[ first manifestation of hyperthyroidism with deep vein thrombosis: a case report]

Primary hyperparathyroidism is a relatively common endocrine disease in which one or more parathyroid glands produce uncontrolled secretion of parathormone [PTH]. The patient was a 53-year-old woman referring to the emergency department with severe pain and swelling in left foot from one night prior to the admission. Examination of the head and neck, chest and abdomen were normal. Left lower limb had 3+ pitting edema and its size was 3cm greater than the right leg. On color Doppler sonography of the left lower extremity, deep vein thrombosis [DVT] extended to the iliac vein was reported. Abdominal and pelvic ultrasound image showed a hypoechoic area in the uterus and a 40mm cyst in the left kidney. Regarding the presence of hip bone osteolytic lesions, high calcium, and low phosphorus, the patient was suspected of hyperparathyroidism. She was referred to a surgeon and a parathyroid adenoma was seen in the left parathyroid gland. After a week, the patient's calcium level was corrected, PT was in the goal range and she was discharged with good general condition

[ comparison of the relationship between the serum level of vitamin D and coronary artery disease in patients with type 2 diabetes]

Cardiovascular diseases are among the most common causes of death and disability in patients with type 2 diabetes. According to some studies, Vitamin D deficiency is associated with risk of type 2 diabetes and cardiovascular diseases. The aim of this study was to compare the serum level of Vitamin D between diabetic patients with coronary artery diseases and control group. In this case-control study, patients with diabetes referred to Shahid Beheshti Hospital of Qom for coronary angiography, were divided into two groups of positive angiography [case group] and negative angiography [control group]. In this study, stenosis of the lumen of at least one coronary artery more than 50% was considered as positive angiography and suffering from coronary artery disease, and stenosis lower than 50% was considered as negative angiography. Personal characteristics, biographical information, consisting of age, gender, history of hypertension, hyperlipidemia, smoking, history of coronary artery disease, and family history were recorded using a questionnaire. Venous blood samples of the patients were taken to measure the serum level of 25-hydroxy Vitamin D, and the two groups were compared in terms of Vitamin D level. The mean serum level of 25-hydroxy Vitamin D was 35.09 +/- 26.41ng/ml. Also, there was no significant difference between case and control groups. The level was 35.67 +/- 29.58ng/ml in the case group and 34.50 +/- 23.30ng/ml in control group. The level of Vitamin D in patients with cardiac disease had no significant difference. The results of this study indicated that there was no relationship between serum level of 25-hydroxy Vitamin D in type 2 diabetic patients and stenosis of coronary arteries

[ case report of a rare complication in patients with jejunostomy tube [spontaneous enteral migration of jejunostomy tube]]

Jejunostomy tube [JT] insertion is an approved method for enteral feeding in patients who cannot feed orally. In spite of all advantages of JT placement, some complications may occur, including mechanical and metabolic complications as well as gastrointestinal infections. Spontaneous enteral migration of JT is a rare complication in these patients that only a limited number has been reported. This event predisposes patient to bowel obstruction; therefore, treatment method of this complication is discussed. In this article, we will describe a case of spontaneous migration of JT into small intestine, 2 months after placement in a 61 years old woman with the history of esophageal cancer. The patient excreted the tube after 15 days of supportive treatment