[Determination of geometric indices of the femoral bone density and its association with bone density of proximal femur]

Geometric indices of the femoral neck and bone mineral density [BMD] have been proposed to play a major role in prediction of hip fracture risk, with some studies showing a racial variation in such indices. However, no data study in Iran has estimated these parameters for Iranian patients, nor has the relationship between these indices and BMD parameters in different sub-regions of hip been investigated. Postmenopausal women referred to the bone densitometry center of the Shariati Hospital comprised the study population. Patients with apparent risk factors of osteoporosis were excluded. Bone mass was determined using dual-energy X-ray absorptiometry on Lunar DPX bone densitometers. For calculation of femoral neck geometric indices, the printout of the hip densitometry with magnification of 1/2 was used. Hip axis length [HAL] and neck-shaft angle [NSA] were the main outcomes of the study. We used Pearson correlation analysis for determination of relationship between geometric indices and other variables and multivariate linear regression analysis for adjustment of other independent variables in prediction of femoral BMD. Among 103 postmenopausal women studied, mean HAL was 99.8 +/- 4.3 millimeters and mean NSA was 120.3 +/- 4.3 degrees. Pearson correlation analysis revealed no correlation between HAL and NSA with BMD results of different sub-regions of hip, but there was a significant positive correlation between HAL and height and weight neither did multivariate regression analysis reveal any significant relationship between HAL and NSA with BMD of total femur and femoral neck. According to our results, it is unlikely that geometric indices play a major role in determination of hip BMD parameters making their routine use in bone densitometry centers not essential supported. Mean HAL of Iranian women is lower than that of Western countries and higher than that of East Asian countries. This is in line with observation of rates of hip fracture in Iran lower that Western rates and higher than Eastern rates

[ epidemiologic study of microscopic colitis in a university related clinic]

Microscopic colitis has been generally recognized as lymphocytic colitis and collagenous colitis: two inflammatory diseases of large intestine without a definite origin. The colon appears normal by colonoscopy. So, biopsy of the colonic mucosa is mandatory for diagnosis. As a descriptive design we assessed epidemiological, clinical and laboratory findings of patients diagnosed as microscopic colitis from 2001 to 2003, retrospectively. This study had been conducted in one of the University related clinics in Tehran. Results: In this setting, 12 patients were diagnosed as microscopic colitis [3 collagenous colitis, and 9 lymphocytic colitis]. Most of these patients were female [11 patients]. The average of the patients' age at the time of the diagnosis was: 47.6 +/- 18.1 years. The delay of diagnosis was distributed from 2 months to 27 years [average: 8 years]. The most prominent complaint was diarrhea [100%]. Most of the cases were presented as a chronic intermittent manner [6 patients- 50%]. Hyperthyroidism, atrophic gastritis, and type 1 diabetes mellitus, each of them were detected in 3 separate patients. After treatment initiation, recurrence of the disease was not seen during 2 years of follow-up. Most of the time, microscopic colitis is mis-diagnosed as irritable bowel syndrome. Clinical suspicion plays the main role in diagnosis of microscopic colitis cases among patients with watery diarrhea and normal colonoscopy

[Clinical course of ulcerative colitis in patients with and without primary sclerosing cholangitis]

We noticed in our practice that the patients with ulcerative colitis [UC] who have developed primary sclerosing cholangitis [PSC] experience a milder course of colonic disease. Our objective in this study was to define whether there is any difference between UC activity and its course in patients with and without PSC. 19 patients with UC and PSC [8 male, mean age 25] were enrolled. To every patient with UC and PSC, 3 patients with UC alone [totally 57 patients, 28 male, mean age 24] matched for age at onset, duration of the disease, and extension of colonic disease were selected as the control group. We used number of hospitalizations due to activity of UC and number of short corticosteroid administrations in various years of follow-up as variables indicating course and severity of the colonic disease in this period. For comparing trends of UC activity between two groups, we used repeated measures two-way analysis of variances. Mean duration of follow up in case and control groups was 12.2 +/- 5.7 and 11.4 +/- 4.9 years, respectively. Two groups had no significant difference in use of sulfasalazine or aminosalicylates. Number of hospitalizations and courses of steroid therapy because of UC activity decreased significantly over time [p<.000] in both groups and it was significantly higher in controls than in cases [p=.045 and .032, respectively]. Development of PSC in patients with UC might have a positive effect on the colonic disease. Further investigation to evaluate basis of this improvement are warranted