Evaluation of general public awareness, knowledge and attitude about common rheumatic diseases in Egypt: a multicenter study

Abstract Background Rheumatic diseases are the diseases of the connective tissue and medical disorders of the musculoskeletal system, with pain and/or stiffness as main manifestations, and which may or may not be accompanied by other organ system involvement. Public and patient’s awareness is needed as the number of patients of various forms of arthritis and other musculoskeletal diseases is constantly on rise. Objective The aim of our multicenter study is to evaluate awareness, knowledge, and attitude of general populations regarding common rheumatic diseases in Egypt. Subjects and methods This was a multicenter study included 3000 subjects from 4 Egyptian governorates (750 subjects from each): Lower Egypt: Dakahlia and Damietta and Upper Egypt: Sohag and Qena. Entire cases completed the Awareness, Knowledge, and Attitude of Egyptian people towards four of the common rheumatic diseases (Rheumatoid arthritis, Systemic lupus erythematosus, Crystal-induced arthritis, and Osteoarthritis): AKARSCO questionnaire that included basic information, general knowledge, and attitude about rheumatic diseases. Results The knowledge and awareness of rheumatic diseases are significantly higher among females. Regarding education level, there is a steady increase in the awareness with the rise of education level, with a highly significant correlation. Non-working and married participants had significantly higher knowledge compared to working and non-married ones. The attitude towards rheumatic diseases is significantly satisfactory among females. Regarding education level, there is a steady increase in the attitude with the rise of education level, with a highly significant correlation. Non-working and married participants had significant satisfactory attitude compared to working and non-married ones. The main sources of information about rheumatic diseases are media and Internet. Conclusion The overall awareness, knowledge, and attitude of population towards rheumatic diseases are limited in Egypt. The participants’ total score regarding the general knowledge level of rheumatic diseases, rheumatoid arthritis, SLE, gout, and osteoarthritis is bad. The participants’ overall level regarding the attitude towards rheumatic diseases is unsatisfactory. The level of knowledge and attitude is affected by many factors like sex, work, education, residence, marital status, and family history of rheumatic diseases. The main sources of information about rheumatic diseases are media and Internet

Comparison of platelet-rich plasma and laser therapy in treatment of chronic lateral epicondylitis

Background Lateral epicondylitis (LE) is the most frequent cause of chronic lateral elbow pain in adults that represents an encumbrance on social and professional life of patients. Many treatment modalities that have been used in the management of LE have recently come into question. Platelet-rich plasma (PRP) and low-level laser therapy (LLLT) have been tried for management of chronic tendinopathies but with some debate about their effectiveness. Objectives This study compared the effectiveness of local injection of PRP and LLLT in pain reduction and functional improvement in chronic LE. Patients and methods This randomized double-blinded, prospective study included 104 eligible patients with chronic LE. Fifty-two patients were treated with local PRP injection and 52 were treated by intermittent LLLT. They were evaluated at 3 and 6 months for subjective pain using visual analog scale (VAS), functional outcome, and grip strength. Results Pain was assessed using the subjective VAS which was improved in both PRP and LLLT groups, DASH score and grip strength revealed improvement in both groups. This improvement was of highly statistical significance in both groups when compared with baseline evaluation (P<0.001). On comparing the PRP group with the LLLT group, there was significant improvement in VAS at 6 months only, whereas there were significant improvements in functional outcome and grip strength evaluation at 3- and 6-month follow-up for PRP group. Conclusion Treating patients with LE with PRP injection improves pain and function more effectively compared with LLLT

Programmed death 1 (PD-1) serum level and gene expression in recent onset systemic lupus erythematosus patients

Aim of the work: To investigate the potential association of protein programmed death 1 (PD-1) serum level and its gene expression inrecent onset systemic lupus erythematosus (SLE) patients and study its association with the disease activity. Patients and methods: The study included 80 recently diagnosed SLE patients and 80 healthy controls. SLE disease activity index (SLEDAI) was assessed. The serum level of soluble (sPD-1) was assessed by enzyme linked immunosorbent assay (ELISA) and its gene expression level was evaluated by real time-polymerase chain reaction (RT-PCR). Results: They were 68 females and 12 males (F: M 5.7:1) with age 30.8 ± 8.7 years and disease duration of 3.2 ± 1.7 months. The sPD-1 and PD-1 gene expression level (folds) were significantly elevated in patients (1280.6 ± 1448.1 pg/ml and 0.3 ± 0.06 folds) than controls (109.1 ± 11.9 pg/ml and 0.03 ± 0.008 folds) (p < 0.001). A significant correlation was found between sPD-1 and hematuria, pyuria, fever and C3 level (p = 0.01, p = 0.001, p = 0.02, and p = 0.03 respectively), and between PD-1gene expression and psychosis and fever (p = 0.03, p = 0.014). No significant correlation was found between SLEDAI and PD-1 gene expression or sPD-1 level (p = 0.1, p = 0.23 respectively). No significant correlation was found between sPD-1 and PD-1 gene expression levels and the autoantibodies. Conclusion: PD-1 gene expression as well as the serum level of sPD-1 are elevated significantly in recent onset SLE patients denoting that they may have a role in the pathogenesis of the disease while there was no relation to the disease activity. This biomarker may be potentially promising for the development of a novel lupus immunotherapy by targeting the PD-1 pathway