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In this case-control study, 58 transfusion-dependent Thalassemic patients compared with 46 normal healthy persons on study of their thyroid size & function. In this study, thalassemia patients divided in two groups: Group one 31 patients with (Ferritin<1500) and group two 27 patients with (Ferritin>1500) and 3rd one was named control group (46 healthy persons). These groups were compared to achieve the best possible results and conclusion out of 31 patients. From first group 26 people had normal thyroid function test only 5 patients (16%) had goiter. From 27 patients in second group, 5 people (19%) had normal thyroid and 22 patients had goiter, in 3rd group 29% had normal thyroid, the difference between second and third groups were significant (P<0.01). In second group T4 level were lower than control, instead the TSH level were more than control group. The difference in second and third group were significant. The mean of T3 and T4 in group one and three don’t have significant differences. Conclusion: The goiter incidence and hypothyroidism in major Thalassemia with poor control (Ferritin>1500) are high.

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The term Noonan syndrome has been applied to phenotypic male and female who have certain anomalies that occur also in female with Turner’s syndrome. These patients have normal karyotype. The disorder is very rare. The most common abnormality are short stature, webbing of the neck, Pectus Carinatum or Pectus excavatum, congenital heart disease. This particular case is a 8-year-old girl-patient who referred to pediatric clinic with short stature. Another abnormality in these patients is abnormal facies (Hypertelorism, hypogonadism, piqure chest and webbing of the neck). The patient had moderate mental retardation. Chromosomal analysis revealed 46xx cytogenetic distinguished Noonan syndrome.

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This study has been performed on show the incidence of sensory neural hearing loss (SNHL) in patients with chronic Otitis Media (COM) and it’s different parameters. 207 patients with persistent or previous otorrhea have been examined. 70 patients had bilateral otorrhea and 137 patients had unilateral problem so overall 277 ears are evaluated. The BC greater than 15 dB without carhartnotch was the basis for diagnosis of SNHL. 66 patients had SNHL and of them 26 cases were bilateral so total number of ears with SNHL were 92 (The incidence of SNHL was 32.2%). 3 cases were due to other causes like TB (1 case) RM fistula (1 case) and squamous cell carcinoma (SCC) of middle ear (1 case). About 90.3% of cases had down slooping high frequency SNHL in their audiogram. In 47.6% of the ears with granulation tissue and cholesteatoma had SNHL while 28.7% of cases with chronic perforation revealed SNHL. Analysis of this study showed that there is a probability of increased SNHL during old ages the cases of prolonged and persisted otorrhea also revealed a higher incidence of SNHL. We didn’t disclose correlation between age and severity of SNHL.

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Diabetes commonly is associated with CAD risk factors, in addition sub-optimal metabolic control of diabetes is associated with increased incidence of thyroid function disorders. In this study patients with diabetes type II who were referred to 5th Azar Hospital in Gorgan were assessed to find out the relationship between thyroid dysfunction and NIDDM in such patients in Gorgan. We studied 210 diabetic patients in hospital outpatient department. The blood pressure, height, weight, serum total Cholesterol, Triglycerides, fasting blood sugar, and glycosylated hemoglobin (HbA1c) were determined. The obesity (BMI>30) were seen in 35% of the subjects. Hypertension and hyperlipidemia were seen in 38 and 65 of our patients respectively. The observed disorders included goiter (30%), sub-clinical hypothyroidism (13%), clinical hypothyroidism (4%), and clinical hyperthyroidism (0.5%). The patients were divided into two groups according to HbA1c: Group 1 with HbA1c<8 and group II with HbA1c?8. A significant difference was observed in TSH serum concentration between group I and II (1.5±1.2 vs. 3.7±11.3 mu/l, P<0.05), whereas the concentration of T4 (10±11 vs. 11±8) and T3 (2.4±3.7 vs. 1.9±3.2) were not significantly different between the two groups. The mean concentration of HbA1c in patients with hypothyroidism was significantly higher than those that of non-hypothyroid subjects (11±2.5 vs. 9±2.5, P<0.005). A significant positive correlation was observed between HbA1c concentration and TSH levels (R=0.2, P<0.01). Our results confirm the association between thyroid dysfunction and uncontrolled diabetes mellitus. It has been recommended that the final diagnosis of thyroid function disorder in diabetic patients should be made after optimal metabolic status has been archived.

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Meningitis is one of the urgent medical ceases, and in spit of tramendous efforts. There is a high prevalency in various part of the world, still has got a high mortality. Rapid diagnosis is one of the best way to control the disease, and the basis for the present study is to find out the rate of occurrence of meningitis in suspicious cases. During nine-month study (Sep 1999-June 2000), 100 children with suspicious sings of meningitis referring to Taleghani children hospital were taken under medical surveillance, and LP has been carried out by the pediatrician. The samples were transferred to the laboratory and various tests has been done on the samples. On the ground of clinical and paraclinical findings 15 meningitis patients (7 bacterial, and 8 viral were diagnosed). The most abundant isolated bacteria from the CSF was Pneumococci (42.8%) and the most significant clinical finding was fever, vomiting, stiffness of neck. In all bacterial meningitis the CSF’s appearance was deeply turbid, and the average WBC in CSF was about 3200, the rate of PMN was 92%, these results had significant meaning with comparison to the viral and non-meningitis sample (P<0.001). CFS’s protein level was much more higher in bacterial meningitis, than other cases (P<0.001), and this can be used as diagnostic tool, but in spit of reduction in CSF glucose concentration, and CSF/blood glucose ratio (48% in bacterial, 70% viral, and 74% in non-meningitis), these ratios didn’t have significant meaning (P<0.4). The results of this research indicate the clinical manifestation such as fever, convulsion, vomiting turbidity of CSF, WBC count more than 500, and positive CRP, could help effectively in the diagnosis of bacterial meningitis.

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One of the best products, which is the favorite of the families is Spaghetti. In various parts of the world, the demand of usage of spaghetti is increasing exceptionally. The most important element for consumer is to have no microbes. To have high quality of cooking. The primary foodstuffs, which are applied, must have suitable condition in order to have healthy product in terms of microbes. At the present surveys at five factories which are producing spaghetti in some areas in Iran such as Jajrood and Rudehen. There have been 160 sample of water, flour and spaghetti in order to determine microbial pollutions especially clostridium perfringens. The pollution of the water in terms of CL.perfringens includes 8 samples (5%), the pollution of flour includes 3 samples (1.87%) and the pollution of spaghetti includes 10 samples (6.25%), according to the result, we are able to relate the pollution of spaghetti to CL.perfringens on the basis of 85% to water and of the basis of 15% to flour. As the reducing of the total number of microbes from 11.87% to 1.25% in flour and from 9.37% to 0.62% in the mould of flour in spaghetti. The result shows that the optimal condition in the produce doesn’t increase not only by the microorganisms, but also it shows a decrease in the their intensity of its rate.

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A variety of extracranial sites have been described for Meningiomas including the nose, various viscera, skin, eye and extraspinal tissue. Among them cutaneous Meningioma generally occur most frequently on the scalp, forehead or paravertebral areas. We are reporting in this article one case of cutaneous Meningioma in the forehead region with respect by reviewing the literatures is very rare tumor. Our patient is a middle age woman with right forehead mass from two years ago, in the skull X-ray and computerized tomography of our case intracranial lesion is not seen and also there is some thickening involving frontal bone. After the surgical excision of the mass and in the microscopic examination of specimens, histopathologic diagnosis is Meningioma (Meningotheliomatous type) and immunohistochemical study react for epithelial membrane antigen. In the clinical course, extracranial Meningiomas enlarge slowly and are usually cured by simple excision alone but incomplete excision may lead to recurrence, the things have been occurred in our patient.

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Urinary incontinence is defined as involuntary loss of urine, which is a social and hygienic problem. The study is about quantity of stress incontinence in high school 15-17 years old girl during (1999-2000). This is a descriptive cross-section study. From 711 cases, 454 (76.4%) did not have urine stress incontinence (USI) and 166 (23.6%) had this problem. From these 166 members 24.1% were 15 years old, 35.8% were 16 years old and 40.1% were 17 years old. Therefore with increasing age we have more urine stress incontinence and the most prevalence of USI occur during laughing predisposing factor for USI is urinary tract infection (UTI) and trauma to hip. 27% of these girl’s mothers had USI and the population was chosen by cluster sampling. Therefore genetic factor could be a cause. The most presentation of USI is in the estrogenic phase and we didn’t have any USI report in the progestronic phase. According to our results the incidence of USI among 15-17 year girls students was 23.6%.

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Biosynthetic growth hormone is now available in virtually unlimited quantities. As a result because of its growth promoting and anabolic effects, it is widely used in various disorders in both children and adults. Growth hormone has been proven to be beneficial in a small number of diseases causing short stature in children, and in adults with severe growth hormone deficiency or acquired immunodeficiency syndrome (AIDS). The hormone is also used on an investigational basis in a variety of disorders causing short stature, as well as in the aged and in several catabolic conditions. It is likely that with time the indications for treatment with this hormone will be increased.

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Background & Objective: The burden of psychiatric disorders in the developed countries has been identified by the screening questionnaires and standard clinical interviews at a high level, but the epidemiological studies of psychiatric disorders in our country are brief and their numbers are few. Providing essential mental health services to the people requires us to be knowledgeable about the present status of psychiatric disorders in the society. The objective of their research was to carry out the epidemiological study of the psychiatric disorders in the 18 years and above individuals in the urban and rural areas of Golestan province. Materials & Methods: 518 individuals selected through randomized clustered and systematic sampling methods from among the existing families of Golestan province and the schedule for affective disorders and Schizophrenia (SADS) questionnaires completed by the clinical psychologist. The diagnosis of the disorders was based on DSM-IV classification criteria. Results: The results of the study showed that the prevalence of psychiatric disorders in the province is 14.69%, which was 18.14% in the women, and 11.47% in the men. The mood and affective disorders respectively with 7.93 and 4.05% had the higher prevalence in the province. The prevalence of psychiatric disorders in this study was 0.97%, neuro-cognitive disorders 1.16% and dissociative disorders 0.58%. In the group anxiety disorders, panic disorder with 4.05% of had the higher prevalence and in the group of affective disorder, major depression, hypomanic and manic disorder with 1.93. Conclusion: This study showed that 7.53% of individuals that were studied suffered from at least one of the psychiatric disorders. The prevalence of psychiatric disorders in the province among the individuals in the age group of 41-55 years with 13.04%, separated or divorced individuals 50%, residents of urban areas 11.03%, illiterate individuals 12.75% and housewives 13.04% was more than other individuals in the sample. Being aware of this matter reveals the responsibility of the health policy makers and programmers, prevention, treatment and medical education more than before in relation to preparing application and executive plans in Golestan province for mental health.

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A 13 years old female caucasition admitted in 5 Azar General Hospital with a 3-day history of deteriorating vision. 2 weeks prior to admission she had received a Measles-Rubella vaccination at school (As a mass compain of MR vaccination in Iran). General & neurological examination except lung wheezing & ocular findings were normal. In visual exam she had questionable light perception in right eye & hand motion sensation in left eye. Funduscopy revealed moderate bilateral optic disc hyperemia. Investigations revealed normal full cell blood count, biochemistry profile, clotting studies & sputum. Brain CT scan & MRI were normal except pansinusitis. CSF examination revealed normal constituents. The patient treated with Methyl Prednisolone (1 gr/daily) for 7 days and patient had dramatic response to therapy. After 6 weeks of starting medical treatment ophthalmologic exam revealed 2 meters finger count vision in right eye & 6/10 visual aquity in Left side. This patient is a rare case of bilateral optic neuritis after MR vaccination.

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The patient was 58 years old lady, admitted due to recurrent right temporal cystic mass, with no previous histopathologic study. On physical examination, a 3*3 cm mobile, cystic mass was present with no other positive finding. Skull CT scanning revealed multilocular cystic lesion of right temporal soft tissue, without involvement of orbit, sinuses and temporal bone. Chest radiography and abdoman sonography was reported to be normal. She undergone operation of cyst evaluation and open underwent draiwage. She dishcharged after 3 days and no recurrence happened in one year follow up. Histopathologic study of the cyst contents, confimed the diagnosis of hydotid cyst. Hydatical cystis, most commonly involves the liver, then lungs and varely striated muscles may be involved at larval stage of edinococcus granulosus and rare edinococcus multilocularis, only in 3% of hydotid disease. Parasite spreads in hematogenous manner. Peritoneal, spleaic, mediastinal, renal, bone, heart, brain, muscular. Arterial, seminal vesicle involvement rarely happens. Preop sonography, CT scanning and MRI and serologic ELISA testing helps diagnosis. New method of FNA and cylologic study as noted by thial, et al may be diagnostic. Appropriate theropy is cysto-peri cystectomy or evacuation. Mebeandazole or albendazole orally as adjunct therapy before and after operation, specially when surgery is impossible may be valuable.

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Background&Objective: Precelampsia with prevalancy of 5-10% is one of the important causes of maternal morbidity and mortality and neonatal prematurity that prevention of it has aessential role in reduction of maternal and fetal mortality. Pathogenesis of disease is endothelial dysfunction and free radicals can exaggerated of endothelial damage.this study designed to evaluate antioxidants (vit E,C) effect on preeclampsia in primipar women. Materials&Methods: This study was a randomized clinical trial in 580 primipar women that randomized in two treatment and control groups. To the Treatmet group in 18-22w of gestation during routin prenatal care vitamin E (400 IU) and vitamin C (lg) administrated daily untile end of pregnany. Control group recieved routin ferrous sulfate and incidence of preeclampisa compaired in two-group .Data analyzed by chi-square test. Results: Incidence of preeclampsia was 1.7% in treatment group and 6.2% in control group (p<0.05). Conclusion: antioxidant (vit E,C) have an effect on reduction of preeclampsia incidence.

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Background & Objective: Despite advances in medical sciences, preeclampsia and eclampsia are still among chief causes of maternal mortality worldwide. In this study, we used classification and regression trees to investigate the role of certain inherent and maternity care factors in severe preeclampsia. Materials & Methods: This study was done on 1643 pregnant women admitted at 4 hospitals in Iran with one of the 53 maternity complaints were enrolled in this study during 2005. Variables of socioeconomic status, history of pregnancy and diseases, health care visits numbers awareness of warning signs, and the body mass index before pregnancy were recorded in the analysis model as predictors, and preeclampsia severity was entered as the dependent variable. A non-parametric method, known as the classification and regression tree was used to predict the studied consequence. Model validation was done using subsets of the study sample. The results were compared with logistic regression analysis. Results: The incidence of preeclampsia among the studied patients was 5.2%. In model 1, variables of frequent headaches and epigastric pain during pregnancy, the number of previous pregnancies, and the amount of maternal care received were predictive of severe preeclampsia. In model 2, only frequent headaches and the number of previous pregnancies were found predictive. Sensitivity for model 1 and 2 was 47.8% and 39.1%, respectively, and specificity was 96.8% and 93.6%, respectively. In logistic regression analysis, only frequent headache was related to severe preeclampsia (OR=2.5, CI 95%: 1.3-5.0). Conclusion: This study showed that using of variables that can be measured during maternity care visits to predict severe preeclampsia. Regarding the simple interpretation of tree models and their application in clinical decision making, which can be used in different levels of the health care system.

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Background & Objective: Dyslipidemia and smoking are among the most important medical problems in human society. Their share in the mortality of coronary heart disease (CHD) has led to multiple investigations about them. This study was done to determine the prevalence of dyslipidemia and the effect of cigarette usage on it. Materials & Methods: This epidemiological cross-sectional study was carried out on 9632 persons selected randomly in Tehran urban with a minimum age of 20 years and over. We measured fasting blood sugar, blood sugar 2 hours after 75 grams oral glucose, triglyceride, total cholesterol, LDL cholesterol, HDL cholesterol. Degree of physical activity was registered according to Lipid Research Clinics classification. Anthropometrics data, social condition, family history and smoking exactly delineated. Our patients were divided into: those having normal lipid profile and primary dyslipidemia (without any risk factor for dyslipidemia) and secondary dyslipidemia (having one or more risk factors such as diabetes mellitus). ANOVA, t.test, and logistic were used to analyze the level of significance. Results: Our population sample consisted of 5619 female and 4013 male. 68.5% of our cases had dyslipidemia. 65.8% of females and 72.3% of males had at least one type of dyslipidemia. There were 1085 smokers (11.4%) that 73.2% of them were dyslipidemic. With comparing smokers to nonsmokers shows that in smokers HDL.cholesterol, LDL.cholesterol and total cholesterol had decreased and triglyceride increased (p<0.05). Conclusion: Tehran population suffers from dyslipidemia. Large number of secondary dyslipidemia and smoking highlighted the importance of education to overcome to these preventable and modifiable factors.

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Background & Objective: Mycobacterium marinum is the etiologic agent of fish Mycobacteriosis and fish tank granuloma in human in this study our objective was to determine of the fish tank granuloma in Fishermen and Mycobacterium marinum infection in Caviar fishes in Ashorade, in the Golestan province of Iran south east Caspian Sea border. Materials & Methods: Any suspected lesions in 387 subjects of Fishermen and 113 autopsy samples from gills of fish of Caviar were obtained and cultured in Lowenstein Jensen media. The mycobacterial species were determined by conventional biochemical tests. Results: No fish tank granuloma was proved in human, but 11 (9.73%) strains of Mycobacteria were isolated from Caviar fishes, that only 2 strains (1.76%) belong to M.marinum. Conclusion: This study showed that was low prevalence any cases of fish tank granuloma and infection due to M.marinum in Caviar fish in this Region.

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Background&Objective: Abusing the married women are among one of the most difficult problem in many countries. In the study, mental health status of spouse abused women was evaluated. Materials&Methods: 1186 women were selected randomly from all districts of Tehran, undergoing spouse abuse questionnaire and general health questionnaire (GHQ-28). Collected data were analyzed by SPSS software with t-test and multiple regression analysis. Results: In 1186 study case, 1013 women (85.4%) experienced emotional abuse, 374 ones (31.5%) physical abuse, 360 ones (30.4%) sexual abuse and 206 ones (17.4%) all types of abuse. Also, the abuse victims suffered worse status of general health (p<0.05). Examining relation between all types of abuse, as a predictive factor ,and general health aspects as an(y) factor,with multiple regression analysis revealed a positive relation, i.e. experiencing any type of abuse could predict worsening of general health (p<0.05). Conclusion: Spouse abused women suffer a worse status in general health. Also they showed emotional disorders. The victims of sexual and physical abuse suffered worse than victims of emotional abuse.

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Background&Objective: People with cancer commonly experience a range of symptoms, including pain and various types of physical and emotional distress. One of important roles of health care providers is managing these complications. The aim of this study was to the evaluation of Therapeutic Touch on hospitalized cancerous females suffering from pain. Materials&Methods: This quasi-experimental study performed on cancerous females hospitalized in Imam Khomeini hospital at Tehran. It was performed on 3 groups (case, placebo, control) 30 female with different cancers were selected, matched and then divided in 3 groups: the case group received five 20-25-minute session of therapeutic touch, the placebo group 5 ten-minute session with no energy exchange and no intervention for control group. Data gathered by two tools include: demographic questionnaire and Visual Analog Scale of Pain (0-10). Pain severity was measured before and after intervention Data was analyzed by SPSS-11.5 using ANOVA, Repeated measurement analysis variance (Wilks lambda test), qui-square and TUKEY tests. Results: The means of pain score in case, placebo and control groups before intervention was 3.8, 4.1 and 4.16 and after intervention 0.8, 6.4, 4.2 respectively. There was significant difference between 3 groups in pain severity during using ANOVA and repeated measurement analysis variance (Wilks lambda test) (p<0.05). Conclusion: Based on the above findings, Therapeutic touch as a non invasive procedure, and non pharmacologic procedure was recommended for relive pain in cancerous females.

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Background&Objective: Foodstuffs additives are a general term for materials that are added to the foodstuffs in order to increase durability and to improve the appearance, composition, taste and food nutritional value. Colors are classified in this group and are added to foodstuffs in order to increase their attraction. Colors may cause illness such as allergy, rash and hyper activation in children and also they may debilitate the Immune system, Anaphylaxis reactions may also occur and they may have cancerous effect. The aim of this survey was to analyze status of added colors to the dried sweets which are produced in south of Tehran city. Materials & Methods: 191 samples of dried sweets were randomly collected and analyzed from south of Tehran areas. First, the samples were de-colored by Clorhidric Acid, and then were analyzed after refining by Thin Layer Chromatography (T.L.C) method. Samples were identified by taking Retention Factor (RF values) into consideration. Results: 93.2 percent from the total samples contained colors. Among chromatic samples, 42 samples (22%) out the total samples, contained artificial, non-edible colors and 96 samples (50.3%) from the total samples contained artificial and edible colors (for Industrial Producers) and 40 samples (21%), contained natural colors. Sunset yellow color was detected more than other added colors in sweets. Conclusion: Low costs, stability, PH, purity, and environmental conditions, motivate the producers for high utilization of edible colors without considering their possible hazards and/or their edible quality aspects. It is suggested that, based on the findings of this study and high consumption of colors.

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Background&Objective: Shiga-toxin producing E. coli (STEC) belonging to several different O serotypes are one of the etiological agent of diarrhea. The STEC strains are considered as an etiological agent for enteritis after non-typhoidal salmonellosis and Campylobacter. They have also been associated closely with the hemolytic uremic syndrome (HUS) and hemorrhagic colitis(HC). The aim of this study was to determine of the frequency of STEC in patients with hemorrhagic colitis referring to Tehran hospitals. Materials&Methods: From March to September 2004, 70 patients with hemorrhagic colitis (Case)an 70 patients with diarrhea (Control) were included in this study. The stx gene was detected by PCR and was used for the determination of STEC strains. Slide agglutination with specific antisera used to detect O serogroup. Polymerase chain reaction- restriction fragment length polymorphism (PCR-RFLP) analysis of the flagellin gene (fliC) was performed for determining their flagellar antigen (H). Results: Two samples (2.9%) from Hemorrhagic colitis cases and 12 samples (17.1 %) from diarrheal cases were positive for STEC. There was no significant correlation between STEC and Hemorrhagic colitis but there was a significant correlation between STEC and diarrhea (p<0.05). STEC isolates O142:H48 serotype was from hemorrhagic colitis cases and O126:H47, O126:H6, O26:H4 and O111:H23 serotypes were from diarrheal cases. These serotypes were not reported in hemorrhagic colitis cases. Conclusion: Our data showed that there was no significant correlation between STEC and hemorrhagic colitis. This could be explained since serotype responsible for hemorrhagic colitis i.e. O157:H7 serotype is not present in Iran.