Fine needle aspiration of thyroid nodules in a general teaching hospital setting performing moderate number of biopsies: Outcome of indeterminate cytologic results

Introduction: Our aim was to assess the usefulness of fine-needle aspiration cytologic biopsy (FNA) of the thyroid in our general teaching hospital with average health care facility performing moderate number of such procedures and to evaluate the outcome of Indeterminate Cytologic Results. Material and method: We studied on all consecutive patients referred for FNA of the thyroid nodule. All samplings were performed primarily by one endocrinologist performing moderate number of samplings and interpreted by one pathologist. Cytological findings were classified as malignant, histologic control recommended (suspicious or indeterminate), benign, and unsatisfactory. Results: Four hundred and seventy six biopsies were performed. Patient acceptance of this procedure was good and no complication was encountered. 64/476 of samples were considered as insufficient (13.4%). Of the remaining samples (355 F, 57 M), 321 specimens (67.4%) were reported to be non-neoplastic lesions, including 251 (52.7%) colloid nodules, 39 (8.2%) hemorrhagic nodules and 31 (6.5%) cases of thyroiditis. A neoplastic nodule was confirmed in 91/476 of cases (19.1%), of which 14 were cytologically malignant (3.0%). Follicular lesions were identified in the remaining 77/476 cases (16.1%). Excluding 21 patients who were lost to follow-up, the remaining 56 patients (72.7%) were surgically followed up. Upon excision, benign lesions were diagnosed in 47/56 (83.8%), of which 32 lesions (57.1%) were follicular adenoma and 15 cases (26.7%) of colloid nodules. Malignancy was confirmed histopathologically in 9 cases (16.2%), including 4 follicular variant papillary carcinomas and 5 follicular carcinomas. Conclusions: FNA is an inexpensive, safe, practical, well tolerated, and easily applied method, even in not fully-experienced hands and provides useful information. Based on our study findings, suspicious cytologic results (cytologically follicular neoplasms) are inconclusive and are associated with a remarkable chance of malignant involvement; hence surgical treatment is necessary for clarification

Bone mineral density in Iranian patients: Effects of age, sex, and body mass index

Introduction: Osteoporosis is a multifactorial skeletal disease that is characterized by reduced bone mineral density (BMD). BMD values de-pend on several factors such as age, sex and age at menopause. The purpose of this study was to determine the prevalence and changes in bone mineral density in Iranian patients. Meth-ods: Three hundred patients were selected through random sampling technique in 2009. BMD was assessed by Norland (Excell) technique at the lumbar and femoral neck. Weight and height were measured through standard methods. A thorough history was taken from each patient. The data was analyzed using SPSS software version 13.0. P-values less than 0.05 were con-sidered statistically significant. Results: From among the 300 studied patients, 86.6% were fe-male. their mean age was 52.7 years. Their av-erage body mass index (BMI) was 28.14 kg/m2. Mean T-Score at lumbar spine and femoral neck was −1.07 ± 1.19 and −1.75 ± 1.33 respectively. Mean BMD value at lumbar spine and femoral neck was 0.92 ± 0.19 and 0.77 ± 0.16 respectively. The prevalence of osteoporosis at lumbar spine and femoral neck was 33.7% and 16.7, respec-tively. There was a significant correlation be-tween age, BMI and BMD values (P-Value < 0.01). Correlation between gender and BMD value at the lumbar spine and femoral neck was not sig-nificant. Conclusion: This study shows that age- ing and low BMI are risk factors associated with bone loss. it is recommended to measure BMD and implement prevention programs for high- risk people. Keywords: Bone Mineral Density; Body Mass Index;Age; Gende

Surface Terms of Quartic Quasitopological Gravity and Thermodynamics of Nonlinear Charged Rotating Black Branes

As in the case of Einstein or Lovelock gravity, the action of quartic quasitopological gravity has not a well-defined variational principle. In this paper, we first introduce a surface term that makes the variation of quartic quasitopological gravity well defined. Second, we present the static charged solutions of quartic quasitopological gravity in the presence of a non linear electromagnetic field. One of the branch of these solutions presents a black brane with one or two horizons or a naked singularity depending on the charge and mass of the solution. The thermodynamic of these black branes are investigated through the use of the Gibbs free energy. In order to do this, we calculate the finite action by use of the counterterm method inspired by AdS/CFT correspondence. Introducing a Smarr-type formula, we also show that the conserved and thermodynamics quantities of these solutions satisfy the first law of thermodynamics. Finally, we present the charged rotating black branes in $(n+1)$ dimensions with $k\leq [n/2]$ rotation parameters and investigate their thermodynamics.Comment: 16 pages, Late

Black Holes in (Quartic) Quasitopological Gravity

We construct quartic quasitopological gravity, a theory of gravity containing terms quartic in the curvature that yields second order differential equations in the spherically symmetric case. Up to a term proportional to the quartic term in Lovelock gravity we find a unique solution for this quartic case, valid in any dimensionality larger than 4 except 8. This case is the highest degree of curvature coupling for which explicit black hole solutions can be constructed, and we obtain and analyze the various black hole solutions that emerge from the field equations in $(n+1)$ dimensions. We discuss the thermodynamics of these black holes and compute their entropy as a function of the horizon radius. We then make some general remarks about $K$-th order quasitopological gravity, and point out that the basic structure of the solutions will be the same in any dimensionality for general $K$ apart from particular cases.Comment: LaTex, 9 figures, 27 pages. A new section on holographic hydrodynamics is added. Introduction and concluding remarks have been revise

Association of the TCF7L2 rs12255372 (G/T) variant with type 2 diabetes mellitus in an Iranian population

In various populations worldwide, common variants of the TCF7L2 (Transcription factor 7-like 2) gene are associated with the risk of type 2 diabetes mellitus (T2DM). The aim was to investigate the association between rs12255372 (G/T) polymorphism in the TCF7L2 gene and T2DM in an Iranian population. 236 unrelated patients with T2DM, and 255 normoglycemic controls without diabetes were studied. The PCR-RFLP method was used for genotyping rs12255372 (G/T) polymorphism, and the SPSS version 18.0 for Windows for statistical analysis. The minor T allele of TCF7L2 rs12255372 was found to significantly increase the risk of T2DM, with an allelic odds ratio (OR) of 1.458 (95% CI 1.108-1.918, p = 0.007). A significant difference in TT genotype was observed between T2DM patients and normoglycemic controls (OR 2.038, 95% CI 1.147-3.623; p = 0.014). On assuming dominant and recessive models, ORs of 1.52 [95% CI (1.05-2.21) p = 0.026)] and 1.74 [95% CI (1.01-3.00) p = 0.043] were obtained, respectively, thereby implying that the co-dominant model would best fit the susceptible gene effect. This study further confirms the TCF7L2 gene as enhancing susceptibility to the development of T2DM. © 2012, Sociedade Brasileira de Genética

Topological Black Holes of Einstein-Yang-Mills dilaton Gravity

We present the topological solutions of Einstein-dilaton gravity in the presence of a non-Abelian Yang-Mills field. In 4 dimensions, we consider the $So(3)$ and $So(2,1)$ semisimple group as the Yang-Mills gauge group, and introduce the black hole solutions with spherical and hyperbolic horizons, respectively. The solution in the absence of dilaton potential is asymptotically flat and exists only with spherical horizon. Contrary to the non-extreme Reissner-Nordstrom black hole, which has two horizons with a timelike and avoidable singularity, here the solution may present a black hole with a null and unavoidable singularity with only one horizon. In the presence of dilaton potential, the asymptotic behavior of the solutions is neither flat nor anti-de Sitter. These solutions contain a null and avoidable singularity, and may present a black hole with two horizons, an extreme black hole or a naked singularity. We also calculate the mass of the solutions through the use of a modified version of Brown and York formalism, and consider the first law of thermodynamics.Comment: 13 pages, 3 figure

Positive effect of low dose vitamin D supplementation on growth of fetal bones: A randomized prospective study

The effect of vitamin D supplementation on growth of fetal bones during pregnancy is unclear. The aim of this study was to assess the effect of low dose vitamin D supplementation during pregnancy on bony anthropometric aspects of the fetus. In this prospective randomized trial, 140 patients were divided into two equally matched groups according to age, 25(OH)D level, exercise, and dietary intake. Then 1000 IU per day vitamin D supplement was given to the intervention group while the control group received placebo. Then crown-rump length (CRL) and femur length (FL) during the first trimester and humerus and femur lengths as well as their proximal metaphyseal diameter (PMD), midshaft diameter (MSD) and distal metaphyseal diameter (DMD) in the second and third trimester were measured using ultrasonography technique. Finally, no significant difference was observed for CRL (p = 0.93). Although FL was not statistically significant in the first trimester (p = 0.54), its measurement in the intervention group and the control group in the second (28.87 ± 2.14 vs. 26.89 ± 2.08; p ≤0.001) and the third (65.31 ± 2.17 vs. 62.85 ± 1.94; p ≤0.001) trimesters was significantly different. Femoral PMD, MSD, and DMD measurement increased more in the intervention group in comparison with the control group with P values <0.05. HL measurement in the intervention group and the control group in the second (28.62 ± 1.94 vs. 27.23 ± 2.08; p ≤0.001) and the third (61.29 ± 2.84 vs. 59.85 ± 1.79; p ≤0.001) trimesters revealed significant differences. Humeral PMD, MSD, and DMD measurement increased in the intervention group in comparison with the control group with P values <0.001 for all. It is suggested to prescribe low dose vitamin D (1000 IU per day) from early pregnancy with possible increment in length and diameter of femur and humerus bones of the fetus