[Prevalence of osteopenia and osteoporosis in patients with celiac disease in northeastern Iran]

Celiac disease is an autoimmune disorder which causes malabsorption in genetically susceptible patients who consume gluten. Celiac disease is not limited to the gastrointestinal system, and exhibits different signs and symptoms in other organs. Malabsorption of calcium and vitamin D can cause osteomalacia and secondary hyperparathyroidism. Celiac disease is no longer a rare disease and is more frequent in the Middle East. It is expected that 1% of the in general population has celiac disease. This study aims to determine the prevalence of osteopenia and osteoporosis in Iranian patients with celiac disease. Individuals with intestinal and extra-intestinal problems who had positive serologic tests for anti-tissue transglutaminase or antiendomysial antibody were offered endoscopic duodenal biopsy to confirm their diagnoses of celiac disease. Biopsy-proven celiac disease patients between the ages of 20 to 60 years were enrolled. Exclusion criteria were as follows: 1] the use of drugs such as corticosteroids, anticonvulsants, heparin, cyclosporine, statins, and beta -blockers, 2] the presence of any neoplasm, and 3] any metabolic disorder such as diabetes, hyperthyroidism, Cushing's, and immobility. After obtaining informed consents, we evaluated 76 patients diagnosed with celiac disease. All enrolled patients underwent BMD measurement of the hip, femoral neck, and spine using dual-energy X-ray absorptiometry [bone densitometry with DEXA scan]. A total of 76 patients with celiac disease of ages 20 to 60 years old [mean: 33 years old] underwent bone densitometry. Of these, 66% were female and 33% were male. There were 44 patients [57%] who had normal bone density in the spine, 17 [22.4%] who had osteopenia, and 15 patients [20%] had osteoporosis. In the femoral neck, 38 patients [50%] had normal bone densitometry, 25 [32.9%] had osteopenia, and 12 [15.8%] had osteoporosis. Low bone mineral density [osteoporosis or osteopenia] was seen in 48% of our patients in the femoral neck and 43% in the spine. The prevalence of osteoporosis among celiac disease is much higher than the general population. Of the study patients, 55% had osteopenia in the femoral neck or spine and 36% had osteoporosis in the femoral neck or spine. The prevalence of osteoporosis is elevated enough to justify a recommendation for osteoporosis screening of all patients with celiac disease

Correlation -IL17A and RANKL concentration in GCF with periodontal disease

Periodontal diseases consist of chronic inflammation in periodontal tissues that induced by periodontophathic bacteria and develop by host immune responses. Several studies reported that IL-17 and RANKL are important in autoimmune diseases, inflammation and bone resorption. Since the exact role of them remains unknown, so the aim of this study was to evaluate the relationship between IL-17A or RANKL concentrations and periodontal diseases. In this analytical and case control study; GCF samples were collected from forty patients with gingivitis and moderate to advanced chronic periodontitis referred to the periodontics clinic of Shahid Beheshti University of medical sciences. IL-17A and RANKL were assayed by enzyme-linked immunosorbent assay. The differences of IL-17 and RANKL concentration analyzed between gingivitis and periodontitis, by Mann-Whitney U- test. The protein level of IL-17A was significantly higher in periodontitis group, while there was not any significant difference regarding RANKL concentration. The elevated level of IL-17A in periodontitis suggests that IL-17A might be an important cytokine in pathogenesis of periodontal disease, which presumably exerts its effect independent of RANKL. Correlations between concentration IL-17A with PD and CAL amplify the role of IL-17A in periodontal tissue destruction

[Establishment and integration of a visceral leishmaniasis surveillance system in the primary health care system and its evaluation, Meshkin-Shahr District, Iran]

Visceral leishmaniasis is a systemic parasitic disease with a high fatality rate in under-5-year-old children. The disease is endemic in some parts of Iran, particularly in the north-west region. In 2001 a visceral leishmaniasis [VL] surveillance system was established for children aged>/=12 years in the primary health system in Meshkin-Shahr District, Ardebil Province, situated in the north-west of Islamic Republic of Iran. All cases with clinical signs and symptoms of VL and confirmed positive by the direct agglutination test [DAT] were referred for physical examination and treatment. The mean annual incidence of VL decreased significantly from 1.88 per 1000 children before [1985-2000], to 0.77 per 1000 child population after [2001-07], the intervention. In the control area with no surveillance, it increased from 0.11 to 0.23 per 1000. Early detection of VL using serological tests and timely treatment of cases can decrease the mortality and morbidity rates of VL in endemic areas

Integrated visceral leishmaniasis surveillance system in primary care for children in Meshkin-Shahr district, north-western Islamic Republic of Iran

In 2001 a visceral leishmaniasis [VL] surveillance system was set up for children aged

Digestive and liver disease statistics in Iran

Gastrointestinal and liver diseases [GILD] are among the most common causes of morbidity in Iran and constitute a substantial proportion of mortality which imposes enormous economic consequences. Our purpose is to collect information and report current statistics on physician visits, hospitalizations, and deaths due to common GILD in Iran. Data on the leading causes of death were obtained from the Iranian Ministry of Health, Office of Health Statistics. A total of 213,322 deaths were reported from March 2003 to February 2004 [excluding mortality from the Bam earthquake] which equaled 4.4 deaths per 1000 population. Of these, 36,575 were due to accidents. Causes of death were reported on the basis of the 10th revision of the International Classification of Diseases [ICD-10; 1992]. The leading causes of hospitalization were obtained from the database of the GILD ward in Shariati Hospital, one of the largest and best known gastroenterology referral hospitals in Iran. Similarly, leading causes of out-patient referrals were identified from a large multi-physician outpatient clinic in Tehran. The five leading gastrointestinal causes of death in order of frequency were: gastric cancer, hepatobiliary cancer, liver cirrhosis, esophageal cancer, and colorectal cancer. The five leading causes of hospitalization in the GILD ward of Shariati Hospital were: liver cirrhosis, hepatitis, peptic ulcer disease, cholycystitis and cholangitis, and colorectal cancer. The most common outpatient diagnosis was gastroesophageal reflux disease followed by irritable bowel syndrome [IBS], duodenal ulcer [DU], non-ulcer dyspepsia, and chronic hepatitis B [HBV]. Gastrointestinal and liver malignancy along with chronic liver disease constitute the main GILD reasons for hospitalization and deaths in Iran. Gastroesophageal reflux disease, IBS, and chronic HBV are the most common GILD outpatient diagnoses

Digestive and liver diseases statistics in several referral centers in Tehran, 2000-2004

Gastrointestinal and liver diseases [GILD] are among the most common causes of morbidity and substantial proportion of mortality with enormous economic consequences in Iran. We aimed to collect and report the most recent statistics on deaths, symptoms, physician visits, and hospitalizations for common gastrointestinal and liver diseases in gastrointestinal referral centers of Tehran. Data on the leading causes of death were obtained from Iranian Ministry of Health, office of Health Statistics, [Table 1]. A total of 189,747 deaths in the 23 [out of the 28] provinces of the country] were reported during March 2003 to February 2004. Causes of death were reported on the basis of the 10th revision of the International Classification of Diseases [ICD-10; 1992]. The leading causes of hospitalizations were obtained from the database of the GI ward of Shariati hospital, one of the biggest and well known GI referral hospitals in Iran, through years 2000 to 2004. Data on the leading symptoms prompting an outpatient clinic visit and related physician's diagnosis were gathered from a large multi-physician outpatient clinic, located in Tehran, during 2000-2004. The first 5 leading gastrointestinal causes of death in the country were: stomach cancer, hepatobiliary cancers, cirrhosis of liver, esophageal cancer and colorectal cancer respectively. The first 5 leading causes of hospitalizations in GI ward of Shariati Hospital were cirrhosis of liver, hepatitis, peptic ulcer diseases, cholycystitis and cholangitis and colorectal cancer. The most common outpatient diagnosis was GERD followed by IBS, DU, Non-ulcer Dyspepsia, and chronic hepatitis B. GI and liver malignancy along with chronic liver diseases constitute the main GI and liver etiology for hospitalization and death in Iran.Gastroesophageal reflux disease, IBS, DU, Non ulcer Dyspepsia, and Chronic HBV are the most common outpatient diagnosis in Iran

[Cavernous hemangioma of liver presenting with high fever and severe abdominal pain; a case report]

Intra-tumoral bleeding, rupture and thrombosis are common complications of hemangioma but spontaneous and self limited rupture and fever is a very rare presentation of hemangioma. This report is about a 38-year-old woman with sever abdominal pain and high fever came for evaluation. In US she had a liver mass of about 15 cm in left lobe with possibility of being hemangioma and, CT scan and MRI confirmed diagnosis of hemangioma. She had persistently abdominal discomfort and fullness in upper abdomen and referred for surgery. Left lobectomy and resection of hemangioma was done successfully