[Evaluating the prevalence of endocrinopathies and metabolic disorders in patients suffering from sickle cell anemia in Kerman]

Introduction: Sickle Cell Disease, Hemoglobinopathy which often requires frequent blood transfusions, is an excessive deposition of iron in the tissues, often resulting in endocrine disorders. This study aimed to determine the prevalence of endocrinopathies and metabolic disorders in patients suffering from sickle cell anemia in Kerman

Materials and Method: This cross-sectional study was conducted on 66 patients, suffering from sickle cell anemia. An information form was completed for all patients and blood samples were obtained for laboratory tests such as fasting blood sugar, serum TSH level, free T4 level, serum LH and FSH levels, serum PTH, total Ca, P and serum prolactin levels. Serum testosterone- and serum estradiol levels were checked separately, based on gender. Results were compared with normal laboratory tests, and statistically analyzed

Results: In this study, sickle cell anemia patients, aged 14-59 were evaluated. None of the patients had diabetes mellitus. Hypothyroidism was observed in 24.2% of patients, hypoparathyroidism in 12.5%, hypogonadism in 21.2% and hyperprolactinemia in 53%. Overall, 65.1% were found to be suffering from endocrine disorders. Statistically significant differences were seen between endocrinopathies and age

Conclusion: Results showed age to be the important factor in endocrine disorders. Timely and appropriate treatments [including blood transfusion and receiving iron chelators] can evidently reduce iron overload in these patients and prevent its endocrine complications

[Comparison of the frequency of recurrent laryngeal nerve injury with and without exploration of the nerve in thyroidectomy]

Surgeons are not willing to participate in thyroid surgeries due to dangerous, although rare, complications of the procedure. Post thyroidectomy complications are divided in early and late onset; hypocalcemia, bleeding, thyroid storm and recurrent laryngeal nerve [RLN] injury are the most important ones. This study was performed to compare the frequency of recurrent laryngeal nerve injury with and without nerve exploration in the thyroidectomy operation. In this Cohort study, we evaluated 566 cases underwent thyroidectomy during about 6 years [2005-2011] in two centers, Bahonar and Afzalipour hospitals, in Kerman, Iran. A total of 566 patients, 124 men [21.9%] and 442 women [78.1%] with the mean age of 40.26 years and the mean hospitalization period of 3.35 days were evaluated. 382 patients [67.5%] underwent total or subtotal thyroidectomy and 184 [32.5%] underwent lobectomy and isthmectomy. 124 patients [21.9%] had malignant and 442 [78.1%] had benign lesions. The most common found malignancy was papillary thyroid carcinoma [PTC], where as the most found benign lesion was multinodular guiter [MNG]. Recurrent laryngeal nerve exploration was done for 337 patients [59/5%]. Totally, 6 cases [1.1%] showed Recurrent laryngeal nerve injury [1 in exploration and 5 in non exploration group] from which, 4 had permanent hoarseness and 2 had permanent dysphonia. Also, malignancy and radical neck dissection had significant effect on nerve injury but re-operation and unilateral or bilateral surgery had not. Recurrent laryngeal nerve identification and exploration decreased the incidence of nerve injury significantly. We believe that recurrent laryngeal nerve identification and exploration during thyroidectomy is the best procedure to decrease the risk of nerve injury

Is opium addiction a risk factor for bone loss?

Drug abuse is one of the most important public health problems worldwide as in Iran. The aim of present study was to determine whether opium addiction can affect bone mineral density or not. Fifty opium addicted and 50 non-addicted volunteer men aged between 25-45 were enrolled. The subjects with positive history of other osteoporosis risk factors were excluded. The vertebral bone density and potential confounders [age, cigarette smoking and body mass index] were measured in all subjects. Twenty six percent of non-addicted vs. 56% of addicted subjects had vertebral osteopenia. According to adjusted ORs, addiction to opium [OR: 3.08, CI95% 1.20-7.92] and age [OR: 1.11 CI95% 1.03-1.20] were significantly related to vertebral bone loss. Opium addicted patients were more susceptible to bone loss than non-addicted individuals. So, early screening and conducting prevention programs should be taken into consideration for this high risk group

Relationship between family history of osteoporotic fracture and femur geometry

The principal aim of this study was therefore to investigate association between family history of osteo-porotic hip fracture, BMD and femur geometry in Bushehr city in South of Iran. In this cross-sectional study, data were obtained from Iranian Multi-center Osteoporosis Study [IMOS] in Bushehr. Healthy men and women aged 50 to 75 years were selected based on randomized clustered sampling of all regions of the corresponding city. BMD was measured once at the lumbar spine [L2-L4] and proximal femur with dual X-ray absorptiometry using Lunar DPX densitometers. From the DXA image the operator manually determines the hip axis length [HAL] and femoral neck-shaft angle. The HAL was measured from the inner pelvic brim to the lateral side of the femur .The femoral neck-shaft angle was defined as the angle between the femoral neck axis and the femoral shaft axis. There were no significant differences between the family fracture history groups with regard to the potential confounders of age and body mass index [BMI]. HAL of women with history of hip fracture was greater but history of hip fracture showed no significant relation with other variables. These findings suggest that individuals with a positive family history may be at higher risk of osteoporotic hip fracture because they have greater HAL and more prone to buckle at the femur neck