Search

Background/Aims Rheumatoid arthritis (RA) is a systemic chronic autoimmune disease. It presents as an inflammatory arthritis with varying severity and symptoms like joint pain, joint stiffness, fatigue, sleep disturbances, dryness, etc reducing the quality of life (QoL).1 Patients with RA experience impairment in all aspects of QoL (limitation of physical function, disability and pain) and mental health (anxiety and depression etc). Depression is two times more common in RA patients and intriguingly a bi-directional relationship with RA has been shown in cross-sectional studies.2 Patients with RA are more likely to suffer from anxiety, depression and low self-esteem, with high levels of associated mortality and suicide.3 There is an imperative need to improve the QoL and emotional wellbeing for these patients. Digitalization plays an incredibly significant role in health care, not only in monitoring but also in self-management of disease and symptoms. The aim of the study is to assess the impact of a digital health program on the emotional wellbeing and QoL of patients suffering from RA. Methods An intervention trial with a patient support program was delivered using Wellthy Care digital platform over a period of 16 weeks. Recruitment of 30 patients was done using a convenient sampling method. Patients who were diagnosed with RA were included in the trial. Patients who were under 18, pregnant/lactating, and with hearing disability were excluded. The program included interventions such as physiotherapy sessions, CBT (cognitive behavioural therapy) counselling, nutrition counselling, health and lifestyle coaching, symptom monitoring, disease awareness and self-management training. WHO-5 wellbeing score4, a widely used questionnaire for assessing subjective psychological well-being was administered along with a proprietary questionnaire for QoL by Wellthy. Results The Mean emotional wellbeing score of patients at baseline was 10.13 and at endline was 18.13. The program positively impacted the emotional wellbeing and quality of life by 78.97% and 41.18 % respectively. The mean Qol score of the patients at baseline was 12.82 and at endline was 18.1. The Paired T-test witnessed significant improvement in emotional wellbeing scores, Qol scores following RA patient support program from 10.13±4.65 to 18.13±3.04, an improvement of 8.0±1.61(p Conclusion The RA support program delivered by Wellthy therapeutics proved to be highly effective in improving emotional wellbeing and QoL for RA patients. This health program had a great impact on several dimensions of patient-reported outcomes for emotional wellbeing and QoL. Digital health technology has the potential to bridge the gap in current care delivery of chronic and debilitating conditions such as RA. Disclosure S. Bhalla: None. A. Shah: None. B. Sinha: None. S. Damse: None. P. Thiyagarajah: None. K. Soulat: None.

Background: Nonsteroidal anti-inflammatory drugs (NSAIDs) are considered the first-line drugs for axial spondyloarthritis because of their high efficacy in controlling symptoms. However, the review of the literature shows that among Caucasian patients, only ~ 1/3rd with recent disease onset and only ~10% with the long-standing disease achieved partial or complete remission. The present study was, therefore, aimed at finding out how many Indian axSpA patients achieved low-disease activity state or remission over a short period of 12 weeks. Methods: This was a retrospective study including 35 patients, both nonradiographic and radiographic axSpA, classified according to the Assessment of Spondyloarthritis International Society criteria (2009). Information was extracted from the electronic medical records for patients who had only received NSAIDs without any disease-modifying anti-rheumatic drugs or biologicals. The primary objective was to analyze the effect of continuous use of NSAIDs on their disease activity status as measured by the Ankylosing Spondylitis Disease Activity Score (ASDAS)-C-reactive protein (CRP) cutoff values at the baseline as compared to that after 3 months. Results: A total of 31/35 patients continuously treated with NSAIDs for 12 weeks showed statistically significant improvement in their disease activity status as measured by ASDAS-CRP (P < 0.05). A total of 19/35 and 12/35 patients achieved remission (i.e., ASDAS-CRP < 1.3) and low disease state (i.e., ASDAS-CRP

The progress in the understanding of inflammatory muscle diseases over the past several decades has been slow but steady. The classification given by Bohan and Peter's in 1975 was based on clinical features. It served well, but inadequacies were also obvious. The increasing discoveries of autoantibodies in this group of disorders have helped in refining the classification of Bohan and Peter's to a large extent. At the present state of knowledge, it is now possible to classify and sub-classify this group of diseases using distinct clinical features combined with the type of autoantibodies in well-defined subsets. Not only the subsets help predicting the type of organ involvement and comorbidities but may also help choose a specific drug for a particular subclass. This approach may lead to the practice of precision medicine for inflammatory myositis.

Background: Inflammatory polyarthritis is seen in ~80% of patients with systemic lupus erythematosus (SLE); yet, there is no validated “instrument” for its assessment. The commonly used measures of disease activity, namely SLE Disease Activity Index 2000 (SLEDAI2K) and British Isles Lupus Assessment Group are complex and impractical for routine use in busy outpatient clinics. This “proof of concept” study's primary aim was to test clinical disease activity index (CDAI) as a possible instrument for measuring the joint disease in SLE that may have a face value and sensitivity to change. The secondary aim was to determine the efficacy of low-dose methotrexate in the SLE joint disease. Materials and Methods: This open-label study included the Systemic Lupus International Collaborating Clinics criteria classifiable thirty patients with SLE with inflammatory polyarthritis as the main manifestation. SLE disease activity and the joint disease activity were assessed using SLEDAI2K and CDAI, respectively, at the baseline and in the follow-up. The CDAI and the SLEDAI2K scores were compared between the first and the last visit, as well as compared with each other, using a nonparametric test (Wilcoxon signed-rank test). Results: CDAI scores improved significantly on treatment from a mean of 19.30 to 1.58 and in SLEDAI2K from 7.83 to 0.6, respectively; the pre- and the postintervention scores were statistically highly significant (P 0.05), indicating similarity in their sensitivity to change. A significant number of patients achieved low disease activity status or remission in their joint disease. Conclusion: CDAI appears to be sensitive to change with treatment. Therefore, it could be used as a tool for assessing inflammatory arthritis in SLE.

Hypoglycemia can cause multiple neuroglycopenic symptoms; seizures being one of them. Misdiagnosis and delay in treatment are common and prolonged hypoglycemia can lead to permanent neurological deficit or fatal coma. Hypoglycemia caused by an insulinoma is a readily treatable condition that should be considered in the differential diagnosis of intractable seizures. The following case report highlights the need for careful reassessment of all seizures that are atypical and refractory to medication.