رحیم رستمی

The phenomenon of suicide in Mazandaran province is influenced by social (sense of social inequality and lacking social cohesion), cultural (wrong beliefs, individuals' weak socialization, and generation gap), and economic (economic crisis and economic problems) variables. Nevertheless, in terms of causal conditions, the phenomenon of suicide in Mazandaran province is linked to individual factors such as love failure, addiction, and mental-psychological problems. These factors directly affect the phenomenon of suicide or suicide attempts, especially for young people. Love failure, false love, failure in dealing with emotional matters, alcohol addiction, medicine abuse, drug addiction, suicidal thoughts, mental disorder, depression and anxiety, hopelessness, sense of uselessness and worthlessness, dissatisfaction with life, failure to achieve goals, etc. personal factors that are distinct in different people. However, by considering the conditions of the interventionist as well as the described suicide bases, each of these factors independently could lead to the phenomenon of suicide in Mazandaran province. The most frequent suicide tools are rice tablets (39.29%), hanging (37.5%), weapons (8.93%), self-immolation (5.35%), poisoning (5.35%), Jumping from height (1.79%), and sea drowning (1.79%). Also, the phenomenon of suicide, especially from pathological perspective, leads to two consequences: consequences for the survivors and social consequences.

This study was aimed to assess the interrelationship between urinary iodine excretion (UIE) and thyroid stimulating hormones (TSH) levels in pregnant women during the first trimester.

Women (n=485; age: >14 years old; without any history of thyroid dysfunction) were recruited at their first prenatal consult before 12 weeks of amenorrhea. Proportion of participants from urban and rural population were 41. 6% (n=223) and 58. 4% (n=283). Random urine and blood samples were collected for the analysis of UIE and TSH، respectively.

The overall median UIE was 74 μg/L and 86. 4% of women had iodine deficiency (ID) as defined by UIE < 150. The respective levels for urban and rural populations were 76 μg/L vs. 64 μg/L and 88. 5% vs. 83. 3%. Median TSH as a whole was 0. 8 mIU/L whilst those for urban and rural subjects were 1 mIU/L and 0. 7 mIU/L. No correlation was seen between UIE and TSH levels.

Our data reveals that sever ID is present in 33% of the subjects during the first trimester and that TSH levels are 12-64% lower than those reported for with adequate or more than adequate iodine intake regions in Iran. This preliminarily result suggest that whole body iodine stores is probably adequate to prevent hypo-thyroxinemia during early pregnancy in regions with mild to moderate iodine deficiency.

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.

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.

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).

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.

Nearly 38 million newborns are at risk of iodine deficiency and related disorders (IDDs) annually. Universal salt iodination strategy is the most cost-effective method to combat IDDs. The aims of this study were to evaluate dietary iodine status in pregnant women attending local healthy authority services in Urmia County and its associations with table-salt iodine content and household usage. Pregnant women (n= 490) at 1st trimester were recruited by cluster-sampling from 5 urban- and 7 rural districts. Subjects were interviewed and relevant information was collected. Household salt samples as well as fasting urine samples were collected during 1st visit. Distribution of rural- and urban inhabitants were 204 (41.6%) and 286 84.6%, respectively. Median UIE for entire population was 73.5 µg/L. Medians UIE for urban- and rural districts were 76 µg/L and 64 µg/L. The difference failed to reach statistical significance. When the subjects were grouped according to WHO criteria for iodine status it was found that 87% of the pregnant women were classified as iodine deficient. 92% of the subjects had declared that they were using iodinate salt for their cooking whilst 96% of households claimed using iodinate salt at the dinner table. Percentage of properly kept iodinate samples was 49%. 16% of households stated that iodinated salt was added at the end of cooking. High prevalence of iodine deficiency among pregnant women in Urmia County indicates that the current USI strategy does cover the demand of both mothers and fetus. Thus, extra iodine is needed to maintain adequate iodine store during gestation in regions with border-line iodine sufficiency.

In spite of salt iodization program which began in Iran in 1989، there are controversies regarding the impact of iodine fortification in certain regions of the country such as West Azerbaijan province. The aim of the present study was to re-evaluate urinary iodine excretion and the prevalence of goiter during puberty in female schoolchildren aged 10-17 years in Urmia city.

In this cross-sectional study، 500 female schoolchildren aged 10-17 years were enrolled by random cluster sampling from schools in different educational areas in Urmia. The schoolchildren were classified into 3 groups according to the puberty status: group 1: prepuberty (n=61); group 2: puberty (n=354) and group 3: post puberty (n=85). Urine iodine excretion and prevalence of goiter was evaluated.

The median urinary iodine excretion in groups 1-3 was 125 µg/L، 142 µg/L، and 170 µg/L، respectively. Prevalence of goiter in groups 1-3 was 3. 3%، 14. 6% and 8. 3%، respectively. The prevalence of goiter between group 1 and group 2 was statistically significant (P=0. 03). A significant positive correlation was found between age and urinary iodine excretion (P=0. 008).

This study revealed that 77. 2% of the studied population was iodine sufficient. The highest prevalence of goiter was seen in schoolchildren at puberty (14. 6%) reflecting the high metabolic rate، hormonal alteration during puberty as well as nutritional factors in particularly the demand for higher iodine intake.

Despite adequacy of dietary iodine intake in the Islamic Republic of Iran, the prevalence of goiter is still high in certain parts of the country such as West Azarbaijan province. This investigation was undertaken to evaluate urinary iodine excretion (UIE) and prevalence of goiter among (10-17 years-old) schoolchildren in Urmia County.

Schoolchildren (n=500; gender: girls) were enrolled by random cluster sampling from different schools districts in Urmia. Studied population comprised 158 primary schoolchildren, 257 secondary schoolchildren and 85 high schoolchildren. UIE was assessed by the Sandell-Kolthoff method while prevalence of goiter determined by palpation.

Median UIE in Urmia’s education districts (1&2) were 145 µg/L and 142 µg/L, respectively. Median UIE in high school children was significantly higher than those in primary- or secondary schoolchildren. Prevalence of goiter in primary -, secondary- and high school were 9.5%, 15.2% and 8.2%, respectively.

The present study reveals that average goiter prevalence among schoolchildren in different education levels was 12.6%. This was markedly higher than the value (0.4%) reported by the 4th national survey in 2006. High prevalence of goiter among secondary schoolchildren is possibly associated with pubertal hormonal changes. Further should be conducted to evaluate distribution of thyroid antibody and autoimmune thyroiditis among school-age children Urmia County.