OBJECTIVES: To evaluate the trends of disease-modifying anti-rheumatic drugs (DMARDs) used in the treatment of rheumatoid arthritis (RA).
METHODS: Patients who fulfilled the ACR criteria for RA from 1995 to 2006 and who attended the Rheumatology clinic at Ipoh Hospital were selected and their records were evaluated to determine the changing trends in the use of DMARDs.
RESULTS: 128 patients with RA were identified. The most commonly prescribed DMARD as monotherapy was sulphasalazine (47.7%), followed by methotrexate (35.9%) and hydroxychloroquine. Methotrexate and sulphasalazine were the most frequently prescribed DMARDs, of which the use of methotrexate has increased 6 folds from 1997 to 2007 and the use of sulphasalazine remains around 30% to 50%. The combination of methotrexate with leflunomide has significantly increased in usage by 4 folds during the study period whilst methotrexate with sulphasalazine combination usage had slightly declined.
CONCLUSION: DMARDs are still the cornerstone in the treatment of RA. Changes in the trend and aggressive use of DMARDs has been markedly influenced by the patient's awareness of early treatment, the incapacitating damage, availability of recently introduced leflunomide and the advancement of current recommended treatment protocol.
Study site: Rheumatology clinic, Hospital Raja, Parmaisuri Bainum (HRBP), Ipoh, Perak, Malaysia
The air separation (O2/N2) based on polymeric membranes is critical because it is more energy efficient than traditional methods. Dense polymeric membranes are now the main stay of industrial processes that generate oxygen and nitrogen enriched gas. Though, regular polymeric membranes often fall short of selective pressure demands because O2 and N2 gases have such comparable equivalent diameters. While polymer composites have their benefits, nanocomposite (NCs) allows for the production of high-performance barriers. Utilising Matrimid® 5218 (Matrimid) as the base framework and multiwall carbon nanotube (MWCNT) as the filler, a novel NCs for O2/N2 separation was developed. Both matrimid and MWCNTs were chemically modified quaternization and functionalizing the MWCNTs. The membranes were casted using solution casting with a combination of quaternized matrimid and functionalized multi-walled carbon nanotubes (f-MWCNT). When f-MWCNT was added to quaternized matrimid, it created interfacial compatibility, which increased O2/N2 selectivity and permeability by 65 % and 35 %, respectively. In the current study, increasing O2 diffusivity and O2/N2 solubility selectivity resulted in improved performance, this paves a way for manufacturing innovation.