[Comparison of serum ferritin level between patients with systemic lupus erythematosus, rheumatoid arthritis and osteoarthritis]

Systemic Lupus Erytematosus [SLE] is a chronic and relapsing disorder affecting several organs. This cross-sectional study was conducted on 60 patients with SLE [divided into two groups with low and high disease activity], 20 patients with osteoarthritis [OA], and 20 patients with rheumatoid arthritis [RA]. After having received informed consent, the blood and urine samples were collected from all patients to be tested for iron, TIBC, and serum ferritin levels and also to calculate the lupus disease activity. Patients with iron deficiency anemia were excluded. Data were analyzes by independent t-test, ANOVA, logistic regression and correlation tests. There was no significant difference between three study groups regarding the sex however, the age and duration of disease showed significant differences among 3 groups [p<0.001]. High serum ferritin level was seen in 61.7% of SLE, 15% of RA, and 5% of OA patients [p<0.001]. Increase in ESR levels demonstrated significant differences among study groups [p<0/001]. In patients with SLE, no significant correlation between serum ferritin and the decreased serum complement level and increased anti dsDNA titer was observed. Both serum ferritin and CRP levels increased in patients with serositis [p=0.019] and neurological complication [p=0.04]. Serum ferritin level was significantly higher in patients with SLE compared to those with OA and RA. There was no significant difference between serum ferritin level and SLE activity

Neuropsychiatric manifestations in patients with systemic lupus erythematosus

Systemic Lupus Erythematosus [SLE] is an autoimmune disease with unknown etiology. It can cause diverse clinical manifestations. Neuropsychiatric [NP] features may appear as the main signs and symptoms of the disease while they can be extremely severe in nature. Since the NP conditions are almost always very important, early diagnosis and aggressive treatment is mandatory. This study was aimed to evaluate the NP manifestations of SLE. This was a descriptive prospective study conducted from 2002 to 2004 at Ghaeni Hospital, Mashhad University of Medical Sciences. Patients, involved in SLE according to American College of Rheumatology [ACR] criteria, entered the study. A neurologist examined all the patients clinically while paraclinical assessments were carried out in parallel when required. All the data were gathered in prepared questionnaires and analyzed statistically. From 88 examined SLE patients, 27 had NP-SLE [30.6%]. The mean age in this group was 25 years. The mean time between the beginning of the disease and the occurrence of the NP manifestations was 2.1 years. Central Nervous System [CNS] and Peripheral Nervous System [PNS] involvements were seen in 88.9% and 29.6% respectively. Cognitive dysfunction [55.5%], among all other NP features, was the most prevalent, and seizure with 37% was the second common manifestation. NP involvement of SLE patients usually occurs in young individuals. CNS involvement [most frequently seizure and psychosis] was more common than the PNS involvement. In our study, cognitive disorders were the most widespread features, which is compatible to the results of other similar studies. The vast variety of neuropsychiatric manifestations and their effects on the prognosis of the underlying disease, necessitate routine complete neurologic examinations as soon as the diagnosis is confirmed

[Assessment of the role of prevention training and care in trauma patients in rural regions 2001-2005]

Trauma-related mortality [due to road accidents and gunshot and disaster...] is unexpectedly high in Iran. Short trauma care training course to rural health system and villager of Mehran, Eylam would improve the care for trauma victims. The objective of the present study is to describe the training and evaluate its effect using changes in physiological function of victims. Advanced trauma care course for physicians and nurses, complementary basic trauma care course for emergency technicians and health workers, basic trauma care for highly educated people and first aid short course for ordinary people were developed. After training, the region traumatic patients entered the system through two channels: to the local Mehran Emergency Clinic [some with primary treatment before the local emergency clinic] or directly to Ham University Hospital. Outcome indicator was the physiological change assessed with the physiologic severity score [PSS]. During courses period, 185 physicians and nurses, emergency technicians and health workers, 239 highly educated people and 4410 ordinary people were trained for trauma care. During 3 years leater 366 injured were transported to Mehran Emergency Clinic [226 received primary treatment before the local emergency clinic] and 245 were admitted directly to Ham University Hospital. Total mortality rate was 10.3 percent [66 out of 641 injured people] and the mine injured mortality rate was 20.7% [37 out of 179 mine injured]. In the injured who received trauma care at Mehran Emergency Clinic, PSS mean was 6.4 which improved to 7.5 in the hospital [P<0.001] in comparison with 6.79 in the other group. Rural health worker and general population could be upgraded to care for victims of injuries by using available resources. This system can improve the indicators and reduce trauma mortality rate