Background & AimsThere is a worldwide epidemic of obesity among adolescents who subsequently are at increased risk for the development of non alcoholic fatty liver disease (NAFLD). The serum alanine aminotransferase (ALT) is the most frequently used test for screening these individuals, but no age and gender-specific upper limits of normal (ULN) based on healthy population data in children are available. The objective of the present study was to define ULN for ALT in healthy children in order to use this as a tool for case finding.MethodsA total of 975 school children (aged 7–18 years) were included in the study cohort. Highly significant correlations (all p<0.001) were noted between ALT values and measures of BMI, systolic and diastolic blood pressure, insulin levels, HOMA-IR, total cholesterol and triglyceride concentrations. In order to define the population with no risk factors, we excluded subjects having abnormal values for factors that correlated with ALT. This population comprised 186 boys and 185 girls.ResultsIn boys, median serum ALT levels were 16 IU/L and 9, 11, 18, and 30 IU/L for the 5th, 25th, 75th, and 95th percentiles. In girls, median serum ALT was 13, and 7, 9, 16, and 21 IU/L for the 5th, 25th, 75th, and 95th percentiles, respectively. The ULNs for ALT were 30 IU/L and 21 IU/L for boys and girls respectively. We found a linear relationship between age and ALT in females (p<0.001) but not in males. By multiple logistic regression, independent predictors of an elevated ALT included the BMI, waist hip ratio and levels of serum total cholesterol. In females, age was an additional inverse predictor.ConclusionsIn children and adolescents, these normal limits for ALT should be applied. Those with persistent elevations should be investigated further.

There was a strong relationship between NAFLD and the abnormal metabolic variables in children. It will be very useful if children are assessed for variables such as waist circumference, fasting blood sugar, fasting insulin and serum lipid profile in order to screen those susceptible to NAFLD.

According to the results, tuberculosis patients still have a low quality of life in spite of receiving new care strategies. Therefore, enhancement in quality of life may improve adherence to anti-tuberculosis treatment, functioning and well-being of patients with tuberculosis.

Aims: Investigation Thyroid dysfunction and autoimmunity in pregnant women with gestational diabetes mellitus. Background: This article was written to evaluate the thyroid function and anti-thyroid peroxidase (anti-TPO) antibodies in pregnant women with gestational diabetes mellitus (GDM). Objective: • More analysis on the levels of iodine intake in the pregnant women. • The geographical area, the type of climate, and other factors are likely to affect on thyroid disorders and GDM. • That thyroid tests be performed in pregnant women, especially those with GDM. • It seems necessary establish new criteria for both thyroid function and GDM according to race and geographical area. Method: A total of 252 women with GDM and 252 healthy pregnant women were enrolled. Thyroid tests, including TSH, FreeT3, Free T4, and anti-TPO were performed for all women at 24–28 weeks of gestation. Data analysis was then carried out using SPSS ver. 22. Result: There was a significant difference between the experimental group (38.4%) and the control group (14.06%) in terms of the prevalence of subclinical hypothyroidism (p= 0.016). The frequency of anti-TPO was higher in the experimental group than the control group and positive anti-TPO was observed in 18.6% of women with GDM and 10.3% of healthy pregnant women (P= 0.008). Conclusion: Thyroid disorders are observed in pregnant women with GDM more frequently than healthy individuals and it may be thus reasonable to perform thyroid tests routinely.

Objectives: Intrauterine growth retardation (IUGR) is a major problem in midwifery medicine for which no effective treatment has been established. This problem has been associated with significant morbidity and mortality, as well as perinatal mortality. IUGR could be prevented when the treatment is administered before the occurance of irreversible changes. Hence appropriate methods for early detection and successful treatment deem necessary. The purpose of this study was to investigate the relationship of vitamin D serum level with IUGR in pregnant women. Materials and Methods: This nested case-control study was conducted on pregnant women who had referred to Fatemieh hospital during 2016. Each of case and control groups included 130 pregnant women. Serum levels of vitamin D were tested in the blood samples obtained from the participants. At the end of the study, all data were analyzed in SPSS software version 16, and χ2 , Fisher exact and t tests were utilized for data analyses. Level of 0.05 was considered statistically significant. Results: Our results showed that the average age, body mass index at the beginning of the pregnancy, blood group, employment status, and education level were not significantly different between the two groups. Moreover, average serum levels of vitamin D were about 14.74 ng/L and 25.34 ng/L in the case and control groups, respectively. In those with vitamin D deficiency, the chance of IUGR was higher compared to those who had sufficient levels of vitamin D (6.27 times). Therefore, women who had vitamin D deficiency, had almost 6 times more chance of IUGR incidence compared to the women with adequate levels of vitamin D (P<0.05). Conclusions: The results verified that serum levels of vitamin D can affect the risk of IUGR; therefore, the incidence of IUGR in babies whose mothers have enough vitamin D level during pregnancy is lower than that in other babies.