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Systemic lupus erythematosus (SLE) is a systemic autoimmune disease with an unknown aetiology. Although there is no definite treatment for this disease using proper prescribed medications, mortality and morbidity ratios could be decreased. The present study attempted to investigate adherence to medical treatment in patients suffering from SLE and to evaluate the related factors which influence adherence in order to improve patients’ prognoses. In this cross-sectional study, 132 patients with SLE who referred to the rheumatology clinic of Imam Khomeini Hospital (Tehran, Iran) over the period of 2012-2013 wereexamined using a questionnaire. The applied questionnaire included two parts; the first part pertained to adherence to medication treatments (CQR: compliance questionnaire rheumatology), and the second part was related to the factors involved in adherence to medication treatments. The obtained data were analyzed using the Chi-Square test and processed by SPSS16.0 software.In this research, the mean adherence to drug treatment was calculated to be 72.48%. Among the variables of age, marital status, salary, education, distance from the clinic (accessibility), disease duration, level of patient activity, main medications consumed, and side effects, the only significant association was found between adherence level and lack of side effects due to SLE (p

Aim: The aim of this study was to compare the prevalence and severity of depression in chronic hepatitis B (CHB) patients, chronic hepatitis C (CHC) patients, and healthy participants. Methods: Two hundred and fifty-three persons participated in this cross-sectional study between 2011 and 2012 in Imam Khomeini Hospital. The prevalence and severity of depression were assessed using the Hamilton Scale. Results: There was significantly higher prevalence of depression in CHC patients (35.9%) than in healthy participants (11.3%) and CHB patients (19.8%) (both P 0.05). Inactive HBsAg carriers differed significantly from CHB patients—excluding inactive HBsAg carriers—in depression prevalence (10.0% vs. 29.3%; P 0.05). Conclusion: Depression screening in chronic hepatitis B and chronic hepatitis C patients may be beneficial in disease management.

Aim: This study was designed to evaluate iron deficiency as a predisposing factor for resistant oral aphthosis inpatients with Behcet’s disease (BD).Methods: In a case control study 220 consecutive BD patients with oral aphthosis were enrolled. All patientshad been treated for at least 3 months. They were divided into two groups according to their treatment response(75 patients in the Case and 145 in the Control group). Demographic and clinical characteristics of the disease,serum iron, total iron binding capacity and serum ferritin were determined in each patient. We used indepen-dent t-test and Mann–Whitney U-test to compare the quantitative variables and chi-square test for qualitativevariables. Odds ratio (OR) and confidence interval at 95% (95% CI) were calculated for each item.Results: There was no significant difference between the two groups in demographics or clinical characteristicsof the disease. We found iron deficiency in 72 patients (32.7%, 95% CI: 6.2), higher in the Case group thanControl (39.2% vs. 30.1%; P = 0.17). Despite the higher frequency of iron deficiency in men (26.8% vs. 14.5%),the difference was not statistically significant (P = 0.09). Multivariate logistic regression analysis showed thatnone of the iron deficiency or sex variables could predict the development of resistant oral aphthosis. The ORfor iron deficiency was 1.52 (95% CI: 0.81–2.86) and for male sex was 1.04 (95% CI: 0.56–1.91).Conclusion: Despite the higher frequency of iron deficiency in BD patients with resistant oral aphthosis, wewere not able to attribute this resistance to this deficiency.Key words: Behcet’s disease, iron deficiency, oral aphthosis, resistant cases, treatment.

Renal tubular acidosis (RTA) may develop in a large population of patients with Sjogren’s syndrome (SS), but most of the subjects are asymptomatic. Here, we report a patient with known rheumatoid arthritis and symptoms of xerostomia, xerophthalmia and periodic paralysis. SS should be considered as a cause of RTA. The treatment of the underlying disorder may ameliorate the symptoms.

With improvement in the diagnosis and treatment of cystic fibrosis cases in recent years, the survival of these cases has been increased. On the other hand, an increasing number of cases are presented during adulthood. Here we report a 24-year-old man with a history of productive cough, bilateral paranasal sinusitis and polyps, and recurrent abdominal pain. Thoracic computed tomography revealed a bilateral scattered tree in bud pattern and some bronchiectatic changes. Semen analysis showed azoospermia. A sweat chloride test was >60 mEq/l in two occasions.

Complex regional pain syndrome type 1 (CRPS1) refers to a disorder usually caused by trauma; it is characterized by pain, swelling, limited range of motion, vasomotor instability, skin changes, joint stiffness, and patchy bone demineralization. Most often it occurs after trauma. Other etiologies include myocardial ischemia, cerebrovascular accidents, infection and emotional stress. We report a case of bilateral CRPS1 of the upper extremities in a 52-year-old woman suffering from major depressive disorder. She was complaining about her hands' stiffness and pain. She also reported swelling of both upper extremities and anhydrosis, thickening of the skin and muscle wasting, finger movement limitation, contracture of the digits and trophic skin changes. The diagnosis of CRPS1 was suspected, according to history, physical examination, radiographic changes and bone scintigraphy.

To explore the awareness and attitudes of Iranian GPs in implementing evidence-based health promotion and disease prevention recommendations in primary care and to describe GPs' perceived barriers to implementing these recommendations.Our survey was carried out in 2007 in a random sample of GPs listed from an educational symposiums held for general practitioners. We developed and pre-tested a questionnaire, it was piloted with 417 GPs in general practitioners educational symposiums attending all parts of Iran. Those who did not respond received follow-up mailings and/or telephone calls. Our data management center started data entry and analyzing as soon as the questionnaires were sent back. Discrete variables were expressed as percentages and were compared with the chi-square test or Fisher's exact test as appropriate. Continuous variables were compared by means of the unpaired, two-sided t test. All statistical analyses were performed using SPSS software Version 13. Statistical significance was accepted for P0.05.Four hundred and seventeen GPs participated in the study. Although they believe they should advise preventive and health promotion activities, in practice, they are less likely to do so. The two most important barriers reported were weak patients' interest in screening tests no reimbursement for GPs. Associations between personal health behaviour and attitudes to health promotion or activities in prevention were found. GPs who exercised felt that they were more effective in helping patients to practice regular physical exercise than sedentary GPs. (P0.001).Significant gaps between GP's knowledge and practices persist in the use of evidence-based recommendations for health promotion and disease prevention in primary care.

Introduction Vitamin B12 deficiency can result in macrocytic anemia. Neurologic abnormalities of B12 deficiency include sensory deficits, loss of deep tendon reflexes, movement disorders, neuropsychiatric changes and seizures. Segmental involvement of the distal ileum, such as in tuberculosis, can cause vitamin B12 deficiency. To our knowledge, macrocytic anemia with unusual manifestations such as brain atrophy and seizures due to intestinal tuberculosis has not been reported in the literature. Case presentation A 14-year-old girl presented with complaints of paraplegia, ataxia, fever and fatigue that had started a few months earlier and which had been getting worse in the last three weeks. Her laboratory results were indicative of macrocytic anemia with a serum B12 level Conclusion Vitamin B12 deficiency should be considered in patients with neurologic features such as paresthesia, sensory deficits, urinary incontinence, dysarthria, and ataxia. The underlying cause of B12 deficiency should be determined and treated to obviate the patients' need for long term vitamin B12 therapy.