Bochdalek hernia presenting as recurrent fever and bicytopenia in a pediatric patient: A rare case report.

Bochdalek hernia is a rare condition characterized by the displacement of abdominal contents into the thoracic cavity. Due to the nonspecific nature of symptoms, prompt diagnosis, and management by emergency care providers can be challenging. Treatment of a Bochdalek hernia typically involves the reduction in the herniated contents back into the abdominal cavity. In this case report, we present the case of a 1-year-old girl who presented to the emergency department with a fever and bicytopenia. Further evaluation revealed a Bochdalek hernia, which was successfully managed with surgical intervention. This case highlights the importance of considering a Bochdalek hernia in the differential diagnosis of patients presenting with recurrent nonspecific symptoms (fever and bicytopenia).

Hyperuricaemia and its association with other risk factors for cardiovascular diseases: A population-based study.

INTRODUCTION: Cardiovascular diseases are very common in the general population, and several factors play a role in their development. The purpose of this study was to investigate the relationship between hyperuricaemia and other cardiovascular disease risk factors. METHODS: This cross-sectional study was conducted on 1008 people over the 15-year-old general population in Kerman, Iran. The blood samples of all patients were analysed for the uric acid serum level, and they completed a checklist including physical activity, previous history of hypertension and diabetes, smoking and opium. RESULTS: A number of 1008 cases of people were entered into the study. According to the results of this study, 254 patients had uric acid levels above the 75th percentile (6 mg/dl in males, and 5 mg/dl in females). No significant difference was observed between gender (p = .249) and age groups (p = .125) of people with and without hyperuricaemia. The prevalence of overweight/obesity (p < .001), hypertension (p = .004) and low physical activity (p = .033) was significantly higher in patients with hyperuricaemia. The duration of hypertension was significantly higher in hyperuricaemic individuals (p = .022). Overweight/obesity (OR = 2.67; 95% CI = 1.87-3.82) and hypertension (OR = 1.40; 95% CI = 1.02-1.93) were two significant independent factors that contributed to the increased risk of hyperuricaemia in the subjects. CONCLUSION: The uric acid serum level is higher in people with hypertension and overweight/obesity. Hyperuricaemia increases the risk of cardiovascular events, which can be prevented by determining the appropriate strategy for the early diagnosis and treatment of this metabolic disorder.

Investigating the relationship between serum uric acid to high-density lipoprotein ratio and metabolic syndrome.

AIMS: This study aimed to determine a parameter to more easily diagnose metabolic syndrome and predict its probability of occurrence in high-risk individuals. METHODS: In this cross-sectional study, data related to the study population in the Kerman Coronary Artery Disease Risk Factor Study (KERCADRS) were examined. Subjects were divided into two groups with and without metabolic syndrome, and the relevant factors such as the ratios of uric acid to high-density lipoprotein (HDL) (UHR) in these two groups were compared, and the best cut-off point was determined. RESULTS: Data related to 817 people including 96 people with metabolic syndrome and 721 people without metabolic syndrome were analysed. The mean UHR was significantly higher in patients with metabolic syndrome (14.76 ± 6.33%) compared with those without metabolic syndrome (10.0 ± 3.10%) (p < .001). People with high UHR are 2.9 times more at risk of metabolic syndrome and the best cut-off point was 9.50% with 86% sensitivity and 55% specificity. CONCLUSIONS: According to our study, UHR is also helpful in diagnosing metabolic syndrome and can also be used to screen people at risk for metabolic syndrome.

Addison's disease in antiphospholipid syndrome: A rare complication.

The association of APS and AI is rare, but it is very important, and in cases where there is an evidence in favor of the association of these two diseases, due to the importance of early treatment of both diseases, further evaluation is necessary.

The effect of suffering from rheumatoid arthritis, systemic lupus erythematosus, and back pain on sexual functioning and marital satisfaction in Iran.

OBJECTIVE: Sexual functioning is an important component of life quality and musculoskeletal disorders may effect sexual functioning, so, the present study was conducted to evaluate sexual functioning in patients suffering from back pain, rheumatoid arthritis, and systemic lupus erythematosus (SLE). METHODS: This study was conducted on 102 patients with rheumatoid arthritis, 103 patients with back pain, 103 patients with SLE, and 210 people in the control group by the consecutive sampling method. The marital satisfaction questionnaire (Enrich), Arizona Sexual Experience Scale (ASEX) questionnaire, and the General Health Questionnaire (GHQ-28) were completed by all the subjects. Disease severity was determined in each group of patients by Disease Activity Score of 28 joints, the Roland Morris questionnaire, and the SLE Disease Activity Index questionnaire. RESULTS: The GHQ in rheumatoid arthritis and lupus patients was meaningfully higher than the control group (P < .05), while there was no meaningful difference between back pain patients and the control group (P = .414). The sexual functioning questionnaire score in all 3 groups showed no statistically meaningful difference with the control group (P < .05). Also, the marital satisfaction questionnaire score in all the groups showed no statistically meaningful difference compared to the control group (P = .791). CONCLUSION: The study has shown that the level of sexual function in participants with back pain and the level of mental health and sexual functioning in patients with rheumatoid arthritis and SLE are significantly lower than healthy people and there is a need for intervention for improving mental health as well as sexual functioning in these patients.

Fasting Blood Glucose and Insulin Level in Opium Addict versus Non-Addict Individuals.

BACKGROUND: Many of lay person believe that opium lowers blood glucose. However some studies show the opposite results. In this study, we tried to evaluate the effect of opium on blood glucose and insulin resistance. METHODS: This comparative study including 53 addicts in case groups who used opium just in the form of smoking and 55 non-addicts in a control group, took part in the study, after proving not to be opium users. After taking blood samples, their fasting blood glucose (FBG), fasting blood insulin and lipid profiles were evaluated. Furthermore, insulin resistance index was analyzed via the homeostatic model assessment of insulin resistance (HOMA-IR) formula with the cut-off points of 7.2 and 7.1. FINDINGS: Age and gender were not significantly different between the groups. There was no significant difference regarding the prevalence of insulin resistance between the two groups, according to the cut-off points of 7.1 and 7.2 (P = 0.196 and P = 0.248, respectively). Mean insulin resistance index was not significantly different between the two groups (P = 0.325). In the case group, fasting blood insulin was considerably lower (P = 0.025) and fasting blood sugar (FBS) was significantly higher (P = 0.016) than the control group. CONCLUSION: According to the level of insulin and FBS in addicts, it does not seem that opium has a significant effect on reducing the blood glucose and insulin resistance.