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Background: In this study, the relationship between involvement by COVID-19 and the recurrence of symptoms of rheumatoid arthritis (RA) was investigated., Materials and Methods: This cross-sectional study was conducted on 112 patients with RA with and without a history of COVID-19. The severity and recurrence of RA symptoms were measured and recorded by the Disease Activity Score in 28 joints (DAS-28) index and clinical evaluations by a rheumatologist., Results: The results showed that the recurrence of RA in patients with and without a history of COVID-19 had a statistically significant difference ( P < 0.001). In addition, there was a statistically significant relationship between erythrocyte sedimentation rate, visual analogue scale (VAS), tender joint count, swollen joint count, and DAS-28 and the history of COVID-19 ( P < 0.05)., Conclusion: The present study showed that infection with COVID-19 leads to the recurrence of joint symptoms in RA patients., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Research in Medical Sciences.)

Background: To investigate the effects of moderate aerobic exercise on the hemoglobin, hematocrit, and red blood cell (RBC) mass of women with rheumatoid arthritis (RA)., Materials and Methods: This randomized clinical trial was conducted at the Specialized Clinic of Physical Medicine and Rehabilitation, Al-Zahra Hospital of Isfahan, during a 4-month period in 2014. We included patients with RA who did not have any malignancy and hematologic disorder. Two groups - one group receiving aerobic therapy along with medical therapy ( N = 16) and the other group receiving medical therapy alone ( N = 17) both for a period of 8 weeks. The levels of RBC mass, Hb, and HCT were measured before and after the intervention. The changes in these parameters were compared between the two study groups., Results: There was no significant difference between the two study groups regarding the baseline characteristics. The aerobic exercise resulted in increased RBC mass ( P < 0.001), Hb ( P < 0.001), and HCT ( P < 0.001). However, those who received medical therapy alone did not experience any significant changes in these parameters. We found that the RBC mass ( P = 0.581), Hb ( P = 0.882), and HCT ( P = 0.471) were comparable between the two study groups after 8 weeks of intervention., Conclusion: Although the aerobic exercise results in increased Hb, HCT, and RBC mass in patients with RA, the increase was not significant when compared to that in controls. Thus, the increase in the HB, HCT, and RBC could not be attributable to aerobic exercise.

Background: The role of obesity in clinical curse of rheumatoid arthritis (RA) is not clear. We investigated the association of obesity and adiposity with disease activity and clinical response to combination therapy in RA patients., Materials and Methods: Active RA patients with the disease activity score using 28 joint counts (DAS28) > 2.6 were studied. Height, weight, and waist and hip circumferences were measured and body mass index (BMI) and waist to hip ratio were calculated. Patients were treated with methotrexate (7.5 to 10 mg/week) plus hydroxychloroquine (200 to 400 mg/day) and prednisolone (2.5 to 10 mg/day) and were followed by DAS28 for up to 24 weeks., Results: One hundred and six patients were studied; age = 48.5 ± 13.8 years, 87.7% female, disease duration = 4.4 years [SE = 0.48]. DAS28 was decreased from 4.5 ± 1.6 to 2.9 ± 1.4 (P < 0.001) after 24 weeks of treatment. Only in patients with disease duration of ≤2 years, BMI (r = -0.415, P = 0.005) and waist circumference (r = -0.296, P = 0.05) were correlated with baseline DAS28. Although BMI (r = -0.337, P = 0.025) and waist circumference (r = -0.315, P = 0.038) were correlated with change in DAS28 after therapy, these correlations were disappeared after controlling for baseline DAS28., Conclusion: Obesity and adiposity are associated with less severe disease activity in early stage of RA, but are not associated with response to combination therapy with methotrexate plus hydroxychloroquine in RA patients.

Background: Osteoporosis and diabetes mellitus are major and growing public health problems particularly among postmenopausal women. This study was conducted to evaluate the relationship between osteoporosis and osteopenia with type 2 diabetes mellitus (DM) in postmenopausal women., Materials and Methods: In a cross sectional study, we compared 200 diabetic postmenopausal women with 400 non-diabetic postmenopausal women over the age of 60 years. Age, Body Mass Index (BMI), T score of the lumbar vertebra (L2-L4) and femoral neck were measured with Dual Energy X-ray Absorptiometry (DXA) and were compared between the two groups. Hemoglobin A1C (HbA1C) was also measured in patients with type 2 DM and its relationship with osteoporosis was studied. Chi-square, Fisher's exact test and Independent T-test was used for analyzing the data. The statistical significance was set at a P value of 0.05 or lower., Results: Mean, SD ages were 65.23 ± 4.80 vs. 66.91 ± 5.78 years and BMI were 28.94 ± 4.06 vs. 31.65 ± 4.42 kg/m(2) in non-diabetic and diabetic groups, respectively. Lumber T scores was -2.10 ± 1.08 vs.-2.16 ± 1.27 (P = 0.60), femoral neck T-score was -0.72 ± 1.00 vs. -1.09 ± 0.96 (P = 0.00) in non-diabetic and diabetic groups, respectively. There was a significant difference in femoral neck T score between the diabetic and non-diabetic group (P = 0.00). In diabetic women, bone loss was more common in those with HbA1C ≥7 compare to those with HbA1C <7 (P = 0.006)., Conclusion: Osteopenia and osteoporosis is more common in diabetic postmenopausal women compare to the non-diabetic postmenopausal women.

Background: Patients with rheumatoid arthritis may be resistant to conventional treatment with disease-modifying antirheumatic drugs (DMARDs). On the other hand, biologic therapy is costly and may be inconvenient for many patients. Pamidronate is a potent bisphosphonate with the capacity of modifying the biological activity of the immune system cells. It may thus be used as an anti-inflammatory agent in patients with inflammatory joint diseases., Materials and Methods: To assess the effectiveness of pamidronate in the management of rheumatoid arthritis, we selected 38 patients with rheumatoid arthritis to enroll in a pilot study to receive pamidronate and conventional treatment with prednisolone and DMARDs in combination. These patients received 60 mg of pamidronate for 3 consecutive months and were followed for 6 months since the first infusion., Results: The mean visual analogue score (VAS) and disease activity score (DAS28) fell steadily until one month after the third infusion. However, no improvements were observed during the 3 months after the last infusion of the drug. All patients, except one, reported decreased pain in response to 3 consecutive pulses of pamidronate and most had improvements in the assessed laboratory and clinical indices. The drug was tolerated well in our patients., Conclusion: Pamidronate infusions had beneficial effects on various clinical and laboratory parameters of patients, but alleviation of symptoms were temporary and did not last for more than 6 months. This treatment option can be a choice for difficult cases of rheumatoid arthritis with severe pain and osteoporosis.