Iranian South Medical Journal
Year:2002 | Volume:4 | Issue:2|Papers Count:15

Medullary thyroid carcinoma (MTC) occurs both sporadically and in the autosomal dominantly inherited multiple endocrine neoplasia (MEN) type 2 syndromes. The distinction between true sporadic MTC and a new mutation familial case is important for future clinical management of both the patient and family. The susceptibility gene for hereditary MTC is the RET proto-oncogene. DNA analysis for germline mutations of the RET proto-oncogene was performed in a series of 24 patients with MTC [apparently sporadic MTC (20 cases), familial MTC (2 cases), MEN 2A (one case) and MEN 2B (one case)] to determine whether they were true sporadic cases or hereditary forms. Genomic DNA was amplified using polymerase chain reaction (PCR) and oligonucleotide primers for exons 10 & 11. The PCR products were examined by restriction enzymes analysis to detect the mutations. One of the 20 patients with apparent sporadic MTC had exon 10 mutation (Cys620 Arg); and exon 11 mutation (Cys-634 Trp) was also found in index case with MEN 2A. No mutation was detected in the other patients. Three of six evaluated members of the MEN 2A patients had the same mutation. We conclude routine application of RET proto-oncogene testing should be included in all cases of apparent sporadic MTC.

Giardiasis is endemic in Iran and metronidazole and furazolidone are used for its treatment. The drugs have some adverse effects. Herbal medicine is a novel area for new drugs. Various concentration of essential oil, boiled and aqueous Soxhlet extracts of Thymus vulgaris compared with metronidazole on Giardia lamblia cyst in 30 and 60 minutes. The undiluted concentration of essential oil of the plant had the most lethal effect (91.1 %; max, 97.8%, min, 77.8%) in comparison to metronidazole (89.4%, max, 95.6%, min, 83.3%), boiled extract of the plant (7%, max, 20, min, 0%) and aqueous Soxhlet extract of the plant (13.8%, max, 22%, min, 8%) in 60 minutes. Thus, essential oil extract of Thymus vulgaris can be a suitable substitute to metronidazole in giardiasis, however, clinical trials should be planned to prove this recommendation.

Today herbal medicine is growing. Teucrium polium is used as antispasmodic, antidiabetic, antilipidemic and antibacterial agent. In a clinical trial, we compared the hypoglycemic effect of this plant with glybenclamide in diabetes mellitus type 2. Forty-three patients with type 2 diabetes mellitus were divided into two groups; group 1 (glibenclamide; 19 cases) and group 2 (125 mg/kg of T. polium powder; 24 cases) after matching for age, sex, BMI and the duration of disease. They were followed up for 42 days in three sessions. Mean of glycosylated hemoglobin was decreased in both groups (p<0.05). Mean levels of triglyceride and total cholesterol and BMI decreased significantly in group 2. Seven patients in group 2 reported decreased appetite. However, HDL-Cholesterol, LDL-Cholesterol and liver function tests showed no change in both groups. It seems that T. polium could be prescribed to patients with type 2 diabetes mellitus for controlling their blood sugar and triglyceride levels.

Systemic lupus erythematosus (SLE) is a systemic autoimmune disease and the presence of anti-double stranded DNA (dsDNA) antibodies is the most important serologic marker. There are several techniques to measure the autoantibodies in SLE, e.g. immunoflourescent, ELISA and RIA. Among these methods ELISA and RIA are the most reliable tests to detect anti-dsDNA antibodies. To evaluate the accuracy of our designed kit, we compared the measurement of 100 patients with SLE and 100 normal sera by the values of a standard kit (Genesis, Germany). The designed ELISA kit had sensitivity 97.7%, specificity 99%. Its positive and negative predictive values and accuracy were 97.2%, 93.1% and 0.96, respectively. In conclusion, the kit could be used as a valuable one for detection of anti-dsDNA antibodies in SLE patients.

Normal saline lock technique is a safe and lees painful way for repeated blood sampling from patients, however its reliability for electrolytes and blood sugar measurements has not been evaluated. This is a quasi-experimental study for assessing the reliability of normal saline lock for measuring electrolytes and blood sugar. The cases consisted of 30 patients admitted in Fatemeh-Zahra academic Hospital of Bushehr/Iran. Two consecutive blood samples obtained via the saline lock after the first 0.5 ml of blood withdrawn was discarded. Blood sugar and electrolytes (sodium & potassium) were compared with measurements determined with a blood sample obtained via venipuncture from the other hand. Blood sugar and electrolytes were not significantly different among the three blood samples (p>0.05). In other word, to obtain blood samples for measurement of blood sugar, sodium, and potassium, a saline lock can be used but the first 0.5 ml of blood withdrawn should be discarded before sampling.

C-reactive protein (CRP) and leukocyte count have an additional diagnostic value on the diagnosis of the acute appendicitis. To find out the clinical diagnostic value of CRP in acute appendicitis, CRP values of 101 consecutive cases during admission in Fatemeh-Zahra academic Hospital and in the 2nd and 5th days after appendectomy were qualitatively evaluated. 64 patients (63.4%) had acute appendicitis and 37 (36.3%) had normal appendices in histopathology. Positive CRP was found in 52 and 9 cases with appendicitis and normal appendix, respectively. Sensitivity, specificity and accuracy of serum CRP for acute appendicitis were 81.2%, 75.7% and 75.0%, respectively. The probability of acute appendicitis in patients with normal CRP level and WBC count was less than 10%. As a result, CRP value is an additional diagnostic test in acute appendicitis.

The most common cause of both unilateral & bilateral proptosis is Graves' disease. Proptosis is an important sign in the severity of ophthalmopathy in Graves' disease. To determine the prevalence of proptosis in Graves' disease and its risk factors, 238 patients were evaluated by exophthalmometery. The prevalence of proptosis in the new cases and old ones were 19.8 and 19.1 per cent, respectively (p>0.05). No relationship with smoking and sex and serum thyroid hormone levels could be found, however, there was significant correlation between hypothyroidism and ablation with radioiodine. There was an inverse relationship with proptosis and age in females (r = -0.24; p<0.000l). Prospective, controlled studies should be conducted to reveal the risk factors for proptosis in Graves' disease.

In Europe and America, flat foot is a common reason for attendance at a children's orthopaedic clinic. In this survey, plantar arches of 1750 primary school children in Zahedan were evaluated. Variables such as sex, weight, height, age and foot print using special stamp and ink were recorded. Joseph's method was used for classification. The prevalence of flat foot for male and female students were 6.9 and 4.5 per cent; respectively (p<0.01). The prevalence of flat foot dropped to 3.1 per cent in the age of 11. There was a positive correlation between body mass index and flat foot (r=0.35; p<0.001). In conclusion, the prevalence of flat foot in Zahedan is as the developing countries and body mass index can affect it.

Exodeviation (phoria & tropia) can cause visual suppression and amblyopia during childhood. In a cross-sectional study, 1500 students (758 boys, 742 girls) in the first to fifth grades of primary schools in four regions of Shiraz were screened, based on alternate test. Then, visual acuity, amounts of deviation and central fusional ability were measured. In 24.06 percent of the students, exodeviation (96.57% exophoria, 3.43% exotropia) was detected. There was no significant difference between the sexes; but exodeviation was statistically more prevalent among 151 and 2nd grade students (p<0.0001). 75.51% of students from different ages had exophoria, less than 10 P.D; 5.88% had exophoria, more than 10 P.D. and 3.43% had exotropia. Fundoscopy and slit lamp were normal in the majority of the patients (96.07% and 86.76%; respectively). Amblyopia was present in 1.4 7% of those who had exodeviation. In conclusion, exophoria is prevalent among primary school children and decreases significantly with increasing the age, but exotropia increase in prevalence by the age.

Family planning knowledge, attitudes and practices of males are essential for needs assessment in order to reform the local health centers. Focus group discussion was used to reveal the men's disinclination in family planning in Bushehr Port. A series of 16 group discussions (with participation of 100 males and females) in two age categories (30 yr. & >30 yr. for women and <35 yr. & >35 yr. for men) were held. The cultural restrictions for male involvement in family planning, disparity in responsibilities for contraception, women's unawareness in their rights in family planning were the major concerns. Unmet needs of men for information, counseling and health services were noted as barriers to the expansion of male involvement. It is recommended that men should be treated as a specific target group in family planning programs and male services through the existing health systems should be encouraged. Reproductive health care providers also should be trained to adapt to counseling men in family planning.

Desirable growth and development of infants depends on proper feeding and appropriate food manners. After six months of age, nutritional requirements of infants can not be satisfied only by breast feeding, and in addition to milk, semi-solid foods should be included for them. This study has conducted with regard to special problems of Sistan & Baluchestan province including high incidence of malnutrition, cultural deprivation, and parents' lack of knowledge concerning the value of starting supplementary foods. In a cross-sectional study, 603 interviews were done with mothers who had 6-24 months age infants in rural and urban areas of the city of Zabol. The average age of starting supplementary food was 7.19±1.07 and 6.93±1.16 months in urban and rural population, respectively (p<0.05). The commencement of supplementary food was with Fereni (43.2%), rice (25.1%), some other food (17.2%), soup (6.9%), ready products like Mammana (4.6%), potato (3%) at the first week of the sixth month, while in rural population, it was with Fereni (58%), rice (29%), soup (4.3%), some other foods (4.2%), ready products like Mammana (3%) and potato (1%). There was no significant association between mother's job, her education and age, the birth rank and starting age of supplementary food. The study showed that starting age of supplementary food in the city of Zabol is a little higher than the rest of the country and only half of mothers follow the supplementary feeding program of the breast feeders. This evidence is indicative of the necessity of better planning for mothers' training and enhancing their knowledge about the proper starting age in supplementary feeding and also type and order of usage of complementary food.