JOURNAL OF MAZANDARAN UNIVERSITY OF MEDICAL SCIENCES
Year:2008 | Volume:18 | Issue:63|Papers Count:14

Background and Purpose: Thyroid dysfunctions are one of the most important diseases in endocrinology. Fine needle aspiration (FNA) is currently the first line diagnostic tool for the evaluation of thyroid nodules. The adequacy of specimens provided by this method is also very important. FNA puncture in thyroid causes intra- parenchyma hemorrhage, which may distribute the quality of tissue specimens. Fine needle non-aspiration (FNNA), may provide better specimens without this problem. The aim of this study was to evaluate the adequacy of thyroid nodules specimens provided by fine needle aspiration and fine needle non - aspiration sampling in Imam Hospital.Materials and Methods: This descriptive study was performed on 200 patients with thyroid nodules in Imam Hospital, Sari, Iran. After a detailed clinical history, systemic examination and thyroid sonography, FNA and FNNA sampling were performed in all patients. The adequacy of specimens was evaluated by Mair scoring system in both techniques. All data, including demographic data and sonographic results and background blood, amount of cellular material, degree of cellular degeneration, degree of cellular trauma and retention of appropriate architecture were recorded. Results were analyzed by means of SPSS (11) software and Wilcoxon Signed Rank Test. The P.value less than 0.05 were considered to be significant statistically.Results: 200 patients, 189 (94.5%) females and 11 (5.5%) males, with mean age of 43.36±12.3 years were studied. Cytological findings showed that in FNA technique, 26 (13%) of specimens were unsui1able for diagnosis, 97 (48.5%) were diagnostic/adequate, while 77 (38.5%) were diagnostic/superior for diagnosis. In FNNA technique, 32 (16%) of specimens were unsuitable, 96 (48%) were diagnostic/ adequate, while 72 (36%) were diagnostic/superior for diagnosis. In the combined application of FNA and FNNA, 9 (4.5%) of specimens were not diagnostible and 191 (95.5%) were diagnostic. Mean of total score in FNA was 5.82±2.3, while in FNNA was 5.70±2.4, with the difference was not statistically significant. Furthermore, there was no statistically significant difference between other parameters.Conclusion: Our study demonstrates that there is no difference between FNA and FNNA sampling, however, applying the combination of these two techniques, may improve the diagnostic quality.

Background and Purpose: The role of castor oil on cervical ripening is poorly understood and data in examining its efficacy within clinical trial are limited. This study was performed to evaluate the effect of utilizing castor oil on cervical ripening in pregnancies after 40 weeks.Materials and Methods: A randomized clinical trial study was performed on 200 pregnant women after 40 weeks in Shabikhany Hospital, in the City of Kashan, in 2004 to 2006.Womenwere divided to two groups (100 women in case group and 100 women in control group). Case group took 60 ml castor oil, while the control group omitted treatment. Comparison was then compared between the two groups for demographic characteristics: increase of Bishop Score, means of Bishop Score at entrance to study and 24 hours after entrance to study, onset of labor within 24 hours, method and time of delivery and newborns Apgar score by X2, followed by Fisher's exact test, and paired-samples T and T-tests.Results: Results showed that there were no significant differences in mother's age, education, nationality, gravidity, gestational age, parity between two groups. Paired-sample T test showed significant difference between means of Bishop Score at entrance of study and 24 hours after entrance of study in case and control groups(p=0.000). Furthermore, the mean increase of Bishop Score in the case group was 4.5±3.63 versus 0.67±1.25 in the control group during the 24 hour period. During 24 hours after entrance to study, uterine contraction occurred in 70% women in case and 12% women in control groups.Statistical test showed significant difference between the two groups and an increase of Bishop Score at the onset of uterine contractions (P<0.001). There were no significant differences in method of delivery and Apgar score in their newborns between the two groups.Conclusion: The results of this study showed that use of castor oil may lead to cervical ripening in pregnant women after 40 weeks, without increase in complication of pregnancy, such as caesarean, and decrease Apgar score.

Background and Purpose: Antioxidant reduces oxidative stress during cryo-preservation. The aim of this study was to find out the effects of vitamin E and C on sperm parameters after cryopreservation.Materials and Methods: Human semen samples were obtained from Vali-e-asr Hospital. The samples were divided in two groups (normal and oligospermia groups). Semen was pooled in liquid nitrogen after thawing, samples were centrifuged, then vitamin E and C were added to medium and the aliquots were incubated for 45 minutes in incubator Co2. In control group, no antioxidant was added to medium. Sperm parameters were analyzed according to WHO criteria. Data was analyzed by ANNOVA test.Results: There was a significant increase in the progressive motility and viability of sperm which was supplemented by vitamin E, with 1, 2 Mm (p<0.05) in the normal groups (the increase in the oligospermia group, after addition of vitamin E with 1, 2, Mm was not significant). Vitamin C did not have a significant effect on sperm parameters with 1, 2 Mm concentration.Conclusion: Supplementation of media with alpha-tocopherol is beneficial for sperm motility and viability rates after cryopreservation and it may be of clinical value in assisted conception procedures.

Background and Purpose: Varthemia persica is an aromatic plant belonging to the Astraceae family. The plant is endemic to Iran. It contains volatile oils and the main constituents of volatile oils are sesquiterepens. There is no information regarding flavonoid constituents.Materials and Methods: Extract was prepared from freeze-dried power of flower, fruit and aerial parts with methanol-water (1-1) and HCl (1.2 M). Determination of myricetin, Lute Olin, apigenin, quercetin and kaempferol in all samples were carried out by HPLC.Results: The plant flowers contain all five mentioned flavonoids, however, fruit and aerial parts contain only kaempferol, lute Olin and quercetin.Conclusion: The plants can be considered as flavonoid containing plant and are a good candidate for pharmacological studies.

Background and Purpose: Various abnormalities of the immune system have been demonstrated in patients with chronic kidney disease (CKD). Patients with CKD commonly present with abnormalities of immune function related with impaired kidney function and the accumulation of uremic toxins. Th1 and Th2 cells produce predominantly some cytokine profiles. The aim of the present study was the determination of the levels of IL-13 and IFN-g in sera of end-stage renal disease. The correlations of IL-13 and IFN-g levels with clinical presentation of the disease were assessed.Materials and Methods: In this case-control study the serum levels of IL-13 and IFN-g were determined by a sandwich enzyme-linked immunosorbent assay in 30 patients on hemodialysis (HD), 30 patients with chronic renal failure (CRF), and 60 healthy individuals. Renal function was evaluated by measuring serum levels of creatinin, albumin and urea.Results: The serum levels of IL-13 and IFN-g were differed significantly between patients and healthy controls. The serum levels of IL-13 was significantly increased in the HD group than in the CRF and control groups (13.7±3.9, 6.7±3.4, 4.5±3.3 pg/ml, respectively) (P=0.001). On the other hand, the IFN-g plasma levels were significantly higher in CRF patients than HD patients and controls (38.8±18.8, 17.4±8.78, 12.5±8.9 pg/ml, respectively).Conclusion: In the HD patients, low production of IFN-g in line with upregulation of IL-13 indicates that Th1/Th2 balance may shift towards Th2 dominance. It is possible that this imbalance contributes to the abnormality of the immune system in HD patients.

Background and Purpose: Dacryocystography or visualization of nasolacrimal duct has been widely used in the assessment of the nasal lacrimal system. The water-soluble agent iohexol is currently widely used in nervous and vascular lesion in diagnostic radiology and also employed in dacryocystography. This study was performed to determine the effects of iohexol on tear parameters in normal donkey as a large animal model.Materials and Methods: We examined 10 normal donkeys mean age approximately 4.5 years.The donkeys received iohexol once a day. All donkeys were housed out doors throughout the study.Different tear parameters (total protein, lysozyme, sodium, and potassium and protein electrophoresis of tear) were measured at 0, 2 hours and 2 weeks after dacryocystography with iohexol.Results: The results showed that mean and standard deviation of total protein of tear were 5.88±2.15 mg/ml before dacryocystography and after 2 hours was 4.10±0.96 and after two weeks was 7.36±3.68. Mean and standard deviation of lysozyme was 858.39±170.88 units in Mg of protein of tear and after two hours was 1013.19±178.67 and after two week was 702.54±360.50. Mean ±SD of sodium of tear before dacryocystography was 3084.90±725.44 m/ml and after two hours and two weeks were 3508.40±1372.52 and 8026.20±2953.88 respectively. Mean ±SD of Potassium of tear before dacryocystography was 863.37±52.55 m/ml and after two hours and two weeks were 753.84±46.81 and 1564.20±276±41 respectively. Results of SDS-PAGE of donkeys tear confirmed that nine protein bands with molecular weights between 10 kDa and 15 kDa are present. No differences found in protein electrophoresis pattern before and after iohexol administration. No significant changes were present in measured factors at different times.Conclusion: In conclusion iohexolis a safe and suitable contrast media for dacryocystography.

Background and Purpose: Although the evolution of industrial systems toward digital technologies decreased the exposure to high levels of noise, it has created some problems encountered with low level and provoking noise (low frequency noise). In the present work, the mental performance of students exposed to low frequency and reference noises at low and high levels (45 & 65 dB) were studied.Additionally, other factors such as annoyance, sensitivity to low frequency noise and hearing status of participants were considered.Materials and Methods: After generating low frequency and reference noises required for the study, a pilot study was conducted. Then, 54 students participated in the main study after preliminary tests. Their mental performances were evaluated with standard psychological tests while they were exposed to low frequency and reference noises at 45 and 65 dBA.Results: The results showed that noise annoyance and low frequency noise sensitivity do not have a significant correlation with age and sex. The results also revealed that, low frequency noise at 65 dB can decrease concentration (P=0.003) and increase response time (P=0.039) of performance in comparison with low frequency noise at 45 dB. On the other hand, reference noise at 65 dB can increase speed (P<0.001) of performance in comparison with reference noise at 45 dB.Conclusion: Low frequency noise can reduce the mental performance and increase its response time.

Background and Purpose: chronic urticaria is a tormenter and does not have a known etiology.Association between chronic urticaria and thyroid auto-immunity has shown different results. The aim of this study is to evaluate the effect of Levo-thyroxine on the chronic urticaria and association between chronic urticaria with thyroid auto-immunity.Materials and Methods: In a prospective case-control study, we compared the frequency of thyroid auto antibodies in 60 patients (all females, with exception of six males, ages 15 to 60 years) with chronic urticaria and compared with 60 mached age healthy volunteers. All cases with chronic urticaria and control group were normal CBC, antinuclear antibodies, rheumatoid factors, complement, stool exam, liver function test (LFT), kidney function and skin prick test, prior to being referred to us. We performed thyroid auto antibodies, thyroid hormones and IgE antibodies before treating all subjects. Half of them with positive anti-thyroid antibody (n=11), received Levo-thyroxine (100 mg) daily for 1 month and the remaining half (n=11) were control group.Results: The frequency of thyroid auto antibodies was significantly higher in patients with chronic urticaria than in healthy control (36.6% vs. 9%; p<0.01). All patients were euthyroid, however, one was found to have increased anti-thyroid antibody levels with sub clinical hypothyroidism (TSH increased, low T4). Total serum IgE increased in ten cases of patients group (16.6%) compared with six control groups (10%). Nine patients (40%) had complete response, five patients (30%) had partial response and five patients (30%) did not show any response to treatment compared with control group, in which complete and partial resolution was 30% and others with no resolution.Conclusion: chronic urticaria may be associated with thyroid disorders (positive anti- thyroid antibodies) despite normal thyroid function test. For chronic urticaria despite increase serum IgE level with unknown origin, must be evaluated by a thyroid function test, along with anti -thyroid antibodies and treatment if necessary.

Background and Purpose: Lipodystrophy is potentially a clinical adverse effect, associated with insulin therapy and is believed that usage of human recombinant insulin's is associated with decreasing prevalence of Lipodystrophy. The objective of this study was to determine the prevalence of insulin induced Lipodystrophy, among diabetic out-patients referred to Imam Khomeini Hospital, in Sari during 2007.Materials and Methods: In this cross sectional descriptive study, 220 diabetic patients referred to the Diabetes Center at Imam Khomeini Hospital, in Sari, who under treatment by insulin at least three months prior to referral was evaluated.First, the demographic and clinical characteristics of the patients were recorded in a questionnaire; then all patients were examined clinically to evaluate lipodystrophy. In all subjects, glycated hemoglobin (HbA1C) was measured to assess the range of blood glucose level control. Recorded data were analyzed by statistical methods, such as descriptive T-test and X2.Results: Of 220 diabetic patients studied, thirty-five (15.9%) showed clinical evidences of insulin induced Lipodystrophy; 32 out of 35 cases of Lipodystrophic patients (14.5%) had Lipohypertrophy, while 3 cases (1.4%) had Lipoatrophy.The factors included Age, Sex, Education, BMI (Body mass index), type of Diabetes, The duration of insulin consumption and injection site had statistically significant effects on development of insulin induced Lipodystrophy (P<0.05).Conclusion: The results of this study demonstrated that despite using human recombinant insulin's, the prevalence of insulin induced lipodystrophy, especially Lipohypertrophy, has remained high up to present. Therefore, regular examination of patients for this side effect is necessary, especially in subjects without good control of blood glucose level.

Background and Purpose: MDI (Methylene Diphenyl Diisocyanate) is a high tonnage product, which comprises about 90% of the total diisocyanate in the market. Polyurethanes are produced by reacting diisocyanate with polyols and other chemicals. They are known as respiratory tract and skin sensitizers and are the most common cause of occupational asthma in the world (NIOSH 1994). On this subject, evaluation of MDI concentration in the polyurethane factories by HPLC, and is worthy to determine its pollution level.Materials and Methods: All sampling methods have some limitation, therefore, this survey the method of NIOSH 5522 has been used as a standard sampling and analyzing method t then, we utilize SPSS V.13 software, for our data to be analyzed for statistical discussion.Results: Results showed that all of the polyurethane industries under this study have high concentration, rate of more than 80 mg/m3. There was a strong correlation between indoor temperature and high MDI concentration, thus, it implies that various temperatures may be increased, in addition to working time ensuring it has a good correlation with MDI concentration. It also implies that whenever they have more working time comparatively, in turn, they have high exposure rate of MDI pollutant in the workplace.Conclusion: To obtain a better way for determination of MDI concentration in the work place is using biological monitoring as a standard method to survey the exposure to diisocyanate, by using metabolite determination, it will be easier to collect and analyze more samples as the sampling is not as time-consuming as air monitoring.

Background and Purpose: An important factor involved in infertility is reactive oxygen species (ROS). ROS can damage sperm DNA, and involve lipid per-oxidation. ROS elevation is under the influence of leukocyte activation. The objective of this study was to evaluate the level of ROS as well as leukocyte, in normozoospermic (NO) and ologoasthenoteratozoospermic (OAT) ejaculates.Materials and Methods: The study population consisted of 75 individuals who were referred to the Research and Clinical Center, regarding infertility in Yazd, for semen analysis. Fifty (50) out of Seventy-Five (75) men were NO, and the remaining was OAT. ROS was measured with laminator, while leukocyte concentration was analyzed with the ENDTZ test.Results: The results showed that ROS levels in OAT was significantly higher compared with NO (1253.49±200.95 vs. 75.64±149.52; P=0.00). Furthermore, men with OAT were divided into 2 groups, with sperm morphology and motility >5% and <5%. In group >5%, ROS level was significantly higher than the group with <5% (3627.55±407.79 vs. 81.29±100.48; P=0.007). In addition, leukocyte concentration in NO was 0.07±0.22x106; while it was 0.12±0.20x106 in OAT samples; P=0.35).Conclusion: The results indicate although ROS is present in normal seminal samples, it is significantly higher in OAT. This shows the vital role of antioxidants, which may improve the sperm quality. Further clinical studies will pinpoint the antioxidant capacity in improving the seminal contents.

In this study a 31 y/o woman who was housewife, came from Mazandaran and lived in Behshahr is presented. Patient's complaints were diarrhea, bloating, abdominal pain and weight loss. Abdominal radiography showed loop dilatation. In primary Para clinic assessments she had Alb: 2.8, Ca: 6.4, P: 2.3 and PTH: 201. Considering malabsorption in early evaluation, upper endoscopy was done. Intestinal folds were disappeared in second and third part of duodenum in endoscopic view and duodenal biopsy was done. Then pathological assessment revealed a large accumulation of intraepithelial lymphocytes and obvious villus atrophy that was accordant to celiac sprue. She was advised to be on gluten free diet. After about 1 month, She was referred because of sever lower extremities edema. Serum albumin was checked that was 2. Enlarged mesenteric lymph nodes were detected in sonography. Considering non- responding treatment, IHC staining of intestinal biopsy was performed with celiac sprue complication suspicion.Therefore the patient was referred to chemotherapy center with the diagnosis of T-cell lymphoma following celiac sprue. She was spent 6 course chemotherapy with CHOP regimen and radiotherapy.