Caspian Journal of Internal Medicine
Volume:1 Issue: 1, Winter 2010

Hypothyroidism (HT), a relatively common condition among general population is associated with lipid profile abnormalities. The present study was designed to determine the contributive role of HT in the development of hypercholesterolemia (HCH). One hundred thirty six consecutive patients with HT and 272 euthyroid controls entered the study. Serum total cholesterol (CH) level was determined before and after treatment of HT and compared with controls. Frequency of subjects with HCH defined as plasma total CH level >240 mg/dl, were determined and compared between hypothyroid patients and sex - age-matched controls. The contributive role of HT in the development of HCH was determined by the comparison of pre-treatment and post-treatment CH levels. HT-induced HCH was regarded as restoration of HCh (reduction of CH level to less than 240 (mg/d) after achievement of euthyroid state with thyroid hormone. The mean ages of patients and controls were 43±13 and 44±13 years, respectively. In HT patients the frequency of HCH and mean level of Ch were significantly higher compared with sex and age-matched euthyroid controls. Replacement therapy of 44 HT patients resulted to a significant reduction of CH level from baseline by 22% (p<0.0001) in the whole number of patients, and reduction of 32.2% (p<0.0001) along with the restoration of HCH in 22(50%) patients. Whereas, in 22 patients after achievement of euthyroid state, despite a significant reduction of Ch from baseline (12%, p<0.05), HCH persisted and CH levels remained>240mg/dl. The results show contributive role for HT in the development of HCH. Two different populations of HCH with different responses to replacement therapy is recognizable in HT.

To evaluate the efficacy of adding the glutazone to maximum dose of sulfonylurea and metformin in patients with poorly controlled type 2 diabetes. Ninety six patients with type 2 diabetes who had failed medical therapy with maximal-dosage of metformin and glibenclamide received glutazone. Fasting blood sugar (FBS), 2 hours postprandial (2hpp) glucose, hemoglobin A1C, cholesterol and HDL levels were assessed at baseline three months later. Ninety-six patients with type 2 diabetes (74 women and 22 men) with the mean age of 55.7±9.9 years were studied. Significant reduction was seen in fasting blood sugar (FBS), 2 hours postprandial (2hpp) glucose, hemoglobin A1C and triglyceride levels three months after adding glutazone to therapeutic regimen (p<0.0005). There was not a significant rise in cholesterol and HDL levels before and after the new therapy. The results show that the combination of glutazone, metformin and glibenclamide may result in better control of glycemic status in diabetic patients resistant to oral first-line agents.

Unstable angina and myocardial infarction are developed due to atherosclerosis of coronary arteries. At present, cholestrol, triglyceride, and lipoproteins are the most common risk factors of death. The purpose of this study was to assess the serum levels of LP (a), LDL-C, VLDL-C, HDL-C in cases of unstable angina and myocardial infarction. This study was conducted to compare the serum level of LP (a) with LDL-C, VLDL-C, HDL-C in 218 cases of unstable angina and myocardial infarction who were admitted at the Department of Cardiology of Babol Medical University from October 2004 to October 2005. Serum levels of LP (a) with LDL, VLDL, and HDL in these cases were measured and recorded. Two-hundred-eighteen cases (188 unstable angina, 30 with myocardial infarction) were studied. There were significant differences between serum levels of LDL-C LP (a), cholesterol, HDL-C, in patients with unstable angina and myocardial infarction, but regarding VLDL-C or TG the differences were not significant. The results show that there is a relation to high levels of LDL-C, LP (a), cholesterol, HDL-C, and HDL-C with unstable angina and myocardial infarction. The level of LP (a) in MI subjects was higher than that of unstable angina.

Several regimens of therapy were recommended for the treatment of genital wart with different efficacies. The purpose of this study was to compare the efficacy of podophylin 20% versus trichloroacetic acid 30% in the treatment of genital wart. This randomized clinical study was conducted on 120 cases with genital wart. They randomly received podophylin 20% or trichloroacetic acid 30%. All cases were followed up for 6 months. The efficacy of both regimens of therapy was compared. Among the 60 cases who were treated by podophylin, 56 cases (93.3%) were completely treated. From the 60 cases treated by thricholoracetic, 56 (93.3%) cases were completely treated (p>0.05). The results show that the efficacy of both regimens of therapy are equal.

Blood donation safety is one of the basic goals of the organization of blood transfusion in the world. Self-exclusion and failed options are additional screening tests to routine diagnostic tests which is performed to detect the transmitted infection through blood or blood products. The purpose of this study was to investigate the efficacy of these systems on the improvement of blood donation safety in Sari organization of blood transfusion. A cross- sectional study was carried out using serologic results of donors who used confidential self-exclusion (CSE) and failed system and the results compared with usual donors (as control group). The donors were tested for hepatitis B surface antigen (HBs-Ag), hepatitis C Virus antibody (HCV-Ab) and human immunodeficiency virus (HIV-Ab). The information was obtained from the data bank of Sari organization of blood transfusion, 2005. The blood of 255 (1.5%) and 87 (0.5%) donors out of 17036 were excluded by failed and confidential self-exclusion methods respectively. The percentage of infection among the control group was 3% compared with 3.9% for the failed group and 9.2% for the self-exclusion donors. The findings obtained from this study indicated that the confidential self-exclusion might be a suitable method to improve blood donation safety. It also revealed that it was possible to exclude infected donors at window period.

Dermatophytosis is a very common fungal infection of skin, hair and nail caused by dermatophytes. The purpose of this study was to evaluate the clinical patterns and etiology of dermatophytosis in Babol, Northern Iran. From September 2003 to December 2005, 200 patients with dermatophytosis who were admitted in the dermatology clinic of Babol Medical University were studied. The diagnosis of the fungal infection was performed in both, direct smear and culture. All patients were positive with direct smear and culture. The frequency of the disease was equal between the male (52%, female (48%)). Tinea cruris (24.5%), tinea pedis (20%), tinea corporis (17%), tinea ungium (15.5%), were the most common dermatophytosis. Trichophyton mentagrophyte was the most prevalent species followed by Epidermophyton floccosum. The results show that tinea cruris and tinea pedis were the most common dermatophytosis in our region. Trichophyton mentagrophyte and Epidermophyton floccosum were the most etiologic agents.

Central Nervous System (CNS) relapse in acute lymphoblastic leukemia was significantly decreased due to the use of new chemotherapyeutic agents, Intrathecal chemotherapy and cranial irradiation. The purpose of this study was to compare the effectiveness of intrathecal (IT) CNS chemotherapy alone versus combination of IT chemotherapy with cranial irradiation for prevention of CNS relapse. From 1998 to 2008 ninety eight cases of acute lymphoblastic leukemia (ALL) admitted in Amirkola Children Hospital were enrolled in this study. The chemotherapy regimen was on the basis of protocol of BFM-79. CNS prophylaxis consisted of intrathecal Cytarabin or Methotrexate, in addition to cranial irradiation for patients more than 3 years old. We assessed the incidence of CNC relapses over 10 years of CNS prophylaxis regimen. From ninety eight cases, 53 were females and 45 were males. Twenty six were below 3 years old and seventy two were above 3 years old (p<0.05). For 10 years of study for the 72 cases who were more than 3 years old and had received prophylactic cranial irradiation CNS relapse did not happen. Among the 26 cases below 3 years old who didnot receive prophylactic cranial irradiation CNS relapse for one case happened (3.8%) (p<0.05). The results show that the combination of prophylactic CNS irradiation and intrathecal chemotherapy is effective in prophylaxis of CNS relapse in ALL.

The clinical and pathological evaluation of oral lesions are very important in this field. The purpose of this study was to assess clinico- pathological agreement on 232 cases with oral lesion s. The consecutive files of 232 patients with oral lesions from pathological laboratory archives of Babol Dental faculty and Shahid Beheshti Hospital were reviewed and the data include age, sex and location of lesion, surgeon''s specialization, clinical and histopathological diagnosis were recorded. Frequency of oral lesions and rate of correct clinical diagnoses were evaluated in site of lesions and surgeon''s specialization. Non neoplastic lesions were more common than neoplastic lesions. Soft tissue reactive lesions were the most common oral lesions. The Correct clinical diagnosis in soft tissue and intra-osseous oral lesions was 66.2% and 66.6% respectively. Clinico- pathological agreement cases were seen in oral and maxillofacial surgeons (68.5%), oral medicine specialists (64.27%) and periodontists (61.9%). From 165 selected oral lesions, the histopathological and clinical diagnoses were in agreement in 110 cases (66.6%).The highest percentage of correct clinical diagnosis was found in mucocele (92.3%) (KS= 0.916, SE=0.59) and the lowest was lymphoproliferative lesions 27.3% (KS= 0.378, SE= 0.16).While in all other groups 36-86% of cases were in agreement. The results of this study show that there is a good agreement between the clinical and pathological diagnosis of oral lesions. The most clinico - pathological agreement was seen in mucocele and the lowest was lymphoproliferative disorders.

Lichen planus is a skin disease that rarely involves mucus membrane. Case: In this study, we introduced a rare case of lichen planus of the right vocal cord in a 51- year -old male presented with hoarseness. The lesion started two years ago and the hoarseness became progressive. There were not any lesions found in his buccal mucosa and skin. The biopsy of the lesion showed lichen planus in his right vocal cord. Lichen planus may rarely involve the vocal cord.