Comparing bone mineral density in postmenopausal women with and without vertebral fracture and its value in recognizing high-risk individuals

Vertebral fracture, the hallmark of osteoporosis, usually occurs in postmenopausal women with low bone mineral density [BMD]. The aim this study was to determine which BMD parameter can best predict women at high risk of fracture. BMD values at the spine and femoral neck were compared in 34 women with vertebral fracture and 34 controls. Mean BMD [g/cm[2]], T-score, and Z-score values at both femoral neck and spine were significantly lower in the fracture than the nonfracture group. Z-score was more sensitive than BMD T-score for detecting low bone mass. T-score was not sensitive enough to identify low BMD in the spine, whereas the femoral neck T-score could recognize women at high risk of fracture with higher accuracy

[Sleep-quality investigation of bus drivers working in the Gorgan's passenger terminal and its relation with the public health in 2008-2009]

One of the most common kinds of human's disorders is sleep disorders which have direct relation with age, gender, physical health status, and occupational activities. Increasing the errors during job activities such as driving is one of the most important complications of sleep disorders. Therefore, this study has been conducted to determine the sleep quality of drivers and its relationship with public health. The under study drivers are from the Gorgan's passenger terminal. In this analytical-partial study, all the drivers working in the Gorgan's passenger terminal were studied using standard 28-question public heath questionnaire and standard 19-question Pittsburg sleep questionnaire. After filling out and collecting all forms, data were analyzed by statistical software SPSS.13, and descriptive analytical statistics. The results showed that the driver's public health is not satisfactory. More than one third of drivers have poor sleep quality and there was a direct and statistically significant relationship between the quality of sleep and general health of drivers [P <0.00 1, r = 0.7]. according to the results of this study, training of drivers is advised such that they have a regular number of shifts, timely and sufficient rests, proper diet which can prevent accidents, conserve passengers, reduce costs due to accidents and irrecoverable damage to other drivers. Also it is important to consider possible age limitation for driving on the road or to allocate a less number of shifts for older drivers

[Study of mental health and its relation with quality of life in addicts]

Because of the progressive nature of addiction in all aspects of life, it influences the health of society individuals and has bad effects on psychological, physical, social, emotional, spiritual and cognitive health. In order to investigate mental health and the quality of life of addicts referring to addiction centers in Golestan province, this research was done. A total of 322 patients were selected from the addiction census centers of the province during 2009 and studied in a descriptive cross-sectional analysis. The data included a questionnaire about demographic characteristics and two questionnaires contained the mental health [MHC] and the quality of life [SF17] variables. Of the total, 52 percent reported their mental health to be somewhat favorable and 17 percent reported favorable. On the other hand, 53 percent reported somewhat favorable quality of life and 8 percent had a desirable quality of life. There was significant relationship between mental health and quality of life. Mental health was significantly related to sex and type of material consumption, while quality of life was significantly related to job and type of material consumed. Many addicts can't give up addiction and repeatedly refer to centers. But care team members can identify common characteristics, personality traits and support systems for promoting mental health and the quality of addict's life which facilitate prevention, treatment and rehabilitation

[Evaluation of the knowledge of rural high school students in Yazd about drugs]

Considering high prevalence of addiction, the age range of drug abuse and availability of new synthetic drugs, evaluation of knowledge of adolescents about drugs would be a priority in research. In this descriptive cross-sectional study, 517 rural high school students were asked to complete a questionnaire and through SPSS software version 13, collected data was analyzed by chi-square and analysis of variance tests. 7.1% of rural families with at least one boy in high school had an addict family member. 70.2% of high school students had had a contact with an addict and 42.5% knew an adolescent addict. Also, 17.5% had been offered drugs and 37.9% of high school students claimed that there was at least one addict in their family or relations. Considering the frequency of addiction in families and rate of invitation to drug abuse in students, there is a high risk of increment of addiction in high schools and therefore real and urgent need to do an intervention

Exudative pleural effusion: effectiveness of pleural fluid analysis and pleural biopsy

The study compared pleural fluid analysis and pleural biopsy in the diagnosis of 100 patients with exudative pleural effusion [PE] in Babol, Islamic Republic of Iran. Tuberculous pleurisy and malignant pleural effusion were confirmed by the identification of acid-fast bacilli from body fluids or tumour cells from tissue specimens. Malignant diseases and tuberculosis were the causes of exudative PE in 43% and 33% of patients respectively. The diagnostic sensitivity of pleural biopsy in patients with tuberculous PE and malignant PE was 70% and 54%, and the diagnostic sensitivity of pleural fluid analysis was 33% and 70% respectively. Combined pleural biopsy and pleural fluid analysis were positive in 97% of tuberculous PE cases and 91% of malignant PE

[Evaluation of bone mass in postmenopausal women presenting with back pain]

Back pain [BP] is a common symptom among the general population,particularly in the elderly subjects. It is the most common feature of osteoporosis [OP] as well as a symptom of vertebral fracture [VF]. In elderly women it may be a heralding symptom of OP and possibly a presenting feature of VF. The present study was designed to determine the frequency of low bone mass in postmenopausal women presenting with BP. 155 postmenopausal women with BP were studied. Bone mineral density [BMD] was measured with use of dual energy x-ray absorptiometry [DXA] with a single Norland Excell densitometer. BMD was determined in the femoral neck [FN] and L2-L4 region of lumbar spine [LS]. T-score and Z-score at both regions were determined. Frequency of OP and osteopenia at the FN and LS regions were detrmined according to WHO criteria. Patients with inflammatory musculoskeletal diseases, inflammatory back pain, infectious, or malignant spinal diseases, and history of rheumatic diseases or spinal surgery were excluded. Chi square and t tests were used for comparisons. The mean age and the mean menopausal duration of patients were 64 +/- 8 and 16 +/- 9 years respectively. Sixty-three percent of patients were 60 years or over. The mean BMD at the LS and FN were 0.70 +/- 0.13 gr/cm-2 and 0.79 +/- 0.18 gr/cm-2 respectively. The proportion of OP at the FN and LS were 30% and 56% respectively. The combined prevalence of OP at both FN and LS was 61.5%. The proportion of patients with Z-score<-1 and<-2 at the LS were 40% and 22% and at the FN were 37% and 11% respectively. In patients, aged 70 years and over, compared with patients below 70 years the BMD was decreased by 14% at the FN and 10% at the LS [P<0.02 and P<0.001 respectively]. Menopausal duration of over than 10 years was associated with 5.6 fold risk of OP. The results of this study indicate that, the majority of postmenopausal women with BP are osteoporotic or osteopenic at the LS or FN. So they are at increased risk of future vertebral or femoral neck fractures

[The role of corticosteriods in knee osteoarthritis with accompanying inflammatory pain]

Intraarticular corticostroids [IAC] are recommended in the treatment of knee osteoarthntis [KOA] specially those cases in which there is joint effusion. On the basis of the recent data, their efficacy is limited in relieving pain for a short duration. To investigate the efficacy of IAC in patients with inflammatory pain [IP] of KOA, the present no controlled prospective study was performed. Patients with KOA according to ACR criteria who presented with persistent IP and joint effusion were enrolled in the study. Intraarticular triamcinolone hexacetonide was prescribed after complete joint fluid aspiration. Patients were evaluated for pain [at rest and movement], performance restriction and physical disability at baseline and 4 weeks after IAC treatment using SPSS software by Wilcoxone match pairs signed rank test and Chi-square Mc nemar test. 71 patients [26 females and 45 males] with mean age of 60 +10 years were studied. Persistent IP and joint effusion were detected in 100%, night joint pain in 95%, performance restriction in 75% and physical disability in 80% of patients. Four weeks after treatment the joint pain [Lickert pain score] decreased from 2.9 + 0.9 to 0.96 + 1.2 [PC 0.01], performance restriction [Lequesn's functional index] from 6.4 + 1.9 to 2.2 + 1. 9 [P< 0.0l], and physical disability [WOMAC functional index] from 10. 2 + 2. 6 to 3.3 + 2. 6 [P< 0.01]. At the end of study the proportion of patients with persistent joint pain at night and rest joint effusion performance restriction and physical disability was, 2%; 5%; ?5%; and 45% respectively [P<0.0l]. In patients with IP of KOA, IAC treatment is accompanied by rapid alleviation of pain and physical disability

Prevalence of intestinal parasites in Ghaemshahr in 2004

Parasitic infections, especially in under developing countries, are major health concerns. They are of utmost importance in our country due to geographical location, suitable weather and cultural background. This study intends to investigate the prevalence of intestinal parasites in urban and rural population of a northern city, Ghaemshahr. The study population included 4898 urban and 1697 rural residents. Stool samples were randomly obtained and examined by direct and flotation methods. The data were analyzed by chi-square. A total of 557 subjects [8.4%] were infected with intestinal parasites among whom 2.8% had protozoa and 5.7% had intestinal helminthes infections. Giardia lamblia was the most frequent parasite [32.8%]. Totally, 7.9% of males and 9% of females were infected [NS]. Meanwhile, 10.6% of rural subjects and 7.7% of urban residents were infected [p<0.001]. Regarding the high rate of infection with Giardia lamblia, filtration of drinking water is strictly recommended. Meanwhile, our study showed a higher prevalence of parasitic infections in the rural area, therefore, general education and promoting hygienic situation may be partly helpful to control the situation

role of weight and age on knee osteoarthritis

Background: Overweight and age are well recognized risk factors for knee osteoarthritis [KOA]Objectives: To determine the role, as well as the sex difference relationship between weight gain, age and KOA

Methods: 429 patients with KOA [306 females,123 males] and 430 healthy controls [307 females,123 males] attending Shaheed Beheshti outpatient clinic between 1995-2000 entered the study. Diagnosis of KOA was confirmed on the basis of the American College of Rheumatology criteria .Patients and controls were compared regarding to age and body mass index [BMI]. Statistical analysis was performed by SAS soft ware using logistic regression analysis to determine the association of KOA with age and weight. Adjusted odds ratio was calculated for both sexes and compared

Findings: The mean age of patients was significantly higher than controls [60 + 11 Vs 55.5 + 11.8 years, P = 0.0001]. BMI of patients and controls were 27.8 +/- 8.1 and 24.8 +/- 5.1 kg/m2 respectively [P=0.0001]. BMI was higher in female patients than males [28.7 + 8 Vs 25.2 + 4.5 kg/m2, P = 0.0001].The age at onset of KOA in women was lower than men .There was also a significant difference in age distribution between two sexes [P=0.0001 .With increasing age the relative risk [RR] of KOA increased in all decades after 50 years in females whereas in male patients increased risk was seen at the sixth and seventh decades. In overweight patients RR of KOA was 3.74 [95% confidence interval [CI], 2.57-5.43, P = 0.0001] in females and 2.58 [95% CI, 1.41-4.76, P - 0.002] in males

Conclusion: The above findings indicate a sex difference, in KOA association with age,weight and age distribution

[Coexistence of gout and sarcoidosis: case report]

Background and Objective: Sarcoidosis [Sa], a multisystem disease of unknown etiology presents protean manifestations. Triad of Sa-gout-psoriasis has been reported in a few patients but coexistence of Sa and gout has not been reported

Case: A 36-year-old man presented with acute polyarthritis, bilateral hilar adenopathies and erythema nodosum. Diagnosis of acute gout was established with regard to clinical findings, refusing other causes of acute arthritis and identification of monourate crystals from synovial fluids. Diagnosis of Sa was confirmed by extensive exploration including CT scanning of thorax, bronchoscopy and biopsy of epitrochlear adenopathies

Conclusion: Development of gout may be due to hyperuricemia [Caused by granolumatous tissue destruction] or release of inflammatory cytokines from granolumatous tissue destruction of Sa

Long-term pulmonary complications of sulphur mustard gas exposure in Iranian chemical war victims

Sulphur Mustard [SM] is a major threat around the world not only on the battle field but also to civilian population. It has been used by Iraqi troops against Iranian veterans and resulted in severe inhalation injury and pulmonary complications in Iranian soldiers. To determine the long-term pulmonary sequelae of SM gas exposure on Iranian veterans of Iraqi -Iran conflict, chemical victims of Babol, who have been referred for follow up examination to Shaheed Beheshti Hospital clinic [were studied]. A total of 220 male chemical exposed victims and 92 age matched healthy controls were studied. Diagnosis of SM-related disease was confirmed on the basis of prior history of SM gas exposure and excluding other unrelated diseases. The results were regarded positive if the FEVI% or FVC% or absolute FEVI volume increased by 15%, 20% or 180 ml respectively compared with baseline value. In statistical analysis, the frequency of respiratory signs and symptoms, radiographic changes of chest radiographs, and the proportion of persons with abnormal PFT results were determined and compared with age matched controls. Emphysema in 2%, cor pulmonale in 4% and severe respiratory disease requiring permanent supportive treatment in 4.5% of patients. Abnormal radiographic findings were detectable in 64% of chest radiographs which were remarkable in only 13%. Obstructive airway disease was detected in 110 [50%] patients and 11 [5.4%] controls [P<0.0001]. The degree of obstruction was mild, moderate or severe in 13.5%,73% and 13.5% of patients and 80%, 20% and 0% of controls respectively. Restrictive airway disease was observed in 22 [10%] patients and 11 [12%] controls [P=NS]. Normal PFT was seen in 40% of patients and 83% of controls [P<0.0001]. Only 30% of patients with obstructive airway disease were responsive to bronchodilator test. The findings of the present study show that, a remarkable number of Iranian veterans are suffering from chronic lung diseases several years after exposure to SM gas

Poncet's disease: a report of four cases and review of the literature

Four cases of polyarthritis concomitant with active tuberculosis are reported. In three patients pulmonary tuberculosis was confirmed by identification of Mycobacterium tuberculosis in the sputum and bronchoalveolar lavage specimens, and in another one tuberculous lymphadenitis was confirmed by excisional biopsy. In all patients arthritis resolved by tuberculosis treatment and did not recur during a follow up period of 18 months to 12 years. The findings of the presented cases are compatible with Poncet's disease [tuberculous reactive arthritis]