Effect of an educational joint protection program on adherence, pain, and self-efficacy perception among female patients with rheumatoid arthritis

Joint protection [JP] is a widely provided part of the management of people with rheumatoid arthritis [RA]. JP education aims to enable people with RA to reduce pain, joint stress and risks of deformity through using alternative movement patterns of affected joints to perform everyday activities. However, the benefit of using alternative methods of task performance has not been evaluated and evidence related to adherence with this is conflicting. To evaluate the effects of a joint protection education program in improving adherence, pain and self-efficacy perception among female patients with rheumatoid arthritis [RA]. A pre-/ post test study design was utilized. Rheumatology outpatients unit in Al Manial University Hospital. Sixty Subjects diagnosed with RA were recruited for the study [mean age 49.4 +/- 6.99 years]. Thirty subjects attended the joint protection education program and thirty subjects received the routine outpatient management. Groups were matched for age, disease duration and drug therapy. Intervention: An 8-hour arthritis education program delivered over four sessions, including four hours of joint protection education. Main outcome The Joint Protection Behavior Assessment [JPBA]: an observational assessment of hand joint protection methods, to measure adherence with education. Other measures included the Hand pain and the Health Assessment Questionnaire's Pain Scale, in addition to the Arthritis Self-efficacy Scale. Subjects were assessed at baseline and at four weeks post JP education. There were no significant differences at baseline between the two groups for adherence with JP, hand and global pain scores or perceived self-efficacy. In comparison with the control group, the joint protection group significantly improved after the four-week program with respect to adherence to the joint protection program [scores improved from 21.9 [SD= 3.38] at baseline to 33.5 [SD=2.96] at 4 weeks]; hand and global pain [p<0.01 for both measures]; and perceived arthritis self efficacy [P <.01]. Significant improvements in adherence, pain, and perceived self-efficacy were found amongst those participated in the joint protection program. This type of programs is a highly effective and relatively inexpensive way of providing patients with tools to better manage their arthritis, reduce pain, and improve function. Therefore, joint protection has to be included as part of routine rheumatology care

Impact of exercise training program on fatigue and health related quality of life among women with breast cancer

Recovering from cancer treatment can be a difficult experience, both physically and psychologically. As the number of women surviving breast cancer is increasing and cancer treatment is linked to high incidence of fatigue and reduced quality of life, it is critical to evaluate interventions that could improve the quality of life of this population and hasten recovery following treatment. Physical exercise has been shown to affect fatigue and enhance quality of life [QOL] among cancer survivors. The current randomized controlled study evaluates the effects of exercise training upon fatigue reduction and health related-quality of life in women who have had breast cancer. A pre-/ post test control group study design was utilized. Rheumatology Rehabilitation outpatients unit in Assiut University Hospital. Sixty subjects were randomized to one of two groups: exercise therapy, or a normal care control group. A supervised exercise training took place three times per week for 12 weeks. Outcome measures included fatigue and quality of life. Fatigue was assessed by Chadler Fatigue Scale. Health-related QOL was measured using the Medical Outcomes Study Short Form-36 [MOS SF-36] questionnaire. All outcomes are assessed at baseline, and at the end of the 12-week training. the mean age of the study subjects was 44.68 years [SD = 6.84]. Total fatigue scores at past -test were lower for patients receiving exercise [mean 24.3 +/- SD 10.73] than for those of the control group [mean 37.2 +/- SD 3.38], resulting in a significant difference between groups at post-test. Scores on the MOS SF-36 varied among the subscales for the two groups at post-test. Physical function, general health perceptions, vitality, social function, role emotional and mental health, improved among the majority of study group after the 12-week exercise program. the results of the current study showed that breast cancer survivors who engaged in regular exercise reported higher quality of life and lower levels of fatigue after a 12-week exercise program. an aerobic exercise program is a potentially effective, low cost and safe intervention to manage fatigue and to improve QOL during adjuvant chemotherapy or radiation therapy for breast cancer. This health promoting self-care activity needs further testing in large randomized clinical trails

anticollagenolytic property of tetracycline: a potential therapeutic implication for juvenile periodontitis

This study was designed to evaluate the effect of systemic tetracycline administration as an adjunct to local therapy in localized juvenile periodontitis [LJP] patients. Sixteen patients [12 females and 4 males], aged 13-20 years, were included in this investigation. Clinical examination was carried out including gingival condition, pocket depth, attachment level and periapical radiographs for the affected sites. The treatment was performed in the form of scaling, root planning, soft tissue curettage under local anesthesia and periodontal surgery when indicated. Each patient received tetracycline 250 mg qds for 2 weeks concomitantly with the start of periodontal treatment. Revaluation of periodontal status was performed 3 and 6 months after treatment. The results revealed that most of patients exhibited resolution in gingival inflammation, gain of attachment, decreased probing depth and bone deposition or at least of bone resorption. In contrast 3 cases failed to respond to the combined therapy. However, the result of this investigation reinforced the use of combined systemic tetracycline administration and local therapy in LJP patients