The aim of the study was to identify the determinants of adherence to medication among Egyptian patients with SLE. A single-center cross-sectional study was conducted among Egyptian patients with SLE. Adherence to medication was measured via The Compliance Questionnaire for Rheumatology-19, and the patients were classified as non-adherers if they were taking <80% of their medication correctly. Predictors of adherence to SLE medication were determined by multiple logistic regressions. The mean age of participants was 30.9 ± 11.7 years. Females constituted 95% of all participants. Thirty-eight (%) were taking <80% of their medication correctly. On logistic regression analysis, the significant independent predictors of medication non-adherence were lower educational level (OR 5.6, 95% CI 2.1-7.3, P < 0.001), very low and low socioeconomic status (OR 2.6, 95% CI 1.6-4.3, P < 0.04), rural residency (OR 3.4, 95% CI 1.4-5, P < 0.01), more number of medications (OR 3.2, 95% CI 2.3-6.9, P < 0.01), and higher depressive symptoms (OR 3.7, 95% CI 1.4-10.2, P < 0.001). The adherence rate reported in this study was quite low. Appropriate adherence enhancing intervention strategies targeted at reducing pill load, minimizing depressive symptoms, and ensuring an uninterrupted access to free services regimen for patients with low socioeconomic status is strongly recommended. More attention should be given to SLE patients who live in rural regions.
OBJECTIVE: To identify the possible factors influencing motor functional outcome of patients with traumatic spinal cord injury (T-SCI) after inpatient rehabilitation. METHODS: 90 patients with T-SCI consecutively admitted for inpatient SCI rehabilitation unit was studied. Demographic characteristics, level and completeness of SC injury using American Spinal Injury Association (ASIA) Impairment Scale, disability level using Functional Independence Measure (FIM), psychological state using Hospital Anxiety and Depression Scale (HADS), and SCI-related medical complications were assessed and recorded at admission. The main measure of functional outcome was the motor FIM gain score at discharge. The univariate and multiple linear regression analyses were performed. RESULTS: The Mean admission motor FIM score was 35.3 (20.1), the mean discharge motor FIM score was 65.3 (22.5), and the mean motor FIM gain score was 30.0 (20.9). Univariate analyses indicated that the significant factors influencing motor functional outcome included age, motor FIM score at admission, level and severity of injury, anxiety/depression score, time between injury and admission to rehabilitation, length of stay, destination at discharge, and family caregiver. However, in multiple linear regression analyses, age, destination at discharge, family caregiver were not significant predictors. CONCLUSION: Age was not predictor of motor functional outcome and rehabilitation can be effective in elderly SCI patients. Rehabilitation intervention should begin as soon as possible. The admission motor FIM score, level and severity of injury, interval between onset and admission, anxiety/depression score, and length of stay can be used to predict functional outcomes of rehabilitation in SCI patients.
ObjectivesFatigue is frequent in rheumatic diseases. Fatigue expression and consequences may be modified by cultural differences. Our objective was to increase the understanding of the fatigue experience and characteristics among Egyptian, Muslim patients with rheumatic diseases.MethodsProspective monocentric qualitative study based on conventional qualitative content analysis, inductive reasoning, grounded theory. Egyptian patients with rheumatoid arthritis (RA), fibromyalgia or axial spondyloarthritis (AxSpA) were asked about fatigue, its patterns, consequences and self-management.ResultsOf the 60 patients interviewed, 20 patients had each disease (RA, fibromyalgia and AxSpA); median ages ranged from 34 to 40 years. Patients were mainly male (N = 40, 66 %), had 3 to 7 years (mean) of disease duration and had moderate disease activity. Some aspects of the patients’ experience of fatigue may be specific to the Egyptian and Muslim culture such as the description of fatigue as a physical more than a mental impact of the disease, the response to the effect of fatigue on sexual function and the gender specific (women more than men) limitation of social activities due to fatigue which was more obvious in our study than other previous studies. Other aspects of patients’ experience of fatigue like overlap between the patients’ perception of fatigue and pain and coping strategies were similar to the findings in previous studies.ConclusionThis study gives insights regarding fatigue in rheumatic diseases in an Arabic and Muslim culture. Similarities and differences with previous studies were noted and should be taken into account when assessing these patients.
Due to the high prevalence of NP manifestations and its severity in SLE patients, systematic assessment to provide prompt diagnosis, early recognition of risk factors and appropriate intervention for NP lupus are essential.
Identification of the genetic basis of systemic lupus erythematosus (SLE) may contribute to the discovery of effective drugs before renal involvement. Our aim of this study was to estimate the association between Fc gamma receptor (FcγR) polymorphisms and SLE and renal involvement in Egyptian patients. FcγRIIB and FcγRIIA R131H gene polymorphisms were genotyped in 180 Egyptian adults. Genotyping for FcγRIIA R131H was performed using allele-specific PCR and FcγRIIB-Ile232 Thr polymorphism was genotyped using polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP). The study showed that the homozygous genotype (Thr/Thr) of FcγRIIB significantly increased in all SLE patients (90 patients) and in SLE patients complicated with nephritis (61 patients). The Thr allele was significantly associated with an increased risk of the disease in all the patients and in patients complicated with nephritis. Our study demonstrated an association of FcγRIIB polymorphisms with SLE and lupus nephritis and a lack of association of FcγRIIA polymorphisms with SLE in the Egyptian patients.
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