Objective: To translate and validate the Modified Health Assessment Questionnaire from English to Urdu. Method: The validation study was conducted at the Rheumatology outpatient department of Fauji Foundation Hospital, Rawalpindi, Pakistan, from July 1 to September 30, 2019. Two translators were given the modified health assessment questionnaire for translation from English to Urdu. It was then back-translated by two independent translators. The translated version of the tool was applied to rheumatoid arthritis patients to check for reliability, test-retest and internal consistency. It was applied to another group of patients to check for criterion validity. Reliability analysis was checked by applying Cronbach alpha. Criterion validity was checked by assessing disease activity score-28 and its correlation with Modified Health Assessment Questionnaire. Data was analysed using SPSS 23. Results: Of the 30 patients in the initial testing, 28(93%) were females and 2(6.6%) were males, with an overall mean age of 38±13.2 years. Of the 100 patients in the second group, 97(97%) were women and 3(3%) were men, with an overall mean age of 42±12.37 years. The mean disease duration of the cohort was 8.4±4.8 years. The Cronbach alpha value was 0.797 and interclass coefficient was 0.7, reflecting good reliability. A significantly high correlation between Modified Health Assessment Questionnaire and disease activity score-28 was noted along with pain, tenderness, swollen joints, patient global assessment, age and erythrocyte sedimentation rate (p<0.05), while poor correlation was found with gender, disease duration, rheumatoid arthritis factor and anti-cyclic citrullinated peptide antibody (p>0.05). ---Continue

Objective: To identify the risk factors of chronic low backache in patients presenting to a tertiary care hospital of Pakistan. Study Design: Cross sectional study. Place and Duration of Study: Department of Rheumatology, Fuji Foundation Hospital, Rawalpindi Pakistan, from Nov 2018 to Apr 2019. Methodology: Patients of ages between 18-80 years of ages with mechanical low backache were selected excluding those with malignancy and inflammatory backache. Patient’s characteristics including gender, age, education, monthly income, smoking status, exercise, previous back trauma, spinal surgery, posture mostly adopted, sleeping material, body mass index (BMI), and co-morbidities were noted down. For assessment of disability and depression Quebec disability index and patient health questionnaire (PHQ9) were used. Results: This study included 155 patients with backache with mean age (in years) of 55.45 ± 10.772. Mean duration of backache was 4.78 ± 4.36 years. Most common risk factor for low backache was age >40 years present in 144 patients (92.9%). 136 patients (87.7%) were not doing regular physical exercise.62.5% patients (97) were uneducated and 90 patients (58%) had low income. 82 patients (52.9%) used soft sleeping material. By using Quebec disability index, 57 patients (36.7%) were classified as having severe disability. Mild depression was present in 75 patients (48.3%) when assessed on PHQ-9 scale. Conclusion: Back pain was caused by many factors. Lack of regular exercise and education, use of soft sleeping material and in appropriate sitting posture can be addressed by education of the patients.

Objective: To determine the relationship between demographic variables and the level of disease awareness among patients of Systemic lupus erythematosus (SLE). Study Design: Cross-sectional study Place and Duration of Study: Fauji Foundation Hospital, Rawalpindi Pakistan, from Mar 2019 to Jan 2020. Methodology: The study included 150 patients, diagnosed with systemic lupus erythematosus according to SLICC criteria. A self-made questionnaire was used, including three sets of questions. The first set collected information on socio-demographic characteristics, and the second set gathered information regarding the symptoms and treatment. While, the third was based on aetiology, aspects of life affected and sources of disease knowledge. Results: A total of 150 participants' data was analysed; the majority of those were females. The mean age was 36.19±12.08 years and 17.3% of the patients had adequate knowledge of the disease. There were no statistically significant differences in awareness based on gender, education level and geographical distribution. Conclusion: SLE is a two-pronged sword that affects patients' mental and physical health. Patient awareness remains an important aspect of disease management which is currently not emphasized appropriately. At the community and national levels, measures must be taken to promote and create awareness regarding SLE.