<p><strong>Background and Objective:</strong> Thyroid imaging reporting and data system (TI-RADS) is developed to determine the risk of malignancy in patients with thyroid nodules. The aim of this study was to determine the diagnostic accuracy of TI-RADS classification for diagnosing malignant thyroid nodules taking Fine needle aspiration cytology (FNAC) as a gold standard in the local population.</p> <p><strong>Methods:</strong> In this cross-sectional validation study, 201 patients presenting with thyroid nodules at the Department of Radiology, Bakhtawar Amin Hospital Multan, Pakistan from July 2020 to December 2020 were included. In all patients, thyroid nodules were evaluated on grey scale (B-mode) modality. TI-RADS score was calculated for each patient. Patients with TI-RADS score 4 and 5 were labelled as having malignant nodules. After that FNAC samples were taken and sent for histopathologic evaluation of thyroid nodules. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of TI-RADS taking FNAC as a gold standard were determined.</p> <p><strong>Results:</strong> The mean age of the patients was 47.8 &plusmn; 4.5 years; there were 129 (67.2%) women and 72 (35.82%) men. There were 42 patients who tested true positive and 36 patients tested false positive and 12 patients were false negative and 111 patients true negative. The TIRADS sensitivity was 77.8%, specificity was 75.5%, PPV was 53.8%, and NPV 90.2%. the diagnostic accuracy was 76.1%.</p> <p><strong>Conclusion: </strong>Differentiating benign thyroid nodules from malignant using the TI-RADS score has a high diagnostic accuracy. Our study results support the TIRADS as a first-line imaging evaluation for diagnosis of thyroid malignancy.</p>

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Objective: To evaluate the validity of new ultrasound classification in diagnosing malignant thyroid nodule keeping fine needle aspiration cytology (FNAC) as gold standard. Materials and Methods: This validation study was carried out at hospital from September 06-2020 to March-2021 in Children Hospital and Institute of Child Health Multan .A total number of 114 patients who presented with inflamed thyroid nodules were included. General information regarding patient like name, age and gender was documented for data collection. Ultrasonography was done using Linear 7.5 MHz and curvilear 3.5 MHz transducer all patient in supine position and comfortable setting. Features of ultrasound were recorded. Patients having U4-U5 score were labelled as having malignant lesions. All cases were followed up by fine needle aspiration and corresponding histopathology report. Results: Mean age of patients was 46.06±10.34 years. Out of 114 patients, 83 (72.81%) patients were female and only 31 (27.19%) were male. On ultrasonography, malignancy was diagnosed in only 24 (21.05%) patients, and remaining 90 (78.95%) were diagnosed of having benign lesions. On histopathology, malignancy was diagnosed in 25 (21.93%) lesions, while remaining 89 (78.07%) patients were diagnosed of having benign lesions. Sensitivity of ultrasound U-score in diagnosing malignant thyroid nodules was 88%, specificity was 97.8%, PPV was 91.7% and NPV was 96.7%. Conclusion: New sonographic classification system has a reliable accuracy for differentiating malignant from benign solid thyroid nodules. So it can be used as preferred radiological scoring system for initial investigation for solid thyroid nodules. Keywords: Thyroid nodules, ultrasound U-Score, Histopathology, Malignancy, Diagnostic accuracy.

The urinary tract has restrictions in its lower parts. This problem can be detected by two different methods. Obstruction in the anterior portion of this tract can be diagnosed by some available standard methods. Objective: To assess the general problems in the male urethra specifically in the anterior portion. Methods: It is a prospective and comparative study with a statistical approach, conducted at Bakhtawar Amin Memorial and Trust Hospital, Multan and MTI Mardan Medical Complex, Mardan for the duration of one year from December 2020 to December 2021. The study was done by using ultrasound of high resolution. Then the comparison of the operative conclusions has to be done with retrograde urethrography (RGU) to find out the efficiency of RGU. For this study work, seventy-seven patients were selected. All these patients had some restrictions in the urinary pathway confirmed by retrograde urethrography. Different characteristics of the patients were studied and matched with the available standard methods. By both tests specificity, sensitivity, and overall accuracy of the protocol were also assessed. Different statistical analyses were performed to find out the results. Results: All the seventy-seven patients were having some restriction of urinary pathway, which were detected by sonourethrography and further confirmation was done by other previously verified methods. The retrograde urethrography shows almost very low sensitivity of this particular problem detection. This test was about 60 to 80% sensitive for this diagnosis. This sensitivity is specific for the length of about 1 to 5 cm. These results were compared with the results of sonourethrography. The problem termed as spongiofibrosis was also diagnosed with sensitivity about 76 to 82 %. A number of other problems were also detected by this method like calculi and further confirmation was done at the time of surgery. The probability was greater than 0.001 and difference in frequency was also not so significant. It was less than 0.5. Conclusions: Both of the methods have equal efficiency for the detection of different restrictions in urinary tract. When other parameters were assessed; it was inferred that sonourethrography is more efficient method