ABSTRACT
Introduction: Rheumatoid arthritis (RA) is a chronicmultisystem disease of unknown cause. The characteristicfeature of RA is persistent inflammatory synovitis usuallyinvolving the peripheral joints in a symmetric fashion.Hence;the present study was undertaken for assessing rheumatoidfactor titers in extra-articular manifestation of rheumatoidarthritis.Material and methods: A total number of 50 patientswho met the inclusion criteria were included in this study.Rheumatoid arthritis diagnosed as per 2010 revised criteriafor the classification of RA were enrolled. The RA patientsthus selected were screened for various common clinicalfeatures, articular and extra-articular manifestations usinga structured Proforma designed for this study. At the end ofthe study the titers of RF factor in articular and extra articularmanifestations in 50 rheumatoid arthritis patients screenedwere calculated and expressed as percentage. All the resultswere recorded in Microsoft excel sheet and were analysed bySPSS software.Results: The clinical examination in the study revealedpallor in 34(68%) patients. Rheumatoid factor titres of 1:16were observed in 4(13%) of patients, 1:32 in 7(24%), 1:64 in8(28%) and 1;128 in 10(35%) of patients. Hemoglobin <8g/dl in 10 patients i.e.;(20%), 8-10g/dl in 14 patients i.e;40%,10-12g/dl in 10 patients i.e.; 28%. (Normal Hb 12-14g/dlin females, 14-16g/dl in males). Peripheral smear showed24 patients i.e 70% of them had normocytic normochromicanemia. Extra-articular manifestations were seen in about72%, Anemia in 34(68%), Lymphadenopathy in 8(16%),Purpuric –rash in 4(8%), Rheumatoid nodules in 4(8%) andSplenomegaly in 2(4%).Conclusion: Extra-articular manifestations contributesignificantly to the morbidity and mortality in rheumatoidarthritis. Careful screening of all patients for extra-articularmanifestations may help reduce the same, with the propermanagement of such patients
ABSTRACT
Background: Hypertension is a major independent risk factor for coronary artery disease, congestive heart failure, stroke, chronic kidney disease and peripheral vascular diseases if left untreated. Drug utilization study of antihypertensive drugs and the study on prevalence of blood pressure control would help in reducing the burden of the disease and health expenditure.Methods: The study was conducted in the Outpatient Department of Medicine in Government Medical College, Thrissur. Patients aged 18yrs or above diagnosed with hypertension, on antihypertensive drugs were enrolled in the study. Patients suffering from secondary hypertension and acutely ill were excluded. Patients were enrolled after taking an informed consent. Demographic data, present treatment for hypertension, associated co- morbid conditions if any, and treatment of the same were recorded. BP was recorded, and cost of treatment was calculated using CIMS.Results: A total of 250 patients were included in the study. Mono therapy was used in 64.8% patients and combination therapy in 35.2%. Overall drug utilization pattern showed that CCBs (42.8%) were most commonly prescribed, followed by ACEIs (32.4%) and ARBs (29.2%). Most commonly prescribed combination therapy was ACE I + BB (29.3%), followed by ARB + CCB (21.3%). Mean cost of antihypertensive drug therapy was 3057.8 Rs / yr. Recommended target BP was achieved in 49.6% of patients.Conclusions: The prescription pattern of antihypertensive drug was in accordance to the JNC-VIII guidelines. The blood pressure target was achieved only in less than 50% of patients.