BackgroundMusculoskeletal complaints are an important occupational problem; nevertheless, few studies have targeted nurses in Saudi Arabia. The aim of this study was to determine the frequency and risk factors of work-related musculoskeletal disorders (WMSDs) among nursing personnel at a tertiary centre in Jeddah.MethodsA comparative cross-sectional study was performed in which full-time registered nurses from four different departments (n = 200) were selected for analysis between September 1, 2011 and February 29, 2012. Musculoskeletal symptoms over the past year were assessed using the Nordic Standardised Musculoskeletal Questionnaire. In addition to demographic questions, the researcher evaluated employment history, physical risk factors at work, and general health status.ResultsIn this study, approximately 85% of the nurses reported experiencing at least one musculoskeletal symptom. Musculoskeletal symptoms occurred most commonly in the lower back (65.7%), ankles and feet (41.5%), and shoulders (29%). Prolonged working hours and being underweight were significantly associated with the development of these symptoms (OR 3.66, 95% CI 1.24-10.79, P = 0.018, and OR 2.66, 95% CI 1.37-5.93, P = 0.004, respectively). Working in the surgical department was a greater risk factor for low back pain compared with working in other departments.ConclusionsWMSDs are common among our nurses, and back pain is the most common symptom. As prolonged working hours and being underweight were factors that contributed most to WMSDs, decreasing shift durations or offering nutrition educational programmes may be suitable solutions. However, further studies are required to examine the best modality for decreasing the occurrence of WMSDs.

Methods Cross-sectional study of patients with SLE. Demo-graphics, coronary risk, disease activity and inflammatory markers were studied. The diagnosis of MS was established with the NHLBI/AHA criteria. Statistical analysis was performed using SPSS 20.0 software and a P value<0.05 was considered significant. Results 126 patients with SLE, 107 women (84%) and 19 men (15%), age 41±13 years old and disease duration 9±7 years. The prevalence of MS was 33.3%. No association was found with age, education level, smoking or steroid use in patients with MS. In multivariate analysis only elevated eryth-rocyte sedimentation rate (ESR) had a statistical significance (p=0.012). Positive association was found between higher values of ESR and hypertriglyceridemia (p=0.0002), body mass index (p=0.0043) and lower levels of HDL and C3 (p=0.0152). Conclusions The prevalence of MS in our population (33%) was higher than reported in the SLICC registry (15%). The association of metabolic and inflammatory characteristics increases cardiovascular risk by a proinflamatory state. The results suggest the need for early diagnosis and treatment of MS to reduce cardiovascular comorbidity in patients with SLE. Background and aims Vitamin D deficiency is common in women living near to equatorial line. Deficiency of vitamin D could lead to more severe manifestation of autoimmune disease , it may accelerate complication in atherosclerosis cardio-vascular disease.

Comorbid conditions play a pivotal role in rheumatoid arthritis management and outcomes. We estimated the percentage of comorbid illness among rheumatoid arthritis patients and explored the relationship between this comorbidity and different prescriptions. A cross-sectional study of patients with rheumatoid arthritis in three centers in Saudi Arabia was carried out. Comorbidity and antirheumatoid medication regimens prescribed were recorded on a specially designed Performa. The association between comorbidity and different drugs was analyzed. A total of 340 patients were included. The most comorbidities were hypertension 122 (35.9%), diabetes 105 (30.9%), osteoporosis 88 (25.8%), and dyslipidemia in 66 (19.4). The most common drug prescribed was prednisolone in 275 (80.8%) patients followed by methotrexate in 253 (74.4%) and biological therapy in 142 (41.5%) patients. Glucocorticoids were prescribed considerably more frequently in hypertensive and diabetic patients as well as in patients with osteoporosis and dyslipidemia. Most patients with rheumatoid arthritis suffered from comorbid diseases.

ExRA were present in a substantial proportion of our patients, which lead to a worse disease outcome. Anemia, thrombocytosis and respiratory system involvement were the commonest. Early recognition and treatment are important to decrease mortality.

Background and objectiveAlthough systemic lupus erythematosus (SLE) is the most common connective tissue disease affecting the lung, few studies have assessed risk factors that predict pulmonary manifestations. The objectives of the present study were to determine the prevalence of lung manifestations in SLE patients from Western Saudi Arabia by analysing results from high-resolution computed tomography (HRCT) scans and to identify independent risk factors for lung involvement.MethodsThis was a 10-year retrospective study involving 184 SLE patients. We examined all HRCT lung abnormalities and determined whether findings were associated with the presence of lupus nephritis (LN), SLE disease activity (as defined by SLE Disease Activity Index 2000 item scores ≥4 for any and all items) or levels of complement and anti-double-stranded DNA (anti-dsDNA).ResultsWe identified 61 patients (33%) with pulmonary involvement, and 52 (85%) of these subjects showed HRCT abnormalities. The most common HRCT findings were pleural effusion, consolidation and atelectasis (58%, 42% and 42%, respectively). There was a significant association between abnormal HRCT results and hypocomplementemia, high levels of anti-dsDNA and disease activity (P < 0.05), particularly with regard to pleuropericardial effusion and consolidation. Pulmonary abnormalities were significantly higher within the first five years after SLE diagnosis (P < 0.001). However, neither disease duration nor LN was associated with increased risk.ConclusionsLung manifestations were frequent in SLE patients from Saudi Arabia, with pleural effusion, consolidation and atelectasis being the most common. Low complement levels, high anti-dsDNA levels and disease activity were significantly associated with abnormal HRCT findings (all P < 0.001).

Our study shows that vitamin D deficiency is highly prevalent in patients with IBS and these results seem to have therapeutic implications. Vitamin D supplementation could play a therapeutic role in the control of IBS.

ObjectivesDiabetes mellitus is a major public health problem worldwide. Most diabetic patients will develop functional disabilities due to multiple factors, including musculoskeletal (MSK) manifestations. The purpose of this study was to determine the frequency of MSK in diabetic patients and to examine the possible predictors for its development.MethodsWe performed a cross-sectional study from June 1, 2010, to June 30, 2011, to evaluate MSK manifestations in adult diabetic patients at an outpatient clinic of King Abdulaziz University Hospital, Jeddah, Saudi Arabia. Baseline variables were examined to determine predictors for the development of MSK complications. Analyses were carried out using the Statistical Package for Social sciences.ResultsWe included 252 diabetic patients; 45 (17.9%) had MSK manifestations. Of these 45 patients, 41 (91.1%) had type 2 diabetes. The most common manifestations were carpal tunnel syndrome (n=17, 6.7%), shoulder adhesive capsulitis (n=17, 6.7%), and diabetic amyotrophy (n=12, 4.8%). A significant association was found between the development of MSK manifestations and manual labor, overweight, and vascular complications. On logistic regression analysis, the presence of vascular complications in general (B-coefficient=1.27, odds ratio=3.57, P<0.05, 95% confidence interval=1.31–9.78), and retinopathy in particular (B-coefficient=1.17, odds ratio=3.21, P<0.05, 95% confidence interval=1.47–7.02) can predict the development of MSK manifestations in about 82% of the cases.ConclusionMusculoskeletal manifestations are under recognized in adult diabetic patients, occurring in 18% of the cases. Physicians should consider examining the periarticular region of the joints in the hands and shoulders whenever a diabetic patient presents with MSK symptoms.

The aim of this study is to standardise the muscuoloskeletal (MSK) examination of the hand and wrist joints and to determine the sensitivity of this standard exam to diagnose arthritis in comparison to ultrasound (US) findings. A standardised approach to MSK examination of the hand and wrist joints was formulated. It consists of inspection, followed by screening exam based on active range of motion testing, and then using specific techniques to detect clinical swelling and tenderness. The scissor and squeeze techniques for metacarpophalangeal (MCP) joints, 4-finger technique for the proximal interphalangeal (PIP) joints and 2-thumb technique for the wrist joints. Patients aged 18-75 years with symptoms suggestive of inflammatory arthritis for more than 3 months were included in the study from two centres. Two rheumatologists conducted MSK examination, while a grayscale with power Doppler US was performed by two ultrasonographers recording signs of arthritis (effusion, proliferation and hyperaemia) on the same day of visit. Statistical analysis was carried out to compare MSK examination findings in detecting swelling and tenderness to US examination findings. A total of 2,112 joints were assessed both clinically and with US. Using a standard MSK examination by a rheumatologist to detect clinical swelling showed the following sensitivities as compared to US findings: 4-finger technique of 69 % in third PIP, the scissor technique of 74 % in second MCP and 70 % in third MCP, and the 2-thumb technique of 80 % at the wrist joint. The MCP squeeze technique showed sensitivity of 66 % for tenderness. A standard MSK examination with its described techniques is a sensitive tool if used appropriately to diagnose clinical arthritis as compared to US.