Mouth and genital ulcerations in the community

To estimate the prevalence of mouth and genital ulceration in the community and its relationship to rheumatic diseases. A house to house survey was carried out over a period of 18 months extending from September 1993 to February 1995, on 5,894 individuals utilizing detailed questionnaires on symptoms of musculoskeletal diseases and associated symptoms including history of mouth, genital ulcers, eye symptoms, and skin changes. After the initial phase, a 2nd phase was completed by trained nurses and paramedical staff, the purpose of which was to explore in detail, the history of those responding positively to any of the questions in phase one. The 3rd stage was conducted by general practitioners and rheumatologist to interview and examine those identified in phase 2 at King Fahad Hospital, Buraidah, Kingdom of Saudi Arabia. We identified 7 [0.1%] cases of genital ulceration, 43 [0.7%] cases of mouth ulceration, 263 [4.5%] cases of reddish eye or blurred vision, and 124 [2.1%] cases of skin rashes. Only 2 cases had both mouth and genital ulceration in addition to eye disease, skin rash and musculoskeletal pain. There was significant correlation between mouth ulcers and skin rash, eye symptoms, genital ulcerations, male sex, single status, weight loss and backpain. The vast majority of mouth and genital ulcers are not associated with a known rheumatic disease

How Common is back pain in Al-Qassim region

The aim of this study was to estimate the prevalence of back pain in the adult population of Al-Qaseem Central Province, Kingdom of Saudi Arabia and to find associated features and factors. A house-to-house survey covering 1,000 household in the towns and villages of Al-Qaseem province was carried out over a period of 18 months extending from September 1993 until the end of February 1995. A total of 5,894 adults, aged 16 years and above, were questioned by trained staff regarding back pain, and the demographic data in addition to general, medical and social history. A response was obtained in 5,743 [97.4%]. Their mean age was 34.14 ' 15.16 [range 16-99]. Back pain was reported by 1,081 [18.8%], wherein 499 [8.8%] were men, and 574 [10%] were women. Back pain was more prevalent in married [23.3%] individuals than unmarried [6.4%]. Adjusted odds ratio [OR] for back pain in married individuals was 1.88 [95% confidence intervals [CI] 1.49-2.37]. Back pain was strongly correlated with age [correlation coefficient = 0.378 P < 0.01]. It also showed significant correlation with weight and height, depression, family history of back pain, change in work ability, frequency of attendance at local doctor, use of medication and lower education level. The association with body mass index became evident only after comparing the heaviest 20th percentile to the lightest [OR 1.335 [95% CI, 1.279-1.402]]. Certain occupational status [unemployed, farmers, professional workers and housewives] were associated with back pain. Back pain was relatively common in this largely unindustrialized community although its prevalence is lower than reported from some western countries

Rheumatoid arthritis: radiological changes in the cervical spine

To describe the radiographic cervical spine changes in rheumatoid arthritis patients. Forty-nine patients [37 females and 12 males] diagnosed with rheumatoid arthritis at King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia, between June 1998 and June 2000, were studied for their radiographic cervical spine changes. Their mean age at disease onset was 41.4 +/- 13.4 years [range of 18-73] and mean duration of the disease was 9.1 +/- 6.28 years [range of 2-34]. Their demographic data including rheumatoid factor status was obtained. Standard conventional radiographs of cervical spine were obtained to study the cervical spine changes. Cervical spine radiographic changes were found in 34 patients [27 females and 7 males], 10 had subluxation [7 with atlanto-axial subluxation, 2 with sub-axial subluxation, and one with lateral subluxation]. No vertical impaction was seen. Erosion of odontoid process was seen in one patient. All were rheumatoid seropositive. Cervical spine changes in patients with rheumatoid arthritis are common, in particular subluxation in the upper cervical spine. Our study showed somewhat lesser prevalence of these changes. These were clinically correlated with disease duration, female sex, and rheumatoid factor, but were not statistically significant

Radiographic osteoarthritis and serum cholesterol

To find out the relationship between radiographic osteoarthritis [OA] of the knee, generalized OA and serum cholesterol. Over a period of 7 months from September 1998 through to March 1999, 246 patients attending 14 primary care clinics in Northern Riyadh, Kingdom of Saudi Arabia, for different non-musculoskeletal complaints were recruited in the study. Their knees, hands and wrists were radiographed. Their ages, sex, weight, height, body mass index [BMI], fasting serum cholesterol, triglycerides and uric acid were recorded. There were 113 females and 133 males with average ages 46 +/- 14.2 and 51.54 +/- 16.0 years. One hundred and twenty-two [49.6%] cases of knee OA and 58 [23.6%] cases of generalized OA were found and analyzed for the association with serum cholesterol levels. Crude odds ratio [OR] for the relationship between knee OA and the third tertile of serum cholesterol was 2.33 [95% CI, 1.19-4.58] which on adjusting for age, sex, BMI, serum uric acid and triglycerides were 2.68 [95% CI, 2.00-3.64]. For generalized OA, the crude odds ratio [OR] in relation to the third tertile of serum cholesterol was 1.65 [95% CI, 0.78-3.53], adjusted OR was 2.18 [95% CI, 1.55-3.15]. The results showed an association between high serum cholesterol level and both knee and generalized OA

Prevalence of Systemic Lupus Erythematosus in Central Saudi Arabia

Although systemic lupus erythematosus of varying severity has been seen in our clinics, there is no information regarding the prevalence of the disease among Saudi nationals. We conducted this study to determine the prevalence of systemic lupus erythematosus in Al-Qaseem region of the Kingdom of Saudi Arabia. A community survey of towns and villages in the Al-Qaseem area of central Saudi Arabia was conducted in 3 phases to determine the prevalence of systemic lupus erythematosus in the region. Of the 10,372 studied, 2 cases of systemic lupus erythematosus were identified using the criteria set for the diagnosis of systemic lupus erythematosus by the American College of Rheumatology. Based on that, the prevalence of systemic lupus erythematosus was estimated to be 19.28 per 100,000 population in the region. The estimated prevalence of systemic lupus erythematosus in Al-Qaseem area is similar to that found in western countries

Lymphomatoid granu;lomatosis with long survival

We present a case of lymphomatoid granulomatosis presenting in a 35-year-old Saudi lady with long survival. She responded to treatment with intermittent cyclophosphamide infusion in addition to corticosteroids. This is the first case of lymphomatoid granulomatosis to be reported in the Arab world. The prolonged survival and response to intermittent cyclophosphamide infusion is discussed