Thyrotropin/Thyroglobulin ratio in combination with thyroid u/s to assess malignancy risk stratification of thyroid nodules

Objective: we aimed to asses if thyrotropin/thyroglobulin ratio has a significant value in detection of malignant thyroid nodules. Design: Retrospective analysis. Material and Methods: This study included finally 100 subject collected as outpatient’s endocrinology clinic of ALHuessine university hospital or admitted at oncology institute of Tanta. Patients who had history of thyroid diseases or surgery, those with abnormal levels of anti- thyroglobulin antibodies, cases without simultaneous measurement of serum anti Tg., with history of current use of thyroid hormone replacement therapy were excluded from this study. Clinico pathological features, as well as serumTSH, Tg, and TSH/Tg were compared between histopathologically benign and malignant groups. Results: Data related to 100 subjects (40%) normal  and 60(60%) patients  with thyroid nodules were analyzed, 30 patients (50%) were malignant thyroid nodules and 30 patients (50%) were benign.The malignant patients exhibited significantly higher TSH, TSH/Tg, , and a lower Tg compared to the benign patients (p<0.05 for each). Conclusion: Preoperative TSH/Tg could be used as a predictive marker for differ-entiating between benign and malignant thyroid nodules

The role of critical care ultrasonography in acute respiratory distress

Introduction: Acute Respiratory Distress and/or Failure (ARF), is a common and serious presentation of patients admitted to intensive care unit (ICU) and traditional diagnosis has a low accuracy except CT chest which may inappropriate to all patient. Bedside ultrasound (US) is now emerging as a valuable tool in dynamic assessment of lungs, heart, vessels and hemodynamic status. Aim of the work: Our aim in this study was to evaluate the diagnostic utility of combined cardiac and thoracic critical care ultrasonography in identifying causes of Acute Respiratory Distress and/or Failure in the early course of critical illness. Patients and method: This prospective observational study was conducted on adult patient admitted to Medical Intensive Care Unit (MICU), Department of Internal medicine, Al Hussein university hospital, Al Azhar University. All included patients underwent bedside CPUS including lung ultrasound (US) and transthoracic echocardiography plus targeted venous US by single investigator, blinded to clinical data. The US diagnosis of ARF etiology was shared with treating intensivist. Initial clinicaldiagnosis (ICD) of each patient were compared with post US clinical diagnosis