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Alireza Abdollahi , Zohreh-Sadat Rozati,
Volume 73, Issue 10 (1-2016)
Volume 73, Issue 10 (1-2016)
Abstract
Background: Congenital hypothyroidism is a major but preventable cause of mental backwardness in infants. In case of hypothyroidism in fetuses, certain complications will occur in vital organs like the central nervous system and the skeleton. Before screening programs were introduced, congenital hypothyroidism was diagnosed with delay due to its few and non-specific symptoms during the first days of life. Given the difference in reference range for various races and populations, this study was aimed to determining a natural range for thyroid hormones used in the screening of infants.
Methods: In a descriptive cross-sectional study at Vali-asr Hospital, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran, from March 2013 to 2014. The level of T4, FT4 and TSH hormones was measured in all natural childbirth, without any complications and with one-minute Apgar score above 7 while this study was underway.
Results: A group of 249 infants (male and female), including 35 (14.1%) aged between 0 and 4 days, 102 (41%) aged between 5 and 7 days and 112 (45%) aged between 7 and 30 days, were examined. The average TSH, T4 and FT4 amounts in infants, aged 0 to 30 days, were respectively 5.35 µU/ml, 10.77 µg/dl and 1.33 ng/dl. The interval was 4.76-6.01 µU/ml for TSH, 10.36-11.17 µg/dl for T4 and 1.29-1.37ng/dl for FT4. The difference between age groups with average TSH concentration is not meaningful (P=0.7) and the average T4 amount in different age groups was meaningfully different (P=0.05). The average FT4 in different age groups is meaningfully different (P=0.007). The thyroid hormone amounts calculated for males and females were not significantly different.
Conclusion: Given the difference in the reference range in race, population and geographical zones, it is necessary to determine a range for screening in Iran. According to the findings of the present study, lower cut-offs, compared with western countries, should be envisaged for TSH in congenital hypothyroidism screening programs that could speed up the diagnosis of minor cases of the disease and prevent complications.
Mehrnoosh Ramezani, Mehdi Hedayati , Saeed Hoseini Asl , Meraj Tabatabaei , Mohammad Mazani , Shirzad Nasiri ,
Volume 74, Issue 4 (7-2016)
Volume 74, Issue 4 (7-2016)
Abstract
Background: Thyroid cancer is the most common endocrine malignancy. Accounting for approximately 1-2% of all cancers. Thyroid cancers have been divided into four main types: papillary, follicular, medullary and anaplastic. The active form of vitamin D (1,25- (OH) 2-vitamin D3) by binding to its receptor, using genomic and non-genomic mechanisms inhibits the proliferative effect of TSH on thyroid cells. Therefore, vitamin D may have a role in regulating of thyroid gland cell proliferation. Many studies have shown anti-cancer effects of vitamin D in cancers. Polymorphisms of Vitamin D receptor can influence the prevalence to various cancers. In the present study, serum level of vitamin D and FokI, BsmI and Tru9I polymorphism of vitamin D receptor was investigated.
Methods: This case-control study was performed in the summer of 2015 in Endocrinology and Metabolism Center of Shahid Beheshti University of Medical Sciences, Tehran, Iran. Forty medullary thyroid cancer patients and 40 healthy controls were investigated. Genomic DNA of subjects was extracted with saturated salt/proteinase K and polymorphisms of vitamin D receptor gene investigated by polymerase chain reaction-sequencing. Serum level of vitamin D evaluated by ELISA technique. The results were analyzed by SPSS, ver. 20 (Chicago, IL, USA) and GraphPad Prism, ver. 5 (GraphPad, Inc., CA, USA) softwares.
Results: Genotypic and allelic abundance of FokI and BsmI polymorphisms between test and control groups have not shown significant different. In Tru9I polymorphism, Tt genotype abundance in test group were 45 percent and in control group were 17.5 percent and t allelic abundance in test group were 25 percent and in control group were 8.7 percent which this different were significant. Average serum level of vitamin D in test group was 23.32 ng/ml and in control group was 18.95 ng/ml which was statistically significant.
Conclusion: Unexpectedly, serum levels of vitamin D in test group were higher than control group. Tru9I polymorphism is significantly correlated to medullary thyroid carcinoma prevalence.
Bakhtyar Tartibian , Rogayee Afsar Garebag , Abbas Malandish , Zeinab Sheikhlou ,
Volume 74, Issue 8 (11-2016)
Volume 74, Issue 8 (11-2016)
Abstract
Background: Hypertension is one of the major risk factors for cardiovascular disease. The studies show that factors such as vitamin D, parathyroid hormone, calcium and phosphorus are involved in the regulation of blood pressure. The purpose of this study was to investigate the relationship between blood pressure with vitamin D, parathyroid hormone, calcium, and phosphorus in sedentary postmenopausal women.
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Methods: This investigation is in the form of a descriptive correlational study that was performed in September 2015. The statistical population was all healthy and sedentary postmenopausal women 50-70 years old in Urmia city, Iran. Fifty-four sedentary postmenopausal women were selected as subjects and voluntarily and bona fide participated in this study. General and anthropometric characteristics of height, weight, and body mass index (BMI) in subjects were measured by wall-meter with an accuracy of one millimeter, digital scale with precision of 100 g (Beurer, Germany), and dual emission X-ray absorptiometry (DXA) (Hologic, USA) machines, respectively. Diastolic and systolic blood pressure was measured by indicator machine. Serum levels of vitamin D, parathyroid hormone, calcium, and phosphorus were measured by ELISA and Auto-analyzer (BT 1500, Biotecnica, Italy machines, respectively. Results: The mean general, anthropometric, and physiological/laboratory variables of subjects were: age 54 yr, height 156 cm; weight 72 kg; BMI 29 kg/m2; systolic and diastolic blood pressure 76.20 and 110.70, respectively; vitamin D 25.22 ng/ml, parathyroid hormone 33.29 ng/ml, calcium 9.44 ng/ml, and phosphorus 3.26 ng/ml. Moreover, results showed that there was no significant relationship between systolic and diastolic blood pressure and vitamin D (P>0.581 and P>0.619, respectively). There was no significant relationship between systolic and diastolic blood pressure and parathyroid hormone (P>0.623 and P>0.341, respectively). There was no significant relationship between systolic and diastolic blood pressure and calcium (P>0.704 and P>0.141, respectively). There was no significant relationship between systolic and diastolic blood pressure and phosphorous (P>0.058 and P>0.357, respectively). Conclusion: The results suggest that there is no relationship between systolic and diastolic blood pressure with serum levels of vitamin D, parathyroid hormone, calcium, and phosphorous in sedentary postmenopausal women 50-70 years old. |
Bakhtiar Tartibian , Zeinab Sheikhlou , Abbas Malandish , Mohammad Rahmati-Yamchi , Rogayee Afsar Garebag,
Volume 74, Issue 10 (1-2017)
Volume 74, Issue 10 (1-2017)
Abstract
Background: Studies show that aerobic exercise prevents osteoporosis in menopause by stimulating osteoblastic cells. Therefore, the purpose of this study was to investigate the effect of 12 weeks of moderate-intensity aerobic exercise on alkaline phosphatase gene expression, serum levels of alkaline phosphatase, parathyroid hormone, and calcium in sedentary women.
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Methods: This investigation is a semi-experimental study that was performed in September 2015 at Urmia University, Iran. The statistical population was all healthy and sedentary postmenopausal women 50 to 65 years old in Urmia city. Twenty sedentary postmenopausal women with an average age 60.12±2.12 yr, weight 72.35±10.50 kg, and body mass index 29.46±3.24 kg/m2 voluntarily and bona fide participated in this study, and then subjects were randomly divided to the Exercise/E (10 women) and Control/C (10 women) groups by random sampling method. E group performed of 12 weeks walking and jogging moderate-intensity aerobic exercise at 65-70% maximal heart rate of training, three sessions per week and per session 50-60 (min), but the C group participated in no intervention. Twenty-four hours before and after the 12-week training program were taken blood samples in order to measure of alkaline phosphatase gene expression and serum markers of bone in the E and C Groups. Evaluation of gene expression and serum markers of bone were measured by real-time reverse transcription PCR (RT-PCR) and Auto-analyzer (Biotechnica, Italy)/ ELISA reader (Awareness Inc., USA) machines, respectively. Data analysis included descriptive and inferential (ANCOVA test) statistics using SPSS version 23 (Chicago, IL, USA) and a significance level of P≥0.05 was considered. Results: The results showed that alkaline phosphatase gene expression and parathyroid hormone after 12 weeks of moderate-intensity aerobic exercise in between-groups were significantly increased (P=0.027 and P=0.006, respectively), while serum levels of calcium and alkaline phosphatase were not significantly different (P=0.941 and P=0.990, respectively). |
Conclusion: The results suggest that 12 weeks of aerobic exercise of walking and jogging at 65-70% maximal heart rate of training increases alkaline phosphatase gene expression and parathyroid hormone in sedentary postmenopausal women.
Marjan Zarif Yeganeh , Samira Kabiri , Sara Sheikholeslami , Hosna Hesanmanesh , Mehdi Hedayati ,
Volume 74, Issue 12 (3-2017)
Volume 74, Issue 12 (3-2017)
Abstract
Background: Thyroid carcinoma is the most common endocrine malignancy. Medullary thyroid carcinoma (MTC) approximately accounts for 5-10% of all thyroid carcinoma. Nowadays, it is obviously, the mutations in REarranged during transfection (RET) proto-oncogene, especially, mutations in exons 10, 11 and 16 are associated with MTC pathogenesis and occurrence. Thus, early diagnosis of MTC by mutation detection in RET proto-oncogene allows to identify patients who do not have any developed symptoms. The aim of this study was to screening of germline mutations in RET proto-oncogene exons 17 and 18 in MTC patients and their first degree relatives in Iranian population.
Methods: In this cross-sectional study, three hundred eleven participates (190 patients, 121 their relatives) were referred to endocrine research center, Shahid Beheshti University of Medical Science during September 2013 until September 2015. The inclusion criteria were pathological and clinical diagnosis. After whole blood sampling, genomic DNA was extracted from peripheral blood leucocytes using the standard Salting Out/Proteinase K method. Nucleotide change detection in exons 17 and 18 was performed using PCR and direct DNA sequencing methods.
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Results: In this study, twenty missense mutations [CGC>TGC, c.2944C>T, p.Arg982Cys (rs17158558)] which included 16 heterozygote and 4 homozygote mutations were found in codon 982 (exon 18). In the present study, 154 G>A (rs2742236) and 4 C>T (rs370072408) nucleotide changes were detected in exons 18 and intron 17 respectively. There was no mutation in exon 17. Conclusion: It seems that because of arginine to cysteine substitutions in RET tyrosine kinase protein structure and its polyphen score (0.955) and SIFT score (0.01) the mutation in codon 982 (exon 18) could be have pathogenic effects. On the other hands, the mentioned mutation frequency was 6.4% among MTC patients, so this mutation of exon 18 could be checked in genetic screening tests of RET proto-oncogene. Although this needs more study. |
Javad Hashemi , Zahra Hesari , Ali-Reza Golshan ,
Volume 75, Issue 1 (4-2017)
Volume 75, Issue 1 (4-2017)
Abstract
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Background: Nowadays, chronic kidney disease (CKD) is known as an epidemic disease all around the world. Chronic kidney disease considered as a serious health problem with numerous side effects, including complications progressive in reducing glomerular filtration rate (GFR), imbalances in the homeostasis of the body and decreased quality of life and finally an increase in mortality due to cardiovascular problems. End-stage renal disease leads to hypocalcemia and hyperphosphatemia, that as a result of, parathyroid hormone (PTH) will increased that secondary hyperparathyroidism will occurred eventually. So it is essential to routine examination of electrolytes in these patients. The current study have been done to determine the electrolytes in saliva as a non-invasive sample in hemodialysis patients in order to the saliva to be presented as an appropriate samples for clinical laboratories. Methods: In the present case-control study that has been performed at Imam Ali Hospital, Bojnord, North Khorasan Province, Iran, in the summer of 2016, 44 hemodialysis patients and 44 aged, gender and body mass index (BMI) matched healthy controls were selected and then their cell count, Hb, HCT, iron, ferritin, total iron binding capacity (TIBC), glucose, CRP, triglycerides, cholesterol, urea, creatinine, calcium, phosphorus, potassium and PTH were measured. Results: Calcium and phosphorus were higher in hemodialysis patients in comparison to the control group. Furthermore, there are not any significant relationship between levels of calcium, phosphorus and potassium in both serum and saliva samples. In addition, we observed the positive relationship between PTH in serum as well as phosphorus and potassium in the saliva. Conclusion: The findings of current study have been shown that salivary levels of calcium and phosphorus in hemodialysis patients is higher than healthy people, therefor could be a non- invasive suitable marker for diagnosis. In addition, blood PTH levels in hemodialysis patients is associated with salivary levels of phosphorus and potassium, so, perhaps these parameters marked PTH's representative in the blood with further investigation of saliva’s electrolytes. |
Leila Asefkabiri , Abbas Alibakhshi , Seyed-Hassan Emami-Razavi , Mahtab Mohammadifard , Alireza Abdollahi ,
Volume 75, Issue 3 (6-2017)
Volume 75, Issue 3 (6-2017)
Abstract
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Background: Hypocalcemia is one of the most prevalent complications following total thyroidectomy. Over recent years, in addition to hormone parathyroid hormone (PTH), vitamin D has been also studied as a factor causing post-total thyroidectomy hypocalcemia. This survey seeks to study the relationship between the serum level of vitamin D before surgery and during post-total thyroidectomy hypocalcemia. Methods: A group of 57 patients volunteering for total thyroidectomy were studied on Vali-e-Asr Hospital, Tehran, Iran, from March 2013 to March 2015. In all these patients, pre-surgery calcium, vitamin D and parathyroid hormone (PTH) as well as the level of calcium during the post-surgery first two days were measured. Based on objectives of this study, the relationship be-tween pre-surgery vitamin D level and post-surgery hypocalcemia was examined. Results: The average age of patients participating in the survey was 24.1±13.3. They included 19 women (33.3%) and 38 men, total of 40 patients (70.2%). Their average post-surgery calcium level was 9.2±0.77 milligrams per deciliters (mg/dl) and their average vitamin D content before the surgery was 42±12.1 nanomole per liter (nmol/l). The average calcium level before the surgery and the first post-surgery day were meaningfully different in terms of statistics (P<0.001). In terms of vitamin D, 37 patients (64.9%) had pre-surgery vitamin D deficiency and 20 patients (35.1%) had vitamin D insufficiency. Of 37 patients with pre-surgery vitamin D deficiency, 26 were diagnosed with post-surgery first-day hypocalcemia and of 20 patients with vitamin D insufficiency, 14 suffered post-surgery first-day hypocalcemia. This difference was not statistically meaningful (P>0.001). Of 37 patients with pre-surgery vitamin D deficiency, 31 suffered post-surgery second-day hypocalcemia and of 20 patients with vitamin D insufficiency, 18 suffered second-day hypocalcemia. This difference was not statistically meaningful either (P>0.001). Conclusion: The current study showed that the serum level of vitamin D before total thyroidectomy does not have any role in the occurrence of post-surgery hypocalcemia which is almost common after this type of surgery. |
Samira Ehyayi , Mehdi Hedayati , Marjan Zarif Yeganeh , Sara Sheikholeslami , Sayed Asadollah Amini,
Volume 75, Issue 6 (9-2017)
Volume 75, Issue 6 (9-2017)
Abstract
Background: Thyroid carcinoma is the most common endocrine malignancy and approximately accounts 2% of all cancer cases. Medullary thyroid cancer (MTC) is an endocrine tumor with differentiation of Parafollicular or C-cells and is categorized into hereditary or sporadic types. Medullary thyroid carcinoma approximately accounts for 5-10% of all thyroid carcinoma. Germ-line and somatic mutations in exons 10 and 11 RET (Rearranged during Transfection) proto-oncogene are responsible for the occurrence of the familial and sporadic types, respectively. Calcitonin is a key marker in MTC diagnose and has been demonstrated to be highly sensitive for differential diagnosis prognostic assessment, follow-up and evaluation of MTC treatment. The aim of this study was to investigate the relationship between plasma levels of calcitonin in MTC patients with or without RET mutation.
Methods: In this cross-sectional study, the population consist of MTC patients who have referred to the endocrine and metabolism research center of Shahid Beheshti University of medical sciences since October 2013 till October 2016. Genomic DNA was extracted from peripheral blood leucocytes using the standard salting out/proteinase K method. Nucleotide change detection in exons 10 and 11 was performed using polymerase chain reaction (PCR) and direct DNA sequencing methods. Participants were then divided into two groups with or without mutation (43 individuals in each group). Plasma calcitonin levels were determined by enzyme-linked immunosorbent assay (ELISA) method in both groups.
Results: Evaluation of the level of plasma calcitonin in 43 patients with a molecular mutation in RET proto-oncogene (mean age 31 years) and 43 patients without molecular mutations in RET proto-oncogene (mean age 43 years) were 7.6 pmol/mL and 3.07 pmol/mL respectively. This difference is statistically significant (P=0.0014).
Conclusion: Routine measurement of calcitonin has been investigated as a screening method for the diagnosis of medullary thyroid carcinoma patients. Nevertheless, additional data are required to definitely support routine measurement of calcitonin due to the role of RET proto-oncogene.
Methods: In this cross-sectional study, the population consist of MTC patients who have referred to the endocrine and metabolism research center of Shahid Beheshti University of medical sciences since October 2013 till October 2016. Genomic DNA was extracted from peripheral blood leucocytes using the standard salting out/proteinase K method. Nucleotide change detection in exons 10 and 11 was performed using polymerase chain reaction (PCR) and direct DNA sequencing methods. Participants were then divided into two groups with or without mutation (43 individuals in each group). Plasma calcitonin levels were determined by enzyme-linked immunosorbent assay (ELISA) method in both groups.
Results: Evaluation of the level of plasma calcitonin in 43 patients with a molecular mutation in RET proto-oncogene (mean age 31 years) and 43 patients without molecular mutations in RET proto-oncogene (mean age 43 years) were 7.6 pmol/mL and 3.07 pmol/mL respectively. This difference is statistically significant (P=0.0014).
Conclusion: Routine measurement of calcitonin has been investigated as a screening method for the diagnosis of medullary thyroid carcinoma patients. Nevertheless, additional data are required to definitely support routine measurement of calcitonin due to the role of RET proto-oncogene.
Elham Shakiba , Monireh Movahedi , Ahmad Majd , Mehdi Hedayati ,
Volume 75, Issue 12 (3-2018)
Volume 75, Issue 12 (3-2018)
Abstract
Thyroid cancer is one of the most common endocrine malignancies and in the last two decades the number of involved people in the world has been increased. Thyroid cancer in Iran is the seventh most common cancer in women and 14th in men. In recent years many achievements regarding to molecular pathogenic factors such as the substantial role of signaling pathways and molecular abnormalities have been made. Nowadays there is no efficient treatment for progressed thyroid cancer that does not respond to radioiodine therapy which are included poorly differentiated, anaplastic and metastatic or recurrent differentiated thyroid cancer. Although the results of some clinical trials in phase II for treatment of progressed thyroid cancer are rewarding but none of the treated patients responded to treatment and only a few of them responded partially to the treatment which indicates that the treatment can only control the condition of patients with advanced disease, therefore it is needed to consider other alternative solutions which would be helpful in controlling the disease. Epigenetic is referred to study of heritable changes in gene expression without changes in primary DNA sequence. The main mechanisms of genetic and epigenetic alterations are including mutations, increasing the gene copy number and aberrant gene methylation. Epigenetic defects are prevalent in different types of cancers. Aberrant methylation of genes that control cell proliferation and invasion (p16INK4A, RASSF1A, PTEN, Rap1GAP, TIMP3, DAPK, RARβ2, E-cadherin, and CITED1), as well as specific genes involved in differentiation of thyroid cancer (Na+/I- symport, TSH receptor, pendrin, SL5A8, and TTF-1) in association with genetic alterations, leads to tumor progression. Growing evidence shows that acquired epigenetic abnormalities participate with genetic alterations to cause altered patterns of gene expression or function. Many of these molecular changes can be used as molecular markers for prognosis, diagnosis and new therapeutic targets for thyroid cancer. This article is about the most common genetic and epigenetic alterations in thyroid cancer which can be complementary together in recognition of new treatments for the disease.
Malihe Hasanzadeh , Mina Baradaran Khalkhale , Akram Behroznea, Leila Musavi ,
Volume 75, Issue 12 (3-2018)
Volume 75, Issue 12 (3-2018)
Abstract
Background: Graves' disease is the most common cause (85% of all cases) of thyrotoxicosis in women in childbearing age. Many of the symptoms are similar to hyper-metabolic status during pregnancy. The cause of the disease is autoantibodies that stimulate the thyroid-stimulating hormone (TSH) receptor. Hyperthyroidism is uncommon in pregnancy and its prevalence is 0.1-%0.4. In this paper we introduce a patient who was admitted with a primary diagnosis of pulmonary embolism and treatment with final diagnosis of thyroid storm and was discharged with good condition.
Case presentation: In the first pregnancy of a 29-year-old woman with gestation age of 31 weeks was referred to obstetric emergency unit Ghaem Hospital, Mashhad, Iran in March 2015. She had Grave’s disease in her past medical history which was treated with methimazole before pregnancy and propylthiouracil (PTU) during pregnancy. In admission, she presented with tachycardia and tachypnea and hypertension and lower extremity edema. During pregnancy, she used propantheline instead of propylthiouracil due to pharmacy mistake. She admitted in Intensive care unit. After rule out of pulmonary embolism, ultrasonography showed a fetus with 30 weeks of gestational age with an approximate weight of 1680 grams. The amniotic fluid was reduced. She was treated with thyroid storm diagnosis due to a medication error. In serial obstetric visits fetal heart rate was not detected. Due to the fetal death, the pregnancy was terminated. Hyperthyroid therapy continued with PTU after delivery. She was discharged with a good general condition.
Conclusion: Despite the rarity of thyroid storm during pregnancy, in the event of unstable hemodynamic condition and cardiac dysfunction in pregnant women, rule out of thyroid disorders should be considered. Clinician should be paid attention to past drug history and underline disease of patient.
Case presentation: In the first pregnancy of a 29-year-old woman with gestation age of 31 weeks was referred to obstetric emergency unit Ghaem Hospital, Mashhad, Iran in March 2015. She had Grave’s disease in her past medical history which was treated with methimazole before pregnancy and propylthiouracil (PTU) during pregnancy. In admission, she presented with tachycardia and tachypnea and hypertension and lower extremity edema. During pregnancy, she used propantheline instead of propylthiouracil due to pharmacy mistake. She admitted in Intensive care unit. After rule out of pulmonary embolism, ultrasonography showed a fetus with 30 weeks of gestational age with an approximate weight of 1680 grams. The amniotic fluid was reduced. She was treated with thyroid storm diagnosis due to a medication error. In serial obstetric visits fetal heart rate was not detected. Due to the fetal death, the pregnancy was terminated. Hyperthyroid therapy continued with PTU after delivery. She was discharged with a good general condition.
Conclusion: Despite the rarity of thyroid storm during pregnancy, in the event of unstable hemodynamic condition and cardiac dysfunction in pregnant women, rule out of thyroid disorders should be considered. Clinician should be paid attention to past drug history and underline disease of patient.
Manijeh Jamshidi , Ahmad Naghibzadeh-Tahami, Elham Maleki, Vahidreza Borhaninejad, Hosniyeh Alizadeh , Mehrdad Farokhnia , Salman Daneshi,
Volume 76, Issue 3 (6-2018)
Volume 76, Issue 3 (6-2018)
Abstract
Background: According to the direct connection between congenital hypothyroidism and iodine deficiency in pregnant women, also relatively high incidence of congenital hypothyroidism in some areas of Kerman province, especially Raver district located in North of Kerman province, this study was performed to determine and compare the urinary iodine concentration (UIC) in pregnant women referring to health centers.
Methods: This cross-sectional study was done during March 2014 and May 2015. Inclusion and exclusion criteria to be considered and UIC were measured by spectrophotometry in 384 and 374 pregnant women in Ravar and Kerman cities, Iran. Sampling method for this study was all of pregnant women in Ravar and random stratified sampling in Kerman. data were collected using a structured questionnaire. All statistical analyses were performed using SPSS Software, version 20.0 (IBM SPSS, Armonk, NY, USA). Chi-square test, Pearson's correlation coefficient and Logistic regression were used for associations and differences.
Results: The mean UIC was 200.21 µg/L in pregnant women of Ravar and 238.79 µg/L in pregnant women of Kerman. 22.7% of pregnant women were with low concentrations of iodine, 57.8% within the normal range and 19.5 percent were with high iodine concentrations in Ravar. While 5.3 percent of pregnant women were with low concentrations of iodine, 54.5% were within the normal range and 40.1% were with high UIC in Kerman. There were no significant differences between demographic variables and UIC in the two regions (P> 05/0). Multivariate regression models showed significant connections between the residence and UIC pregnant women (P< 0.001).
Conclusion: The results of this study showed that UIC in pregnant women of Ravar was significantly lower than Kerman and the place of living can be considered as a predictor of UIC in pregnant women.
Methods: This cross-sectional study was done during March 2014 and May 2015. Inclusion and exclusion criteria to be considered and UIC were measured by spectrophotometry in 384 and 374 pregnant women in Ravar and Kerman cities, Iran. Sampling method for this study was all of pregnant women in Ravar and random stratified sampling in Kerman. data were collected using a structured questionnaire. All statistical analyses were performed using SPSS Software, version 20.0 (IBM SPSS, Armonk, NY, USA). Chi-square test, Pearson's correlation coefficient and Logistic regression were used for associations and differences.
Results: The mean UIC was 200.21 µg/L in pregnant women of Ravar and 238.79 µg/L in pregnant women of Kerman. 22.7% of pregnant women were with low concentrations of iodine, 57.8% within the normal range and 19.5 percent were with high iodine concentrations in Ravar. While 5.3 percent of pregnant women were with low concentrations of iodine, 54.5% were within the normal range and 40.1% were with high UIC in Kerman. There were no significant differences between demographic variables and UIC in the two regions (P> 05/0). Multivariate regression models showed significant connections between the residence and UIC pregnant women (P< 0.001).
Conclusion: The results of this study showed that UIC in pregnant women of Ravar was significantly lower than Kerman and the place of living can be considered as a predictor of UIC in pregnant women.
Ziba Aghsaiefard , Ziba Hossenifard , Reza Alizadeh , Tayeb Ramim ,
Volume 76, Issue 4 (7-2018)
Volume 76, Issue 4 (7-2018)
Abstract
Background: The role of high levels of parathyroid hormone in the development of anemia either directly or by mediating mechanisms is unclear, and there is a controversy about the pathophysiological role of parathyroid hormone (PTH) in the development and intensification of anemia associated with renal disease. The aim of this study was to investigate the relationship between anemia and parathyroid hormone and dialysis adequacy in chronic hemodialysis patients.
Methods: A cross-sectional study was performed in patients undergoing dialysis in Soodeh Hemodialysis Center, Vavan city, Tehran province, Iran, in two years (September 2013 to September 2015). Patients with age>18 years who underwent dialysis for at least three months were enrolled. Anemia was calculated based on the absolute amount of hemoglobin, hematocrit, and the percentage of patients who achieved the hemoglobin treatment goal of more than 11 g/dL. Parathyroid hormone levels were measured intact PTH and enzyme immunoassay (EIA) method.
Results: 176 patients who had entry criteria participated in this study. Patients included 102 males (58%) and 74 women (42%). The mean age of the patients was 54.14±13.98 years (18-85 years). The mean weight of patients was 68.07±14.17 kg (36-120 kg). 23 (13.1%) of the patients had a previous history of kidney transplantation. Of the 176 patients, only one had a history of parathyroidectomy (0.6%). The mean dialysis time in the patients was 6.38±5.29 years (1-28 years). The type of dialysis access in 132 patients (75%) was AV fistula and in 44 patients (25%) was Shaldon catheter. The mean erythropoietin intake of patients was 10,000 units per week. The mean of hemoglobin, hematocrit and PTH were 10.73 g/dl 33.6% and 403 pg/ml, respectively.
Conclusion: The findings of the study showed that there was no significant correlation between hemoglobin and hematocrit levels with parathyroid hormone levels and dialysis adequacy. Increased levels of serum iron, total iron binding capacity (TIBC) and resistance to erythropoietin were associated with a decrease in hematocrit levels due to decreased hemoglobin levels and resistance to erythropoietin.
Methods: A cross-sectional study was performed in patients undergoing dialysis in Soodeh Hemodialysis Center, Vavan city, Tehran province, Iran, in two years (September 2013 to September 2015). Patients with age>18 years who underwent dialysis for at least three months were enrolled. Anemia was calculated based on the absolute amount of hemoglobin, hematocrit, and the percentage of patients who achieved the hemoglobin treatment goal of more than 11 g/dL. Parathyroid hormone levels were measured intact PTH and enzyme immunoassay (EIA) method.
Results: 176 patients who had entry criteria participated in this study. Patients included 102 males (58%) and 74 women (42%). The mean age of the patients was 54.14±13.98 years (18-85 years). The mean weight of patients was 68.07±14.17 kg (36-120 kg). 23 (13.1%) of the patients had a previous history of kidney transplantation. Of the 176 patients, only one had a history of parathyroidectomy (0.6%). The mean dialysis time in the patients was 6.38±5.29 years (1-28 years). The type of dialysis access in 132 patients (75%) was AV fistula and in 44 patients (25%) was Shaldon catheter. The mean erythropoietin intake of patients was 10,000 units per week. The mean of hemoglobin, hematocrit and PTH were 10.73 g/dl 33.6% and 403 pg/ml, respectively.
Conclusion: The findings of the study showed that there was no significant correlation between hemoglobin and hematocrit levels with parathyroid hormone levels and dialysis adequacy. Increased levels of serum iron, total iron binding capacity (TIBC) and resistance to erythropoietin were associated with a decrease in hematocrit levels due to decreased hemoglobin levels and resistance to erythropoietin.
Saeed Nouri , Anahita Zoghi , Mohammad Reza Sharif , Najla Farhang , Maziar Shojaei ,
Volume 76, Issue 7 (10-2018)
Volume 76, Issue 7 (10-2018)
Abstract
Background: Each toxic agent results in unique presentations, depending on what neurophysiological changes occur following exposure. Scientific understanding of lead toxicity in the organ systems and at low levels of exposure continues to evolve. However, effects of lead poisoning on the thyroid gland function are controversial. In this descriptive study, changes in thyroid hormones in patients with lead poisoning were compared with patients with opioid addiction and healthy individual who were matched for age and sex.
Methods: In this descriptive study, which was conducted from March 2016 to February 2017 in Loghman Hakim Hospital in Tehran, ninety patients were evaluated using convenient sampling method for lead and thyroid hormones levels. The levels of lead and thyroid hormones were evaluated using standard laboratory method, in thirty male patients with lead poisoning, thirty male patients with opioid addiction referring to addiction treatment center and thirty healthy male referring to a blood donation center who were matched for age. Thyroid function parameters in patients with lead toxicity were compared with those of control groups.
Results: The lead level in the lead toxicity group was 57.5±23.5 µg/dl, in the first control group with opium addiction 7.8±3.8 µg/dl and in the healthy male referring to a blood donation center, 5.9±9 µg/dl. Thyroid stimulating hormone (TSH) was significantly lower in patients with lead poisoning (0.2±0.01 Milli-International Units Per Liter (mIU/L) than in the patients with opioid addiction (2.4±1/05 mIU/L) and healthy male referring to a blood donation center (2.3±0.01 mIU/L) (P= 0.04), and thyroxine hormone (T4) was significantly higher in patients with lead poisoning (17.8±2.6 µg/dl) than in the patients with opioid addiction (8.8±1/9 µg/dl) and healthy male referring to a blood donation center (7.4±3.5 µg/dl) (P= 0.02).
Conclusion: Lead toxicity has an effect on thyroid function and it reduces thyroid stimulating hormone and increases thyroxin levels. Clinicians should be aware of the potential hazardous effects of lead on the thyroid and mechanisms through which lead causes these effects on thyroid function need to be elucidated.
Methods: In this descriptive study, which was conducted from March 2016 to February 2017 in Loghman Hakim Hospital in Tehran, ninety patients were evaluated using convenient sampling method for lead and thyroid hormones levels. The levels of lead and thyroid hormones were evaluated using standard laboratory method, in thirty male patients with lead poisoning, thirty male patients with opioid addiction referring to addiction treatment center and thirty healthy male referring to a blood donation center who were matched for age. Thyroid function parameters in patients with lead toxicity were compared with those of control groups.
Results: The lead level in the lead toxicity group was 57.5±23.5 µg/dl, in the first control group with opium addiction 7.8±3.8 µg/dl and in the healthy male referring to a blood donation center, 5.9±9 µg/dl. Thyroid stimulating hormone (TSH) was significantly lower in patients with lead poisoning (0.2±0.01 Milli-International Units Per Liter (mIU/L) than in the patients with opioid addiction (2.4±1/05 mIU/L) and healthy male referring to a blood donation center (2.3±0.01 mIU/L) (P= 0.04), and thyroxine hormone (T4) was significantly higher in patients with lead poisoning (17.8±2.6 µg/dl) than in the patients with opioid addiction (8.8±1/9 µg/dl) and healthy male referring to a blood donation center (7.4±3.5 µg/dl) (P= 0.02).
Conclusion: Lead toxicity has an effect on thyroid function and it reduces thyroid stimulating hormone and increases thyroxin levels. Clinicians should be aware of the potential hazardous effects of lead on the thyroid and mechanisms through which lead causes these effects on thyroid function need to be elucidated.
Marjan Ghorbani-Anarkooli , Sara Dabirian, Hasan Moladoust, Adib Zendedel, Mohammad Hadi Bahadori,
Volume 77, Issue 1 (4-2019)
Volume 77, Issue 1 (4-2019)
Abstract
Background: Evaluation of cell viability is momentous in pharmacologic and oncological research. Cell viability evaluation determines cell sensitivity and consequently treatment outcome. Various methods are available to determine cell survival. Each of these methods evaluates different endpoints. Accordingly, determining the correlation between these methods is important. In this study, in order to determine the viability of human anaplastic thyroid cancer cell line, the sensitivity of MTT [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide] assay, trypan blue test and clonogenic assay were compared.
Methods: This experimental study was performed in the Cellular and Molecular Research Center at Guilan University of Medical Sciences, Rasht, Iran from October 2016 to March 2017. The human anaplastic thyroid cancer cell line was cultured in Dulbecco's modified Eagle's medium (DMEM) with 10% fetal bovine serum (FBS). The cultured cells were treated with melatonin, for 24 hours. Then, the viability of the cells was evaluated by MTT assay, trypan blue test and clonogenic assay. Furthermore, plating efficiency and surviving fraction were used in order to draw survival curve in the clonogenic assay.
Results: The concentration of melatonin at IC50 point was 4.794±0.117 millimolar (mM) in MTT assay, 4.375±0.894 mM in trypan blue test and 2.246±0.326 mM in clonogenic assay. Comparing the IC50 values of these test revealed that C50 values obtained from MTT assay and trypan blue test had no significant difference (P=0.6446), while there was a significant difference between IC50 values obtained from MTT and clonogenic assays (P=0.0032). Moreover, the IC50 values obtained from trypan blue test and clonogenic assay were also significantly different (P=0.0078). The results of the regression analysis of cell viability were shown a linear, positive and significant correlation between these three methods and MTT assay and trypan blue test showed higher correlation (r=0.99, P<0.001).
Conclusion: Based on our results, all these methods were effective to identify cytotoxicity in human anaplastic thyroid cancer cell line, while MTT assay and trypan blue test were more sensitive than clonogenic assay.
Methods: This experimental study was performed in the Cellular and Molecular Research Center at Guilan University of Medical Sciences, Rasht, Iran from October 2016 to March 2017. The human anaplastic thyroid cancer cell line was cultured in Dulbecco's modified Eagle's medium (DMEM) with 10% fetal bovine serum (FBS). The cultured cells were treated with melatonin, for 24 hours. Then, the viability of the cells was evaluated by MTT assay, trypan blue test and clonogenic assay. Furthermore, plating efficiency and surviving fraction were used in order to draw survival curve in the clonogenic assay.
Results: The concentration of melatonin at IC50 point was 4.794±0.117 millimolar (mM) in MTT assay, 4.375±0.894 mM in trypan blue test and 2.246±0.326 mM in clonogenic assay. Comparing the IC50 values of these test revealed that C50 values obtained from MTT assay and trypan blue test had no significant difference (P=0.6446), while there was a significant difference between IC50 values obtained from MTT and clonogenic assays (P=0.0032). Moreover, the IC50 values obtained from trypan blue test and clonogenic assay were also significantly different (P=0.0078). The results of the regression analysis of cell viability were shown a linear, positive and significant correlation between these three methods and MTT assay and trypan blue test showed higher correlation (r=0.99, P<0.001).
Conclusion: Based on our results, all these methods were effective to identify cytotoxicity in human anaplastic thyroid cancer cell line, while MTT assay and trypan blue test were more sensitive than clonogenic assay.
Atiyeh Vatanchi, Narjess Ayati , Susan Shafiei , Farzane Ashourzade , Leila Purali , Seyed Rasoul Zakavi ,
Volume 77, Issue 7 (10-2019)
Volume 77, Issue 7 (10-2019)
Abstract
Background: Differentiated thyroid cancer (DTC) frequently occurs in women at fertility age. One of the cornerstones in treating this malignancy is Radioactive Iodine (RAI) therapy following thyroid resection. In this study, we evaluated the effect of RAI therapy on the fertility rate and pregnancy complications.
Methods: This is a retrospective study on 41 patients with differentiated thyroid cancer, with at least one experience of pregnancy after standard treatment (thyroid resection followed by radioiodine therapy). All patients have been signed a written consent form in initial admission to our department. Furthermore, we asked our patients to fill in a questionnaire about their thyroid cancer and its treatment as well as pregnancy and its complication. As a control group with no different mean age, the same checklist has also been filled in for the patient’s healthy sister too, just related to gravidity and its complications. The complications of pregnancy were registered in these patients and compared with the control group consisted of their healthy sisters. Also, the association of abortion rate with other underlying factors has been assessed. All data has been included in SPSS software, version 22 (IBM SPSS, Armonk, NY, USA) and analyzed using logistic regression. This study conducted at the Nuclear Medicine Department of Ghaem Hospital in Mashhad, from May 2017 to February 2018 with the support of Mashhad University of Medical Sciences, Iran.
Results: No significant difference was noted in the mean age between case (differentiated thyroid cancer) and control groups (P=0.9). The two groups were also statistically similar in terms of pregnancy frequency (P=0.05) and number of alive children (P=0.8). Abortion seems to be the only item in DTC patients which was more than healthy sisters (0.2 versus 0.7) (P=0.003). However, this statistical difference showed no direct relationship with radioiodine treatment (RIT). As in DTC patients before and after RIT, no significant difference has been detected in DTC patients before and after RIT (P=0.48). Birth weight was not statistically different in DTC patients before and after RIT (P=0.66) and between DTC patients and their healthy sisters (P=0.2).
Conclusion: Radioiodine therapy for differentiated thyroid carcinoma has no considerable negative impact on pregnancy, whether on fertility rate or on gravity complications.
Methods: This is a retrospective study on 41 patients with differentiated thyroid cancer, with at least one experience of pregnancy after standard treatment (thyroid resection followed by radioiodine therapy). All patients have been signed a written consent form in initial admission to our department. Furthermore, we asked our patients to fill in a questionnaire about their thyroid cancer and its treatment as well as pregnancy and its complication. As a control group with no different mean age, the same checklist has also been filled in for the patient’s healthy sister too, just related to gravidity and its complications. The complications of pregnancy were registered in these patients and compared with the control group consisted of their healthy sisters. Also, the association of abortion rate with other underlying factors has been assessed. All data has been included in SPSS software, version 22 (IBM SPSS, Armonk, NY, USA) and analyzed using logistic regression. This study conducted at the Nuclear Medicine Department of Ghaem Hospital in Mashhad, from May 2017 to February 2018 with the support of Mashhad University of Medical Sciences, Iran.
Results: No significant difference was noted in the mean age between case (differentiated thyroid cancer) and control groups (P=0.9). The two groups were also statistically similar in terms of pregnancy frequency (P=0.05) and number of alive children (P=0.8). Abortion seems to be the only item in DTC patients which was more than healthy sisters (0.2 versus 0.7) (P=0.003). However, this statistical difference showed no direct relationship with radioiodine treatment (RIT). As in DTC patients before and after RIT, no significant difference has been detected in DTC patients before and after RIT (P=0.48). Birth weight was not statistically different in DTC patients before and after RIT (P=0.66) and between DTC patients and their healthy sisters (P=0.2).
Conclusion: Radioiodine therapy for differentiated thyroid carcinoma has no considerable negative impact on pregnancy, whether on fertility rate or on gravity complications.
Alireza Rai, Shirin Alord , Parisa Janjani , Siros Norozi ,
Volume 77, Issue 9 (12-2019)
Volume 77, Issue 9 (12-2019)
Abstract
Background: Nowadays, cardiovascular diseases (CVDs) are among the most common causes of mortalities worldwide. Parathyroid hormone (PTH) has an important role in the pathogenesis of CVDs. The aim of the current study was to compare serum PTH levels between patients with acute myocardial infarction (MI), unstable angina, and normal coronary function.
Methods: This descriptive and analytic study was performed on patients with acute MI, unstable angina, and normal coronary function visiting Imam Ali Hospital of Kermanshah city in Iran, during years 2016 to 2017. Data collection was done from December 2017 to March 2018. Of the patients who met inclusion criteria, 120 were selected by accessible sampling and were allocated into three groups. Serum level of PTH was determined in the three groups.
Results: Among the studied subjects, females and males comprised 43 (35.8%) and 77 (64.2%) respectively. Among those with normal coronary function, 22 (55%) and 18 (45%) were females and males respectively. In acute MI group, women and men comprised 8 (20%), and 32 (80%) respectively. Finally, males and females constituted 13 (32.5%) and 27 (67.5%) in unstable angina group. Based on this study, the overall mean serum PTH level was obtained 18.32 pg/ml. The highest PTH level was observed in individuals with normal coronary function, while the lowest level was recorded in patients with unstable angina. There was a significant difference in mean serum parathyroid hormone levels between the study groups in those with no history of smoking.
Conclusion: Our results indicated that parathyroid hormone serum level can be associated with cardiovascular diseases including unstable angina. There were significant differences in the means of parathyroid hormone level between the studied groups depending on the presence or absence of hyperlipidemia. In vitro evaluation of parathyroid hormone level in suspected subjects should be performed in the case of myocardial infarction, unstable angina and normal coronary, prevented from these diseases by testing.
Methods: This descriptive and analytic study was performed on patients with acute MI, unstable angina, and normal coronary function visiting Imam Ali Hospital of Kermanshah city in Iran, during years 2016 to 2017. Data collection was done from December 2017 to March 2018. Of the patients who met inclusion criteria, 120 were selected by accessible sampling and were allocated into three groups. Serum level of PTH was determined in the three groups.
Results: Among the studied subjects, females and males comprised 43 (35.8%) and 77 (64.2%) respectively. Among those with normal coronary function, 22 (55%) and 18 (45%) were females and males respectively. In acute MI group, women and men comprised 8 (20%), and 32 (80%) respectively. Finally, males and females constituted 13 (32.5%) and 27 (67.5%) in unstable angina group. Based on this study, the overall mean serum PTH level was obtained 18.32 pg/ml. The highest PTH level was observed in individuals with normal coronary function, while the lowest level was recorded in patients with unstable angina. There was a significant difference in mean serum parathyroid hormone levels between the study groups in those with no history of smoking.
Conclusion: Our results indicated that parathyroid hormone serum level can be associated with cardiovascular diseases including unstable angina. There were significant differences in the means of parathyroid hormone level between the studied groups depending on the presence or absence of hyperlipidemia. In vitro evaluation of parathyroid hormone level in suspected subjects should be performed in the case of myocardial infarction, unstable angina and normal coronary, prevented from these diseases by testing.
Safura Pakizehkar, Samaneh Hosseinzadeh, Majid Valizadeh, Mahdi Hedayati,
Volume 79, Issue 3 (6-2021)
Volume 79, Issue 3 (6-2021)
Abstract
The presence of the antibodies against the main thyroid antigens, which include thyroid peroxidase (TPO) or microsomal antigen, thyroglobulin (Tg) as well as thyrotropin receptor or Thyroid Stimulating Hormone Receptor (TSH-R), is a hallmark and symbol of the autoimmune thyroid diseases (AITDs) as one of the most common autoimmune diseases (AD) around the world. The prevalence of the thyroid peroxidase antibodies (anti-TPO antibody) and the thyroglobulin antibodies (anti-Tg antibody) is considerably higher in patients suffering from Graves’ disease (GD) and Hashimoto's thyroiditis (HT, chronic autoimmune thyroiditis, autoimmune hypothyroidism). While the TSH receptor antibodies (TRAbs) are common in the patients suffering from GD, they are relatively rare and infrequent in HT patients. This fact may indicate that TRAbs are more specific than other antibodies. In fact, TRAbs as one of the most important autoantibodies against the different thyroid antigens, are a set of the heterogeneous group of antibodies that based on the function, fall into three categories, including TSHR-stimulating antibodies (TSAbs), TSHR-blocking antibodies (TBAbs), and the neutral antibodies (no effect on receptor). TSAbs and TBAbs result in overproduction and reduction of intracellular cAMP respectively. Therefore the induction of the relevant signaling pathways can be the cause of different clinical symptoms in the form of hyperthyroidism or hypothyroidism consecutively. The extra-thyroidal effects of TRAbs as the extra-thyroid GD manifestations, such as ophthalmopathy and dermopathy, often have an effect on the eyes as well as the skin with the relatively well-known immunological mechanisms of the antibodies functions. Hashimoto encephalopathy is an extra-thyroidal effects of anti-TPO that provokes the central nervous system. On the other hand, anti-TPO like anti-Tg can affect the reproductive organs of women and lead to infertility by an unknown mechanism. Moreover, the circulating antibodies against the thyroid antigens can also be detected in other autoimmune diseases such as rheumatoid arthritis (RA), type I diabetes (T1DM) and celiac disease (CD). In this review article, the most important types of thyroid autoantibodies, their essential immunological processes in AITD as well as the main and important clinical extra-thyroidal manifestations of them have been discussed and reviewed.
Samaneh Hosseinzadeh, Safura Pakizehkar,
Volume 79, Issue 11 (2-2022)
Volume 79, Issue 11 (2-2022)
Abstract
Medullary thyroid cancer accounts for 5-10% of thyroid carcinomas. RET proto-oncogene mutations occur in all of the hereditary MTCs and about 66% of the sporadic MTCs. So, the detection of the RET mutations is necessary for rapid and proper diagnosis and treatment. This systematic review seeks to find a comprehensive list of RET gene mutations in the diagnosis of medullary thyroid cancer.
The previous studies on RET proto-oncogene mutations in the diagnosis of medullary thyroid cancer were searched in the major databases including PubMed, Scopus, Medline, Embase and NCBI between 2010 and 2021.
Missense mutations in exons 10, 11, 13, 14, 15, and 16 of the RET proto-oncogene have the highest frequency in MTCs. The most common mutations in FMTC, are in codons 609, 611, 618, and 620 in exon 10, codon 768 in exon 13, codon 804 in exon 14, and codon 634 in exon 11. In the case of MEN2A, RET gene mutations have been observed in exons 5, 8, 10, 11, with the highest mutations in exons 10 (codons 609, 611, 618, and 620) and exon 11 (codons 630 and 634). Moreover, M918T mutation in exon 16 and A883F mutation in exon 15 have been detected in 95% and 5% of the patients with MEN2B respectively. In the case of MTC, the M918T mutation in exon 16 is the most common mutation, which is associated with a poor prognosis. RET genetic screening is crucial for an exact approach to the diagnosis and treatment of MTC. Anyone with MTC, even without a family history of MEN2, should be genetically tested for the RET mutations to confirm or rule out the inherited disease and, if necessary, preventive thyroidectomy. This systematic review provided a comprehensive list of the reported mutations in the RET gene for the diagnosis of medullary thyroid cancer.
Behzad Hatami , Saeed Abdi , Hosein Noori, Hamid Mehrad,
Volume 80, Issue 1 (4-2022)
Volume 80, Issue 1 (4-2022)
Abstract
Background: Exposure to lead, damages vital organs and is now a global concern. Toxic effects of lead on the liver and thyroid gland have been mentioned previously, sometimes with conflicting results. Therefore, the present study aimed to assess changes in liver and thyroid function tests in patients with lead poisoning.
Methods: This case-control study was performed on 100 patients with clinical evidence of lead poisoning who were referred to Loghman-e-Hakim hospital in Tehran from April to December 2018. Also, another 100 participants with the matched sex and age, a history of opium use, and exposure to lead or non-work-related metals, and with normal lead levels, were considered as a control group. Demographic information was collected by a trained researcher by reviewing hospital records or interviewing participants. To monitor lead levels in the control group, 5 ml of venous blood was collected from the antecubital vein at 7 to 8 am in sterile tubes containing EDTA as an anticoagulant. Serum lead levels were assessed by GBC Avanta atomic absorption spectrophotometer. Values in the two groups were compared. SPSS version 16 (SPSS Inc. Chicago, Il, The USA) was used for data analysis. A P-value below 0.05 was considered statistically significant.
Results: The mean level of serum lead in case and control groups were 63.0±12.4 μg/dL and 6.0±2.1 μg/dL, respectively with a statistically significant difference (p<0.001). However, Alkaline phosphatase (ALKp), aspartate aminotransferase (AST) and alanine aminotransferase (ALT) enzymes were significantly higher in cases compared to controls (p<0.001). The thyroid-stimulating hormone in patients with lead poisoning (0.3±0.04 MIU/L) was significantly lower than those in the control group (2.5±1.23) (P=0.04).
Methods: This case-control study was performed on 100 patients with clinical evidence of lead poisoning who were referred to Loghman-e-Hakim hospital in Tehran from April to December 2018. Also, another 100 participants with the matched sex and age, a history of opium use, and exposure to lead or non-work-related metals, and with normal lead levels, were considered as a control group. Demographic information was collected by a trained researcher by reviewing hospital records or interviewing participants. To monitor lead levels in the control group, 5 ml of venous blood was collected from the antecubital vein at 7 to 8 am in sterile tubes containing EDTA as an anticoagulant. Serum lead levels were assessed by GBC Avanta atomic absorption spectrophotometer. Values in the two groups were compared. SPSS version 16 (SPSS Inc. Chicago, Il, The USA) was used for data analysis. A P-value below 0.05 was considered statistically significant.
Results: The mean level of serum lead in case and control groups were 63.0±12.4 μg/dL and 6.0±2.1 μg/dL, respectively with a statistically significant difference (p<0.001). However, Alkaline phosphatase (ALKp), aspartate aminotransferase (AST) and alanine aminotransferase (ALT) enzymes were significantly higher in cases compared to controls (p<0.001). The thyroid-stimulating hormone in patients with lead poisoning (0.3±0.04 MIU/L) was significantly lower than those in the control group (2.5±1.23) (P=0.04).
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Conclusion: Lead poisoning could potentially damage liver function and elevate liver enzymes. Moreover, it can also affect the levels of TSH and levothyroxine. Understanding the exact mechanisms might help to control The hepatotoxic effects of lead in patients. Also, knowing the pattern of elevated liver enzymes and thyroid hormones changes might help discriminate lead poisoning with other differential diagnoses.
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Fariba Zarei , Mohammadreza Sasani, Banafsheh Zeinali-Rafsanjani , Mahdi Saeedi-Moghadam ,
Volume 80, Issue 7 (10-2022)
Volume 80, Issue 7 (10-2022)
Abstract
Background: Fine needle aspiration biopsy (FNAB) is usually used to distinguish the malignant and benign nodules. Applying a biopsy needle evokes a sense of fear and pain in the patients. Although some studies refute the usefulness of local anesthesia (LA) prior to fine needle aspiration biopsy, it is still debatable. This prospective cross-sectional study intended to evaluate the effect of LA prior to fine needle aspiration biopsy on pain and anxiety considering nodule size.
Methods: Amongst the patients who were referred to Shiraz Shahid Fagihi Hospital for Thyroid fine needle aspiration biopsy from August 2017 to January 2018, 114 patients participated in this study. LA was performed for 41 patients, and 73 underwent the thyroid nodule fine needle aspiration biopsy without LA. Patients' pain and anxiety were scored using the visual-analog-score and Spielberger anxiety scale. The nodules were categorized into five groups. Pain and anxiety of patients were compared considering their nodule sizes to assess the effects of LA in the reduction of pain and anxiety considering the nodule size.
Methods: Amongst the patients who were referred to Shiraz Shahid Fagihi Hospital for Thyroid fine needle aspiration biopsy from August 2017 to January 2018, 114 patients participated in this study. LA was performed for 41 patients, and 73 underwent the thyroid nodule fine needle aspiration biopsy without LA. Patients' pain and anxiety were scored using the visual-analog-score and Spielberger anxiety scale. The nodules were categorized into five groups. Pain and anxiety of patients were compared considering their nodule sizes to assess the effects of LA in the reduction of pain and anxiety considering the nodule size.
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Results: The patients undergoing LA had a mean age of 44.69 years old and average body mass index (BMI) of 26.7, the patients who performed thyroid nodule fine needle aspiration biopsy without LA had a mean age of 48.17 years old with an average BMI of 26.0. The patients with the maximum nodule size of<10 mm, experienced more pain during the fine needle aspiration biopsy without LA, but there was no significant difference between the S/T-anxiety of these patients. There was no significant difference between the pain and anxiety scores of the patients with larger nodules.
Conclusion: The more pain experienced by the patients with the smallest nodules can be attributed to the need for more needle manipulation due to the small nodule size and less precision while piercing the needle into the nodule. Thus, it can be suggested that in patients with a small nodule size, less than 10mm, usage of LA prior to fine needle aspiration biopsy can reduce the pain significantly. |
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