[Cardiovascular autonomic neuropathy among non- insulin dependent diabetics patients]

Cardiovascular autonomic neuropathy [CAN] is the most common and important type of diabetic autonomic neuropathy. Silent myocardial infarction, respiratory failure and increased mortality are the outcomes of CAN. This study was carried out to screen the cardiovascular autonomic neuropathy in non- insulin dependent diabetics patients. This descriptive - analytic study was carried on 70 [22 males, 48 females] non- insulin dependent diabetics' patients. Resting heart rate, heart rate variability, orthostatic changes in heart rate, blood pressure and corrected QT interval were recorded for each subject. The final findings were categorized as follow: 0=normal, 1=borderline and 2=CAN positive. 10 [14.3%] of patients were normal, 35 [50%] of patients were borderline and 25 [35.7%] of patients were considered cardiovascular autonomic neuropathy positive. There was significant differences between duration of diabetes and three CAN scores [P<0.05]. The systolic blood pressure alterations showed the maximum correlation with CAN scores [r=0.509]. In our study, the rate of cardiovascular autonomic neuropathy was higher than other reports. The most important risk factor for cardiovascular autonomic neuropathy was more than 10 years history of diabetes mellitus

value of thyroid fine needle aspiration in evaluation of follicular neoplasms

The presence of single or multiple nodules with in the thyroid glandis a common clinical problem. It is immposible to differentiate benign and malignant follicular neoplasms in cytologic examinations. Estimation of risk of malignancy in thyroid nodules who are cytologically assumped to be follicular neoplasm has a critical importance. The aim of this research is evaluation of diagnostic value of thyroid FNA in follicular neoplasm. This survey was done on 476 patients with thyroid nodule whome were biopsied in a 7 years period [in 5th Azar hospital, Gorgan]. Standard aspirations and biopsies techniques performed and necessary smears prepared. Wet-fixed smear glass slides are placed immediately in alcohol [70%] 7-10 slides from the aspiration. The patients with cytologic report whome considered follicular neoplasm followed total thyroidectomy or lobotomy. From 476 patients for thyroid nodules 412 cases [86.5%] are suitable for cytologic evaluation which 312 cases [77.9%] of them were benign and 14 cases [3.3%] were malignant. The rest [77 cases] reported to have follicular neoplsm, this patients also undergone thyroid surgery. The result of histological findings appeared in 32 cases [57.1%] follicular adenoma, 15 cases[26.7%] non-euplastic nodules, 5 cases[8.9%] follicular carcinoma and 4 cases [7.1%]follicular type of papillary carcinoma. 9 cases [16%] found malignant among cases which cytologic reports considered as "follicular neoplasms" and subsequently undergone thyroid surgery [consist of follicular carcinoma and follicular type of papillary carcinoma], confirme the importance of histopathologic study of follicular lesions for differentiation between malignant and benign lesions

Frequency distribution of urinary and breast-milk iodine concentrations in postpartum period, Gorgan, 2003

Adequate dietary iodine is essential for the production of thyroid hormones. Breastfed infants are reliant on adequate maternal iodine intake. The aim of this study was to evaluate iodine sufficiency in lactating women in Iran. The study population included 100 randomly selected lactating mothers referred to the Taleghani Hospital of Gorgan between April and June 2003. Subjects were within the 1[st]-6[th] month of their postpartum period. Goiter was graded according to WHO classification. Spot urine [2-3 ml] and breast-milk [5-10 ml] samples were collected for the measurement of iodine concentrations using acid digestion method. Urine iodine concentrations [UIC] of <100 and breast-milk iodine concentrations [MIC] of <50 micro g/L were considered as iodine deficiency. Mean [ +/- SD] age of women was 25.6 +/- 1.6 years. 43% and 8% had grade 1 and 2 goiters, respectively. The median [range;%95 CI] UIC was 259micro g/L [35-519; 226-275]. UIC of <100 micro g/L was detected in 16%, 50-99 in 13% and 20-49 micro g/L in 3%. Grade 1 and 2 goiters were present in 8% and 8% of mothers with UIC <100 micro g/L, respectively. The median [range;%95 CI] MIC was 93.5 micro g/L [17-696; 97-137]. MIC of <50 micro g/L was reported in 19%, 35-49 in 13%, 20-34 in 3%, and <20 micro g/L in 3%. Grade 1and 2 goiters were present in 11% and 8% of women with MIC <50 micro g/L, respectively. MIC was significantly correlated with UIC levels [r=0.44, p < 0.0001]. Meanwhile, there was a significant association between iodine-deficiency and goiter [p < 0.0001]. UIC and MIC levels show sufficient iodine supplementation in Gorgan. However, some infants remain at risk for low iodine intake via breast milk

[ assessment of urinary iodine and serum TSH concentration in pregnant women referred to Deziani Hospital in Gorgan - Iran [2004]]

No nutrient deficiency is as bad as iodine deficiency which attributed to a broad spectrum of disorders like goiter, abortion, hypothyroidism, etc. screening for hypothyroidism must be done before or just after pregnancy. The present study was conducted to evaluate serum TSH and urinary iodine concentration in pregnant women in Gorgan several years after salt iodization in Iran was implemented. From December to March 2004, 97 pregnant women referred for prenatal care to the Deziani Hospital of Gorgan were selected. 2 cc of blood for serum TSH measurement and 2cc of urine for iodine concentration measurement were collected. Urine iodine concentration was measured by acid digestion and TSH concentration was measured by ELISA method. 97 women, 86 [89%] women had normal urinary iodine, 11 women had iodine deficiency, 9 women had mild iodine deficiency [82%] and two women [18%] had moderate iodine deficiency none of them had severe iodine deficiency. Serum TSH was normal in 90 women and only in 7 women it was more than 4 and none of them had TSH less than 0.3. There were not any significant statistical correlation between age, weight, height, parity, goiter grading, salary, gestational age and urinary iodine concentration. According to low prevalence of iodine deficiency in this study iodine programs were successful in Gorgan and the mean urinary iodine is high so evaluating of iodine consumption for preventing of iodine overload is necessary. Because of complications of iodine deficiency especially in the first trimester of pregnancy regular measurement of urinary iodine must be done in reproductive ages before pregnancy or just after pregnancy