Prevalence of musculoskeletal disorders in southeastern Iran: a WHO-ILAR COPCORD study (stage 1, urban study).

OBJECTIVE: The purpose of this study was to determine the prevalence of musculoskeletal complaints and rheumatic diseases in southeast of Iran. METHODS: Subjects were selected based on a cluster sampling from 20 districts of urban areas in Zahedan, Iran. Subjects 15 years old and over were randomly selected and interviewed by trained interviewers in their houses. The Community Oriented Program for the Control of Rheumatic Disease (COPCORD) and Core Questionnaire (CCQ) were used in this study. The people with musculoskeletal complaints (pain, stiffness and swelling) were examined by the rheumatologist. Laboratory tests and radiographic exams were carried out when necessary to further categorize diagnoses. RESULTS: Data were collected from October 10, 2008 to September 15, 2009. Two thousand and one hundred subjects including 921 (43.9%) males and 1179 (56.1%) females were interviewed. The average age of the population was 33.1 ± 14.7 years. The prevalence of complaints within the past 7 days prior to the interview was 54.13%. The most common sites of complaint were as follows: knee (30.59%), dorsolumbar (28.83%), shoulder (22.26%) and neck (17.07%). The most common rheumatic diseases were osteoarthritis and low back pain with the prevalence of 18.66% and 17.71%, respectively. Finally, the prevalence of rheumatoid arthritis was 0.98%. CONCLUSION: Musculoskeletal complaints are highly common in southeast Iran. Knee and low back pain were the most common sites of complaints. The most frequent diagnosed diseases were osteoarthritis of knee followed by low back pain and soft tissue rheumatism. Rheumatoid arthritis was the most prevalent inflammatory disease.

High prevalence of vitamin D deficiency in Zahedan, southeast Iran.

BACKGROUND: Several studies show a high prevalence of vitamin D deficiency in Asia. Data regarding the prevalence of vitamin D deficiency in southeast Iran are inadequate. OBJECTIVES: The purpose of this study was to determine the prevalence of vitamin D deficiency in Zahedan, a sunny area in southeast Iran. SUBJECTS AND METHODS: This population-based cross-sectional study was performed on 993 apparently healthy subjects. Serum levels of 25-hydroxy vitamin D (25-OH vit D), parathyroid hormone, calcium, phosphate, and alkaline phosphatase activity were measured. RESULTS: Inadequate vitamin D status was diagnosed in 94.7% of the subjects (25-OH vit D <30 ng/ml). The frequencies of deficiency (<20 ng/ml), insufficiency (20-30 ng/ml), sufficiency (30-150 ng/ml), and toxicity (>150 ng/ml) were 85.2, 9.5, 5.3, and 0.0%, respectively. CONCLUSION: The results indicate that vitamin D deficiency is common in the population of Zahedan. Based on our results, fortification of milk and the use of supplements is suggested in this region.

Evaluation of the serum leptin in normal pregnancy and gestational diabetes mellitus in Zahedan, southeast Iran.

PURPOSE: There is conflicting data regarding leptin in gestational diabetes mellitus (GDM). The aim of the present study was to compare serum leptin levels between individuals with GDM and normal pregnancy. METHODS: This case-control study was performed on 26 GDM and 22 healthy pregnant women. Leptin concentrations were measured using an enzyme immunoassay. RESULTS: The level of serum leptin was not significantly different between GDM (9.890 ± 7.764 ng/ml) and normal pregnant women (13.80 ± 10.32 ng/ml) (p = 0.14). CONCLUSION: There are no significant differences between GDM and normal pregnant women regarding leptin levels.

Serum adenosine deaminase activity in gestational diabetes mellitus and normal pregnancy.

PURPOSE: To our knowledge, there is no report regarding adenosine deaminase activity (ADA) in gestational diabetes mellitus (GDM). The aim of the present study was to investigate the level of serum ADA activity in normal pregnancy, GDM and normal non-pregnant women. METHODS: The serum catalytic concentration of ADA was measured in samples of 20 GDM, 40 normal pregnant and 20 non-pregnant healthy women. RESULTS: Adenosine deaminase activity was significantly higher in GDM (24.30 +/- 8.04 IU/L) and pregnant women (23.88 +/- 8.66 IU/L) than those of normal non-pregnant individuals (11.85 +/- 3.23 IU/L) (P < 0.0001), but the ADA level was not significantly different from GDM and normal pregnant women (P = 0.97). CONCLUSIONS: Adenosine deaminase activity was significantly higher in GDM and pregnant individuals than normal group in this study. Previous reports in this field are contentious; therefore, ADA activity could be regulated in different population by immunologic and genetic factors.

Serum trypsin inhibitory capacity in normal pregnancy and gestational diabetes mellitus.

BACKGROUND: Alpha-1-antitrpsin (AAT) is the main antiprotease of plasma. Concentration of serum alpha-1-antitrypsin (AAT) may not be delegate of the functional capacity of this antiprotease. To our knowledge there is not any report regarding the functional level of AAT in gestational diabetes mellitus (GDM). The aim of the present study was to determine serum trypsin inhibitory capacity (sTIC) in gestational diabetes mellitus. METHODS: This case-control study was performed in 41 GDM and 40 healthy pregnant women. sTIC was measured by enzymatic assay. RESULTS: The serum trypsin inhibitory capacity was significantly lower (p<0.001) in GDM (5.84+/-2.27 micromol/min/ml) than healthy pregnant women (7.24+/-1.91 micromol/min/ml). CONCLUSION: In gestational diabetes mellitus reduction of serum trypsin inhibitory capacity may be due to non-enzymatic glycosylation of alpha-1-antitrypsin or oxidation of methionin in the active site of alpha-1-antitrypsin which remains to be cleared.

Traumatic posterior urethral fistula to hip joint following gunshot injury: a case report.

INTRODUCTION: Urinary system fistula to the hip joint is a rare complication. We report a case of delayed posterior urethral fistula to the hip joint following penetrating gunshot wound injury. CASE PRESENTATION: A 37-year-old Iranian Balochi male was shot with a firearm in the superior part of his right pelvis. He underwent primary closure on the same day. Ten months later, he developed urinary retention. He underwent retrograde urethrography and antegrade cystography which showed a stricture measuring 5 cm in length. There was also a history of progressive pain in the right hip joint accompanied by low grade fever which started 2 months after the initial injury. Hip X-ray showed evidence of an acetabular cavity and femoral head destruction diagnostic of complicated septic arthritis. The patient subsequently underwent reconstructive surgery for the urethral stricture and urethral fistula via a transperineal approach followed by total hip arthroplasty. CONCLUSION: Hip joint contamination with urine following a urethro-acetabular fistula can lead to severe and disabling complications such as septic arthritis. We recommend that every clinician should keep these fistulas in mind as a complication of penetrating urethral injury and every attempt should be made for their early diagnosis and prompt treatment.