Damage index in childhood-onset systemic lupus erythematosus in Egypt

<p>Abstract</p> <p>Background</p> <p>To investigate the prevalence of cumulative organ damage among Egyptian children with juvenile-onset systemic lupus erythematosus (jSLE) and the relationships between the organ damage and the demographic data, clinical variables, and disease activity.</p> <p>Methods</p> <p>A total of 148 patients with jSLE have been followed in the pediatric rheumatology clinic and section at Cairo University. These patients were evaluated by retrospective chart review. The organ system damage due to SLE was measured using the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI). Risk factors for damage were also studied including demographic criteria as well as clinical and laboratory manifestations.</p> <p>Results</p> <p>Overall, 43.9% of the patients had damage within a mean of 6.57 ± 3.59 years of disease diagnosis. Neuropsychiatric (NPS-21%) and renal (16.9%) system involvement were observed most frequently, followed by cardiovascular (11.5%), skin (9.5%), pulmonary (6.1%), and ocular (4.8%), with a mean SDI score of 0.93 ± 1.37. In our study, the presence of neuropsychiatric manifestations at diagnosis showed the strongest association with the presence of later disease damage.</p> <p>The number of SLE diagnostic criteria at presentation was strongly associated with the total SDI score, and the renal damage was significantly more prevalent in patients with age at disease diagnosis below 10 years of age. A higher mean disease duration was found in patients with musculoskeletal damage.</p> <p>Conclusion</p> <p>We found that cumulative organ damage, as measured by the SDI, was present in 43.9% of Egyptian patients with juvenile-onset SLE. The damage was significantly more likely in patients who had more SLE diagnostic criteria at time of disease presentation and NPS manifestations at the time of diagnosis.</p

Production and Immobilization of Halophilic Invertase Produced from Honey Isolate Aspergillus niger EM77 (KF774181)

Honey isolate Aspergillus niger EM77 was a good halophilic invertase producer in the presence of wheat bran as a complete medium (114.55 U/g), using solid state fermentation technique. Different parameters influence the enzyme productivity such as different pH values, temperature, incubation period, nitrogen and carbon sources were investigated. The optimum pH, temperature and incubation period for enzyme production were 5.5, 30oC and 72 hrs, respectively. Sucrose at 2 % was more suitable carbon source for invertase production (144.39 U/g) and (NH4)2SO4 at 0.15 % was the ideal nitrogen source. Among different metals ions MnSO4 enhanced the enzyme productivity than other tested ions to 194.71 U/g. The partially purified enzyme was successfully entrapped in polyvinyl alcohol sponge shielded with agar starch layer (PVAsp Gs) and achieved 71% immobilization yield. The optimum conditions for immobilization were: pH 5.2, an incubation time of 15 min and a protein concentration of 250 mg/ml. Immobilized enzyme was reused 12 times with 29% activity loss. The free enzyme lost its activity completely at 70˚C after 45 minute and the immobilized form retained 80% of its activity at the same condition.The free and immobilized form reported extreme halophilic property since the highest enzyme activity was obtained between 3.5- 5 M

Epidemiology and demographics of juvenile idiopathic arthritis in Africa and Middle East

Juvenile Idiopathic Arthritis (JIA) is a group of chronic heterogenous disorders that manifests as joint inflammation in patients aged <16 years. Globally, approximately 3 million children and young adults are suffering from JIA with prevalence rates consistently higher in girls. The region of Africa and Middle East constitute a diverse group of ethnicities, socioeconomic conditions, and climates which influence the prevalence of JIA. There are only a few studies published on epidemiology of JIA in the region. There is an evident paucity of adequate and latest data from the region. This review summarizes the available data on the prevalence of JIA and its subtypes in Africa and Middle East and discusses unmet needs for patients in this region. A total of 8 journal publications were identified concerning epidemiology and 42 articles describing JIA subtypes from Africa and Middle East were included. The prevalence of JIA in Africa and Middle East was observed to be towards the lower range of the global estimate. We observed that the most prevalent subtype in the region was oligoarticular arthritis. The incidence of uveitis and anti-nuclear antibody (ANA) positivity were found to be lower as compared to the incidence from other regions. There is a huge unmet medical need in the region for reliable epidemiological data, disease awareness, having regional and local treatment guidelines and timely diagnosis. Paucity of the pediatric rheumatologists and economic disparities also contribute to the challenges regarding the management of JIA

Seeing revolution non-linearly: www.filmingrevolution.org

Filming Revolution, launched in 2015, is an online interactive data base documentary tracing the strands and strains of independent (mostly) documentary filmmaking in Egypt since the revolution. Consisting of edited interviews with 30 filmmakers, archivists, activists, and artists based in Egypt, the website is organised by the themes that emerged from the material, allowing the viewer to engage in an unlimited set of “curated dialogues” about issues related to filmmaking in Egypt since 2011. With its constellatory interactive design, Filming Revolution creates as much as documents a community of makers, as it attempts to grapple with approaches to filmmaking in the wake of such momentous historical events. The non-hierarchical polysemous structure of the project is meant to echo the rhizomatic, open-ended aspect of the revolution and its aftermath, in yet another affirmation and instantiation of contemporary civil revolution as a non-linear, ever-unfolding, on-going, event

Defining criteria for disease activity states in systemic juvenile idiopathic arthritis based on the systemic Juvenile Arthritis Disease Activity Score

Objective To develop and validate cutoff values in the systemic Juvenile Arthritis Disease Activity Score 10 (sJADAS10) that distinguish the states of inactive disease (ID), minimal disease activity (MiDA), moderate disease activity (MoDA), and high disease activity (HDA) in children with systemic juvenile idiopathic arthritis (sJIA), based on subjective disease state assessment by the treating pediatric rheumatologist. Methods The cutoffs definition cohort was composed of 400 patients enrolled at 30 pediatric rheumatology centers in 11 countries. Using the subjective physician rating as an external criterion, 6 methods were applied to identify the cutoffs: mapping, calculation of percentiles of cumulative score distribution, Youden index, 90% specificity, maximum agreement, and ROC curve analysis. Sixty percent of the patients were assigned to the definition cohort and 40% to the validation cohort. Cutoff validation was conducted by assessing discriminative ability. Results The sJADAS10 cutoffs that separated ID from MiDA, MiDA from MoDA, and MoDA from HDA were ≤ 2.9, ≤ 10, and > 20.6. The cutoffs discriminated strongly among different levels of pain, between patients with or without morning stiffness, and between patients whose parents judged their disease status as remission or persistent activity/flare or were satisfied or not satisfied with current illness outcome. Conclusion The sJADAS cutoffs revealed good metrologic properties in both definition and validation cohorts, and are therefore suitable for use in clinical trials and routine practice

Rheumatoid arthritis activity and severity in relation to commonly used contraceptive methods in a cohort of Egyptian female patients

International audienc

Rheumatoid arthritis activity and severity in relation to commonly used contraceptive methods in a cohort of Egyptian female patients

International audienc

Frequency of vitamin D inadequacy among Saudi males visiting a Rheumatology Outpatient Clinic of a tertiary hospital in Al-Qassim region: Effect of vitamin D supplementation

Background: Vitamin D inadequacy (deficiency and insufficiency) has become an epidemic with the assumption that women in Arab countries are at a higher risk due to their clothing style of wearing dark colored suits or a veil. Aim of the work: To determine the frequency of vitamin D inadequacy among young adult and early middle-aged males in Al-Qassim region and to study the effect of vitamin D supplementation. Patients and methods: Sixty Saudi males visiting Rheumatology Outpatient Clinic of a tertiary hospital in Al-Qassim region were enrolled and evaluated for musculoskeletal state including assessment of chronic diffuse musculoskeletal pains using Numeric Rating Pain Scale (NRPS) and functional evaluation of lower limb proximal muscle power using chair–rise performance test. Serum 25(OH)D was evaluated. Vitamin D supplementation was provided for symptomatic subjects. Follow-up clinical evaluation as well as serum 25(OH)D measurement after 12 weeks vitamin D3 supplementation was performed. Results: The mean age of the patients was 43.2 ± 6.4 years. 54 (90%) had vitamin D inadequacy; 42 (70%) deficiency and 12 (20%) had insufficiency. Significant increase in baseline serum 25(OH)D (13.92 ± 5.67 ng/ml) after 12 weeks of supplementation (35.94 ± 4.11 ng/ml) with significant decrease in NPRS (7.42 ± 2.12 vs 2.06 ± 2.04) (p < 0.001), as well as significant improvement of functional status scores of chair–rise performance test (93.95 ± 23.56 vs 203.1 ± 58.6 (p < 0.001). Conclusion: Vitamin D inadequacy is a major health problem not only in elderly people or women with in-door residency and dark-colored clothes, but also in Saudi male young adults in Al-Qassim region

The effect of regular hemodialysis on the nutritional status of children with end-stage renal disease

Growth failure is one of the most common and profound clinical manifestation of chronic kidney disease (CKD) in infants, children and adolescents. The aim of this study was to assess the nutritional status of Egyptian children with end-stage renal disease (ESRD) on regular hemodialysis (HD). The study included 50 Egyptian children with ESRD on regular HD, following-up at the Pediatric Nephrology unit, Cairo University. History, including dietary history, was taken for all patients and clinical examination was performed on all of them. Body weight, standing height, height or length SD score, the skin fold thickness, mid-arm circumference, mid-arm muscle circumference and mid-arm muscle circumference area were also assessed. The height of the patients was the most affected anthropometric parameter, as 78% of the patients were shorter (height SDS below -3). Body weight is less affected than height, as body weight SDS of 34% of patients was less than -3 SDS. In addition, the body mass index of 16% of the patients was 97 th percentile. Although most ESRD patients received adequate protein and caloric intake, their growth was markedly affected, especially with longer period on HD. We suggest that assessment of growth parameters should be performed at a minimum period of every six months in children with CKD stages 2-3. For children with more advanced CKD (stages 4-5 and 5D), more frequent evaluation may be warranted due to the greater risk of abnormalities