Intravenous pamidronate for refractory lymphedema

Based on beneficial reports of pamidronate use for reflex sympathetic dystrophy in reduction of pain and swelling, this drug can be studied as a novel treatment for refractory lymphedema. This study aims to determine the effectiveness of pamidronate on lymphedema and its possible side effects. Twelve cases of lower limb refractory lymphedema were enrolled. They received intravenous pamidronate monthly for 3 consecutive months and were followed by measuring any discomfort with visual analog scale [VAS] and physician global assessment, based on objective signs of limb volume and circumference. The limb volume, circumference, and satisfaction of the patients improved significantly. Pamidronate when is added to conservative treatments may reduce lymphedema and improve the patient's comfort

Osteoporosis screening tools in Iranian postmenopausal women

Osteoporosis is a major health problem, but testing low bone mineral density is not practical for screening all postmenopausal women. The objective of this study was to evaluate the efficiency of the clinical tools to help clinicians to identify the Iranian women at an increased risk for Osteoporosis. The popular Osteoporosis screening tools were evaluated in 341 postmenopausal women without secondary cause for Osteoporosis, using data from a bone densitometry centre, and compared the results with their bone mineral density. National Osteoporosis Foundation recommendations had only a sensitivity of 48% for screening patients with low bone mass but the Osteoporosis Risk Assessment Instrument and the Simple Calculated Osteoporosis Risk Assessment Estimation with a sensitivity of 70.9% and 87.2%, respectively, showed better results in respect to the screening for Osteoporosis of postmenopausal women. The efficiency of these Osteoporosis screening tools in our Iranian patients was relatively similar to that of other populations, and these screening tools accurately identify the vast majority of postmenopausal women likely to have low bone mineral density

[Evaluation of simple calculated osteoporosis risk estimation [SCORE] in Iranian postmenopausal women]

Osteoporosis is a major health problem for postmenopausal women in all over the world. Use of dual x-ray absorptiometry [DXA] as standard diagnostic procedure, due to the cost is not economical for screening of all postmenopausal women. Based on clinical risk factors, several screening tools have been invented and one of the most popular screening tools is Simple Calculated Osteoporosis Risk Estimation [SCORE]. The objective of this study was to evaluate performance of this tool in screening of Iranian women for osteoporosis. This descriptive - analytical study was performed on 341 postmenopausal women who were referred to Isfahan bone densitometry centre. We made use of the osteoporosis screening tools [SCORE] for postmenopausal women aged 45 years or more, without secondary cause for osteoporosis, and the results were compared with their bone mineral density. Among 341 postmenopausal women, who were studied in this study, 20.8% were osteoporotic [71persons], 39.6% had low bone mineral density in one or both studied areas by DXA and the rest of women [39.6%] were found normal. SCORE tool was shown to have sensitivity about 87.2% [95% CI 97.2%-76.4%] and specificity of 37.9% for screening of low bone mass in postmenopausal women. SCORE tool has acceptable sensitivity and accuracy to be used as a tool to identify low bone mineral density in vast majority of Iranian postmenopausal women

Different duration of colchicine for preventing recurrence of gouty arthritis

Gout is a Common recurrent clinical syndrome characterized by increased serum uric acid and recurrent attacks of acute arthritis. Colchicine is used for Prophylaxis against recurrence of arthritis, but the duration of its administration has mentioned variable. In this study, optimal duration of prophylactic colchicine for prevention of gouty arthritis was assessed. In a clinical trial 190 patients with gouty arthritis divided randomly to group 1,2and 3 and received colchicine for 3 to 6, 7 to 9 and 10 to 12 months then colchicine discontinued and the patients followed one year for recurrence of arthritis. Result assessed by survival analysis with Kaplan 'Meier method. The probability of recurrence of arthritis [in order of duration of colchicine prophylaxis] was 54%, 27.5% and 23%, respectively. The difference between group one and others was statistically significant, but between group 2 and 3 was not statistically significant. The most suitable duration of colchicine prophylaxis that accompanied with lower recurrence rate was 7-9 months, which seems more cost -effective than 10-12 months regimen

Does chloroquine decrease liver enzyme abnormalities induced by methoterexate in patients with rheumatoid arthritis?

Methotrexate has been the most frequently used antirheumatic drug in rheumatoid arthritis. Nevertheless, the possibility of hepatotoxicity continues to represent a major problem in tolerance. This study evaluated beneficial effect of chloroquine on incidence of liver enzyme abnormalities in patients with Rheumatoid Arthritis [RA] treated with Methotrexate. Eighty patients with RA who had elapsed from onset of disease less than two years, randomly divided into two groups [MTX alone vs MTX with Chloroquine]. Liver enzymes and some indicators of disease activity were evaluated in two months intervals and for maximum of 10 months follow-up. Five patients [12.5%] in MTX group and four patients [10%] in combination regimen developed abnormal liver enzymes. Response rate was more in combination therapy [87.5%] than MTX alone [80%] without significant difference. The incidence of liver enzyme abnormalities were not different in patients received MTX alone and MTX with Chloroquine