Introduction: Rheumatoid arthritis (RA) is a chronic inflammatory disease of unknown etiology marked by a symmetric, peripheral polyarthritis. It is the most common form of chronic inflammatory arthritis and often results in joint damage and physical disability. As it is a systemic disease, it may result in variety of extra-articular manifestations, including fatigue, subcutaneous nodules, lung involvement, pericarditis, peripheral neuropathy, vasculitis, and hematologic abnormalities. Aim of the work: Show changes of serum lipid profile in patients with rheumatoid arthritis. Patients and Methods: Fifty patients with rheumatoid arthritis who diagnosed according to (EULAR/ ACR2010) criteria for rheumatoid arthritis, 47 females and 3 males with a mean age of 36.80 ±6.03 years. Fifty control healthy subjects included 43 females and 7 males with a mean age of 36.14 ±7.73 years were examined for their lipid profile parameters and disease activity. Lipid profile parameters (total cholesterol, high-density lipoprotein cholesterol, lowdensity lipoprotein cholesterol and atherogenic index ratio), erythrocyte sedimentation rate and C-reactive protein; all were determined for both the patients and control groups. Results: The results of the present study revealed that rheumatoid arthritis patients exhibited a highly significant increase in total cholesterol and low-density lipoprotein cholesterol (p=0.0001), with a significant increase in high-density lipoprotein cholesterol (p= 0.002). As a consequence, the atherogenic index ratio was significantly higher (p=0.0001). The rheumatoid factor, CRP and ESR were higher in patients with RA than in control group with very highly significant difference (p=0.0001). There is a significant correlation between disease activity score (DAS 28) and different parameters of lipid profile which was a highly significant with LDL and TC/HDL (0.9-0.8) respectively and was less significant with other parameters. The disease duration for rheumatoid arthritis patients was significantly correlated with Das28 score (p=0.01). Conclusion: Rheumatoid arthritis patients are characterized by an atherogenic lipid profile in comparison with the healthy controls. Recognition and treatment of early rheumatoid arthritis and reduction of cardiac risk factor has greater impact on the course of the disease.
BackgroundSacroiliac joint injection in axial spondyloarthritis (SpA) patients with steroid was controversial. A well designed randomized clinical trial testing its effect on different disease outcome measures particularly bone marrow edema was missing [1].ObjectivesTo test the effect of steroid injection in the sacroiliac joint of axial SpA patients on different disease outcome measures.MethodsN = 43 were registered. They were randomly assigned into 2 groups; Group I (23 cases) received sacroiliac joint injection lidocaine hydrochloride mixed with triamcinolone, whereas Group II (22 cases) received subcutaneous saline injections. All participants fulfilled the ASAS criteria for axial SPA and they all had bone marrow edema at baseline. Outcomes measures were: Visual Analogue Scale (VAS), ASDAS, BASFI, and SPARCC scores. Participants were assessed at baseline (before and after sacroiliac joint injection) and after 3 months.ResultsThere was a significant difference between both groups regarding pain, spine mobility, SPARCC and ASDAS scores in favor of group I. Spine mobility showed the earliest improvement, followed by pain whilst SPARCC and ASDAS scores showed improvement after 3 months. Higher disease activity, younger age, and shorter disease duration all were associated with better outcomes. Bilateral hip involvement was a predictor of poor responseConclusionSacroiliac joint injection of lidocaine and triamcinolone in axial SpA patients is effective in controlling pain, improving function, disease activity scores, and bone marrow edema with acceptable complications and relatively sustained effect.References[1]Elsaman, A., A. Hamed, and A. Radwan, Ultrasound-guided epidural block in axial spondyloarthritis patients with limited spine mobility: a randomized controlled trial. The Korean journal of pain, 2021. 34(1): p. 114.Table 1.Comparison between the two study groupsGroup I (N=24)Group II (N=23)P value*Age35.4±6.233.5±6.70.354SexMale17(77.3%)16(76.2%)1.000Female5(22.7%)5(23.8%)VASBefore injection (0)7.95±0.847.86±0.730.688After injection (1)3.55±1.446.95±1.02<0.00112 weeks later (2)4.82±1.377.19±0.81<0.001P value 0 vs 1**<0.0010.003-P value 0 vs 2**<0.0010.001-P value 1 vs 2**<0.0010.397-ASDASBefore injection2.69±0.442.60±0.370.45112 weeks later1.51±0.442.40±0.46<0.001P value **<0.0010.022BASFIBefore injection61.91±9.7062.95±11.710.75212 weeks later57.50±8.1361.24±0.530.199P value **<0.0010.081-SPARCCBefore injection34.73±9.1433.48±8.930.65212 weeks later15.68±6.6030.95±7.85<0.001P value **<0.0010.024-Finger to floorBefore injection (0)27.68±9.9426.90±11.620.815After injection (1)17.09±7.0025.48±11.230.00512 weeks later (2)19.64±7.8326.76±11.790.024P value 0 vs 1**<0.0010.001-P value 0 vs 2**<0.0010.791-P value 1 vs 2**0.0010.072-Lateral bendingBefore injection (0)21.64±5.9122.29±4.510.688After injection (1)25.50±6.1322.57±3.430.06012 weeks later (2)24.55±4.9522.24±2.950.071P value 0 vs 1**<0.0010.649-P value 0 vs 2**0.0030.947-P value 1 vs 2**0.0870.426-* p values were calculated using Independent t test, except for the sex, where Fisher Exact test was used.** p values for paired data was calculated using paired t test, to compare the baseline values (0) with either immediate post-injection (1) or 12 weeks later (2) values.Disclosure of InterestsNone declared
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