Athletic Injuries ; diagnosis ; Biomechanical Phenomena ; Humans ; Knee Injuries ; diagnosis ; physiopathology ; Magnetic Resonance Imaging

INTRODUCTIONWe aimed to compare the malignancy risk stratification of histologically proven thyroid nodules using the 2015 American Thyroid Association (ATA) Management Guidelines, 2014 British Thyroid Association (BTA) Guidelines for the Management of Thyroid Cancer and the Thyroid Imaging Reporting and Data System (TIRADS).

METHODSThyroid nodules measuring > 1 cm resected over 5.5 years were retrospectively studied. Demographic information as well as cytology and histopathology results were collected. Static ultrasonography (US) images and radiologists' reports of each resected nodules were reviewed and classified based on the above risk classification systems.

RESULTSA total of 167 thyroid nodules from 150 patients were examined. More malignant nodules were solid (78.4% vs. 62.5%; p = 0.049) or hypoechoic (70.6% vs. 28.6%; p < 0.001), and had irregular margins (35.3% vs. 8.0%; p < 0.001), taller-than-wide morphology (9.8% vs. 2.7%; p = 0.031), microcalcifications (33.3% vs. 8.0%; p < 0.001), disrupted rim calcifications (9.8% vs. 0.9%; p = 0.012) or associated abnormal cervical lymphadenopathy (13.7% vs. 0.9%; p = 0.001) compared with benign nodules. The guidelines' diagnostic performance was: ATA - sensitivity 98.0%, specificity 17.3%, positive predictive value (PPV) 35.0%, negative predictive value (NPV) 95.0%; BTA - sensitivity 90%, specificity 50.9%, PPV 45.5%, NPV 91.8%; and TIRADS - sensitivity 94.0%, specificity 28.2%, PPV 37.3%%, NPV 91.2%.

CONCLUSIONSonographic patterns outlined by the three guidelines displayed high sensitivity and NPV. Although isolated suspicious US features cannot predict malignancy risk, they should be considered when risk stratifying nodules that do not fit into particular sonographic patterns based on current guidelines.

Background: Sexually transmitted infections (STIs) are common worldwide. This study aims to determine the patterns of STIs among attendees in the Genito-Urinary Medicine (GUM) clinic of Sarawak General Hospital (SGH). Methods: This is a retrospective study. Medical records of new cases referred to GUM clinic, SGH between the year 2018 and 2020 were reviewed. Demography data, diagnosis, and clinical characteristics of STIs were reviewed and analysed using SPSS software. Results: There was a total of 225 patients with newly diagnosed STIs. Their mean age was 30.9 years old. There were 124 (55.1%) males and 101 (44.9%) females. Nearly half (46.7%) of the patients were Malay, followed by Sarawak indigenous groups (33.3%), and Chinese (18.7%). Most patients (n=119, 52.9%) were single at the time of diagnosis. Three quarters (73.3%) of the patients were heterosexual, while 47 (20.9%) patients were homosexual or bisexual, and missing data in the remaining 5.8%. Anogenital wart was the commonest STI (49.8%), followed by syphilis (n=91, 40.4%), genital herpes (n=24,10.7%) and gonorrhoea (n= 15, 6.7%). The commonest symptoms were genital growth (n= 107, 47.6%), followed by pelvic discharge (n=22, 9.8%). Conclusion The most common STIs in our study are anogenital warts, syphilis, genital herpes and gonorrhea. Effective national sexuality education in Malaysia is paramount in reducing premarital sex and STIs. Human Papillomavirus (HPV) vaccines are effective to reduce genital warts and HPV related malignancies.
Sexually Transmitted Diseases ; Papillomavirus Vaccines ; Genito-Urinary Medicine Clinic, Sarawak General Hospital (Malaysia)