Background: It is generally believed that multinodular goiter (MNG) is associated with a lower risk of malignancy compared to solitary thyroid nodules (STN). This will be the null hypothesis in this retrospective study and we aim to prove or reject it.Methods: Medical files and histopathology reports of 600 patients who underwent thyroidectomy over 4-year period were reviewed. Data including patient' age, gender, presentation, ultrasonography, FNAC, surgical procedures, final histopathologic diagnosis and stage of malignant tumors were collected and analyzed. The primary end point was assessment of risk of thyroid carcinoma in patients with MNG compared to those with STN. Secondary endpoints included demographic differences and prognosis.Results: There were 459 females (76.5%). Mean age was 44.3 AE 14.5 years (range 14-85). After exclusion of 33 patients, 224 (39.5%) had STN and 343 (60.5%) had MNG. The prevalence of thyroid cancer was 41.1% (92/224) in STN compared to 29.2% (100/343) in MNG (Chi-Square = 8.593, p < 0.01). However, on multiple logistic regression analysis this correlation was found insignificant ( p = 0.640). Only male gender ( p = <0.000005) and preoperative impression of malignancy ( p = 0.000082) were significantly associated with thyroid carcinoma.

Acute poisoning by potassium permanganate is a rare condition with high morbidity and mortality. Diagnosis of the condition relies on a history of exposure or ingestion and a high degree of clinical suspicion. Oxygen desaturation and the presence of methemoglobin are also helpful indicators. Since no specific antidote is available, treatment is mainly supportive. Few cases have been reported in the literature following potassium permanganate ingestion, whether intentional or accidental, and most of the patients in these cases had unfavorable outcomes, which was not the case in our patient. Our patient, a 73-year-old male, purchased potassium permanganate over the counter mistaking it for magnesium salt, which he frequently used as a laxative. Several hours after he ingested it, he was admitted to the endocrine department at King Hussein Medical Center, Jordan, with acute rapidly evolving shortness of breath. During hospitalization, his liver function tests deteriorated. Since he was diagnosed early and managed promptly he had a favorable outcome.

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Wolfram syndrome (WS) is a rare autosomal recessive neurodegenerative disorder characterized by the presentation of early onset type I diabetes mellitus and optic atrophy with later onset diabetes insipidus and deafness. WFS1 gene was identified on chromosome 4p16.1 as the gene responsible for WS disease given that most of the WS patients were found to carry mutations in this gene. This study was carried out to investigate the molecular spectrum of WFS1 gene in Jordanian families. Molecular and clinical characterization was performed on five WS patients from two unrelated Jordanian families. Our data indicated that WS patients of the first family harbored two deletion mutations (V415del and F247fs) located in exon 8 and exon 7 respectively, with a compound heterozygous pattern of inheritance; while in the second family, we identified a novel nonsense mutation (W185X) located in exon 5 in the N-terminal cytoplasmic domain with a homozygous pattern of inheritance. This mutation can be considered as loss of function mutation since the resulting truncated protein lost both the transmembrane domain and the C-terminal domain. Additionally, the W185X mutation lies within the CaM binding domain in wolframin protein which is thought to have a role in the regulation of wolframin function in response to calcium levels.

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.