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The Prevalence of Goiter and Urinary Iodine Exertion in 7 – 10 year old
R Sheikholeslam
Qom University of Medical Sciences Journal , 2012,
Abstract: Background and objectives Iodine deficiency was a public health problem in Iran before the start of iodine supplementation program in 1989. This study has been conducted in the framework of the national monitoring survey in 2001 to find the prevalence of goiter and urinary iodine levels in order to evaluate the effect of national supplementation program on the iodine status of school-aged children in the city of Qom. Methods In a descriptive, cross-sectional study, 1200 schoolchildren, aged 7-10 years, were selected randomly from all regions of Qom, and the grade of goiter was determined in 600 boys and 600 girls according to WHO classification. Urinary iodine content was estimated using the digestion method in one tenth of the schoolchildren. Results Goiter was observed in 26% of children (24.3% of girls and 27.7% of boys). The average urinary iodine level was 15.2 μg/dl. Urinary iodine levels higher than 10 μg/dl was measured in 71.7% and less than 5 μg/dl in 8.1% of children. Urinary iodine levels less than 2 μg/dl has not been observed in any of the cases. No significant difference was observed in prevalence of goiter and the urinary iodine level between males and females, and students in living in urban or rural areas. ConclusionComparison of these results with those of the year 1996 shows that prevalence of goiter has significantly decreased in these students. Also, it shows that in the city of Qom, the urinary iodine levels of schoolchildren fall in the standard range determined by WHO. This indicates that the iodine intake is adequate in the province of Qom. Therefore, this province can be considered as an “iodine deficiency-free” zone
Comparison of urinary iodine excretion in pregnant women with and without goiter and their newborns
Setoodeh A,Amirhakimi Gh
Tehran University Medical Journal , 1999,
Abstract: Iodine availability for the maternal thyroid is reduced during pregnancy as a result of the loss of the nutrient by increased renal clearance, and competition by the fetoplacental unit. So with a marginal iodine intake, pregnancy constitutes a stimulus for both the maternal and fetal thyroids. On the other hand, iodine deficiency in the first trimester of pregnancy results in impaired development of the central nervous system, lack of T4 then results in smaller brain size associated with fewer neurons which are also shorter in length. This cross-sectional study was undertaken to evaluate pregnant women and their newborns, these two susceptible groups to IDD in an endemic area such as Shiraz. Urinary excretion of iodine as iodine (μg/dl)/creatinine (gr) ratios in two groups of pregnant women, one group without goiter (52.88%) and the other with goiter (grade Ib and II 47.2%) and their newborns were compared. There was no significant difference in urinary excretion of iodine in mothers and newborns of the 2 groups. In all newborns even in those of mothers excreting <50 mg iodine/gr creatinine, there was a significantly greater excretion of iodine probably due to increased renal clearance of iodine by the immature kidney, and their excretion of iodine was not parallel to those of mothers. There was no significant difference between weight, height and head circumference of the two groups of newborns. It is concluded that iodine excretion in neonates can not be used as an indicator of iodine deficiency disorder. In iodine deficient areas pregnancy justifies monitoring thyroid function and volume and therapeutic intervention to avoid hypothyroxinemia and goiterogenesis in both mother and newborn. Likewise neonatal thyroid screening constitutes a valuable and sensitive index for detecting the presence of iodine deficiency.
Continuous Adequate Iodine Supplementation in Fars Province: The 2007 Goiter and Urinary Iodine Excretion Survey in Schoolchildren
Atieh Amouzegar,Hossein Delshad,Mehran Mehraein,Ladan Mehran
Iranian Journal of Medical Sciences , 2010,
Abstract: Background: The iodine deficiency elimination program thatbegan two decades ago resulted in Iran becoming an iodinedeficiency disorders free country in the Middle East region.The present study was performed to evaluate the adequacy ofiodine supplementation after 17 years of universal salt iodizationin Fars province.Methods: In a cross-sectional study, 1200 schoolchildren (480girls and 720 boys) aged 8 to10 years, were randomly selectedfrom Fars province and evaluated in 2007. Goiter prevalence,urinary iodine excretion, and iodine content of household saltswere measured and the data were compared with those obtainedin 1996 and 2001.Results: Total prevalence of goiter was 1.3% (CI: 0.53-2.47)and no grade 2 goiter was found. One-tenth of the childrenenrolled for goiter assessment, were randomly selected forurinary iodine measurement. The median urinary iodine inthese 120 schoolchildren was 159.4 μg/L (85.6-252.3), with14.8% having urinary iodine excretion less than 50 μg/L. 98%of households were using purified iodized salt. 70% of householdshad appropriate salt storage and none of the householdsalts contained less than 15 μg iodide.Conclusion: Goiter prevalence has significantly decreased inthe Fars province, 17 years after universal salt iodization. Themedian urinary iodine of schoolchildren was adequate as thatreported in 1996 and 2001, indicating a well established sustainableiodine deficiency elimination program in the province.
Journal of Research in Medical Sciences , 2001,
Abstract: Introduction: Iodine deficiency disorders (IDD) is a worldwide health problem. Many parts of the Islamic Republic of Iran had been known as areas of endemic goiter. IDD was accepted as a priority health problem in the country, and a National lDD council was formed in 1989 under the supervision of the Ministry of Health and Medical Education. One of the main strategies of National council for IDD control was to provid at least 150 g of iodine per day to the entire population through making available iodized salt. This study was performed to evaluate the national IDD council program in 1996, in rural and urban areas of Isfahan province. Methods: One thousand and four hundred schoolchildren, aged 8 to 10 year, including 50% girls and 500k boys, were selected through random sampling. Grading of goiter was performed according to WHO"s classification. Serum T3. T 4 and TSH were measured by RIA and uninary iodine by digestion method. Results: The mean of serum T 4. T3 and TSH were 10.2±1.7 μgldl, 166±97 ngldl and 2.7±0.8 μlu/ml, respectively. There were no difference between males and females and schoolchildren of rural and urban areas. 0.6 percent had serum T4 more than 12.5 μg/dl and eight person had TSH more thans 5 μlu/ml. The median urinary iodine was 21 μg/dl in entire population, 76 percent had urinary iodine more than 10 μg/dl. Only 10 percent had urinary iodine less than 5 μg/dl. Total prevalence of goiter was 58 percent (60 percent in girls and 53 percent in boys). Disussion: Based on the available data, seven years after generalized use of iodized salt and 2 years after more than 50 percent of pupulation used iodized salt, uninary iodine of school children in Isfahan province showed sufficient iodine intake. However goiter is still hyperendemic in Isfahan province.
The prevalence of clinical goiter and urinary iodine concentration in 8-12 years old students of Semirom in 2004 (15 years after execution of national program for eliminationof iodine deficiency disorders)
A. Kachouei,M. Hashemipour,H. Rezvanian,A. Aminorroaya
Journal of Mazandaran University of Medical Sciences , 2006,
Abstract: Background and purpose: With respect to the high prevalence of goiter in Semirom before the initiation of National Program for Elimination of Iodine Deficiency Disorders (NPEIDD), the impact of the program on the prevalence of goiter in 8-12 years old students of Semirom was investigated in this study, after 15 years of sucessful execution of NPEIDD.Materials and Methods: After excluding students with any clinical evidence of hyper- or hypo-thyroidism, 1817 students aged 8-12 years were recruited based on a cluster sampling method. The participants were examined for the presence of goiter by experiencd endocrinologists. Urinary iodine was measured in 182 examined students, too. Chi- Square statistical method was used to analyze the data.Results: Goiter was detected in 36.7% of the students (grade 1: 30.4%, grade 2: 6.3%). The median urinary iodine was 18.5 and mean was 19.37 ± 9.22 μg/dl in collected specimens.Conclusion: The adequacy of urinary iodine in students of Semirom confirms the success of NPEIDD, however, the higher than expected prevalence of goiter in the region suggests the probable role of other goitrogenous or autoimmune factors. Further studies should be performed to investigate the possible causes.
Study of the Prevalence of Endemic Goiter and Its Relation with Urinary Iodine and Thyroid Hormonal Levels in 6-18 Year Old School Children in Rafsanjan in 2000
GR Asadi Karam,M Sajadi,M Sheykh Fatollahee,AH Zangiabadi
Journal of Shahid Sadoughi University of Medical Sciences , 2004,
Abstract: Introduction: Endemic goiter due to iodine deficiency is one of the health problems in the developing countries. Material & Methods: In this cross-sectional study, 109 schoolboys and 92 schoolgirls, aged between 6 and 18 years in Rafsanjan city were selected randomly by proportionate-multistage cluster sampling method. All the students underwent clinical examination for presence of goiter according to criteria recommended by WHO, and urinary iodine excretion, T4, FTI and TSH were measured. Results: The point Prevalence rate of goiter in boys and girls were 71.6% and 55.6%, respectively. Prevalence rates of Grade I and II were 51.3% and 12.9%, respectively. Urinary iodine excretion was normal in 68.1% (>10 μg/dl) mild in 30.6% (5-9.9 μg/dl) and moderate in 1.3% (2.1-4.9 μg/dl). Of 68.1% of schoolchildren with normal urinary iodine, 56.9% showed different grades of goiter. There was no relation between goiter stages and urinary iodine deficiency (P>0.05). T4, FTI and TSH in 96% of schoolchildren were normal. In 3%, TSH levels were more than the normal range (>3.5 μU/ml) and in 1%, T4 concentration was less than the normal range (0.05). Conclusion: With respect to the fact that urinary iodine levels were normal in 68.1% of the students and thyroid parameters were normal in 94% of the subjects, the very high prevalence rate of goiter in the city of Rafsanjan seems to be due to certain unknown etiological factors which needs further studies
Evaluation of Malnutrition, as a Possible Cause of Persistence of Goiter Despite Iodine Supplementation
M Aminzadeh,Z Karamizadeh,GhH Amirhakimi,M Vakili
Iranian Journal of Pediatrics , 2007,
Abstract: Background: Iodine deficiency is the most common cause of endemic goiter. Frequency of goiter has remained >5% despite iodide supplementation and sufficient iodide intake. Other causes have to be investigated. This study was conducted to assess influences of malnutrition on persistence of goiter frequency while iodine intake is sufficient. Methods: 1504 school age children (8-10 year) were selected randomly and examined in south of Iran – Firoozabad. 102 cases with goiter grade 2 and 3 were found. 100 completely normal children regarding thyroid examination were also selected randomly as control. Growth parameters (Weight for age, Height for age and Body Mass Index) and urinary iodine as an indicator of iodine intake were assessed in both groups. Findings: Median of urinary iodine was 21 μg/dL in patients. (>10μg/dL indicates sufficiency of iodine intake.) Regarding growth indicators there was not statistically significant difference between the two groups, which rules out malnutrition as a cause of persistence of goiter. On the other hand our study may show that malnutrition (several nutritional deficiencies) could be as a cause of goiter just in the presence of iodine deficiency. Larger studies in iodine sufficient but with more severe malnutrition or comparison of frequency of goiter before and after nutritional improvement in a population with malnutrition and iodine sufficiency may be more helpful. Conclusions: Malnutrition per se could not be considered as a cause of goiter when iodine intake is sufficient.
Iodine nutritional status and goiter prevalence in primary school children aged 6-12 of Panchmahal district, Gujarat, India
Haresh Chandwani,Vihang Mazumdar
Electronic Physician , 2010,
Abstract: Introduction: Iodine deficiency disorders (IDD) create major public health problems in India, including Gujarat. Panchmahal district is known for endemic iodine deficiency. The present study was conducted to (1) estimate the prevalence of goiter in primary school children, (2) determine median urinary iodine concentration, (3) assess the level of iodine in salt samples at the household and retail shop level, and (4) profile of salt sold at retail shops in Panchmahal district, Gujarat. Methods: A total of 70 students including five boys and five girls from 1st to 7th standard who were present on the day of the first visit were selected randomly for goiter examination from each village. Urine samples were collected from one boy and one girl from each standard in each cluster. From the community, at least 28 students, including two boys and two girls from each standard in the same age group, were examined, and salt samples were tested from their households. A total of 2100 students were examined in schools and 928 students were examined in the selected villages. From each village, one retail shop was visited, and salts purchased from those shops were immediately tested for iodine with spot kits.Results: Among young primary school children, goiter prevalence was 23.35% (grade 1—18.35%, grade 2—5.0%). As the ages increase, goiter prevalence also increases except for 9-year-olds. The median urinary iodine excretion level was 110 μg/L. An iodine level >15 ppm was found in 78.3% of the salt samples tested at household level. Conclusion: The present study showed considerable goiter prevalence in primary school children in Panchmahal district of Gujarat and an inadequate iodine content of salt at the household level.
Evaluation of Goiter Prevalence and Iodine to Creatinine Ratio among School-aged Girls in Urmia County
R Rostami,A Biravand,H Estabraghnia,MR Aghasi
Journal of Shahid Sadoughi University of Medical Sciences , 2013,
Abstract: Introduction: Clinical evaluation of iodine deficiency disorders (IDDs) is often accomplished by assessment of urinary iodine excretion (UIE) in random samples; however, the utilization of 24 hour urine samples is a more reliable biomarker of nutritional iodine status. This study was designed to evaluate total goiter prevalence (TGP) and iodine/creatinine ratio among school-aged children in Urmia County. Methods: Schoolchildren (n=500) were recruited by cluster sampling from different educational areas in Urmia County. Goiter prevalence was assessed by thyroid palpation, UIE was determined by Sandell-Koltoff reaction, and Urinary creatinine was measured by the Jaffe-method. Results: In general, TGP was 12.2%. Among these, there were 48 individuals (9.6%) with grade I goiter and 13 subjects (2.6%) with grade II goiter. Mean urinary creatinine, median UIE and median I/Cr ratio were respectively 1.36±0.76 mg/dL, 14.3μg/dL, and 11.5μg/mg. Prevalence of iodine deficiency according to UIE criteria was 22.8% and that of I/Cr ratio was 41.2%. There was a correlation between age and UIE (P=001; r=0.163). UIE and urinary creatinine were correlated as well (P<0.003; r= 0.133). A correlation was also detected between I/Cr ratios and UIE (P=0.003; r=0.133) whilst a negative association was seen between age and I/Cr ratios (P=0.001; and r=–0.263). Conclusion: This investigation reconfirms that there is slight-to-mild iodine deficiency in Urmia County. The utilization of I/Cr ratio in conjugation with UIE and palpation may provide a better assessment in investigating nutritional iodine status.
Jorge A Jara Y,Eduardo A Pretell,Juana Zaracho de Irazusta,Sonia Goetting
Revista Chilena de Nutricíon , 2004,
Abstract: Paraguay, país mediterráneo ubicado en el corazón de America del Sur, con una superficie de 406.542 Km2 y con una población de 5,8 millones de habitantes importa toda la sal que consume de países cercanos como la Argentina, Brasil y Chile. En el presente estudio observacional, de tipo descriptivo utiliza el método ecográfico para determinar el tama o y las características de la glándula tiroides, se examinaron 1034 escolares de ambos sexos de 13 distritos del país y fue realizado durante 3 meses del a o 2000. Los lugares elegidos tenían antecedentes de bajo consumo de sal yodada con valores de yoduria por debajo de 50 μg/L, como también la medición de la yoduria por el método de trinitrito , el tenor de yodo en sal y la relación talla/peso de los escolares estudiados. El 82.9% del volumen tiroideo de los escolares resultó dentro de los limites normales. Se detectó un volumen tiroideo aumentado en el 17.1% de los ni os según la edad y sexo y en 22% según la superficie corporal. Nódulos tiroideos se observaron en 5 ni os y sólo1 ni o tenía antecedentes de haber tenido cirugía tiroidea. El 53% de los distritos presentaron medias urinarias de yodo por encima de 200 μg/dL con un promedio de 301.3 μg/dL. El 40% de los distritos presentaron yodurias óptimas (entre 100 y 199 μg/dlL) con una media de 145 μg/dL. Solo el 7% presentó una media urinaria de yodo bajo 100 μg/dL. El estudio demostró una mejoría en la yodación de la sal de consumo humano al compararlo con los realizados en 1988 en el Paraguay,sin embargo,existen riesgos de producir en la población tirotoxicosis y enfermedades tiroideas autoinmunes por el porcentaje de yodo en la sal en aumento, por lo que se recomienda un seguimiento y control con los ajustes necesarios de los niveles de yodación. Paraguay, a mediterranean country located in the heart of South America , with a surface of 406.542 Km2 and a population of 5,8 million inhabitants, import all the salt to consume from neighbord countries as Argentina, Brazil and Chile. The present observational study, of descriptive type uses the ultrasonography method to determine the size and the characteristics of the thyroid gland in 1,034 school children of both sexes of 13 districts of the country. The study was carried out during 3 months of the year 2000. The elected places had antecedents of under consumption of iodized salt with urinary iodine excretion values below 50 μg/L, as well as the mensuration of the yoduria for the trinitrito method, the level of iodine in salt and the relation height/weight of the studied children. Thyroid volume of school
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