US elastography can be used to increase both the sensitivity and the specificity of US for the detection of malignant thyroid nodules, and so it seems to have great potential as a new tool for the diagnosis of thyroid cancer.

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Objective:The objective of this study is to evaluate the role of high resolution ultrasonography (US) and endoscopic ultrasound (EUS)-elastography in predicting malignant lymphadenopathy.Patients and Methods:This prospective study included 88 patients who underwent EUS or US examination of different groups of lymph nodes (LNs). The classification as benign or malignant based on the real time elastography pattern and the B-mode US/EUS images was compared with the final diagnosis obtained by EUS or US guided fine-needle aspiration cytology (FNAC), tru-cut biopsy or excisional biopsy and follow-up in benign lesions not indicated for biopsy for at least 12 months.Results:Regarding the echogenicity, 98.3% of the benign LNs were hyperechoic, 1.7% was hypoechoic while 89.7% of the malignant LNs were hypoechoic, 3.4% were heterogenous and 6.9% were hyperechoic. With cut-off value of 1.93, the sensitivity of longitudinal to transverse ratio was 73% and the specificity was 100%. Score 1 elastography had specificity of 100% in diagnosis of benign LNs, sensitivity was 76.3%, positive predictive value (PPV) was 100%, negative predictive value (NPV) was 84.7% while score 2 had a sensitivity of 60%, specificity of 31.5%, PPV of 15.3%, NPV of 79.3%. Score 3 had a sensitivity of 70.2%, specificity of 100%, PPV of 13.8%, NPV of 100% in detecting malignancy while score 4 had a sensitivity of 85.5%, specificity of 100%, PPV of 100%, NPV of 65.5%.Conclusion:Elastography is a promising diagnostic modality that may complement standard ultrasound and EUS and help guide FNAC during staging of LNs.

Background: Since the onset of the COVID-19 pandemic, concerns about health-related and economic hazards of the virus, the restrictions imposed by the public health measures, the lack of social interactions, and the financial losses have affected people's mental health in various ways. People with diabetes are more vulnerable to comorbid mental illness that may interfere with treatment adherence and disease prognosis. This study explores the psychological state of Egyptian patients suffering from diabetes mellitus (DM) during the COVID-19 pandemic. Methods: Egyptian adults with DM were invited to participate through an online survey in the period from April 24 to May 12. The survey included sociodemographic information, questions assessing diabetes status, and general assessment of the psychological health status using the General Health Questionnaire (GHQ-12). Results: In total, 849 participants shared in the survey. 51.4% of the studied population were at risk, while 21.2% were at high risk of psychological distress. There was a statistically significant difference with the non-working group with a mean GHQ-12 score of 17.44, SD= 6.267, SE 0.491, 95% (16.47-18.41), and p-value of 0.01. Regarding the disease precautions, there was a statistically significant difference between home isolation and those who did not home isolate with a mean 16.23 and SD 6.285 compared to a mean 15.32 SD 5.701 p-value 0.028. There was a significantly increased number of 4 or more diabetes complications and comorbidities with a mean 20. 60 SD 8.675, SE 2.240,) with a p-value of less than 0.001 and mainly with hypertension as comorbidity. Conclusion: The current study shows that Egyptian patients suffering from DM are likely to psychological distress amid the COVID-19 pandemic. Risk factors included female gender, non-working, and patients with diabetic complications, particularly hypertension. Further attention to the psychological needs of Egyptian patients with DM amid the COVID-19 is recommended.