[Systemic lupus erythematosus [SLE] in pregnancy and severe nephritis [a case-report]]

Nephritis is one of the most dangerous presentations of SLE. Lupus in pregnancy can increase maternal and fetal mortality. In this report a pregnant woman with lupus nephritis is presented. A thirty year old woman in 30th week of pregnancy was admitted to internal medicine ward for evaluation of peripheral edema and hypertension. Important findings of her laboratory exam were: azotemia, hematuria, proteinuria, anemia, large size kidneys, active urine sediment, pleural and pericardial effusion, ascites, high titer of ANA, anti double strand DNA and lupus anticoagulant. Renal biopsy was done, pulse of methyl prednisolon prescribed and hemodialysis was started. After delivery, pulse of cyclophosphamide was also given and her renal function improved. The patient had not history of rheumatologic disease and the first presentation of lupus was severe nephritis during pregnancy. Fortunately, the response of patient to the treatment was good. After about 3-years follow-up, patient's renal function is normal and her son seems healthy

[Relationship between serum leptin level and parathormone in continuous ambulatory peritoneal dialysis [CAPD] patients]

Background and aims: Leptin is produced by fat cells and is secreted into the blood stream. Serum leptin level is higher in continuous ambulatory peritoneal dialysis [CAPD] patients, compared to the healthy peoples. There are a few studies with controversial results about the relationship between serum leptin level and bone metabolism. The aim of this study was to evaluate the relation between serum leptin level and some bone metabolism factors

Methods: In a descriptive-analytical study, 75 CAPD patients in Alzahra Hospital in Isfahan were enrolled from October 2007 to February 2008. Serum levels of leptin, albumin, KT/V, PTH, Ca, P, alkaline phosphates and demographic findings were measured in all patients. Data were using analyzed t-test and the coefficient of correlation

Results: Mean serum leptin level was higher in women compared to men. There was a significant correlation between serum leptin level with body mass index [BMI] [P<0.001]. There was no significant correlation between serum leptin level and KT/V, duration of renal failure, serum Ca[2+], serum phosphorus and alkaline phosphates. There was a reverse correlation between serum leptin level and serum PTH

Conclusion: Results of this study demonstrated that leptin may have a role in suppression of bone turn over

Treatment of low-strength industrial wastewater using anaerobic baffled reactor

The performance of an anaerobic baffled reactor at the pilot scale, with a 100-L volume and six compartments, that is used to treat low-strength industrial wastewater [671.5 +/- 49.9 mg COD/L, 350.1 +/- 36.8 mg BOD[5]/L and 443.8 +/- 60.7 mg SO[4][-2]/L] was studied. The reactor was started with a hydraulic retention time [HRT] of 25 h at 35 °C, which was gradually reduced to 3.33 h. The best reactor performance was observed with an organic loading rate [OLR] and a sulfate loading rate [SLR] of 4.45 g COD/L.d and 3.32 g SO[4][-2]/L.d, which was obtained at a HRT of 4 h. The COD and SO4-2 removal efficiencies were 78.6% and 89.2%, respectively. Additionally, the majority of the COD and SO[4][-2] removal occurred in the first compartment, up to 51.2% and 69.1%, respectively. Moreover, the pH in the first compartment was also the lowest. Subsequently, when the temperature was reduced to 20 °C at a HRT of 4 h, the maximum removal efficiencies for COD and SO[4][-2] decreased to 59.4% and 66.1%, respectively. In this case, the highest COD and SO[4][-2] removal efficiencies were observed in the third and fourth compartments, respectively, and these compartments had lower pH values. This phenomenon indicates that decrease in temperature causes transference of the acidogenic phase toward subsequent reactor compartments. In addition, these findings further show the potential for sulfate removal of the acidogenic phase

[Factors associated with ecstasy use in students of Qazvin University of Medical Sciences]

Drug addiction, especially addiction to Ecstasy has ruinous effect on lives. Lack of knowledge is the most important cause of Ecstasy use among young adults. Research studies showed that students use these pills in order to get comfort and to overcome grieves. Addiction to ecstasy has been increased in Iran in recent years. This study was carried out to assess the factors associated to Ecstasy use in students of Qazvin University of Medical Sciences. In this cross-sectional study, we recruited 200 students using clustered, random sampling. Data collection tool was a structured valid and reliable questionnaire containing 28 questions in two sections. Data were analyzed using Student t-test, ANOVA and chi-square tests. Results indicated that the prevalence of Ecstasy use was 1.5%. Prevalence of alcohol and cigarette use was 1.5% too. Mean score of knowledge on Ecstasy was 9.8% [SD=3.8]. Knowledge of the female students was higher than the knowledge of male ones. About 86.7% of the students took Ecstasy in order to end grieve due to family problems. Most important associated factors to Ecstasy use were: positive attitude toward Ecstasy use, lack of knowledge [96.5%], peer pressure [96%], and 1ck of parents' attention to their young children [94.5%]. Lack of knowledge about complications of addiction to Ecstasy is the most important factor leading to addiction among students. Living in places such as dormitories and rented houses, and lack of parents' control over their children can be important factors related to addiction of students to Ecstasy, as well

[Clinical evaluation of a topical doxepin cream [5%] in treatment of eczema]

Eczema is one of the most common pruritic skin disorders for which various treatments are used to relieve the symptoms. There are several reports about the efficacy and in part safety of topical doxepin in the treatment of pruritic dermal diseases. However, lack of a suitable topical preparation from this drug in our country persuaded us to design the present trial. A randomized, double blind, placebo controlled and multi- central clinical trial was carried out in Isfahan during the years of 1383-84 by using 60 volunteers and both the drug and placebo were given QID for 8 days. The efficacy, side effects and their relevance to sex and age of subjects were assessed before, during and after the treatment. The data were analyzed using non-parametric tests including Mann-Whitney, Wilcoxon, and Kendall Tau where appropriate. Results indicated that doxepin cream effectively reduced disease symptoms including pruritus [75.5%], inflammation [43.8%] skin dryness [37.5%] exudates [59.5%], lichenification [41.5%], and eczema [41.5%] after the course of treatment [the day of 8]. Same results were obtained by using placebo. Stinging as an adverse effect was occurred in both the drug [30%] and placebo [27%] groups. Although there was no significant difference between the two groups, it can be concluded that doxepin cream [5%] is effective in depressing the signs and symptoms of pruritic skin disorders. A larger clinical trial is needed to evaluate the efficacy and safety of the product more precisely

Determination of incidence of macroprolactinemia in hyperprolactinemia by Poly ethylen glycol and evaluation of its clinical and radiological findings

Prolactin exists in 3 different molecular forms, i.e., monomeric, big and at times big big [macroprolactine] in human serum. Macroprolactine is a complex of prolactine and IgG and may account for a significant proportion of idiopathic hyperprolactinemia. Its biological activity is considered low or absent, but it is measured by the common immunoassay method, thus can lead to expensive explorations and ineffective treatments. Conventionally the diagnosis of macroprolactinemia has been done by Gel Filtration Chromatography, which cannot be used routinely. Recently Poly Ethylene Glycol has been employed to precipitate macroprolactine, allowing its rapid detection, dependably and inexpensively. The objective of the present work is to assess the incidence of macroprolactinemia in patients with hyperprolactinemia, by its identification with PEG, and to establish the clinical [galactorrhea and oligomenorrhea] and radiological findings [sella MRI] of such a cohort. 50 patients with hyperprolactinemia were investigated for macroprolactine. Prolactine was measured before and after precipitation of macroprolactine by PEG, with recovery of

Therapeutic effects of joint lavage and steroid injection in patients with primary osteoarthritis of the knee

Background: osteoarthritis [OA] is one of the most common forms of articular disease and one of the major causes of pain and disability especially among the elderly. The purpose of this study was to assess the effect of lavage and interaarticular [IA] injection of corticosteroid in the knee joint for the treatment of OA compared to interaarticular injection of corticosteroid alone

Methods: this prospective clinical trial was done on 39 patients. In the first group [lavage plus interaarticular injection], 19 patients were enrolled and in the second group [interaarticular injection alone], 20 patients included. Initially the patients were classified with respect to their intensity of joint pain using a 100 mm visual analog scale [VAS], their global status [0-100] and Lequesne's functional Index [0-25]. These data were obtained at baseline, 4th week, 8th week and 12th week

Results: in the first group, the intensity of pain in 4th, 8th and 12th weeks became significantly attenuated in comparison with baseline value [P<0.001]. Although in the second group its intensity in 4th week became attenuated compared to baseline value [P<0.001], its intensity did not decrease in 8th and 12th week significantly. There were significant changes regarding global status and Lequesne's functional index till 12th week and in the second group till 4th week [P<0.001]. Maximum amount of pain attenuation and improvement in global status and Lequesne's functional index in the first group was observed in 12th week but responsiveness in the second group decreased significantly after 4th week

Conclusion: joint lavage with or without steroid injection relieves pain and improves function, yet joint lavage and IA injection put a longer effect