RESUMO
Objective: To assess the cardio vascular disease [CVD] risk using framingham risk score and frequency of other co-morbidities associated with rheumatoid arthritis [RA]
Study Design: Cross sectional descriptive study
Place and Duration of Study: Rheumatology department of Fauji foundation hospital [FFH], Rawalpindi. The duration of the study was six months, from Nov 2017 to Apr 2018
Material and Methods: RA Patients between 40 to 80 years of age were selected from rheumatology outpatient department [OPD] at Fauji Foundation Hospital [FFH] Rawalpindi. After 12 hours of fasting, venous blood was taken for total serum cholesterol [TC], triglycerides [TG], low density lipoproteins [LDL], high density lipoproteins [HDL] and ESR [mm/1st hour]. Framingham risk score was calculated using online calculator and it was multiplied by a factor 1.5 as per European League against Rheumatism [EULAR] recommendations to find the correct cardiovascular risk. This gave us 10 year cardiovascular risk in each RA patient
Results: The study included 205 RA patients with a mean age [in years] of 53.12 +/- 10.60. Mean duration of disease [years] was 9.71 +/- 7.1. The commonest comorbidity in RA patients was hypertension found in 82 [40 percent] patients. 100 [48.78 percent] patients were overweight with mean body mass index [BMI] of 25.35 +/- 4.96. Diabetes was found in 38 [18.5 percent] patients. 51 [24.87 percent] patients had high low density lipoprotein [LDL] with mean LDL of 116.75 +/- 29.50 [mg/dL] whereas 88 [42.92 percent] patients had either borderline high or high total cholesterol with mean of 194.64 +/- 30.62 [mg/dL]. 104 [50.73 percent] patients had borderline high triglyceride levels with a mean of 166.48 +/- 63.03 [mg/dL]. 25 [12.2 percent] patients were smokers. 24[11.7 percent] patients had dexa scan proven osteoporosis [ T score <-2.5]. Amongst all, 54 [26.3 percent] patients had low cardiovascular risk, 93 [45.4 percent] had moderate risk and 58 [28.3 percent] had high risk according to Framingham risk score
Conclusion: RA patients have high cardiovascular risk. Other co-morbidities like hypertension, high BMI, diabetes, dyslipidemia, smoking and osteoporosis add to the morbidity and mortality of these patients
RESUMO
Objective: To determine the effects of timing of prednisolone on duration of early morning stiffness, pain score, number of swollen and tender joints, erythrocyte sedimentation rate [ESR] and disease activity score 28 [DAS-28] in joints in patients with rheumatoid arthritis. Study Design: It was quasi experimental study. Place and Duration of Study: This study was conducted in the department of rheumatology Fauji Foundation Hospital Rawalpindi over a period of 3 months, from Dec 2015 to Feb 2016
Material and Methods: Total sample size of 85 was calculated by using non probability consecutive sampling technique. Patients with established rheumatoid arthritis diagnosed on the basis of ACR 1987 criteria were included in the study. All these patients had a disease duration of minimum 6 months and were on disease modifying anti rheumatic drugs and were taking
Results: A total of 85 patients of established rheumatoid arthritis were included in the study. All patients were female with a mean duration of disease of 7.87 +/- 6.41 years. The mean age of patients was 49.39 +/- 10.24 years. Mean of pain score, duration of morning stiffness, DAS-28, number of tender and swollen joint count, and ESR was decreased in patients who took prednisolone at 10:00 pm and had significant statistical difference [p-value <0.001]
Conclusions: Administration of low dose of prednisolone at night has good effects on duration of early morning stiffness, pain scores, number of swollen and tender joints, ESR and DAS-28