TB] is the leading cause of death from an infectious disease in women worldwide especially in developing countries. There is limited number of literature available on factors associated with the relapse of TB and very few studies on gender differences in this regard. This study aimed to compare the factors associated with the relapse of TB in males and females. A cross-sectional study was conducted in the medical department of Civil Hospital in Hyderabad from August 2008 to November 2008. A total of 100 consecutive patients of any age or gender, diagnosed with relapse of TB who had positive sputum smear after completion of a standard course of anti-tuberculosis therapy [ATT] were included in this study. Those with newly diagnosed tuberculosis and cases of treatment failure or treatment defaulters were excluded from the study. Demographic variables, factors associated with the previous TB infection and underlying medical conditions were among the variables compared in both sexes. The mean age of patients was 36.84 +/- 17.40 years in males and 36.21 +/- 16.41 years in females. There were 38 females and 62 males. Among the factors associated with the relapse of TB, there were statistically significant differences between males and females in regard to addiction [p=0.01], employment [p<0.001], weight gain [p=0.01] and mean hemoglobin value [p=0.05]. Further studies with larger sample sizes are required for evaluation and comparison of factors associated with the reactivation of TB in males and females. This would provide solutions for TB control agencies in the future