Vitamin D levels in systematic lupus erythematosus patients: association with disease activity index and interferon alpha

Background: In different studies the correlation between systemic lupus erythematosus (SLE) and disease activity with vitamin D has been shown. The role of different interferons especially interferon alpha (IFN-α) in lupus pathogenesis have been previously shown. Considering the role of vitamin D and IFN-α, it is possible that these two could demonstrate the SLE activity. This study aimed to investigate the association between vitamin D levels and IFN-α with disease activity index in Ardabil city SLE patients.Methods: In this case control study, 50 SLE patients and 50 age and sex matched healthy subjects were recruited. Patients had serum 25-OH Vitamin D concentration and disease activity recorded. Vitamin D and IFN-α levels were compared between two groups and also, levels of anti-dsDNA, and SLEDAI in case group was measured. Statistical methods were used to determine the correlation between vitamin D and IFN-α with disease activity index at baseline.Results: Vitamin D deficiency (<40 nmol/L) was detected in 20% of SLE patients. Vitamin D level in case group significantly lower than control group (23.94±11.93 vs. 29.10±11.40 ng/ml, p=0.02). The IFN-α amount in case group significantly upper than control group (396.60±54.73 vs. 200.38±14.42, p=0.001). There was significantly negative correlation between vitamin D with IFN-α (r=-0.413, p=0.003), SLEDAI (r=-0.492, p<0.001) and anti-dsDNA (r=-0.417, p=0.003). There was positive correlation between IFN-α with SLEDAI (r=0.358, p=0.01) and anti-dsDNA (p=0.297, p=0.03).Conclusions: Results showed that the low vitamin D was associated with a higher disease activity in SLE patients. Also, it seems that, the improvement of vitamin D levels by decreasing IFN-α could help in controlling disease activity in future

Frequency of pes anserine bursitis in patients with knee osteoarthritis

Background: Knee pain is a very common disease in the elderly, which is often attributed to osteoarthritis but pes anserine bursitis also can cause knee pain, especially in OA patients. The aim of this study was to determine the frequency of pes anserine bursitis in patients with knee osteoarthritis. Methods: This cross-sectional descriptive study included 245 patients with definitive knee osteoarthritis referred to Imam Khomeini Hospital in Ardabil city from September 2020 to December 2021. All patients were sent to ultrasonography to diagnosis Pes Anserine Bursitis. Osteoarthritis was divided into 4 groups based on the radiographic classification of Kellgren-Lawrence. The severity of knee pain was also determined by the Visual Analogue Scale (VAS). The necessary data were collected by a checklist and then analysed by statistical methods in SPSS version 22. Results: Total 175 out of 245 patients (71%) were diagnosed with pes anserin bursitis. There was a significant relationship between age, gender, BMI, OA and staging of OA with the risk of anserin bursitis. Conclusions: Results showed that the high prevalence of anserine bursitis in patients studied indicates the importance of this issue and the need for attention by physician as one of knee pain reasons. Since the clinical examination has a significant diagnostic power in the detection of anserin bursitis, it is recommended that special attention be paid to the clinical examination. Attention to the risk factors in the country such as obesity, the use of toilets and so on, which can be controlled and can be prevented

Interstitial Keratitis, Vertigo, and Vasculitis: Typical Cogan’s Syndrome

Cogan’s syndrome (CS) is a chronic inflammatory disorder of unknown etiology that most commonly affects young adults. Clinical hallmarks are bilateral interstitial keratitis and vestibuloauditory dysfunction. Association between CS and systemic vasculitis as well as aortitis also exists. The diagnosis of CS is based upon presence of characteristic inflammatory eye disease and vestibuloauditory dysfunction. We describe classic Cogan’s syndrome in a 47-year-old female from Ardabil. The patient was admitted with headache, vertigo, nausea, vomiting, right leg claudication, musculoskeletal pains, bilateral hearing loss, and blindness for the past two months. Ophthalmologic examination revealed that visual acuity was 0.1 bilaterally. Conjunctival hyperemia, bilateral cataract, and interstitial keratitis were detected with a slit lamp examination. Pure tone audiogram (PTA) and auditory brain stem response (ABR) showed bilateral sensorineural hearing loss. The other differential diagnosis of CS was studied and ruled out. Pulse i.v. methylprednisolone and cyclophosphamide were given and were followed by oral prednisolone and cyclophosphamide. Clinical follow-up showed partial improvement

Efficacy of orlistat in the treatment of patients with non-alcoholic fatty liver

Background: Nonalcoholic fatty liver disease (NAFLD) is a reversible condition of fat accumulation that is associated with liver inflammation and can disrupt the normal activity of the liver. People with a diagnosis of NAFLD have a higher risk of all- cause mortality than the general population. The purpose of the present study was to determine, the efficacy of orlistat in the treatment of patients with NAFLD.Methods: This semi-experimental study was performed on 45 fatty liver patients of the gastroenterology clinic of Imam Khomeini Hospital in Ardabil city in April 2016 to April 2017. Data was collected by a checklist which included demographic and clinical data such as age, sex, body mass index (BMI), alanine aminotransferase (ALT), aspartate aminotransferase (AST), triglyceride (TG), cholesterol and result of ultrasound before and after orlistat consumption.Results: The mean decrease in the variables examined was as follows: weight 8.3 kg, BMI 3.5 kg/m2, ALT 31.6 U/l, AST 18.1 U/l, cholesterol 15.5 mg/dl and TG 33.1 mg/dl. All of the upper indexes were decreased significantly following received drug.Conclusions: Orlistat therapy was associated with significant decreases in ALT, AST, TG and cholesterol level. Orlistat is effective in weight loss, body mass index reduction and can be used to treat non-alcoholic fatty liver disease

The global burden of cancer attributable to risk factors, 2010-19 : a systematic analysis for the Global Burden of Disease Study 2019

Background Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk-outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. Findings Globally, in 2019, the risk factors included in this analysis accounted for 4.45 million (95% uncertainty interval 4.01-4.94) deaths and 105 million (95.0-116) DALYs for both sexes combined, representing 44.4% (41.3-48.4) of all cancer deaths and 42.0% (39.1-45.6) of all DALYs. There were 2.88 million (2.60-3.18) risk-attributable cancer deaths in males (50.6% [47.8-54.1] of all male cancer deaths) and 1.58 million (1.36-1.84) risk-attributable cancer deaths in females (36.3% [32.5-41.3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20.4% (12.6-28.4) and DALYs by 16.8% (8.8-25.0), with the greatest percentage increase in metabolic risks (34.7% [27.9-42.8] and 33.3% [25.8-42.0]). Interpretation The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.Peer reviewe

Clinical, Demographic and Laboratory Information of Patients with SLE in Ardabil Province (Original article)

Background: Systemic lupus erythematosus is an autoimmune disease in which organs and cells are damaged in the initial stages by tissue-binding autoantibodies and immune complexes. Clinical, demographic and laboratory information of patients with SLE in Ardabil province is the aim of this study. Methods: The present study is a cross-sectional descriptive study that examines demographic data (age, gender), clinical information such as the first manifestation of the disease, clinical symptoms, etc., and laboratory findings such as CBC, ESR, CRP, proteinuria, FANA, Anti dsDNA, C3, C4, Anti RO and APS Ab of patients who referred to the rheumatology clinic of Imam Khomeini Hospital (RA) in 2021. Results: Information related to the clinical characteristics of 50 patients, including 46 women (92%) and 4 men (8%), with an average age of 12.14 ± 40.78 years (range: 21-73) and age at diagnosis of 10.62 ± 31.76 years were investigated. The most common initial complaint in the studied patients was related to isolated joint symptoms (28%). The most common clinical symptoms observed in the examined patients were related to joint symptoms along with sensitivity to light with a frequency of 20%. ANA, anti-dsDNA tests positivity and reduced C3 and C4 levels were observed in 88%, 70% and 26% of patients, respectively. Conclusion: The establishment of a registry system for the structured registration of information of patients with systemic lupus erythematosus in each region is necessary to a better understanding of the characteristics of the disease and better management policy of patients

Comparison of Bone Mineral Densitometry at 2 Sites Versus 3 Sites in Patients Suspicious for Osteoporosis

Objectives: In this study, we aim to evaluate the bone mineral density (BMD) results of 2 standard sites with 3 sites including wrist in diagnosing osteoporosis. Methods: We evaluated the BMD results of 1272 individuals referred for suspected osteoporosis between 2012 and 2015. Those individuals were included with BMD at lumbar spine, femur neck, and wrist. Bone mineral density was measured using a dual-energy X-ray absorptiometry (DXA) device. Bone mineral density and T score were measured for all 3 sites. Results: There was significant correlation between wrist T score with hip T score ( r = 0.606, P < .001) and lumbar T score ( r = 0.527, P < .001). With BMD of 2 sites, patients had osteopenia in 46.3% and osteoporosis in 23.7%, while by adding wrist T-BMD, subjects had osteopenia in 46.6% and osteoporosis in 33%. Between BMD at 2 sites and 3 sites, there was concordance in 81.9%, minor discordance in 17.6%, and major discordance in 0.5%. Conclusions: We observed discordance between BMD measurements of 2 sites and 3 sites, with latter detecting more cases with osteoporosis. In fact, measurement of T scores of wrist along with lumbar and femur neck improves the diagnosis

The global burden of cancer attributable to risk factors, 2010–19: a systematic analysis for the Global Burden of Disease Study 2019

BackgroundUnderstanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally.MethodsThe GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk–outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented.FindingsGlobally, in 2019, the risk factors included in this analysis accounted for 4·45 million (95% uncertainty interval 4·01–4·94) deaths and 105 million (95·0–116) DALYs for both sexes combined, representing 44·4% (41·3–48·4) of all cancer deaths and 42·0% (39·1–45·6) of all DALYs. There were 2·88 million (2·60–3·18) risk-attributable cancer deaths in males (50·6% [47·8–54·1] of all male cancer deaths) and 1·58 million (1·36–1·84) risk-attributable cancer deaths in females (36·3% [32·5–41·3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20·4% (12·6–28·4) and DALYs by 16·8% (8·8–25·0), with the greatest percentage increase in metabolic risks (34·7% [27·9–42·8] and 33·3% [25·8–42·0]).InterpretationThe leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden

The global burden of cancer attributable to risk factors, 2010-19: a systematic analysis for the Global Burden of Disease Study 2019

Background Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk-outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. Findings Globally, in 2019, the risk factors included in this analysis accounted for 4.45 million (95% uncertainty interval 4.01-4.94) deaths and 105 million (95.0-116) DALYs for both sexes combined, representing 44.4% (41.3-48.4) of all cancer deaths and 42.0% (39.1-45.6) of all DALYs. There were 2.88 million (2.60-3.18) risk-attributable cancer deaths in males (50.6% 47.8-54.1] of all male cancer deaths) and 1.58 million (1.36-1.84) risk-attributable cancer deaths in females (36.3% 32.5-41.3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20.4% (12.6-28.4) and DALYs by 16.8% (8.8-25.0), with the greatest percentage increase in metabolic risks (34.7% 27.9-42.8] and 33.3% 25.8-42.0]). Interpretation The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license