BackgroundTo develop a culturally adapted and validated Bengali Short Form SF 12v2 among Rheumatoid arthritis (RA) patients.MethodsThe English SF 12v2 was translated, adapted and back translated into and from Bengali, pre-tested by 60 patients. The Bengali SF 12v2 was administered twice with 14 days interval to 130 Bangladeshi RA patients. The psychometric properties of the Bengali SF 12v2 were assessed. Test-retest reliability was assessed by intra-class correlation coefficient (ICC) and Spearman’s rank correlation coefficient and internal consistency by Cronbach’s alpha. Content validity was assessed by index for content validity (ICV) and floor and ceiling effects. To determine convergent and discriminant validity a Bengali Health Assessment Questionnaire (B-HAQ) was used. Factor analysis was done.ResultsThe Bengali SF 12v2 was well accepted by the patients in the pre-test and showed good reliability. Internal consistency for both physical and mental component was satisfactory; Cronbach’s alpha was 0.9. ICC exceeded 0.9 in all domains. Spearman’s rho for all domains exceeded 0.8. The physical health component of Bengali SF 12v2 had convergent validity to the B-HAQ. Its mental health component had discriminant validity to the B-HAQ. The ICV of content validity was 1 for all items. Factor analysis revealed two factors a physical and a mental component.ConclusionsThe interviewer-administered Bengali SF 12v2 appears to be an acceptable, reliable, and valid instrument for measuring health-related quality of life in Bengali speaking RA patients. Further evaluation in the general population and in different medical conditions should be done.Electronic supplementary materialThe online version of this article (doi:10.1186/s12955-017-0683-z) contains supplementary material, which is available to authorized users.
Aim: To translate and adapt the Health Assessment Questionnaire Disability Index (HAQ-DI) into Bengali (B-HAQ) for use in Bangladeshi populations and to test its reliability and validity in patients with rheumatoid arthritis (RA).Method: The HAQ-DI was translated using rigorous forward-backward protocols and the translated version was subsequently cognitively pretested in a sample of 30 outpatients with RA. The pre-final version of the questionnaire was psychometrically tested for internal consistency and construct validity in a new sample of 100 consecutive RA outpatients.Results: Ten questions were changed to suit the Bengali culture. Pretests showed that the items included in the B-HAQ were well understood by Bengali patients, while some of the original items were difficult to understand for a majority of patients. The resulting B-HAQ showed good internal consistency and construct validity in the psychometric validation study. Conclusion:This study suggests that the B-HAQ is a reliable and valid instrument for measuring functional disability in a Bengali-speaking population with RA. Future studies should examine the test-retest reliability and responsiveness of the B-HAQ before it can be confidently recommended as an outcome measure in intervention studies.
Objective Little is known about gut lesions in AS patients in a developing country, such as Bangladesh. Methods Full colonoscopy, including the terminal ileum, was performed in 60 AS patients and 20 controls, without diarrhoea, to study macroscopic and microscopic lesions. Results In the colon, in 60 AS patients 17 macroscopic lesions were found, of which 11 were in the rectum; only one lesion was found in 20 controls. The prevalence of microscopic lesions in the ascending colon, sigmoid colon and rectum was 51, 44 and 50 in patients, respectively, and 13, 9 and 8 in controls. In the terminal ileum, macroscopic and microscopic lesions were seen in 21/56 and 43/56 AS patients, respectively, and in 1/20 and 9/20 controls. In the AS group, macroscopic (38.5 vs 5%, P < 0.01) and microscopic (76.8 vs 45%, P = 0.009) lesions were more frequent than in controls; no IBD was diagnosed. Findings were comparable in the axial AS group ( n = 25) and the mainly peripheral group ( n = 35). In AS patients, marked eosinophilic infiltration was observed in the ascending colon and sigmoid colon but not in the rectum, and this infiltration was more than in controls. The colonic mucosa in controls was otherwise comparable with western studies. Anaemia was seen in 18/60 cases. No association was found between anaemia or HLA-B27 status and gut lesions. Conclusion There was an equal percentage of microscopic lesions in the whole gut in AS cases and healthy controls. Previous helminth invasions might have played a role. Lesions differ significantly between AS and controls only in the ileum; therefore, the ileal lesions might be more disease related than the colonic ones.
Abnormal liver tests are common (60%) in some point of Systemic Lupus Erythematosus (SLE) illness. In rare cases, severe cholestasis may invite diagnostic dilemma. Here we reported a 48-years-old female SLE patient with severe cholestasis (serum bilirubin 37mg/dl) and her management in a financial constrain situation. J MEDICINE 2022; 23: 162-164
Background and aims The tubercular infections (TB) are most important cause of morbidity and mortality in SLE patients worldwide and an ongoing alarming issue in developing countries. This study was aimed to observe frequency and risk factors of tuberculosis in SLE patients. Methods This observational study was carried out in SLE clinic of BSMMU, Bangladesh. A total 230 consecutive SLE patients were enrolled. Patient's clinical characteristics, history of TB, SLEDAI score, cumulative doses of immunosuppressants were recorded. In clinically suspected cases tuberculin test, chest X-ray, spot and first morning sputum for AFB, Gene Xpert MTB/RIF, ADA, FNAC and tissue biopsy were requested along with routine tests. The multivariate logistic regressions were done for risk factors. Ethical clearance was obtained from IRB of BSMMU. Results Out of 230 patients TB was documented in 23 (10%) subjects. Among TB cases 16 women and 7 men. Mean age of patients was 27.56±9.3 years and mean duration of occurrence of tuberculosis after SLE diagnosis was 4.26±5.38 years. Cough, night sweat, fever, anorexia were significant presenting features. Present and past TB was observed in 10 and 13 cases respectively. Fifteen and 8 patients had pulmonary and extra pulmonary TB respectively. Organ involvement pattern was multi-lobed lungs, joint, meninges, lymph nodes, peritoneum and pleura. None had drug resistance. Active disease (SLEDAI score), intake of prednisolone >500 mg were notable risk factors. Conclusions Frequency of tuberculosis was high (10%) in SLE patients. Awareness including prevention of flares and judicious use of steroids might reduce the rate of TB. Background and aims CD8 T cell responses to viral pathogens is crucial for the prompt resolution of acute infections. SLE patients are more likely to have infections due to long-term glucocorticoid and immunosuppressive agent intake. The present study is to evaluate the potential anti-infection effect of low-dose IL-2 in SLE patients. Methods Peripheral blood mononuclear cells from nine refractory SLE patients and 9 health controls (HCs). The disease activities were evaluated by rheumatologist. The frequencies of T cell subsets were assayed by flow cytometry. Virus-specific CD8 T cells responses were determined based on TNF-a IFNg and Granzyme B producing CD8 T cells upon CMV-EBVFlu(CEF) viral peptide pool stimulation. 357 INCREASED PERIPHERAL CD8 T CELL RESPONSES IN SLE BY LOW-DOSE IL-2 TREATMENT
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