Background: Behcet’s disease (BD) is a vasculitis with multisystem and multiorgan involvement. Cardiac involvement in BD is a rare complication with a poor outcome that manifests itself in different forms. In this study, we aimed to investigate cardiac involvement in BD.  Methods: This is a retrospective study based on cardiac manifestations in BD according to the data of the Behçet’s Disease Unit, the Rheumatology Research Center, Tehran University of Medical Sciences, from registered patients from 1975 until June 2017. Cardiac manifestations consisted of pericarditis, myocardiopathy, myocardial infarction, stable ischemic heart disease, endomyocardial fibrosis, thrombosis, and valvular and coronary involvement. All the patients’ baseline and demographic data were recorded in a designed questionnaire. The laboratory workups, imaging, and pathological tests were also performed.      Results: We studied 7650 patients with BD, of whom 51% were male. In the entire study population, 47 patients manifested cardiac involvement: valvular involvement in 6.1%, myocardial infarction in 23.4%, stable ischemic heart disease in 20%, pericarditis in 21.3%, intracardiac thrombosis in 2.1%, coronary aneurysm in 2.1%, heart failure in 12.8%, and dilated cardiomyopathy in 4.3%. Conclusion: The prevalence of cardiac involvement in our patients with BD was 0.6%. A multidisciplinary approach can reduce mortality and morbidity rates. Consequently, we suggest that echocardiography and other cardiac diagnostic tests be routinely considered for early diagnosis and subsequent treatment.

Introduction: Fibromyalgia (FM) syndrome is a chronic musculoskeletal disorder with extensive symptoms. Its most characteristic manifestation is the presence of persistent and diffuse chronic pain. The prevalence of this disease is 1% to 6% in different studies. Its exact nature and manifestations are not fully known; hence the empirical diagnosis of doctors and the proposed diagnostic criteria may differ in diagnosis. Objectives: This study aims to investigate the prevalence of FM symptoms among rheumatology patients, identify components of symptom and laboratory markers, and determine the interrater agreement between clinician judgment and diagnostic criteria. Patients and Methods: During one year, all patients referred to the rheumatology clinic were selected by simple sampling and underwent medical history collecting and physical examination by a single experienced rheumatologist, and the clinician’s judgment on the diagnosis of FM in the patients was recorded. Also, the American College of Rheumatology (ACR) standard questionnaire was used to evaluate the diagnosis of FM. Results: Between May 2018 and May 2019, 1762 patients were recruited, of whom 1428 (81%) were female, and 334 (19%) were male, with a mean age of 48.4±13.4 years. According to the rheumatologist and ACR criteria, 620 (35.1%) and 491 (27.8%) were diagnosed with FM respectively. Analysis indicated a lower agreement between the two in patients with underlying rheumatologic conditions of a mechanical origin. Younger age in patients with FM (P<0.001). A higher prevalence of FM was found among women (P<0.001). There was a significant correlation between concomitant rheumatologic conditions and FM occurrence (P=0.0004). Symptoms were clustered into 10 components with the component including fatigue explaining 22.18% of the variance in the results. Laboratory markers were clustered into 5 components. Conclusion: Fibromyalgia is a widespread disease among women that is frequently comorbid with other rheumatologic conditions. Agreement between ACR criteria and rheumatologist judgment is acceptable but can be improved by examining the symptoms in clusters rather than individually.

Introduction: Spondyloarthropathies (SpAs) are inflammatory diseases with symptoms such as spinal pain, sacroiliac, and peripheral involvement. The prevalence of SpAs is reported from 0.2% to 1.6%. SpAs can cause significant disabilities for patients. Its medical treatment is mainly with non-steroidal anti-inflammatory (NSAIDs) and anti-TNF drugs. Objectives: The primary purpose of this study is to carefully detect the clinical manifestations of patients, demographic characteristics, and the effectiveness of common medications in this disease. Patients and Methods: The present study is a retrospective descriptive study. The statistical population is 101 patients with SpA who have demographic information and items related to clinical conditions, radiographic findings and response to treatment. Results: One hundred one patients with SpA [46 (45.5%) female] with the age of 36.83± 10.45 years were studied. Around 66 patients (64.7%) had ankylosing spondylitis (AS), with the highest prevalence of AS. The most common clinical symptoms in patients were axial and peripheral/ extra-articular symptoms. The response to patients’ treatment were 61 patients (60.4%) had responded to the first stage of treatment, since only one patient needed to change the treatment steps in five times. Conclusion: We found, most patients with SpA were young patients. The most common radiological finding was Sacroiliitis. The most common clinical finding was extra-articular manifestations. Peripheral manifestations of the disease in women and axial images in men were common. The highest response to treatment was observed with the combination of indomethacin, sulfasalazine (SSZ) and indomethacin (alone).

Adherence to treatment is of utmost importance for the management of patients with cardiovascular disease. The present study aimed to determine the degree of adherence to treatment and its relationship with anxiety and depression in patients with cardiovascular diseases. Materials and Methods: A cross-sectional study was conducted among patients with cardiovascular disease admitted to teaching hospitals in Qom, Iran in 2016. One hundred sixteen patients who met the inclusion criteria were selected via the convenience sampling method. Data collection instruments included demographic information form, Adherence to Refills and Medications Scale, as well as Hospital Anxiety and Depression Scale. The data were analyzed in SPSS software using descriptive tests and linear regression analysis. Results: Based on the obtained results, about half of the patients (49.1%) scored lower than average in adherence to treatment. The results of multiple linear regression analysis showed that among the variables included in the univariate model (P<0.15), depression (P=-0.26; β = 0.047) and body mass index (BMI) (P=0.22; β = 0.26) were significantly correlated with treatment adherence. Conclusion:As evidenced by the results of the current study, patients' adherence to a medication regimen was associated with depression and BMI. Psychological problems, especially depression, deserve assiduous attention as important determinants of treatment adherence.