[Evaluation of simple calculated osteoporosis risk estimation [SCORE] in Iranian postmenopausal women]

Osteoporosis is a major health problem for postmenopausal women in all over the world. Use of dual x-ray absorptiometry [DXA] as standard diagnostic procedure, due to the cost is not economical for screening of all postmenopausal women. Based on clinical risk factors, several screening tools have been invented and one of the most popular screening tools is Simple Calculated Osteoporosis Risk Estimation [SCORE]. The objective of this study was to evaluate performance of this tool in screening of Iranian women for osteoporosis. This descriptive - analytical study was performed on 341 postmenopausal women who were referred to Isfahan bone densitometry centre. We made use of the osteoporosis screening tools [SCORE] for postmenopausal women aged 45 years or more, without secondary cause for osteoporosis, and the results were compared with their bone mineral density. Among 341 postmenopausal women, who were studied in this study, 20.8% were osteoporotic [71persons], 39.6% had low bone mineral density in one or both studied areas by DXA and the rest of women [39.6%] were found normal. SCORE tool was shown to have sensitivity about 87.2% [95% CI 97.2%-76.4%] and specificity of 37.9% for screening of low bone mass in postmenopausal women. SCORE tool has acceptable sensitivity and accuracy to be used as a tool to identify low bone mineral density in vast majority of Iranian postmenopausal women

Knowledge, attitude and practice of mothers about neonatal swaddling in Jahrorn

Swaddling as a current custom in our country has many advantages and disadvantages. The mothers' knowledge about them affects the neonatal care. The present study aims to assess the mothers' knowledge, attitude and practice about swaddling. In the present study, 190 mothers in spring 2006 were studied through a questionnaire. Data including age, place of living, parity, job, education, and also the reasons, advantages and disadvantages of swaddling were collected. Moreover, knowledge, attitude and practice of mothers and their correlation with other variables were evaluated. More than 95 percent of the mothers swaddled their babies due to custom or recommendation of their families. Better sleep [36.3%] and strong foot [30%] were the most common reasons for swaddling, as stated by mothers. More than 90 percent of the mothers had no knowledge about the disadvantages of swaddling. There was a statistically significant correlation between the mothers' level of knowledge and their age, parity, place of living and education. In regard to swaddling as a current custom and with respect to many advantages and disadvantages of swaddling in growth, development and better care of infants, it seems that it would be better to provide pamphlets for increasing the mothers' knowledge

Usefulness of thrombopoietin and IL-6 serum levels in thrombocytopenic newborn

Thrombocytopenia remains a common problem in sick newborns. A quarter of all neonates admitted to neonatal intensive care units develop thrombocytopenia and in 20% of neonatal bleeding episodes, the thrombocytopenia is severe [platelets < 50.000/mm[3]]. Thrombopoietin [TPO] regulates platelets production stimulating megakaryocyte prolieration and mutation. Interleukin 6 [IL-6] is one of the most potent thrombopoietin cytokines. Establishment of thrombopoietin and IL-6 serum levels in healthy and thrombocytopenic neonates is an important step in further understanding of the pathophysiology of neonatal thrombocytopenia. We measured circulating TPO and IL-6 in groups of neonates with thrombocytopenia to find out if mey have a role in thrombopoiesis and to determine their value in diagnosis of several of thrombocytopemu. One hundred and five newborns with thrombocytopenia [47 fullterm and 58 preterms] were the study population. Their ages ranged between 1 and 29 days [2.8 +/- 4.5]. Thirty age and sex - matched healthy newborns constitute the control group. Half of them were preterm and other half were fullterm. Serum TPO and IL-6 levels were measured by enzyme-linked immunoassay [ELISA]. Thrombocytopenia patients had higher serum TPO and IL-6 levels [575.04 +/- 430.7 pg/ml, 112.83 +/- 128.83 pg/ml respectively] than the control group [301 +/- 112.48 pg/ml, 61.9 +/- 73.28 pg/ml] and the difference was statistically highly significant [p < 0.001]. TPO and IL-6 serum levels showed positive significant correlation [r =0.25. p = 0.003]. In thrombocytopenia neonates, the lower the platelet count, the higher the serum TPO concentration. The differences for serum Il-6 levels in fullterm and preterm thrombocytopenic neorates when compared to healthy fullterm and preterm controls were statistically significant [P = 0.02, 0.007 respectively] while those for serum TPO levels gave insignificant results [P = 0.3 and 0.07]. Thrombocytopenic neonates with sepsis had higher and significant TPO and IL-6 serum levels than thrombocytopenic neonates with other etiologies and controls [633.68 +/- 406.58, 333.04 +/- 203.39, P < 0.0001]. Measurements of serum TPO and IL-6 levels provide valuable diagnostic information for the analyses of thrombocytopenia in neonatal infants

study of goiter among female adolescents referred to centre for nuclear medicine, Lahore

To study goiter and thyroid dysfunction in female adolescents residing in Lahore referred to Centre for Nuclear Medicine [CENUM], Mayo Hospital for thyroid scanning and thyroid function tests. Design: Retrospective study of thyroid size, thyroid scan patterns and serum FT, and TSH levels. Setting: Centre for Nuclear Medicine [CENUM], Mayo Hospital, Lahore Patients: 350 female adolescent referred during September 2002 to April 2003. Main outcome measures: adolescent goiter, thyroid nodules, hyperthyroidism, hypothyroidism, Graves' disease, toxic multinodular goiter. Among 350 adolescents 212[60.6%] had goiter of various grades mostly visible. Among goiterous patients 136[64.2%] had diffuse and 76 [35.8%] had nodular presentation. The number of patients with solitary nodular goiter [20.7%] was more than multinodular goiter [15.1%] and number of patients with solitary cold nodule [16.5%] was more than functioning nodule [4.2%]. The incidence of biochemical thyroid dysfunction, both overt and subclinical, was detected in 42[19.8%] patients and was significantly more frequent in patients with nodular than diffuse presentation [29% VS 14.7%; p<0.001] and in multinodular than solitary nodular goiter [p<0.005]. More than 80% of the patients with solitary nodular goiter were euthyroid. Simple goiter was detected in 116[54.7%], Graves' disease in 5[2.4%] and toxic multinodular goitre in 4[1.9%] patients. Overall incidence of hypothyroidism was more than double as compared to hyperthyroidism. Incidence of nodularity and hypothyroidism was more in large goiter but duration of goiter was not significant in promoting nodularity. Goiterous adolescents need urgent attention because they don't have just diffuse hypertro- phy with normal thyroid function. Many are afflicted with dysfunction and nodularity, particularly solitary cold nodule bearing risk of thyroid malignancy

Brainstem auditory evoked potedntial the normal and mentally retarded and its relationship to intelligence

This study selected randomly a group of mentally retarded children consisting of 33 male members ranging in age between 107-169 months in addition to 29 normal children matched for age and sex and served as controls. Subjects of both groups were free from hearing h and icaps and all were subjected to brain stem auditory evoked potential [BAEP] measurement. Raven progressive matrices test was used for the evaluation of intelligence aiming to find out any possible differentiating characteristics between normal and mentally retarded children as well as establishing the correlation if present between the level of IQ and brain stem evoked wave structure

Study of load-independent index of left ventricular myocardial contractility in infants with isolated ventricular septal defect and congestive heart failure

Twenty-nine infants with isolated VSD [15 symptomatic and 14 asymptomatic] and with age ranged from 5 to 14 months were compared with 15 control infants, to determine if symptoms of congestive heart failure were due to depressed contractility or defect size or both. We found that the symptomatic infants had a significant increased heart rate and respiratory rate [P < 0.01] and a significant lower systolic blood pressure [P < 0.05] than the other groups. The symptomatic patients had non significant increased ESD, EDD and End-systolic stress [ESS] than other groups of the study but there was no significant difference between the three groups as regards fractional shortening [FS] and velocity of circumferential fiber shortening [VCFc]. We found that the left ventricular contractility in the symptomatic patients was not depressed as the predicted VCFc was lower than the measured VCFc, at any given ESS. The ESS/VCFc curve slope of the symptomatic patients [-0.005] was less than asymptomatic patients [-0.009] and the control infants [-0.012] and shifted to the right, due to increased LV preload and wall stress as the symptomatic patients had a significant bigger VSD and a significant increased pulmonary/ systemic flow ratio [Qp/Qs] than asymptomatic patients [P < 0.01]. It is concluded that the left ventricular contractility in patients with VSD and CHF was not depressed and their symptoms may be related to increased pulmonary flow due to increased left- to -right shunt through a big VSD

Pulmonary mycosis in chronic obstructive air way diseases and effects of some medicinal plant extracts

Pulmonary mycosis is not uncommon finding in patients complaining of chronic obstructive airway diseases. Excess use of corticosteroids enhances the infection. Candida and Aspergillus species were the predominant strains isolated. The isolated fungi were sensitive [in vitro] in different degrees to different medicinal plant extracts

Value of lysozyme [muramidase] in pleural effusion and serum of children

The study included 55 patients with pleural effusion [18 transudate, 27 bacterial empyema and 10 tuberculous exudate] their ages ranged from 1-10 years. Also 20 apparently healthy children of matched age and sex were taken as control. No significant difference was found in the levels of serum lysozyme between disease and control groups. There was a significant increase in pleural fluid lysozyme levels in bacterial empyema than in transudate or tuberculous exudates [P = 0.000, P = 0.001] respectively. There was also a significant increase in pleural fluid lysozyme in cases of tuberculous effusion when compared with transudate group [P = 0.002]. Pleural fluid-to-serum lysozyme [PL/SL] ratio was 0.81 +/- 0.11 mg/dL in cases of transudate, 11.69 +/- 2.48 mg/dL in bacterial empyema and 1.98 +/- 0.75 mg/dL in tuberculous effusion groups. The existence of a raised PL/SL ratio in cases of tuberculous and bacterial empyema groups suggested important local synthesis of lysozyme. Comparing patients of tuberculous effusion with patients of transudate a PL/SL ratio higher than 1.4 showed a sensitivity of 90%, specificity of 100%, positive predictive value of 100%, negative predictive value of 94.7% and accuracy of 96.4% for discrimination of tuberculous effusion. All of these suggest that the determination of pleural fluid lysozyme and PL/SL ratio is a simple, fast method for obtaining corroborative information in the differential diagnosis of tuberculous pleurisy from transudate