effect of thiazolidenedione on glucocorticoid induced central obesity in rats

Central obesity is a common complication of glucocorticoids which is associated with insulin resistance. In some studies, thiazolidinediones have decreased central obesity in type 2 diabetic patients. The purpose of this study was to investigate the effect of pioglitazone on glucocorticoid induced central obesity in rats. Forty Sprague-Daily rats were divided into 2 groups, with 10 male and 10 female rats in each. In group 1, methylprednisolone succinate 5 mg/kg was injected 3 times per week and pioglitazone 30 mg/kg/day was given. In group 2, only methylprednisolone succinate was administered. After 3 weeks, the rats were sacrificed and visceral fat was removed, and the weight of visceral fat, abdomen circumference and total body weight in the 2 groups were compared. The weight of animals was not different significantly however animals given pioglitazone had less visceral fat [7.32 +/- 2.60 vs 11.95 +/- 2.76 gr P < 0.001] and lower abdominal circumference [11.92 +/- 1.20 vs 14.98 +/- 1.74 cm P < 0.001]. Pioglitazone has antagonistic effect on glucocorticoid induced central obesity

Incidence of hip fracture in Shiraz

Hip fracture, the most serious complication of osteoporosis, burdens lots of costs on any health providing system. Previous reports on rates of hip fractures in Asian countries used to differ a lot. The aim of this study was to estimate the incidence rate of hip fractures in the city of Shiraz, Iran. All operating room logs with the diagnosis of hip fracture were reviewed for hip fractures proceeded by a simple falling down in patients over 50 years, between 21st of March 2000 to 21st of March 2003. According to patients medical records, age, sex, type of fracture [intertrochanteric, neck, subtrochantheric] and patients residency regions regarding to Shiraz municipality division were obtained. The age adjusted incidence rates of hip fracture comparing to the United States population records in 1985. [325.74/100000 for men and 519.05/100000 for women] and to the United States population records in 1989 [384.61/100000 for men and 548.17/100000 for women] was the highest in Asia. The intertrochanteric fracture was significantly higher among females [P=0.003]. The incidence of intertrochanteric and neck fractures were increased with age. In all the age groups, females had more incidence rates of fractures except of the ages of over 80, in which males had more incidence rates than females. High incidence rate of hip fractures in our population especially in our males of over 80 shows that preventive strategies for hip fractures and osteoporosis should be considered in males as well as females. Further studies are needed to find this incidence rate in other cities especially city of Tehran

Prognostic factors in the relapse of Graves' disease following treatment with antithyroid drugs

Patients with Graves' disease exhibit a considerable rate of relapse after treatment with antithyroid drugs and require ablative therapy. The purpose of this study was to evaluate variables which can be used as prognostic factors in predicting the outcome of Graves' disease after treatment with antithyroid drugs. Age, sex, duration of antithyroid drug therapy, pretreatment T3 and T4 values, T3 to T4 ratio, size of thyroid gland before and after treatment, and the effect of salt iodination were determined in 439 patients at an endocrine clinic in southern Iran during a 15- year period. The patients included 338 [77%] females and 101[23%] males with a mean age of 34.1 11.2 years. Overall, the relapse rate was 62%. The relapse rates were 58% and 76% in females and males, respectively [P=0.001]. The mean age was 35.0 11.6 years in the relapse group [n=275] and 32.6 +/- 11.3 in the remission group [n=164] [P=0.03]. T4 was 20.4 6.3 and 18.1 5.4 g/dl in the relapse and remission groups, respectively [P=0.000]. In the relapse group, T3 was 443.0 189.5 ng/dl and in the remission group, it was 373.4 182 ng/dl [P=0.009]. T3 to T4 ratio was higher in the relapse group [21.8 8.3 vs 18.6 7.0 ng/ g, P<0.005]. Larger pre- and post-treatment thyroid size were associated with higher relapse rate [P<0.05 and P=0.001, respectively]. Logistic regression analysis showed that male sex, old age, higher pretreatment T4, T3, and T3 to T4 ratio, and larger pre- and post-treatment thyroid size were associated with higher relapse rates. Iodinated salt consumption and duration of treatment beyond 12 months had no effect on the relapse rate. Patients with male gender, older age, higher pretreatment T3, T4 higher T3/T4 ratio, and larger thyroid size before and after treatment have higher risk of relapse

Treatment of thyroid hot nodules by percutaneous ethanol injection

Twenty-eight patients with autonomously functioning thyroid nodules of 2-6 cm diameter were selected. Fifteen patients were clinically and biochemically hyperthyroid. Depending on the nodule size, 2-4 ml of 95% ethanol was injected into the nodules. There were no major complications. Thyroid scans were done at two-month intervals and repeated injections were done only if the hot nodules were still present. 71.4% needed only one, 25% needed two, and 3.6% needed three injections for complete ablation of the hot nodules. On follow-up examination all nodules had shrunken in size and those patients with hyperthyroidism showed improvement of their symptoms. The hormone levels also returned to normal range.Repeated thyroid scans showed disappearance of the hot nodule and gradual resumption of function of the previously suppressed thyroid tissue. This study shows that percutaneous ethanol injection is a safe and cheap alternative to surgical and radioiodine ablation of AFTN's and this can be achieved in most cases in one or two sessions. Importantly, with this method, the chance of future hypothyroidism will be nil

Massive osteolysis with chylothorax: a case report and review of literature

A case of massive osteolysis in a young man with complaints of chest pain and respiratory difficulty is presented. The patient was found to have destruction of several ribs and bilateral chylothorax. Massive osteolysis is discussed and relevant medical literature is reviewed