ABSTRACT
Objective: To determine the frequency of modifiable cardiovascular risk factors in the Pakistani cohort with Ankylosing Spondylitis (AS). Method: After IRB approval, a cross-sectional study was conducted among patients of AS, at the Department of Rheumatology Indus Medical College, Tando Mohammad Khan, from 15th March to 15th September, 2022. After obtaining demographic data, other parameters such as blood pressure (BP) and body mass index were recorded. In addition, a 5 ml blood sample was collected to assess their serum lipid profile, and fasting blood sugar levels. Using the laboratory data, the Framingham cardiovascular risk score was calculated for each patient and they were categorized into low, intermediate, or high-risk categories. Results: Total 131 cases of ankylosing spondylitis: frequency of modifiable risk factors were: obesity (75.6%), high TG level (62.6%), high risk FRS score (40.5%), high LDL level (38.1%), low HDL (34.4%), hypertension (30.5%), diabetes mellitus (26.7%), high cholesterol level (17.6%), smoking (16%). In univariate analysis AS cases shows that increasing disease duration was associated with more risk of modifiable risk factors (p<0.05), on multivariate analysis, a positive association of age, diastolic blood pressure, smoking, diabetes mellitus, DMARDS, herbal medication-but not statistically significant (p>0.05). Conclusion: In chronic AS there's higher prevalence of modifiable cardiovascular risk factors, earlier recognition and effective management helps in prevention of future cardiovascular events.
ABSTRACT
Objective: To perform ultrasound examination in un-resolving frozen shoulder disorder, in Pakistani cohort visiting rheumatology clinic. Methods: This cross sectional study was carried out at Department of Rheumatology, Indus Medical College Tando Mohhamad Khan, from 16th March 2022 to 30th October 2022. Patients diagnosed as unilateral frozen shoulder on clinical grounds and received intra-articular injection (s) in last six months, never been investigated, still persisting with pain and restricted range of shoulder motion were enrolled. After the demographic details and shoulder examination, ultrasound examination of both shoulder joints was performed by senior musculoskeletal radiologist, to know the exact diagnosis. Results: In 138 cases on ultrasound examination following injuries were noted: rotator cuff tendinopathy (RCT) (61%), adhesive capsulitis (21%), mixed lesion (rotator cuff tendinopathy and adhesive capsulitis) (14%).In age group < 50 years rotator cuff tendinopathy was the major lesion, while in cases >50 years age group: adhesive capsulitis (AC) was predominant lesion (p-0.05).Rotator cuff tendinopathy had significant association with supraspinatus tears (p<0.5). Conclusion: In Un-resolving frozen shoulder pain, ultrasound examination of involved joint helps in reaching the exact cause which may differ from the existing diagnosis and guides to further management.
ABSTRACT
Objective: To know the frequency of modifiable cardiovascular risk factors in knee osteoarthritis patients. Method: Cross sectional study was done at Department of Rheumatology Indus Medical College, Tando Mohammad Khan from March 25, 2022 to November 24, 2022. Total 246 Osteoarthritis of knee cases with (Kellgren-Lawrence grad-II and above) on x-ray, were selected after demographic details, blood pressure, body mass index and physical examination was done, 5ml of venous blood was drawn by phlebotomist, sent for fasting blood sugar, serum lipids analysis and Framingham 10years risk score was calculated afterward for each participant. Results: In this study males (126) and females (120). Overall (78%) had risk factors, Patients having one CVD risk factor were (22.8%), two risk factors in (21.1%), three in (21.5%), four (9.8%) and five factors in (1.6%) while frequency of modifiable cardiovascular risk shows obesity (45.5%) hypertension (40.2%) intermediate to high risk of framingham score (40%) diabetes mellitus (25%), smoking (17%), high low density lipoproteins (8.1%). In males obesity(54.2%), hypertension (47.5% ) and (45.8%) were on medication, diabetes mellitus(31.7%), smoker(31%), high risk FRS(39.2%), K-L grade-IV(58.4%) and in females: obesity (42%), hypertension (43.7%) and (40.5%) were on medication, diabetes mellitus in (19%), smoking (4%), high risk FRS (13.5%), K-L Grade-4 (42%), significant association of diabetes mellitus, smoking, FRS and K-L grades with gender (p<0.05). Conclusion: In OA knee there is high prevalence of modifiable cardiovascular risk factors and together these imposes a major health risk for future cardiac events and disability.
ABSTRACT
Objective: To determine the frequency of premature ejaculatory dysfunction in rheumatoid arthritis patients. Methods: After approval from IRB, cross sectional study was conducted from November 1st, 2020 to August 1st, 2021 at Department of Rheumatology, Indus Medical College, Pakistan. RA patients were included, written and informed consents were taken. Demographic data was noted and detailed history and examination was carried out. Each participant BMI and Blood pressure was measured. Afterward 5-ml of blood was drawn by a trained phlebotomist for CBC, ESR, fasting blood sugar levels, HBs Ag and anti HCV Antibody test.DAS-28 Calculator was used for RA clinical activity. Premature ejaculation diagnostic tool was used for the assessment of premature ejaculation. Results: Total 168 patients with mean age 32.27 (SD=±9.49) and mean disease duration of 6.35 (SD=±3.95) years were included,. Prevalence of premature ejaculation dysfunction was (44.6%), with mean PED of score 9.17 (SD=±5.23). Hypertension, HCV, Hakeem medications, use of DMARDS had positive association while High BMI and higher DAS-28 has negative association with PED (p<0.05). Conclusion: There is high prevalence of PED in RA, it needs proper evaluation, treatment and urgent research is needed to know more about it.
