scholarly journals SPECTRUM OF RHEUMATOID ARTHRITIS PATIENTS PRESENTING TO A TERTIARY CARE HOSPITAL IN PAKISTAN

2021 ◽  
Vol 71 (4) ◽  
pp. 1193-97
Author(s):  
Muhammad Khan ◽  
Muhammad Salman Mushtaq ◽  
Babur Salim ◽  
Sumera Mushtaq ◽  
Haris Gul ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Activity Index ◽  
Tertiary Care ◽  
Disease Activity Index ◽  
Joint Space ◽  
Care Hospital ◽  
Mineral Density ◽  
Cross Sectional ◽  
Sharp Score ◽  
Co Morbidity

Objective: To describe the demographic, clinical, serological and radiological scores in patients with rheumatoid arthritis (RA) presenting in a tertiary hospital in Pakistan. Study Design: Cross sectional study. Place and Duration of Study: Department of Rheumatology, Fauji Foundation Hospital (FFH), Rawalpindi, from Sep 2018 to Feb 2019. Methodology: The study included 52 female patients with RA between the ages of 18 and 80 years. Data were obtained from FFH Rawalpindi's outpatient department. Demographic details, reference data, and serological status were recorded. The joints involved in the onset of the disease, joint deformities, clinical disease activity index (CDAI) and overall functional status were evaluated. Extra-articular manifestations of rheumatoid arthritis have also been examined during a detailed physical examination. The patient's bone mineral density was calculated by the use of dual energy absorptiometry (DEXA scan). Radiological scores were evaluated using modified sharp score. Results: Mean age of the patient was 55.08 ± 8.79 and mean duration of disease 9 .73 ± 7.54. The most common co-morbidity in rheumatoid arthritis patients was hypertension 20 (38.5%). Twenty four (11.7%) patients had osteoporosis. Wrist was the first joint involved in 17 (32.7%) patients. Ulnar deviation was the most common deformity in 12 (23.1%) patients. Sharp score for joint space narrowing was 61.09 ± 36.90 and sharp score joint erosions were 36.90 ± 42.41. Most common extra articular manifestation was anemia. Conclusion: Rheumatoid arthritis as a variable spectrum of disease with different manifestations. Patients had radiological damage as demonstrated by high sharp score even before starting.................

scholarly journals Knowledge, Attitude and Practices Regarding First Aid against Domestic Injuries in Mothers of Children less than 5 Years of Age Attending Fauji Foundation Hospital Islamabad

2021 ◽  
Vol 11 (3) ◽  
pp. 151-157
Author(s):  
Raima Asif ◽  
Naila Azam ◽  
Fatima Ali Raza ◽  
Mehwish Riaz ◽  
Shaista Zulfiqar ◽  
...  
Keyword(s):  
Statistical Analysis ◽  
Tertiary Care ◽  
First Aid ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Chi Square ◽  
Cross Sectional ◽  
Co Morbidity ◽  
Strongly Agree ◽  
Home Accidents

Background: The objective is to assess the knowledge, attitude and practices regarding first aid towards home related injuries among mothers of children less than 5 years of age at tertiary care hospital of Islamabad. Methods: A questionnaire based cross sectional study was conducted in Fauji Foundation Hospital Islamabad. 400 participants were selected using convenience sampling the mother of children under 5 years of age were included and mother of children with any major co morbidity, congenital abnormalities and who didn’t give consent were excluded from the study. A pretested, structured, self-administered questionnaire was used for data collection after obtaining permission from Institutional Ethical Committee. Statistical analysis was carried using SPSS version 20. Frequencies and percentages were computed, descriptive statistical analysis was done. Chi- Square was applied for association between socio demographic variables and knowledge of mothers regarding first aid. Results: About 44% of the mothers and 63% children fall in age group of 31 and 2-5 years respectively. Half of the mothers (48%) are below intermediate level of education. About 34% of the respondents stated bleeding as most urgent and important injury requiring first aid. Regarding attitudes, 50% of the mothers strongly agree towards necessity of first aid and lack of awareness about dealing with domestic injuries. Sixty-five (65%) of the mothers had given first aid to their child. About 33%, 75%, 44% and 39% of the mothers have faced a child with difficulty in breathing; bleeding, burning and insect/sibling bite respectively. Age of mother (p=0.041), education of mother (p=0.001) and total no of children (p=0.001) were significantly associated with knowledge of first aid. Conclusion: Although home accidents are a common problem, mother’s knowledge regarding home accidents was deficient although majority of the respondents have positive attitude.

scholarly journals A retrospective study of febrile seizures among children admitted in a tertiary care hospital

2018 ◽  
Vol 5 (7) ◽  
pp. 3121
Author(s):  
Pralhad Sureshrao Potdar
Keyword(s):  
Family History ◽  
Febrile Seizure ◽  
Tertiary Care ◽  
Positive Family History ◽  
Complex Form ◽  
Febrile Convulsion ◽  
Febrile Seizures ◽  
Care Hospital ◽  
Cross Sectional ◽  
Co Morbidity

Background: Convulsion is the most common neurologic finding in children (10%). Prevention of febrile convulsions is therefore desirable, and is of particular relevance in children with factors carrying a high risk of recurrence. Aim and Objectives were to study the demographic profile and some risk factors of febrile seizures among children.Methods: A record based descriptive cross-sectional study was conducted at paediatric department of Dr. S.C.GMC, Nanded. Considering inclusion & exclusion criteria all children in the 6 month to 6 year age who were diagnosed as having febrile convulsion admitted during January to December 2015 were included in the study.Results: Of the 288 children 173 (60.1%) were boys and 115 (39.9%) were girls. 46.9% children were in the 1-3 year age group. Mean age of occurrence was 2.8 years (±1.5 years). In this study, 80.2% (231) of the patients had simple and 19.8% (57) had the complex form of febrile seizure. In our study, 51.73% (149) of affected children had positive family history of febrile seizure. URTI (9.7%) followed by AGE (7.3%) was the most common co-morbidity. 54.2% children were hospitalized for 1-3 days.Conclusions: Most of the children had a positive family history and the most common causative factor was URTI, LRTI, AGE etc. are associated with febrile convulsion and these diseases can be managed effectively thereby reducing the occurrence of febrile convulsion. 

scholarly journals Guideline adherence and control of diabetes mellitus with or without co-morbidities in various wards of a tertiary hospital in Malaysia

2014 ◽  
Vol 3 (8) ◽  
pp. 309-312 ◽  
Author(s):  
Muhammad Zahid Iqbal ◽  
Muhammad Shahid Iqbal ◽  
Dayana Nicholas ◽  
Jamaluddin Awang ◽  
Amer Hayat Khan ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
General Hospital ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Negative Association ◽  
P Value ◽  
Care Hospital ◽  
Cross Sectional ◽  
Prescription Pattern ◽  
Co Morbidity

To assess the adherence of physicians involved in the management of diabetes mellitus with or without co-morbidities with reference to Clinical Practice Guideline 2009 given by Ministry of Health Malaysia in the tertiary care hospital, Pinang General Hospital Malaysia. Cross-sectional study was done at tertiary care hospital, Penang, Malaysia. The total 51 physicians and 1020 patient’s prescriptions written by same physicians were taken from the record of the Penang General Hospital (20 prescriptions for each enrolled physician). All 1020 patients were suffering from diabetes mellitus with or without co-morbidities. These patients were recruited from the different wards of the Penang General Hospital. Depending on the recommendations of CPG 2009 the prescriptions of patients were divided into adherent and non-adherent prescriptions. The overall good level of physician adherence was seen with respect to the recommendations of CPG 2009 in all prescriptions. A statistically significant negative association (?= 0.094, p-value=0.003) was observed between diabetes mellitus control and co-morbidities. CPG adherent had statistically weak negative association (?= -0.081, p-value=0.010) with patients having co-morbidities. No statistically significant association was observed between CPG adherence and any other co-morbidity. The study explored the several features of prescription pattern of physicians involved in the management of diabetes mellitus with or without co-morbidities and recognized the need for improvement in their prescription pattern for treating the diabetes mellitus.DOI: http://dx.doi.org/10.3329/icpj.v3i8.19405 International Current Pharmaceutical Journal, July 2014, 3(8): 309-312

The Effect of Different Remission Definitions on Identification of Predictors of Both Point and Sustained Remission in Rheumatoid Arthritis Treated with Anti-TNF Therapy

2014 ◽  
Vol 41 (8) ◽  
pp. 1607-1613 ◽  
Author(s):  
Cheryl Barnabe ◽  
Joanne Homik ◽  
Susan G. Barr ◽  
Liam Martin ◽  
Walter P. Maksymowych
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Activity Index ◽  
Disease Activity Index ◽  
Joint Disease ◽  
Tender Joint Count ◽  
Sustained Remission ◽  
Tender Joint ◽  
Cross Sectional ◽  
Das28 Remission

Objective.Predictors of remission in rheumatoid arthritis (RA) have been defined in cross-sectional analyses using the 28-joint Disease Activity Score (DAS28), but not with newer composite disease activity measures or using the more clinically relevant state of sustained remission. We have evaluated predictors of remission using cross-sectional and longitudinal durations of disease state, and by applying additional definitions of remission [American College of Rheumatology/European League Against Rheumatism Boolean, Simplified Disease Activity Index (SDAI), and Clinical Disease Activity Index (CDAI)].Methods.Individuals in the Alberta Biologics Pharmacosurveillance Program were classified for the presence of remission (point and/or sustained > 1 yr) by each of the 4 definitions. Multivariate models were constructed including all available variables in the dataset and refined to optimize model fit and predictive ability to calculate OR for remission.Results.Nonsmoking status independently predicted point remission by all definitions (OR range 1.20–2.71). Minority ethnicity decreased odds of remission by DAS28 (OR 0.13) and CDAI (OR 0.09) definitions. Male sex was associated with DAS28 remission (OR 2.85), whereas higher baseline physician global (OR 0.67) and erythrocyte sedimentation rate values (OR 0.98) decreased odds of DAS28 remission. Higher baseline patient global score (OR 0.77) and swollen joint counts (OR 0.93) were negative predictors for CDAI remission. Higher baseline Health Assessment Questionnaire (OR 0.62) reduced odds for remission by the SDAI definition, and educational attainment increased these odds (OR 2.13). Sustained remission was negatively predicted by baseline physician global for the DAS28 (OR 0.80), and higher tender joint count (OR 0.96) for the CDAI.Conclusion.We demonstrate the influence of duration of remission state and remission definition on defining independent predictors for remission in RA requiring anti-tumor necrosis factor therapy. These predictors offer improved applicability for modern rheumatology practice.

scholarly journals High Burden of Sexual Dysfunction in Female Patients with Rheumatoid Arthritis: Results of a Cross-sectional Study

2018 ◽  
Vol 46 (1) ◽  
pp. 19-26 ◽  
Author(s):  
Rudolf Puchner ◽  
Judith Sautner ◽  
Johann Gruber ◽  
Elia Bragagna ◽  
Andrea Trenkler ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Sexual Dysfunction ◽  
Disease Activity ◽  
Sexual Functioning ◽  
Activity Index ◽  
Short Form ◽  
Health Assessment ◽  
Disease Activity Index ◽  
Cross Sectional ◽  
Female Patients

Objective.To evaluate the effect of rheumatoid arthritis (RA) on impairing women’s sexuality regarding motivation, activity, and satisfaction, and to assess the correlation of disease-related physical impairment within sexual functioning.Methods.An anonymous survey among women with RA and healthy controls (HC) using standardized questionnaires, predominantly the Changes in Sexual Functioning Questionnaire-short form (CSFQ-14). In addition, disease activity, depression, and disability were evaluated.Results.There were 319 questionnaires distributed to patients and 306 to HC. Of these, 235 patient questionnaires (73.7%) and 180 HC questionnaires (58.8%) were returned, of which 203 and 169 were completed, respectively. Of the patients with RA, 47.8% had a total CSFQ-14 score of ≤ 41, indicating female sexual dysfunction (FSD), as compared to 14.2% of HC (p < 0.0001). The median CSFQ-14 score was lower in patients with RA [42 points, interquartile range (IQR) 36–48] than in HC (49 points, IQR 44–54; p < 0.0001), resulting in an OR of 5.53 (95% CI 3.19–9.57; p < 0.0001). After adjustment for confounders, given a higher mean age of patients (55.2 ± 11.3 yrs) than HC (47.4 ± 11.8 yrs; p < 0.0001), the OR for FSD in patients with RA was still 3.04 (95% CI 1.61–5.75; p = 0.001). Neither the Health Assessment Questionnaire–Disability Index nor the Clinical Disease Activity Index was associated with FSD after adjustment.Conclusion.FSD apparently is highly prevalent in female patients with RA, affects all subdomains of sexual function, and is most likely underestimated in daily clinical practice. Of note, FSD could not be linked to disability or RA disease activity.

scholarly journals Psychiatric co morbidities in ESRD Patients Recently Placed on Haemodialysis : A Prospective Observational Study from a Tertiary Care Hospital

2016 ◽  
Vol 4 (1) ◽  
pp. 28-32
Author(s):  
Sarwar Iqbal ◽  
Umme Salma Talukder ◽  
Tufayel Ahmed Chowdhury ◽  
Md Mostarshid Billah ◽  
Mehruba Alam Anana ◽  
...  
Keyword(s):  
Acute Stress ◽  
Tertiary Care ◽  
Adjustment Disorder ◽  
Cross Sectional Study ◽  
Maintenance Hemodialysis ◽  
Care Hospital ◽  
Newly Diagnosed ◽  
Cross Sectional ◽  
Co Morbidity ◽  
Esrd Patients

Background: Psychiatric co-morbidity especially anxiety and depression are common in patients who are recently placed on dialysis, but very little research has been done on this subject. Mental illness results in increased non-compliance in accepting dialysis and this results in increased mortality in End Stage Renal Disease (ESRD) patients.Methodology: This cross- sectional study was done on ESRD patients newly diagnosed and initiated hemodialysis in the department of Nephrology of Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM), Dhaka, Bangladesh with informed written consent and maintaining privacy. Diagnostic and Statistical Manual of Mental Disorders (DSM-V) was used for diagnosis of psychiatric disorders. Patients on maintenance hemodialysis for more than 1 month and patients on Chronic Ambulatory Peritoneal Dialysis were excluded in this study.Results: There were total 83 patients out of whom there were 50 (62.2%) males and 33(39.38%) females. Mean age of study patients was 56.8±9.96 years. Bulk of the patients was clinically depressed (68.7%), followed by anxiety disorder (13.3%) rest were acute stress disorder, adjustment disorder and one case of psychosis. 8.4% participants denied any symptoms.Conclusion: Significant psychiatric co-morbidities developed in newly diagnosed ESRD subjects when they were prescribed hemodialysis. This study showed majority of the patients with renal failure on initiating hemodialysis who develop different psychiatric problems that need prompt diagnosis and appropriate treatment. These interventions will improve the quality of life of ESRD patientsBangladesh Crit Care J March 2016; 4 (1): 28-32

scholarly journals Prevalence of feet and ankle arthritis and their impact on clinical indices in patients with rheumatoid arthritis: a cross-sectional study

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Sung Won Lee ◽  
Seong-Yong Kim ◽  
Sung Hae Chang
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Activity Index ◽  
Disease Activity Index ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Ankle Arthritis ◽  
Cross Sectional ◽  
Clinical Indices ◽  
Mtp Joints

Abstract Background We aimed to evaluate the prevalence of foot and/or ankle arthritis (FAA) and its impact on clinical indices in patients with rheumatoid arthritis (RA). Methods This cross-sectional study used data from the Korean College of Rheumatology Biologics & Targeted therapy registry to observe clinical outcomes of patients undergoing biologics therapy and conventional therapy. FAA was defined as ≥1 tender or swollen joint in the ankle and/or 1st-5th metatarsophalangeal (MTP) joints. Disease Activity Score 28 (DAS28), Routine Assessment of Patient Index Data 3 (RAPID3), Simplified Disease Activity Index (SDAI), and Clinical Disease Activity Index (CDAI) were assessed. Results Among 2046 patients, 598 had FAA. The ankle joint was the most commonly involved joint in FAA (tender joint, 71.4%; swollen joint, 59.5%), followed by the third and second MTP joints. Patients with FAA showed higher DAS28, RAPID3, SDAI, and CDAI scores. FAA presence was significantly associated with non-remission as per DAS28-ESR (odds ratio, 3.4; 95% confidence interval, 2.0–5.8), DAS28-CRP (3.6, 2.4–5.3), SDAI (6.3, 2.8–14.6), CDAI (7.6, 2.4–24.3), and RAPID3 (5.6, 2.7–11.5) indices on adjusting for age, sex, disease duration, presence of rheumatoid factor, presence of anti-cyclic citrullinated peptide antibody, lung disease, use of methotrexate, and previous use of biological disease-modifying anti-rheumatic drugs. Patients with FAA were less likely to achieve remission of SDAI (n = 6, 1.0%) and CDAI (n = 3, 0.5%) than that of DAS28-ESR (n = 21, 3.5%), DAS28-CRP (n = 38, 6.4%), and RAPID3 (n = 12, 2.0%). Conclusions FAA represents a severe disease activity and is an independent risk factor for non-remission in patients with RA.

Smoking, Smoking Cessation, and Disease Activity in a Large Cohort of Patients with Rheumatoid Arthritis

2012 ◽  
Vol 39 (5) ◽  
pp. 904-909 ◽  
Author(s):  
MARK C. FISHER ◽  
MARC C. HOCHBERG ◽  
MUHAMMAD EL-TAHA ◽  
JOEL M. KREMER ◽  
CHENG PENG ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Smoking Cessation ◽  
Disease Activity ◽  
Primary Outcome ◽  
Activity Index ◽  
Disease Activity Index ◽  
The United States ◽  
Cross Sectional ◽  
Observational Cohort ◽  
Never Smokers

Objective.While cigarette smoking is the best-studied environmental factor contributing to rheumatoid arthritis (RA), no study to date has examined the influence of smoking cessation on disease activity. We examined this relationship in an observational cohort of patients with RA in the United States.Methods.Patients enrolled in the Consortium of Rheumatology Researchers of North America registry (CORRONA) were stratified into never, former, and current smokers at enrollment. Current smokers were further stratified into continued and ceased smoking groups during their followup in the registry. The primary outcome was change in Clinical Disease Activity Index (CDAI) at last visit in a multivariate, random-effects regression model accounting for multiple timepoints.Results.At last visit, there was no significant change in CDAI between ceased smokers and continued smokers (coefficient −0.00091, SE 0.0033, p = 0.7834). The study did confirm prior cross-sectional studies that current smokers have worse disease activity than former or never smokers.Conclusion.In the short term, smoking cessation did not appear to influence change in disease activity over time.

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