Journal of Kerman University of Medical Sciences
Year:2012 | Volume:19 | Issue:3|Papers Count:12

Background & Aims: Since at early pregnancy (<20 week) fetal thyroid gland is undeveloped, normal development of the Fetal brain is highly dependent on maternal thyroid hormones. There are excessive adverse perinatal outcomes associated with overt and subclinical hypothyroidism such as increase of Abortion, preeclampsia, placenta Abruption, LBW, preterm labor, impaired fetal neuropsychological development and low IQ scores. The aim of this study was to determine the prevalence of hypothyroidism and its relationship with some known risk factors among pregnant women with gestational age <20 wk.Methods: A total of 620 pregnant women referred to Dadbin clinic (Kerman/Iran) for their first prenatal care before the 20th week of gestational age were studied for TSH and FT4 levels by Elexis method. A questionnaire including known risk factors of hypothyroidism was filled out for each participant. The prevalence of both clinical and subclinical hypothyroidism and its probable association with some risk factors were studied.Results: The prevalence of hypothyroidism was 10.15% (clinical=2.25% and subclinical=7.9%). Except for allergy, no relationship between hypothyroidism and considered risk factors was found.Conclusion: Due to the high prevalence of hypothyroidism (clinical and subclinical) and its neonatal and maternal outcomes, hypothyroidism screening in all pregnant women as one of the routine prenatal cares is suggested.

Background & Aims: Lipoprotein lipase (LPL) is one of the key enzymes regulating the metabolism of triglycerides (TG) and HDL cholesterol. The lipoprotein lipase (LPL) gene polymorphisms are possibly involved in the pathophysiology of dyslipidemia. Hind III polymorphism is one of the most common polymorphisms in LPL gene. In some studies, association of Hind III polymorphism with dyslipidemia has been reported. Due to the high incidence of dyslipidemia in Iranian adults, this study was designed to investigate the frequency of rare allele (H-) LPL gene Hind III polymorphism and its association with serum lipids levels in an Iranian population.Methods: Total genomic DNA was prepared from 76 Iranian patients with hyperlipidemia [Total cholesterol (TC) >200 mg/dl, Triglyceride (TG) >150 mg/dl] and 75 healthy subjects (TC<200 mg/dl, TG<150). The Hind III polymorphism was analyzed by polymerase chain reaction and restriction fragment length polymorphism.Results: The frequencies of the Hind III polymorphism minor allele (H-) were 17 and 30 in the case and control groups respectively (P<0.01). In the case group, patients with H+H+ genotype had significantly higher mean total cholesterol (TC) and low density lipoprotein (LDL), compared to those with H+H- and H-H- genotypes (P<0.05).Conclusion: The presence of rare H+ allele was associated with increased TC and LDL-c levels in the studied population. The association between the LPL gene Hind III polymorphism and dyslipidemia is quite complicated and genotyping of LPL Hind III polymorphism in a larger-scale screening and with other polymorphisms is necessary and justifiable.

Background & Aims: In spite of frequent produce and use of magnetic nanoparticles in biological fields, there are few studies on their side effects, especially under in-vivo conditions.Method: In this research, the effect of the single-dose intraperitoneal injection of DMSA (dimercaptosuccinic acid) coated magnetic iron oxide nanoparticles (Fe3O4) in different doses (50, 100, 200 and 300 mg/kg) on liver and kidney function was studied.Results: Clusters of iron oxide nanoparticles were observed in treatment mice liver and kidney tissues as dark blue accumulations with Prussian blue staining up to 4 days after administration; so, the nanoparticles were absorbed into and were accumulated in these organs. No histological disorders were observed in the tissue sections in comparison with controls. Considering biochemical analysis, the mean amounts of SGOT, SGPT, and LDH enzymes, also albumin, uric acid, urea and creatinine were not different significantly than control group; but in contrast to the control group, the mean numbers of the blood cells were decreased significantly in treatment groups with doses higher than 50 mg/kg. During the study, no death was found in animals.Conclusion: The data suggest that the future applications of DMSA- coated magnetic iron oxide in medicine and biology has not probably toxic effects on health human.

Background & Aims: Esophageal Cancer is the sixth fatal cancer in the world. Squamous and adenocarcinoma account for 95% of esophageal cancer. The expression of EGFR has a role in the pathophysiology of epidermal-based malignancies such as esophageal cancer. EGFR is also an important criterion in the evaluation of disease staging and prognosis. The aim of this study was to survey the prevalence of EGFR gene mutations in patients with esophageal cancer by MLPA Technique.Methods: A total of 60 parafinated blocks from patients with esophageal cancer were investigated for the presence of EGFR mutations by MLPA technique.Results: EGFR mutation was discovered in 82 percent of samples of which 52% were deletion mostly seen in exon 2 (52%) and duplication mostly seen in exon 27 (54%). In some cases deletion and/or duplication were seen in more than one exon simultaneously.Conclusion: With regard to the obtained results and since the definitive diagnosis of esophageal cancer is made by biopsy and pathology techniques, it is suggested that all biopsy specimens be detected for EGFR mutations, particularly on exons 2 and 27 in order to achieve a noninvasive molecular diagnostic technique in future.

Background & Aims: Amputation has different causes and is increasing in many countries. This study tried to determine the etiology of the amputations in one of the relatively large cities of Iran.Method: This retrospective study was undertaken on all of the amputees in hospitals affiliated to Kerman University of Medical Sciences during 9 years. Patients’ demographic features including age and sex, as well as the amputated limb and its etiology, side and level were recorded. The level of amputation was recorded as minor (below wrist or ankle) or major (above wrist or ankle) too.Results: In whole, 624 patients were enrolled into the study. The number of amputees per year was 54-118 ones. From all participants, 508 ones (31.4%) were male and 118 ones (18.6%) were female. Mean age of male participants was less than females’. Upper extremities had been amputated more than of lower ones and while 61.9% (n=386) of the amputations were major, 38.1% (n=238) were minor. Overall, the most common cause of amputation was trauma and the most common level was transmetatarsal. The most common level for major amputations was below knee.Conclusion: In the present study, in contrast to similar studies in the developed countries, trauma was found to be the major cause of all types of amputations and in all age groups, which emphasizes the need for preventive measures in the country.

Background & Aims: Knee joint is a complex structure and anterior cruciate ligament (ACL) tear is one of the most common injuries of it. Anterior cruciate ligament, because of its proprioceptive function, has an important role in balance control and its tearing may tend to balance control deficiency. The aim of the present study was to evaluate the effect of functional brace on the balance in patients with anterior cruciate ligament rupture.Method: In this quasi-experimental study, 20 patients with anterior cruciate ligament tear, with the age of 18 to 44 years, were recruited. Patients were selected by simple sampling method. Force plate was used for testing the postural balance, as a dependent variable. Data were analyzed using paired-t and chi-square tests.Results: The velocity of center of pressure in x and y directions was not statistically significant comparing the bracing position with bare feet. The difference between pre and post orthotic intervention testing of displacement was not statistically significant in with/without brace position (P>0.05).Conclusion: According to the results, it seems that the functional brace is not effective in improvement of postural balance in patients with anterior cruciate ligament tear.

Background & Aims: Blood inflammatory factors have been recognized as major risk factors of cardiovascular diseases. The purpose of this study was to compare the efficacy of two methods of excessive aerobic continuous and interval training on plasma lipoproteins (TC, TG, LDL, HDL, VLDL) and serum CRP in women.Methods: A total of 20 women aged 35-45 years were randomly divided into the two groups of aerobic continuous and interval training. Subjects participated in an 8- week either aerobic continuous or interval running program (3 day/week, at 65-75% HRmax). Twenty four hours before the first training program and 24 hours after the final training session blood samples were collected in a fasted state.Results: No significant difference was found between the two groups in regard to TC, TG, LDL, HDL, VLDL and CRP levels in both pre- and post- tests. Aerobic continuous training induced significant decrease in TC, LDL, CRP and increase in HDL. Aerobic interval training induced significant decrease in TC, TG, LDL, CRP and increase in HDL too, but no significant difference was found between the two methods of training on plasma lipoproteins and serum CRP.Conclusion: Excessive aerobic continuous and interval training can have similar effects on plasma lipoproteins and serum CRP in women.

Background & Aims: Preterm labor is often resulted in preterm births and increased rate of neonatal morbidity and mortality. Treatment consists of bedrest, hydration, pharmacologic interventions, and combinations of these. The purpose of this study was to compare the efficacy of intravenous magnesium sulfate (MgSO4) and indomethacin in the treatment of preterm labor pains. Neonatal and maternal side effects of each method were also studied.Methods: A total of 120 women between 26 and 31 weeks’ gestation admitted due to preterm labor were randomized to receive either MgSO4 (n=60) or oral indomethacin (n=60). All women received betamethasone and prophylactic antibiotics. Data were analyzed using student t-test and X2.Results: The two groups had no significant difference in mean gestational age and cervical dilation and effacement at enrollment. The gestational age at delivery was similar in both groups (p=0.279). Delivery was delayed for more than 48 hours in 81% of subjects in MgSO4 group and in 87% of subjects in the indomethacin group (P=0.298). Neonatal birth weight, type of delivery, recurrent preterm labor pain and mean time to suppress the contractions were similar in both groups. No serious side effect was seen in the two groups.Conclusion: Acute tocolysis by either IV MgSO4 or oral indomethacin can delay preterm birth for 48 hours, provide the critical period of steroid effect, arrest an episode of preterm labor, and consequently delays delivery and improves neonatal outcomes. It is therefore necessary that all Obstetricians remain up-to-date regarding the efficacy, indications, contraindications, and side effects of all tocolytics.

Background & Aims: Surgeons are not willing to participate in thyroid surgeries due to dangerous, although rare, complications of the procedure. Post thyroidectomy complications are divided in early and late onset; hypocalcemia, bleeding, thyroid storm and recurrent laryngeal nerve (RLN) injury are the most important ones. This study was performed to compare the frequency of recurrent laryngeal nerve injury with and without nerve exploration in the thyroidectomy operation.Methods: In this Cohort study, we evaluated 566 cases underwent thyroidectomy during about 6 years (2005-2011) in two centers, Bahonar and Afzalipour hospitals, in Kerman, Iran.Results: A total of 566 patients, 124 men (21.9%) and 442 women (78.1%) with the mean age of 40.26 years and the mean hospitalization period of 3.35 days were evaluated. 382 patients (67.5%) underwent total or subtotal thyroidectomy and 184 (32.5%) underwent lobectomy and isthmectomy. 124 patients (21.9%) had malignant and 442 (78.1%) had benign lesions. The most common found malignancy was papillary thyroid carcinoma (PTC), whereas the most found benign lesion was multinodular guiter (MNG). Recurrent laryngeal nerve exploration was done for 337 patients (59.5%). Totally, 6 cases (1.1%) showed recurrent laryngeal nerve injury (1 in exploration and 5 in non exploration group) from which, 4 had permanent hoarseness and 2 had permanent dysphonia. Also, malignancy and radical neck dissection had significant effect on nerve injury but re-operation and unilateral or bilateral surgery had not.Conclusion: Recurrent laryngeal nerve identification and exploration decreased the incidence of nerve injury significantly. We believe that recurrent laryngeal nerve identification and exploration during thyroidectomy is the best procedure to decrease the risk of nerve injury.

Background & Aims: Cancer is a major public health problem in many countries of the world and the third leading cause of death in developing countries. The most frequently diagnosed cancers in females and males are breast and lung cancers respectively. The aim of this study was to investigate the pattern of age distribution and the frequency of different cancers in East Azerbaijan province during the year 2009.Methods: This descriptive analytic study was performed by community based method on 5455 new cancer cases obtained from cancer registries in East Azerbaijan province in 2009. Characteristics of all registered cancers (including age, sex, and etc.) were collected in a form. Then data were summarized and coded using the International Classification of Disease (ICD). Data were analyzed by SPSS software. The 95% confidence interval of the study Variables were calculated using Excel software.Results: Among 5455 cases, 3189 ones (58.5%) were males and 2256 ones (41.4%) were females. Mean age of cancer incidence was 57.3±18.5 years. About 47.8% of malignancies occurred in ages over 60 years and 52.2% below 60 years. Among men, 57.8% of all cancers occurred in the age group of 60-70 years but in women 53.5% of them occurred in the age group of 50-60 years. Mean age at diagnosis was significantly higher (P<0.001) among males (60 years, 95%CI: 59.7-60.9) than females (53 years, 95% CI: 52.2-53.8). The 10 most common cancers among males and females were stomach (15.5%) and breast (20.9%) cancers respectively.Conclusion: More than half of all registerd cancers in the province were in the age group of above 60 years. Stomach and breast cancers are the most common malignancies of this region and occur most frequently during the 7th and 5th decades of life respectively. Comprehensive and complementary studies for recognizing relevant factors are among the priorities of health system research in this province.