Birth outcomes in pregnant women with epilepsy: A Nationwide multicenter study from Türkiye.

OBJECTIVE: The present study was aimed at investigating the effects of anti-seizure medications (ASMs), patient demographic characteristics, and the seizure type and frequency on the development of congenital malformations (CMs) in the infants of pregnant women with epilepsy (PWWE). METHODS: PWWE followed up at the neurology outpatient clinic of 21 centers between 2014 and 2019 were included in this prospective study. The follow-up of PWWE was conducted using structured, general pregnant follow-up forms prepared by the Pregnancy and Epilepsy Study Committee. The newborns were examined by a neonatologist after delivery and at 1 and 3 months postpartum. RESULTS: Of the infants of 759 PWWE, 7.2% had CMs, with 5.6% having major CMs. Polytherapy, monotherapy, and no medications were received by 168 (22.1%), 548 (72.2 %), and 43 (5.7 %) patients, respectively. CMs were detected at an incidence of 2.3% in infants of PWWE who did not receive medication, 5.7% in infants of PWWE who received monotherapy, and 13.7% in infants of PWWE who received polytherapy. The risk of malformation was 2.31-fold (95% confidence interval (CI): 1.48-4.61, p < .001) higher in infants of PWWE who received polytherapy. Levetiracetam was the most frequently used seizure medication as monotherapy, with the highest incidence of CMs occurring with valproic acid (VPA) use (8.5%) and the lowest with lamotrigine use (2.1%). The incidence of CMs was 5% at a carbamazepine dose <700 mg, 10% at a carbamazepine dose ≥700 mg, 5.5% at a VPA dose <750 mg, and 14.8% at a VPA dose ≥750 mg. Thus the risk of malformation increased 2.33 times (p = .041) in infants of PWWE receiving high-dose ASMs. SIGNIFICANCE: Birth outcomes of PWWE receiving and not receiving ASMs were evaluated. The risk of CMs occurrence was higher, particularly in infants of PWWE using VPA and receiving polytherapy. The incidence of CMs was found to be lower in infants of PWWE receiving lamotrigine.

Before emergency aneurysm surgery, CTA or DSA? A single center experience.

OBJECTIVE: Subarachnoid hemorrhage (SAH) due to an intracranial aneurysm is a life-threatening surgical emergency. After the diagnosis of SAH, physicians should find the reason for the bleeding. CT- Angiography (CTA) and Digital Subtraction Angiography (DSA) are techniques used to visualize the aneurysm. However, which one will surgeons prefer? In this study, we have compared these two radiological examinations. PATIENTS AND METHODS: This study includes 58 patients diagnosed with SAH and intracranial aneurysm diagnosis based on CTA (n=30) and DSA (n=28). We evaluated the patients according to demographic properties, CTA and DAS findings, aneurysm location, Fisher score, postoperative complications, and Glasgow outcome score. RESULTS: The most common location of aneurysms was the M1 level (48.3%). Patients in the DSA group had significantly more extended hospital stays (p= 0.021). There was no statistically significant difference between the two groups in complications. CONCLUSIONS: Enhanced CT Technologies provide higher fidelity images and shorten hospital stays. With CTA, surgeons may gain time for an emergency surgical procedure. Despite the fact that DSA remains a significant factor in aneurysm diagnosis, DSA is an invasive procedure and needs more time to diagnose.

Mice make temporal inferences about novel locations based on previously learned spatiotemporal contingencies.

Animals learn multiple spatiotemporal contingencies and organize their anticipatory responses accordingly. The representational/computational capacity that underlies such spatiotemporally guided behaviors is not fully understood. To this end, we investigated whether mice make temporal inferences of novel locations based on previously learned spatiotemporal contingencies. We trained 18 C57BL/6J mice to anticipate reward after three different intervals at three different locations and tested their temporal expectations of a reward at five locations simultaneously, including two locations that were not previously associated with reward delivery but adjacent to the previously trained locations. If mice made spatiotemporal inferences, they were expected to interpolate between duration pairs associated with previously reinforced hoppers surrounding the novel hopper. We found that the maximal response rate at the novel locations indeed fell between the two intervals reinforced at the surrounding hoppers. We argue that this pattern of responding might be underlain by spatially constrained Bayesian computations.

Eye closure sensitivity and genetic generalized epilepsies: A prospective study of 123 cases.

PURPOSE: To investigate the possible relationship between eye closure sensitivity (ECS) and genetic generalized epilepsy (GGE) in terms of epilepsy syndromes, photosensitivity (PS), and prognosis. METHOD: One hundred and twenty-three patients diagnosed with GGE were classified according to epilepsy syndromes. Among them, ECS and PS were detected in repeated video-EEGs. In patients with ECS, the impact of sleep deprived EEG on awakening on ECS was evaluated. To explore the ECS as a possible accurate predictor designating the prognosis in GGEs, we defined the ECS rate in poor prognosis group (n = 21) and in patients without antiseizure drug (ASD) treatment and seizure-free for at least for 2-5 years (n = 20). RESULTS: ECS was found in almost all types of GGE but at different rates. ECS was detected in all groups with highest rate in eyelid myoclonia with or without absences (EMA). Sleep deprived EEG on awakening was performed in 44 of 59 patients with ECS and enhanced ECS prominently. In all groups except EMA, PS rate was lower compared with ECS. Both ECS and PS were observed in 15 patients with poor prognosis (71 %) and one patient with good prognosis (5%). CONCLUSIONS: ECS can occur in all types of the GGEs. We claim that ECS can be asserted as a syndrome-specific feature for EMA among GGEs. Sleep deprived EEG on awakening can enhance ECS prominently in all types of GGE. ECS and PS might overlap but their impact on prognosis is different. In the poor prognosis group, the number of patients having ECS together with PS was high compared to the group without ASD and excellent prognosis. Therefore, we suggest that this combination predicts worse outcome in GGEs.

Evaluation of lung densitometric and volumetric changes in silicosis patients using three-dimensional software for multidetector CT and the relationship with profusion scores.

AIM: To evaluate the density and volume changes in the lungs of silicosis patients and their relationship with the disease severity classification of the International Labor Organization (ILO). MATERIALS AND METHODS: The multidetector computed tomography (CT) images of 44 patients diagnosed with silicosis and 32 controls that underwent thoracic CT due to trauma were evaluated. Patients with silicosis were divided into three categories according to the ILO classification. Data related to the total lung volume, total lung mean density, lung opacity score, percentage of lung high opacity, and mean density in the lower and upper lobes were obtained using three-dimensional (3D) software. RESULTS: There was no significant difference between the total lung mean densities of the silicosis and control groups (p=0.213); however, a significant difference was observed between the two groups in terms of the total lung volume (p<0.0001). According to the ILO classification, there was a significant difference between the disease severity categories in relation to the percentage of lung high opacity (p=0.000005). A strong correlation was detected between disease severity and high opacity percentage (p<0.0001, r=0.804). According to the ILO classification, there was also a significant difference between disease severity categories in terms of the lung opacity score (p=0.000144), as well as a moderate correlation between disease severity and opacity score (p<0.0001, r=0.580). CONCLUSION: Total lung volume is a CT finding that shows variation in exposure to crystalline silica. The percentage of high opacity determined using multidetector CT is an effective parameter in evaluating disease severity.

Protective effect of benfotiamine on methotrexate induced gastric damage in rats.

Methotrexate (MTX) is widely used for treating cancers and inflammatory diseases; it is a potential anti-metabolite and folate antagonist. We investigated potential protective effects of benfotiamine on MTX damage. We used a rat model of MTX induced gastric injury to assess changes in gastric histopathology, oxidative stress and visfatin levels due to MTX treatment. Rats were divided into four groups: an untreated control group, an MTX group treated with a single dose of MTX, a benfotiamine group treated with benfotiamine daily for two weeks, and a benfotiamine + MTX group treated with a single dose of MTX followed by benfotiamine daily for two weeks. Total tissue antioxidant status (TAS), total oxidant status (TOS) and visfatin levels were measured at the end of the experiment. At the end of the experiment, we investigated both visfatin expression and the histopathology of gastric tissues. The mean visfatin level was lower in the MTX group than in the benfotiamine group. The mean tissue TOS levels were higher in MTX group than in the control, benfotiamine or benfotiamine + MTX groups. Significant gastric gland dilation, and erosion and loss of mucosa were found on the gastric surface in the MTX group compared to the control group. The dilation, erosion and mucosal loss were decreased significantly in the benfotiamine + MTX group compared to the MTX group. Compared to the control group, visfatin immunoreactivity was reduced significantly in the MTX group. Decreased visfatin levels appear to play a role in the mechanism of gastric damage. Benfotiamine may be useful for preventing MTX induced gastric injuries.

Synergistic Induction of Apoptosis by Quercetin and Curcumin in Chronic Myeloid Leukemia (K562) Cells: II. Signal Transduction Pathways Involved.

Flavonoids are phenolic substances with chemo-preventive and chemotherapeutic properties. They are widely found in fruits and vegetables. The polyphenols quercetin and curcumin have antioxidant, anti-inflammatory, anti-carcinogenic, and pro-apoptotic properties. They were successfully used against different human cancers, especially chronic myeloid leukemia cancer cells. We have previously investigated anti-proliferative and apoptotic effects of quercetin and curcumin combination in K562 cells. Our data showed that they had beneficial synergistic effects. Based on these findings, we aimed to clarify signaling pathways involved in synergistic combination treatment with quercetin and curcumin in these cells. Proteins were investigated by Western blotting and by confocal microscopy. Changes in several genes in 10 different pathways related to cell proliferation, apoptosis, cell cycle, inflammation, hypoxia and oxidative stress were observed. Combination of quercetin and curcumin was effective on genes that were particularly related to p53, NF-κB and TGF-α pathways. Down-regulatory (CDKN1B, AKT1, IFN-γ) and up-regulatory (BTG2, CDKN1A, FAS) effects on genes and related protein expressions may provide a multi-targeted therapy potential for chronic myeloid leukemia cancer cells without affecting healthy cells.

Analysis of posterior circulation diameters depending on age, sex and side by computed tomography angiography.

BACKGROUND: Posterior circulation of brain is important because of vital organs' blood supply provided by them. In this study, we evaluate the relationship of posterior circulation measurements with age, gender and side by using computed tomography angiography (CTA) images. MATERIALS AND METHODS: A total 199 brain CTA examinations were retrospectively analysed for all posterior circulation arteries (vertebral artery, basilar artery, posterior cerebral artery [PCA], superior cerebellar artery [SCA], anterior inferior cerebellar artery, and posterior inferior cerebellar artery [PICA]) to compare the difference based on age, gender and side. RESULTS: There is no correlation between age and the mean diameters of all vessels (p > 0.05). The mean diameter of left vertebral artery was higher than right vertebral artery in all genders (p = 0.004 for males and p < 0.001 for females). The mean diameter of left SCA and PICA were higher than right SCA and PICA in females (p = 0.032 and p = 0.027, respectively). The mean diameters of basilar, left PCA, left SCA, left vertebral, right PCA, right SCA, right PICA and right vertebral artery were higher in males and that differences were statistically significant (p < 0.001, p = 0.002, p = 0.006, p = 0.004, p = 0.001, p = 0.003, p = 0.002, and p = 0.006, respectively). CONCLUSIONS: The posterior circulation vessel diameter is not affected by aging. The mean diameters of basilar artery, both PCAs, both SCAs, right PICA, both vertebral arteries were higher in males. The mean diameter of left vertebral artery is higher than that of right vertebral artery in all genders.

Relationship of vascular variations with liver remnant volume in living liver transplant donors.

BACKGROUND: In this study, we investigated the relationship between the portal vein and hepatic artery variations and the remaining liver volume in living donors in liver transplantation. MATERIALS AND METHODS: In the study, triphasic abdominal computed tomography images of 180 live liver donor candidates were analysed retrospectively. Portal veins were divided into four groups according to the Nakamura classification and seven groups according to the Michels classification. The relationship between vascular variations and remnant liver volume was compared statistically. RESULTS: According to the Nakamura classification, there were 143 (79.4%) type A, 23 (12.7%) type B, 7 (3.9%) type C and 7 (3.9%) type D cases. Using the Michels classification, 129 (71%) type 1, 12 (6.7%) type 2, 24 (13%) type 3, 2 (2.2%) type 4, 10 (5.6%) type 5, 1 (0.6%) type 6, and 2 (1.1%) type 7 cases were detected. There was no significant difference in the percentage of the remaining volume of the left liver lobe between the groups (p = 0.055, p = 0.207, respectively). CONCLUSIONS: Variations in the hepatic artery and portal vein do not affect the remaining liver volume in liver transplantation donors.

Proteasome modulator 9 (PSMD9) gene rs14259 polymorphism in Alzheimer's disease.

IM: Alzheimer's disease (AD) is a progressive and fatal neurodegenerative disorder resulting in degeneration of certain neuronal structures in certain brain regions and severe neuronal loss, characterized by a pathological accumulation of senile amyloid plaques (SP) and neurofibrillary tangles (NFT) within the brain . Alzheimer's disease has been associated with Type 2 diabetes mellitus (T2DM) in recent years. We designed our study on the relationship between AD and T2DM. Genome screening studies in different populations had linked the chromosome 12q24 region to type 2 diabetes. Within this region, there is the PSMD9 gene encoding a transcriptional coactivator of insulin production. METHOD: The effect of PSMD9 gene E197G (rs14259) polymorphism on AD was investigated in29 Alzheimer's patients and 25 healthy controls, who were included in the study. RESULTS: In our study, it was determined that the variant of PSMD9 gene E197G (rs14259) did not cause genetic risk factor for Alzheimer's disease in Turkish population. CONCLUSIONS: Our study was the first to investigate the relationship between PSMD9 gene and Alzheimer's disease. A larger sample group is needed to investigate the contribution of the PSMD9 gene to Alzheimer's disease in further studies (Tab. 5, Ref. 8).

Artemisinin attenuates doxorubicin induced cardiotoxicity and hepatotoxicity in rats.

We investigated the effects of artemisinin on doxorubicin (Dox) induced heart and liver pathology in rats. We divided 49 male rats into seven groups: group 1 was the untreated control. Dox was administered intraperitoneally to groups 2, 3 and 4 on day 1. Artemisinin was administered by gavage to groups 3 and 6 at a dose of 7 mg/kg, and to groups 4 and 7 at a dose of 35 mg/kg for 14 days. Group 5 was given only 0.9% NaCl orally for 14 days. At the end of the study, heart and liver samples were collected for histopathology and immunohistochemistry. Hyperemia and slight hemorrhages were observed in both livers and hearts of rats treated with Dox only. Significant increases in caspase-3, TNF-α, iNOS and NF-κB expression were observed in the myocardial cells and hepatocytes of group 2. Significant reductions in caspase-3, TNF-α, iNOS and NF-κB expression were observed in groups 3 and 4 following artemisinin treatment compared to group 2. Artemisinin may exert protective effects against Dox induced cardiotoxicity and hepatotoxicity in rats.

The Confidence Database.

Understanding how people rate their confidence is critical for the characterization of a wide range of perceptual, memory, motor and cognitive processes. To enable the continued exploration of these processes, we created a large database of confidence studies spanning a broad set of paradigms, participant populations and fields of study. The data from each study are structured in a common, easy-to-use format that can be easily imported and analysed using multiple software packages. Each dataset is accompanied by an explanation regarding the nature of the collected data. At the time of publication, the Confidence Database (which is available at https://osf.io/s46pr/) contained 145 datasets with data from more than 8,700 participants and almost 4 million trials. The database will remain open for new submissions indefinitely and is expected to continue to grow. Here we show the usefulness of this large collection of datasets in four different analyses that provide precise estimations of several foundational confidence-related effects.

The potential use of natural products to negate hepatic, renal and neuronal toxicity induced by cancer therapeutics.

Different types of chemotherapeutics are used for cancer treatment. These drugs act on several signal pathways, lead to programmed cell death, and damage cancer cells. Although many specific mechanisms of action have been suggested for chemotherapeutics, there are still gaps in understanding their effects. They may affect different components of the cell, particularly proteins with specific functions, such as enzymes. Recently, targeted and immuno therapies were introduced for treatment of different cancers. However, many cancer patients still depend on traditional and well-known drugs. Doxorubicin and platinum-based drugs are among the most frequently used chemotherapeutics. They are highly cytotoxic for cancer cells, but they also act on healthy cells. Hence, it is crucial to understand the mechanisms involved in order to decrease their side effects. Natural products, many of which are also available over-the-counter, may be considered to decrease various cancer drug-induced side effects. This review focuses on the use of these compounds to overcome side effects of chemotherapeutics, primarily doxorubicin and cisplatin, in the liver, kidney, and neuronal systems.

Whey proteins: targets of oxidation, or mediators of redox protection.

Bovine whey proteins are highly valued dairy ingredients. This is primarily due to their amino acid content, digestibility, bioactivities and their processing characteristics. One of the reported bioactivities of whey proteins is antioxidant activity. Numerous dietary intervention trials with humans and animals indicate that consumption of whey products can modulate redox biomarkers to reduce oxidative stress. This bioactivity has in part been assigned to whey peptides using a range of biochemical or cellular assays in vitro. Superimposing whey peptide sequences from gastrointestinal samples, with whey peptides proven to be antioxidant in vitro, allows us to propose peptides from whey likely to exhibit antioxidant activity in the diet. However, whey proteins themselves are targets of oxidation during processing particularly when exposed to high thermal loads and/or extensive processing (e.g. infant formula manufacture). Oxidative damage of whey proteins can be selective with regard to the residues that are modified and are associated with the degree of protein unfolding, with α-Lactalbumin more susceptible than ß-Lactoglobulin. Such oxidative damage may have adverse effects on human health. This review summarises how whey proteins can modulate cellular redox pathways and conversely how whey proteins can be oxidised during processing. Given the extensive processing steps that whey proteins are often subjected to, we conclude that oxidation during processing is likely to compromise the positive health attributes associated with whey proteins.

Combined effects of quercetin and curcumin on anti-inflammatory and antimicrobial parameters in vitro.

In this in-vitro study, combinatory anti-inflammatory interactions between Quercetin (Q) and Curcumin (C) along with their combined antimicrobial activity against MRSA were studied. Anti-inflammatory markers of (i) COX-2 expression, (ii) NFκß activation and (iii) NO levels were investigated. Antimicrobial synergy was tested by checkerboard assay. We found that, treatment with the "low-concentration combination group" (QC), where Q and C were combined, resulted in significant downregulation of COX-2 expression (P < 0.0001) and inhibition of NFκß activation in cells (P < 0.0001), to a similar extent to that induced by higher concentrations of Q and C alone. QC treatment was also found to induce a significant reduction in NO production (P < 0.0001). QC was significantly more effective in the reduction of total NO levels when compared to Q alone (P < 0.001). Checkerboard assay indicated that the combination of Q and C provides better killing of MRSA in lower dilutions than standalone Minimum Inhibitory Concentrations. These results suggest that combining low concentrations of Q and C yield similar or better anti-inflammatory effectiveness when compared to treatment with each agent alone. Moreover, they co-operate synergistically in the context of antimicrobial activity, with an increased effectiveness when compared to Q or C alone at high concentrations.

Evaluation of Oxidative Stress Parameters and Antioxidant Status in Plasma and Erythrocytes of Elderly Diabetic Patients with Sarcopenia.

OBJECTIVES: Oxidative stress may play a role in the pathogenesis of both sarcopenia and diabetes. Although the risk of sarcopenia is increased in people with type 2 diabetes, the relationship between sarcopenia oxidative stress and antioxidant status among the older diabetes population is not well studied. The aim of this present study was to evaluate the relationship between oxidative stress and antioxidant status and sarcopenia in elderly diabetic patients. DESIGN: This was a cross-sectional designed study with a control group. A total of 60 type 2 diabetic elderly patients were enrolled in the study (30 sarcopenic and 30 controls). MEASUREMENTS: Comprehensive geriatric assessments and anthropometric measurements were performed. Sarcopenia was diagnosed according to the European Working Group on Sarcopenia in Older People. Skeletal muscle mass was measured using bioelectrical impedance analysis. A handheld dynamometer was used for skeletal muscle strength measurements. Gait speed was measured using a 4 meter walking test. Plasma malondialdehyde (MDA), glutathione peroxidase (GSH-Px) and erythrocyte MDA, GSH-Px, superoxide dismutase (SOD), catalase and xanthine oxidase (XO) measurements were performed. RESULTS: While plasma XO was significantly higher in sarcopenic individuals (0.406(0.225-0.775)) compared to controls (0.312(0.112-0.712)) (p=0.006), plasma GSH-Px was significantly lower in sarcopenic individuals (0.154(0.101-0.274)) compared to controls (0.204(0.12-.0312)) (p=0.003). Plasma XO (OR: 2.69 (CI 95% 0.13-52.76, p=0.041) and BMI (OR: 0.6 (CI 95% 0.41-0.89, p=0.009) were independently associated with sarcopenia of diabetes in multivariate analysis. CONCLUSIONS: Only plasma XO was found to be independently associated with sarcopenia. XO can be important in the pathogenesis of sarcopenia in diabetes. Oxidative stress and antioxidant status might be associated with sarcopenia in diabetic older individuals but this association seems to be mediated by other factors. Further studies are needed on this subject.

Synergistic Induction of Apoptosis by Quercetin and Curcumin in Chronic Myeloid Leukemia (K562) Cells.

Chronic myeloid leukemia is a major hematopoietic malignancy characterized by expansion of myeloid cells. In this study, we have investigated whether quercetin, curcumin and their combination induce apoptosis and inhibit growth of K562 cells. We have observed that quercetin and curcumin combination induced apoptosis accompanied by increased ROS and decreased GSH levels as well as loss of mitochondrial membrane potential. Our mRNA and protein expression results suggested that cytochrome c was released from mitochondria causing PARP and caspase-9 cleavages, the hallmarks of mitochondrial apoptotic pathway. We believe that triggering of apoptosis is mostly via mitochondrial pathway and ROS generation may induce impairment of mitochondrial membrane potential. The use of quercetin and curcumin combination potentiates individual apoptotic effects of the polyphenols and reduces their effective dose thereby preventing potential toxic effects on normal cells. Additional preclinical studies and clinical trials are certainly required to further validate their usefulness as potent anticancer agents.

Panayiotopoulos Syndrome with a special emphasis of ictal semiologic features.

PURPOSE: The aim was to identify the demographic, electroencephalographic findings, clinical features, especially ictal semiological symptoms of patients diagnosed with Panayiotopoulos Syndrome. METHOD: The semiologic and EEG findings of 42 patients were reviewed. Statistical analysis was used to determine the frequencies of semiologic features and to define the symptom clusters. RESULTS: The most common clinical features were nausea (54.8%), vomiting (50.0%), pallor (50.0%), deviation of head and eyes (45.2%), generalized seizures (35.7%), ictal syncope (33.3%) and stomach ache (26.2%). Visual manifestations which were observed in 38.9% of the patients were amaurosis, flashes of colourful lights, flashes of brightful lights, visual hallucinations and blurring of vision. Autonomic status epilepticus was observed in 21.4% of the patients. Cluster analysis of 13 most common symptoms showed a tendency toward 3 clusters. Pallor constituted a subgroup on its own whereas nausea, vomiting, deviation of head and eyes tended to occur together in the second subgroup and the third subgroup included semiologic features some of which were atypical for PS. CONCLUSIONS: A broad spectrum of typical and atypical clinical features might be observed in patients with PS. Some of the semiologic features of PS might have tendency to occur together. Overlapping of typical autonomic features with some of the atypical features might suggest that PS, RE and ICOE-G were the constituents of the same neurobiological spectrum. Our detailed data might contribute to the awareness of a wide range of variabilites in the electroclinical features of PS.

Bethesda classification is a valuable guide for fine needle aspiration reports and highly predictive especially for diagnosing aggressive variants of papillary thyroid carcinoma.

BACKGROUND: A fine needle aspiration biopsy (FNAB) is the most valuable diagnostic procedure for pre-operative discrimination of benign and malignant nodules. The Bethesda System for Reporting Thyroid Cytopathology provides standardised reporting and cytomorphological criteria in aspiration smears. The aim of the present study was to determine malignancy rates in nodules with different cytology results and evaluate the diagnostic value of Bethesda for variants of papillary thyroid carcinoma (PTC). MATERIALS AND METHODS: A retrospective analysis of 2534 cases with 5784 thyroid nodules, who underwent FNAB followed by surgery, were included in this study. FNAB was performed with ultrasonography guidance. Cytological diagnoses were classified as: non-diagnostic (ND), benign, atypia of undetermined significance/follicular lesions of undetermined significance (AUS/FLUS), follicular neoplasm/suspicious for follicular neoplasm (FN/SFN), suspicious for malignancy (SUS) and malignant. Histopathological diagnoses were classified into four groups: benign, PTC, follicular thyroid cancer and other types of thyroid cancer (including medullary thyroid cancer, undifferentiated thyroid cancer and thyroid tumours of uncertain malignant potential). Cases with PTC were further divided into four categories: conventional variant, follicular variant, aggressive variants (tall cell, diffuse sclerosing and columnar variant) and other variants (oncocytic, solid/trabecular and warthin-like variants). FNAB results were compared with histopathological results. RESULTS: Malignancy rates were 6.3%, 3.2%, 20.7%, 33.3%, 74.2% and 95.6% in the nodules with ND, benign, AUS/FLUS, FN/SFN, SUS and malignant cytology results, respectively. Pre-operative cytology was malignant or SUS in 56.6% of conventional, 24.3% of follicular, 92% of aggressive and 41.7% of other variants of histopathologically confirmed PTC. The difference between the groups was significant (P < 0.001). CONCLUSION: The Bethesda classification is a reliable indicator of malignancy in nodules with different cytology results and seems to be very effective in predicting the malignancy for the nodules diagnosed with aggressive variant PTC on the final histological examination.