Epidemiology and clinical manifestation of GOUT in Imam Khomeini Hospital in Tehran, Islamic Republic of Iran

Gout is an increasingly prevalent condition worldwide, creating a heavy economic burden. Acute gout can be effectively treated with non-steroidal anti-inflammatory drugs and recurrent episodes can be prevented with the uricostatic xanthine oxidase inhibitors. This study was conducted to determine the epidemiology and clinical manifestations of 100 patients with acute or chronic gout in Imam Khomeini Hospital in Tehran, Iran. One-hundred patients with gout who referred to the Rheumatology Department were reviewed. Their demographic data, family and drug history, comorbide diseases, body mass index, symptoms and signs at the time of referral to our clinic and lab data were collected. Among patients, 84 were men and 16 women [mean age=55.8 years and mean Body Mass Index=26.1 kg/m[2]. Thirty three percent of the patients were smokers and 10% drank alcohol. Seventy cases had previous gout attack of whom, 56 were in the first metotarso-phalangeal joint. The mean serum uric acid was 8.5 mg/dl. In our study, the mean age and mean body mass index of the patients were similar to those in others studies. Alcohol consumption was low in our study. Hypertension was found to be a risk factor for gout

Evaluation of il1-alpha and TNF-alpha serum levels in rheumatoid arthritis patients with active and inactive, with or without bone erosion

Rheumatoid arthritis is the most common inflammatory joint disease with 1 percent prevalence in community which presents with symmetrical polyarthritis of hands with inflammatory behavior. Several studies in recent years were conducted for evaluation of inflammatory cytokines such as ILl-alpha [Interleukin la] and TNF- alpha [Tumor necrosis factor] in rheumatologic disorders including rheumatoid arthritis to find new treatment methods base to pathogenesis. In this study different serum levels of ILl-alpha and TNF- alpha in 160 rheumatoid arthritis patients with active and inactive disease and also disease with or without bone erosion are assessed. 4% of our patients had rheumatoid nodule and 70% of all patients had positive RF, ILl-alpha, and TNF- alpha levels. Active with bone erosion patients had ILl-alpha and TNF- alpha serum levels higher than active without bone erosion patients; it was not significant in T-test but it was significant in Mann-Whitney Test. The results was the same as expected; ILl-alpha, and TNF- alpha serum levels were higher in active with bone erosion in comparison with inactive without bone erosion patients

[ accuracy of clinical diagnosis of discal sciatic neuralgia at construction labors: a comparative study]

Mechanical low back pain [L.B.P] is most common in middle-aged people especially in developing countries and the symptom compromises routine life activities of the patients. Disk herniation is the most frequent cause of LBP. The less costly way for diagnosing the cause of LBP is performing a careful physical examinations. This study aimed to evaluate the sensitivity and specificity of clinical diagnosis of the cause of Discal Sciatic Neuralgia at Construction Labors in comparison to MRI as the gold standard. In a descriptive-analytic study 60 middle-aged professional construction workers were evaluated. Their age range was 25-45 years old and all of them had the complaint of mechanical LBP. Medical history was taken and all cases under went a cautious physical examination. The presence of disk herniation between L4-L5 orL5-S1 was recorded according to clinical signs and symptoms. Lumbosacral MRI was performed for all cases and the results were compared to clinical data. The clinical diagnosis of presence and severity of pathology was confirmed by MRI in all stages of discopathy in L5-S1 and L4-L5 vertebrae [sensitivity= 100%]. This study showed that careful physical examinations will be sufficient for the sciatic neuralgia diagnosis and even the staging of disk herniation can be performed clinically. Requesting MRI as an expensive procedure is not recommended for diagnosis of Discal sciatic neuralgia because of feasibility of the cost effective way of precise physical examination

[Diagnostic value of synovial biopsy by Polley and Bickle's needles in chronic monarthritis of knee]

Chronic monarthritis is one of the problems in the realm of rheumatology. Synovial biopsy [SB] plays an important role in the diagnosis of chronic monarthritis. In order to evaluate the diagnostic value of SB in identifying the cause of chronic monoarticular arthritis of knee, we retrospectively studied 100 patients [mean age: 35.3 year] admitted in rheumatology ward of Imam Khomeini Hospital. Monarthritis duration ranged between 4 to 6 months. After history taking, physical examination, laboratory and radiological studies, histopathological studies and culture had been performed in all of the biopsy samples. SBs were successfully performed in all of the patients without any complication. SB was able to indicate a definite diagnosis in 77 patients. The most common causes of chronic monarthritis were rheumatoid monarthritis [60 patients] and tuberculous monarthritis [10 patients]. The present results revealed the safety and diagnostic value of SB in chronic monarthritis. Obviously, timely diagnosis of monarthritis leads to selective and effective treatment and prevention of articular complications in the form of osteoarthritis