BackgroundJuvenile idiopathic arthritis (JIA) is the most common arthropathy of childhood. Different diseases affect school attendance to varying degrees. The aim of this study was to assess the impact of juvenile idiopathic arthritis (JIA) on Moroccan children’s schooling.MethodsThirty-three children with JIA were included in this study, having been previously diagnosed according to the classification criteria of the International League of Associations for Rheumatology (ILAR). Seventy-four healthy children were recruited to serve as controls. Data was obtained for all children on their school level, educational performance, and attendance. The rate of absenteeism due to health complications was noted.ResultsAll healthy children were able to attend school (p<0.0001), while 33% of children with JIA were unable to attend school due to their condition. The students with JIA who were able to attend school were absent much more often than controls (63% compared to 20%), with a highly significant p value (p<0.0001). Slightly less than half of the JIA patients (48.5%) failed in their schooling. In univariate analysis, there was an association between absenteeism and tender joints (p=0.02), disease activity score (DAS28) (p=0.007), Childhood Health Assessment Questionnaire (CHAQ) (p=0.01), and erythrocyte sedimentation rate (ESR) (p=0.03). In multivariate analysis, the only association persisted between DAS28 and absenteeism.ConclusionsOur study suggested that the schooling of children with JIA was negatively impacted due to the disorder. More studies, with a larger sample of children, are needed to confirm our findings.
BackgroundIn addition to its important metabolic activities, vitamin D also contributes to the regulation of the immune system. The aim of this study was to assess the relationship between hypovitaminosis D and disease activity in Moroccan children with juvenile idiopathic arthritis (JIA).MethodsIn this cross-sectional study, forty children with JIA were included, all having been diagnosed according to the classification criteria of International League of Associations for Rheumatology (ILAR). The children underwent anthropometric assessment and clinical evaluation. Disease activity was measured using the Disease Activity Score in 28 joints (DAS28) for polyarticular and oligoarticular JIA and the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) for enthesitis-related arthritis. Serum 25-hydroxyvitamin [25(OH)D] D2 and D3 were measured using radioimmunoassay (RIA). Hypovitaminosis D was defined as serum 25(OH)D <30 ng/ml.ResultsThe average age of participants was 11 years ± 4.23. Hypovitaminosis D was observed in 75% of patients. In univariate analyses, 25(OH)D levels were negatively associated with DAS28 for polyarticular and oligoarticular JIA. No significant relationship was found between 25(OH)D levels and BASDAI for juvenile spondylarthropathy. In multivariate linear regression analysis, no association persisted between 25(OH)D levels and DAS28.ConclusionsOur study suggested that serum levels of vitamin D were low in Moroccan children with JIA disease. Future studies with a larger population are needed to confirm our results.
Abnormal puberty is often reported in children suffering from many chronic diseases. Juvenile idiopathic arthritis (JIA) is the most common joint disorder in developing children. The aim of this study was to assess sexual maturation of Moroccan children with JIA and to compare the development of secondary sexual characteristics in children with JIA to children in the general population. Forty children with JIA and 74 healthy controls were included in a cross-sectional study. The diagnosis of JIA was made according to the criteria of the International League of Association of Rheumatology. Every child was examined for the development of genitalia as per criteria given by Tanner. The children with JIA were also divided into 3 groups: pre-puberty (stage 1), puberty (stages 2-3) and post-puberty (stage 4-5), and the association between puberty and cumulative dose of steroids, disease duration, disease activity, height, weight and age was investigated. Forty children with JIA were included (22 male, 18 female); the mean of age of the patients was 11 ± 4.23 years. Puberty in the patients (mean of tanner 2.43 ± 1.36) was lower than controls (2.55 ± 1.36). The prevalence of the children in prepuberty was of 15 (37.5 %) and 8 (20 %) in postpuberty. The prevalence of the children having a delayed puberty was of 6 (15 %) versus 1(1.4 %) in healthy controls (p = 0.005). There was an association between dose of corticosteroids, age at the administration of corticosteroids and the delayed puberty in boys (p = 0.009). In addition, there was no significant association in both sex between this poor puberty and duration of JIA (p = 0.45 in boys and p = 1.99 in girls) and its activity calculated by the DAS28 (p = 0.73 in boys and p = 1). Our study suggests that the puberty is retarded in Moroccan patients with JIA comparing to healthy children and that the dose of corticosteroid and the age at its administration may contribute to delayed puberty in boys.
IntroductionThe link between bone mass and body composition is widely recognized, but only few works were selectively performed on subjects with juvenile idiopathic arthritis. The aim of our study was to investigate the effect of body composition on bone mineral density (BMD) in Moroccan patients with juvenile idiopathic arthritis.MethodsThirty three children with juvenile idiopathic arthritis (JIA) were included in a cross-sectional study. The diagnosis of JIA was made according to the criteria of the International League of Association of Rheumatology (ILAR). Body mass index (BMI) was calculated from the ratio of weight/height2(kg/m2). Pubertal status was determined according to the Tanner criteria. Bone status, body composition and bone mineral content (BMC) were analyzed by using dual-energy X-ray absorptiometry (DXA). BMD was assessed at the lumbar spine (L1-L4) and at total body in (g/cm2). Total body fat tissue mass (FTM) and lean tissue mass (LTM) were also analyzed by DXA and expressed in kilograms. In children, low BMD was defined as a Z-score less than -2 and osteoporosis was defined as a Z-score less than -2 with a fracture history.ResultsA cross-sectional study was conducted in 33 Moroccan patients with JIA aged between 4 and 16 years, Fat mass was not related to bone density; in contrast, BMD was positively associated to LTM in total body(r = =0.41, p= 0.04) but not in lumbar spine (r = 0.29, p= 0.17). There exist significant correlation between BMC and BMD in total body (r = 0.51, p = 0.01).ConclusionThis study suggests that the LTM is a determining factor of the BMD during adolescence. Other studies with a broader sample would be useful to confirm this relation.
Our study shows a significant association between vitamin D deficiency and chronic LBP in Moroccan postmenopausal women. Further studies are clearly warranted to determine the effectiveness and the mechanism(s) of this links between vitamin D deficiency and chronic LBP.
Background to evaluate the quality of life in women suffering from knee osteoarthritis, Consecutive outpatients consulting for primary knee OA were included in this cross sectional study. This study suggests a high impact of knee OA on all aspects of quality of live in women. Objectives We aimed to investigate the impact of knee osteoarthritis (OA) on the quality of life (QoL) in moroccan women patients with non-end-stage knee osteoarthritis. We suggest also to search possible factors associated with to health related QoL. Methods Patients consulting for primary knee OA were included. Most patients had an interviewer-administrated questionnaire. Functional status was assessed by womac and lequesne and QoL with the Moroccan version of OAKHQOL. Relationship between patients and disease features and the different domains of the OAKHQOL was evaluated by using Spearmann Correlation. The significant factors of related to the OAKHQOL were analyzed by a forward stepwise multiple regression model. Results: Table 1. Assessment of quality of life in patients with OA using OAKHOL ParametersPhysical activitiesMental healthPainSocial supportSocial functioning AgeNSNSNSNSNS Disease durationNSNSNSNSNS BMINSNS–0.323* <0.05NSNS BMINSNS–0.323* <0.05NSNS VAS pain–0.540**–0.432**–0.506**NSNS <0.001<0.002<0.001 Lequesne–0.605**–0.306*–0.689**NSNS 0.0010.04r <0.001 WOMAC–0.531**–0.564**–0.763**NSNS <0.001<0.001<0.001 Multiple linear regression models have shown that only WOMAC (-5.4 [-1.2-0.5]; p<0.001) and lequesne (3,1 [-1,2-4,9]; p<0.02) were significant independent factors related to QoL. Conclusions This study suggests a high impact of knee OA on all aspects of quality of live in women especially: physical activities, social support and social functioning. These disturbances re associated to poor functional status. Domains affected should be taken into account order to improve QoL in women with OA. These results should be confirmed by larger studies. Disclosure of Interest None Declared
Objectives: Rheumatoid arthritis (RA) is well known to affect many different organ systems. Previous work suggests that this includes the auditory system. The objectives of this work are to evaluate the pattern of hearing impairment in patients with rheumatoid arthritis and to examine the possible associations between hearing impairment and related RA features especially disease activity. Materials and methods: Thirty RA patients (mean age of 44.5 ± 9.9 years; female sex (90%)) and 17 healthy controls (mean age of 41.5±9.1 years; female sex (76.4%)) were included in our study. The 2 groups were matched for age and sex (p>0.05). Otoscopic examination was normal in all participants. No subject of the 2 groups has had any abnormalities at otoscopic examination. Hearing impairment was evaluated by pure tone audiometry and tympanometry including the static compliance, middle ear pressure, stapedial reflex threshold test. In all patients the clinical features, laboratory data, X-rays, disease activity index-DAS 28 were performed.
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