Thyroid function test in pre-term neonates during the first five weeks of life

Congenital hypothyroidism [CHT] is one of the most common congenital endocrinal disorders. The prevalence of CHT is estimated about 1 in 3,000 newborns. The prevalence, etiology and associated disorders of abnormal thyroid screening tests are reported in different ranges. In this study, we assessed the pre-term newborns for CHT and associated factors that influence thyroid function. One hundred newborns with the gestational age fewer than 35 weeks were investigated. Baseline serum thyroid stimulating hormone [TSH] and free thyroxin [FT4] levels were measured during the first 5 days of life and were repeated during the first 5 weeks. We analyzed the effects of demographic factors and the presence of respiratory distress syndrome on the alteration of thyroid function tests during the first 5 weeks of life. The mean gestational age [GA] at delivery was 32.35 +/- 1.97 [range 28 to 35] weeks. CHT was observed in 13[13%] preterm infants. GA was the only factor which affect the FT4 changes over the two weeks follow-up [P < 0.001, b: -2.783, Power: 70.2%] although the differences between baseline and follow-up amount of TSH were not significantly influenced by GA [P = 0.062, power: 46%]. However, the adjusted TSH and FT4 serum level changes during follow-up were significantly different between two groups [between CHT and normal, P = 0.006, 0.000, respectively]. It seems that thyroid function tests should be repeated in preterm infants, especially for patients with lower gestational age, to confirm the diagnosis of CHT. Also, CHT should be considered among the newborns that are affected by RDS.

Magnetic resonance imaging findings in epileptic children and its relation to clinical and demographic findings

Epilepsy is an important disease with a cumulative incidence of 3% all over the life and more than half of them are started from childhood. In this study we surveyed magnetic resonance imaging [MRI] findings in epileptic children and its relation with clinical and demographic findings in order to find better diagnostic and treatment modalities for these children in the future. In this cross sectional study, we investigated consecutively all 1 to 15-year-old epileptic children who referred to the pediatric neurology outpatient clinic from 2004 to 2010. Two hundred children were enrolled for investigation. There were 85 [42.5%] girls and 115 [57.7%] boys, aged 1 to 15-year-old [7.7 +/- 4]. 196 [98%] of the children had abnormal electroencephalography [EEG]. Abnormal MRI was seen in 57 [28.5%] patients and consisted of brain atrophy [10%], increasing white matter signal intensity in T2-weighted images [8%], benign cysts [5%], brain tumors [4%] and vascular abnormalities [1.5%]. Abnormal MRI findings had significant relation with abnormal EEG, age, positive family history for epilepsy, dysmorphic appearance, and abnormal physical exam. Considering 98% EEG abnormalities in these epileptic children, benign nature of MRI findings in most of our cases, the high price of MRI and the small minority of patients who benefit from active intervention as a result of MRI, we suggest to use EEG for confirmation of epilepsy and perform MRI for patient with abnormal physical exams, focal neurologic deficits or focal EEG abnormalities

Thyroid function in epileptic children who receive carbamazepine, primidone, phenobarbital and valproic acid

In this study, we investigated the changes of the serum levels of thyroidhormones including Thyroxine [T4], Triiodothyronine [T3], T3 resin uptake andThyroid stimulating hormone [TSH] in epileptic children during treatment withanti-epileptic drugs [AEDs] including carbamazepine [CBZ], primidone [PRM],phenobarbital and valproic acid [VPA]. This study consisted of four case-series comparisons, was conducted on 115epileptic children [37 girls and 78 boys with an age range between 2 months and 15 years, mean: 62.06 A +/- 44.97 months]. These children were divided into4 groups who took either phenobarbital [n=29], PRM [n=28], CBZ [n=29], or VPA [n=29] for 3 months. Thyroid hormone levels [T3, T3 resin uptake, T4 and TSH] were measured at the beginning and three months after starting the study. At first, all patients were euthyroid and there were no clinical or laboratory findings suggestive of hypothyroidism. Regarding thyroid hormones before and after the administration of phenobarbital, carbamazepine, valproic acid and primidone, there were no significant changes in serum T3, T4, T3 resin uptake and TSH levels. Our findings showed that short term therapy with phenobarbital, carbamazepine, valproic acid and primidone had no effect on thyroid function tests

[Assessment of cardiac troponin I in patients with pulmonary emboli and its relationship with right ventricular dysfunction]

Right ventricular dysfunction is common in major pulmonary embolisms. The purpose of this study was to evaluate the prevalence and diagnostic utility of cardiac troponin I and also to identify patients with RV dysfunction in pulmonary embolism. This study was conducted on 42 patients with pulmonary embolism in Ekbatan Hospital, in Hamedan city. Data from history, echocardiogram, and lung perfusion scan was obtained from medical records. Blood samples were obtained immediately after pulmonary embolism was diagnosed. Cardiac troponin was measured using chromatographic assay. Two patients [4.8%] had positive troponin I [>/= 0.5 microg/l], and 40 patients [95.2%] had negative troponin I [< 0.5 microg/l]. RV dysfunction was detected in 16 patients [38%]. RV dysfunction was detected in 1 of positive troponin I patients and 15 with negative troponin I [37.5%]. No significant relationship was found between RV dysfunction and troponin I level [p>0.05]. Our data demonstrates that troponin I measurement is not able to distinguish specifically between coronary and non- coronary causes of chest pain