Ultrasonographic Enthesopathy and Disease Activity in Psoriatic Arthritis

BACKGROUND: To our knowledge, the correlation between ultrasonographic enthesopathy and severity in psoriatic arthritis (PsA) has been done before. However, the correlation between ultrasonography of enthesopathy and the Psoriatic Arthritis Disease Activity Score (PASDAS) have not been done.AIM: To compare the results of ultrasonographic enthesopathy of foot and PASDAS in PsA.MATERIALS AND METHODS: A total of 65 PsA patients were involved and divided into two groups. The first group of 35 active PsA and the second group of 30 ages and sex matched inactive PsA as a control group were recruited in this study. Both groups were evaluated by examination, radiological findings and ultrasonography.RESULTS: Of 70 entheses in 35 active PsA patients, the most entheseal abnormalities were tender plantar fascia (18.5%), tender Achilles tendon (37.8%). PASDAS was a direct highly significant correlated with plantar fascia and Achilles tendon thickness in in active PsA (r = 0.823 and r = 0.796, p < 0.001 respectively).CONCLUSION: Musculoskeletal US is an accurate and low-cost method for assessment of enthesopathy with significant correlation to disease activities in psoriatic arthritis

Public Knowledge, Attitude and Practice of Complementary and Alternative Medicine in Riyadh Region, Saudi Arabia

 Objectives: Complementary and alternative medicine (CAM) iswell established world wide. The present work is aimed at studying the knowledge, attitude and practice of CAM by the people of Riyadh region, Saudi Arabia.Methods: A cross-sectional descriptive household survey studyof the people living in Riyadh city, as well as the surrounding governorates. A multistage random sample was taken from1st January to the end of March 2010, with a total number of 518 participants. Data were collected using a pre-designed questionnaire through direct interview. The data was collected based on socio-demography, as well as knowledge, attitude and practice of CAM.Results: Participants were nearly sex-matched, consisting of approximately 70�0Saudi and 30�0non-Saudis. About 89�0ofthe participants had some knowledge of CAM. Mass media e.g.(T.V., newspapers and radio) and family, relatives and friends represented the main sources of CAM knowledge, (46.5�0and46.3�0respectively). Nearly 85�0of participants or one of their family members has used some form of CAM before, and the most common users of CAM practices were females, housewives, and illiterate subjects (or those who could just read and write), as well as participants aged 60 years and above. Medical herbs (58.89� prayer (54� honey and bee products (54� hijama (35.71�nd cauterization or medical massage therapy (22�20were thecommonly used CAM practices. Most participants agreed that there are needs for; CAM practices (93.8� regulations for CAM(94.9� health education (96.6� specialized centers (94.8�20and CAM clinics (92.7� While only 8.3�0of participants usually discussed CAM with their physicians.Conclusion: There is a high prevalence and increased public interest in CAM use in the Riyadh region. There is a positiv eattitude towards CAM, yet most participants are reluctant to share and discuss CAM information with their physicians

Influence of adipocytokines and IL-6 on ankylosing spondylitis disease activity and functional status

AbstractAim of the workThis study aimed to assess serum levels of some adipocytokines (leptin, adiponectin and resistin) and IL-6 in patients with ankylosing spondylitis (AS) to evaluate their relationship to disease activity and functional capacity.Patient and methodTwenty-five AS patients were enrolled. Body mass index (BMI), Bath AS Disease Activity Index (BASDAI), Bath AS Functional Index (BASFI) and acute phase reactants, such as erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels, were assessed. Serum leptin, adiponectin, resistin and interleukin (IL)-6 levels were determined using enzyme-linked immunosorbent assay (ELISA).ResultsThe mean levels of leptin (9.1±3.9ng/ml), resistin (2.27±1.15ng/ml) and IL-6 (9.2±5.8pg/ml); were significantly elevated in patients with AS compared to the controls (p=0.000, p=0.0028 and p=0.000, respectively). Only serum leptin levels correlated significantly with IL-6 (p=0.004), and both serum leptin and IL-6 levels correlated significantly with BASDAI (p=0.02 and p=0.005, respectively), ESR (p=0.04) and CRP (p=0.01 and p=0.006, respectively) in AS patients. Serum resistin did not correlate with any of the AS disease parameters, whereas, serum adiponectin neither significantly elevated nor correlated with any of these parameters.ConclusionThe associations of significantly increased levels of serum leptin and IL-6 with AS disease activity parameters give clues to their role in the inflammatory process of the disease. Failure to find any correlation between high serum resistin levels and AS disease activity parameters is suggestive of its role in the pathogenesis rather than disease activity

Egyptian consensus on treat-to-target approach for osteoporosis: a clinical practice guideline from the Egyptian Academy of bone health and metabolic bone diseases

Abstract Background This study was carried out to achieve an Egyptian expert consensus on a treat-to-target management strategy for osteoporosis using Delphi technique. A scientific committee identified researchers and clinicians with expertise in osteoporosis in Egypt. Delphi process was implemented (2 rounds) to establish a consensus on 15 clinical standards: (1) concept, (2) diagnosis, (3) case identification, (4) whom to treat, (5) who should treat?, (6) case stratification and intervention thresholds, (7) falls risk, (8) investigations, (9) treatment target, (10) management, (11) optimum treatment duration, (12) monitoring, (13) drug holiday, (14) osteoporosis in men, and (15) post-fracture care and fracture liaison service. Results The surveys were sent to an expert panel (n = 25), of whom 24 participated in the two rounds. Respondents were drawn from different governorates and health centres across Egypt including the Ministry of Health. Most of the participants were rheumatologists (76%), followed by internists (8%), orthopaedic doctors (4%), rehabilitation doctors (4%), primary care (4%), and ortho-geriatrics (4%) physicians. Seventy-two recommendations, categorised into 15 sections, were obtained. Agreement with the recommendations (rank 7–9) ranged from 83.4 to 100%. Consensus was reached (i.e. ≥ 75% of respondents strongly agreed or agreed) on the wording of all 15 clinical standards identified by the scientific committee. An algorithm for the management of postmenopausal osteoporosis has been suggested. Conclusion A wide and representative panel of experts established a consensus regarding the management of osteoporosis in Egypt. The developed guidelines provide a comprehensive approach to the assessment and management of osteoporosis for all Egyptian healthcare professionals who are involved in its management