Displaying publications 1 - 20 of 178 in total

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  1. Ni H, Moe S, Myint KT, Htet A
    ISRN Rheumatol, 2013;2013:357904.
    PMID: 23970975 DOI: 10.1155/2013/357904
    Since the introduction of immune modulators in the treatment of rheumatoid arthritis (RA), there has been hope that orally effective biologic agents would be developed. Tofacitinib, a Janus kinase inhibitor, has become the first oral biologic to receive approval for use in active RA patients. This paper reviews the efficacy and safety profile of Tofacitinib at dosages of 5 mg and 10 mg twice daily. Remarkable improvement in terms of ACR 20 response and HAQ-DI score was noted at month 3 and month 6. DAS 28-4 ESR < 2.6 achievement was noticeably obvious at month 6 for both dosages. No significant serious adverse events, serious infections, neutropenia, or anaemia were observed compared to placebo. In fact, Tofacitinib 5 mg was even found to have significant protective effect of anaemia in the meta-analysis (P = 0.004). Tofacitinib has a noticeable efficacy in controlling disease activity in RA with a manageable safety profile. However, longer studies are needed for its long-term safety profile.
    Matched MeSH terms: Arthritis, Rheumatoid*
  2. Nur Shafawati AR, Sulong S, Wan Ghazali WS, Abdul Talib N, Wan Taib WR
    MyJurnal
    Rheumatoid Arthritis (RA) is a chronic inflammatory polyarthritis disease predominantly involving synovial tissue of the joints and characterized by destructive and debilitating arthritis (Choy et al., 2012; Weyand, 2000; reviewed by Worthington, 2005; Gabriel et al., 1999). It can cause progressive and irreversible destruction of tendons, cartilage and bone, which leads to lack of ability to perform daily activities (Singh et al., 2015). Although the aetiology of RA remains unsolved, the strength of the genetic component in RA is estimated based on familial aggregation and information about epidemiology and population prevalence (reviewed by Gregersen, 1999, Choy et al., 2012). (Copied from article).
    Matched MeSH terms: Arthritis, Rheumatoid*
  3. Hee CS, Gun SC, Naidu R, Das Gupta E, Somnath SD, Radhakrishnan A
    Matched MeSH terms: Arthritis, Rheumatoid
  4. Giritharan R
    Family Practitioner, 1984;7(1):25-28.
    Matched MeSH terms: Arthritis, Rheumatoid
  5. Mok CC, Cha HS, Hidayat R, Nguyen LT, Perez EC, Ramachandran R, et al.
    Int J Rheum Dis, 2016 Jan;19(1):30-7.
    PMID: 26403254 DOI: 10.1111/1756-185X.12755
    OBJECTIVE: In patients with rheumatoid arthritis (RA), morning stiffness is linked more to functional disability and pain than disease activity, as assessed by joint counts and markers of inflammation. As part of the Asia Pacific Morning Stiffness in Rheumatoid Arthritis Expert Panel, a group of eight rheumatologists met to formulate consensus points and develop recommendations for the assessment and management of morning stiffness in RA.
    METHODS: On the basis of a systematic literature review and expert opinion, a panel of Asian rheumatologists formulated recommendations for the assessment and medical treatment of RA.
    RESULTS: The panel agreed upon 10 consensus statements on morning stiffness, its assessment and treatment. Specifically, the panel recommended that morning stiffness, pain and impaired morning function should be routinely assessed in clinical practice. Although there are currently no validated tools for these parameters, they should be assessed as part of the patients' reported outcomes in RA. The panel also agreed on the benefits of low-dose glucocorticoids in RA, particularly for the improvement of morning stiffness.
    CONCLUSIONS: These recommendations serve to guide rheumatologists and other stakeholders on the assessment and management of morning stiffness, and help implement the treat-to-target principle in the management of RA.
    KEYWORDS: consensus recommendations; morning stiffness; rheumatoid arthritis
    Matched MeSH terms: Arthritis, Rheumatoid
  6. Lee YH, Baharuddin NA, Chan SW, Rahman MT, Bartold PM, Sockalingam S, et al.
    Clin Oral Investig, 2021 Mar;25(3):1441-1450.
    PMID: 32656595 DOI: 10.1007/s00784-020-03452-9
    OBJECTIVES: It has been proposed that citrullination and carbamylation occur in the inflamed periodontium and could be the plausible mechanisms for the generation of antigens involved in the development and progression of RA. The purpose of this study was to determine the presence and location of citrullinated and carbamylated proteins in the gingival tissues and compare their abundance in periodontitis (PD) patients with or without RA.

    MATERIALS AND METHODS: Gingival tissue samples of healthy (n = 5), PD with RA (n = 5) and PD without RA (n = 5) were collected. Specimens were formalin fixed, paraffin embedded and sectioned at 4 μm. The tissue sections were analysed for the presence of citrullinated and carbamylated proteins by immunohistochemistry. Semi-quantitative analysis was performed to quantify and compare the protein abundance between groups.

    RESULTS: The number of cells containing citrullinated and carbamylated proteins with higher intensity was markedly increased in gingival tissues from PD with or without RA in comparison with healthy controls.

    CONCLUSION: Inflamed gingival tissue is a potential source of citrullinated and carbamylated proteins other than synovial tissues. The extent to which the local accumulation of these proteins contributes to the pathogenesis of RA needs further elucidation.

    CLINICAL RELEVANCE: If PD is a potential source of post-translationally modified proteins, untreated PD should not be taken lightly in the context of RA. Hence, addressing gingival inflammation should be viewed as an important preventive measure in the general population not only for the progression of periodontal disease but also reducing the risk of developing extra-oral comorbidities.

    Matched MeSH terms: Arthritis, Rheumatoid*
  7. Eezammuddeen NN, Vaithilingam RD, Hassan NHM
    J Periodontal Res, 2023 Feb;58(1):29-42.
    PMID: 36317493 DOI: 10.1111/jre.13065
    BACKGROUND AND OBJECTIVE: Periodontitis (PD) is a dysbiotic disease of tooth-supporting structures that has been associated with various systemic diseases including rheumatoid arthritis (RA). To date, evidence demonstrated increased prevalence of RA among PD patients and postulated PD to have a role in the development of autoantibodies in RA patients. Therefore, a systematic review was conducted to assess the available evidence to ascertain the effect of PD on levels of autoantibodies in the serum, saliva and gingival crevicular fluid (GCF) of RA patients.

    MATERIAL AND METHODS: The systematic review was conducted in compliance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement guidelines. Relevant literature was searched from PubMed, Web of Science, Scopus and Ebscohost databases from inception until 31 August 2020. The risk of bias in each study was determined based on the Newcastle-Ottawa Scale tool. Results from random-effect meta-analyses were presented as summary estimates of odds ratios (ORs) for seropositivity and standardised mean difference (SMD) of autoantibody levels with 95% confidence intervals. Sensitivity tests and meta-regression were performed to assess the robustness of the results and potential cause of heterogeneity.

    RESULTS: The electronic and manual searches gathered 932 articles. Following screening and full-text assessment, a total of 29 studies were included in the analysis. Twenty-eight published observational studies were included in the quantitative analysis in the form of random-effect meta-analysis which revealed that PD was associated with anti-citrullinated proteins autoantibodies (ACPAs) and Rheumatoid Factor (RF) seropositive RA patients (OR for ACPA seropositivity: 1.82; 95% CI: 1.13-2.93) (OR for RF seropositivity: 1.53; 95% CI: 1.05-2.24). Also, RA patients with PD had increased serum levels of ACPA and RF. However, high heterogeneity among studies' results, partially ascribed to the unstandardised case definition of PD and laboratory testing of autoantibodies. Apart from ACPA and RF in serum, studies which reported on other RA-related autoantibodies, as well as autoantibody levels in saliva and GCF were scarce.

    CONCLUSION: RA patients with PD tend to have greater ACPA and RF levels in their serum when compared with the RA patients without PD supporting the plausible role of PD in the development of systemic autoimmunity in RA patients.

    Matched MeSH terms: Arthritis, Rheumatoid*
  8. Arshad A
    DOI: 10.1111/j.1479-8077.2005.00116.x
    Pulmonary involvement in rheumatoid arthritis (RA) is a recognized complication but not often well described in the literature and also in major medical textbooks. Thus, for most medical practitioners who look after RA patients, pulmonary complications are often missed and not given much attention. This article will review the current literature of pulmonary involvement in RA and to increase awareness of its existence., Copyright (C) 2005 Blackwell Publishing Ltd
    Matched MeSH terms: Arthritis, Rheumatoid
  9. Lew PH, Rahman MT, Safii SH, Baharuddin NA, Bartold PM, Sockalingam S, et al.
    BMC Oral Health, 2021 07 20;21(1):360.
    PMID: 34284769 DOI: 10.1186/s12903-021-01712-y
    BACKGROUND: Previous studies have reported conflicting findings between serum anti-citrullinated protein antibodies (ACPA) levels in rheumatoid arthritis (RA) participants with and without periodontitis (Pd). This study aimed to analyse possible correlations between serum ACPA levels and clinical parameters in Pd and RA participants.

    METHODS: Full mouth periodontal examination (probing pocket depth, clinical attachment levels, gingival bleeding index, visual plaque index) was conducted and serum samples obtained from 80 participants comprising RA, Pd, both RA and Pd (RAPd) and healthy individuals (HC). Erythrocyte sedimentation rates (ESR) and periodontal inflamed surface area (PISA) were obtained. Serum samples were analysed for ACPA quantification using enzyme-linked immunosorbent assay (ELISA).

    RESULTS: Median levels (IU/mL) of ACPA (interquartile range, IQR) in RAPd, RA, Pd and HC groups were 118.58(274.51), 102.02(252.89), 78.48(132.6) and 51.67(91.31) respectively. ACPA levels were significantly higher in RAPd and RA as compared to HC group (p  RA > Pd > HC. However, lack of any significant correlation between the serum ACPA levels with the clinical Pd and RA parameters warrants further studies to investigate the causal link between RA and Pd for such a trend. Further studies involving more inflammatory biomarkers might be useful to establish the causal link between Pd in the development and progression of RA or vice versa.

    Matched MeSH terms: Arthritis, Rheumatoid*
  10. Naqvi AA, Hassali MA, Iffat W, Zia M, Fatima M, Shakeel S, et al.
    Int J Rheum Dis, 2019 Nov;22(11):2031-2044.
    PMID: 31595667 DOI: 10.1111/1756-185X.13721
    AIM: Rheumatoid arthritis (RA) is a chronic progressive disabling disease that mainly affects joints. Studies documenting Pakistani patients' knowledge regarding RA disease are lacking and there is a need for such endeavor. The purpose of this study was to develop and validate a novel research tool to document patient knowledge about RA disease.

    METHODS: A novel research instrument known as the rheumatoid arthritis knowledge assessment scale (RAKAS) which consisted of 13 items, was formulated by a rheumatology panel and used for this study. This study was conducted in rheumatology clinics of three tertiary care hospitals in Karachi, Pakistan. The study was conducted in March-April 2018. Patients were recruited using a randomized computer-generated list of appointments. Sample size was calculated based on item-to-respondent ratio of 1:15. The validities, factor structure, sensitivity, reliability and internal consistency of RAKAS were assessed. The study was approved by the institutional Ethics Committee.

    RESULTS: A total of 263 patients responded to the study. Content validity was 0.93 and response rate was 89.6%. Factor analysis revealed a 3-factor structure. Fit indices, namely normed fit index (NFI), Tucker Lewis index (TLI), comparative fit index (CFI) and root mean square of error approximation (RMSEA) were calculated with satisfactory results, that is, NFI, TLI and CFI > 0.9, and RMSEA 19 and difficulty index <0.95. Sensitivity and specificity of RAKAS were above 90%. The tool established construct and known group validities.

    CONCLUSION: A novel tool to document disease knowledge in patients with RA was formulated and validated.

    Matched MeSH terms: Arthritis, Rheumatoid/diagnosis; Arthritis, Rheumatoid/physiopathology; Arthritis, Rheumatoid/psychology*; Arthritis, Rheumatoid/therapy
  11. Lau CS, Chia F, Harrison A, Hsieh TY, Jain R, Jung SM, et al.
    Int J Rheum Dis, 2015 Sep;18(7):685-713.
    PMID: 26334449 DOI: 10.1111/1756-185X.12754
    Rheumatoid arthritis is a chronic inflammatory condition that affects approximately 1% of the world's population. There are a wide number of guidelines and recommendations available to support the treatment of rheumatoid arthritis; however, the evidence used for these guidelines is predominantly based on studies in Caucasian subjects and may not be relevant for rheumatoid arthritis patients in the Asia-Pacific region. Therefore, the Asia Pacific League of Associations for Rheumatology established a Steering Committee in 2013 to address this issue.
    Matched MeSH terms: Arthritis, Rheumatoid/diagnosis; Arthritis, Rheumatoid/therapy*
  12. Bungau SG, Behl T, Singh A, Sehgal A, Singh S, Chigurupati S, et al.
    Nutrients, 2021 Sep 26;13(10).
    PMID: 34684377 DOI: 10.3390/nu13103376
    Rheumatoid arthritis (RA) is a progressive inflammatory disorder characterized by swollen joints, discomfort, tightness, bone degeneration and frailty. Genetic, agamogenetic and sex-specific variables, Prevotella, diet, oral health and gut microbiota imbalance are all likely causes of the onset or development of RA, perhaps the specific pathways remain unknown. Lactobacillus spp. probiotics are often utilized as relief or dietary supplements to treat bowel diseases, build a strong immune system and sustain the immune system. At present, the action mechanism of Lactobacillus spp. towards RA remains unknown. Therefore, researchers conclude the latest analysis to effectively comprehend the ultimate pathogenicity of rheumatoid arthritis, as well as the functions of probiotics, specifically Lactobacillus casei or Lactobacillus acidophilus, in the treatment of RA in therapeutic and diagnostic reports. RA is a chronic inflammation immunological illness wherein the gut microbiota is affected. Probiotics are organisms that can regulate gut microbiota, which may assist to relieve RA manifestations. Over the last two decades, there has been a surge in the use of probiotics. However, just a few research have considered the effect of probiotic administration on the treatment and prevention of arthritis. Randomized regulated experimental trials have shown that particular probiotics supplement has anti-inflammatory benefits, helps people with RA enhance daily activities and alleviates symptoms. As a result, utilizing probiotic microorganisms as therapeutics could be a potential possibility for arthritis treatment. This review highlights the known data on the therapeutic and preventative effects of probiotics in RA, as well as their interactions.
    Matched MeSH terms: Arthritis, Rheumatoid/microbiology; Arthritis, Rheumatoid/therapy*
  13. Chandirasekar R, Kumar BL, Jayakumar R, Uthayakumar V, Jacob R, Sasikala K
    Clin Chim Acta, 2015 Jan 15;439:77-83.
    PMID: 25307208 DOI: 10.1016/j.cca.2014.10.005
    BACKGROUND: Rheumatoid arthritis is the commonest inflammatory joint disease, affecting nearly 1% of the adult population worldwide. Early and accurate diagnosis and prognosis of rheumatoid arthritis (RA) have become increasingly important. In the present study, we aimed to elucidate the relationships between hematological, biochemical, immunological and cytogenetic parameters in rheumatoid arthritis patients and healthy normal controls.
    METHODS:The study group comprised of 126 RA patients and equal number of healthy normal control subjects. The blood wa s collected and analyzed for biochemical, immunological, enzymatic and cytogenetic parameters.
    RESULTS: Results of the present study indicated that 20% of RA patient's hematological, 31% of biochemical and 70% immunological parameters had a significant difference from the controls and reference range. The RF and anti-CCP antibody levels were also positive in 70% of RA patients. A significant increase in minor chromosomal abnormalities was also observed in patients as compared to controls.
    CONCLUSION: The knowledge about autoimmune diseases is very low among the South Indian population. The present study has thus helped in understanding the RA disease in a better way based on a pattern of various clinical markers of the disease condition which might help in planning therapeutic intervention strategies and create awareness about the disease management among RA patients of the population studied.
    KEYWORDS: Anti-cyclic citrullinated peptide (anti-CCP); Rheumatoid arthritis (RA); Rheumatoid factor (RF)
    Matched MeSH terms: Arthritis, Rheumatoid/blood; Arthritis, Rheumatoid/diagnosis*
  14. Das Gupta E, Tee HS, Sakthiswary R
    Pak J Med Sci, 2014 Sep;30(5):976-81.
    PMID: 25225510 DOI: 10.12669/pjms.305.5112
    Objective: The main objective of this study was to determine the predictors of frequent oral analgesic use among Rheumatoid Arthritis (RA) patients who were prescribed with the above medication on an ‘as needed’ basis.
    Methods: Patients with RA were recruited consecutively from the Rheumatology outpatient clinics in this cross-sectional study. The sociodemographic data, frequency of oral analgesic intake, Patient Global Assessment (PGA) scores and HAQ (Health Assessment Questionnaire) scores were determined by interviewing the subjects. Subjects were divided into 2 groups; frequent users (3 days and above in a week) and less frequent users (less than 3 days in a week).
    Results: In a total of 112 subjects, 39 (34.8%) were frequent analgesic users. Both the HAQ and PGA scores were significantly higher among the frequent users (p < 0.05). Using multivariate analysis, the HAQ scores (p=0.015, odds ratio 3.161 [95% confidence interval of 1.246-8.015]) and PGA scores (p=0.039 odds ratio 1.291 [95% confidence interval of 1.012-1.646]) were found to be independent predictors of frequent analgesic use.
    Conclusions: Our study confirms that the frequency of analgesic intake in Rheumatoid Arthritis has a significant relationship with patient-reported functional capacity and well being.
    KEY WORDS: Analgesic, Rheumatoid arthritis.

    Study site: Rheumatology clinic, Hospital Tunku Jaafar, Seremban, Negeri Sembilan, Malaysia
    Matched MeSH terms: Arthritis, Rheumatoid*
  15. Lee YH, Lew PH, Cheah CW, Rahman MT, Baharuddin NA, Vaithilingam RD
    J Int Acad Periodontol, 2019 07 01;21(3):99-110.
    PMID: 31473702
    Periodontitis (PD), a chronic inflammatory disease which results in irreversible attachment loss, bone destruction and tooth loss, is a major oral health problem. Rheumatoid arthritis (RA), with a global prevalence of 1%, is an autoimmune disease characterized as a chronic inflammatory disorder leading to synovial inflammation and destruction of cartilage and bone. Studies have reported an association between PD and RA whereby PD is reportedly more severe in patients with established RA. Justification for the plausible link between both conditions is based on shared characteristics and pathogenic similarities with regard to risk factors, immunogenetics and tissue destruction pathways. The search for the possible mechanism linking PD to RA continues as it can play an important role in enabling early intervention in the form of prevention and treatment of infection. This will ultimately improve patients' oral health related quality of life and reduce societal burden related to increased patient discomfort and treatment costs. The current review provides an update on the cellular and molecular events that have thus far explained the link.
    Matched MeSH terms: Arthritis, Rheumatoid*
  16. Wong TH, Das Gupta E, Radhakrishnan AK, Gun SC, Chembalingam G, Yeap SS
    MyJurnal
    Rheumatoid arthritis (RA) is a chronic inflammatory condition that can be associated with abnormal bone turnover and hence osteoporosis. Osteocalcin (OC) levels are increased in conditions with high bone turnover, including high RA disease activity. Thus, OC levels could possibly be used as a marker to assess bone health and disease activity in RA patients. As there have been no previous studies looking at serum OC levels in Malaysian RA patients, this study was performed to examine possible correlations between OC, bone mineral density (BMD) and disease activity in this population. A cross-sectional study of 75 female RA patients and 29 healthy controls was performed. Serum OC was measured using a Quantikine® ELISA kit. Dualenergy x-ray absorptiometry (DXA) was used to assess BMD. Serum OC levels were not significantly different between RA patients (median 14.44 ng/mL, interquartile range [IQR 12.99]) compared to healthy controls (median 11.04 ng/mL IQR 12.29) (p=0.198). Serum OC increased with age (Spearman’s rho r=0.230, p=0.047). There was no significant correlation between serum OC and body mass index (BMI), menopause status, BMD, DAS28, swollen or tender joint counts. Overall, there were 11 (14.7%) patients with osteoporosis and 27 (36.0%) with osteopenia. Menopause status was significantly associated with BMD at all sites (lumbar spine p=0.002, femoral neck p=0.004, total hip p=0.002). Serum OC were similar in RA patients compared to healthy controls. In RA patients, serum OC did not correlate with RA disease activity or BMD. Menopause status remains an important influence on BMD. Thus, measuring serum OC levels in Malaysian RA patients was not useful in identifying those at risk of low BMD.
    Study site: Rheumatology clinic, Hospital Tuanku Jaafar, Seremban, Negeri Sembilan, and Klinik Pakar Puchong, Kuala Lumpur, Malaysia
    Matched MeSH terms: Arthritis, Rheumatoid*
  17. Dalila AS, Mohd Said MS, Shaharir SS, Asrul AW, Low SF, Shamsul AS, et al.
    Kaohsiung J. Med. Sci., 2014 Jul;30(7):337-42.
    PMID: 24924839 DOI: 10.1016/j.kjms.2014.02.010
    The purpose of this study was to compare the serum interleukin (IL)-23 levels between rheumatoid arthritis (RA) patients and healthy controls and to determine the correlation of IL-23 levels with disease activity, joint damage and functional disability in RA. Serum samples were obtained from 45 patients with RA and 45 healthy controls. The enzyme-linked immunosorbent assay method was used for quantitative analysis of IL-23. All the RA patients were assessed for disease activity based on the 28-joint disease activity score, joint damage based on modified Sharp score, and functional ability using the Health Assessment Questionnaire-Disability Index. The mean serum IL-23 level was much higher among the RA patients (24.50 ± 13.98 pg/mL) compared to the controls (5.98 ± 3.40 pg/mL; p < 0.01). There was a significant positive relationship between IL-23 levels and disease activity and questionnaire scores (p = 0.003 and 0.020, respectively). On logistic regression analysis, IL-23 levels were significantly higher in patients with moderate to high disease activity (p = 0.008, odds ratio = 1.073, 95% confidence interval = 1.019-1.130) and patients with significant functional disability (p = 0.008, odds ratio = 1.085, 95% confidence interval = 1.021-1.153). RA patients have significantly higher levels of serum IL-23. The IL-23 levels correlate well with disease activity and functional disability but not with radiographic joint damage.

    Study site: Rheumatology clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)
    Matched MeSH terms: Arthritis, Rheumatoid/blood*; Arthritis, Rheumatoid/physiopathology; Arthritis, Rheumatoid/radiography
  18. Yeap SS, Mohd A, Kumar G, Kong KF, Chow SK, Goh EM, et al.
    Autoimmunity, 2007 May;40(3):187-90.
    PMID: 17453717 DOI: 10.1080/08916930701233755
    OBJECTIVE:
    To assess the relationship between the HLA-DRB1 genes with disease severity as assessed by radiological erosions in Malaysian patients with rheumatoid arthritis (RA).

    METHODS:
    In this cross-sectional study, we studied 61 RA patients who fulfilled the ACR criteria for the diagnosis of RA. HLA-DRB1 genotyping was performed by sequence specific primer (SSP) - PCR. Radiological grading and erosive score of the hands and wrists was calculated according to the Larsen-Dale method. Demographic data and treatment given to the patients were obtained from their case records.

    RESULTS:
    Fifty-six females and five males were studied from three ethnic groups. In 57 patients with erosions, rheumatoid factor was detected in 80%, HLA-DR4 in 40%, HLA-DRB1*0405 in 24% and shared epitope (SE) in 31%. The median delay in starting DMARDs was 24 months. The presence of rheumatoid factor, HLA-DR4 and HLA-DRB1*0405 were not significantly associated with a worse erosive score. Patients who possessed the SE had a higher erosive scores, compared to those who did not (p = 0.05). Concurrently, a delay in starting DMARD was associated with a high erosive score (p = 0.023, r = 0.348). However, after adjustment for the delay in starting DMARD, SE was no longer significantly associated with the erosive score.

    CONCLUSIONS:
    In these patients, the delay in starting DMARDs had a greater influence on the erosive score than SE alone. Whilst we cannot discount the contribution of the SE presence, we would advocate early usage of DMARDs in every RA patient to reduce joint erosions and future disability.
    Matched MeSH terms: Arthritis, Rheumatoid; Arthritis, Rheumatoid/genetics*; Arthritis, Rheumatoid/pathology*; Arthritis, Rheumatoid/radiography
  19. Hussain Manik Z, George J, Sockalingam S
    Scientifica (Cairo), 2016;2016:5609132.
    PMID: 27190682 DOI: 10.1155/2016/5609132
    Objective. To compare ultrasound synovial thickness of the 2nd, 3rd and 4th metacarpophalangeal joints (MCPJ) in a group of patients with proven rheumatoid arthritis (RA) and a control group of normal individuals. Materials and Methods. This is a cross-sectional study comprising 30 rheumatoid arthritis patients and 30 healthy individuals. Ultrasound scans were performed at the dorsal side of 2nd, 3rd, and 4th MCPJ of both hands in RA patients and the healthy individuals. Synovial thickness was measured according to quantitative method. The synovial thickness of RA patients and healthy individuals was compared and statistical cut-off was identified. Results. Maximum synovial thickness was most often detected at the radial side of the 2nd MCPJ and 3rd MCPJ and ulnar side of the 4th MCPJ of both hands which is significantly higher (p < 0.05) in RA patients compared to healthy individuals. With high specificity (96%) and sensitivity (90%) the optimum cut-off value to distinguish RA patients and healthy individuals' synovial thickness differs for the radial side of the 2nd and 3rd MCPJ and ulnar side of the 4th MCPJ. Conclusion. Patients with early RA appear to exhibit a characteristic pattern of synovitis which shows radial side predominance in the 2nd and 3rd MCPJ and ulnar side in the 4th MCPJ.
    Study site: University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
    Matched MeSH terms: Arthritis, Rheumatoid
  20. 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.
    Matched MeSH terms: Arthritis, Rheumatoid
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