High prevalence of goiter in schoolchildren in Isfahan; zinc deficiency does not play a role

Wstęp: Dane dotyczące znaczenia niedoboru cynku w etiologii wola endemicznego są niejednoznaczne. Celem niniejszego badania było ustalenie związku między stężeniem cynku w surowicy a występowaniem wola u dzieci w wieku szkolnym w Isfahanie. Materiał i metody: Badanie przeprowadzono w 2005 roku. Włączono do niego 2331 dzieci, u których oceniono palpacyjnie wielkość tarczycy. U części dzieci oznaczono stężenie jodu w moczu (UIC, urinary iodine concentration) i stężenie cynku w surowicy. Wyniki: Obecność wola stwierdzono u 32,9% dzieci. Średnie UIC wynosiło 195,5 μg/l. Stężenie cynku w osoczu oznaczono u 94 dzieci z wolem i 326 dzieci, u których nie stwierdzono wola. Średnie stężenie cynku w osoczu ± odchylenie standardowe wynosiło 100,81 ± 22,33 μg/dl u dzieci z wolem i 96,00 ± 25,79 μg/dl u dzieci bez wola (p = 0,08). Częstość niedoboru cynku (stężenie cynku w surowicy ≤ 65 μg/dl) nie różniła się istotnie w grupie dzieci z wolem i bez wola (6,4% v. 8,0%, p = 0,61). Wnioski: Częstość występowania wola u dzieci w wieku szkolnym w Isfahanie jest nadal duża. Wydaje się, że niedobór cynku nie ma wpływu na znaczną liczebność przypadków wola w tym regionie. Wskazane są dalsze badania mające na celu identyfikację czynników zwiększających częstość występowania wola w Isfahanie. (Endokrynol Pol 2010; 61 (3): 287-290)Introduction: There are controversial data about the role of zinc deficiency in the aetiology of endemic goiter. The aim of the present study was to determine the association between zinc status and goiter in schoolchildren of Isfahan. Material and methods: This study was performed in 2005. Two thousand three hundred and thirty-one schoolchildren were enrolled, and thyroid size was determined by inspection and palpation. Urinary iodine concentration (UIC) and serum zinc level were measured in a group of those children. Results: The prevalence of goiter was 32.9%. The median UIC was 195.5 μg/L. Serum zinc was measured in 94 goitrous and 326 nongoitrous children. The mean ± standard deviation of serum zinc in goitrous and non-goitrous children was 100.81 ± 22.33 and 96.00 ± 25.79 μg/dL, respectively (P = 0.08). The prevalence of zinc deficiency (serum zinc ≤ 65 μg/dL) in goitrous and non-goitrous children did not differ significantly (6.4 % v. 8.0%, P = 0.61). Conclusions: The prevalence of goiter is still high in Isfahan schoolchildren. It seems that zinc status is not involved in the high prevalence of goiter in this region. The role of other possible goitrogens should be investigated in Isfahan. (Pol J Endocrinol 2010; 61 (3): 287–290

Association between Serum Ferritin and Goitre in Iranian School Children

Despite long-standing supplementation of iodine in Iran, the prevalence of goitre among general people remains high in some regions. The study investigated the role of iron status in the aetiology of goitre in school children in Isfahan, Iran. Two thousand three hundred and thirty-one school children were selected by multi-stage random sampling. Thyroid size was estimated by inspection and palpation. Urinary iodine concentration (UIC) and serum ferritin (SF) were measured. Overall, 32.9% of the children had goitre. The median UIC was 195.5 μg/L. The mean±SD of SF in the goitrous and non-goitrous children was 47.65±42.51 and 44.55±37.07 μg/L respectively (p=0.52). The prevalence of iron deficiency in goitrous and non-goitrous children was 9.6% and 3.1% respectively (p=0.007). Goitre is still prevalent in school children of Isfahan. However, their median UIC was well in the accepted range. Iron deficiency is associated with goitre in a small group of goitrous children. The role of goitrogens should also be investigated in this region

Association between Serum Ferritin and Goitre in Iranian School Children

Despite long-standing supplementation of iodine in Iran, the prevalence of goitre among general people remains high in some regions. The study investigated the role of iron status in the aetiology of goitre in school children in Isfahan, Iran. Two thousand three hundred and thirty-one school children were selected by multi-stage random sampling. Thyroid size was estimated by inspection and palpation. Urinary iodine concentration (UIC) and serum ferritin (SF) were measured. Overall, 32.9% of the children had goitre. The median UIC was 195.5 \u3bcg/L. The mean\ub1SD of SF in the goitrous and non-goitrous children was 47.65\ub142.51 and 44.55\ub137.07 \u3bcg/L respectively (p=0.52). The prevalence of iron deficiency in goitrous and non-goitrous children was 9.6% and 3.1% respectively (p=0.007). Goitre is still prevalent in school children of Isfahan. However, their median UIC was well in the accepted range. Iron deficiency is associated with goitre in a small group of goitrous children. The role of goitrogens should also be investigated in this region

Vitamin D status of 6- to 7-year-old children living in Isfahan, Iran

Wstęp: Witamina D ma podstawowe znaczenie dla utrzymania dobrego zdrowia. O niedoborach witaminy D donoszą autorzy z wielu krajów, również tych o dużym stopniu nasłonecznienia. Niniejsze badanie przeprowadzono w celu dokonania oceny stężenia witaminy D u zdrowych dzieci w wieku 6-7 lat, zamieszkałych w Isfahanie, Iran. Materiał i metody: Do badania włączono 513 zdrowych dzieci. Zmierzono u nich stężenie PTH i 25-hydroksywitaminy D (25-OHD) w surowicy. Określono spożycie witaminy D w diecie, czas ekspozycji na słońce w ciągu doby i odsetek powierzchni ciała wystawionej na działanie słońca. Przyjęto, że stężenia 25-OHD wynoszące < 20 ng/ml i 10 ng/ml odpowiadają odpowiednio łagodnemu i ciężkiemu niedoborowi witaminy D. Do ustalenia lokalnych punktów odcięcia dla niedoborów witaminy D użyto krzywych ROC. Wyniki: U 3% dzieci stężenie witaminy 25-OHD wynosiło < 20 ng/ml, a u 26% wynosiło < 33 ng/ml (lokalny punkt odcięcia dla niedoboru witaminy D). Czas ekspozycji na słońce i dzienne spożycie witaminy D w diecie miały istotny wpływ na stężenie witaminy D w surowicy. Wnioski: W omawianym badaniu wykazano częste występowanie niedoboru witaminy D u dzieci zamieszkałych w Isfahanie. Wydłużenie czasu ekspozycji na słońce i zwiększenie dziennego spożycia witaminy D w diecie może zapobiec niedoborom witaminy D u tych dzieci. (Endokrynol Pol 2010; 61 (4): 377-382)Introduction: Vitamin D is essential for the maintenance of good health, and vitamin D deficiency has been reported from many countries, including those with a lot of sunshine. This study was conducted to evaluate the vitamin D status in healthy 6- to 7-year-old children in Isfahan, Iran. Material and methods: Five hundred and thirteen healthy children were enrolled. Serum PTH and 25-hydroxyvitamin D (25-OHD) were measured. Dietary vitamin D intake, duration of daily sunlight exposure, and percentage of exposed body surface area were determined. 25-OHD levels < 20 ng/mL and < 10 ng/mL were defined as mild and severe vitamin D deficiency, respectively. The ROC curve was utilized to obtain a local cut-off point of vitamin D deficiency. Results: 25-OHD was < 20 ng/mL in 3% and < 33 ng/mL (local cut-off point of vitamin D deficiency) in 26% of subjects. Duration of sunlight exposure and daily intake of vitamin D had significant effects on serum level of vitamin D. Conclusions: A high prevalence of vitamin D deficiency in Isfahan children was observed in this study. Improvements in duration of sunlight exposure and daily intake of vitamin D can prevent vitamin D deficiency in these children. (Pol J Endocrinol 2010; 61 (4): 377-382

Sepsis recognition tools in acute ambulatory care::associations with process of care and clinical outcomes in a service evaluation of an Emergency Multidisciplinary Unit in Oxfordshire

To assess the performance of currently available sepsis recognition tools in patients referred to a community-based acute ambulatory care unit.Service evaluation of consecutive patients over a 4-month period.Community-based acute ambulatory care unit.Observations, blood results and outcome data were analysed from patients with a suspected infection. Clinical features at first assessment were used to populate sepsis recognition tools including: systemic inflammatory response syndrome (SIRS) criteria, National Early Warning Score (NEWS), quick Sequential Organ Failure Assessment (qSOFA) and National Institute for Health and Care Excellence (NICE) criteria. Scores were assessed against the clinical need for escalated care (use of intravenous antibiotics, fluids, ongoing ambulatory care or hospital treatment) and poor clinical outcome (all-cause mortality and readmission at 30 days after index assessment).Of 533 patients (median age 81 years), 316 had suspected infection with 120 patients requiring care escalated beyond simple community care. SIRS had the highest positive predictive value (50.9%, 95% CI 41.6% to 60.3%) and negative predictive value (68.9%, 95% CI 62.6% to 75.3%) for the need for escalated care. Both NEWS and SIRS were better at predicting the need for escalated care than qSOFA and NICE criteria in patients with suspected infection (all P<0.001). While new-onset confusion predicted the need for escalated care for infection in patients ≥85 years old (n=114), 23.7% of patients ≥85 years had new-onset confusion without evidence for infection.Acute ambulatory care clinicians should use caution in applying the new NICE endorsed criteria for determining the need for intravenous therapy and hospital-based location of care. NICE criteria have poorer performance when compared against NEWS and SIRS and new-onset confusion was prevalent in patients aged ≥85 years without infection

Comparison of Electro-Coagulation and Photo-Oxidation UV/O3 Processes in Removal of Acid Blue 113

Every day million liters of dye wastewater is produced in different industries that cause environmental problems. The purpose of this research was to investigate the possibility of Acid Blue 113 removal, which is one of the most consumed textile dyes, by using electro-coagulation and photo-oxidation UV/O3 processes in batch condition. Iron electrodes were used and the effect of current density, electrolysis time, pH, initial dye and electrolyte concentrations on dye removal were evaluated. Regarding photo-oxidation UV/O3 process, parameters including ozone dosage, light power, time, pH and dye concentration were determined and optimized. The results in the optimum conditions showed that in the electro-coagulation method, over 90 percent of 100 mg/L dye was removed after 5 minutes in the applied current density of 44 mA/m2, pH of 6.5 and electrolyte concentration of 3 g/L. However, in the photo-oxidation UV/O3 process, only 70 percent of 15 mg/L dye was removed after 15 minutes in pH of 9, 4 g/h of ozone and 15 mW/cm2 of power. According to the results, electro-coagulation method had better capability in comparison to photo-oxidation UV/O3 process. Although, the first method was operated with simple equipments and was more economical but had still sludge producing remained. Therefore, according to the type of industry, the proper method should be selected

Effectiveness of cognitive behavioral therapy, acceptance and commitment therapy on irrational beliefs of medical students

Background and Objective: Irrational beliefs underlie a wide range of cognitive impairments. This study was performed to compare the effect of cognitive-behavioral therapy and acceptance and commitment therapy on irrational beliefs of medical students. Methods: In this quasi-experimental study, 45 medical students of Golestan University of Medical Sciences in north of Iran were non-randomly divided into control, cognitive-behavioral therapy (first intervention) and acceptance, commitment therapy (second intervention) groups. All three groups completed the pre-test, but the control group did not receive any therapy. The intervention groups were received 8 sessions of therapy. The data were collected through Jones's 1969 (IBQ-40) irrational beliefs questionnaire. Results: The total score of irrational beliefs in the both intervention groups were reduced in comparison with control group (P<0.05). The mean score of the problem-based avoidance subscale (35.26±6.32) was significantly reduced in the second intervention group compared to the first intervention group (30.53±9.47) (P<0.05). Also, the mean scores of emotional impulsivity in the first intervention group (22.73±9.49) were significantly increased compared to the second intervention group (29.93±1.75) (P<0.05). Conclusion: Two methods of cognitive-behavioral therapy and acceptance and commitment therapy reduce the irrational beliefs of medical students

The Customer Quality of Delivered Care to Patients with Inflammatory Bowel Disease in Tabriz City, Iran, 2012

Abstract Background and purpose: Customer quality (CQ) refers to knowledge, attitude, and skills of service-user in treatment process and this study aims to assess it in delivered care to patients with inflammatory bowel disease (IBD) in Tabriz city, Iran, 2012. Materials and Methods: This is a cross-sectional investigation in which the target population includes 94 patients with IBD, who had medical care files in Imam Reza Hospital and Tabriz Golgasht Specialized Clinic. A 19-question inventory is the tool for data collection that its validity was approve by 10 experts and its reliability was examined and verified by conducting a pilot study and with calculation of internal consistency (&alpha; = 0.78). SPSS software was employed to analyze data. Results: The mean score of the variable of CQ was derived (70.63 &plusmn; 9.67) in patients with IBD disease. All participants had acquired the scores of self-management at the first phase. However, at last 11.7% of them had reported the highest scores in variable of CQ and they could continue their own medical care trend under variable conditions like stress and financial problems. Similarly, there was a significant relationship among CQ with an educational degree in the participants (P = 0.050) so that as the educational level was higher, the score of CQ was also increased. Conclusion: The acquired results signify that CQ is relatively acceptable in the studied population but major problems are visible in some areas, and this may imply the necessity for consideration by healthcare directors