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Background: Gout is the most prevalent inflammatory arthritis in the Asia‐Pacific region and worldwide. This clinical practice guideline (CPG) aims to provide recommendations based on systematically obtained evidence and values and preferences tailored to the unique needs of patients with gout and hyperuricemia in Asia, Australasia, and the Middle East. The target users of these guidelines are general practitioners and specialists, including rheumatologists, in these regions. Methods: Relevant clinical questions were formulated by the Steering Committee. Systematic reviews of evidence were done, and certainty of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation methodology. A multi‐sectoral consensus panel formulated the final recommendations. Results: The Asia‐Pacific League of Associations for Rheumatology Task Force developed this CPG for treatment of gout with 3 overarching principles and 22 recommendation statements that covered the treatment of asymptomatic hyperuricemia (2 statements), treatment of acute gout (4 statements), prophylaxis against gout flare when initiating urate‐lowering therapy (3 statements), urate‐lowering therapy (3 statements), treatment of chronic tophaceous gout (2 statements), treatment of complicated gout and non‐responders (2 statements), treatment of gout with moderate to severe renal impairment (1 statement), and non‐pharmacologic interventions (5 statements). Conclusion: Recommendations for clinically relevant scenarios in the management of gout were formulated to guide physicians in administering individualized care. [ABSTRACT FROM AUTHOR]

Macrodystrophia lipomatosa (ML) is a rare congenital non-hereditary condition caused by an increase in all mesenchymal elements. We report a 14-year-old girl who presented to the Medical Outpatient Department, Kunhitharuvai Memorial Charitable Trust Medical College, Kozhikode, India, in 2017 with progressive enlargement of digits. An X-ray and T1-weighted magnetic resonance imaging scan showed enlargement of the phalanges of the middle and index finger of the left hand with an overgrowth of soft tissues. The patient was subsequently diagnosed with ML. As the condition is benign and usually asymptomatic, no medical treatment was deemed necessary. This report describes a case of ML and proposes a set of diagnostic criteria to aid clinicians in the differential diagnosis of the condition. [ABSTRACT FROM AUTHOR]

Objective: Antiphospholipid antibody syndrome (APS) is one of the most common acquired thrombophilic disorders resulting in arterial and venous thromboses. APS is a major cause for cerebrovascular accidents or stokes, myocardial infarction, venous thromboembolism and recurrent abortions/pregnancy losses especially in young patients. APS patients have an increased risk of atherosclerotic cardiovascular events. There are only two studies on lipid abnormalities in APS patients. None of them have studied the relationship between individual laboratory tests for APS and lipid profile abnormalities. Here we describe the significance of the relationship between various APS tests and lipid profile abnormalities in a subset of APS patients who presented with arterial thrombosis in a tertiary care hospital. Material and Methods: The study was conducted at Government Medical College, which is a tertiary care referral hospital. All patients who presented to the medicine department with APS during a two-year period were studied. A patient was considered to be positive for anticardiolipin (aCL) antibody or anti-ß2 glycoprotein (anti-ß2G) if the titer was more than 15 IU/mL, and a high titer was considered to be more than 40 IU/mL for Immunoglobulin (lg) IgG and IgM isotypes. The fasting lipid profile was measured in all patients, and lipid profile abnormalities were defined with cutoffs of low-density lipoprotein (LDL) levels of >150 mg/dL, triglyceride (TG) levels of >150 mg/dL, and high-density lipoprotein (HDL) levels of <40 mg/dL. The relationship between lipid abnormalities and individual tests for APS, aCL IgG and IgM and anti-ß2G IgG and IgM, were determined by statistical analysis. Results: The study population included 77 APS patients, with 53% of patients between 20 and 40 years. The commonest abnormality in the lipid profile test was elevated TG levels of >150 mg/dL in 51.9% of the patients, followed by low HDL levels (<40 mg/dL) in 38.9% of the patients and high LDL levels (>150 mg/dL) in 40.2% of the patients. There was a statistically significant relationship between anti-ß2G IgG levels and HDL and LDL levels, but not TG levels. Only LDL levels had a statistically significant relationship with aCL IgM levels. None of the lipid abnormalities had any statistically significant relationship with aCL IgG levels. Conclusion: This study highlights the importance of testing lipid profile abnormalities in APS patients and the existence of a statistically significant relationship between antiphospholipid antibody tests and lipid profile abnormalities. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented about integrating musculoskeletal disorders into the national program for non-communicable diseases.