The objective of this study is to study the prevalence of musculoskeletal complaints and disorders in a rural area in Iran. Interviews were conducted in randomly selected subjects from five villages in Tuyserkan County, northwestern part of Iran. The three phases of stage 1 Community Oriented Program for Control of Rheumatic Diseases were done during the same day. A total of 614 houses was visited, 1,565 persons interviewed, and 1,192 persons examined. Musculoskeletal complaints during the past 7 days were detected in 66.6% (shoulder 22.7%, wrist 17.4%, hands and fingers 14.9%, hip 13.9%, knee 39.2%, ankle 19.6%, toes 12.7%, cervical spine 17.9%, and dorsolumbar spine 41.9%). Degenerative joint diseases were detected in 20.5% (cervical spondylosis 2.2%, knee osteoarthritis [OA] 19.3%, hand OA 2.7%, and hip OA 0.13). Low back pain was detected in 23.4%, soft tissue rheumatism in 2.2%, rheumatoid arthritis in 0.19%, ankylosing spondylitis in 1.1%, systemic lupus erythematosus in 0.06%, and fibromyalgia in 0.06%. The prevalence of rheumatic complaints in rural Iran is very high and needs attention in the curricula of medical schools and in the planning of rural health care by the government.
To determine the efficacy of oral vitamin D [25(OH)D] in patients with active rheumatoid arthritis (RA) who are in methotrexate (MTX) therapy, patients receiving stable doses of MTX were randomized to one of two dose groups and received 12 weeks of double-blind vitamin D[25(OH)D] (50,000 IU per week) or matching placebo. The moderate and major efficacy measure was the proportion of patients with >0.6 and >1.2 improvement in RA based on the Disease Activity Score 28(DAS 28) at 12 weeks. Safety measures included adverse events and laboratory assessments. On a background of MTX, the percentage of patients with a moderate/major DAS 28 response at week 12 in the vitamin D groups (76/44%) was not significantly different from placebo (64.6/33.4%). Adverse events were typically mild and included small hepatic enzyme elevation; we did not have any undesirable events resulting in discontinuation of study drug. In patients with active RA receiving stable doses of MTX, vitamin D showed non-significant improvement in efficacy outcomes compared to placebo.
Idiopathic granulomatous mastitis is an inflammatory mass in the breast. Patients typically present with a firm breast mass, often associated with inflammation of the overlying skin. Nipple retraction, peau d'orange-like changes, and axillary adenopathy may be present. We describe a 23-year-old pregnant woman with arthritis, erythema nodosum, and mastitis.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.