Pub Date : 2023-07-01DOI: 10.4103/injr.injr_155_22
B. Vaishnav, Swapnil Patil, Nirali Thakkar, Pragya Sharma
{"title":"Coexistence of pancytopenia due to autoimmune myelofibrosis and seizures as presenting complaints in a newly diagnosed case of systemic lupus erythematosus – An interesting combination","authors":"B. Vaishnav, Swapnil Patil, Nirali Thakkar, Pragya Sharma","doi":"10.4103/injr.injr_155_22","DOIUrl":"https://doi.org/10.4103/injr.injr_155_22","url":null,"abstract":"","PeriodicalId":54167,"journal":{"name":"Indian Journal of Rheumatology","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48931534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-01DOI: 10.4103/injr.injr_128_23
M. Adarsh, Ananya Sharma, Aman Sharma
{"title":"Comorbidities in psoriatic arthritis need more attention","authors":"M. Adarsh, Ananya Sharma, Aman Sharma","doi":"10.4103/injr.injr_128_23","DOIUrl":"https://doi.org/10.4103/injr.injr_128_23","url":null,"abstract":"","PeriodicalId":54167,"journal":{"name":"Indian Journal of Rheumatology","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44708984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-01DOI: 10.4103/injr.injr_277_21
Debanjana Chowdhury, Sangita Sen, Tibar Banerjee
Background: Carpal tunnel release operation (CTR) is required to alleviate the symptoms of carpal tunnel syndrome (CTS), the most common entrapment neuropathy. Methods: Thirty-two patients (39 hands) of CTS were subdivided into Group I is moderate CTS (n = 9 hands), Group II is severe CTS (n = 14 hands), and Group III is extreme CTS (n = 16 hands) and underwent conventional electrophysiological evaluation and short segment transcarpal nerve conduction studies preoperatively and 1 and 3 months after open CTR operation. Results: In the case of motor conduction parameter, distal motor latency showed statistically significant improvement after 1 month of CTR (P < 0.05) in all three groups of patients, and improvement consistently increased during 3rd month follow-up (P < 0.001). In Group III patients, preoperatively forearm motor conduction velocity (FMCV) and transcarpal motor conduction velocity (TMCV) were nonrecordable, FMCV became recordable in 6 hands, while TMCV in all 16 hands post CTR. In case sensory parameters, both distal sensory latency (DSL) and sensory nerve conduction velocity (SNCV) showed significant improvement in Group I, and no improvement was noted in Group III patients. Group II (6 of 14 hands) patients showed a reappearance of DSL and SNCV at 1-month follow-up and continued a steady improvement in 3rd month after CTR. Conclusion: We found that TMCV is a more sensitive parameter in assessing improvement of median nerve function after CTR. It is possible to identify patients with a poor outcome by performing electrophysiological studies.
{"title":"Neuroelectrophysiological evaluation of carpal tunnel syndrome before and after surgical intervention","authors":"Debanjana Chowdhury, Sangita Sen, Tibar Banerjee","doi":"10.4103/injr.injr_277_21","DOIUrl":"https://doi.org/10.4103/injr.injr_277_21","url":null,"abstract":"Background: Carpal tunnel release operation (CTR) is required to alleviate the symptoms of carpal tunnel syndrome (CTS), the most common entrapment neuropathy. Methods: Thirty-two patients (39 hands) of CTS were subdivided into Group I is moderate CTS (n = 9 hands), Group II is severe CTS (n = 14 hands), and Group III is extreme CTS (n = 16 hands) and underwent conventional electrophysiological evaluation and short segment transcarpal nerve conduction studies preoperatively and 1 and 3 months after open CTR operation. Results: In the case of motor conduction parameter, distal motor latency showed statistically significant improvement after 1 month of CTR (P < 0.05) in all three groups of patients, and improvement consistently increased during 3rd month follow-up (P < 0.001). In Group III patients, preoperatively forearm motor conduction velocity (FMCV) and transcarpal motor conduction velocity (TMCV) were nonrecordable, FMCV became recordable in 6 hands, while TMCV in all 16 hands post CTR. In case sensory parameters, both distal sensory latency (DSL) and sensory nerve conduction velocity (SNCV) showed significant improvement in Group I, and no improvement was noted in Group III patients. Group II (6 of 14 hands) patients showed a reappearance of DSL and SNCV at 1-month follow-up and continued a steady improvement in 3rd month after CTR. Conclusion: We found that TMCV is a more sensitive parameter in assessing improvement of median nerve function after CTR. It is possible to identify patients with a poor outcome by performing electrophysiological studies.","PeriodicalId":54167,"journal":{"name":"Indian Journal of Rheumatology","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42364590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
V. Shobha, K. Chanakya, S. Chandrashekara, Sharath Kumar, V. Haridas, Vijay K R Rao, R. Jois, M. Daware, Y. Singh, Shweta Singhai, B. Dharmanad, P. Chebbi, Subramanian Ramaswamy, A. Kamath, Uma Karjiigi, V. Jain, Chethana Dharmaplaiah, S. Prasad, C. Srinivas, R. Janardana, B. Pinto, Beenish Nazir, A. Harshini, Mahendranath
Introduction: Comorbidities frequently accompany psoriasis and psoriatic arthritis (PsA) and add to the disease burden. We aimed to identify the comorbidity burden in patients with PsA and evaluate its impact on the disease activity measures in our geographic region. Methods: This was a multicenter, cross-sectional study involving consecutive PsA patients from 17 rheumatology centers. Their disease variables and comorbidities were recorded. Results: In 549 enrolled patients, the mean age was 39.2 (14.9) years, with male predominance (6:5). The mean duration of PsA was 63.1 (76.3) months and 232 (42.3%) patients had one or more comorbidities. Dyslipidemia was the most prevalent comorbidity, followed by hypertension (HTN) (19.8%) and diabetes (16.6%). About 39% of patients were overweight and 18% were obese. Smoking, ischemic heart disease, hypothyroidism, osteoarthritis, depression, anxiety, and fractures were seen in <5% of the cohort. Increasing age, longer duration of psoriasis, a family history of cardiovascular disease (CVD) or stroke, smoking, alcohol consumption, and higher waist circumference were associated with the presence of one or more comorbidities. Overall, 104 (18.9%) patients needed hospitalization for various comorbidities. Infections accounted for 59 (10.8%), of which skin (23) was the most common site, followed by urinary tract (6) and lung (4). Conclusions: More than 40% of PsA patients have comorbidities. Dyslipidemia, HTN, diabetes, and obesity were most prevalent, putting these patients at risk for CVDs. Active screening for these comorbidities is crucial for providing comprehensive care to these patients.
{"title":"Comorbidity burden in psoriatic arthritis and its impact on disease measures","authors":"V. Shobha, K. Chanakya, S. Chandrashekara, Sharath Kumar, V. Haridas, Vijay K R Rao, R. Jois, M. Daware, Y. Singh, Shweta Singhai, B. Dharmanad, P. Chebbi, Subramanian Ramaswamy, A. Kamath, Uma Karjiigi, V. Jain, Chethana Dharmaplaiah, S. Prasad, C. Srinivas, R. Janardana, B. Pinto, Beenish Nazir, A. Harshini, Mahendranath","doi":"10.4103/injr.injr_29_22","DOIUrl":"https://doi.org/10.4103/injr.injr_29_22","url":null,"abstract":"Introduction: Comorbidities frequently accompany psoriasis and psoriatic arthritis (PsA) and add to the disease burden. We aimed to identify the comorbidity burden in patients with PsA and evaluate its impact on the disease activity measures in our geographic region. Methods: This was a multicenter, cross-sectional study involving consecutive PsA patients from 17 rheumatology centers. Their disease variables and comorbidities were recorded. Results: In 549 enrolled patients, the mean age was 39.2 (14.9) years, with male predominance (6:5). The mean duration of PsA was 63.1 (76.3) months and 232 (42.3%) patients had one or more comorbidities. Dyslipidemia was the most prevalent comorbidity, followed by hypertension (HTN) (19.8%) and diabetes (16.6%). About 39% of patients were overweight and 18% were obese. Smoking, ischemic heart disease, hypothyroidism, osteoarthritis, depression, anxiety, and fractures were seen in <5% of the cohort. Increasing age, longer duration of psoriasis, a family history of cardiovascular disease (CVD) or stroke, smoking, alcohol consumption, and higher waist circumference were associated with the presence of one or more comorbidities. Overall, 104 (18.9%) patients needed hospitalization for various comorbidities. Infections accounted for 59 (10.8%), of which skin (23) was the most common site, followed by urinary tract (6) and lung (4). Conclusions: More than 40% of PsA patients have comorbidities. Dyslipidemia, HTN, diabetes, and obesity were most prevalent, putting these patients at risk for CVDs. Active screening for these comorbidities is crucial for providing comprehensive care to these patients.","PeriodicalId":54167,"journal":{"name":"Indian Journal of Rheumatology","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43344250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-01DOI: 10.4103/injr.injr_118_22
H. Quiñones-Moya, Armando Valle, A. Camargo-Coronel, F. Jiménez-Balderas, Miriam Bernal-Enriquez, Pedro Madinabeitia-Rodríguez, Kenia Morales-Medino, Cynthia Roque-Ibanez, M. Hernandez-Zavala
Background: Special attention has been paid to the sequelae caused by SARS-CoV 2 infection (Long-COVID), the prevalence of these sequelae in patients with rheumatological diseases has not been studied in detail. As these patients have immunosuppressive therapy and this syndrome has inflammatory characteristics, we postulate that these patients will have a lower prevalence of sequelae. Methods: We conducted a retrospective, cross-sectional, single-center study in which we interrogated all the patients who had the diagnosis of rheumatological diseases who attended our hospital between August 1, 2021 and November 30 and who had a history of 3 or more months of SARS CoV2 infection. The interrogation consisted of a brief questionnaire on the persistence of symptoms 3 months after the event. Results: We included 64 patients: 19 patients with rheumatoid arthritis (RA), 21 patients with systemic lupus erythematosus (SLE), and 24 with other rheumatological diseases. Long COVID symptoms reported were similar to those described in the literature of patients without rheumatic diseases. The prevalence of fatigue was significantly lower in SLE compared to RA and the rest of the pathologies, but there were no other significant differences between them. Conclusions: The long COVID syndrome is common in patients with and without rheumatic diseases, and the prevalence of each of these symptoms differs little between these groups. A lower prevalence of post-COVID symptoms was seen in patients with SLE than in the rest of the rheumatological diseases, but after we run a binary logistic regression model, most of these differences were not significant and they did not differ much from the general population.
{"title":"Long COVID in patients with rheumatologic disease: A single center observational study","authors":"H. Quiñones-Moya, Armando Valle, A. Camargo-Coronel, F. Jiménez-Balderas, Miriam Bernal-Enriquez, Pedro Madinabeitia-Rodríguez, Kenia Morales-Medino, Cynthia Roque-Ibanez, M. Hernandez-Zavala","doi":"10.4103/injr.injr_118_22","DOIUrl":"https://doi.org/10.4103/injr.injr_118_22","url":null,"abstract":"Background: Special attention has been paid to the sequelae caused by SARS-CoV 2 infection (Long-COVID), the prevalence of these sequelae in patients with rheumatological diseases has not been studied in detail. As these patients have immunosuppressive therapy and this syndrome has inflammatory characteristics, we postulate that these patients will have a lower prevalence of sequelae. Methods: We conducted a retrospective, cross-sectional, single-center study in which we interrogated all the patients who had the diagnosis of rheumatological diseases who attended our hospital between August 1, 2021 and November 30 and who had a history of 3 or more months of SARS CoV2 infection. The interrogation consisted of a brief questionnaire on the persistence of symptoms 3 months after the event. Results: We included 64 patients: 19 patients with rheumatoid arthritis (RA), 21 patients with systemic lupus erythematosus (SLE), and 24 with other rheumatological diseases. Long COVID symptoms reported were similar to those described in the literature of patients without rheumatic diseases. The prevalence of fatigue was significantly lower in SLE compared to RA and the rest of the pathologies, but there were no other significant differences between them. Conclusions: The long COVID syndrome is common in patients with and without rheumatic diseases, and the prevalence of each of these symptoms differs little between these groups. A lower prevalence of post-COVID symptoms was seen in patients with SLE than in the rest of the rheumatological diseases, but after we run a binary logistic regression model, most of these differences were not significant and they did not differ much from the general population.","PeriodicalId":54167,"journal":{"name":"Indian Journal of Rheumatology","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42196934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-05DOI: 10.4103/injr.injr_159_22
Saba Saif, Spenta Kakalia, Rizwana Kitchlew, H. Khan, M. U. Sarwar
{"title":"Translation and Validation of the Urdu Version of the Methotrexate Intolerance Severity Score in Patients with Inflammatory Arthritis","authors":"Saba Saif, Spenta Kakalia, Rizwana Kitchlew, H. Khan, M. U. Sarwar","doi":"10.4103/injr.injr_159_22","DOIUrl":"https://doi.org/10.4103/injr.injr_159_22","url":null,"abstract":"","PeriodicalId":54167,"journal":{"name":"Indian Journal of Rheumatology","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45706584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-27DOI: 10.4103/injr.injr_187_22
S. Nalloor, Rajesh Puttur Pooja, B. S. Prasad, H. V. Vijay, P. ChandraShekar
{"title":"Diabetic Myonecrosis: A Single-Center Experience","authors":"S. Nalloor, Rajesh Puttur Pooja, B. S. Prasad, H. V. Vijay, P. ChandraShekar","doi":"10.4103/injr.injr_187_22","DOIUrl":"https://doi.org/10.4103/injr.injr_187_22","url":null,"abstract":"","PeriodicalId":54167,"journal":{"name":"Indian Journal of Rheumatology","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46493305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
V. Konda, Sirisha Kommireddy, D. Anil, R. Murugan, G. Kumar, G. Yadav, M. Kousalya
{"title":"Medication Adherence and its Association with Socioeconomic Factors and Quality of Life in Patients with Rheumatoid Arthritis","authors":"V. Konda, Sirisha Kommireddy, D. Anil, R. Murugan, G. Kumar, G. Yadav, M. Kousalya","doi":"10.4103/injr.injr_88_22","DOIUrl":"https://doi.org/10.4103/injr.injr_88_22","url":null,"abstract":"","PeriodicalId":54167,"journal":{"name":"Indian Journal of Rheumatology","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43484703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-01DOI: 10.4103/injr.injr_197_21
Harpreet Singh, Kusum Yadav, Ritu Sangwan
Background: Fatigue affects 40%–80% patients of rheumatoid arthritis (RA), impairing their quality of life. Objectives: The aim of this study was to assess fatigue by means of Bristol RA Fatigue Multidimensional Questionnaire score (BRAF-MDQ) and correlate it with the disease activity of RA patients. One hundred RA patients (as per American College of rheumatology 1987 criteria) having no underlying other chronic disease were evaluated at baseline (M0), 1 month (M1), and 3 months (M3) for fatigue (using BRAF-MDQ) and disease activity Disease Activity Index 28 (DAS-28) and Clinical Disease Activity Index (CDAI). The correlation between fatigue score and disease activity score was evaluated. Results: Fatigue score (BRAF-MDQ) decreased from 19.28 ± 13.846 at baseline to 17.46 ± 13.56 at M1 and 13.27 ± 11.633 at M3, respectively (P < 0.001). Similarly, there was significant decrease in disease activity of DAS-28 from 4.439 ± 1.41 at baseline to 3.715 ± 1.655 at M1 and 3.668 ± 1.46 at M3; while CDAI reduced from 18.82 ± 14.314 at baseline to 14.16 ± 12.611 at M1 and 11.65 ± 11.769 at M3, respectively (P < 0.001). There was a positive significant correlation (P value < 0.001) between BRAF-MDQ score and DAS-28 score (r = 0.503; 0.687 and 0.680) and CDAI score (r = 0.642,0.728 and 0.732) at baseline, 1 month, and 3 months, respectively. Multivariate analysis showed that CDAI (M0) was a significant factor affecting BRAF-MOQ score at follow-up of 3 months (M3) with beta coefficient of 0.872, P < 0.0001. Conclusion: The results of the present study indicate that fatigue quantum is related to disease activity and should be evaluated at the time of diagnosis. BRAF-MDQ is a simple, yet effective patient reported outcome questionnaire which assessed the fatigue quantum. Routine assessment of fatigue through BRAF-MDQ along with assessment of disease activity will be a holistic approach in management of RA.
{"title":"Assessment of correlation of fatigue in patients of rheumatoid arthritis using bristol rheumatoid arthritis fatigue multidimensional questionnaire score with disease activity – An Indian experience","authors":"Harpreet Singh, Kusum Yadav, Ritu Sangwan","doi":"10.4103/injr.injr_197_21","DOIUrl":"https://doi.org/10.4103/injr.injr_197_21","url":null,"abstract":"Background: Fatigue affects 40%–80% patients of rheumatoid arthritis (RA), impairing their quality of life. Objectives: The aim of this study was to assess fatigue by means of Bristol RA Fatigue Multidimensional Questionnaire score (BRAF-MDQ) and correlate it with the disease activity of RA patients. One hundred RA patients (as per American College of rheumatology 1987 criteria) having no underlying other chronic disease were evaluated at baseline (M0), 1 month (M1), and 3 months (M3) for fatigue (using BRAF-MDQ) and disease activity Disease Activity Index 28 (DAS-28) and Clinical Disease Activity Index (CDAI). The correlation between fatigue score and disease activity score was evaluated. Results: Fatigue score (BRAF-MDQ) decreased from 19.28 ± 13.846 at baseline to 17.46 ± 13.56 at M1 and 13.27 ± 11.633 at M3, respectively (P < 0.001). Similarly, there was significant decrease in disease activity of DAS-28 from 4.439 ± 1.41 at baseline to 3.715 ± 1.655 at M1 and 3.668 ± 1.46 at M3; while CDAI reduced from 18.82 ± 14.314 at baseline to 14.16 ± 12.611 at M1 and 11.65 ± 11.769 at M3, respectively (P < 0.001). There was a positive significant correlation (P value < 0.001) between BRAF-MDQ score and DAS-28 score (r = 0.503; 0.687 and 0.680) and CDAI score (r = 0.642,0.728 and 0.732) at baseline, 1 month, and 3 months, respectively. Multivariate analysis showed that CDAI (M0) was a significant factor affecting BRAF-MOQ score at follow-up of 3 months (M3) with beta coefficient of 0.872, P < 0.0001. Conclusion: The results of the present study indicate that fatigue quantum is related to disease activity and should be evaluated at the time of diagnosis. BRAF-MDQ is a simple, yet effective patient reported outcome questionnaire which assessed the fatigue quantum. Routine assessment of fatigue through BRAF-MDQ along with assessment of disease activity will be a holistic approach in management of RA.","PeriodicalId":54167,"journal":{"name":"Indian Journal of Rheumatology","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48218566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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