Current Clinical and Medical Education

Decoding Thyroid Lesions – A Correlative Study Between Cytology and Radiological Findings

2026-07-15T06:02:11+00:00

Background: Thyroid nodules are among the most frequently encountered endocrine lesions, with the majority being benign while a small but significant proportion harbor malignancy. Accurate preoperative risk stratification is essential to avoid unnecessary surgical intervention and ensure timely management of malignant lesions. Fine-needle aspiration cytology (FNAC) and ultrasonography are widely used diagnostic tools, and their combined application may enhance diagnostic accuracy.

Objectives: To correlate cytological findings categorized according to the Bethesda System for Reporting Thyroid Cytopathology with ultrasonographic findings classified using the ACR TI-RADS system and to evaluate their diagnostic performance against histopathological examination.

Materials and Methods: This cross-sectional observational study included 261 patients with thyroid lesions who underwent FNAC, ultrasonographic evaluation, and subsequent surgical excision between January 2023 and December 2024. Cytological diagnoses were reported according to the Bethesda System, while ultrasonographic findings were categorized using ACR TI-RADS. Histopathological examination served as the gold standard. Sensitivity, specificity, positive predictive value, negative predictive value, diagnostic accuracy, and agreement between modalities were assessed.

Results: Of the 261 patients studied, females constituted 80.1% of cases, with the highest frequency observed in the 21–40-year age group. Bethesda category II lesions were the most common cytological diagnosis (67.4%), while TI-RADS category TR3 represented the largest radiological group (30.3%). FNAC demonstrated a sensitivity of 86.0%, specificity of 91.5%, and diagnostic accuracy of 89.3%. Ultrasonography showed a sensitivity of 82.4%, specificity of 88.7%, and accuracy of 86.2%. The combined use of FNAC and TI-RADS significantly improved diagnostic performance, achieving a sensitivity of 92.9%, specificity of 94.1%, and overall accuracy of 93.4%. Discordant findings were predominantly encountered in indeterminate cytological categories.

Conclusion: Integration of Bethesda-based cytological reporting with ACR TI-RADS risk stratification substantially improves the preoperative evaluation of thyroid nodules. The combined approach enhances diagnostic accuracy, facilitates more effective risk stratification, and supports informed clinical decision-making, thereby reducing unnecessary surgical procedures while ensuring appropriate management of malignant thyroid lesions.

Comparative Effects of Saroglitazar, Vitamin E and Lifestyle Modification on Liver Fibrosis Markers in Metabolic Dysfunction-Associated Steatotic Liver Disease

2026-07-15T06:16:51+00:00

Introduction: This study presents the effects of metabolic dysfunction-associated steatotic liver disease (MASLD), which is a global health issue. It is related with obesity, metabolic dysfunction, and progressive liver fibrosis. In order to prevent this issue, it requires an effective treatment plan. This study assessed the effect of Saroglitazar, Vitamin E, and lifestyle modification on liver fibrosis markers and metabolic parameters in patients with MASLD/metabolic dysfunction-associated steatohepatitis (MASH).

Methods: This investigator-initiated, prospective, randomised study was conducted among 170 patients from May 2025 to April 2026 in our hospital. 170 participants were divided into three groups: Saroglitazar (n=60), Vitamin E (n=60), and Only Lifestyle group (n=50). Each parameter was measured at baseline and after 24 weeks.

Results: Baseline characteristics were comparable across the Saroglitazar (n=60), Vitamin E (n=60), and Lifestyle (n=50) groups. Median age (33–35 years; p=0.72), male distribution (86–88%; p=0.91), anthropometric measures, and all baseline laboratory parameters showed no significant differences (all p>0.05). After 24 weeks, improvements were observed across all groups, with significant between-group differences only for triglyceride reduction, which was greatest with Saroglitazar (−14.2 vs. −4.5 vs. −13.5 mg/dL; p=0.034). The proportion achieving ≥2 kPa liver stiffness reduction was highest with Saroglitazar (40%), followed by Vitamin E (35%) and Lifestyle intervention (20%), with Saroglitazar significantly outperforming Lifestyle intervention (p=0.028).

Conclusion: The study concluded that the Saroglitazar showed improvement in the triglyceride levels and liver stiffness response, while all other three interventions showed similar improvement in the fibrosis and the functional marker for liver.

Pattern and Prevalence of Acute and Delayed Transfusion Reactions Following Blood Component Therapy

2026-07-15T06:31:11+00:00

Introduction: The blood transfusion procedure is crucial from a therapeutic standpoint but may cause adverse effects to the patients through acute and delayed adverse transfusion reactions (ATRs). It is therefore crucial to maintain constant hemovigilance in order to reduce such occurrences. The objective of this study was to determine the frequency, type, and presentation of these ATRs.

Methods: The study is based on observations made by the researchers in the Department of Transfusion Medicine, L.N. Medical College and Research Center, Indore during the period from July 2025 to March 2026. Information from 160 transfused patients and 520 blood component units is used in the study. Transfusion reactions are classified clinically and biochemically and described.

Results: Of 160 patients who had adverse transfusion reactions, adult patients represented 78.7% and female patients 56.2%. Of 520 units of blood components transfused, packed red blood cells were the highest in percentage (36.5%), and they were responsible for 68.0% of all the reactions. Febrile non-hemolytic transfusion reaction accounted for 40.0% of all the reactions, and allergic reactions 36.0%. Fever accounted for 28.0%, and itching 24.0% of all the reaction.

Conclusion: The study concluded low incidence of mild adverse transfusion reactions, along with FNHTRs and allergic reactions as the most common associated with the PRBC transfusions.