Propagating Relationship of Cerebral Oximetric Volume and the Clinical Outcome of Recombinant Tissue Plasminogen Activator (r-TPA) Therapy on Acute Cerebral Ischemic Stroke Patients

Introduction: Currently, the most available treatment for acute ischemic stroke (AIS) is thrombolytic therapy with recombinant tissue plasminogen activator (r-TPA). A challenge in r-TPA therapy is the prediction of recovery in each case. Objective: The aim was to find a possible relationship between the cerebral oximetry indexes and the clinical outcome of r-TPA therapy to assess the cerebral oximetry as a non-invasive monitoring agent for therapy. Methods: The inclusion criteria were all patients with AIS who received r-TPA. The neurologic status was evaluated based on the national institutes of health stroke scale (NIHSS) score at arrival, and after a period of 24 hours. In addition, the levels of brain oxygenation in both hemispheres were measured before and continuously over the first 24 hours after r-TPA injection, using an oximetric sensor in the frontal lobes. The clinical success was defined as a 4-point improvement from the baseline NIHSS. Results: Total 44 patients with the mean age of 58.2 ± 2.18 years were enrolled, of whom 68.18% were male. Twenty-eight patients remained clinically unimproved and 16 patients were improved. A significant difference was found in the mean surface area under the brain oximetric curve in the 24 hour, in the affected hemisphere in the improved group, compared to the unimproved group (P = 0.007). There was a significant difference between the mean increase in brain oxygenation within 24 hours in the improved and unimproved groups (P = 0.002). Conclusion: The cerebral oximetry could contribute to predict the likelihood of r-TPA prognosis in patients with AIS

Reliability of Fine Needle Aspiration Cytology for Salivary Gland Lesions

Background and Aim: Fine needle aspiration (FNA) cytology is a safe, reliable, mini-mally invasive and cost-effective technique for the diagnosis of salivary gland lesions. This study aimed to assess the accuracy, reliability and diagnostic value of FNA cytology in Iran. Materials and Methods: A total of 200 records of patients with a history of biopsy or surgical excision of salivary gland lesions along with their histological and cytological examination results were retrieved and evaluated in the Pathology Department of Amir Alam Hospital during 2007-2013. The results of cytological diagnosis were divided into 4 groups of unfavorable, benign, suspicious and malignant. The cytological results were compared with the histological data. The accuracy, sensitivity, specificity, positive predic-tive value (PPV) and negative predictive value (NPV) of FNA cytology were calculated using SPSS version 16.00. Results: Of the specimens chosen for the study, 173 were from the parotid, 22 from the submandibular and 5 from the minor salivary glands. FNA cytological diagnosis was be-nign in 161 cases, suspicious for malignancy in 4 cases, and malignancy in 35 cases. Of 161 cases diagnosed as benign by FNA cytology, 25 were malignant and the frequency of false positive results was 15.5%. The accuracy, sensitivity, specificity, PPV and NPV of the FNA test were 82, 53, 93, 72 and 84%, respectively. Conclusion: A good agreement exists between the FNA results and final histopathological diagnosis of salivary gland tumors. Also, this study showed that FNA cytology has mod-erate accuracy and relative diagnostic value for diagnosis of salivary gland lesions