Background: Cardiac surgeries induce many inflammatory responses with remarkable clinical implications. Tryptophan (Trp) is a precursor for serotonin, melatonin and kynurenine (Kyn). Plasma kynurenic acid (Kyna) and Kyn concentrations are thought to be related to the severity of inflammation. Plasma Trp/Kyn ratio is used to measure inflammatory cytokine activity.

Methods: We performed the current longitudinal study in a tertiary care center and included 62 patients divided into two groups; group A (on-pump CABG patients) and group B (off-pump CABG patients). Plasma Trp and Kyn were measured using the high-performance liquid chromatography (HPLC) technique. Serum interlukin-6 (IL-6) and white blood cells (WBCs) were measured using ELISA and routine blood count, respectively.

Results: The present study revealed that the intraoperative levels of plasma Kyn, IL-6 and WBCs were significantly increased while the plasma Trp/Kyn ratio was significantly decreased in both the groups; however, the changes were more significant in the on-pump CABG group. Moreover, the levels in both the groups returned to preoperative levels 72 h postoperative. Our study has shown that WBCs is positively correlated with IL-6, but has negative correlation with Trp/Kyn ratio.

Conclusions: Kyn and Trp/Kyn ratio might be utilized as markers of the severity of inflammation in major surgery. In addition, off-pump CABG might be more preferable than on-pump CABG regarding stress and release of inflammatory markers.

Background & Objectives: platelet indices are widely available and relatively cheap platelet parameters. The critical objective of this study is to assess the reliability of platelet indices as biomarkers for diagnosis and prognosis in adult thrombocytopenic patients.

Methods: A retrospective case-control study, including 81 immune thrombocytopenia (ITP) cases, 50 aplastic anemia (AA) cases, and 150 participants as a control group. This study included patients admitted from 2016 to 2021 to the Clinical Hematology Unit, Department of Internal Medicine, University Hospital. The collected data included Socio-demographic information, clinical data, laboratory data, and an assessment of the therapeutic response in the studied groups.

Results:For the diagnosis of adult thrombocytopenic patients, platelet distribution width (PDW) showed the best diagnostic accuracy (85% for ITP and 91.9% for AA) at cutoff points of 14.9% and 17.2%, respectively. This was followed by mean platelet volume (MPV) with diagnostic accuracies of 77% for ITP and 89.3% for AA at a cutoff point of 9.4 fl. Platelet large cell ratio (PLCR) demonstrated insignificant accuracy in diagnosing either ITP or AA. Conclusion Platelet indices can play a crucial influence in the diagnosis, not the prognosis, of adult thrombocytopenia.

Keywords: immune thrombocytopenic purpura, aplastic anemia, mean platelet volume; platelet distribution width, platelet large cell ratio

Ethical approval number:(IRB No:17101645).

Clinical trial ID: NCT05116033

https://classic.clinicaltrials.gov/ct2/show/NCT05116033

Abstract
Background: Thyroid nodules are a common occurrence in the general
population.Ultrasound provides a safe and fast sensitive method for the
detection of thyroid nodules, and suspicious features can be used to guide
further investigation/management decisions. However, given the financial
burden on the health service and unnecessary anxiety for patients, it is
unrealistic to biopsy every thyroid nodule to confirm diagnosis .
Aim:This study aimed to develop a rational, cost-effective approach to
ordering and interpreting imaging and diagnostic tests in the evaluation of
the thyroid nodule.
Methods: this was a cross-sectionalprospective study including all patients
presented with thyroid nodules either clinically or incidentally discovered in
thyroid clinic of endocrine unit in period between March 2019 to March
2022thyroid function test, thyroid ultrasound andFine needle aspiration
cytology (FNAC) was done.
Results: According to TI-RADS classification, 2, 7 and 32 nodules
categorized as TI-RADS I, II and III were benign on FNAC with specificity
of 100%. Therefore, the estimated decrease in unnecessary FNACs was
63.08%. Meanwhile, all nodules categorized as TI-RADS V (very
suspicious) were confirmed to be malignant by FNAC with sensitivity,
specificity, PPV and NPV of 100%.
Conclusion: The sonographic features, severe hypo-echogenicity and micro-
calcification can be used for diagnosis of malignancy. TI-RADS
classification and thyroid cancer were associated; TI-RADS 3 and 2 are the
most frequently noted classification of TNs in or study.
Keywords: thyroid nodules; thyroid ultrasound ;FNAC.