Introduction: Rheumatoid arthritis (RA) is a chronic rheumatologic disease, affecting different aspects of patient life. Although several studies have reported a higher rate of depression among patients with RA, there is still controversy over the underlying risk factors and probable covariates of depression in these individuals. The present study investigated the relationship between disease activity, serum levels of vitamin D, and depression in patients with RA. Methods: In this cross sectional study patients with confirmed RA based on the American College of Rheumatology guidelines entered the study. Disease activity was measured using the Disease Activity Score (DAS). The Hospital Anxiety and Depression Scale (HADS) was also administered to determine the subjects' level of depression. The Health Assessment Questionnaire (HAQ) was applied for evaluating the subjective disability of the patients in their daily activities. Serum levels of vitamin D, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) were also measured. Results: 62 patients were enrolled in the study. Depression was present and possibly present in 12 (19.4%) and 15 (24.2%) cases, respectively. According to the results the DAS was inversely associated with vitamin D3 levels (P<0.001). There were also significant relations between the DAS and scores on both the HAQ and HADS. Moreover, higher levels of vitamin D3 were related with lower scores on the HAQ and HADS (P=0.018). Conclusion: Higher scores on the HADS were directly associated with lower levels of vitamin D, HAQ score anddisease activity. Nevertheless, no significant association was found with HADS and patients' sociodemographic characteristics.Targeted approach to psychological aspects and vitamin D levels among patients with RA may have considerable implication for the optimal management of RA.
Diabetes mellitus (DM) is a common metabolic disease associated with carpal tunnel syndrome (CTS) and tendinopathy. This study aimed to assess the ultrasonographic (US) parameters of the flexor tendon and median nerve in asymptomatic subjects with diabetes in comparison with controls without diabetes. In this study, 22 DM and 22 non-DM subjects with no symptoms or manipulations in non-dominant hands and wrists were assessed. Ultrasound evaluations of the length, width, cross-sectional area, and circumference of the fourth flexor tendon and the median nerve were performed in the two groups. There was no statistically significant difference in age (P value= 0.473), gender (P value= 0.364), or wrist circumference (P value= 0.1921) between the groups. This study showed no significant difference between the two groups in median nerve length (P value= 0.35), width (P value= 0.17), cross-sectional circumference (P value= 0.23), or cross-sectional area (P value= 0.16). Also, a comparison of the sonographic data of the fourth flexor tendon between the two groups presented no significant difference in length (P value = 0.68), width (P value= 0.80), cross-sectional circumference (P value= 0.70), or cross-sectional area (P value= 0.80). In conclusion, data from the present study showed that sonographic values of the median nerve and fourth flexor tendon in asymptomatic subjects with DM did not differ significantly with those of non-diabetics. These findings demonstrate that still more case studies and more evaluations are required to validate the applicability of ultrasonography in the prediction of carpal tunnel syndrome and tendinopathy in diabetic patients.
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