Aims We aimed to assess the level of non-adherence and poor illness perception among rheumatoid arthritis (RA) patients. Additionally, we examined their associations with clinical indicators and outcomes. Methods This was a cross-sectional study conducted using data collected at the time of patient enrolment in the Pakistan Registry of Rheumatic Diseases (PRIME) registry. A wide range of clinical variables was studied. To measure adherence, we used the Urdu version of the General Medication Adherence Scale (GMAS), which has recently been validated in RA patients. A Brief Illness Perception Questionnaire (BIPQ) was used to measure illness perception. Results The data of consecutive 320 RA patients were reviewed. Thirty-six percent of the cohort (n=116) was noted to have non-adherence. On multiple logistic regression analysis, a significant association of non-adherence was noted with moderate-to-severe stress (odds ratio {OR}: 1.85, confidence interval {CI}: 1.04-3.2), DAS-28 scores (OR: 1.83, CI: 1.52-2.21), Health Assessment Questionnaire (HAQ) scores (OR: 1.77, CI: 1.07-2.92), and deformed joint counts (OR: 1.30, CI: 1.15-1.46). Additionally, non-adherence due to "patient behavior" had a significant association with the male gender (OR: 0.48, CI: 0.26-0.87), unemployment (OR: 1.82, CI: 1.07-3.10), and stress at home (OR: 2.17, CI: 1.35-3.49). Twenty-six percent of the cohort (n=86) was noted to have the most negative illness perception, and on multiple logistic regression analysis, it was significantly associated with male gender (OR: 0.24, CI: 0.11-0.53), age of onset of arthritis (OR: 0.96, CI: 0.94-0.99), and worse HAQ scores (OR: 3.7, CI: 2.2-6.1). Conclusions Important adverse factors contributing to non-adherence and negative illness perception highlighted in this study were stress at home, female gender, and younger age of patients.

Background and objectiveSystemic lupus erythematosus (SLE) is one of the most devastating systemic autoimmune connective tissue diseases. There is a paucity of prospective data on Pakistani SLE patients, and in this prospective study, we aimed to investigate the disease course, clinical outcomes, and the predictors of poor outcomes in a random population-based cohort of newly diagnosed SLE patients (diagnosed within the last one year). MethodsThis was a prospective observational study carried out in the rheumatology department of the Fatima Memorial Hospital, Lahore. Lupus patients are regularly reviewed in our dedicated lupus clinic every one to three months. For the purpose of this study, a focus group of newly diagnosed patients (diagnosed within the last one year) attending our lupus clinic was identified and prospectively followed up for 12 months. A wide range of demographical and clinical parameters was recorded. The association of clinical variables with the progressive disease was determined using univariate and multivariate logistic regressions. ResultsProspective data of 89 newly diagnosed SLE patients regularly attending our dedicated lupus clinic were reviewed. During the study period, (January 2021 through January 2022), these patients had multiple visits overall -median: five, minimum: three, and maximum: nine visits [interquartile range (IQR) 4-7]. All 89 patients had completed one year of follow-up. Of note, 46% of the cohort was noted to have an ongoing active disease during the majority of visits in the study period. On multiple logistic regression analysis, there was a significant association between ongoing active disease ("progressors") and low education status [odds

Background: Pregnancy may worsen underlying autoimmune rheumatologic illnesses. The trans-placental transmission of autoantibodies can harm the foetus or newborn. Aim: To determine the impact of maternal rheumatological disorders on fetal and newborn outcomes. Methods: A descriptive longitudinal study was conducted at Fatima Memorial Hospital enrolling 32 pregnant women with rheumatologic disorders by consecutive sampling. Data was collected regarding maternal demographics, diagnosis, serum markers, Fetal & neonatal outcome factors (IUGR, Fetal distress, Umbilical Doppler findings, Fetal Echo, Place of birth, Mode of delivery, discharge status, Term/pre-term birth, Gender, Low Birth Weight, Cardiac defect, NICU stay, the reason for NICU stay) Results: The diagnosis of 50% of the subjects was SLE. 25%subjects were suffering from RA. Regarding serum markers, 50% of the mothers were Anti ds DNA positive followed by ANA with 34.4% & Lupus anticoagulant with 21.9% positivity. IUGR was recorded in 9.4%, fetal distress in 28.1%, abnormal umbilical doppler in 9.4%, and 12.5% of a newborn could not survive. Pre-term delivery was recorded in 31.3% of cases, low birth weight in 34.4%, cardiac defects in 6.3%, thrombocytopenia in 6.3%, NICU stay was required in 31.3%, EOS was reason in 12.5% and RDS in 25%. Conclusion: Prevalence of IUGR, fetal distress, low birth weight, preterm delivery, cardiac defects and admission to NICU was high in autoimmune rheumatological pregnant females. Pre-term delivery, fetal distress and LBW were significantly associated with SLE. Keywords: Pregnancy outcome, rheumatic disease outcome, fetus, neonate, SLE