Short-term effectiveness of methotrexate in the treatment of active rheumatoid arthritis

To determine the effectiveness of 6-month treatment with methotrexate in a dose range of 5-15mg once weekly in 103 patients with active rheumatoid arthritis. This descriptive study was conducted in outpatient department of Medical B unit Lady Reading Hospital from October 2008 to August 2009 and included 103 active rheumatoid arthritis patients who received methotrexate in a dose range of 5-15mg once weekly for 6 months. The primary efficacy endpoint was a >/= 20% response according to the American College of Rheumatology response criteria 20 and disease activity score 28 after 6 months. Female patients made up 51.5% of the study population while males were 48.5%. The mean age was 46.1 years and the mean disease duration was 10.90 +/- 3.42 years. According to the disease activity score 28, 30.1% of patients had good while 38.8% had a moderate response. 31.1% were non-responders. Mean improvement in tender joint count were -8.3 +/- 4.59 [from baseline of 15.54 +/- 5.85] and in swollen joint count were -7.37 +/- 3.98 [from baseline of 10.59 +/- 4.96]. ESR improved to 15.24 +/- 10.42 from baseline of 58.7 +/- 11.16 and physical global assessment improves to 34.42 +/- 20.43 from baseline of 66.21 +/- 10.58. At 6 months, the rate of American college of rheumatology response criteria 20 was 68.2%. Treatment related adverse events were reported in 27.2% of patients. The study showed a favorable effectiveness for methotrexate in a dose range of 7.5-15mg once weekly

Short-term effectiveness of leflunomide in the treatment of active rheumatoid arthritis

To measure the effectiveness of 6-month treatment with Leflunomide in patients with active rheumatoid arthritis. This descriptive study was conducted in Medical B Unit, Lady Reading Hospital Peshawar from August 2008 to August 2009 and included 103 active Rheumatoid Arthritis patients who received Leflunomide 20mg daily for 6 months. The primary effectiveness endpoint was a >/= 20% response according to the American College of Rheumatology criteria 20 and disease activity score 28 response after 6 months. All the 103 selected patients were treated with Leflunomide. The mean age was 56.12% +/- 4.796 years. According to the disease activity score 28, 46.6% of patients had a good response, 41.7% had a moderate response and 11.7% were non-responders. Improvements in tender joint count were-8.63 +/- 3.418 [from baseline of 15.74 +/- 2.9], in swollen joint count were-4.26 +/- 3.058 [from baseline of 9.34 +/- 2.383], Erythrocyte Sedimentation Rate improves to 14.74 +/- 11.527 from baseline of 60.58 +/- 9.608 and physical global assessment improves to 17.38 +/- 15.35 from baseline of 70.24 +/- 7.933. The American College of Rheumatology criteria 20 response criteria show improvement in 87.4% patients. Treatment related adverse events were reported in 23.3% of patients. 17% of total patients discontinue the due to non compliance and side effects. This 6-month study carried out under daily routine practice conditions showed a favorable treatment response for Leflunomide in a dose of 20 mg daily in a typical sample of Rheumatoid Arthritis patients

Risk factors stratification in 100 patients of acute stroke

To find out the relative frequencies of various risk factors associated with first ever stroke. This prospective observational study was conducted in medical B unit of the Department of Medicine, Post Graduate Medical Institute, Government Lady Reading Hospital, Peshawar, Pakistan from March 2001 to January 2002. A total number of 100 patients, 64 males and 36 females, with first ever stroke were included in the study. A questionnaire was designed comprising detailed history, general physical and neurological examinations. The association of different risk factors with stroke was studied. The ages of patients ranged from 17 to 100 years with mean age of 59 years +11.63 years standard deviation [SD]. Cerebral infarction constituted 68%, intracerebral hemorrhage 31% and subarachnoid hemorrhage 01%. Hypertension [HTN] was the most common risk factor [60%] followed by diabetes mellitus [DM] [28%], hyperlipidemia [28%], smoking [22%], ischemic heart disease [IHD] [18%], atrial fibrillation [12%] and history of oral contraceptive use [10%]. Main risk factors for stroke are Hypertension, Diabetes mellitus, Hyperlipidemia and Smoking. Stroke can be prevented by modification of these risk factors. There is a genuine need for health education programmes on stroke and their mortality