[Effect of hyperthyroidism on bone mineral density in premenopausal women]

Hyperthyroidism is a state of high bone turnover, but there is controversy about its effects on bone mineral density. It is more common in females [F: M ratio 10:1]. Since post-menopausal women are potentially at risk for osteoporosis because of aging and estrogen deficiency and because hyperthyroidism is more common in females, this study was done to determine the effects of hyperthyroidism on bone mineral density [BMD] in premenopausal thyrotoxic women. In this case- control study 50 women with untreated hyperthyroidism [age- range 20-50 yr] from outpatient endocrine clinics in the years 2004 - 2005 were selected. Patients who used drugs or had diseases that affect bone mineral density were excluded. After history taking and physical examination, thyroid function tests, PTH, phosphorus, calcium, alkalin phosphatase, fasting plasma glucose and creatinine were measured and then bone densitometry by LUNAR [DPX-IQ] device was performed. One hundred and ten age- and weight - matched healthy women from participants in Iranian Multicenter Osteoporosis Study [IMOS] were selected as controls. SPSS version 11.5 was used for data analysis and P value less than 0.05 cosidered as significant. Mean of age, height and weight was similar in patients and controls. Forty seven cases [94%] had Graves' disease and 3 cases [6%] had toxic solitary adenoma. Mean duration of disease before diagnosis was 6.02 +/- 4.38 months. There was no significant difference in mean of bone mineral density in vertebral column [p=0.83] and also in femural neck [p=0.74] between patients and controls. There was no correlation between bone mineral density in vertebral column and also in femural neck with serum levels of T4, T3, TSH and FT4I. There was no correlation between bone mineral density and duration of disease before diagnosis and also between bone mineral density and age. Hyperthyroidism is a known state of high bone turnover, but in hyperthyroid premenopausal women with disease of short duration and without other risk factors of low bone mass, bone densitometry could not be recommended as a required routine measurement

[Frequency and clinical characteristics of amyotrophic lateral sclerosis [ALS] disease in patients referred to neurology department of ghaem hospital]

ALS is a neurodegenerative disease due to degeneration of both upper and lower motor neurons [UMN and LMN]. There is no treatment for this disorder and it is important to distinguish from other conditions that may mimic ALS. This is a descriptive study since September 2002 until September 2004 among the patients whom referred to neurology department of Ghaem hospital. 21 patients were studied [14 men]. Mean age was 41.58 years. UMN and LMN symptoms were the presenting complaint of our patients except 5 cases with bulbar onset. Symptoms began before age of 40 in 40% of our all patients, and 27% of Charcot type of ALS. 15 Cases had charcot type of ALS, 4 cases had juvenile ALS, 1 case had Kennedy syndrome and finally 1 case had Madras motor neuron disease [MMND]. In this study we found the first case of MMND in Iran. There was a large proportion [40%] of cases with age of onset below 40 years in comparison with previous studies, more epidemiological and toxicological studies should be done

[ comparison between colour doppler ultrasonography and intravenous urography in diagnosis of ureteral obstruction due to ureteral stone]

Urinary stone is one of the most common cause ofureteral obstruction. Degree of obstruction has an important role in choosing time and method of treatment. The aim of this cross-sectional study is comparison between Color Doppler Ultrasound and Intravenous Urogram in diagnosis ofureteral obstruction in patients with ureteral stone. 35 patients with unilateral renal colic were studied from October 2004 to June 2005. In all patients the presence of stone in the ureter was confirmed by Sonography. Mean age was 36.9 +/- 9.1 years. After analgesia and determination of serum creatinin level, color Doppler ultrasound [CDU] was done with semi-distended bladder. Number, velocity, and duration of ureteral jets were observed in five minutes, bilaterally. Immediately after CDU, the patients were transferred to the next room to perform standard IVU. All data was recorded and analyzed with statistical methods.%71.4 of patients were male and 28% were female. Mean serum creatinine was 0.9 +/- 0.18 mg/dl. In all patients with complete ureteral obstruction in IVU, ureteral jets were diminished [42.1%] or absent [57.9%] in CDU. In patients with partial obstruction in IVU, diminished jets in CDU were noted in 86.7%; and only in 2 patients [13.3%] normal jets were seen. Number of jets in one minute was 0.84 +/- 1.46 in patients with complete obstruction, and 5.18 +/- 3.4 in partial obstruction [P<0.001]. There was a significant difference in velocity and duration of jets between complete and partial obstruction [P<0.01 and P<0.001 respectively]. The number, velocity, and duration of the jets in the normal side was not significantly different between the two groups of patients [P=0.31, P=0.51, and P=0.27 respectively]. This study showed that CDU can determine ureteral obstruction in renal colic patients in most cases. It is a safe, fast, and noninvasive test. CDU of ureteral jets is recommended as a functional test in renal colic patients