Primary hyperparathyroidism is the most common cause of hypercalcemia in outpatients and it is usually attributed to parathyroid adenoma, which is managed by surgical resection of the adenoma. Successful management requires accurate localization of the adenoma prior to surgery. Objective: To describe our institution's experience in assessing the diagnostic value of parathyroid Fine Needle Aspirate (FNA) and PTH washout in localizing and confirming parathyroid adenoma. Methods: Twenty three patients (91.3% females) diagnosed to have primary hyperparathyroidism(PHPT) were enrolled in our study: parathyroid scanning (sestamibi), Ultrasound (US)and USguided FNA of the suspected parathyroid adenoma done to all patients by the same radiologist. The aspirate form FNA was washed out with one centimeter cubic normal saline and PTH was measured in the washout. Results: Mean(±SD) age was 51.3±13.5 year. Mean serum PTH (289.3±384.7) pg/ml and mean serum Calcium was (10.9±1.2) mg/ dl. Mean (±SD) PTH values in the washout is1172.3 ± 1877.6 pg/ml. Three patients had negative sestamibi scan but had positive results in PTH washout. The sensitivity and specificity of PTH washout are 82% and 100% respectively, with 100% positive predictive value and 67 % negative predictive value. For Sestamibi scan are 76.5% and 83.3% respectively with 92.9 % positive predictive value and 55.6 % negative predictive value and for ultrasound are 76 % and 67 % respectively with 87% positive predictive value and 50% negative predictive value. Conclusion: This study highlights the superiority of Parathyroid FNA with PTH washout over US or sestamibi scanning in confirming a parathyroid adenoma.

Introduction: To assess the rate of thyroid cancer and mortality rate in a cohort of patients who received RAI 131 treatment for hyperthyroidism and to report the index cases' characteristics and management Material and methods: A cohort of 264 patients who received RAI 131 treatment for different causes of thyrotoxicosis were followed up over a period of 18 years (1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014) by physical exam, radiological evaluation and serial thyroid function tests. Results: During the follow up period, three cases of thyroid cancer were identified. The prevalence of thyroid cancer was 1.136% of cases who received RAI 131 . The relative risk was 378.79 (95% CI: 76.8 < RR < 1868.23). The P value was < 0.0000004 and the SMR is 1.99/1000. Conclusions: The prevalence of thyroid cancer was 1.136% in the cohort of patients treated with RAI

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Type 2 diabetes often requires a pharmacological treatment approach if lifestyle modification alone fails. Abdallah Al Eyadeh and Paul E Jennings provide an overview of new approaches for treatment