Displaying publications 1 - 20 of 33 in total

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  1. Eashwary M, Hussein H
    APLAR Journal of Rheumatology, 2006;9 Suppl 1:A89.
    DOI: 10.1111/j.1479-8077.2006.00199_15.x
    Introduction: Gout is a clinical syndrome resulting from the deposition of monosodium urate monohydrate crystals. Recent studies have shown gout to be a significant metabolic disorder. However, there has been insufficient information on the clinical spectrum in the Malaysian population.
    Objective: This study is conducted to review the clinical characteristics of patients with gout.
    Study methods: In this cross-sectional study 52 patients with gout were recruited. The records of 13 patients from National University of Malaysia Hospital and 39 patients from Putrajaya Hospital, attending the rheumatology clinic between October and December 2005 were reviewed. Results: Gout was found predominantly among ethnic Malays 83%, and Chinese 17% in these centers. The male to female ratio was 12 :1. The peak age of onset of the disease was less than 40 years in 46% of the subjects. Primary gout in females was seen after menopause. 37% cases had a definitive hereditary incidence. At the first presentation 83% had acute monoarthritis and 17% acute polyarticular arthritis. Podagra was seen in 62%. Peripheral joints involvement was seen in 81% patients. Tophaceous gout was seen in 42%. In 85% cases the disease had a chronic polyarticular course, whereas in 15% the disease remained only at a single joint. In 10% cases, there was associated sero-negative arthritis. Associated disorders included hypertension (65%), diabetes mellitus (33%), dyslipidemia (56%), ischemic heart disease (23%), urate nephropathy (39%), uric acid nephrolithiasis (2%). In 88% of cases, there was associated hyperuricaemia. Most of the patients were overweight with body mass index 25-29 (39%) and obese with body mass index 30-70 (36%). Conclusions: Gout is not an unusual disorder in our centre. The age of onset of gout occurred much earlier with forty-six per cent of patients having their first attack of gout before the age of 40. Primary gout in females was seen after menopause. Majority of patients first presented with acute monoarthritis, of which sixty-two per cent presented with podagra. The incidence of tophi was high. Patients with gout should be screened for other associated disorders like diabetes mellitus, hypertension, dyslipidemia and obesity.
  2. Hussein H, Azizi ZA
    Asian J Surg, 2008 Apr;31(2):87-9.
    PMID: 18490221 DOI: 10.1016/S1015-9584(08)60064-0
    A 62-year-old man presented with continuous, persistent backache shortly after completion of antituberculosis medication for tuberculosis (TB) of the spine. Computed tomography scan revealed a pseudoaneurysm involving the infrarenal aorta. He was restarted on anti-TB medication and underwent repair of the pseudoaneurysm with an in situ silver-coated bifurcated Dacron graft. His postoperative recovery was uneventful and he remained well up to 12 months of follow up. To our knowledge, this is the first case in the literature where an in situ silver-impregnated vascular graft has been successfully used in treating a tuberculous pseudoaneurysm.
  3. Rajeswari B, Sinniah B, Hussein H
    Asia Pac J Public Health, 1994;7(1):21-5.
    PMID: 8074940
    Fecal specimens collected from 456 school children in Gombak, Malaysia, revealed an overall prevalence rate of 62.9%. The most common parasite found was Trichuris trichiura (47.1%) followed by Giardia intestinalis (14.7%), Entamoeba coli (11.4%), Entamoeba histolytica (9.9%) and Ascaris lumbricoides (7.9%). Infection rates were high among the Indonesian immigrant workers' children (90%) followed by the Orang Asli (79.5%), Malay (59.4%) and Indians (36.4%). Females (66.3%) had a higher prevalence rate than the males (58.5%). The prevalence of infection was found to be associated with the socio-economic status, water supply, sanitary disposal of feces and family size. Albendazole administered as a single dose (400 mg) was found to be effective against Ascaris (100%) and hookworm (92.3%) but was not effective against Trichuris (39.2%).
  4. Chong YH, Hussein H
    Med J Malaysia, 1982 Mar;37(1):40-5.
    PMID: 7121345
    The birthweights of 13,614 singleton infants comprising 5376 Malays, 5352 Chinese and 2886 Indians born at the Maternity Hospital Kuala Lumpur, during 1973, 1975 and 1977 have been extracted and analysed. Male Chinese infants (3.16 ± 0.37 kg) were significantly heavier than Malay and Indian infants while the male Malay infants (3.12 ± 0.41 kg) were significantly heavier than the Indian (2.97 ± 0.41 kg). Both female Chinese (3.04 ± 0.38 kg) and Malay infants (3.05 ± 0.38 kg) were heavier than the female Indian (2.89 ± 0.39 kg) but there was no difference in birthweight between Chinese and Malay female infants. The mean gestational period and the proportion of full-term births were similar for all 3 races with averages of 39.9 weeks and 77.8 percent respectively. Maternal age at first birth was also closely similar for the three communities with an average of 22.9 years. Significant correlations were found between birthweight and length of neonates, birthweight and gravida, birthweight and maternal age. Indians have a higher incidence of low birthweight or small-for-gestational age infants (14.5 percent) compared to the Chinese (5.6 percent) and the Malays (7.6 percent); the incidence of low birthweights being higher in girls than in boys. Present-day Malay and Indian full-term male and female infants are significantly heavier than their counterparts born at the same Hospital two decades ago, but no difference in birthweight was observed for Chinese infants during this time interval. The gap between the incidence of low birthweight found in Malaysia and those in the developed countries seems to be narrowing and this may be taken to reflect the overall effects of socioeconomic development, including the greater availability of general health and ante-natal care throughout the country since its Independence in 1957.
  5. Huang M, Hussein H
    AIDS Educ Prev, 2004 Jun;16(3 Suppl A):100-9.
    PMID: 15262569
    Since the first case of HIV/AIDS was identified in 1986 in Malaysia, the number of infected individuals has increased steadily each year, so that by the end of 2002 the cumulative number of people living with HIV/AIDS was 57,835 (51,256 with HIV and 6,579 with AIDS), with 5,676 AIDS deaths. The epidemic in Malaysia, currently in a concentrated epidemic stage, is primarily fueled by drug use, but there is ample evidence that heterosexual transmission has increased over the last few years. A strategic plan that includes prevention, care, support, and treatment run by both the government and nongovernmental organizations has been in place since the beginning of the epidemic. However, Malaysia will need to take a more pragmatic approach to reduce new infections (which numbered 19 each day in 2002) among the youth on whom the country relies for development. Leaders need to recognize that HIV/AIDS is not just a health issue, but also a socioeconomic concern that can eliminate all the developmental gains achieved over the years. Working together, Malaysians can overcome the epidemic, but there is a need to act quickly and to act in effective ways so that the devastating effects (already evident in the number of AIDS orphans and widows) can be reduced.
  6. Balakrishnan S, bin Haji Hussein H
    Med J Malaysia, 1977 Sep;32(1):22-4.
    PMID: 609338
  7. Balakrishnan S, Hussein HB
    PMID: 585738
  8. Sakthiswary R, Rajalingam S, Norazman MR, Hussein H
    Clin Ter, 2015;166(2):e98-101.
    PMID: 25945451 DOI: 10.7417/CT.2015.1827
    OBJECTIVE: The etiology of recurrent pregnancy loss (RPL) is unknown in a significant proportion of patients. Autoimmune processes have been implicated in the pathogenesis. The role of antinuclear antibody (ANA) in this context is largely undetermined. In an attempt to address the lack of evidence in this area, we explored the clinical significance of antinuclear antibody (ANA) in unexplained RPL.
    MATERIALS AND METHODS: We studied 68 patients with RPL and 60 healthy controls from September 2005 to May 2012. All subjects were tested for ANA by immunofluorescence testing, and a titer of 1: 80 and above was considered positive. We compared the pregnancy outcome between the ANA positive and ANA negative RPL cases.
    RESULTS: The incidence of ANA positivity among the cases (35.3%) was significantly higher than the controls (13.3%) (p=0.005). ANA positive cases showed significantly higher number of RPL (p=0.006) and lower number of successful pregnancies (p=0.013) compared to the ANA negative cases . The ANA titre had a significant association with the number of RPL (p<0.05, r=0.724) but not with the number of successful pregnancies (p=0.054).
    CONCLUSIONS: ANA positivity predicts a less favorable pregnancy outcome in RPL. Our findings suggest that the ANA titre is a useful positive predictor of the number of RPL. Hence, ANA test is a potential prognostic tool for this condition which merits further research.
  9. Rajalingam S, Sakthiswary R, Hussein H
    Arch Rheumatol, 2017 Mar;32(1):15-20.
    PMID: 30375543 DOI: 10.5606/ArchRheumatol.2017.5960
    Objectives: This study aims to determine the predictors of poor sleep quality in rheumatoid arthritis (RA).

    Patients and methods: This was a monocentric, cross sectional, case-control study which was conducted at the Putrajaya Hospital, Malaysia. We recruited 46 patients with RA (3 males; 43 females; mean age 48.15±14.96) and 46 age and sex-matched healthy controls (3 males; 43 females; mean age 47.11±12.22). RA patients were assessed for their disease activity based on disease activity score in 28 joints, disease damage based on radiographic erosions, and functional status based on Health Assessment Questionnaire Disability Index. The Pittsburgh Sleep Quality Index (PSQI) scores were determined by interviewing all the subjects. Subjects with RA were further subdivided based on their PSQI scores as "good sleepers" with PSQI scores of <5 and "poor sleepers" with PSQI scores of ≥5.

    Results: The percentage of poor sleepers was significantly higher among RA patients (47.83% versus 9.57%). Median scores of 5 out of 7 components of the PSQI were higher among RA patients compared to controls. Among poor sleepers with RA, a significantly higher proportion tested positive for anti-citrullinated cyclic peptide autoantibodies (p=0.037). Besides, poor sleepers had significantly higher median Health Assessment Questionnaire Disability Index (p=0.017) than good sleepers. However, both Health Assessment Questionnaire Disability Index (p=0.968) and anti-citrullinated cyclic peptide (p=0.431) were insignificant when entered in the equation of a logistic regression model.

    Conclusion: The findings of this study demonstrate a link between functional disability, anti-citrullinated cyclic peptide antibodies, and sleep quality in RA.
  10. Sulaiman ZH, Abdul Rahman KH, Ying TY, Taha HH, Muhd Taha NH
    Integr Zool, 2008 Sep;3(3):208-15.
    PMID: 21396070 DOI: 10.1111/j.1749-4877.2008.00098.x
    The genetic population structure of red snapper Lutjanus malabaricus and orange-spotted grouper Epinephelus coiodes in Brunei and Sabah was investigated using allozyme electrophoresis. Samples were collected from three sites in Brunei for E. coiodes and from three sites in Brunei and Sabah for L. malabaricus. A total of 22 loci and 16 loci were scored, respectively. The index of fixation (F(ST) ) for the E. coiodes population was 0.176 but, in general, it lacked within-population structuring. The F(ST) was particularly high between Brunei Bay/Jerudong and Brunei Bay/ Kuala Belait, suggesting genetic subdivision on a small spatial scale. Isolation of Brunei Bay from the South China Sea may constrain the movement of adult fishes and larval dispersal, thereby reducing homogeneity among subpopulations. All variable loci for E. coiodes were in Hardy-Weinberg equilibrium except for MDH* and GTDHP* (P < 0.01), in which two subpopulations showed an excess of heterozygotes (P < 0.01). The study on the L. malabaricus population showed a heterozygote deficit of approximately 60% in variable loci (F(ST) genetic variation within population = 0.45; P < 0.05); however, the mean observed heterozygosity for the population far exceeded L. malabaricus populations in Australia and Indonesia. A F(ST) value of 0.076 revealed moderate genetic differentiation among subpopulations of L. malabaricus. The genotypes were likely to be drawn from the same distribution in Jerudong and Kuala Belait. This study infers that sustainable management of snapper and grouper resources in Brunei waters must take into account the presence of a single stock and two stocks, respectively.
  11. Hussein H, Mustafa R, Quek KF, Hassanudin NS, Shahid S
    Int J Rheum Dis, 2008;11(3):237-240.
    DOI: 10.1111/j.1756-185X.2008.00384.x
    Objective: To validate the Malay version of the Health Assessment Questionnaire (Malay-HAQ) for use in Malay-speaking rheumatoid arthritis (RA) patients in the Malaysian setting. The HAQ - Disability Index has been validated in several languages, but not in Malay.Methods: The original HAQ was modified and translated into Malay by two translators, one of whom was aware of the objectives of the Questionnaire and the other as a lay translator. Two sets of Malay-HAQ were distributed to RA patients during their routine follow-up visits; one set to be completed immediately and another set to be completed 2 weeks later. A total of 61 patients completed the two sets of Malay-HAQ. The data collected was analysed using SPSS V. 11.0. Reliability of the data was evaluated using the test-retest method and internal consistency was assessed by Cronbach's alpha.Results: The study showed that the Malay-HAQ is feasible and reliable. The Spearman's correlation coefficient ranged from 0.65 to 0.82, while the internal consistency was 0.88-0.92.Conclusion: The Malay-HAQ is a sensitive, reliable and valid instrument for the measurement of functional status in RA patients in a Malay setting. © 2008 Asia Pacific League of Associations for Rheumatology.
  12. Wan Ali WASR, Mohd Shahrir MS, Hussein H
    MyJurnal
    A 35-year-old Jordanian gentleman presented with worsening right iliac fossa pain of three-day durations with vomiting, loose stool and intermittent fever. He later underwent laparoscopic surgery, which was subsequently converted to open laparotomy. Intraoperatively, there was thickened bowel with multiple mesenteric lymph nodes, and also thrombosis of the small bowel vein supplying the affected bowel lesion, the diagnosis which was later confi rmed with the histopathological report. Resection with end-to-end anastomosis was done during the surgery. Within one-week post laparotomy, he developed another progressive abdominal pain and distension, vomiting and no bowel opening. He was sent for another exploratory laparotomy. Intraoperatively, there was a gangrenous small bowel segment measuring 130 cm, with an intact large bowel and previous anastomotic site. Resection of 150 cm of the small bowel was subsequently done.
  13. Sakthiswary R, Rajalingam S, Norazman MR, Hussein H
    EXCLI J, 2012;11:624-631.
    PMID: 27847450
    Objective: Although osteoarthritis (OA) is widely accepted as a degenerative disease, autoimmune processes are believed to be involved in the pathogenesis. There are limited studies in this area and most of them focused on antibodies against chondrocyte membrane. In an attempt to address the paucity of evidence in this regard, we explored the clinical significance of antinuclear antibody (ANA) in primary osteoarthritis of the knee (OAK).
    Method: We studied 106 patients with primary osteoarthritis of at least 1 knee and 63 healthy controls from two tertiary centres in Malaysia from September 2005 to May 2012. All subjects were tested for ANA by immunofluorescence testing, and a titer of 1:40 and above was considered positive. Besides, the radiographs of bilateral knees were evaluated for grading, tibiofemoral compartment involvement and total knee replacement (TKR) implants. We compared the clinical characteristics between the ANA positive and ANA negative OAK cases.
    Results: The incidence of ANA positivity among the cases (39.4 %) was higher than the controls (27 %) but this difference was statistically insignificant (p=0.754). ANA positive cases showed significantly higher incidence of bilateral and Grade IV OAK with higher frequency of TKR. In the multiple regression analysis, bilateral OAK (p< 0.0001; odds ratio 9.00), Grade IV OAK (p<0.001, odds ratio 3.44) and TKR (p=0.009; odds ratio 2.97) remained associated with ANA positivity.
    Conclusions: ANA test is a potential prognostic tool in primary OAK and its positivity is associated with the clinical outcomes of bilateral, Grade IV OAK and TKR.
    Study site: Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur; Putrajaya Hospital, Wilayah Persekutuan
  14. Sakthiswary R, Rajalingam S, Hussein H, Sridharan R, Asrul AW
    Clin Rheumatol, 2017 Dec;36(12):2683-2688.
    PMID: 28889184 DOI: 10.1007/s10067-017-3817-0
    The aim of the study is to investigate the correlation of serum cartilage oligomeric matrix protein (COMP) levels with articular cartilage damage based on sonographic knee cartilage thickness (KCT) and disease activity in rheumatoid arthritis (RA). A total of 61 RA patients and 27 healthy controls were recruited in this study. Serum samples were obtained from all subjects to determine the serum COMP levels. All subjects had bilateral ultrasound scan of their knees. The KCT was based on the mean of measurements at three sites: the medial condyle, lateral condyle and intercondylar notch. Besides, the RA patients were assessed for their disease activity based on 28-joint-based Disease Activity Score (DAS 28). Serum COMP concentrations were significantly elevated in the RA patients compared to the controls (p = 0.001). The serum COMP levels had an inverse relationship with bilateral KCT in RA subjects and the healthy controls. COMP correlated significantly with disease activity based on DAS 28 (r = 0.299, p = 0.010), disease duration (r = 0.439, p = 
  15. Sakthiswary R, Syahrul Sazliyana S, Mohd Shahrir MS, Shahril NS, Hussein H
    EXCLI J, 2012;11:142-9.
    PMID: 27385955
    Tumor necrosis factor alpha (TNFα) is a multifunctional cytokine which plays a pivotal role in the pathogenesis of rheumatoid arthritis (RA). Apart from its well recognized proinflammatory properties, it is known to interfere with lipid metabolism and erythropoiesis. We evaluated the effects of adalimumab on hematologic, lipid and inflammatory parameters using data from patients on adalimumab 40 mg fortnightly from 2 centers in Malaysia. Mean changes in laboratory values from baseline to Weeks 4, 12 and 24 were compared using paired T test and Wilcoxon signed-rank test. We studied 18 patients with RA who were on adalimumab 40 mg fortnightly. The inflammatory markers i.e. erythrocyte sedimentation rate and C reactive protein showed significant changes as early as at week 4 compared to baseline with p values of 0.003 and 0.005, respectively. From a baseline of high disease activity with a mean Disease Activity Score using 28 joint counts (DAS 28) of 5.3, there was a steady improvement in the disease activity and remission was achieved at week 24 with a DAS 28 of 2.4. The hemoglobin level improved at week 12 (p=0.013) and this was sustained till week 24. As opposed to previous studies, the LDL level significantly decreased at week 12 (p=0.015) and this change persisted till week 24 (p=0.001). The total cholesterol showed a similar pattern as the LDL. The pharmacodynamics of adalimumab therapy in rheumatoid arthritis extend beyond the joints with favorable effects on haemoglobin and lipid profile.

    Study site: Putrajaya Hospital and Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
  16. Ahmad Y, Shahril NS, Hussein H, Said MS
    J Clin Med Res, 2010 Dec 11;2(6):284-8.
    PMID: 22043264 DOI: 10.4021/jocmr482w
    We would like to report a case of a 29-year-old male patient who presented with multiple lymphadenopathy and vague symptoms of low grade fever, cough, weight loss, rashes, vomiting, dry eyes and dry mouth. Physical examination revealed submandibular lymphadenopathy, vasculitic rashes over both lower limbs, and parotid gland enlargement. Blood investigations showed mild anemia with leukocytosis, predominantly eosinophilia and high erythrocyte sedimentation rate and C-reactive protein. Computed tomography of the neck, thorax and abdomen showed bilateral submandibular, submental adenopathy, mediastinal and para-aortic lymphadenopathy with generalized reticulonodular densities in both lower lobes. There were hepatomegaly and bilateral enlarged kidneys with renal cyst. Histopathological examination from the cervical lymph node later revealed non-caseating granuloma, consistent of sarcoidosis. Patient responded well to prednisolone 50 mg daily with subsequent reduction in the size of cervical lymphadenopathy and parotid swelling.

    KEYWORDS: Lymphadenopathy; Granuloma; Sjogren; Sarcoidosis.
  17. Leong CR, Funami K, Oshiumi H, Mengao D, Takaki H, Matsumoto M, et al.
    Oncotarget, 2016 10 18;7(42):68179-68193.
    PMID: 27626689 DOI: 10.18632/oncotarget.11907
    Hepatitis B virus (HBV) barely induces host interferon (IFN)-stimulated genes (ISGs), which allows efficient HBV replication in the immortalized mouse hepatocytes as per human hepatocytes. Here we found that transfection of Isg20 plasmid robustly inhibits the HBV replication in HBV-infected hepatocytes irrespective of IRF3 or IFN promoter activation. Transfection of Isg20 is thus effective to eradicate HBV in the infected hepatocytes. Transfection of HBV genome or ε-stem of HBV pgRNA (active pgRNA moiety) failed to induce Isg20 in the hepatocytes, while control polyI:C (a viral dsRNA analogue mimic) activated MAVS pathway leading to production of type I IFN and then ISGsg20 via the IFN-α/β receptor (IFNAR). Consistently, addition of IFN-α induced Isg20 and partially suppressed HBV replication in hepatocytes. Chasing HBV RNA, DNA and proteins by blotting indicated that ISG20 expression decreased HBV RNA and replicative DNA in HBV-transfected cells, which resulted in low HBs antigen production and virus titer. The exonuclease domains of ISG20 mainly participated in HBV-RNA decay. In vivo hydrodynamic injection, ISG20 was crucial for suppressing HBV replication without degrading host RNA in the liver. Taken together, ISG20 acts as an innate anti-HBV effector that selectively degrades HBV RNA and blocks replication of infectious HBV particles. ISG20 would be a critical effector for ameliorating chronic HBV infection in the IFN therapy.
  18. Shahar MA, Hussein H, Sidi H, Shah SA, Mohamed Said MS
    Int J Rheum Dis, 2012 Oct;15(5):468-77.
    PMID: 23083037 DOI: 10.1111/j.1756-185X.2012.01753.x
    AIM: To determine the prevalence of sexual dysfunction (FSD) among women with rheumatoid arthritis attending the Rheumatology Clinic in Universiti Kebangsaan Malaysia Medical Centre (UKMMC) and Hospital Putrajaya, Malaysia, and to determine its associations with potential clinical and disease activity factors.
    METHOD: This was a cross-sectional study involving women with rheumatoid arthritis between the ages of 20 and 60 years. A validated Malay Version Female Sexual Function Index (MVFSFI) was administered to diagnose FSD. Sociodemographic and disease activity profiles were obtained and those who had and did not have FSD were compared.
    RESULTS: Among 63 respondents, 51 patients were included in the analysis for FSD. The prevalence of FSD in women with rheumatoid arthritis attending UKMMC and Hospital Putrajaya Rheumatology Clinic was 29.4%. Erythrocyte sedimentation rate (ESR) and Disease Activity Score in 28 joints (DAS28-ESR) correlates with MVFSFI score with r=-0.364 (P=0.009) and r=-0.268 (P=0.057), respectively. Sociodemographic factors that correlate with MVFSFI score were: patient's age (r=0.520, P<0.001); duration of marriage (r=-0.355, P=0.001); husband's age (r=-0.460, P=0.001); age of oldest child (r=-0.449, P=0.001); and age of youngest child (r=-0.627, P<0.001).
    CONCLUSION: We found in this study that the prevalence of FSD in rheumatoid arthritis in our centers was 29.4%. Age and family dynamics appear to be more important predictors compared to disease activity.
    Study site: Rheumatology Clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM) and Hospital Putrajaya, Malaysia
  19. Abdul Muizz AM, Mohd Shahrir MS, Sazliyana S, Oteh M, Shamsul AS, Hussein H
    Int J Rheum Dis, 2011 Feb;14(1):18-30.
    PMID: 21303478 DOI: 10.1111/j.1756-185X.2010.01593.x
    AIMS: The aim of this study was to evaluate the left ventricular (LV) diastolic dysfunction in rheumatoid arthritis (RA) patients without clinically evident cardiovascular manifestations and to estimate whether there is any correlation between RA disease severity and disability and LV diastolic dysfunction.
    METHODS: The study was a cross-sectional study involving 53 patients (47 female and 6 male) with RA without clinically evident heart disease and 53 healthy subjects (47 female and 6 male) who served as a control group. Both groups were matched for age and sex. Echocardiographic and Doppler studies were conducted in all patients with RA and control subjects.
    RESULTS: Of 17 cardiac parameters assessed, only two were abnormal. None of the specific cardiac diastolic dysfunction parameters were significantly different in RA patients compared to the control group. There was no significant correlation between diastolic function values in RA patients and value of Disease Activity Score 28 (DAS-28) and value of Health Assessment Questionnaires Disability Index (HAQDI). Atrial (A) wave velocity was greater in RA patients compared to the control group (0.71 [0.58-0.83] vs. 0.61 [0.51-0.71]; P < 0.04). However, interventricular relaxation time (IVRT) ([73.08 ± 9.92 vs. 70.74 ± 9.02], P = 0.207), lower E/A ratio (1.27 [1.02-1.56] vs. 1.42 [1.20-1.68], P = 0.102), diastolic dysfunction parameters according to Redfield Classification (25 [47.2%] vs. 27 [50.9%] P = 0.56), diastolic dysfunction using E/A (P = 0.321) and tissue doppler imaging (E/E') (P = 0.148) were not different.
    CONCLUSION: Prevalence of diastolic dysfunction in the rheumatoid arthritis group (47.2%) was not different from controls (50.9%). LV diastolic function had no significant correlation with RA disease severity and duration of disease.
  20. Mazlan SA, bin Mohamed Said MS, Hussein H, binti Shamsuddin K, Shah SA, Basri H
    Acta Medica (Hradec Kralove), 2009;52(3):107-16.
    PMID: 20073422 DOI: 10.14712/18059694.2016.114
    INTRODUCTION: Psoriatic Arthritis (PsA) is an inflammatory arthritis associated with Psoriasis. Its recognition as an inflammatory disease distinct from Rheumatoid Arthritis has put forward for consideration several questions regarding its specific CVS mortality and morbidity (9, 11, 16, 26). Carotid intima media thickness is a useful surrogate and sensitive marker to determine atherosclerosis even in its subclinical stages (6, 14, 22, 27, 32).

    OBJECTIVE: Prevalence of carotid intima media thickness in patients with Psoriatic arthritis is unknown in Asian population. We aim to identify the presence of subclinical atherosclerosis in patients with psoriatic arthritis and disease activity association and its predictors in a series of patients with PsA attended to the rheumatology clinic, tertiary hospitals.

    METHODS: A total of 63 patients with PsA who fulfilled the CASPAR criteria were recruited from UKM Medical Centre and Hospital Putrajaya. Common carotid intima media thickness (IMT) was measured in both right and left carotid artery by using high resolution B-mode ultrasound. This was a cross sectional study first done in Malaysia for PsA patients.

    RESULTS: The positive IMT (IMT > 1.00 mm) among PsA was observed in 10 out of 63 patients (15.9 %) regardless of background cardiovascular risk. The mean +/- SD of IMT was 0.725 +/-0.260 mm for this study. Variables significantly associated with positive IMT (p < 0.05) included age at the time of study (p = 0.005), waist circumference (p = 0.001), Hypertension (p = 0.007), Diabetes (p = 0.002) and Metabolic syndrome (p = 0.001) and not associated with gender, ethnicity, duration of PsA disease, pattern of PsA, disease activity and severity. Above all, only age had positive IMT independent predictor (p = 0.032), with OR 1.116; 95 % CI (1.010-1.234).

    CONCLUSIONS: There was a significant association between CVS risk and positive Intima Media Thickness in Psoriatic Arthritis patients. Otherwise, there was no association in disease activity, disease severity and DMARDS therapy with positive Intima Media Thickness in Psoriatic Arthritis patients. The study was approved by Research and Ethics Committee of the faculty of medicine, Universiti Kebangsaan Malaysia with project code FF-114-2008 and by Community Research Center (CRC) of National Institutes of Health (NIH) for the case study in Hospital Putrajaya with the project code NMRR-08-970-2125.
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