[ prevalence of hypothyroidism based on risk factors in pregnant women referred to Shahid Dadbin Clinic, Kerman, Iran]

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. 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. 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. 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

[Comparison of the frequency of recurrent laryngeal nerve injury with and without exploration of the nerve in thyroidectomy]

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. 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. 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], where as 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. 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

[Report of two cases with mycetoma of foot in Kerman and overview of other reported cases from Iran]

Background and Objective: Mycetoma is a chronic progressive and destructive subcutaneous disease that can involve fascia and bone. More than 20 microbial and fungal agents can cause mycetoma

Cases: The first case was a 41-year-old man that a swollen and painless lesion was observed in dorsum of his right foot when he was six. After a few months that the lesion got larger and pus to come out of its ducts, operation was done. After 10 years, he had pain and swelling in his foot again because of touching with iron foreign body. Mycetoma of foot was confirmed by radiology and testing that treated with co-trimoxazole and amikacin and a recurrence of the disease was not observed for 1.5 years. The second case was a 38- year- old man who referred with pain and swelling of foot after a hit that with diagnosis of infectious arthritis was treated. After six months due to lack of improvement, mycetoma of foot was confirmed by testing and radiology which treated with cotrimoxazole and the recurrence of the disease was not seen until one year later

Conclusion: Low environmental and public hygiene due to this disorder with long-term morbidity. According to this report, considering health care by individuals and early diagnosis is important