Ankylosing spondylitis (AS) is a chronic inflammatory disorder of the axial skeleton. In recent years, several authors reported an increased prevalence of sexual dysfunction among AS patients. We aimed to find out, whether the prevalence of erectile dysfunction among AS patients is different from age-matched healthy controls. Thirty-seven male patients with AS who were diagnosed according to the modified New York criteria and 67 normal healthy controls (NHC) were included in this study. Clinical characteristics of patients including age, disease duration and morning stiffness were noted. Disease activity was evaluated by using Bath AS disease activity index (BASDAI), functional statement was evaluated by using Bath AS functional index, and scores of spinal measurements were done by using Bath AS metrology index. Erectile function is evaluated using the International Index of Erectile Function (IIEF) scoring system. Health-related quality of life was assessed by short form 36. The mean age of the patients and controls were 42.8 + 10.8 and 43.6 + 5.9 years (P = 0.666). The prevalence of erectile dysfunction in AS patients and NHC were 35.1 and 26.9%, respectively (P = 0.335). There was no statistically significant difference between IIEF domain scores of AS patients and NHC except for the sexual desire domain (P = 0.014). Duration of morning stiffness and BASDAI was negatively correlated with sexual desire and overall satisfaction; however, they have no negative impact on erectile function, orgasmic function and intercourse satisfaction domains of IIEF. In this report, we showed that only the sexual desire domain of IIEF was significantly lower in AS patients. The prevalence of erectile dysfunction among AS patients is similar to NHC, which is a finding contrary to previous reports. AS patients do not suffer from erectile dysfunction, they rather have problems of satisfaction from the intercourse.

A web-based application patient follow-up program was developed to create a registry of patients with ankylosing spondylitis (AS) by the Turkiye Romatizma Arastirma Savas Dernegi (TRASD) AS Study Group. This study describes the methodological background and patient characteristics. The patient follow-up program is a web-based questionnaire, which contains sections on socio-demographic data, anamnesis, personal and family history, systemic and musculoskeletal examination, laboratory and imaging data and treatment. Between October 1, 2007 and February 28, 2009, 1,381 patients from 41 centers were included in the registry (1,038 males [75.2%]; mean age 39.5 ± 10.7 years). Mean disease duration was 12.1 ± 8.5 years, and mean time from initial symptom to diagnosis was 5 ± 6.8 years (median 2 years). HLA-B27 positivity was detected in 73.7% of 262 patients tested. Manifestations of extraarticular involvement were anterior uveitis (13.2%), psoriasis and other skin and mucous membrane lesions (6%) and inflammatory bowel disease (3.8%). The prevalence of peripheral arthritis was 11.2%. In 51.7% of patients, the Bath AS Disease Activity Index was ≥4. But since our patients consisted of the ones with more severe disease who referred to the tertiary centers and needed a regular follow-up, they may not represent the general AS population. Disease-modifying anti-rheumatic drugs were being used by 41.9% of patients, with 16.4% using anti-TNF agents. TRASD-IP (Izlem Programi: Follow-up program) is the first AS registry in Turkey. Such databases are very useful and provide a basis for data collection from large numbers of subjects. TRASD-IP gives information on the clinical and demographic profiles of patients, and the efficacy and safety of anti-TNF drugs, examines the impact on quality of life, and provides real-life data that may be used in cost-effectiveness analyses.

In this study, we evaluated fatigue by using the multidimensional assessment of fatigue (MAF) index in 68 ankylosing spondylitis (AS) patients. To determine the disease activity, functional status and quality of life, bath ankylosing spondylitis disease activity index (BASDAI), bath ankylosing spondylitis functional index (BASFI) and Short Form 36 (SF36) were used respectively. Mander enthesis index (MEI) was used for evaluation of enthesitis. The mean age of the patients was 37.7 (11.1) years. The prevalence of fatigue was 76.5%. There were significant correlations between MAF and BASDAI (P < 0.001), BASFI (P < 0.001), MEI (P = 0.048), pain (P = 0.001), hemoglobin (P = 0.001), ESR (P = 0.035), dorsal Schober's (P = 0.009), occiput-wall distance (P = 0.048). Also MAF was correlated with all dimensions of SF36 except for social function and emotional role. BASFI was found to be the most significant correlated (P = 0.002) parameter with MAF. This study suggests that fatigue is an important symptom in AS and it seemed to occur in severe AS patients. It should appropriately be measured with respect to its intensity with appropriate measures, such as MAF. Moreover, fatigue may increase functional disability, which is already present as a feature of the disease.

Objective: Measurement of Serum Vitamin D levels in patients with knee osteoarthritis and compare with age matched healthy population in order to assess their association. Design: Prospective clinical control study. Methods: Clinically proven two hundred patients of osteoarthritis knee (OA) and two hundred control included in study according to inclusion and exclusion criteria on OPD basis after getting written and informed consent, Serum 25-OHD was measured by the ELISA method and concentrations <20 ng/ml were considered as deficient levels. Results: Four hundred subjects participated in study. The mean ages of patients and controls were 59.2 ± 12.9 and 58.9 ± 10.2 years respectively. The mean 25OHD in OA patients aged <60 years was significantly lower than controls (19.8 ± 18.8 vs. 36.7 ± 27.5 ng/ml, p< 0.01). In this age group knee OA was significantly associated with serum 25-OHD deficiency. The association between OA and serum 25-OHD deficiency in patients aged ≥60 years did not reach a significant level. Conclusions: These findings indicate a significant association between serum 25-OHD deficiency and knee OA in patients aged <60 years and suggest serum 25-OHD measurement in any patient with symptoms suggestive of knee OA particularly at the initial stage of disease. Introduction Osteoarthritis (OA) is the most common disease of joints in adults around the world [1]. Worldwide, it is estimated to be the fourth leading cause of disability [2]. Nearly one-third of all adults have radiological signs of osteoarthritis [3]. Clinically too, significant osteoarthritis of the knee, hand, or hip is reported to affect around 8.94% of the adult population [4]. Its prevalence increases gradually in individuals older than 40 years. Studies suggests that prevalence of OA knee is >60% in subjects older than 70 years [5, 6]. Community survey data in rural and urban areas of India shows the prevalence of osteoarthritis to be in the range of 17 to 60.6% [7, 8, 9]. The disease usually evolves with increasing levels of pain, mobility restriction and physical disability [5, 10]. About 80% of persons affected by OA already report having some movement limitation and 20% report not being able to perform major activities of daily living; with an 11% of the total affected population reporting the need of personal care [11]. Both vitamin D deficiency and OA knee are age dependent and worldwide problem [12]. Vitamin D status influences the incidence and progression of knee OA [13]. Sunlight exposure and serum 25-OHD levels are both associated with decreased knee cartilage loss [14]. Previous studies also suggest that in serum 25-OHD deficient men the prevalence of OA was two times greater than those with sufficient levels [15]. In OA, changes in subchondral bone play an essential role in the onset and progression of cartilage lesions. In this condition bone resorption markers are higher and bone formation markers are lower compared with a control group. In progressive OA, bone metabolism and bone turnover are increased similar to tha...

Early passive mobilization in patients with zone V injuries resulted in higher percentage of good to excellent results when compared with zone II injuries. However, this does not translate into recovery in grip strength and disability. This study suggests that although the level of the injury is an important factor for the anatomic improvement, it may not be the predictor of functional improvement.