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Objectives: This study investigated the effect of cervical flexor muscles fatigue on neck proprioception and postural stability., Methods: Forty-five male and female subjects were evaluated pre, immediate after induction of fatigue, and after recovery. Isometric neck flexor muscle endurance test (NET) was used for the induction of cervical flexor muscle fatigue. Cervical proprioception was assessed by cervical joint position error test (JPET) via overhead laser pointer while postural stability was assessed by using (a) biodex balance system measuring "Overall stability index (OSI), Anterior/ posterior (A/P) index and medial/ lateral (M/L) index", (b) multidirectional reach test., Results: There was a significant decrease in cervical proprioception (cervical joint position error test) and postural stability (biodex balance system & multidirectional reach test) immediate post-induction of fatigue compared with both before induction of fatigue & after recovery from fatigue (p<0.001)., Conclusion: Subjects suffering from cervical muscles fatigue are vulnerable to have a significant effect on neck proprioception and postural instability as it impaired the cervical proprioception sense & postural stability. Therefore, our study provides information for the clinicians and patients to avoid overload fatigue of the cervical muscles because it affects overall postural balance, neck proprioception & righting reaction., Competing Interests: The authors have no conflict of interest.

Introduction Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease that can vary among different ethnic and racial groups. Objective The objective of this paper is to study the prevalence of various manifestations of SLE in a sample of the Egyptian population. Patients and methods Information in this study was derived from the medical records of SLE patients who sought medical advice at a private clinic in Cairo from January 1980 to June 2016. Results This study included 1109 SLE patients, of whom 114 (10.3%) were males and 995 were females (89.7%). Mean age of onset was 25.89 ± 10.81 years, while the median of disease duration from the onset of the disease till the last recorded visit was 26 months. The most common cumulative manifestations were arthritis (76.7%), malar rash (48.5%), leukopenia (45.7%), and photosensitivity (45.6%). A total of 33.1% of the patients had nephritis, and neuropsychiatric lupus was present in 6.4% of the patients. Secondary antiphospholipid syndrome was present in 11.5% of the patients. Antinuclear antibody and anti-double-stranded deoxyribonucleic acid were present in 1060/1094 (96.9%) and 842/1062 (79.3%) of the patients, respectively. Antiphospholipid antibodies were present in 266/636 (41.8%) of the patients, anti-Smith in 54/240 (22.5%), anti-SSA/Ro in 61/229 (20.4%), and anti-SSB/La in 32/277 (11.6%) of the patients. Male patients had a statistically higher prevalence of nephritis ( p = 0.01), whereas arthritis and alopecia were statistically higher in females ( p = 0.012 and p = 0.006, respectively). Patients with juvenile onset had a statistically higher prevalence of nephritis and seizures ( p < 0.001 and p = 0.012, respectively). Conclusions Arthritis and malar rash represented the most common clinical manifestations. Male and juvenile-onset patients had a predilection toward a more severe disease. These results are in agreement with many studies conducted in the Middle East and worldwide. On the other hand, major organ involvement was exceptionally low, which is contradictory to several reports from the Middle East and across the globe.