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Introduction: Cryoglobulins are found in a wide spectrum of disorders but are often transient and without clinical implications. The so-called essential mixed cryoglobulinaemia shows a striking association with hepatitis C virus (HCV) infection (greater than 90 percent). Type II cryoglobulinaemia is the major extrahepatic manifestation of HCV infection. This study aims to investigate the frequency of cryoglobulinaemia in HCV-positive patients in central Iran., Methods: 50 HCV-positive patients referred to the Shaheed Sadoughi Hospital in Yazd, Iran from May 2004 to December 2005, were included in the study. Their sera were assessed for cryoglobulins. The sera were separated by centrifugation at 37 degrees Celsius and placed in a four degrees Celsius refrigerator in two tubes, one simple and the other, a Wintrobe tube, to see if precipitation occurs during a 48-hour up to a seven-day period., Results: In this study, 50 HCV positive patients were evaluated. Only two patients were female. Mean age was 32 years (ranging from 17 to 52 years). In eight patients, the cryoglobulin test was positive. In seven patients, the test became positive less than 72 hours after sampling. Only one patient who was positive for cryoglobulinaemia, had clinical manifestation of frank vasculitis., Conclusion: The prevalence of cryoglobulinaemia in Iran may be lower than other areas, and it may be due to a higher prevalence of cryoglobulinaemia in females and lower prevalence of cryoglobulinaemia in HCV genotype-1a. Most of the cases in our study were male and the more prevalent genotype in Iran is genotype-1a.

Introduction: Low back pain and lumbar radicular pain are the leading causes of job loss worldwide. Therapeutic approaches to lumbar radicular pain, including sciatica and spinal canal stenosis, are diverse. Many clinicians use 80 mg long-acting glucocorticoids in epidural steroid injections (ESI). The aim of this study is to compare the clinical response of 80 mg versus 40 mg methylprednisolone in ESI., Methods: 84 patients with newly exacerbated lumbar radicular pain were randomly al located into two groups. 43 patients under went ESI with 80 mg Depo-Medrol and 41 age- and sex-matched cases received 40 mg Depo-Medrol as the comparison group. The pain in the second week, and every month thereafter was assessed using a visual analogue scale (VAS)., Results: Remarkable improvement in one month VAS occurred in 64 cases (75 percent) from both groups. VAS values between 80 mg and 40 mg groups were comparable in the two-week (p-value is 0.827) and three-month (p-value is greater than 0.746) post-injection periods. Slightly better results were shown in patients in the 40 mg group after one month., Conclusion: In the case of lumbar radicular pain, ESI with low dose (40 mg) methylprednisolone is as effective as high dose (80 mg) with comparable results and less adverse profile.