Rheumatology Research Articles

Assessment of sexual dysfunction in females with systemic lupus erythematosus

Introduction Sexual dysfunctions are common sexual health problems affecting a substantial proportion of females with systemic lupus erythematosus (SLE). Objective This study aimed at the evaluation of female sexual dysfunction in patients with SLE. Materials and methods A total of 50 females with SLE and 50 matched healthy female volunteers were assessed using the Arabic version of Female Sexual Function Index. Married and sexually active females during the past 6 months with established diagnosis of SLE were recruited from the Rheumatology Clinic, Beni-Suef University hospital during the period from March to August 2017. All data were statistically analyzed using the IBM statistical package for the social sciences version 20. Results The study showed that 60% of females with SLE and 16% of healthy controls reported abnormal sexual function according to the FSFI total scores, with a statistically significant differences in-between (P=0.00). Conclusion Female sexual dysfunction is a common problem among patients with SLE.

Rheumatology in India: Yesterday, today, and tomorrow?

Rheumatology in India: Yesterday, today, and tomorrow?

Drug-Induced Musculoskeletal Syndromes and Soft-Tissue Rheumatism

Drug-induced musculoskeletal syndromes represent a broad clinical spectrum, ranging from asymptomatic biological abnormalities to severe organ-threatening manifestations. Many drugs have been implicated in inducing rheumatological adverse events. For some compounds, there is pathological or epidemiological evidence for a causal link, and for others, the association is based on anecdotal reports. Several different types of musculoskeletal symptoms occur ranging from chondropathy to arthritis to periarticular symptoms. The most common afflictions are hyperuricemia and gout arising from a variety of commonly used medications such as antitubercular drugs, diuretics, and low-dose aspirin. Although virtually all drug classes may induce some form of musculoskeletal disorders, a significant chunk is corticosteroids, especially injectable, antibiotics, lipid-lowering agents, and newer generation antidiabetics. Knowledge of drug-induced musculoskeletal disorders avoids burdening the patient with an array of unnecessary investigations and allows optimal management of the patients, which includes early discontinuation of the offending agent.

Mediterranean Journal of Rheumatology December 2019 Highlights.

Mediterranean Journal of Rheumatology December 2019 Highlights.

Mediterranean Journal of Rheumatology March 2020 Highlights.

Mediterranean Journal of Rheumatology March 2020 Highlights.

Fellowship in rheumatology

Fellowship in rheumatology

Mediterranean Journal of Rheumatology September 2019 Issue Highlights.

Mediterranean Journal of Rheumatology September 2019 Issue Highlights.

Fellowship in rheumatology

Fellowship in rheumatology

Rheumatology in Greece: pros and cons.

Rheumatology in Greece: pros and cons.

Approach to non-compressive back pain.

Back pain is the most common manifestation among rheumatologic conditions, with an 80% lifetime risk of development in each individual. Most patients have no specific identifiable etiology. Low back pain has always been an important public health problem, having a significant impact on the working class of the population. Hence, it is pertinent for the physician to be aware of the various causes of back pain and identify promptly the various red flags and poor prognostic markers. Lamentably, widespread access to technology and fear of litigation in this era of evidence based medicine has made us slaves of medical imagery in the context of back pain. It is crucial to recognize the teachings of ancient medicine, where keen observation, a detailed history-taking and a meticulous examination were the mainstay of good decision-making. Its precise management can help in obviating debility, preventing the work absenteeism, and consequently, decreasing health-care expenses.

Drug-induced psoriasis

Psoriasis is known to be triggered by a number of factors including drugs. Some therapeutic agents for the treatment of psoriasis are also known to have a paradoxical effect and alter the course of the disease. The drugs may either cause de novo psoriasis or are responsible for aggravating preexisting psoriasis. The distinction is not always clear-cut and is clinically often indistinguishable from psoriasis vulgaris. The morphological types can vary from plaque psoriasis to pustular psoriasis and even erythroderma. There are certain established agents which are known to trigger psoriasis. Many of the biological agents and targeted therapies available today can trigger psoriasis by activating signaling pathways. The lag time between the intake of drug and onset of psoriasis is highly variable and thus requires a high index of suspicion. Due to the various systemic comorbidities, patients with psoriasis often receive polypharmacy and hence it is important for dermatologists, rheumatologists, and physicians to be aware of the possible triggers.

Book Review: Rheumatology in Questions

Book Review: Rheumatology in Questions

Mediterranean Journal of Rheumatology December 2018 Highlights.

Mediterranean Journal of Rheumatology December 2018 Highlights.

Behavioral management of the pediatric dental patient among clinical dental students and interns

Anaemic syndrome is a common manifestation of rheumatoid arthritis. Both anaemia of chronic disease and iron deficiency anaemia are present in patients with rheumatoid arthritis. Patients with active rheumatoid arthritis are more like to be anaemic with a high impact on the quality of life. The diagnosis of anaemia of chronic disease is made by exclusion. Treatment of the anaemia consists merely of anti-rheumatic treatment. This was a retrospective study of 34 patients diagnosed of rheumatoid arthritis between July 2013 and June 2016. These were the patients that satisfied the 1987 revised diagnostic criteria of the American College of Rheumatology for the diagnosis of rheumatoid arthritis. Anaemia was diagnosed based on the packed cell level and laboratory analysis of red blood cell morphology. Patients with rheumatoid arthritis were divided into 3 groups; rheumatoid arthritis patients without anaemia, rheumatoid arthritis patients with anaemia of chronic disease, and rheumatoid arthritis patients with iron deficiency anaemia. The laboratory results for packed cell volume (PCV), mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH), and mean corpuscular haemoglobin concentration (MCHC) were noted and analyzed. Erythrocyte sedimentation rate and rheumatoid factor results were documented. Five hundred and two rheumatology patients were seen over a period of three years (July 2013 –June 2016). Thirty-four rheumatoid arthritis patients were diagnosed (F-26, M-8) with a female to male ratio of 3.3:1. The age range was 18 to 65 years with a mean age of 45 ± 6yrs. The mean duration of onset at presentation was 5 ±2.6 years, and the mean early morning joint stiffness was 3 ±1.2 hours. The mean swollen and tender joint count was 14 ± 2. Erythrocyte sedimentation rate was uniformly elevated with a mean value of 78 ± 5mm/hr. Rheumatoid factor was positive in 27 patients. Anaemia was predominant in age group 41 to 50 years. The prevalence of anaemia was 70.6%, and anaemia of chronic disease was predominantly seen (70.8%). Among patients with rheumatoid arthritis, the prevalence of anaemia was found to be relatively high. Anaemia of chronic disease was the leading cause of anaemia. The degree of anaemia was closely related to the age and duration of the disease.Keywords: Haemoglobin, iron deficiency, mean corpuscular haemoglobin, anti-rheumatic drugs, rheumatoid arthritis

Period prevalence of knee osteoarthritis among the elderly patients attending a rheumatology clinic

Osteoarthritis is the most prevalent articular disease in older adults. Disease markers that will detect early disease and allow early intervention with pharmacologic agents are presently unavailable. This was a hospital based observational prospective study carried out over a period of six months from April 2016 to October 2016. Patients were interviewed and data were recorded on a standardized predesigned and a pretested questionnaire. Measurements of height, weight and body mass index (BMI) were recorded. Patients in the age group 60-80 years who fulfilled the American College of Rheumatology (ACR) clinical criteria were included. Patients below the age of 60 years, patients with inflammatory arthritis, trauma induced pain, systemic illness and mentally impaired were excluded. Two hundred and fifty four patients were seen during the study period. Eighty six patients that met the ACR clinical criteria were studied. Patients in the age group 60 to 70 (67.4%) years dominated the study group. The mean age was 68 ± 7.5 and female to male ratio was 2.6 to 1. The duration of knee pain before presentation was 3 to 16 years with a mean of 9 ± 3 years. Knee osteoarthritis was positively associated with body mass index (p <0.05). Obesity was more common amongst women (67.8%) compared to men (58.3%).. Knee pain and joint crepitus were the leading clinical presentations. The period prevalence of knee osteoarthritis was 33.9%. The prevalence among men was 9.4% while the prevalence among women was 24.4%. Osteoarthritis was common among the elderly people and women were more affected. There was a positive correlate between knee osteoarthritis and the body mass index.

Titrated Urate-Lowering Therapy Improved Clinical Outcomes in Patients with Gout

Most patients with gout are treated in the primary care setting. Although rheumatology organizations uniformly recommend titrating urate-lowering

Arthritiden: verfeinerte Diagnostik, effizientere Therapie

Arthritiden: verfeinerte Diagnostik, effizientere Therapie

26th Panhellenic Rheumatology Congress, 6-9 December 2018, Athens, Greece.

26th Panhellenic Rheumatology Congress, 6-9 December 2018, Athens, Greece.

Mediterranean Journal of Rheumatology September 2018 Highlights.

Mediterranean Journal of Rheumatology September 2018 Highlights.

Arthritis in type 2 diabetes mellitus

Objectives The objective of this study was to estimate the correlation between diabetes mellitus (DM) and arthritis through some laboratory changes in patients with type 2 DM complaining of arthropathy. Patients were recruited from outpatient clinics of Internal Medicine Department at Menoufia University Hospital. Background DM has become one of the main threats to human health in recent decades. Uncontrolled diabetes is strongly correlated to causing long-term microvascular and macrovascular complications. Rheumatological diseases are now common, which have an increased prevalence in the diabetic population. Patients and methods The study included 90 patients. Patients were divided into three groups: group 1 comprised 30 patients with type 2 DM without arthropathy, group 2 comprised 30 patients with type 2 DM with arthropathy, and group 3 comprised 30 nondiabetic patients with arthropathy. Results BMI was significantly higher among patients with arthropathy (33.64 ± 2.26), random blood sugar was significantly higher among patients with arthropathy (288.10 ± 83.64), Alc was significantly higher among patients with arthropathy (8.72 ± 1.09), erythrocyte sedimentation rate was significantly higher among nondiabetic patients (58.60 ± 27.29), serum uric acid was significantly higher among nondiabetic patients (5.11 ± 1.18), C-reactive protein was higher among diabetic patients with arthropathy (60%), rheumatoid factor was significantly higher among patients with arthropathy (75.0%), and antinuclear antibody was significantly higher among patients with arthropathy (98.0%). Conclusion Musculoskeletal complications were most commonly seen in patients with a long-standing history of type 2 DM. The incidence of DM and the life expectancy of the diabetic patient have both increased, resulting in increased prevalence and clinical importance of musculoskeletal alterations in diabetic patients. The development of musculoskeletal disorders is dependent on age and the duration of DM.