[Effect of diagnostic and treatment factors on growth development of children with congenital hypothyroidism: a prospective longitudinal study]

Introduction: no study has yet been conducted evaluate the factors influencing the growth of patients with congenital hypothyroidism [CH], in Iran. The high prevalence of this disease in Iran, particularly in Isfahan, made it necessary to investigate biomedical diagnostic and early treatment factors potentially affecting growth status among patients with CH

Materials and Methods: in this prospective cohort study, 760 CH neonates [born 2002-2010], diagnosed and followed up [minimum 1, maximum 5 years] during the CH screening program in Isfahan were enrolled. Height, weight and head circumferences of the patients, during follow up and in subsequent periods, were measured. Diagnostic and therapeutic factors included serum T4 and TSH concentration at diagnosis and after treatment initiation, age at onset of therapy, initial dosage of levothyroxine and age at first normalization of T4 and TSH. Quantile regression for longitudinal data was used for investigating the effects of main factors determining growth development. R free software was used for analyzing data

Results: longitudinal growth in height and weight was significantly correlated with age at onset of therapy and initial dosage of treatment [p<0.01], while head circumference was associated only with initial dosage [P<0.05]. Increase in weight and head circumference were affected by serum TSH concentration at diagnosis [p<0.05], and age of T4 normalization also had significant impact, on some of the proposed quantiles, i.e. weight [p<0.05], height [p<0.01] and head circumference [p<0.001]

Conclusion: among the factors studied, initial dosage of treatment and age at onset of therapy seem to be more important factors for growth development, suggesting that more optimal outcomes are possible through earlier treatment and appropriate levothyroxine dosage

survey of the students' perspectives of open-book examinations in the histology/embryology course

Background and purpose: An open-book exam permits the examinees to consult some specific selected reference sources or materials while answering the exam questions. This study focused on the students' perspectives of open-book examinations in the histology/embryology courses, Zahedan University of Medical Sciences [ZUMS], Zahedan, Iran

Methods: The survey was conducted via a questionnaire after open-book examinations had been conducted in the histology and embryology courses, between 2009 and 2010. Of the 254 students who entered the new education system, 160 students were selected at random

Results: The results revealed that 72% of the students preferred the open-book type to the closed-book kind of examinations. Most of the students voiced that this type of examination was more suited to test high cognitive learning skills and solving real life situation problems, involving less stress while preparing for and taking the exam. They also mentioned that their marks in these examinations were not higher than those from the closed-book examinations. The overall satisfaction scores of the students of the biological sciences were significantly [p<0.001] higher than those of the medical sciences students [16.28 +/- 4.17 vs. 12.65 +/- 5.16]; in the government run university students it was significantly [P<0.001] higher than in the international university students [14.93 +/- 4.53 vs. 10.24 +/- 5.08]; the embryology course results were significantly [p<0.001] higher than the histology course [15.23 +/- 4.07 vs. 12.79 +/- 5.4] and among the MD students it was significantly [p<0.001] lower than those of the BSc students [12 +/- 5.1 vs. 15.93 +/- 4.29]. There was a positive correlation between the scores they acquired in their course and the overall satisfaction scores with the open-book type of examinations [r=0.46, p value=0.01]

Conclusions: The finding of a positive response towards the open-book examination augurs well for extending such a type of examination to other subjects in our university

Seroprevalence of human hydatidosis using ELISA method in Qom Province, Central Iran

The objective of this study was to determine the prevalence of cystic echinococcosis [CE] in Qom Province, central Iran using ELISA test. Overall, 1564 serum samples [800 males and 764 females] were collected from selected subjects by randomized cluster sampling in 2011-2012. Sera were analyzed by ELISA test using AgB. Before sampling, a questionnaire was filled out for each case. Data were analyzed using Chi-square test and multivariate logistic regression for risk factors analysis. Seropositivity was 1.6% [25 cases]. Males [2.2%] showed significantly more positivity than females [0.9%] [P= 0.03]. There was no significant association between CE seropositivity and age group, occupation, and region. Age group of 30-60 years encompassed the highest rate of positivity. The seropositivity of CE was 2.1% and 1.2% for urban and rural cases respectively. Binary logistic regression showed that males were 2.5 times at higher risk for infection than females. Although seroprevalence of CE is relatively low in Qom Province, yet due to the importance of the disease, all preventive measures should be taken into consideration

[Antithyroid drugs induced vasculitis]

The aim of this article is to review current information documented on antithyroid drug induced vasculitis. MEDLINE was searched for studies between 1960 and 2009 with the key words [antithyroid drugs and vasculitis], [antithyroid drugs and diffuse alveolar hemorrhage], and [antithyroid drugs and glomerolonephritis]. Ninety-two articles met the selection criteria. The data obtained showed that 15 to 46% of patients treated with propylthiouracil [PTU] developed anti-neutrophil cytoplasmic antibody [ANCA], in contrast to 0 to 3% of the patients treated with methimazole [MMI], the former being the most often reported for causing vasculitis, a disease seen most commonly in association with Graves' disease. Signs of PTU-induced vasculitis include fever, malaise, anemia, lymphadenopathy, skin lesions, arthralgia, hematuria/proteinuria, diffuse alveolar hemorrhage [DAH], pleural effusion, and crescentic glomerulonephritis. Once PTU-induced vasculitis is determined, the simple withdrawal of PTU usually causes resolution of the symptoms within 1-4 weeks. Overall prognosis of antithyroid drug-induced vasculitis is much better than that of primary vasculitis. Antithyroid medications such as PTU can induce [ANCA]-associated vasculitis. Its pathogenesis might be multifactorial. Diagnosis is based on the relationship between clinical vasculitis, and the antithyroid drugs prescribed, and the excluding of any other medical states that mimic vasculitis. After the diagnosis, antithyroid drugs should be discontinued immediately, and the prognosis is usually good

Comparison of metronidazole and placebo in control of gaseous symptoms in patients with functional bowel disorders; a randomized double- blind controlled study

To compare the efficacy of metronidazoie versus placebo in the control of gaseous symptoms in patients with functional bowel disease. In the absence of organic or systemic diseases, all cases with chief complaints of bloating and normal laboratory tests were consecutively enrolled in this double-blind study. Lactase deficiency and bacterial overgrowth were ruled out by the lactose breath test. Patients were randomly assigned to receive either metronidazole or placebo. Demographic characteristics as well as frequency and severity of the patients' scores [mean total symptom score] before and after therapy, their compliance and drug adverse effects were evaluated. A 50% decrease in the total symptom scores was defined as effective treatment. During one year, 46 patients [17 males, 29 females, mean age: 38.9 +/- 9.9 years] were enrolled in the study. A total of 23 patients received metronidazole [cases] and 23 received placebo [controls]. Two patients in the metronidazole group did not tolerate the drug and one patient in the placebo group did not continue with follow-up. Patients responded similarly to both regimens: 59% of patients in the placebo group and 52.2% of patients in the metronidazole group had a 50% decrease in their total symptom score [p = 0.64]. Side effects of metronidazole were frequent, but tolerable. Bad taste in the mouth and anorexia were the most common complaints in the metronidazole group. This study showed no difference between placebo and metronidazole in relief of bloating and other related complaints in patients with functional bowel disease

Prevalence of HPV infection and high risk HPV genotypes [16, 18], among monogamous and polygamous women, in Zabol, Iran

This study was performed to compare the prevalence of HPV infection and high risk HPV genotypes [16,18] between monogamous and polygamous women, in Zabol, Iran. This cross sectional study was conducted in Zabol in 2006 - 2007. Two hundred sixty five married women attending the Gynecology Clinic for Cervical Diseases Screening entered to this study. One hundred sixty two cases had monogamous, and 103 had polygamous husbands. HPV PCR samples were obtained from scrape of papsmear specimens. The biotinylated primers MY09/MY11, GP5+/GP6+, were utilized to enable amplification and detection of positive PCR products. Confirmation of HPV-16 and -18 were done by type-specific PCR primers HPV-16/F, HPV-16/R and HPV-18/F, HPV-18/R. Prevalence of HPV infection in monogamous and polygamous groups was 29% and 37.9%, respectively. The most HPV infection was found in 15-25 years group. The most prevalence of infection in monogamous group was HPV-18 and HPV- non 16, 18 in 15-25 years, and HPV-16 in 26-35 years group. In polygamous group the most prevalent type was HPV-16, 18 in 15-25 years group. The most prevalent HPV-16 was seen in sever inflammation and dsyplasia cytology in both groups. Prevalence of HPV infection of Zabol is high, and in women with polygamous husbands group is slightly more than monogamous. Screening for this infection must be recommended in this region of Iran

Seroepidemiological study of human hydatidosis in Meshkinshahr district, Arbadil province, Iran

The aim of this study was to conduct a sero-epidemiological survey in Meshkinshahr, Ardabil Province, northwestern Iran to detect the rate of hydatidosis in the city and nearby villages. Literature shows that no such study has been conducted so far. Overall, 670 serum samples were collected from 194 males and 476 females from patients referred to different health centers of the region. All patients filled out a questionnaire and an informed consent. Sera were analyzed using indirect-ELISA test. Ten micro g/ml antigens [Antigen B derived from hydatid cyst fluid], serum dilutions of 1:500 and conjugate anti-human cocombs with 1:100000 dilutions were utilized to perform the test. Data analysis was conducted using SPSS software ver. 11.5. The seroprevalence of human hydatidosis was 1.79% by ELISA test in the region. This rate for females was 1.68% and males 2.6%, respectively. There was no significant difference as regards all factors studied and the seropositivity. According to job, farmers and ranchmen had the highest rate of infection as 3.17%. The sero-prevalence of infection was 2.6%, respectively. There was no significant difference as regards all factors studied and the seropositivity. According to job, farmers and ranchmen had the highest rate of infection as 3.17%. The sero-prevalence of infection was 2.6% in illiterate people which showed the highest rate. As regards residency, urban life showed no significant difference with rural life [1.1% vs. 2.58%]. Age group of 69-90 yr old, with 4.62 as prevalence had the highest rate of positivity. Obtained sero-prevalence of hydatidosis shows more or less a resemblance to other cities of Iran, although due to the specific condition of the city we expected more rate of sero-positivity

[Familial clustering of central obesity and cardiovascular disease risk factors]

The risk of obesity among children increases in proportion to parental obesity. This study aimed at investigating the familial clustering of central obesity and cardiovascular disease risk factors. In this observational cross-sectional survey, enrolling 787 mother-daughter pairs in three age stratum [3-9 y, 10-15 y, 16-20 y], familial associations for central obesity and cardiovascular disease risk factors were assessed. Mothers with central obesity had higher probability of having daughters with central obesity compared to normal mothers [p=0.0001]. Central obesity indices among daughters were positively correlated with those of their mothers [r=0.39, r=0.42 and r=0.46 for waist circumferences in the three age strata, respectively]. The correlations were significant and positive between central obesity indices and systolic blood pressure, diastolic blood pressure, fasting plasma glucose, total cholesterol, triglycerides, and LDL-C in mothers [r=0.34, 0.30, 0.28, 0.19, 0.32 and 0.13 respectively] and their daughters [r=0.33, 0.27, 0.17, 0.16, 0.26 and 0.20]. Correlation between central obesity indices and HDL-C were negative and significant in mothers [r=-0.18] and daughters [r=-0.21]. There was an increase with age in mother-daughter central obesity correlations. After subjects' cardiovascular risk factor levels were adjusted for mother and daughter waist circumferences, the mother-daughter correlations remained significant. The close association of central obesity indices between mothers and daughters may indicate the key role of the mother for the primary prevention of obesity and its complications, particularly in high-risk families

Evaluation of power of components of metabolic syndrome for prediction of its development: a 6.5 year longitudinal study in Tehran lipid and glucose study [TLGS]

This study amis at determining which components of the metabolic syndrome are the best predictors of its development. In this cohort study, from the participants of the cross sectional phase of the Tehran Lipid and Glucose Study [TLGS], 2279 subjects [aged 20-87] who did not have the metabolic syndrome, based on modified ATP III criteria, and 2310 subjects [aged 20-87] without the metabolic syndrome according to IDF criteria were followed. After a mean interval of 6.5 years, 462 and 602 new cases of the metabolic syndrome were diagnosed on basis of the modified ATP III and IDF criteria, respectively. The adjusted odds ratio for development of the metabolic syndrome by ATP III criteria was highest for central obesity in men, 2.8 [2.2-3.7] and for triglycerides in women, 2.8 [2.0-4.1]. The adjusted odds ratio for development of the metabolic syndrome by IDF criteria was highest for triglycerides in both men and women, OR being: 2.8 [2.2-3.7] and 2.9 [1.9-4.3] respectively. The area under the ROC curves for waist circumference, triglycerides and HDL were the highest. A model that included waist circumference and triglycerides or waist circumference and HDL predicted the metabolic syndrome as well as a model that included all five metabolic syndrome components. High risk subjects should undergo periodic screening, including measurement of waist circumference, triglycerides and plasma HDL, for timely prediction of development of metabolic syndrome

Breast cancer screening knowledge and practice among women in southeast of Iran

Breast cancer is the most common cancer in women. The mortality rate of breast cancer can be reduced by regular breast cancer screening program. This study was carried out to identify the knowledge and practice of women about breast cancer screening in Zahedan, southeast of Iran. In this cross-sectional study, 384 women were selected as an improbability sample of women referring to Qouds Maternity Hospital. Knowledge and practice of them about breast cancer screening were investigated through face-to-face interview based on a purposed questionnaire, and data were analyzed using descriptive and analytical statistics. Only 8.3% of women were aware of breast cancer screening methods. About breast self-examination 21.6% and about mammography 3.4% had good knowledge. Overall knowledge of breast cancer screening was insufficient in 67.4%. There was statistically significant relationship between knowledge of breast cancer screening and level of education, history of individual breast disease, and history of breast cancer in their families [P < 0.001]. There was statistically significant and inverse relationship between knowledge of how to examine the breasts and knowledge about mammography with age [P < 0.001]. Practices of women in Zahedan about breast cancer screening were very low. Only 4.5% of women performed breast self examination, on a regular basis, 4.1% had ever had a clinical breast examination, and%1.3 had a mammography throughout their life. Our findings suggest that knowledge and practice about breast cancer screening was relatively poor and it needs to be improved

[ effect of vacuum-compression therapy [VCT] on the diabetic foot ulcer healing]

Among the most common problems in patients with diabetes mellitus is the faulty healing of foot ulcer wounds which leads to foot or leg amputations. Many attempts were done to treat diabetic foot ulcers. This study evaluated the effect of vacuum-compression therapy [VCT] on healing diabetic foot ulcers. A single-blinded, randomized clinical trial was conducted in Zahedan in 2006. Twenty-two patients with diabetic foot ulcer limbs were used for this study through simple non-probability sampling. Patients were randomly assigned to either an experimental group or a control group. The surface area of the foot ulcer was measured stereologically based on Cavalieri's Principle after 3 weeks and before any intervention. The point counting method was chosen to measure the surface area. In addition to the conventional therapy, the experimental group was also treated with vacuum-compression therapy produced by Vasotrain [VCT]. The control group received conventional therapy only, which included debridement, systemic antibiotics, wound cleaning with normal-saline, and daily dressings. Independent-samples t-test and paired t-test allowed for comparisons between the pretreatment and post treatment test results between groups and within groups, respectively. The mean of foot ulcer surface area decreased from 48.05 +/- 10.3 mm[2] to 34.6 +/- 4.4 mm[2] in experimental group [P<0.01] and also from 59.9 +/- 14.4 mm[2] to 56.8 +/- 13.8 mm[2] in the control group [P<0.01]. The surface area of the foot ulcer in the experimental group and control group decreased by 28.4 percents and 6 percents respectively [P<0.05]. After the treatment a significant decline in the surface area of the foot ulcer was observed within the experimental group in comparison to the control group [P<0.01]. Vacuum-compression therapy enhances diabetic foot ulcer healing when used in conjunction with appropriate wound care. It is recommended that patients with diabetic foot ulcer and non-healing wounds achieve wound healing and limb preservation by using a vacuum-compression therapy

Burning mouth Syndrome in Zahedan; the Southeast of Islamic Republic of Iran

Burning mouth syndrome [BMS] is characterized by a burning sensation in the tongue or other oral sites, usually in the absence of clinical and laboratory findings. The aim of this study was to evaluate the main epidemiological and clinical features involved in burning mouth syndrome in Zahedan; southeast of Iran. In this case series study, 89 BMS patients were selected from those referred to the Department of the Oral Medicine, Faculty of Dentistry, and Khatam-ol-anbia, central hospital, Zahedan University of Medical Sciences, during 2002 to 2003. The study group consisted of 62 female [69.7%] and 27 male [30.3%] patients, with a mean age of 60.9 years, ranging from 40 to 89 years. In all cases a study protocol, specially designed for this disease was completed, including general, medical and oral information and an intraoral examination. Comparative and descriptive statistical analysis was performed. The Chi-square test was considered significant at p<0.05. The 50-59 years age group showed the highest prevalence among the studied cases [24.3%]. The tongue was the most frequent location of symptoms, affected in 86 patients [96.6%]. In addition to the burning sensation, 25.8% and 48.3% of the patients complained of oral dryness and dysgusia, respectively. Type III BMS was the most common subtype [50.6%]. In women, 90.3% were postmenopausal. Type II diabetes was observed in 36% of the patients and 37.1% suffered from respiratory disease, 23.6% from gastritis, 15.7% from liver diseases, 30.3% from renal disease, 40.4% from hypertension and 43.8% had sleep disorders. Also, 52.8% revealed seasonal allergy, 32.6% had temporomandibular joint disorders and 59.6% had poor oral hygiene. BMS is a complex and multifactorial disease process in which numerous possible etiologies must be eliminated before the proper treatment can be initiated

[Cephalic and prosopic indices: comparison in one-day newborn boys in Zahedan]

Background: Cephalometry is one of the important branches of anthropometry that has wide uses in identification, forensic medicine, plastic surgery, orthodontics, archeology and determining the origins of races. This research was investigated to determine the head and face phenotypes among one-day newborn boys in two aborigines of Sistani and Baluchi who were resident in Zahedan

Materials and Methods: The investigation is based on cross-sectional analytical descriptions of 420 newborn aborigine boys [216 Sistani and 204 Baluchi], who were clinically healthy, in Quds hospital in summer 1381, in Zahedan. In this study cephalic and prosopic indices were determined by classical cephalometric

Results: The mean and the standard deviations of cephalic index were 83.67 +/- 4.80 and 83.64 +/- 4.77 and prosopic index 86.79 +/- 5.87 and 86.53 +/- 6.76 for Sistani and Baluchi subjects respectively. Based on the cephalic index, the dominant head types in sistani group were hyperbrachycephalic [37%] and brachycephalic [37%]. In Blachui group, the hyperbrachycephalic [37.3%] and brachycephalic [35.3%] type were the dominant one. Furthermore, according to the prosopic index. The dominant face type among sistanis was euryprosopic type [42.6%]. In Baluchi group, the dominant face type was also euryprosopic [39.2%]

Conclusion: This research showed no statistically significant differences in terms of head and face type indices between two aborigines of Zahedan. Based on this cross-sectional study, it seems that there is similarities between the aforementioned groups

Histochemical study of developing cartilage of the primordial vertebrae in rat embryo

The aim of this study was to investigate the presence anddistribution of cell surface terminal sugars in developing cartilage of theprimordial vertebrae in rat embryo. Material and Fifty female and 25 male Wistar rats were chosenrandomly. After adaptation, mating was done. Vaginal plug observationwas performed on O-day of gestation. Specimens were collected from9-18 days old embryos and were fixed in B4G solution. After routinehistological processing and embedding in paraffin, blocks were cut into4-micrometer thickness sections. Then sections were stained byPAS-Alcian blue and Lectin histochemistry methods [VVA-B4, MPA, WFA].On the basis of intensity of staining, sections were graded andnonparametric statistical test [Kruskal Wallis] was used to comparedifferences between samples. The commencment of chondroblast differentiation in the centrumof future vertebrae was specified by appearance of D-Gal Terminal sugarin 13th day of embryonic period. On the 14th to 16th days of presence ofGal/GalNac, D-GalNac terminal sugars were detected in developingvertebrae. Reactions were first observed in centrum and then in pediclesand laminae of vertebrae. From the 17th day on ward, reaction with theabove mentioned lectins showed a significant reductions [P<0.05]. This study showed that changes in surface terminal sugarsregulate morphologic changes and the fate of the cell, during tissuegrowth and development