فهرست مطالب

  • Volume:4 Issue: 2, 2019
  • تاریخ انتشار: 1398/02/01
  • تعداد عناوین: 6
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  • Elmira Esmaeilzadeh, Mohammadali Nazarinia *, Saeedeh Shenavandeh Pages 41-47
    Aim
    Assessing the effect of Diltiazem gel on scleroderma digital ulcers compared to Nitroglycerin ointment and placebo.
    Methods
    A single blind randomized controlled trial was done on 90 scleroderma patients, randomly divided to three groups: one receiving Diltazem gel 2%, the other receiving Nitroglycerin ointment 2% and control one receiving Vaseline as placebo for 2 times per day for 8 weeks. The patients' demographic information and disease characteristics were summarized. The longest diameter of the ulcers was measured in 3 groups at the beginning and at the end of the study. The site of the ulcers and the number of new ones were, also, determined for each patient
    Results
    The effect size of the ulcers, in each three groups, was significantly lower at the end of the survey (Diltiazem P
    Keywords: Scleroderma, Diltiazem, Nitroglycerin, Ulcer
  • Mandana Pourian *, Iman Mohseni, Maryam Biglari, Mahbod Sianpanah Pages 49-56
    Background
    Systemic sclerosis is a chronic disease of connective tissue accompanied with increased risk of foot ulcers. Biomechanical indexes (soft tissue thickness and compressibility) could affect the risk of this phenomenon.
    Objective
    The aim of this study was assessment of heel pad and first metatarsal head soft tissue thickness and compressibility index in scleroderma patients with and without foot ulcers and comparison with healthy individuals.
    Methods
    Heel pad thickness in standing(loaded) and lying(unloaded) positions was measured in 40 scleroderma patients by means of lateral foot radiography. Compressibility index was measured as the ratio of loaded to unloaded thickness. Also, soft tissue thickness of first metatarsal head was measured with ultrasound. Results were compared with 40 healthy controls of matched age and body mass index.
    Results
    Among 40 scleroderma patients (36 females, 4 males) with mean age of 45 (±12) years and mean body mass index of 25.5 (±4) and mean disease duration of 10 years (±9.6), 8 (20%) had foot ulcers. Heel pad thickness (p-value 0.03) and compressibility index (p-value 0.005) in the dominant side and both-sides metatarsal head soft tissue thickness (P-value
    Keywords: systemic sclerosis, Ulcer, heel pad, Biomechanics
  • Mandana Khodashahi *, Nayereh Saadati, Bahram Naghibzadeh, Rozita Khodashahi Pages 57-61
    Background and Objectives
    Cytokines are produced and secreted from various cells, including T cells. Cytokines play an effective role in the responses elicited by the immune system. As brucella infection cause is an intracellular aerobic rod, cellular immunity has a considerable effect on this disease. The aim of the present study was to evaluate the relation between cytokines and brucellosis arthritis, spondylitis, and sacroiliitis.
    Materials and Methods
    This descriptive case-control study was carried in two tertiary hospitals in Mashhad, Iran in 2010. The study population consisted of a case group, including the patients with the diagnosis of brucella arthritis with lower back pain and a control group, including normal healthy participants. The brucellosis was investigated regarding the history, physical examinations, and serologic examinations. The interferon gamma (IFNγ), interleukin 2 (IL-2), interleukin 4 (IL-4), interleukin 10 (IL-10), and tumor necrosis factor alpha (TNFα) were measured in the serum samples of both groups using enzyme-linked immunosorbent assay technique.
    Results
    The IL-10 had a significant difference in the brucella and control groups (P=0.02). However, IL-2, IL-4, and the TNFα were comparable between brucella and control groups (P=0.1). There was a significant difference between the IFNγ and brucella in the control group (P=0.05).
    Conclusion
    The IFNγ and IL-10 levels were higher in brucella group than those in control group.
    Keywords: Cytokines, Brucella, arthritis, spondylitis, sacroiliitis
  • Seyed Hossein Safiabadi, Fatemeh Shirani *, Anousheh Haghighi, Nahid Kianmehr, Ali Javadzadeh, Farrokh Naderi, Haleh Chehrehgosha, Majid Khoshmirsafa Pages 63-69

    Diabetes mellitus (DM) is a common metabolic disease associated with carpal tunnel syndrome (CTS) and tendinopathy. This study aims to assess the ultrasonographic (US) parameters of the flexor tendon and median nerve in asymptomatic subjects with diabetes in comparison with controls without diabetes. 22 DM and 22 non-DM subjects without any symptoms or manipulations in non-dominant hands and wrists were assessed. The ultrasound evaluation of the length, width, cross-sectional area and circumference of forth flexor tendon and the median nerve was performed in the two groups. There was no statistically significant difference of age (P = 0.473) , gender (P = 0.364) , wrist circumferences (P = 0.1921) between the two groups. This study showed no significant difference between the two groups in the median nerve length (P = 0.35), width (P = 0.17), cross-sectional circumference (P = 0.23) and cross-sectional area (P = 0.16). Also, comparing of the sonographic data of the fourth flexor tendon between the two groups presented no significant difference in the length (P = 0.68), width (P = 0.80), cross-sectional circumference (P = 0.70) and cross-sectional area (P = 0.80). In conclusion, our data showed that sonographic values of the median nerve and fourth flexor tendon in asymptomatic subjects with DM did not significantly differ with non-diabetics. These findings demonstrate that still more case studies and more evaluations are required to validate the applicability of ultrasonography in the prediction of carpal tunnel syndrome and tendinopathy in diabetic patients.

    Keywords: diabetes mellitus, carpal tunnel syndrome, tendinopathy, Ultrasonography
  • Mohammadhassan Jokar *, Hosein Azadeh, Zahra Mirfeizi, Zhaleh Shariati, Kamila Hashemzadeh Pages 71-75
    Background objectives

    Cartilage oligomeric matrix protein (COMP) as a marker of cartilage destruction. We aimed to compare the effect of a mixture of avocado-soybean unsaponifiables versus celecoxib on the serum level of COMP in patients with knee osteoarthritis.

    Methods

    This was a randomized controlled trial and the patients with knee osteoarthritis were recruited from those who attended Imam Reza Hospital, Mashhad, Iran. The patients were divided randomly into two groups; Group 1 (n=30) received avocado+soybean mixture (300 mg daily) and group 2 (n=30) received celecoxib (200 mg/day) for 2 months. At the enrollment and then every month up to 2 months, the patients' venous blood samples were collected to measure serum COMP.

    Results

    The total number of patients was 60 (male 38%, female 62%) with a mean age 56±7 years. Before treatment, the serum levels of COMP were 14.5±1.4 unit/liter (U/L) and 13.9±1.4 U/L in avocado+soybean mixture and celecoxib groups, respectively (P=0.052). After the first month the serum levels of COMP were 12.3±1.5 U/L and 12.8±1 U/L in avocado+soybean mixture and celecoxib groups, respectively (P

    Keywords: Cartilage oligomeric matrix protein, Avocado, soy, Celecoxib, Knee osteoarthritis
  • Nira Ferdous_Md Islam_Farah Rahman_Zahedur Pannu_Fahid Nazrul_Ashik Zaman_Johannes J Rasker * Pages 77-85
    A 40-year-old woman had been suffering of many symptoms of Behçet’s disease (BD) since her childhood without being diagnosed. She had recurrent mouth ulcers and from the age of 21 vulva ulcers followed by loss of vision due to central retinitis and later also ankle arthritis. At the age of 31, uveitis due to BD was diagnosed. The fact that BD is often not recognized in Bangladesh explains the marked delay in her diagnosis. The initial central retinitis responded well to oral glucocorticoids, azathioprine and cyclosporine, but in the course of time she became refractory to these agents. Considering her financial constraints, low dose Infliximab (3mg/kg) was used resulting in a remarkable but temporal improvement, she came in remission by using 5mg/kg regimen with increased interval time. We summarize the treatment options for ocular involvement in BD patients
    Conclusions
    In countries like Bangladesh diagnosis of Behçet’s disease can be delayed. Early cooperation of dermatologists and eye surgeons with rheumatologists is necessary. Most cases of resistant ocular BD can nowadays be successfully treated with anti TNF-agents. Promising results are published with other biologics for refractory and multi-resistant cases.
    Keywords: Ocular Behçet’s Disease, Refractory, Low Dose Infliximab