Research in Medicine
Year:2001 | Volume:25 | Issue:2|Papers Count:9

Background: According to the reports of thyrotoxicosis after iodination projects in Africa, WHO, UNICEF, and ICCIDD have revised the median of urinary iodine as 100-200 µg/l. This figure implied that part of our society especially children, pregnant and lactating women are highly susceptible to iodine deficiency, so this study was conducted following iodination with 40 ppm of iodized salt, in Iran. Since 1994 more than half of our society have received iodized salt-and this study has been carried out 2 years later. Materials and methods: 30 clusters including 10 schoolchildren aged 8-10 years old were randomly chosen with PPS method through 26 provinces, in the meanwhile 2720 normal individuals aged 6-80 years old were selected randomly through 3 big cities and surveyed separately. Urinary iodine was measured by means of "Digestion" method, whereas the serum level of T3, T4 and TSH was determined using radioimmunoassay and T3RU, antithyroglubulin and antimicrosomal antibodies were determined using Kodak kits. Results: Median of urinary iodine was 223 µg/l and 2.6%, 3.3%, and 9% of the schoolchildren had urinary iodine of less than 20, 50, and 100 µg/l, respectively. In 7 provinces, the median of urinary iodine was 150-200 µg/l, where 5-20% of the schoolchildren had urinary iodine of less than 50µg/l. Meanwhile, in other 12 provinces the median of urinary iodine was 200-300 µg/l, where 1-11% of the schoolchildren had urinary iodine of less than 50µg/l. Among 2720 individuals urinary iodine of less than 50µg/l was reported in 15% of the cases, however, among 258 women aged 18-40 years old 7%,16%, and 31% had urinary iodine of less than 50, 100, and 150 µg/l, respectively. T4, T3, and TSH were reported in normal range, however, hyperthyroidism and hypothyroidism were revealed in 3 and 4 cases, respectively. Positive antithyroid antibodies were detected in 2.1% of our society. Conclusion: Study has revealed that in case of urinary iodine of 100-200 µg/l, some of the children and women in fertility age are highly susceptible to iodine deficiency. Meanwhile, altered thyroid function was rarely seen with daily usage of 40 ppm iodized salt.

Background: Reference values are differing according to the dominant variable distribution in different societies. Since our clinical decisions and patients' assessment are based on these reference values, determination of these values is of great importance in our society. Materials and methods: In a 6-year study, blood indices were determined through CBC test performed on under-marriaged population in Isfahan with automatic devices, then, reference values have been calculated according to the standard deviation and centiles, and compared among age and gender subgroups. Results: Excluding patients under 15 years old and inappropriate data recording, 162373cases had entered our study.Women have shown lower level ofhemoglubin, hematocrit, MCV, MCR, MCHC, and RBC count. Hemoglubin has shown descending movement in 15-65 year-old women, however, MCV has increased as age increasing in both groups.Conclusion: RBC count revealed to be higher comparing with previous studies, whereas MCV found to be lower.

Background: Regarding the highly prevalence of impotency in men and its psychological effects and also the necessity of cavernosometry and cavernosography for venous system evaluation, which is one of the most common etiologic factors, this study has been carried out to compare two different cavernosometry techniques. Materials and methods: 30 patients aged 21-77 years old with mean age of 45.6, suffering from erectile dysfunction (impotence) for at least 6 months and undergone Combined and Injection Stimulation (CIS),had entered our study and underwent cavernosometry and cavernosography with and without intracavernosal injection of vasoactive drugs. Two different techniques were compared: pump cavernosometry using an injection pump as the inflow source and gravity cavernosometry using an injection set at determined height (160cm of penis) as the inflow source. Several hemodynamic parameters were studied. Results: Among these 30 patients, normal cavernosometry was reported in 5 (16.6%) cases (psychological impotence), whereas venous leakage was determined in 6 cases (20%) and arterial insufficiency in 11 cases (36.7%). The remaining 8 cases (26.7%) had both venous leakage and arterial insufficiency. Gravity cavernosometry had sensitivity, specificity, and accuracy of 86.6%, 93.3%, and 90%, respectively. In pump cavernosometry maintenance flow is the most accurate criteria, whereas the pressure drop and pressure drop time are also of great importance. Meanwhile, results are questionable if vasoactive drugs are not injected.Conclusion: Both techniques revealed to have comparable diagnostic value. Since the gravity cavernosometry is a simple and cheap method it could be a suitable alternative for pump cavernosometry.

Background: Iodine deficiency disorders (IDD) are a worldwide health problem. It was a known problem in Iran, where control and preventive programs including preparing and distribution of iodized salts have been introduced since 1988. This study has been carried out on 8-10 year-old schoolchildren in Tehran province, 1996,to evaluate the IDD control program. Materials and methods: 1400 schoolchildren (M/F=1) aged 8-10 years old had been studied through a descriptive -cross sectional study with randomized sampling. Goiter was graded according to the clinical examination and measurement of T3, T4, TSH (radioimmunoassay), T3RU and urinary iodine (Digestion method). Results: Mean of T4, T3, and TSH was reported 10.4±1.8 µg/dl, 205±46 ng/dl, and 1.4± 0.8 µIU/ml, respectively. No significant difference was noted among male and female or rural and urban areas. 18(1.3%) cases had serum T4above 12.5 µg/dl and one had TSH above 5 µIU/ml. Mean of urinary iodine was recorded 21.8 µg/dl, where 92% had urinary iodine above 10 µg/dl. Urinary iodine of less than 5 µg/dl was found in 4% of the cases. Total prevalence of goiter was 51% (30% in male and 21% in female). Conclusion: Results have revealed that 7 years after introducing the IDD control program and just 2 years after using iodized salt by more than 50% of the population, urinary iodine of schoolchildren aged 8-10 years old has increased and met adequate levels approved by WHO.

Background: Regarding the widely usage of antibiotics as prophylactic agents against infections followed by operations, this study has been carried out to determine the prophylactic effects of intravenous single dose of cefalotin, in comparison with the common regimen of the same antibiotic for one week, in clean (non-infected and those not related to air ways or GI tract) head and neck surgery in ENT ward, Loghman Hakim hospital, 1996-97. Materials and methods: This clinical trial of double-blinded and sequential type was achieved on 124 patients aged 6-72 years old. Patients were distributed in two groups of case and control. Case group was received a single dose of cefalotin intravenously (25mg/kg) 30 minutes before the operation, then received placebo every 6 hours (QID) for a week. In the control group the same pre-operation regimen was observed, however, intravenous cefalotin was given at the dose of 12.5 mg/kg every 6 hours for a week. Patients were examined at the Ist,2nd, and 3rd week. Results: 62 patients were put in each group. Post-operation infection incidence was 6.5% (4 cases) and 4.8%(3 cases) in the case and control group, respectively, where the difference is not statistically significant. Conclusion: Concerning our results and also other similar studies, single dose of intravenous cefalotin revealed to be an effective prophylactic agent in clean operations and could be a suitable alternative for routine regimens. Further studies to determine the efficacy of this approach for clean-contaminated and/or infected operations are highly recommended.

Background: We have surveyed the physical disability as a SLE outcome and its correlation with psychosocial factors in affected individuals. Physical disability would lead to psychosocial stress, disability in movement and personal cares, increasing the use of toilet, income decrease, and imposed on social sources. Materials and methods: 96 patients with SLE referring to rheumatologic outpatient centers in Shiraz (public or private centers) have entered our study and undergone Stanford Health Assessment Questionnaire (HAQ); Arthritis Impact Measurement Scale (AIMS), Beck Depression and Hamilton Anxiety tests. Results: Mean of disability was reported 4.59 (0-17). Patients most common problems were elevating stairs (64.6%) and managing daily affairs (59.4%). As 93.8% of the affected cases are women, these problems could mainly impair their routine daily affairs, which in turn would remove their independency in physical and economical aspects. Indeed, half of the patients were unable in managing toilet affairs. Disability and psychosocial problems were chiefly existing in patients feeling tired (non-significant manifestation) very often. These differences were statistically significant. Disability was strongly correlated with psychosocial problems, however, its correlation with social problems was 2 times as likely as psychological problems (r=0.44 vs. r=0.23). Conclusion: Disability has great impact on social affairs, so it seems as if psychosocial supports could improve patients ability.

Background: Corn oil plays an important role in supplying essential fatty acids and vitamin E, however, its impact on cardiovascular and immune system was not negligible. This product is mainly composed of unsaturated fatty acids and small amounts of saturated fatty acids. This study was conducted to determine the effects of corn oil on rats body composition, physical growth, and blood fat concentration.Materials and methods: 8 rats were divided in two groups of case and control and studied for 9 weeks. Rats were killed by means of ether and 5cc blood was taken for determined laboratory tests. Their cadavers were used for protein and fat analysis. For the first 4 weeks both groups have received the same regimen, but after that the case group (receiving corn oil) was given less food. Results: Total food intake was 1300±128 and 1059±69 gr in the control and case group, respectively. The control group has received fewer calories in comparison with the case group. No significant difference was found between the groups concerning the cholesterol, LDL, and triglyceride level, however, HDL level was reported higher in the case group. Both groups had similar amount of protein, but the case group has shown higher amount of fat and lesser amount of carbohydrate.Conclusion: Regarding the higher amount of HDL in the corn oil group (case), further studies are highly recommended.

Background: Since the first educational workshop introduced in the middle east by Shiraz University of Medical Sciences in 1973 no attempt has been made to evaluate such programs. Regarding the great importance of medical education such workshop should be be evaluated with the aim of eliminating the weak points and reinforcing the positive aspects.Materials and methods: In this descriptive-analytical study 85 faculty members participating in 3 educational workshops including "The Educational Basis and Programming", "Educational Methods", and "Evaluation" during 1993 till 1996, have entered. Questionnaire surveyed the participants insight, change in interest, educational ability and performance, and also recommendations. 71 candidates had replied the questions.Results: The mean scores of questions dealing with changes in insight, ability of educational programming, education, evaluation, and usefulness of workshops contents in participants daily performance were compared regarding the level of education, specialty, and gender. Statistically significant differences were seen in comparing the mean scores of "changes in educational programming" with gender, where female had higher mean scores. The vast majority of the candidates (38) have stated that shortage of time is the main reason of not applying the obtained knowledge of the workshops. 66 candidates have found the workshops effective on educational methods improvement. Totally, "The Educational Methods" workshop (69%) and "The Evaluation" workshop (46.5%) had greater impact. Conclusion: Results have revealed that workshops have positive effects on the participants. Meanwhile workshops like "Educational Methods" or "Evaluation" that are directly related to the professors performance seem to be more effective.

A 14 years old boy presented with multiple attacks of choaking pain during his sleeping period since months ago. His physical activity was markedly decreased, so that he had avoided fast walking due to choaking pain. Familial hypercholesterolemia was confirmed concerning multiple xanthoma on his hands and feet, arcus cornea, and high blood level of cholesterol. To evaluate the severity of CAD, exercise test was achieved, but it was terminated in the first stage due to severe choaking and marked ECG changes. Further investigations have revealed severe stenosis at three major coronary arteries. Regarding the rarity of homozygous familial hypercholesterolemia (one per million), and CAD presentation as choaking attacks that delayed the diagnosis of angina, he was introduced as a useful case report.