[Thyroid dysfunction in perimenopausal women]

There are mild changes in Hypothalamous - pituitary -thyroid axis with aging that may be accompanied with thyroid dysfunctions without clinical manifestation. The aim of this study is evaluation thyroid dysfunction in perimenopausal women. This is a cross-sectional descriptive study that was performed on 100 women at the age of 40-60yr, who had referred to Gynecology and Menopausal clinic of Ghaem hospital, Mashhad University in 2005. At first, a questionnaire including clinical symptoms was completed, then patients were submitted to laboratory tests including T3, T4, T3 RU, TSH, TG [triglyceride], HDL-cholesterol and LDL cholesterol. The information was analyzed by chi2 and fisher exact tests. [P

[Diabetic ketoacidosis in a patient with acromegaly, a case report]

Although impaired glucose tolerance affects 36% and overt diabetes mellitus can be seen in 30% of cases with acromegaly, diabetic ketoacidosis is rarely reported in patients with this disease. We present an unusual complication of acromegaly: a 22 year old woman with amenorrhea [6 month age] and blurred vision of left eye [4 month ago] referred to Ghaem neurology clinic in Mashhad. With a growth hormone [GH] level of = 100 ng/ml, Insulin like growth Factor-1 [IGF-1] =1560 ng/ ml and pituitary macro adenoma in magnetic resonance imaging [MRI], she was candidated for surgery. A few hours before surgery she had dyspnea, loss of consciousness, fever and with blood sugar [BS] =500 mg/ml, Hco3 = 2.4, PH=7.06 and keton in urine. Diabetic ketoacidosis was diagnosed. The patient was treated with high dose of insulin [500 IU/day] and hydration. After octerotide administration the need for insulin decreased and after pituitary adenectomy, there was no need for insulin therapy and the patient was discharged on metformin [one tablet per day]

[Anemia in patients with hypothyroidism]

In hypothyroidism reduction of oxygen demand and supply can reduce the synthesis of erythropoietin and cause anemia. Autoimmune mechanisms causing hypothyroidism can also cause vitamin B12 deficiency and related anemias. Furthermore absorption of iron and other elements are disturbed and further accelerates anemia. Menorrhagia, is another cause of iron loss. Changes in WBC are not significant and platelet function may change which is not clinically important. We studied 30 new cases of hypothyroidism. Control group [32 person] was chosen among individuals having simple goiter and normal thyroid function tests. We compared hematological parameters in patients and control group. Comparison was made between patients with severe [TSH>70] and mild [TSH<70] hypothyroidism and relationship between severity and duration of hypothyroidism with these parameters. 1-anemia was found in 56.7% of patients [10% macrocytic, 16.7% normochrome normocytic and 30% hypochromic microcytic]. In control group 40.625% were anemic [6.25% macrocytic, 3.125% normochromic normocytic and 31.25% hypochromic microcytic].2- Hemoglobin, hematocrit and number of RBCs had statistically significant difference between patients and control group. 3- MCH, MCHC and MCV had no statistically significant difference between patients and control group. 4- There was no significant difference in the number of WBC and platelets between patients and control group. 5- No relationship was found between blood parameters and duration of the disease. 6- There was no correlation between severity of disease and hemoglobin and hematocrit values but MCHC was significantly lower in patients with severe hypothyroidism. Erythroid lineage showed the most important changes in hypothyroidism. All 3 types of anemia were found. Hemoglobin, hematocrit, and number of RBC showed marked decrease in patients compared with controls. White blood cells and platelets had no changes in hypothyroid patients

Evaluating semen parameters and time to pregnancy [TTP] in 234 Couples in Isfahan

Defining the lowest normal values of semen parameters, which are required for fertility, is of utmost importance in the diagnosis and management of infertile couples. These values are defined periodically by W.H.O. However, it has been emphasized that semen parameters should be determined regionally or nationally. The objective of this study was to evaluate semen parameters in fertile couples in Isfahan. Semen samples were obtained from partners of 234 pregnant women referring to gynecologists throughout Isfahan. Questionnaires, including time to pregnancy [TTP], were filled out. Semen samples were analyzed according to WHO guidelines. Results were analyzed and odds ratios were calculated by the use of SPSS statistical software and the level of significance was considered <.05%. The 10% cut-off point for the values such as volume, density, total count, motility and normal morphology, being considered as the minimum requirement for fertility, were 1ml, 45x10[6] per ml, 75x10[6] per ejaculate, 57% and 28% respectively. Semen parameters with TTP of less than 6 months were grouped according to the mentioned cut-off points and the pregnancy ratio and relative risks of pregnancy were calculated for each group. The results showed no significant differrence between the relative risks for pregnancy with respect to the cut-off points. Due to lack of information on sperm parameters in different parts of the world, regional and national evaluations of these parameters is of great value for demographic studies. Genetic characteristics and regional climate as environment, may affect sperm parameters. Isfahan, for example, is situated in a region with warm and dry climate and this may justify the low mean volume and higher concentration of sperm in the obtained samples from the subjects

Effects of karyotype variations on phenotype of patients with turner syndrome

Turner syndrome [TS] is a sporadic disorder caused by the absence of all or some parts one X-chromosome with major developmental consequences such as short stature and ovarian failure etc. The minor manifestations of TS are cubitus valgus, micrognatism, high-arched palate, short and/or webbed neck, hypothyroidism, etc. Different karyotype abnormalities may lead to different clinical features; therefore, in this study we have tried to postulate karyotype-phenotype correlations in these patients. In order to assess karyotype-phenotype correlations, 209 proven TS patients were studied and chromosomal analysis was performed on the basis of G-banding technique at high resolution. According to cytogenetic findings, karyotype abnormalities were classified into four groups: classic form 19%; mosaic form 76%; long arm isochromosome 4% and short arm deletion 1%. Clinical manifestations were more severe in classic TS rather than the other forms of chromosomal abnormalities. The results of this study suggest that karyotype variations might affect phenotype of Turner syndrome. Therefore, chromosomal investigation for all suspected cases of Turner syndrome should be considered in order to approach an appropriate treatment protocol

Relation of hyperthyroidism with urine volume and specific gravity

Introduction: Polyuria and nocturia may be the first clinical manifestation of hyperthyroidism. Most of the reported studies about renal function in Hyperthyroidism are performed in animals

Material and Methods: In this study we have evaluated 12-hour urine volume and specific gravity of morning urine in 50 new hyperthyroid patients and we have compared the results with similar study in 34 normal persons from their families in the same age group [control]

Results: We found significant increase in urine volume [p<0.001] and decrease in specific gravity in patients with hyperthyroidism [p<0.001]. There was no significant correlation between urine volume and specific gravity with plasma concentration of thyroid hormones

Conclusion: There is increased urine volume and decreased specific gravity. This should be considered in differential diagnosis of diabetes insidious

Report of two cases of idiopathic precocious puberty in family

Precocious Puberty is the result of premature activation of LHRH neuronal function due to structural damage of the neuroendocrine brain systems, or generalized activation of the neuronal glial mechanisms. In this article we present two sisters with idiopathic precocious puberty, one of them recived medication and the other under follow up

Effect of human sperm MTT viability assay on outcome of intraycytoplasmic sperm injection

Sperm MTT Viability Assay has been shown to be a suitable test for differentiation of viable from non-viable sperms. In this procedure MTT is converted to observable purple MTT Formazan by mitochondrial dehydrogenase in the midpiece region and therefore viable sperms can be distinguished which makes this test suitable for ICSI. Therefore, in order to study the effect of MTT positive sperms on fertilization, cleavage and blastocyst formation, 109 fresh human oocytes [metaphase II] were divided in to two groups; one group was injected with MTT positive sperms and the other one was taken as control. The results of study showed that there is not significant difference with respect to fertilization, cleavege and blastocyst formation between these two groups. Therefore, if MTT proves to be nether mitogenic nor teratogenic, sperm MTT viability assay might be useful for ICSI in patients with absolute or severe asthenospermia, especially in cases with tail abnormality