ABSTRACT
To estimate the most prevalent age of patients and disease status and progression in terms of severity at different age groups in the Pakistani Rheumatoid Arthritis [RA] patients. A total of five hundred [500] RA patients were enrolled during October, 2009 to October, 2013. A screening questionnaire was filled for each patient satisfying America College of Rheumatology [ACR] criteria under the supervision of certified rheumatologists. Epidemiological and demographic variables were statistically analyzed for correlation with progression of the disease using SPSS ver 17.0.1 software. In general, rheumatoid arthritis preferentially affects women with female to male ratio of about 3:1; however, patients with above 60 years of age have equal female to male ratio. The most prevalent age is 45-60 years. The disease severity increases with increase in the age and reaches to its peak in above 60 years of age [p=0.001]. The pattern of progression of RA in the Pakistani patients is almost consistent with other relevant studies conducted on European and European derived populations
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Surveys and Questionnaires , Immune System Diseases , Disease ProgressionABSTRACT
Objective: To study the correlation of anti C1q antibodies with disease activity in patients with systemic lupus erythematosus [SLE]
Study Design: Cross sectional, observational study
Place and Duration of study: The Department of Immunology, Armed Forces Institute of Pathology, Rawalpindi in collaboration with Military Hospital, Rawalpindi, Pakistan Institute of Medical Sciences, Islamabad and Benazir Bhutto Hospital, Rawalpindi, from Jan 2012 to Dec 2013
Material and Methods: Patients with a clinical diagnosis of SLE were included in the study on fulfilling revised American College of Rheumatology [ACR] criteria [1997]. Main outcome measures were SLE disease activity index [SLEDAI] score and anti C1q antibody levels in serum. SLEDAI scores were calculated for each patient on the basis of physical examination, patient interviews and previous clinical records. Anti C1q antibody levels in the serum were determined by enzyme-linked immunosorbent assay [ELISA] and correlated with the SLEDAI scores by calculating Pearson's correlation coefficient 'r'. The cutoff value for anti C1q antibody positivity in the serum was determined by evaluating the serum levels of anti C1q antibodies in 25 healthy subjects and was 12 U/ml
Results: Six male and forty nine female SLE patients with an age range of 16-47 years [mean 34.5 years] and 8-70 years [mean 31.7 years] respectively were studied. The correlation between anti C1q levels and SLEDAI scores in all patients was demonstrated by calculating the correlation coefficient and was not significant [r=0.19, p=0.14]. However, there was an inverse correlation between anti C1q levels and SLEDAI scores in patients with severe disease and this was statistically significant [r=-0.448, p=0.037]. The difference in anti C1q antibody positivity between patients with and without nephritis was not significant. The anti C1q antibody levels correlated poorly with anti double stranded deoxyribonucleic acid [dsDNA] antibody positivity. A significantly higher percentage of patients with evidence of complement consumption was found to be positive for anti C1q antibodies [p=0.01]. This significance was only seen in patients with reduced C3 levels [p=0.04] and not reduced C4 levels [p=0.23] or both [p=0.23]. Anti C1q antibody levels had significant inverse correlation with serum C3 levels. [p=0.007]
Conclusion: A significant inverse correlation was found between SLEDAI scores and serum anti C1q antibody levels in patients with severe SLE. The anti C1q antibody positivity is significantly higher in patients with reduced C3 levels
ABSTRACT
To determine the prevalence of hepatitis C virus [HCV] and hepatitis B virus [HBV] infection by detection of anti-HCV and hepatitis B surface antigen [HbsAg] in general population of Pakistan. Design: Observational. Place and Duration of Study: Community clinic of Shifa International Hospital, Islamabad, from January 1998 to June 2004. Materials and Sera of healthy adult individuals who presented for medical evaluation as a pre-employment criteria in the Gulf region were examined for presence of hepatitis B surface antigen and anti-HCV antibody. Alanine aminotransferase levels were also determined. A total of 47,538 individuals were examined. Out of these, 2528 [5.31%] were positive for anti-HCV and 1221 [2.56%] individuals had positive HBsAg. Hepatitis B surface antigen and anti-HCV both were found in 92 [0.19%] individuals. Mean age of subjects, positive for HCV antibody was 44 years and 40.5 years for HBV. Ninety-four% individuals were males and 6% were females. Alanine aminotransferase [ALT] was normal in 56% of subjects with positive HCV and 84% of individuals with HBV. This study which evaluated predominantly a healthy male population, showed a high seroprevalence of anti-HCV and average seroprevalence of hepatitis B virus infection. A large majority of these patients was young and had normal ALT