Satisfaction and Adherence to Biological Treatment in Patients with Rheumatic Diseases

2021 ◽  
Vol 18 ◽  
Author(s):  
Marwa Hammad ◽  
Huny Bakry

Background: Autoimmune inflammatory rheumatic diseases have long been treated by conventional disease-modifying anti-rheumatic drugs. Biological therapy is a new era in the treatment of rheumatic diseases, but satisfaction and adherence to it is still not well tested. Aim: To assess the satisfaction and adherence to biological treatment among patients with autoimmune inflammatory rheumatic diseases. Methods: A cross sectional study was conducted among 56 patients suffering from inflammatory rheumatic diseases using Morisky 8 questionnaire and Treatment Satisfaction Questionnaire for Medication (TSQM) over a period of one month Results: About 76.8% of the patients had medium adherence and the underlying cause of missing doses was the unavailability of the drugs. The mean satisfaction with biological treatment was 62.7±6.9. Patients who did not receive formal education had significantly higher satisfaction with the biological treatment than others 64.94±5.01 at a P value 0.04 (<0.05). Conclusion: Patients with inflammatory rheumatic diseases in our study showed medium adherence and satisfaction. Authorities in the medical field are providing great help to these patients in need of biological therapy, but ensuring the availability of all doses of the biological treatment regimen is still necessary. Patient, family and nurse education programs are also necessary to maximize adherence and satisfaction.

2020 ◽  
Vol 6 (2) ◽  
pp. 74-77
Author(s):  
Mohammad Enayet Hussain ◽  
Bithi Debnath ◽  
AFM Al Masum Khan ◽  
Md Ferdous Mian ◽  
Md Nahidul Islam ◽  
...  

Background: The visual evoked potentials (VEP) is a valuable tool to document occult lesions of the central visual channels especially within the optic nerve. Objectives: The purpose of the present study was to observe the findings of first few cases of VEP done in the neurophysiology department of the National Institute of Neurosciences (NINS), Dhaka, Bangladesh. Methodology: This cross-sectional study was conducted in the Department of Neurophysiology at the National Institute of Neurosciences and Hospital, Dhaka, Bangladesh from September 2017 to March 2020. All patients referred to the Neurophysiology Department of NINS for VEP were included. Pattern reversal VEPs were done using standard protocol set by International Federation of Clinical Neurophysiology (IFCN). Results: The mean age of the study population was 30.70 (±12.11) years (6-68 years) with 31 (46.3%) male and 36 (53.7%) female patients. The mean duration of illness was 8.71 (±1.78) months (3 days- 120 months). Most common presenting symptom was blurring of vision (37.3%) and dimness of vision (32.8%). Patterned VEP revealed mixed type (both demyelinating and axonal) of abnormality in most cases [29(43.35)]. The most common clinical diagnosis was multiple sclerosis (29.85%) and optic neuropathy (26.87%). In the clinically suspected cases of multiple sclerosis, optic neuropathy and optic neuritis most of the cases of VEP were abnormal and the p value is 0.04 in optic neuropathy and optic neuritis. Conclusion: The commonest presentation of the patients in this series were blurring of vision and dimness of vision. The most common clinical diagnosis for which VEP was asked for, was optic neuritis and multiple sclerosis. Most abnormalities were of mixed pattern (demyelinating and axonal). Journal of National Institute of Neurosciences Bangladesh, 2020;6(2): 74-77


2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 508.2-509
Author(s):  
K. Maatallah ◽  
H. Boussaa ◽  
H. Riahi ◽  
H. Ferjani ◽  
M. Habechi ◽  
...  

Background:Foot disease is a common problem in rheumatoid arthritis (RA). Therapeutic decisions are often based on clinical examination (CE) alone, which can be adversely affected by factors such as deformity, obesity, and peripheral edema. Ultrasonography (US) has previously been shown to be more sensitive than CE for detecting synovitis and tenosynovitis in RA forefeet, but few data exist for the hindfoot and ankle.Objectives:The aim of this study was to compare CE and US for the detection of hindfoot and ankle synovitis and tenosynovitis in patients with established RA.Methods:We conducted a cross-sectional study including patients with RA (ACR/EULAR 2010). Demographic data and disease parameters were collected. CE was performed by a rheumatologist for the presence or absence of tenderness, swelling, and mobility restriction of both ankles. The following tendons were examined for tenosynovitis: tibialis anterior (TA) and posterior (TP), fibularis longus (FL), and brevis (FB) (assessed together). In a second time, US examination of the tibiotalar, talonavicular, and subtalar joints and the same tendons as CE was performed by a blinded radiologist experienced in musculoskeletal imaging using a Philips HD11 device with a high-frequency linear transducer. The presence or absence of synovitis and tenosynovitis was recorded, and the composite synovitis score (power doppler / grayscale ultrasound (PDUS)) was measured for each joint. The US score of each patient was defined by the sum of the composite scores of the joints studied (0-30). A p-value <0.05 was considered significant.Results:Sixty-two feet were examined in 31 RA patients (25 women and six men) with a mean age of 54.8±10.8 years old [32-70]. The mean disease duration was 8.5±7.2 years [1-37]. Rheumatoid Factor (RF) and Anti-Citrullinated Peptides Antibodies (ACPA) were positive in 61.3% and 83.8% of cases. The mean DAS28 ESR was 3.8±1.5 [0.6-7].Clinical examination of ankles revealed tenderness in 57.4% of cases, swelling in 38.8% of cases, and restriction in the range of motion in 11.1% of cases. TA tenosynovitis was noted in 14.8% of cases, TP tenosynovitis in 22.2% of cases, and FL and FB tenosynovitis in 31.5% of cases.US showed tibiotalar synovitis in 59.3% of cases, talonavicular synovitis in 64.8% of cases, and subtalar synovitis in 46.3% of cases. TA tenosynovitis was noted in 5.6% of cases, TP tenosynovitis in 22.2% of cases, and FB and FL tenosynovitis in 25% and 11.1% of cases respectively.An association was found between clinical tenderness and US synovitis of the tibiotalar joint (p=0.013) and the talonavicular joint (p=0.027). No association was noted between clinical swelling and US synovitis in these joints.No association was noted between clinical and US tenosynovitis of TA (p=0.279), TP (p=0.436), FB (p=0.495) and FL (p=0.315).Conclusion:Clinical examination of RA ankles may be challenging and needs to be coupled with US, which is more sensitive and accurate in the detection of synovitis and tenosynovitis.Disclosure of Interests:None declared


2021 ◽  
Author(s):  
Anas Shamala ◽  
Ebtesam Al-Maimooni ◽  
Salsbeel Al-Matari ◽  
Ryhana Hiyat ◽  
Mohammed Al-wesabi ◽  
...  

Abstract Backgrounds: The present study sought to assess tooth loss and oral hygiene practices among a sample of Yemeni women in association with giving births (parity).Subjects and Methods: This cross-sectional study included a sample of 644 Yemeni women. They were interviewed to gather socio-demographic (age, education, number of children) and behavioral data (oral hygiene practices, khat chewing and smoking). Additionally, they were examined clinically to assess number of tooth loss. Data were analyzed using SPSS with a P-value < 0.05 was considered statistically significant. Results: The participating women aged between 16 and 51 years. Only one fifth of the sample reported brushing their teeth regularly (i.e, at least once a day), and around 36.8% reported using dental aids occasionally. Additionally, 52% and 21% of the sample reported they were khat chewers and smokers, respectively. The mean number of tooth loss was 4.7. The mean number of children was 4.15, with approximately 54% of the participating women had more than 3 children. The results of the logistic regression revealed a significant association between number of children and tooth loss. Conclusion: Yemeni women had poor oral hygiene practices and high prevalence of tooth loss increased proportionally with the increased number of children. This emphasizes the importance of an effective oral hygiene motivation and health education among female patients during pregnancy periods.


2020 ◽  
Vol 7 (6) ◽  
pp. 997
Author(s):  
Dharmendra Jhavar ◽  
Neha Kirti ◽  
Sumit Kumar Vishwakarma ◽  
Umesh Kumar Chandra ◽  
Vinod Verma

Background: Since a long time ago, the experts have realized that determination of cut-off point for diagnosing diabetes will be revised over time with the lower blood glucose level as the more sensitive diagnosis for detecting the occurring complication and biochemical changes.Methods: This cross sectional study was carried out in the department of medicine, M.G.M. Medical College and M.Y. Hospital Indore from July, 2016 to August, 2017 in 200 individuals and patients having euglycemic status attending General Medicine OPD.Results: In the low and high normal group 2 (2.0%) and 8 (8.0%) were having abnormal total cholesterol (TC) level respectively. The mean total cholesterol in the low normal group was 117.16±26.94mg/dl and it was 154.74±28.38mg/dl in the high normal group. The difference was found to be statistically significant (p value 0.000). In the low and high normal group, 4 (4.0%) and 17 (17.0%) were having abnormal triglyceride (TG) levels respectively. The mean TG levels in the low and high normal group were 96.93±22.64mg/dl and 110.55±32.37mg/dl respectively. The difference was found to be statistically significant (p value 0.001). In the low and high normal group, 6 (6.0%) and 14 (14.0%) patient was having abnormal uric acid levels respectively. The mean uric acid levels in the low and high normal group was 4.88±1.10mg/dl and 5.31±1.31mg/dl respectively. The difference was found to be statistically significant (p value 0.013).Conclusions: Higher levels of Cholesterol and Triglycerides were found more commonly in high normal euglycemic group compared to low normal euglycemic group. Mean cholesterol and mean triglyceride levels were higher in high normal euglycemic group.


Author(s):  
Asma Abdelaal Abdalla ◽  
Siham Ahmed Balla ◽  
Amna Abdalla Babiker ◽  
Safaa Abdelhameed Medani ◽  
Rania Abdalla Osman Khalfa ◽  
...  

Aims: To measure the waist circumference of Sudanese adults in Khartoum Locality and its relationship to blood pressure and lifestyle  during celebration of international day of hypertension in May 2016 . Study Design: It was a descriptive cross-sectional study. Place of the Celebration: Khartoum Locality at Alsahaa Alkhadraa (The Green Park). Methodology: A total of 364 adult participants, 196 men and 168 women were interviewed using structured questionnaire. Blood pressure (BP) was measured considering hypertension as ≥ 140 mmHg and ≥ 90 mmHg for systole and diastole BP respectively. Waist circumference was measured using an anthropometric measuring tape at cut-off point of 94 cm and 80 cm for men and women respectively. Data was managed by SPSS version 20 and Chi-square test at 95% CL was used to test the association between waist circumference, blood pressure and life style characteristics. Results: Age distribution of the study population showed 48.2% females and 45.4% males in the middle age group (38-57 years). Two thirds of the study population were hypertensive, 62.8% of males and 64.3% of females. The mean waist circumference of men was 97.82 cm + 16.7, mean Systolic BP was 127 + 22 and mean Diastolic BP was 85 + 15. The mean waist circumference of women was 99.31 + 16.2, mean Systolic was 128 + 24 and mean Diastolic BP was 84 +17. Abnormal waist circumference was found in 61.2% of males and 86.9% of females. Fifty nine (30.1%) of the males and 86 (51.2%) of the females with abnormal waist circumference were hypertensive. The association between abnormal waist circumference and high blood pressure was significant among both sexes, P value = 0.001. Physical exercise and fat and salt foods were not significantly associated waist circumference in both men and women. Conclusion: Two thirds of women and men in the celebrating areas were hypertensive.  Half of women and one third of men were significantly hypertensive and having abnormal waist circumference. Doing physical exercise, avoiding fat and salt foods was insignificantly associated with normal waist circumference. Large survey with representative sample is needed to estimate the real Sudanese waist circumference.  


Author(s):  
Oluwaseun Oladapo Akinyemi ◽  
Babatunde Ayeni ◽  
Olayinka Stephen Ilesanmi ◽  
Oluwatomi Owopetu

Objective: The management of Diabetes Mellitus (DM) is long-term and can be expensive. This study aimed to describe access to anti-diabetic medicines among patients in tertiary health care facilities in Oyo State, Nigeria. Materials and Methods: This was a hospital-based cross-sectional study. The study sites were the University College Hospital (UCH), Ibadan, and Ladoke Akintola University Teaching Hospital, Ogbomosho. It was conducted among 366 diabetic patients who had been attending the endocrinology clinic of these two tertiary health institutions for at least one year. Data analysis was done with the Statistical Program for Social Sciences. Results: Female participants were 186 (50.8%) and 298 (85.6%) depended on close relatives to purchase their drugs. Those who had difficulties affording their anti-diabetic medications were 142 (38.8%) and 80 (56.3%) preferred buying a cheaper brand of anti-diabetic medication. Also, 136 (37.2%) respondents had missed their required drugs at some point due to insufficient funds. Males who were able to afford their anti-diabetic medication were 96 (53.3%) compared to 128 (68.8%) females (P-value= 0.002). Those with no formal education had the highest proportion of respondents who could not easily afford anti-diabetic drugs (60.9%), those with tertiary education had the highest proportion of respondents who could afford their medication (77.5%), (P-value=< 0.001). Among those in the 61-70 years age group, 78 (66.1%) achieved glycaemic control compared to 34 (42.5%) of those above 70 years (P-value=< 0.001). Conclusion: To improve affordability, subsidizing the cost of anti-diabetic medications and encouraging patients to enrol in the Health Insurance Scheme will be beneficial.


2020 ◽  
Vol 3 (2) ◽  
pp. 59
Author(s):  
Dian Sarah Mutiara ◽  
Diana Sunardi ◽  
Esthika Dewiasty

Introduction: Neurodegenerative disease is the most problem in elderly. Amyloid β (Aβ) accumulation is the major cause of cognitive impairment. Zinc has an important role in antioxidant and Aβ accumulation process. This study aimed to evaluate the correlation between hair zinc level and cognitive function in elderly.Methods: A cross sectional study was conducted involving 58 subjects of elderly in Jakarta. Subjects were recruited by consecutive sampling. Hair zinc level was measured by inductively coupled plasma emission spectrometer (ICPS) and cognitive function assessed by abbreviated mental test (AMT). Data analysis was done by spearman rank correlation test and p-value less than 0.05 were considered statistically significant.Results: The mean of age was 65.4 ± 4.4 years old and 56.9% of subjects were female. The mean of hair zinc level was 123.23 ± 69.71 µg/gram hair and 32.8% subjects had hair zinc deficiency. There was 91.4% subjects had normal cognitive function. The study showed no correlation between hair zinc level and cognitive function in elderly (p=0.871 ; r=-0.022).Conclusions: There was no correlation between hair zinc level and cognitive function in elderly. Further research is expected to be performed with different level of cognitive function.Keywords: cognitive, elderly, hair zinc level, zinc.


Medicina ◽  
2018 ◽  
Vol 54 (4) ◽  
pp. 57 ◽  
Author(s):  
Muhammad Sarwar ◽  
Sadia Iftikhar ◽  
Muhammad Sarfraz

Objective: To evaluate influence of education level of older patients on polypharmacy, potentially inappropriate medications (PIMs) listed in Beer’s Criteria, and unplanned hospitalization. Methods: A cross-sectional study was conducted among older people aged ≥65 years between 1 December 2017 and 28 February 2018. For data analysis, descriptive statistics and logistic regression analysis were employed. Results: Among 385 older patients, 88.8% were prescribed PIMs and 56.4% underwent PIMs associated unplanned hospitalization. Older people were less exposed to polypharmacy or excessive polypharmacy as their education levels increased (no formal education vs. primary vs. secondary vs. tertiary, 74% vs. 69.8% vs. 60.5% vs. 58.1%). Patients having higher education were also accompanied by significantly lower prescription of PIMs (no formal education vs. primary vs. secondary vs. tertiary, 96% vs. 87.3% vs. 84.5% vs. 79.1%) as well as unplanned hospitalization (no formal education vs. primary vs. secondary vs. tertiary, 64.7% vs. 76.2% vs. 40.3% vs. 46.5%). Results of regression analysis revealed that no formal education (OR = 1.202, 95% CI = 1.032–2.146, p-value = 0.003) and primary education level (OR = 1.175, 95% CI = 1.014–1.538, p-value = 0.039) were significantly associated with the use of polypharmacy among older people. On the other hand, no formal education was significantly associated with the prescription of PIMs (OR = 1.898, 95% CI = 1.151–2.786, p-value = 0.007). Furthermore, older people with no formal education (OR = 1.402, 95% CI = 1.123–1.994, p-value = 0.010) and primary education level (OR = 1.775, 95% CI = 1.281–3.018, p-value = <0.001) were significantly more likely to undergo unplanned hospitalization. Conclusions: Patients having low literacy level are more likely to receive PIMs, polypharmacy, and undergo unplanned hospitalization in comparison to highly educated patients. Hence, promotion of health literacy for patients is crucial to overcome these problems.


Author(s):  
Fatemeh Rahimi ◽  
Elahe Alamdar ◽  
Hengame Sadat Seyed Mirnasab ◽  
Somaieh Borjalilu ◽  
Mahnaz Pouresmaeil ◽  
...  

Background and purpose: There is concern that students may have an unhealthy lifestyle as a result of changes that occurred during corona conditions, so this study aimed to determine the status of the lifestyle and its relationship with the demographic characteristics of postgraduate students during the corona span.  Material and Methods: This cross-sectional study was conducted at Tehran University of Medical Sciences in 2020. The link to the online Health-Promoting Lifestyle Questionnaire Profile2 was sent to conduct the research. To examine the relationships between the mean scores of health-promoting lifestyle and different variables, an independent samples t-test was applied in the case of dichotomous demographic variables (gender, education level, and income-generating activity), while one-way analysis of variance test was used to evaluate the multilevel demographic variables (marital status, place of residence, and faculty). The Pearson correlation coefficient was also used for testing age.  Results: The sample 240, (75.4%) were female and 145 of them, (60.4%) were single. The mean age of them was 32.21±7.45.45 years old. The lifestyle total score was 138.28± 21.18 at the average level. The highest score was related to spiritual growth (26.93±5.01), whereas the lowest score was reported on physical activity (16.92±5.17). The difference between the mean of health-promoting lifestyle was not significant in terms of demographic variables.According to the results, a statistically significant difference was observed between male and female students in the field of nutrition. Also, students were significantly different in the nutrition domain regarding students’ residence (p-value <0.05). Spiritual growth was significantly different among students in terms of marital status (p-value <0.05). Conclusion: Although the mean score of health-promoting lifestyle was not different from other studies, further studies are proposed to plan health interventions in accordance with epidemic conditions for students. 


2020 ◽  
Vol 36 (1) ◽  
Author(s):  
Shakeel Ahmad ◽  
Rashida RIaz ◽  
Muhammad Haseeb ◽  
Hafiza Ammara Rasheed ◽  
Samia Iqbal

Purpose: To compare the mean difference of visual acuity as measured by auto refraction and subjective refraction. Study Design:  Descriptive cross-sectional study. Place and Duration of Study:  Department of ophthalmology, Services hospital Lahore from November 2013 to April 2014. Material and Methods:  Using non-probability consecutive sampling 300 eyes of 300 patients fulfilling inclusion criteria were recruited through OPD registration slip. Demographic data including age and gender was recorded. Complete ophthalmic examination was performed. This included measurement of refractive error by auto-refraction as well as subjective refraction. Detailed anterior segment examination with slit lamp and dilated fundus examination with indirect ophthalmoscopy was performed. The collected data was analyzed by using software SPSS version 17. Results:  The mean age of patients was 34.71 ± 7.45 years. There were 156 (52%) males and 144 (48%) females. There were 263 (87.69%) patients who had visual acuity of 6/6 and 37 (12.33%) had 6/9. Mean spherical auto-refraction and subjective refraction was 0.0290 ± 2.58 and -0.2842 ± 2.37 D with mean difference of -0.3133 ± 1.27 D. The mean cylindrical auto and subjective refraction in this study was -.9742 ± 0.78 D and -0.7500 ± 0.81 D and mean difference was 0.2242 ± 0.74 D. The mean cylindrical axis of auto and subjective refraction was 114.88 ± 49.75 and 115.60 ± 49.70 with mean difference as 0.72 ± 3.02 D (p-value < 0.05). Conclusion:  Difference of spherical, cylindrical and cylindrical axis in auto and subjective refraction was significantly different.


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