Sonographic fatty liver in overweight and obese children, a cross sectional study in Isfahan

Introduction: Children’s obesity is a known health problem in the world and is a strong predictor of obesity in adulthood which increases the incidence of related diseases such as metabolic syndrome. According to the MONIKA project by the World Health Organization (WHO), Iran is one of the seven countries with a high rate of child obesity. Fatty liver is an abnormality related to metabolic syndrome, with higher prevalence in obese children according to some previous studies. This study investigates the presence of Sonographic Fatty Liver (SFL) in Iranian obese children in comparison with normal and overweight children. Material and methods: This was a cross-sectional study on 962 randomly selected children between the ages of 6 to 18 years. The subjects were divided into three groups of normal, overweight and obese based on body mass index (BMI). A questionnaire including demographic and anthropometric characteristics was filled for each one. To detect the presence of SFL all the subjects underwent assessments with ultrasonography by radiologist who was not aware of their BMI. The incidence of SFL was determined based on the ultrasonographic diagnosis criteria. Results: The average age of the children in the study was 12.59 ± 3.25 years. The mean of the liver span in the normal, overweight and obese groups were 111.36 ± 18.73, 121.18 ± 16.63 and 118.21 ± 19.15 respectively. The prevalence of SFL in obese children was 54.4%, which was significantly higher than overweight (10.5%) and normal ones (1%). According to present results, there was no significant difference in prevalence of SFL between sexes. Conclusions: The high rate of detected SFL in obese children in this study suggests that Iranian obese children are at risk of metabolic syndrome. Moreover, the WHO indicated Iran as one of the countries with high rate of obese children. Based on this information, we can conclude that the prevalence of metabolic syndrome and its related non-communicable diseases will be increasing future in . Therefore, it is necessary to develop some plan to control overweight problem including teaching healthy lifestyle in schools and kindergartens as well as mass media.Wstęp: Otyłość u dzieci jest znanym na świecie problemem zdrowotnym oraz silnym czynnikiem prognostycznym wystąpienia otyłości w wieku dorosłym, która zwiększa częstość chorób jej towarzyszących, takich jak zespół metaboliczny. Według projektu Światowej Organizacji Zdrowia (WHO, World Health Organization) MONIKA Iran jest jednym z siedmiu krajów o dużym odsetku dzieci otyłych. Stłuszczenie wątroby jest zaburzeniem towarzyszącym zespołowi metabolicznemu, zgodnie z wynikami niektórych wcześniejszych badań, często występującym u otyłych dzieci. W niniejszej pracy badano obecność ultrasonograficznie rozpoznanego stłuszczenia wątroby (SFL) w populacji otyłych dzieci irańskich w porównaniu z grupą dzieci z nadwagą i prawidłową masą ciała. Materiał i metody: Niniejsze badanie przekrojowe przeprowadzono w grupie 962 losowo wybranych dzieci w wieku 6-18 lat. Badani zostali podzieleni według wskaźnika masy ciała (BMI) na trzy grupy: o prawidłowej masie ciała, z nadwagą i na grupę dzieci otyłych. W przypadku każdego uczestnika wypełniano kwestionariusz zawierający charakterystykę demograficzną i antropometryczną. U wszystkich uczestników dla wykrycia SFL wykonywano badanie ultrasonograficzne przeprowadzane przez radiologa, który nie znał BMI badanych. Częstość SFL ustalano na podstawie ultrasonograficznych kryteriów diagnostycznych. Wyniki: Średni wiek dzieci uczestniczących w badaniu wynosił 12,59 ± 3,25 roku. Średnie wymiary pionowe wątroby wynosiły: 111,36 ± 18,73, 121,18 ± 16,63 i 118,21 ± 19,15 mm odpowiednio w grupach dzieci z prawidłową masą ciała, z nadwagą i otyłych. Częstość występowania SFL u dzieci otyłych wynosiła 54,4%, co było wartością istotnie wyższą w porównaniu z grupą dzieci z nadwagą (10,5%) i prawidłową masą ciała (1%). Według wyników tego badania nie było znamiennych różnic w częstości występowania SFL między płciami. Wnioski: Duży odsetek SFL wykrywanego u dzieci otyłych w tym badaniu sugeruje, że irańskie otyłe dzieci obciążone są ryzykiem wystąpienia zespołu metabolicznego. Co więcej, WHO określa Iran jako jeden z krajów o dużym odsetku dzieci otyłych. Opierając się na tych informacjach, można wysunąć wniosek, że częstość występowania zespołu metabolicznego i związanych z nim chorób niezakaźnych będzie się zwiększać w przyszłości. Dlatego konieczne jest opracowanie określonego planu dla kontroli problemu nadwagi, uwzględniającego nauczanie zdrowego stylu życia w szkołach, przedszkolach i środkach masowego przekazu

Sonographic and functional characteristics of thyroid nodules in a population of adult people in Isfahan

Wstęp: Celem badania była ocena cech sonograficznych zmian ogniskowych tarczycy u mieszkańców Isfahanu, obszaru w cenralnym Iranie, który wcześniej charakteryzował się niedoborem jodu. Materiał i metody: W przekrojowym badaniu przeprowadzonym w 2006 roku wybrano próbę liczącą 2523 dorosłych osób (wiek > 20 lat) metodą wielostopniowego losowania grupowego. Spośród tej grupy, 263 ochotników poddano badaniom sonograficznym. Badanie tarczycy przeprowadzili doświadczeni specjaliści w zakresie ultrasonografii. Ponadto oznaczono stężenia T3, T4, T3RU, TSH, TPO Ab i Tg Ab w surowicy oraz wydalanie jodu z moczem. Wyniki: Kobiety stanowiły 46% grupy poddanej badaniom sonograficznym (n = 263). Średnia wieku wynosiła 35,5 lat (zakres 20-64 lat). Mediana stężenia jodu w moczu wynosiła 19.4 μg/dl. Obecność zmian ogniskowych tarczycy wykazano w badaniu sonograficznym u 22,4% osób z badanej grupy; u 30% kobiet i 16,3% mężczyzn (OR = 2,2; p = 0,01). Częstość występowania zmian ogniskowych tarczycy zwiększała się z wiekiem (p = 0,006). Zmiany ogniskowe tarczycy występowały częściej u osób z niedoczynnością tarczycy niż w grupie z eutyreozą (35,1% v. 20,5%, OR = 2,1; p = 0,04). Nie stwierdzono korelacji między stężeniem jodu w moczu ani stężeniem autoprzeciwciał a występowaniem zmian ogniskowych tarczycy w badaniu sonograficznym. Wnioski: Częstość występowania zmian ogniskowych tarczycy oceniana na podstawie wyników badania sonograficznego jest nadal duża w badanej populacji, mimo prawidłowego stężenia jodu w moczu. (Endokrynol Pol 2010; 61 (2): 188-191)Introduction: The aim of this study was to investigate the current status of sonographic characteristics of thyroid nodules in Isfahan, a previously iodine deficient area in central Iran. Material and methods: In a cross-sectional study conducted in 2006, 2523 adult people (age > 20 years) were selected by a multistage clustering sampling method. Of these people, 263 volunteered persons were underwent sonographic evaluation. Thyroid examination was done by two expert sonographers. Serum T3, T3, T3RU, TSH, TPO Ab and Tg Ab, and urinary iodine were measured. Results: Forty-six per cent of the 263 people were women. Their mean age was 35.5 years with a range of 20-64 years. Median urinary iodine was 19.4 μg/dL. The prevalence of thyroid nodules on sonography was 22.4% in the whole group; 30% in women and 16.3% in men (OR = 2.2, P = 0.01). The prevalence of thyroid nodules increased with age (P = 0.006). The prevalence of thyroid nodules was higher in hypothyroid people than in euthyroid people (35.1% v. 20.5%, OR = 2.1, P = 0.04). Neither urinary iodine nor autoantibody concentrations correlated with the prevalence of thyroid nodules in sonography. Conclusions: The prevalence of thyroid nodule by sonography is still high despite relatively normal urinary iodine in this population. (Pol J Endocrinol 2010; 61 (2): 188-191

Częstość występowania incydentaloma tarczycy w Isfahanie, Iran - badanie populacyjne

Introduction: Thyroid nodules not detected in palpation but diagnosed following a radiological procedure or during surgery are called thyroid incidentalomas. We designed this study to investigate the prevalence of sonographic thyroid incidentaloma in Isfahan, Iran, for the first time. Material and methods: By a multistage cluster sampling method, 2523 adults were selected randomly. From this group, 2045 had normal thyroid examination. 234 out of the 2045 were selected randomly for thyroid sonography. Thyroid stimulating hormone (TSH), urinary iodine concentrations (UIC) and antithyroid antibodies were measured. Results: The prevalence of thyroid incidentaloma was 13.2% [Confidence interval (CI) 95% = 8–18]. The average age of subjects with and without incidentaloma was 46.1 (12.4) and 38.4 (12.1), respectively (P = 0.002). It was more prevalent in females than in males (19% vs. 10%) [Odds ratio (OR) = 2.59, CI 95% = 1.17–5.76, P value (P) = 0.01]. Median UIC in the incidentaloma group (14 μg/dl) was significantly lower than in the group of subjects without nodules (20 μg/dl) (OR = 0.9, CI 95% = 0.91–0.99, P = 0.02). There was no difference in the levels of TSH and antithyroid antibodies between the two groups (P > 0.05). Mean diameter of nodules was 8.14 (3.43) mm. Conclusions: The prevalence of thyroid incidentaloma was 13.2% in Isfahan. It was higher in females than males and increased with age.Wstęp: Incidentalona to guzki tarczycy niewykrywalne palpacyjnie, lecz zdiagnozowane przypadkowo podczas badania obrazowego lub zabiegu chirurgicznego. Celem badania było określenie po raz pierwszy częstości incidentaloma wykrywanych w badaniu sonograficznym w populacji irackiego miasta Isfahan. Materiał i metody: Metodą wielostopniowego losowania zespołowego wybrano grupę 2523 dorosłych osób. Spośród 2045 osób, u których nie stwierdzono zmian w badaniu palpacyjnym, wytypowano losowo 234 osoby do badania sonograficznego tarczycy. Oznaczono u nich również stężenie hormonu tyreotropowego (TSH, thyroid stimulating hormone), stężenie jodu w moczu (UIC, urinary iodine concentration) oraz przeciwciała przeciwtarczycowe. Wyniki: Incidentaloma tarczycy wykryto u 13,2% badanych (95% przedział ufności [CI] = 8–11). Średni wiek osób, u których wykazano obecność guzków wynosił 46,1 (± 12,4) lat, natomiast osób bez guzków - 38,4 (± 12,1) lat (p = 0,002). Incidentaloma występowały częściej u kobiet niż u mężczyzn (19 vs. 10%; iloraz szans [OR] = 2,59; 95% CI = 1,17–5,76; p = 0,01). Obie grupy nie różniły się pod względem stężeń TSH i przeciwciał przeciwtarczycowych (p > 0,05). Średnica guzków wynosiła średnio 8,14 (± 3,43) mm. Wnioski: Częstość incidentaloma tarczycy w populacji Isfahanu wynosiła 13,2%; była większa u kobiet niż u mężczyzn i wzrastała z wiekiem

Diameter of common bile duct: what are the predicting factors?

<p><strong>BACKGROUND</strong>: This was a study to determine the correlation between the common bile duct (CBD) diameter and demographic data, fasting, and the history of opium addiction.<br /><strong>METHODS</strong>: This was a cross-sectional study on 375 patients (>16 years old) including 219 females and 156 males. They had no evident hepatobiliary or pancreatic disease and underwent abdominopelvic ultrasonography for measurement of their CBD diameter. Ultrasound (US) was performed to measure CBD diameter at the porta hepatis (proximal part) and behind the head of the pancreas (distal part). Correlation coefficients for the association between CBD diameter and predictive factors were calculated. t-test was applied to compare the means between the groups.<br /><strong>RESULTS</strong>: The mean CBD diameter (1 standard deviation), in proximal and distal parts were 3.64 mm (±1.2) and 3.72 mm (±1.2), respectively. The CBD diameters (proximal and distal) were significantly (P<0.05) correlated with age (r = 0.55 and 0.54, respectively), BMI (r = 0.25 and 0.27, respectively) and portal vein diameter (r = 0.24 and 0.22, respectively). Distal diameter of CBD was significantly larger in opium addicts (5.66 ± 2.65) in comparison with non addicts (3.68 ± 1.17, P = 0.04).<br /><strong>CONCLUSIONS</strong>: CBD diameter associates with age, BMI, portal vein diameter and opium addiction. CBD dilatation, if it can not be explained by age, opium usage or large BMI, should be evaluated further to rule out obstruction.<br /><strong>KEY WORDS</strong>: Common bile duct, predicting factors, ultrasonography.</p&gt

Bone Density in Postmenopausal Women with or without Breast Arterial Calcification

Background: Identification of osteoporosis in women in order to prevent its related morbidity and mortality is considered a priority. Routine mammography is performed on all menopausal women as a screening tool. Determination of the relation between breast arterial calcification (BAC) on mammography and the bone density of this high-risk population could help us to determine those with osteoporosis. The aim of this study was to investigate the mentioned probable relation between BAC and osteoporosis. Materials and Methods: In this cross-sectional study, menopausal women referred for annual screening mammography were enrolled. According to the results of mammography, they were classified into two groups: menopausal women with and without calcification of breast arteries. The selected women were referred for bone mineral density (BMD) evaluation by dual-energy x-ray absorptiometry (DXA). The results of BMD were compared between the two studied groups. Results: In this study, BMD was measured in 43 and 45 menopausal women with and without BAC, respectively. After age adjustment the difference between BMD measurements were not statistically significantly different (P > 0.05). There was a significant negative correlation between age and lumbar (P = 0.002, r = -0.42) and hip bone (P = 0.000, r = -0.67) density in menopausal women with BAC. Conclusion: The results of the current study indicated that there was no significant relationship between BAC and BMD in our studied population, but it seems that increasing age has an important role in both developing BAC and reducing BMD. For obtaining more conclusive results, further studies with larger sample sizes and considering the severity of BAC is recommended

Reference values of nuchal fold thickness in an Iranian population sample

Background: Considering that ethnicity and gestational age (GA) could affect the value of nuchal fold thickness (NFT) in mid-trimester, we aimed to determine the reference intervals of NFT values for each gestational week from 16 to 24 weeks of pregnancy among a group of Iranian pregnant women. Materials and Methods: In this cross-sectional study, medical files of pregnant women who underwent fetal anomaly scanning at 16–24 weeks of gestation were reviewed and the following data were extracted: GA, value of NFT, value of nuchal translucency (NT) in their previous ultrasound study, if available, and head circumference (HC). The 5th, 25th, 50th, 75th, and 95th percentiles of NFT for each gestational week were determined. The association between NFT and HC, GA, and NT were also determined. Results: Medical files of 882 pregnant women were studied. The expected 95th percentile value of NFT between 16th and 24th weeks of gestation ranged from 4 mm to 5.9 mm. The mean (standard deviation) of NFT increased with GA from 2.67 (0.90) mm at 16th weeks to 4.69 (0.71) mm at 24th weeks. There was a significant positive association between NFT and GA (β = 1.11, p < 0.001), HC (β = 0.21, p < 0.001), and NT (β = 0.351, p < 0.001). Conclusion: The findings of this study revealed that before the 20th week of gestation, the appropriate cutoff value of NFT is 5 mm, and for 21st to 24th weeks, the proper cutoff is 6 mm. However, for providing more conclusive results, further studies with larger sample size and considering the impact of other influencing variables are recommended

Comparison of Ovarian volume and Antral follicle count with Endocrine tests for prediction of responsiveness in ovulation induction protocols

Background: The aim of this study was to determine if the basal antral follicle number and ovarian volume contributes to the prediction of responsiveness in ovulation induction protocol and comparison of it with hormonal tests. Materials and Methods: 52 irregularly-menstruating patients, aged 18-46 years, participated in this prospective study. All the patients underwent a transvaginal sonography to measure the basal ovarian volume and the basal antral follicles count (AFC). Clomiphene citrate challenge test was measured by summation of measurements of FSH on day 2 and 10. All the women received clomiphene citrate from day 2 to 6. Ovarian responsiveness was measured 1 week after termination of clomiphene citrate and was used as gold standard. Results: Multiple regression analysis revealed that AFC was the only significant factor for ovarian responsiveness prediction. The area under the curve for AFC to discriminate responder ovaries was 0.66 (95% confidence interval, 0.87-0.99). The cutoff value for predicting ovarian responsiveness was 15.5. Conclusion: AFC can contribute to the prediction of responsiveness in ovulation induction protocol better than ovarian volume and hormonal tests

Prevalence of Nonalcoholic Fatty Liver Disease and its Related Metabolic Risk Factors in Isfahan, Iran

Background: This study aimed to determine the prevalence of nonalcoholic fatty liver disease (NAFLD) and its related risk factors among the general population of Isfahan city located in the central part of Iran. Materials and Methods: In this cross-sectional study, the prevalence of NAFLD among 483 general adult populations was determined using ultrasonography. Anthropometric and biochemical variables were compared in groups with and without NAFLD and their predictive value for occurrence of NAFLD was investigated also. Results: Prevalence of NAFLD was 39.3%. Frequency of focal fatty infiltration (FFI), Grade I, Grade II, and Grade III of NAFLD was 9.5%, 21.1%, 7.2%, 1.4%, respectively. Prevalence of different types of NAFLD and FFI, was not different between female and male participants (P = 0.238). Ordinal regression was determined that all of the studied variables have significant predictive value for NAFLD (P < 0.001, γ = 0.615). Spearman correlation indicated that there was a significant relationship between NAFLD and BMI (r = 0.37, P< 0.001), age (r = 0.15, P = 0.001), FBS (r = 0.20, P< 0.001), cholesterol (r = 0.19, P< 0.001), triglyceride (r = 0.20, P< 0.001), LDL (r = 0.16, P< 0.001), AST (r = 0.17, P< 0.001), and ALT (r = 0.31, P< 0.001). Conclusions: Considering the high prevalence of NAFLD specially its lower grades among Isfahani adult general population and their association with studied variables, it seems that interventional studies which target-related mentioned risk factors could reduce the overall occurrence of NAFLD

Normal bladder wall thickness measurement in healthy Iranian children, a cross-sectional study

Background: Normal bladder function is necessary for micturition. Many causes such as urinary tract infection, bladder outlet obstruction, and neuropathic bladder can influence bladder wall thickness (BWT).This study was designed to determine normal BWT in Iranian children. Materials and Methods: This was a cross-sectional study done in Isfahan in 2012 comprising 82 children aged 2-14 years without any urinary complaint. We measured thickness of posterior and lateral walls of the bladder in all children. Mean bladder wall thickness (MBWT) and mean bladder volume (BV) were also calculated. Results: In this study, we included 82 children (40 boys and 42 girls). Patients′ mean age was 6.43 ± 2.89 years, mean weight was 21.32 ± 8.40 kg, mean height was 111.57 ± 20.51 cm, and mean Body Mass Index was 17.12 ± 4.93. Mean lateral bladder wall thickness (LBWT) was 1.75 ± 0.32 mm and mean posterior bladder wall thickness (PBWT) was 1.59 ± 0.34 mm. Mean BV was 111.65 ± 72.11 ml and MBWT was 1.67 ± 0.28 mm. BVW all Index (BVWI) was 1249.05 ± 701.67. Conclusions: LBWT was1.75 ± 0.32 mm and PBWT was 1.59 ± 0.34 mm

An Evaluation of Ultrasound Features of Breast Fibroadenoma

Background: Breast cancer is among the most common cancers in the world. Ultrasound evaluations of breast have come into attention as an alternative route. Ultrasound features of benign lesions such as fibroadenoma can be overlapping with those in a malignant tumor. Here, we assessed the reports of breast ultrasound in patients with pathologic diagnosis of fibroadenoma. Materials and Methods: We conducted a cross-sectional study and enrolled female patients with confirmed histologic diagnosis of fibroadenoma. Ultrasound studies were performed on the participants to see which sonographic patterns are more frequent in such lesions. Results: In 92 patients with 40.4 ± 9.2 years of age, all participants were classified as stage 4 on Breast Imaging-Reporting and Data System scale. The mean ± standard deviation of size for the lesions was 167.4 ± 101.4 mm2. Upper outer quadrants in the breasts had the most number of lesions. Almost lesions were round with only 2.2% were oval. When assessed for the margin definition, 57.8% were circumscribed. Noncircumscribed masses were reported in 21.7%. About 91.3% of cases were hypoechoic in the ultrasound evaluation. Lobulated masses were in 28.3% of the cases. 8.7% of the masses were spongy whereas 9.8% and 2.2% of them had calcification and heterogenic appearance, respectively. Conclusion: The most frequent features include a hypoechoic mass with a circumscribed border; however, complex presentations that overlap malignant masses are also detectable including noncircumscribed margin, lobulation, presence of a posterior shadow, heterogenicity, and micro calcification