hamidreza bashiri

Systemic lupus erythematosus (SLE) is a systemic autoimmune disease affecting 20–50 per 100,000 people. This study aimed to assess the relationship between ultrasound indices and pathological and laboratory parameters in patients with lupus nephritis (LN).

 This cross-sectional, descriptive-diagnostic study was conducted on 32 patients and 32 healthy individuals. Sonographic indices, renal biopsy results, and laboratory parameters were assessed. A Receiver Operating Characteristic (ROC) curve was used to predict sensitivity and specificity. P-value <0.05 was considered significant.

 The mean GFR and anti-dsDNA levels in patients were 77.4±30.2 ml/min/1.73m² and 2.8±4.4 IU/ml, respectively. Abnormal C3, abnormal C4, and positive aPL were observed in 17 (60.7%), 9 (32.1%), and 8 (28.5%) patients, respectively. In terms of biopsy classification, most patients were in class II (32.1%). The mean biopsy activity index (bxAI) and biopsy chronicity index (bxCI) were 12.11±7.8 and 4.39±3.60, respectively. There was no significant association between the resistive index (RI) and pathological or laboratory parameters (P>0.05). However, a significant association was found between peak systolic velocity (PSV) and end-diastolic velocity (EDV) with GFR, and a negative association between PSV and EDV with aPL and bxCI in patients with LN(P<0.05). The sensitivity and specificity of the anti-dsDNA test for detecting bxCI using a cut-off value of 0.245 were 84% and 96%, respectively (area under the ROC curve = 0.92).

 This study found no association between RI and pathological or laboratory parameters. However, there was a negative association between PSV and EDV with the degree of chronic kidney damage in patients with LN. Anti-dsDNA appears to be a useful predictor of long-term renal outcomes in these patients.

Leprosy is a chronic granulomatous disease in which the musculoskeletal system has been described as the third most commonly affected system. Leprosy infections may manifest with various autoimmune phenomena reminiscent of classic autoimmune diseases. Among the leprosy factors affecting the prognosis of the disease, early diagnosis was reported to be the most effective. A 46-year-old married woman was referred to the hospital with initial articular symptoms. The patient also had deep folds, increased thickness of the skin in the forehead area, and dryness of the skin with a progressive course. The finger deformities and swelling are certainly misleading, but they may constitute an unsuspected inaugural form of leprosy, especially in its lepromatous form. The skin smear and biopsy confirmed leprosy, and treatment consisting of multi-drug therapy, as suggested by the WHO, was prescribed for the patient. According to these findings, it seems that one of the major symptoms of leprosy is musculoskeletal involvement and rheumatological manifestations, which may obscure and mislead diagnostic and treatment plans.

There is a higher prevalence of oral health problems among people with rheumatoid arthritis (RA) than the general population. Receiving and continuing dental treatment is challenging for this patient group for many reasons. Therefore, the purpose of this study was to identify the most common oral concerns and the barriers and facilitators of access to dental health care through a qualitative evaluation.

In this study, an interpretative/hermeneutic approach was used. Through purposive sampling, 50 RA patients (38 women and 12 men) who referred to 3 rheumatology centers in Yazd, Iran, between May and July 2021 were recruited. Sampling was continued until data saturation was reached. To determine the main oral concerns of patients, unstructured interviews and an audio recorder were used for face-to-face interviews.

The information extracted from the questionnaires and recorded information were classified into 4 main themes: 1) physical limitations of RA patients in chewing, swallowing, or following oral hygiene instructions; 2) pain and discomfort that RA patients reported in their mouth and teeth; 3) social and psychological limitations; and 4) barriers and facilitators of dental treatments.

Due to differences in the level of awareness and unique systemic conditions of each interviewee, they had different oral health-related concerns. It seems that a comprehensive approach is necessary to adapt oral health services to the needs of this population. We hope that our findings can help determine the priorities of oral and dental care inthese patients and simplify their access to dental services.

 Due to the overall wide range of oral manifestations and the lack of comprehensively categorized information in Iran, this study was performed to investigate the prevalence of different oral manifestations and report their possible associated factors in patients with SLE.

 This cross-sectional study was performed on 96 SLE patients referred to two rheumatology clinics in Yazd, Iran, from September 2020 to February 2021. SLE patients were diagnosed based on the last revision of American College of Rheumatology (ACR) criteria in 1997. A questionnaire was created to collect demographic information and oral health status. Data were analyzed using SPSS v20.0 and p-values of P < 0.05 were considered statistically significant.

 This study included 13 men (13.5%) and 83 women (86.5%), with an average age of 31.9 ±11.35 years. Oral lesions were diagnosed in 64.4% of patients, with white and red lesions being the most frequent (58%), and the most common region involved was buccal mucosa (25.8%). 97.1% of participants had caries and 86.5% had periodontal diseases. There was a significant association between the presence of oral lesions and female gender, longer duration and higher activity level of the disease and simultaneous presence of periodontal disease and missing or filled teeth. (P < 0.05).

 Given the frequency of oral lesions in more than 60% of patients, as well as the high incidence of caries and periodontal disorders, regular oral examinations in these patients appear to be particularly important.

Peripheral neuropathy may be reversible or permanent. Hence, we would like to present a 38-years-old man without any previous medical history admitted to ShahidSadoughi Hospital in Yazd in terms of reduced force of all four limbs, shortness of breath, cough and hemoptysis. Electromyography and nerve conduction velocity study was performed after the para-clinical examinations and Guillain–Barré syndrome was considered first diagnosis. Regarding the pulmonary symptoms, sinusitis and bilateral alveolar opacities, and positive anti-neutrophil cytoplasmic antibodies, Wegener's granulomatosis was suggested as a potential diagnosis and more steps were performed. This patient has been verified to have concurrent increasing limb weakness, also known as Guillain-Barré syndrome.

Hemophagocytic lymphohistiocytosis (HLH), is a disorder seen more often in children and is life-threatening in terms of over- activation of macrophages, and T cells resulting in cytokine storm. HLH can be familial or secondary to infections,malignancy, immunosuppression, and autoimmune conditions, such as systemic lupus erythematosus (SLE). Here, we report a 10-year old female with previously diagnosed SLE who hospitalized because of fever and pancytopenia.

Hypercalcemia is a rare manifestation in systemic lupus erythematosus (SLE) patients. In this case report, a thirty-five-year-old woman with a 3-year-old history of lupus was reported. Our case had symptoms of SLE flare, including joint pain, hair loss, photosensitivity, high level of calcium and creatinine, and lymphadenopathy. In her brain magnetic resonance imaging, intracranial hemorrhage was detected. Given her high serum level of calcium and phosphorus, reduced parathyroid hormone, and normal level of vitamin D, her hypercalcemia was attributed to the presence of stimulating parathyroid hormone receptor autoantibody. Regarding the findings of this study, it is suggested to consider SLE as a rare but possiblecause of severe hypercalcemia.

Water scarcity is a major deterrent to agricultural development. Adopting appropriate policies to sustain this resource has become an important strategic issue in the country. One of the policies implemented in the agricultural sector for sustainable water resources is the policy of changing the pattern of cropping and reducing the level of water crop cultivation based on the pattern and increasing irrigation efficiency. Accordingly, the aim of this study was to determine the effectiveness of gradual reduction of rice cultivation area along with increasing irrigation efficiency on economic and environmental indices in Marvdasht County. For this purpose, a Positive Mathematical Planning Model (PMP) and calibrated based on crop area data for the year 2017-2018 used. The method used for data collection was based on survey, documentary studies and the use of expert opinions and experiences. The results of this study showed that the application of water demand management policies in the context of different scenarios of reducing rice crop area, in spite of the decrease in the economic benefits of the agricultural sector, improves the economic efficiency index of water resources and decreases the water demand. Therefore, in order to stabilize surface and ground water resources in Marvdasht city, it recommend to change the optimum cropping pattern, in order to reduce the cultivation level of water crops and provide farmers with facilities to equip their farms with new irrigation systems.

Several studies have been done on Lupus Nephritis (LN) and the related outcomes, but there are limited data about the outcome of the disease in Iranian patients. Our aim of this study was to determine predictive factors of poor prognosis of LN amongst an Iranian population. This retrospective study included 111 LN patients, which were followed at least for one complete year according to their medical records. Data such as age, gender, geographical region, classification of renal biopsy, serum creatinine, blood pressure, complement levels, proteinuria, anti-dsDNA level, hemoglobin, Glomerular Filtration Rate (GFR) and serum albumin were collected. The short-term outcome was considered as complete remission, partial remission or non-remission; possible factors affecting the occurrence of these outcomes were evaluated. Pearson Chi-Square test and logistic regression were used for data analysis. A P value of less than 0.05 was considered statistically significant. Female: male ratio was 9.1:1 and the mean age of patients was 26.86±7 years. Low albumin, low GFR, low hemoglobin, high systolic and diastolic blood pressure, high serum creatinine, proteinuria and biopsy class IV at baseline were significantly associated with no remission or partial remission. There was no relationship between the mentioned outcomes and age, gender and geographic region of the subjects. All variables associated with the risk of non-remission should be considered in determining the prognosis and treatment plan. Of all the factors mentioned above, systolic blood pressure and low C3 levels had the highest correlation with the failure of remission.

Renal oncocytoma is a benign renal tumor, which is commonly asymptomatic and discovered incidentally with diagnostic imaging. This benign tumor occasionally co-exists with a malignant neoplasm, which may be present within or near the oncocytoma; in addition a few rare cases of renal oncocytoma have simulated a malignant course, showing extension to branches of the renal vein or distant metastasis. Report of the case: A rare case of renal oncocytoma has been reported in a 56 year- old woman, who referred with distant metastatic disease.