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The amount of stainable Iron in the bone marrow is frequently used as a means of assessing Iron stores. In our study marrow Iron assessed in needle biopsy sections and simultaneously obtained aspirated smears from 75 patients. Significantly different amounts of stainable Iron were observed in needle biopsy and aspirated smears in 53.3% of the specimen. The usual difference consisted of significantly less stainable Iron in needle biopsy sections as compared to the aspirated smears (49.3%). In according to this study, in comparison of needle biopsy section to aspirated smears (As a golden test), sensitivity and specificity were 88 and 64 percent, respectively. Also, positive and negative predictive values were 56.5 and 91%, respectively. It can be appreciated that marrow assessment of Iron content may be associated with distinct differences between the needle biopsy specimens, and the aspirated smears, and could lead to diagnostic error, although, with some limitations and cautions biopsy specimen can be used for Iron assessment.

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The cancer of breast is the most common malignancy among women and after cancer of the lung is the second cause of death in females. Thus, early diagnosis and treatment can have a effect significant in prognosis and clinical course of disease. One of the numerous controversial tissues to the clinical management of breast cancers is the role of fine-needle aspiration (FNA) to assess the accuracy and determine the role of FNA in breast cancer diagnosis, we performed both FNA and excisional biopsy in 86 unselected patients with palpable breast masses and correlated the cytologic and histopathologic findings. In our study, FNA had no false-negative and no false-positive results, and the sensitivity of diagnosis of malignant tumors was 88.8%, the specificity of diagnosis of benign lesions was 96.2% and the predictive values were 100%, respectively. On the basis of above study, breast FNA may add a measure of confidence in the diagnosis of benign lesions, provides a safeguard for preventing misdiagnosis of malignant lesion, and might expedite and reduce the cost of managing breast cancer. Also, breast FNA like any diagnostic method depends to individual techniques and continual practice.

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Background&Objective: Sellick’s maneuver is a routinely used technique for the prevention of pulmonary aspiration of gastric contents during anesthesia. The rationale for the application of cricoid pressure necessitates that it is applied at the loss of consciousness during rapid sequence induction. Cricoid pressure therefore, may be fully applied at a level of anesthesia where awareness, and possibly recall, of the maneuver occurs. Materials&Methods: This study was setup to determine the frequency of awareness and recall Sellick's maneuver following 100 patients (ASA I, II) who candidates for lower extremity surgery were randomly enrolled in this prospective study. After induction of anesthesia and application of cricoid pressure, symptoms of awareness and recall were recorded. Data were analyzed by SPSS software and Spearman correlation. Results: The frequency of awareness and recall were 45% and 16% respectively. The frequency distribution of awareness severity based on grade 1, 2 and 3 were 16%, 6% and 1% respectively. The frequency distribution of recall severity based on mild, moderate and sever were 15%, zero and 1% respectively. The correlation between awareness severity and recall severity was statistically significant (P<0.05). Conclusion: Due to high frequency of awareness and recall following Sellick's maneuver and its complications, it is advaiable to revise the procedure of this maneuver and inparticular the accurte time in its application.

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Background&Objective: The presence of single or multiple nodules within the thyroid gland is a common clinical problem. It is immposible to differentiate benign and malignant follicular neoplasms in cytologic examinations.Estimation of risk of malignancy in thyroid nodules who are cytologically assumped to be follicular neoplasm has a critical importance.The aim of this research is evaluation of diagnostic value of thyroid FNA in follicular neoplasm. Materials&Methods: This survey was done on 476 patients with thyroid nodule whome were biopsied in a 7 years period (in 5th Azar hospital, Gorgan). Standard aspirations and biopsies techniques performed and nessassary smears prepared. Wet-fixed smear glass slides are placed immediately in alcohol (70%) 7-10 slides from the aspiration. The patients with cytologic report whome considered follicular neoplasm followed total thyroidectomy or lobectomy. Results: From 476 patients for thyroid nodules 412 cases(86.5%) are suitable for cytologic evaluation which 312 cases(77.9%) of them were benign and 14 cases(3.3%) were malignant.The rest(77 cases)reported to have follicular neoplsm, this patients also undergone thyroid surgery.The result of histological findings appeared in 32 cases(57.1%) follicular adenoma,15 cases(26.7%) non-neoplastic nodules,5 cases(8.9%) follicular carcinoma and 4 cases(7.1%)follicular type of papillary carcinoma. Conclusion: 9 cases (16%) found malignant among cases which cytologic reports considered as “follicular neoplasms” and subsequently undergone thyroid surgery (consist of follicular carcinoma and follicular type of papillary carcinoma), confirme the importance of histopathologic study of follicular lesions for differentiation between malignant and benign lesions.

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Aspiration pneumonia is a critical disease and can result from a various causes. Epiphrenic diverticula is a rare disorder, which can cause aspiration of food material contained in it. Mediastinal tuberculosis can also cause traction diverticula at mid-esophagus, which usually are asymptomatic and induce no complication. In this article we describe a case, suffering of all these three disorders and after seven years of surgery and medical treatment any symptom was not found in the patient.

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Pulmonary aspiration of gastric contents during the peri-operative period is rare but with significant morbidity and mortality. A 21 years old pregnant woman with preeclampsia was scheduled for an emergency cesarean section under spinal anesthesia. After 18 hours of operation, epilepticus status was occurred. One day after control of seizure, aspiration pneumonitis was diagnosed and treated with mechanical ventilation and positive end-expiratory pressure (PEEP). In patients with the history of loss, consciousness, complication of aspiration, aspiration pneumonia and pneumonitis particularly should be considerated. In case of onset of pneumonitis, PEEP treated procedure with other mechanical ventilation is recommaded.

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Background and Objective: Thyroid nodules are common among the general population and they increase the risk of thyroid malignancies. This study was done to evaluate the correlation of findings of ultrasound based on Thyroid Imaging and Reporting Data System (TIRADS) and cytology of fine needle aspiration (FNA) based on Bethesda system to evaluate of thyroid nodules.
Methods: This descriptive-analytical study, was performed on 165 patients (152 females and 13 males) referred to the sonography center of Sayyad Shirazi Educational Hospital, Gorgan, northern Iran during 2018. Ultralosonographic features of nodules were recorded in the pre-filled checklist. According to TIRADS and endocrinologist clinical suspicion, couple of patients was eligible for FNA under the ultrasound guidance. The cytology of FNAs was reported based on the Bethesda system classification.
Results: The mean age was significantly lower in patients with malignant nodules (35.4 vs 44.8; P<0.05). Frequency of malignancy was 8 times higher among females than males (16 vs. 2). TIRADS 3 and 4 were the most common categories among the others with the prevalence of 44.4% and 32.3%, respectively. Bethesda 2 and 4 were the most prevalent categories with prevalence of 58.8% and 20.6%, respectively. The strongest agreement was observed between TIRADS 2 and Bethesda 2 that showed benign findings. Kappa index was 0.061 between TIRADS and Bethesda (P<0.05). Echogenicity, echogenic foci, shape, and margin of nodules were seen significantly more in malignancy.
Conclusion: The most accurate prediction of TIRADS belongs to benign nodules. The correlation between TIRADS and Bethesda was evaluated to be significant overall and the maximum level of correlation was at benign findings. Therefore, these two systems can efficiently be used in order to rule out malignancies and reduce the rate of invasive interventions.

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Background and Objective: Foreign body aspiration is the cause of death in 7% of children under two year’s olds. Children’ molars teeth do not erupt and under devedoled ability to swallow food and generally likely to be distracted, playing or ambulatory while eating. This study was performed to determine the frequency of foreign body aspiration in children under ten years old in north of Iran.
Methods: This descriptive study was done on 50 children (21 boys, 29 girls) less than ten years old with the final detection of foreign body aspiration hospitalized in Taleghani hospital in Gorgan, north of Iran during 2016-17. Demographic characteristics, results of physical examination, radiography and bronchoscopy recorded in the file and the radiology report was collected by a pulmonologist and radiologist.
Results: The common age of foreign body aspiration was between 1-3 years (58%) followed by over 3 years (24%) and under 1 years old (18%). Symptoms of patients with foreign body aspiration were including cough (64%), rhonchi (52%), respiratory distress (32%), wheezing (32%), choking (30%). Common physical examination findings were wheezing (40%), unilateral pulmonary sound (34%), stridor (20%), and rhonchi (6%). The most common findings in Chest X-Rays were unilateral air trapping (48%) in right lung, left mediastan shift (30%), right lung atelectasia (20%), pneumonia (16%). Just in one case (2%) was found the body of radio opac in right lung and in 32% of cases, the graghs were normal. In 70% of patients less 24 hours, in 26% between 1-15 Dayes and in 4% of cases more than 15 Dayes were taken to medical centers. The most common foreign body was nuts (32%) followed by plastic objects (26%), aspiration by sunflower seeds (14%) and beens (10%) and other foreign objects (18%).
Conclusion: The most common clinical signs of foreign body aspiration were cough, wheezing and right lung pneumonia.

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Background and Objective: Thyroid masses are one of the most common reasons for patients to visit endocrinology clinics. Fine needle aspiration (FNA) is used to reduce thyroid surgery for benign lesions. This study was done to determine the diagnostic accuracy of FNA of thyroid mass(s) compared with histological results in Medical Centers, Gorgan, Iran.
Methods: In this descriptive-analytical study, 102 patients (12 males and 90 females) were diagnosed with a thyroid mass and referred for surgery to Medical Centers, Gorgan, Iran during 2020-21. FNA was performed, and the samples were sent to the pathology department for examination. The result of cytology was recorded in the checklist. According to cytology results, some patients were referred for surgery. Then, the surgical pathology results were compared with the cytology findings. In addition, the sensitivity and specificity of the results of the cytology of thyroid masses were calculated compared to the results of pathology.
Results: FNA, mass size, and the patient’s main complaint had a significant relationship with histological results (P<0.05). According to FNA findings compared to pathology, sensitivity was 74%, specificity was 88.1%, positive predictive value was 88.1%, negative predictive value was 74%, false positive rate was 12%, false negative rate was 26%, and accuracy was 80.4%.
Conclusion: FNA remains a key tool in evaluating thyroid nodule(s). Improving FNA techniques is necessary to increase the accuracy of FNA.