RESUMO
Objective: To determine the frequency of cognitive dysfunction in patients with Systemic Lupus Erythematosus in a Pakistani population, presenting at a tertiary care Rheumatology setting
Methods: This cross-sectional study was conducted at the Division of Rheumatology, Fatima Memorial Hospital, Lahore, from March to June 2016. A total of 43 consecutive patients, who fulfilled the 2012 SLICC [Systemic Lupus International Collaborating Clinics] classification criteria for Systemic Lupus Erythematosus [SLE], were enrolled. Cognitive function was assessed using Montréal Cognitive Assessment [MoCA] questionnaire. Demographic data and disease dynamics were collected in a proforma. Cognitive dysfunction was defined as score < 26/30, adjusted for duration of formal education. SPSS version 16.0 for windows was used to analyse data and to calculate frequency of cognitive dysfunction
Results: Out of 43 enrolled patients, 95.3% were females and 4.7% were males, with mean age of 28.72 +/- 9.25 years and mean formal education duration of 10.98 +/- 3.29 years. The mean disease duration was 24.21 +/- 30.46 months. Anti-nuclear antibodies [ANA] were present in all patients and anti-ds DNA in 93% patients. Cognitive dysfunction according to MoCA score was found in 65.1% [n=28] patients. For patients with disease duration more than two years, cognitive dysfunction was found in 60% patients [p>0.05] and for duration of formal education less than 12 years in 74.1% patients [p>0.05]
Conclusion: In this study, two third of SLE patients had Cognitive dysfunction. Hence, there is an increasing need to recognise and initiate early therapy for this overlooked aspect of SLE with an aim to achieve better quality of life
RESUMO
To determine the level of depression in Rheumatoid Arthritis and its relationship with severity of Rheumatoid Arthritis. This cross sectional analytical study was conducted from March 2014 to May 2014. Total 102 cases of Rheumatoid Arthritis [RA] diagnosed as per ACR [American College of Rheumatology] 1987 criteria were enrolled from Rheumatology Department, Fatima Memorial Hospital. Severity of Rheumatoid Arthritis was assessed by Health Assessment Questionnaire [HAQ] and disease activity score [DAS - 28] while severity of depression was measured by Beck Depression Inventory [BDI] scale II questionnaire. The relationship between depression and disease activity [severity] of Rheumatoid Arthritis was assessed by calculating correlation coefficient between depression, disease activity score [DAS 28] of Rheumatoid Arthritis and health assessment questionnaire [HAQ]. Out of 102 patients, 77 [75.5%] were females and 25 [24.5%] males. The mean age of patients was 43.5 +/- 11.9 years and the mean duration of disease was 7.8 +/- 5.5 years.71.5% of Rheumatoid Arthritis patients were found to have some degree of depression and this was directly related to the severity of disease. Moderate and severe depression were present in 23 [22.5%] and 19 [18.6%] patients respectively. In this study, almost three-fourths of Rheumatoid Arthritis patients were found to have depression. There was a strong association between Rheumatoid Arthritis disease activity and the level of depression. So it is imperative for clinicians treating Rheumatoid Arthritis patients to screen them for co morbid depression and manage it accordingly