Evaluation of simple calculated osteoporosis risk estimation (SCORE) in Iranian postmenopausal women

زمینه و هدف: پوکی استخوان به یک مشکل عمومی سلامت در تمام جهان تبدیل شده است. روش جذب دوگانه پرتو ایکس، به عنوان مطمئن ترین روش برای تشخیص به دلیل هزینه بالا و عدم سهولت دسترسی، جهت غربالگری پوکی استخوان توصیه نمی گردد. بر اساس عوامل خطر، ابزارهایی برای غربالگری و سنجش میزان خطر ابتلا به استئوپروز ابداع، که مشهورترین آنها ابزار محاسبه ساده تخمین خطر پوکی استخوان (SCORE) می باشد، این مطالعه با هدف بررسی کارآیی این ابزار در غربالگری زنان یائسه ایرانی برای ابتلا به استئوپروز انجام گردیده است. روش بررسی: در این مطالعه توصیفی-تحلیلی 341 زن یائسه که جهت سنجش تراکم استخوان به مرکز تشخیصی سنجش تراکم استخوان اصفهان مراجعه نموده بودند، مورد پرسش قرار گرفته و فرم پایش پوکی استخوان (SCORE) بر اساس خصوصیات افراد برای آنان تکمیل گردید. نتایج فرم ها و امتیاز بدست آمده با نتایج تراکم استخوان بدست آمده در هر فرد، با هم مقایسه و حساسیت، اختصاصی بودن و ارزش اخباری این روش غربالگری مشخص گردید. یافته ها: از 341 زن یائسه مورد مطالعه، 71 نفر دچار استئوپروز (8/20)، 135 نفر (6/39) دارای تراکم استخوان پایین (استئوپنی) در یک یا هر دو ناحیه مورد بررسی و 135 نفر (6/39) نیز دارای سنجش تراکم استخوان نرمال بودند. ابزار SCORE دارای حساسیت 2/87 و اختصاصی بودن 9/37 برای مشخص کردن زنان دارای تراکم استخوان پایین بود. نتیجه گیری: ابزار SCORE برای غربالگری زنان یائسه ایرانی نیز با حساسیت قابل قبول می تواند مورد استفاده قرار گرفته و برای پایش زنان یائسه ایرانی و ارجاع آنها برای سنجش تراکم استخوان مناسب و قابل اطمینان می باشد

Anticonvulsant and neuroprotective effects of Pimpinella anisum in rat brain

Background: Essential oil of Pimpinella anisum L. Apiaceae (anise oil) has been widely used in traditional Persian medicine to treat a variety of diseases, including some neurological disorders. This study was aimed to test the possible anti-seizure and anti-hypoxia effects of anise oil. Methods: The effects of different concentrations of anise oil were tested on seizure attacks induced by pentylenetetrazol (PTZ) injection and neuronal hypoxia induced by oxygen withdrawal as well as on production of dark neurons and induction of long-term potentiation (LTP) in in vivo and in vitro experimental models of rat brain. Results: Anise oil significantly prolonged the latency of seizure attacks and reduced the amplitude and duration of epileptiform burst discharges induced by injection of intraperitoneal PTZ. In addition, anise oil significantly inhibited production of dark neurons in different regions of the brain in epileptic rats. Anise oil also significantly enhanced the duration of the appearance of anoxic terminal negativity induced by oxygen withdrawal and inhibited induction of LTP in hippocampal slices. Conclusions: Our data indicate the anticonvulsant and neuroprotective effects of anise oil, likely via inhibition of synaptic plasticity. Further evaluation of anise oil to use in the treatment of neurological disorders is suggested

A phase III, randomized, two-armed, double-blind, parallel, active controlled, and non-inferiority clinical trial to compare efficacy and safety of biosimilar adalimumab (CinnoRA (R)) to the reference product (Humira (R)) in patients with active rheumatoid arthritis

Background: This study aimed to compare efficacy and safety of test-adalimumab (CinnoRA (R), CinnaGen, Iran) to the innovator product (Humira (R), AbbVie, USA) in adult patients with active rheumatoid arthritis (RA). Methods: In this randomized, double-blind, active-controlled, non-inferiority trial, a total of 136 patients with active RA were randomized to receive 40 mg subcutaneous injections of either CinnoRA (R) or Humira (R) every other week, while receiving methotrexate (15 mg/week), folic acid (1 mg/day), and prednisolone (7.5 mg/day) over a period of 24 weeks. Physical examinations, vital sign evaluations, and laboratory tests were conducted in patients at baseline and at 12-week and 24-week visits. The primary endpoint in this study was the proportion of patients achieving moderate and good disease activity score in 28 joints-erythrocyte sedimentation rate (DAS28-ESR)-based European League Against Rheumatism (EULAR) response. The secondary endpoints were the proportion of patients achieving American College of Rheumatology (ACR) criteria for 20% (ACR20), 50% (ACR50), and 70% (ACR70) responses along with the disability index of health assessment questionnaire (HAQ), and safety. Results: Patients who were randomized to CinnoRA (R) or Humira (R) arms had comparable demographic information, laboratory results, and disease characteristics at baseline. The proportion of patients achieving good and moderate EULAR responses in the CinnoRA (R) group was non-inferior to the Humira (R) group at 12 and 24 weeks based on both intention-to-treat (ITT) and per-protocol (PP) populations (all p values >0.05). No significant difference was noted in the proportion of patients attaining ACR20, ACR50, and ACR70 responses in the CinnoRA (R) and Humira (R) groups (all p values >0.05). Further, the difference in HAQ scores and safety outcome measures between treatment arms was not statistically significant. Conclusion: CinnoRA (R) was shown to be non-inferior to Humira (R) in terms of efficacy at week 24 with a comparable safety profile to the reference product

The effect of Vitamin D supplementation in disease activity of systemic lupus erythematosus patients with Vitamin D deficiency: A randomized clinical trial

Background: The aim of this study was to check the effectiveness of Vitamin D supplementation on the disease activity of Vitamin D-deficient systemic lupus erythematosus (SLE) patients. Materials and Methods: In this randomized, double-blind, placebo-controlled trial, 45 Vitamin D-deficient SLE patients were studied in two groups, namely interventional and placebo groups. The interventional group patients were treated with Vitamin D (50,000 unit/weekly Vitamin D for 12 weeks and then 50,000 unit/monthly for 3 months) and placebo group patients were only administered the placebo. The level of Vitamin D and the level of disease activity using SLE disease activity index (SLEDAI) were measured before and after intervention period in each group, and for intra- and between-groups comparison, we used t-test and repeated measure ANOVA. Results: A total of 90 patients were enrolled in this study. The mean of Vitamin D was increased significantly after therapy in interventional group (17.36 ± 4.26 ng/ml vs. 37.69 ± 5.92 ng/ml, P < 0.001). The mean of Vitamin D had no significant difference before and after intervention in placebo group (16.78 ± 4.39 ng/ml vs. 16.62 ± 4.61 ng/ml, P = 0.53). The mean of disease activity (SLEDAI) was not different significantly before and after Vitamin D administration in interventional group (3.09 vs. 1.62 ± 1.25, P = 0.39). The mean of disease activity (SLEDAI) was not different significantly before and after intervention in placebo group (3.09 vs. 1.98 ± 2.47, P = 0.42). Conclusion: According to our study, it is suggested that using Vitamin D in patients with SLE could not have better outcomes in this regard. However, there are many unknown environmental or biological factors which are associated with the disease activity of SLE and have not been identified yet

The Relationship of Opium Addiction with Coronary Artery Disease

Objectives: There is some controversy regarding the effect of opium addiction on the coronary artery disease (CAD). The aim of this study was to determine the association between chronic opium consumption and CAD. Methods: This study had a case-control design. The patients re-cruited to the study were selected from angiography files in De-partment of Cardiology in Kerman University of Medical Sci-ences, Kerman, Iran. The comparison was done between CAD patients and normal subjects. Opium addiction was diagnosed by patient self-report and confirmed with interview based on DSM-IV criteria. Odds ratio with 95% confidence interval were esti-mated by unconditional logistic regression. Results: The risk factor of CAD was the same in the two study groups. The significant difference in opium consumption was demonstrated between CAD patients and normal coronary artery subjects (OR=3.8, 95%CI=1.5-9.5). Because of the strong associa-tion between cigarette smoking and opium addiction, analysis was done in smoker and non-smoker groups separately. Logistic re-gression showed opium addiction was the independent risk factor for CAD in non-smokers after adjusting to other CAD risk factors (OR=38, 95%CI=2.7-531.7), but in cigarette smokers opium was not a significant risk factor (OR=13.2, 95%CI=0.85-206.5). Conclusions: We confirmed that the opium was an independent risk factor for CAD. Health managers and policy makers should try to aware general population and prepare many preventive pro-grams against substance abuse

Agreement of clinical examination and ultrasound methods for detection of joints involvements in rheumatoid arthritis

Background: Rheumatoid arthritis is a chronic autoimmune disease characterized by synovial tissue inflammation and destruction of articular components which if not controlled properly, can cause disability in patients. For this reason, evaluation of disease activity and its control is very important. In recent years using sonography is promising for the evaluation of disease activity. This study aimed to compare “clinical examination” and “ultrasonography” methods in the detection of disease activity in patients with rheumatoid arthritis. Materials and Methods: This cross-sectional study was conducted during 2015 in Al-Zahra Hospital of Isfahan. Based on the American College of Rheumatology 2010 criteria, ninety patients with rheumatoid arthritis who diagnosed by rheumatologist entered into the study. All patients, collaborator by radiologists were subjected to sonography of specific joints structures using two methods, i.e., high-resolution ultrasonography and power Doppler. Results: A total of 2520 joints from ninety patients were examined by physical examination and ultrasonography that 244 joints (9.7%) in physical examination and 348 joints (13.4%) in ultrasonography were involved and the difference between the two groups was statistically significant (P < 0.001). Conclusion: Probably, ultrasonography can diagnose joint involvement better than physical examination in patients with Rheumatoid arthritis

Comparison the percentage of detection of periarthritis in patients with rheumatoid arthritis using clinical examination or ultrasound methods

Background: This study aimed to compare the percentage of detection of periarthritis in patients with rheumatoid arthritis using clinical examination and ultrasound methods. Materials and Methods: This study is a cross-sectional study which was conducted in Al-Zahra Hospital (Isfahan, Iran) during 2014–2015. In our study, ninety patients were selected based on the American College of Rheumatology 2010 criteria. All patients were examined by a rheumatologist to find the existence of effusion, and the data were filled in the checklist. The ultrasonography for detecting effusion in periarticular structures was done by an expert radiologist with two methods, including high-resolution ultrasonography and power Doppler. The percentage of effusion existence found by physical examination was compared by sonography, and the Chi-square and t-tests were used for data analysis. Results: The percentage of effusion found in areas with physical examination by rheumatologist was lower than the frequency distribution of effusions found by sonography (8.3% VS 14.2%) (P < 0.001). In sonography, rotator cuff tendonitis is the most common periarthritis. Other findings in sonography were biceps tendinitis (10 cases), wrist tendonitis (13 cases), olecranon bursitis (9 cases), golfers elbow (4 cases), tennis elbow (4 cases), trochanteric bursitis (6 cases), anserine bursitis (6 cases), prepatellar bursitis (11 cases), and ankle tendonitis (7 cases). Tenderness on physical examination was found in 15% of the cases, and the evidence of periarthritis was found in 21/7% through sonography (P < 0.001) and 34% through Doppler sonography (P < 0.001). Conclusion: The percentage of periarthritis detection by ultrasonography and power Doppler sonography was higher than clinical examination. Hence, the ultrasonography is more accurate than physical examination