Prevalence of goiter among children aged 11-16 years in Ahwaz, Iran

This cross-sectional study was conducted in Ahwaz, Iran to find out the prevalence of goiter among schoolchildren ages 11-16 years. Multistage sampling methodology was followed for selecting the study population. A total of 1,950 children [1,050 males, 900 females] were clinically assessed for thyroid gland enlargement. Data were collected on age, sex, weight height, iodized salt consumption, family history of goiter, and thyroid size by palpation. One hundred forty-six of the 1,950 children showed various grades of goiter, giving a prevalence of overall goiter of 7.48%. Of the 146 persons with goiter, 46 [31.5%] were male and 100 [68.5%] were female. Prevalence of goiter among male and female students was 4.4 and 11.1%, respectively. Prevalence of grade 1, 2, and 3 goiters was 56.8% [83 cases], 37.7% [55 cases], and 5.5% [8 cases], respectively. A significant difference existed between height of students with grade 1 goiter and those with grade 2 and 3 goiter [p < 0.001]. A significant difference also was found between weight of students with grade 1 goiter and students with grade 2 goiters [p < 0.002]. These results indicate that Ahwaz City is not an endemic area for iodine deficiency, probably because of its geographic location [the low altitude of sea level] or nutritional habits of its population [consumption of fish and iodized salt]

case report of a survival from Ekiri syndrome

Lethal toxic encephalopathy of shigellosis [Ekiri syndrome] is a rare complication of the shigella infection presented with fever, severe toxicity, seizure and diffuse brain edema, coma and death in the absence of dehydration and is nearly always lethal. This report is about a child who has survived the Ekiri syndrome. A three-year old child was admitted to the emergency ward because of fever, one attack of generalized tonic-clonic seizure, drowsiness and diarrhea with no signs of dehydration. The differential diagnosis was meningitis, shigellosis and atypical febrile convulsion. All test results for blood, urine, stool and cerebro-spinal fluid samples were normal except for serum sodium [119 mmol/1] and stool exam [many RBCs]. He was treated with anticonvulsants because of the recurrent seizures and ceftriaxone with probability of shigellosis. The emergency brain CT scan showed diffuse brain edema. After 48 hours the consciousness was improved. Stool culture showed the growth of Shigella flexneri. Second brain CT scan revealed a dramatic decrease of the brain edema. Because neurological symptoms are among the extra intestinal complications of the shigellosis, it is recommended to put this disease in the list of differential diagnosis of unexplained neurological signs in endemic areas and consider the specific medications in the treatment programs