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Introduction: During the history of internal medicine Goiter has always been at the center of attention as one of the most important endemic disorders. It is estimated that about one billion people around the globe are affected with Goiter. Iran is recognized as an cndemic area for Goiter. The aim of this study was to reveal the pattern of distribution of different thyroid disorders in-patients with Goiter in Markazi Province.
Material and methods: It was a descriptive-cross-sectional study that enrolled 2138 patients with Goiter who were selected randomly and by categorized sampling (F=1542, M=596) TSH serum titers were checked for screening and if abnormal, detailed thyroid function tests were done. We used Radon ELISA Kits previously checked with RIA in our study. Patients were first examined for Goiter and graded if Goiter was found, and if it was nodular, the patient was referred for sonography, thyroid scan and FNA. Then the patients were further evaluated based on clinical findings and laboratory results for various thyroid disorders.
Results: In this study we evaluated 2138 pts with Goiter (72% (1542)=F, 28% (596)=M) from which 83.1% had a simple Goiter, 6.94% were hypothyroid, 3.36% had subclinical hypothyroidism. 4.8% were hypothyroid, and 1.17% had subclinical hypothyroidism.
13 pts (0.7%) had nodular Goiter that in one case it was diagnosed as papillary carcinoma. Three patients had coid nodules and the rest had multiple warm nodular or diffuse Goiters. In 44.3% of cases Goiter was in grade IA and in 34% cases it was graded as IB. Goiter was the most prevalence (32.5%) in 10-19 age group and it was least prevalence (2.1%) in pts over 70.
Conclusion: Goiter is endemic in Markazi Province, but its prevalence in the children of recent decade is declining and in previous decades, clinical and subclinical forms of hypothyroidism and hypothyroidism are more prevalent.

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Background: Oetection of congenital hypothyroidism (CH) in Arak has begun since 2006. The aim of this study was to investigate on recall rate (RR) and the incidence of this disease in Arak. Materials and Methods: In this descriptive study, according to the national screening program for CH in Iran, heel blood samples of 3-5 day- old neonates were taken on special filter paper and TSH values were measuned using ELISA method. TSH values bigger than 5mu/lit were recalled and thyroid function tests (TSH, T4 and T3RUP) were done on venous blood samples and assayed using ELISA method. Neonates with TSH values >10 mu/lit, T4<6.5 ug/dl were viewed as patients. Data related to neonates born up to the end of March 2009 were recorded in special forms. Results: Of 25685 screened neonates, 608 newborns were recalled. RR was estimated to be 2.36%. TSH values in 3.78% were less than 5, in 83.55% between 5-9.9, in 7.56% between 10-19.9 and in 5.09% more than or equal to 20. Eighty six neonates had CH (1/300 live births). Disease rate in recalled neonates was 14.2%. In 80.26 percent of neonates, sampling was done between 3-5 days while the times of sampling in 18.5 and 1.1 percents of the newborns were in days 6-21 and after day 22, respectively. Conclusion: The incidence of CH in Arak is remarkably higher than national and international rates. RR in Arak is higher than the national but lower than the international rates. Also, the ratio of the disease to the recalled neonates is low.

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Background: Subclinical hypothyroidism is the compensatory stage before overt hypothyroidism. In overt hypothyroidism, risk of ischemic heart disease increases due to elevation of lipoprotein (a) as atherogenic agent, but evidence for subclinical hypothyroidism is one of the controversial issues in researches. According to the atherogenic lipoprotein (a) and other serum lipids, this study is conducted to compare the serum lipoprotein (a) and other serum lipids in patients with subclinical hypothyroidism and euthyroidism.

Materials and Methods: In this descriptive - analytic study, 90 persons (60 with subclinical hypothyroidism and 30 euthyroid state) are participated and these referred to Imam Reza and Taleghani Hospitals which are located in Kermanshah. The sampling method is selected with available sampling methods. After differentiating data by age, sex and underlying disease (liver, kidney, drugs), then they were subjected to determination lipoprotein (a) and other serum lipids profile tests.

Results: In both cases and controls, 16/7% were men and 83/3% were women. Based on results, there is no significant difference between serum lipoprotein (a), triglycerides, cholesterol, HDL and LDL in both statistical groups (p>0.05). Also there is no association between lipoprotein (a) and other serum lipids (p>0.05).

Conclusion: Serum levels of lipoprotein (a) and other serum lipids in young patients with normal weight with subclinical hypothyroidism is not increase, thus it can be concluded early treatment is not necessary for them.

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background: Early detection and treatment are crucial to prevent mental retardation in congenital Hypothyroidism (CH). The aim of this study was to evaluating of screening program of CH in Markazi Province.

Materials and Methods: In cross sectional descriptive study we used recorded data in Markazi province health center. From 2006 to 2012,127112 newborns were screened by measurement of serum TSH level by heel prick. Neonates who had blood TSH&ge5MIU/L were recalled for more evaluation. Neonates with confirmed hypothyroidism underwent treatment.

Results: From127112 screened neonates, 414 were diagnosed as CH patients (both permanent and transient). The prevalence of CH was . Recall rate was 4.8%. In 94.4% of patients, treatment were begun before the 40th day of life. The coverage percent in the province was 100% from the second year of the program.

Conclusion: Recall rate and the incidence of CH were higher than those in other studies, both in Iran and other countries. The mean age of treatment initiation and coverage percent were in favorable range.

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