Pyrazinamide-induced acute gouty arthritis: a case report

Gout is a common inflammatory and metabolic disease caused by the deposition of monosodium urate crystals in articular and non-articular tissues. Drugs used to treat tuberculosis, such as pyrazinamide and ethambutol, have been linked to hyperuricaemia. However, acute gout is uncommon. We report a case of a 28-year-old female who developed acute gouty arthritis of the left knee joint as a result of taking pyrazinamide as part of a tuberculosis therapy regimen. Although pyrazinamide-induced hyperuricemia is frequently regarded as asymptomatic, the clinician should be aware of the likelihood of acute gouty arthritis, which can result in significant morbidity and an impaired quality of life

Poncet’s disease (tuberculous rheumatism) in a Nigerian male: a frequently overlooked diagnosis

Poncet’s disease is an uncommon syndrome and a reactive polyarthritis associated with active tuberculosis with no evidence of mycobacterial infection of the joint. The condition is different from tuberculous arthritis which is usually monoarticular and caused by direct tubercular involvement of the joint. There has been a paucity of case reports on Poncet’s disease in Nigeria despite the high incidence of tuberculosis. We report a case of a 45-year male who presented with inflammatory polyarthritis involving the knees, wrists, ankles, small joints of the hands bilaterally of four weeks duration. This was preceded by three week’s history of productive cough. Chest radiograph and sputum Gene Xpert revealed features consistent with tuberculosis. Synovial fluid from knee joint effusion showed no evidence of mycobacterium tuberculosis. He was diagnosed to have Poncet’s disease based on the clinical findings and investigation results. He was commenced on antituberculous medications with complete resolution of symptoms after two months. Poncet’s disease is a rare manifestation of tuberculosis and should be considered a differential in any case of active tuberculosis presenting with arthritis. The correct and prompt identification of this condition by clinicians is important with the aim of instituting the appropriate therapy

Pattern and trends of respiratory diseases in an outpatient setting: a five-year review in a tertiary hospital in South-South, Nigeria

Background: Limited information exists on the epidemiology of respiratory diseases in South-South Nigeria, especially regarding changing risk factors. This study aimed to assess the frequency and pattern of respiratory diseases in an adult outpatient clinic in a teaching hospital in South-South Nigeria. Methods: Medical records of newly referred patients with respiratory diseases who received care at the chest clinic of Irrua Specialist Teaching Hospital from January 2018 to December 2022 were retrospectively reviewed. Results: The study included 655 patients (mean age: 54.7±18.7 years). The majority of cases occurred in the 41-60 age group, and 55.4% were female. Non-communicable respiratory diseases accounted for 60.9% of cases, while communicable respiratory diseases accounted for 39.1%. The most common respiratory diseases observed were bronchial asthma (22.6%), tuberculosis (21.1%), chronic obstructive pulmonary disease (19.2%), pneumonia (11.1%), interstitial lung diseases (6.7%), and lung cancer (4.1%). Less common respiratory diseases included pulmonary aspergilloma (1.5%), pleural-related diseases (0.8%), hypersensitivity pneumonitis (0.8%), and obstructive sleep apnoea syndrome (0.6%). The study's annual trend showed a gradual increase in the number of respiratory cases, reaching a low point in 2020. Significant differences were found in the age and gender distribution of the top six respiratory diseases (p <0.001). Conclusions: This study provides valuable insights into the demographic and disease patterns of respiratory diseases in an outpatient setting, informing targeted prevention and treatment measures for these conditions

Prevalence and pattern of soft‐tissue rheumatism in a rural community in South‐South Nigeria: A cross‐sectional survey

Abstract Background Soft tissue rheumatism arises from the pathology of periarticular structures. They are marked by pain and disability. Epidemiological studies in sub‐Saharan Africa are sparse. This study aimed to determine the epidemiology of soft‐tissue rheumatism in a rural community in South‐South Nigeria. Methods This was a community‐based, cross‐sectional study conducted from February to July 2017 in South‐South Nigeria among 319 participants using the Community Oriented Program for the Control of Rheumatic Diseases (COPCORD) methodology. Participants aged 18 years and older were included in the study. Subjects reporting positive musculoskeletal pain were examined for specific soft tissue rheumatism. The diagnosis was based on established criteria. Results The mean age of the study population was 48.87 ± 19.58 years. The prevalence of soft‐tissue rheumatism was 11.0% (35/319). Soft tissue rheumatism was more prevalent in females (24, 68.6%) than in males (11, 31.4%). The most common form of soft‐tissue rheumatism diagnosed was adhesive capsulitis (20.0%), closely followed by rotator cuff tendinitis (14.3%), carpal tunnel syndrome (14.3%), and plantar fasciitis (14.3%). Age (p = 0.06), body mass index (p = 0.034), and dyslipidemia (p = 0.028) were significantly associated with the prevalence of soft‐tissue rheumatism. A significant disability index (HAQ‐DI ≥ 1) was recorded in 40.0% of participants with soft tissue rheumatism. Twelve (34.3%) participants with soft‐tissue rheumatism attributed the disorder to their work, and 74.3% used hospital‐prescribed medications for treatment. Conclusion Soft‐tissue rheumatism is associated with a significant disability affecting activities of daily living. Factors associated with its prevalence include increasing age and obesity

Epidemiology of low back pain: frequency, risk factors, and patterns in South-South Nigeria

Introduction Low back pain (LBP) is a prevalent musculoskeletal condition that poses significant public health challenges. However, its epidemiology in Sub-Saharan Africa, especially in rural settings, remains largely unexplored. This study aimed to determine the epidemiology of LBP in a Nigerian Teaching Hospital. Material and methods This was a retrospective review of the records of all LBP cases seen at the rheumatology clinic from 2018 to 2022 in a Teaching Hospital in South-South Nigeria. The sociodemographic and clinical data, including disability scores, was extracted from the patients’ medical records. The data was analyzed using IBM SPSS version 25, and the level of significance was set at p < 0.05. Results Among 1,580 patients, 319 (20.2%) reported LBP. The mean age was 59.51 ±10.21, and the peak age incidence was 51–60 years. Low back pain was more prevalent in females (61.4%). Work-related factors (47.3%) such as heavy lifting (26.3%), prolonged sitting (19.4%), and poor posture (27.9%) were the prominent risk factors. Sedentary behavior (11.5%) and obesity (16.9%) contributed. Common clinical manifestations included difficulty standing or bending (73%), walking difficulties (67.7%), sleep disturbances (51.4%), and radicular pain (45.8%). Common etiologies were spondylosis (66.5%), spondylolisthesis (22.3%), disc prolapse (19.4%), spinal canal stenosis (15.4%), muscle spasm (12.2%), and tuberculous spondylitis (9.7%). Acute and chronic LBP constituted 12.2% and 79.9% of cases, respectively. In terms of disability, 33.5% had minimal, 44.5% had moderate, 15.4% had severe, and 6.6% had crippling disabilities. Conclusions Mechanical causes were the most implicated in LBP. Work-related factors and lifestyle choices contribute to the occurrence of LBP. Adjusting posture and lifestyle modification reduces LBP risk. Understanding its epidemiology is crucial for optimizing care and implementing preventive strategies

Long-term safety of COVID vaccination in individuals with idiopathic inflammatory myopathies: results from the COVAD study

Limited evidence on long-term COVID-19 vaccine safety in patients with idiopathic inflammatory myopathies (IIMs) continues to contribute to vaccine hesitancy. We studied delayed-onset vaccine adverse events (AEs) in patients with IIMs, other systemic autoimmune and inflammatory disorders (SAIDs), and healthy controls (HCs), using data from the second COVID-19 Vaccination in Autoimmune Diseases (COVAD) study. A validated self-reporting e-survey was circulated by the COVAD study group (157 collaborators, 106 countries) from Feb-June 2022. We collected data on demographics, comorbidities, IIM/SAID details, COVID-19 history, and vaccination details. Delayed-onset (> 7 day) AEs were analyzed using regression models. A total of 15165 respondents undertook the survey, of whom 8759 responses from vaccinated individuals [median age 46 (35-58) years, 74.4% females, 45.4% Caucasians] were analyzed. Of these, 1390 (15.9%) had IIMs, 50.6% other SAIDs, and 33.5% HCs. Among IIMs, 16.3% and 10.2% patients reported minor and major AEs, respectively, and 0.72% (n = 10) required hospitalization. Notably patients with IIMs experienced fewer minor AEs than other SAIDs, though rashes were expectedly more than HCs [OR 4.0; 95% CI 2.2-7.0, p < 0.001]. IIM patients with active disease, overlap myositis, autoimmune comorbidities, and ChadOx1 nCOV-19 (Oxford/AstraZeneca) recipients reported AEs more often, while those with inclusion body myositis, and BNT162b2 (Pfizer) recipients reported fewer AEs. Vaccination is reassuringly safe in individuals with IIMs, with AEs, hospitalizations comparable to SAIDs, and largely limited to those with autoimmune multimorbidity and active disease. These observations may inform guidelines to identify high-risk patients warranting close monitoring in the post-vaccination period

COVAD survey 2 long-term outcomes: unmet need and protocol

Vaccine hesitancy is considered a major barrier to achieving herd immunity against COVID-19. While multiple alternative and synergistic approaches including heterologous vaccination, booster doses, and antiviral drugs have been developed, equitable vaccine uptake remains the foremost strategy to manage pandemic. Although none of the currently approved vaccines are live-attenuated, several reports of disease flares, waning protection, and acute-onset syndromes have emerged as short-term adverse events after vaccination. Hence, scientific literature falls short when discussing potential long-term effects in vulnerable cohorts. The COVAD-2 survey follows on from the baseline COVAD-1 survey with the aim to collect patient-reported data on the long-term safety and tolerability of COVID-19 vaccines in immune modulation. The e-survey has been extensively pilot-tested and validated with translations into multiple languages. Anticipated results will help improve vaccination efforts and reduce the imminent risks of COVID-19 infection, especially in understudied vulnerable groups