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Tibiotalar dislocation without concomitant fracture in the surrounding bones is a rare injury. We report one of them presenting unreduced after a 10 month interval. A 23 y/o female presented to our clinic 10 months after Bam earthquake, during which she had sustained an anterior tibiotalar dislocation without any associated fracture. Open reduction was tried two times, but both attempts were unsuccessful because of the very poor quality of bone. Although ankle dislocation has been reported to be associated with good prognosis, it was not the case with our late presenting patient.

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Background and Objective: Destructive effects of thyroid diseases in pregnancy and fetal frowth is well established subclinical autoimmune thyroid diseases can double the rate of preterm labor, abortion and postpartum thyroiditis. This study was done to compare thyroid function and autoimmunity derangment in goiterous and non-goiterous pregnant women. Materials and Methods: This case – control study was done on 100 healthy and 100 goiterous pregnant women in Dezyani hospital located in Gorgan, Northern Iran during 2005. Five mililiter of blood sample was obtained from each subject to measure thyroid hormones concentration including T3/ T4/ TSH/ T3 RUP and thyroid autoantibodies (Anti Tg/Anti TPO). Thyroid hormone and auto antibodies were measured using IRMA and ELISA techniques. Results: Thyroid volume was enlargel twice and tripl of its orginal size in 34% and 66% goitrious pregnant women respectively. Mean serum TSH in cases and controls were 1.81+/-1.33 microU/ml and 1.84+/-1.4 microU/ml respectively. The mean of Anti TPO and Anti Tg in cases were 373.91+-197.36 U/ml and 248.80+-70.59 U/ml respectively. The same indecs for controls were 79.52+-63.99 U/ml and 248.80+-70.59 U/ml respectively. In pregnant women with goiter 36% had high Anti TPO and 9% had high Anti Tg, but in control group 16% and 4% of controls had elevated Anti TPO and Anti Tg, respectively. Conclusion: According to thyroid function tests there were elevation of antibody in 20% of the healthy subjects and 45% of the goiterous subjects, therefore it is advisable to measure thyriod function tests accompanied with thyriod antibodies in all pergnant women either with or without goiter in order to prevent feto-maternal disorders.

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Background and Objective: Low birth weight (LBW) is one of the most important problems in the world. Many morbidity are more prevalent in LBW included in attention deficit and hyper activity disorder (ADHD). This study was done to find the Relation between low birth weight with attention deficit and hyper activity disorder in children. Methods: This historical cohort study was done on 226 rural children in Yazd province, central area of Iran. ADHD symptoms were evaluated in LBW and NBW using DSM-IV criteria. Results: Frequency of ADHD was 22.8% in LBW and 12.5% in NBW (P<0.05). The mean of family members was 4.7±0.6 and 4.2±0.8 in child with ADHD versus child without ADHD (P<0.05). Odd's ratio for ADHD was 3.1 in patient with more than one sister or brother (95% CI: 1.2-7.9, P<0.001), and 5.7 in patients with positive familial history (95% CI: 2.6-12.4, P<0.001). Conclusion: Relationship between ADHD and LBW was statistically significant. Positive familial history for ADHD and over-crowded family were social factors related with ADHD. LBW is one of the risk factors for ADHD and can be considered in children health program ADHD was frequent in child with low birth weight than child with normal birth weight.