Rheumatology Research Journal
Volume:8 Issue: 2, Spring 2023

Rheumatoid arthritis (RA) is one of the most common autoimmune diseases causing many physical and mental complications, and disorders in patients. This study aimed to evaluate the mental health and sleep quality of RA patients referred to the Rafsanjan Rhematology Clinic. This descriptive-analytical study was conducted on 35 patients and 35 healthy people referring to Rheumatology Clinic of Rafsanjan. Data collection tools included demographic information, Depression, Anxiety and Stress Scale 21 (DASS21), and Pittsburgh Sleep Quality Index. Then, the data were analyzed by SPSS 20 and using independent t-test, Chi-square, and multivariate analysis of covariance. The total score of DASS21 indicated that stress, anxiety, and depression in the patient was significantly higher than the healthy group. In comparison to the healthy group, patients' mean total scores for sleep and all of its subscales (apart from subjective sleep quality) were considerably higher (P = 0.001). The mean total score of sleep, and all its subscales (except the subjective sleep quality) in the patients was significantly higher than the healthy group, indicating that they had a lower sleep quality. Based on the results of our study, mental health, and sleep quality are common problems in RA patients. Therefore, along with standard treatments for the disease, attention should be paid to mental health, and sleep status of affected patients.

Felty syndrome is a form of rheumatoid arthritis (RA) that usually presents with neutropenia and splenomegaly. It usually occurs in the setting of long-lasting (RA)and rarely as an early manifestation of RA.

A 47-year-old female patient presented to the emergency department with a history of fever and arthralgia. She was found to have splenomegaly and pancytopenia. After ruling out hematologic malignancies by bone marrow biopsies, she was diagnosed with RA. Rheumatoid factor (RF) and cyclic citrullinated peptide antibody (Anti-CCP) levels were elevated. The patient was ultimately diagnosed with early-onset Felty syndrome in the course of RAand an occult hepatitis B infection. Despite the low incidence rate of Felty syndrome, it should be considered as a differential diagnosis of patients with arthralgia, fever, neutropenia, and splenomegaly.

Literature described wide disparities in incidence and prevalence between different types of vasculitis. There were no comprehensive studies on ethnic or racial associations in all types of primary systemic vasculitis (PSV) in any published article until this review commenced in 2020. The review aims to synthesize the evidence regarding the relation between ethnicity and the incidence and/or prevalence of different types of PSV. A total of 52 selected articles which include clinical trials, cohorts, cross-sectional studies, case series, and case studies and have been published within the last 10 years in the human population, were reviewed by searching Medline, PubMed, and Google Scholars databases using predefined keywords. The PRISMA diagrams were followed to identify relevant articles. The methodological qualities of the studies were assessed using the EPHPP tool. Finally, a summary of the evidence on the association between ethnic origin and PSV was painstakingly compiled. The connection between ethnicity and different types of PSV has been found to be significantly diverse in this researchas vasculitis is more common in Asians and Scandinavians, Kawasaki disease and periarteritis nodules are more prevalent in Japanese and Alaskanatives,ANCAassociated vasculitis is more frequent in Caucasians, whereas Henoch-Schonleinpurpura and Cogan syndrome more usual in Caucasians and Asians. Furthermore, Behçet's disease more commonly occurs on the "Silk Road," especially in Turkey. Genetic susceptibility and environmental elements could contribute to the global variation in the incidence and prevalence of primary systemic vasculitis.

Because osteoporosis is largely preventable and an essential principle in preventing this condition is the way of thinking, lifestyle, and daily habits of people, the current study aimed to determine the knowledge, attitude, and practice of nurses at Rafsanjan University of Medical Sciences regarding osteoporosis. The population of this descriptive study comprised 418 nurses at Ali-Ibn Abi-Talib Hospital in Rafsanjan by census in 2021. The data collection tool was a valid questionnaire that was completed through self-reporting. Data were entered into SPSS software version 24 and analyzed using the chi-square, independent t-test, and one-way analysis of variance tests. The mean age of participants was 34.15±7.28 years, and the mean work experience was 9.36±7.46 years. Of the 418 subjects, 214 (51.2%) were female, and 204 (48.8%) were male. The mean score in the field of knowledge was 20.84 (out of 28 points), in the field of attitude was 18.70 (out of 22 points), and in the field of practice was 9.32 (out of 18 points). The mean scores of knowledge (p=0.001), attitude (p=0.015), and practice (p<0.001) of nurses were significant according to different age groups. Women obtained higher mean scores for knowledge than men (p<0.001), but men achieved higher mean score for practice than women (p<0.001). The current finding indicate that nurses' knowledge and attitude towards osteoporosis in Rafsanjan are optimal. Nonetheless, their practice of preventing this disease is weak and requires influential factors.

Since the beginning of COVID-19 pandemic, there was a concern whether patients with rheumatic diseases are at increased risk of severe COVID-19 in terms of the multi-system involvement, underlying comorbidities, and anti-rheumatic medications. We intended to evaluate the severity and mortality of COVID-19 in these patients, as well as the demographic, laboratory, and clinical risk factors associated with the disease. In patients with plasma chane reaction positive COVID-19 admitted to the hospital, laboratory and clinical measures after hospitalization and severity measures such as length of hospitalization, hospitalization in the intensive care unit, and mortality were compared between patients with and matched patients without a history of rheumatic disease. Moreover, risk factors associated with COVID-19 mortality in the case group were calculated by odds ratio (OR). We found no statistically significant difference in COVID-19 severity between the two groups (mortality rate of 22% in case and 25% in control groups, P-value = 0.83). Except for platelet markers, which were considerably greater in the case group despite not being related with the severity of the illness, the available laboratory measurements did not vary between these groups. In addition, we showed that age over 65 years (OR = 4.06), lactic dehydrogenase level, percentage of lung involvement and ischemic heart disease (OR = 6.24) were associated with poorer outcome in the patients with rheumatic diseases. Hence, we found that usage of conventional synthetic disease modifying anti-rheumatic drugs (OR = 2.3, P-value = 0.48) or daily treatment dose of prednisolone >10 mg/d (OR = 1.04) were not associated with COVID-19 mortality. Although the patients with rheumatic disease may be at increased risk of developing a COVID-19 infection, they do not experience more severe disease.

One of the problems of employees in different occupations, especially employees in multiple wards of the hospital,is work-related musculoskeletal disorders. Evaluating the incidence of work-related musculoskeletal illnesses and associated variables among employees is crucial in light of the significance of this problem and staff health. Therefore, we evaluated the prevalence of work-related musculoskeletal disorders among Ali-Ibn Abi-Talib Hospital’s staff in Rafsanjan city in 2019. In this study, 220 staff members (143 females and 77 males) entered the study in 2019 with personal consent, and to collect data, the demographic information questionnaire and Nordic Musculoskeletal Questionnaire was used.The mean age of staff was 35.43 ± 8.08 including treatment staff (nurses-physicians) (46.8%,) administrative staff (33.6%), and service staff (drivers-workers) (19.6%). Additionally, 40% of all work-associated musculoskeletal diseases were connected to the neck region, 38% to the knees, 36%to the lower back, and 12% to the elbows, feet, and ankles, 16% to the thighs, and 24.1% to the back. The prevalence of disorders in some areas, such as the neck was high as in some studies. Therefore, it seems that the necessary planning should be done to prevent further occurrence of these disorders among hospital staff, which may lead to inefficiency.