Tehran University Medical Journal

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Levamizole hydrochloride (C11H12 N2 S.HCl) is a drug capable of being rapidly absorbed from the gastrointestinal tract and is also rapidly eliminated from plasma. It has a modulating effect on the immunesystem, and may be used in treatment of parasitic diseases and infections. Because of its toxicity to liver and its rapid clearance from plasma, this drug must be formulated in such a way so as to decrease its necessary dosage and thus its toxic effect on the liver while improving or at least maintaining its present tolerance to disintegrating factors in the surrounding and its ability to efficiently reach its target tissues (the immune system). Therefore, the liposomal form of levamizole hydrochloride can be helpful in achieving the stated goals. In this study, first a preparation of a multilayer liposome with hydrophilic coating was done. For this purpose, a mixture of phosphate buffer (soudium and potassium phosphate I, 4 mmol, pH =7.4) ethanol and lipid (100 mg phosphatidyl choline, extracted from soya) was used (buffer 200 mg, ethanol 80 mg, lipid 100 mg). Also levamizole hydrochloride with half a solubility in water was used. The above solutions from levamizole containing liposomes under a few cycles of freeze-thawing method (20-60°C). Ultracentrifugation (45 min, 60.000 rpm) was used to determining the extent of drug encapsulation in this method we can calculate the percent encapsulation using a control. In our method this percentage was calculated to be 92.7%.

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Psoriasis is a chronic, inflammatory scaling disorder of the skin. Different patterns of psoriasis exist including plaque type, erythrodemic, pustular, palmoplantar and guttate. The most commonly involved sites are the elbows, knees, lumbosacral area and scalp. PUVA (Psoriasis Plus UVA) therapy [administration of oral psoralen followed by exposure to UVA (320 to 440 nm)] is widely used to treat severe psoriasis. Oral PUVA produces some adverse effects that may limit its applicability in a number of patients. The carcinogenic potential limits its use in patients with psoriasis who probably receive other carcinogenic treatments. Oral PUVA may induce complications such as nausea, vomiting and headache. In light of these problems Bath PUVA therapy is an important alternative to oral PUVA therapy. Bath PUVA is a kind of photochemotherapy in which UVA radiation after administration of topical psoralen in a warm water bath is used. We treated 30 patients with generalized plaque type psoriasis with 8-Mop Bath PUVA in Razi hospital. Bath PUVA cleared psoriasis more rapidly than oral PUVA and required fewer treatments (mean number of sessions: (17.6±2.1) and lower cumulative UVA dose. (49.2±15.4 J/cm²). 83.3 percent of our patients showed complete response to treatment and 13.4 percent showed good response.

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Dorsal traumatic dislocation of metatarsophalangeal joint of great toe is a rare injury. Ability to reduce the dislocation by nonoperative measures depends largely on the type of dislocation and involvement of the sesamoid complex. There are three basic types of dislocations. Type I cases are usually irreducible on closed reduction, the metatarsal head being incarcerated by the conjoined tendons with their intact sesamoids. In type II, the sesamoid complex disruption usually pemits closed reduction. We present an irreducible dislocation of the first metatarsophalangeal joint with fibular sesamoid fracture in an 80-year-old man. In addition, he had a concomitant dorsal dislocation of the second MTP of the same foot, to our knowledge only one case with this injury was reported in the literature.

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Background: Osteoid osteoma is a well-known benign tumor of bone. It occurs in children and young adults and is rarely seen above the age of 40. It is uncommon in hand and wrist. If it occurs in hand and wrist, its diagnosis is difficult because of its unusual presentations both clinically and radiologically.

Materials and Methods: We encountered ten patients with osteoid osteoma of hand during the last ten years in orthopedic department of Emam university hospital from 1970 to 1979.

Results: The average age of ten patients with osteoid osteoma of the hand and wrist that were treated in Imam hospital from 1369 to 1378, was 22.9 years (range, 14 to 33 years). Five lesions were in proximal phalanx, one in middle phalanx, and one in distal phalanx. In the wrist, one lesion was in the capitate, one in the lunate, and one in the hamate. The average time from onset of symptoms to successful treatment was 20 months (range, 4 months to 60 months). Three of ten patients had had treatment elsewhere, all of them had had unsuccessful operative procedures related to incorrect diagnosis. All patients had a minimum follow-up of 6 months (range, 6 months to 9 years, mean: 4.6 years). The operative treatment were successful in all ten patients without any signs or symptoms of recurrence. Only limitation of proximal interphalangeal joint range of motion was remained in one patient due to 60 months delay in diagnosis and treatment.

Conclusion: High index of suspicion is necessary for diagnosis of osteoid osteoma of hand because of unusual presentation of it. The most important factors for successful treatment of osteoid osteoma of hand are accurate diagnosis and exact preoperative planning.

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Introduction: Coronary artery disease (CAD) and its complications are the most prevalent etiology of mortality all over the world and diabetes mellitus (DM) is one of its risk factors. In this study prevalence of MI and unstable angina have been compared with different kinds of retinopathy and their severity.

Materials and methods: This study is a descriptive, cross sectional one that performed on 100 patients admitted in Imam, Farabi and Amir Alam Hospitals.

Results: Most important findings are as below: 1) Non-proliferative diabetic retinopathy (NPDR) are more prevalent than proliferative diabetic retinopathy (PDR), 41 Vs 17 cases, and 24 person were normal in MI population. And 12 persons had NPDR and 2 PDR and 5 normal in unstable angina. 2) Different diabetic retinopathy lesion were: 23 Venous dilation, 22 aneurysme, 18 hemorrhagic, 11 neovascularization, 10 macula edema, 6 retroretinal detachment, 2 gliosis. 3) on the point of presence or absence of diabetic retinopathy (DR), 72 percent had some kind of DR and 28 percent had nothing. Finally, in MI population 58 patients (70 percent) had DR and 24 patients (30 percent) didn't have any. In unstable angina 14 patients (77 percent) had diabetic retinopathy and 4 didn't have (23 percent).

Conclusion: Regarding the lack of facilities and shortcoming of necessary data, it was not possible to conduct a prospective investigation in this item, so the design and implementation of a prospective study based on enough cases and controls is strongly recommended.

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The genus acinetobacter are intestinal gram negative, encapsulated, non motile, aerobic bacilli, which are rod shaped during rapid growth and cocobacillary in stationary phase. Risk factors associated with nosocomial infections include: length of hospital stay, surgery, wounds, previous infection, fecal colonization, treatment with broad spectrum antibiotics, parenteral nutrition, indwelling central intravenous or urinary catheters, admission to a burn unite or ICU and mechanical ventilation. Acinetobacter meningitis occur infrequently and is generally found after neuro‌surgical procedures.
Here, we are presenting a 19 year-old female patient who developed multi-drug resistant (MDR) acinetobacter meningitis after operation on maxillary bone, but despite good clinical response to imipenem and amikacin succumbed aminoglycoside induced otoxicity.

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Background: Patellofemoral joint disorders are the most common cause of anterior knee pain in patients who referred to orthopedic clinics. Patellar lateralization cause anterior knee pain due to weakness of vastus medialis oblique muscle or tightness of lateral structures like lateral retinaculum or iliotibial band muscle.

Materials and Methods: For evaluation of this abnormality, plane radiography, CT scan and MRI are useful. In plane radiography only one view in a single joint position can be obtained, because of that it is not a good method to detect abnormal tracking during knee range of motion. The purpose of this study was to evaluate patellar tracking by kinematics MRI during five serial degrees of knee range of motion (40, 30, 20, 10, 0 degrees) in 30 patients with patellar lateralization and 10 normal subjects, aged 18-30 years.

Results and Conclusion: tistical analysis showed that in patients group, patella had the most stability in 40 degree of knee flexion and this stability reduced when knee reached to full extension. At this point, patella moved laterally and the most instability was seen during 20 to 0 degree of knee extension.

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Background: One of the most important concerns in orthopedic medicine is the low back. Considering the importance of muscle function in preventing LBT by controlling too much load and stress applied on the spinal joints and ligaments.

Materials and Methods: The aim of this research was to determine the timing and level of activities of lumbopelvic muscles in response to postural perturbations caused by unexpected loading of the upper limbs in standing on three different supporting surfaces (neutral, positive slope, negative slope) in 20 healthy females 18 to 30 years old ( = 23.20 SD = 2.55 ). The electromyographic signals were recorded from the deltoid, gluteus maximus, internal oblique abdominis and lumbar paraspinal muscles of the dominant side of the body to evaluate the onset time, end time, level of muscle activity (RMS) and duration of different muscles in one task and one muscle in different tasks.

Results: The results showed that the agonists (posterior muscles) activated at first to compensate the flexor torque caused by loading and then the antagonists (anterior muscles) switched-on to compensate the reaction forces caused by agonist activities. With regards to continuous activity of internal oblique and its attachments via thoracalumbar fascia to the transverse processes of the lumbar vertebrae, it can be considered as one of the major stabilizer muscles of the trunk .

Conclusion: Finally the results indicated that supporting surface type didn’t have any effect on timing and scaling of muscle activities in different tasks suggesting that probably spinal and trunk priprioceptors are just responsible for triggering postural responses and they don’t have any role in determining timing and scaling.

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Background and Aim: Quality of care and its concordance with scientific evidence has a significant role in improvement of prognosis in patients with acute coronary syndrome (ACS). The present study was performed to evaluate the quality of care in a TUMS-affiliated hospital.

Materials and Methods: The quality indicators of the process and outcome of care according to guidelines of the MONICA project was used in this study. 320 cases with primary impression of ACS (including 80 cases from each trimester during Aug-2003 to Jul-2004) were evaluated according to MONICA standard definitions of diagnosis, provided care and survival in 28th day after heart attack.

Results: The Equivalent Treatment Score (ETS) was 43.4 percent (95%CI: 32.86-53.94) and the Weighted Treatment Score (WTS) was 22.2 percent (95%CI: 13.36-31.03) in patients with definite myocardial infarction. The 28-day case fatality among the evaluated patients was 9.09 percent (95%CI: 5.85-12.33).

Conclusion: Although the measures of quality of care in this patient setting were acceptable in comparison with MONICA collaborative centers, however the difference between ways of hospital sampling (in the present study) and the population-based method (applied in the MONICA populations) should be taken in to consideration. Adding pre-hospital fatal events to this data set will decrease the precision of quality measures.

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Background: There is considerable professional debate over which technique is the best for lifting. The aim of this study is to compare three static lifting styles, the stoop, semi-squat and arm lift, using maximum isometric voluntary contraction (MIVC) as one indicator for recommending a lifting style.
Methods: Thirty healthy women (mean age: 22.37 years) participated in this quasi-experimental study. They performed the tests in static postures by standing on the platform of the Lift TrackTM and pulling the dynamometer of the instrument with maximum effort in three lifting styles: the stoop, semi-squat and arm lift. The subjects warmed-up by practicing the lifts first. The mean MIVC from the two other sets of lifts were used for statistical analysis by repeated measurements and SPSS (ver.10) software.
Results: There were significant differences between the MIVC of the three lifting styles in this study. The largest MIVC was for the semi-squat lift and was the least was for the arm lift (p<0.001). The MIVC of the stoop lift was larger than that of the arm lift (p<0.001).
Conclusion: The largest MIVC for the semi-squat lift suggests that this style is useful for lifting objects from the floor. The differences in biomechanical and muscle pattern activity changes could explain these results. It seems that activation of the quadriceps muscles in the semi-squat lift was a main factor for producing more MIVC, so when this style is recommended for lifting, attention to the power of the quadriceps is important.

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Background: The typical features of eccentric exercise-induced muscle damage are delayed-onset muscle soreness (DOMS) and prolonged loss of muscle strength. It has been shown that passive warmth is effective in reducing muscle injury. Due to the interaction of different systems in vivo, we used isolated perfused medial gastrocnemius skeletal muscle to study the direct effect of temperature on the eccentric contraction-induced force loss.

Methods: After femoral artery cannulation of a rat, the left medial gastrocnemius muscle was separated and then the entire lower limb was transferred into a prewarmed (35^oC) chamber. With the chamber temperature at 31, 35 and 39^oC before and during eccentric contraction. Isometric force loss was measured after 15 eccentric contractions (N=7-9).

Results: Maximum contraction force reduction has been used as an index for eccentric contraction-induced force loss. In this study eccentric contraction caused a significant reduction in maximum isometric tension (p<0.01), but no significant difference was seen in isometric force loss at 31^oC and 39^oC compared with that at 35^oC.

Conclusions: Our results suggest that temperature changes before or during eccentric contractions have no effect on eccentric contraction-induced force loss.

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Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 !mso]> ject classid="clsid:38481807-CA0E-42D2-BF39-B33AF135CC4D" id=ieooui> Background: Chlamydia trachomatis is a common and curable STI that may be symptomatic or asymptomatic. The few studies on C. trachomatis among Iranian women have had, for the most part, small sample sizes and are therefore unsuitable for epidemiological deductions. The aim of this study was to estimate the prevalence of urogenital C. trachomatis infections by PCR on urine samples of married women in their fertile years in order to determine the need for a C. trachomatis screening program for asymptomatic women in Iran.
Methods: This descriptive-analytical and cross-sectional study was performed on 991 married women. The research material consisted of questionnaires and urine samples, which were transported daily to Avesina Research Institute, Tehran, Iran, to extract their DNA and prepare them for PCR tests. The gathered data were analyzed by SPSS, version 13, and evaluated statistically by t-test, chi-square test, Fisher's exact test and logistic regression, considering p<0.05 as significant.
Results: Of all the subjects, 127 (12.8%) were positive by PCR for C. trachomatis. The mean age of the participants was 28.88± 6.19 years. Infection was more prevalent among those with lower levels of education, who were employed and not pregnant. This infection was more prevalent among those who were using contraception, especially condoms. Reproductive history revealed that infection was more prevalent among participants with a history of vaginal discharge, pelvic pain, infertility and low birth-weight infants, and less prevalent among those with a history of abortion, preterm delivery and ectopic pregnancy. However, these patterns were not statistically significant.
Conclusion: In populations with C. trachomatis prevalences higher than 4%, screening programs are recommended. Thus, Chlamydia screening should be part of the health care program in Iran to reduce the burden of this disease. 

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Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: The preferred modality of dialysis is a controversial issue in nephrology. In this study we compare some demographic and epidemiological characteristics of hemodialysis and peritoneal dialysis patients in an attempt to analyze this issue.
Methods: The results of the research protocol "A survey of the epidemiological characteristics of chronic dialyzed patients in Khorassan province", was used to compare some demographic and epidemiological aspects of chronic hemodialysis and peritoneal dialysis patients in search of any statistically significant difference.
Results: A total of 836 chronic dialysis patients entered this study, 802 (95.9%) of which were under chronic hemodialysis, and 34 (4.1%) patients were undergoing peritoneal dialysis, with 339 (42.3%) and 12 (35.3%) being female, respectively. The mean age for each group was 47.57 and 46.75 years, respectively. The causes of end-stage renal disease in hemodialzed patients were most commonly hypertension (32.2%), followed by diabetes mellitus (22.3%), unknown causes (19.6%) and chronic glomeru-lonephritis (10.2%). In the peritoneal dialysis group, chronic glomerulonephritis (32.4%) was the most common reason for dialysis, followed by diabetes mellitus (26.5%) and unknown causes (11.8%). The mean serum hemoglobin creatinine, calcium, and phosphorus levels for hemodialysis patients were 10.42, 8.5, 8.93, and 6.03 mg/dL, respectively, and those for peritoneal dialysis patients were 11.28, 8.52, 9.41 and 5.40 mg/dL. There were no statistical differences between the median age, sexual distribution and mean levels of Hgb, Ca, phosphorus, creatinine, HCV antibody and HbsAg of the hemodialysis patients and those of the peritoneal dialysis patients.
Conclusions: The results of our study show that hemodialysis and peritoneal dialysis are similarly effective treatments.

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Background: Proper knee function is essential for daily activity. Since almost all complex tibial plateau fractures involve soft tissue compromise, there is some controversy as to the best treatment method. Currently, progress toward indirect reduction and external fixation, such as the hybrid external fixator, with minimal complications is underway. Herein we evaluate the outcomes of complex tibial plateau function repaired with hybrid external fixation at one of the most important trauma centers in Iran. 

Methods: This case-series study involved the postoperative follow up (>6 months) of 20 patients with complex tibial plateau fracture repaired using hybrid external fixator at Sina Hospital from 2002-2004. We evaluated surgery complications and outcomes including soft tissue and skin necrosis, knee range of motion, degenerative joint disease, infection, neurovascular injury, ::::union:::: time, and knee score at final visit, among others.

Results: Of the original 20 cases enrolled in this study, five dropped out. All subjects were men, with a mean age 38.6 (18-74) years. The most common injury mechanism was motor vehicle accident mean time from trauma to surgery was 4.7 (1-15) days. Mean follow up duration was 11.6 (6-26) months. At the end of the study, 80% had good knee range of motion (>90 flexion), with knee scores of 80 or more for 60% of the subjects. Although all patients had had soft tissue injury, there was no postoperative soft tissue compromise. Two patients (11%) had postoperative infection, but ultimately recovered. Less time between trauma and surgery, less periarticular soft tissue injury, less operative manipulation of soft tissues, better articular congruency, and more stable and anatomical knee alignment are associated with better outcome and prognosis.

Conclusions: This procedure reduces operative complications, especially infection and soft tissue necrosis, and requires less rest, all of which results in a stable, aligned and functional knee joint. Furthermore, adding minimal open reduction and internal fixation (ORIF) may promote even better results.

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Background: Behavioral Consultation Centers are the main organizations responsible for providing HIV/AIDS patients with services according to the Iranian Ministry of Health guidelines. In this study we assessed provision of these supposed services to Iranian HIV/AIDS patients referring to Behavioral Consultation Centers.

Methods: One hundred seventy one clinical files were selected by systematic random sampling from the files of all new HIV/AIDS patients accepted at Imam Khomeini behavioral consultation center who were registered during 2005-2006 and were followed for at least six months. Data were extracted from files and included consultation, vaccination, laboratory and treatment services.

Results: Family planning and HIV prevention methods consultation were performed for 32.5% and 2.29% of patients respectively. CD4 count was done for 69% of patients. 65.6% of patients who needed anti-retroviral treatment were given medication. Hepatitis B and Td vaccination were done for 21.7% and 3.5% of patients respectively. Coverage of pneumococal and influenza vaccinations was less than 5%. 79.5% of patients who needs tuberculosis prophylaxis were given medication. TB case finding was 14% during one year and the cure rate for patients under anti TB treatment were 95.8%.

Conclusion: Coverage of consultations and vaccination services are very low. Antiretroviral therapy coverage is intermediate. TB case finding and its cure rate are appropriate.

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Background: Adenosine receptors play an important role in the treatment of paroxysmal supraventricular tachycardia in cardiovascular system. This effect is through interaction with A1 type of G-protein-coupled adenosine receptors. The effect of N6-cyclopentyladenosine (CPA), an A1-selective adenosine agonist, was studied on ouabain-induced toxicity in spontaneously beating isolated guinea pig atria.

Methods: In the beginning the isolated guinea pig atria were mounted on the organ bath containing modified krebs and contractile responses in the four groups (shame, CPA, ouabain, CPA- ouabain) were measured.

Results: CPA (2-16nM) produced a dose-dependent decrease in the force of contractions (34%-51%) and in the rate of contractions (22%-48%). CPA significantly increased the time of onset of arrhythmia (toxicity) induced by ouabain (1.2µM) when it was administered 10 min before ouabain was added in organ bath. Ouabain (1.2µM) alone produced arrhythmia at 7 min and either asystole or standstill at 22 min. CPA (8nM) increased the time required to produce arrhythmia to 27.5 min and prolonged beating atria to more than 63 min and prevented the occurrence of asystole.

Conclusion: CPA produces direct cardiac action, probably due the inhibition of cardiac Ca²⁺ channel and membrane hyperpolarization of atrium cells in guinea pig atria. Moreover, our results suggest that CPA may reduce the membrane conduction through inhibition of ionic channels, which decrease ouabain- induced toxicity.

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Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: During recent three decades, parallel to the improvement of arthroscopic techniques, intra-articular block by direct injection of anesthetics into the joint has been used in knee arthroscopy. In this study the efficacy of intra- articular block by complex of bupivacaine, lidocaine and adrenaline in knee arthroscopy has been assessed.
Methods: Forty one healthy adults (age range: 18-55 years) with knee problems selected for diagnostic arthroscopy. Anesthesia was induced by direct injection of 10ml 2% bupivacaine, 10ml 0.5% lidocaine plus 1/100000 adrenaline into the knee joint.  Duration of operation and volume of serum used for irrigation during the procedure pain and analgesics requirement, during and after arthroscopy VAS (Visual Analogue Scale) score, at time of discharge from recovery and also patient's and surgeon's satisfaction were assessed.
Results: Sixty eight percent and 29% of cases reported mild and moderate degree of pain perception during arthroscopy, respectively, and only one case for which general anesthesia was performed, reported severe pain. VAS mean was 2.78. Seventy eight percent of cases and the surgeon in 80% of procedures had excellent or good satisfaction with intra-articular block.
Conclusions: Considering high level of satisfaction in both patients and surgeon and mean of VAS, complications of other modalities of anesthesisa and simplicity of the technique, intra-articular block can be used as an easy, safe and efficient method for knee arthroscopy.

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Background: The inguinal hernia is a common disorder in general surgery. Different methods have been described for repair of these hernias. In modern methods, synthetic mesh is used to cover the wall defect and the most known method is Lichtenstein surgical repair. The laparoscopic totally extra peritoneal procedure (TEP) is a newer technique of repairing hernia. The aim of this study is to compare the outcomes of totally extraperitoneal laparoscopic inguinal hernia repair versus Lichtenstein open repair in patients with inguinal hernia. Methods: Among 50 patients, 25 cases underwent Lichtenstein procedure and 25 patients underwent TEP technique for repairing primary unilateral inguinal hernia. Findings during the operation have been recorded and the 12-months follow-up of patients in different views was performed through a questionnaire and then the results were compared. Results: The operation duration, the rate of complications and frequency of recurrence were similar in two groups but the hospital stay, postoperative pain, chronic groin pain and the required time to return to normal activity were significantly lower in patients who underwent the TEP method compared to the patients who underwent the Lichtenstein technique (p<0.001, p<0.001, p=0.012, p<0.001, respectively). Conclusion: The TEP surgical technique can be recognized as a safe method with acceptable results for patients and has significant effects on improvement of patients’ quality of life after hernia repair. Suitable results of this surgical method are achieved when the surgeon goes through the learning curve.

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Background: Asthma is a major health condition in Iran. This randomized clinical trial was aimed for the comparison of the effects of two exercise protocols (aerobic and aerobic-strength) on the pulmonary indices and quality of life of asthmatic patients.

Methods: The study was conducted in pulmonary ward of Dr Shariati Hospital in Tehran, and Research Center of Exercise Medicine of Tehran in 2009. Fifty six asthmatic patients were selected and after two weeks of education, their spirometric parameters were recorded and the St George's respiratory questionnaire was completed. Then patients were randomly assigned to two groups of A and B. For ten weeks group A did the aerobic-strength exercises and group B did only the aerobic ones at home. At the end, again their spirometric parameters were recorded and the questionnaire was completed. Finally 42 patients completed the study.

Results: After the intervention, FEV1 and FVC but not FEV1/FVC increased in group A. There were no changes in these parameters in group B. In addition, post-intervention FEV1 and FVC were significantly higher in group A than group B. All scores of St George's respiratory questionnaire were significantly improved in both groups but they were not different between them.

Conclusions: Our findings showed that regular aerobic exercises, individually or concomitant with strength exercises, could improve vital signs and quality of life of mild to moderate asthmatic patients. However, only aerobic exercises with strength ones improve spirometric parameters. Therefore, a combination of both aerobic and strength exercises could be considered in treatment protocols of asthmatic patients.

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Background: Radioactive synoviorthesis by injection of safe radioisotopes into the joints affected to chronic arthritis is accounted as a novel method to treat haemophilic arthropathy. The main goal of this therapy would be decrease in frequency of hemarthrosis and consumption of coagulation factors. In this study we assessed the effect of radioactive synoviorthesis on the frequency of hemarthrosis, factor consumption and other related parameters.

Methods: In an interventional study in Imam Khomeini Hospital in Tehran, Iran, after meeting of inclusion criteria and taking written consent, colloid 32p radiosynovectomy was performed for 56 joints with haemophilic arthropathy. After local anesthesia of injection site, one mci of 32P for large joints (knee) and 0.5 mci for small joints (ankle and elbow) was injected, respectively. Half of these doses were considered for children (age <12 years).

Results: The mean of age was 16.78 year old (Range: 2.5-36 SD: 7.46) and 98.2% of cases were male. Injected were knee 80.35%, ankle 12.5%, and elbow 7%. The mean of follow-up was 43.63 months (range: 3-102) that at the end, the result was 62% decrease in frequency of hemarthrosis (p=0.0001) and 84% decrease in factor consumption (p=0.0001). However, the involvement of other (non injected) joints during follow-up could lower the decrease of mean of total factor consumption.

Conclusions: Radioactive synoviorthesis can be a cost-effective alternative to decrease hemarthrosis and factor consumption in haemophilic arthropathy.