Background: The risk of cardiovascular disease in patients with inflammatory joint diseases is very high and rheumatologists need to screen their patients for this risk. A number of screening tools have been used in this patient population. Objective was to compare the cardiovascular risk assessment in patients with inflammatory joint diseases using QRISK®2 and Reynolds Risk Score. Methods: Four hundred and one patients with inflammatory joint diseases were enrolled via consecutive non-probability sampling. Their future cardiovascular disease risk was calculated via the QRISK®2 and Reynolds Risk Scores. The resulting scores were analyzed for any correlation. Results: There was no significant correlation between the scores obtain via both risk assessment tools (p>0.05).
Objective: To evaluate matrix metalloproteinase-9 gene expression in rheumatoid arthritis patients on disease modifying anti-rheumatic agents with the objective to further modify the current treatment regimen if indicated in order to prevent progression to deforming rheumatoid arthritis.
Objective: To compare the respiratory complications of COVID-19 among patients with rheumatological conditions taking bDMARDs and csDMARDs at Pak Emirates Military Hospital Rawalpindi.
Study Design: Comparative prospective study.
Place and Duration of Study: Pak Emirates Military Hospital, Rawalpindi Pakistan from Mar to May 2020.
Methodology: Patients diagnosed with COVID-19 on polymerase chain reaction having previously rheumatological conditions managed either with bDMARD or cs DMARD were included in the study. They were followed up for three weeks after the positive polymerase chain reaction. Complications leading to the use of oxygen or ICU support or death were compared in both groups of patients.
Results: A total of 82 patients with any rheumatological condition managed either with bDMARD or csDMARD tested positive for covid-19 on polymerase chain reaction and were included in the final analysis. 30 (36.6%) patients were taking bDMARDs while 52 (63.4%) were taking csDMARD. In addition, 4 (4.8%) low dose oxygen therapy, 5 (6.1%) required moderate dose oxygen therapy, while 5 (6.1%) required severe dose oxygen therapy or intensive care unit support. 2 (2.4%) patients died within the three weeks. The requirement of moderate or severe dose oxygen and intensive care unit support was found statistically significantly more in the group taking csDMARDS.
Conclusion: The presence of complications of COVID -19 and the requirement of oxygen and intensive care unit support were present in some of the patients taking DMARDs. Among the DMARDs, bDMARDs were less linked with complications, but large studies with better design required better results.
Objective: To determine the efficacy of Methotrexate versus Leflunomide versus combination of both among patients managed at Pak Emirates Military Hospital with active rheumatoid arthritis.
Study Design: Prospective comparative study.
Place and Duration of Study: Rheumatology/General Medicine Department, Pak Emirates Military Hospital Rawalpindi, from May 2019 to June 2020.
Methodology: Patient of active rheumatoid arthritis who fulfilled American college of rheumatology criteria of 1997 were included in the study. They were randomly divided into three groups with group A receiving Methotrexate, group B receiving Leflunomide while group C received the combination of both Methotrexate and Leflunomide. Disease activity was assessed by using the Disease Activity Score-28 in all the three groups after three months of treatment.
Results: Mean age of the study participants was 36.919 ± 6.85 years. One hundred and fifty (83.3%) patients were female while 30 (16.7%) were male. Out of 160 (88.9%) patients achieved remission according to Disease Activity Score-28 score at the end of three months while 20 (11.1%) did not achieve remission. Pearson chi-square test revealed that none of the factors studied including the treatment option had any statistically significant relationship with presence of remission among the target population (p-value 0.386, 0.815, 0.194 and 0.145 for age, gender, duration of symptoms and type of treatment respectively).
Conclusion: Remission rate among the rheumatoid arthritis patients in response to treatment was overall good in the study. In terms of efficacy for symptoms of rheumatoid arthritis and achieving remission, after three months of treatment all the three options..................
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