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Serum Zinc and Copper Level in Juvenile Idiopathic Arthritis (JIA) Patients and Its Correlation with Disease Duration-A Tertiary Hospital Study

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Open Journal of Rheumatology and Autoimmune Diseases 2024年第2期14卷 60-68页

作者： Mohammad Imnul islam Mujammel Haque Tanzida Sultana Mousumi Ahmed mohammed mahbubul islam Kamrul Laila Manik Kumar Talukder Department of Paediatrics Bangabandhu Sheikh Mujib Medical University (BSMMU) Dhaka Bangladesh

Background: Juvenile Idiopathic Arthritis (JIA) is the most prevalent rheumatic disease in children. It is associated with abnormal levels of serum zinc (Zn) and copper (Cu) as during inflammation serum copper concentration increases and zinc decreases. Objective: To assess the serum Zn and Cu levels in different sub-types of JIA patients and their correlation with the disease duration. Methods: This cross-sectional study was conducted over twelve months at the Pediatric Rheumatology Division, Department of Paediatrics, Bangabandhu Sheikh Mujib Medical University. Sixty-nine JIA cases that fulfilled the International League of Association for Rheumatology (ILAR) criteria were taken as cases and age and sex-matched healthy children were considered as controls. The serum Zn and Cu tests were done using the spectrophotometric method with INDIKO PLUS Drug Analyzer. Data were recorded in a pre-designed questionnaire. Data were checked, verified and analyzed manually where continuous variables were analyzed using unpaired t-test and categorical variables using the ANOVA test. Pearson’s correlation coefficient test was used to see the correlation of serum zinc and copper levels with disease duration. Results: Boys were predominant in both case and control groups, with the majority within the 10 to 16-year-age group. Enthesitis-related arthritis (ERA) was the most common subtype followed by sJIA, Oligo JIA, Poly JIA (RF-) and unclassified subtypes. Disease duration was found less than 12 months in 30.4% of JIA patients. Serum analysis revealed a statistically significant reduction in mean zinc levels and increased copper levels in JIA patients compared to controls. This study observed a negative correlation between serum zinc levels and disease duration, whereas serum copper levels exhibited a positive correlation with disease duration. Conclusion: In conclusion, this study revealed that JIA patients exhibit alterations in serum zinc and copper levels. Serum copper levels s

关键词： Copper Juvenile Idiopathic Arthritis Zinc

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Frequency of Uveitis among Juvenile Idiopathic Arthritis Patients in a Tertiary Care Hospital of Bangladesh: A Retrospective Study

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Open Journal of Rheumatology and Autoimmune Diseases 2024年第3期14卷 144-156页

作者： Md. Asif Ali Mujammel Haque Kamrul Laila Mohammad Hafiz Al-Mamun mohammed mahbubul islam Mohammad Imnul islam Manik Kumar Talukder Pediatric Rheumatology Division Department of Pediatrics Bangabandhu Sheikh Mujib Medical University Dhaka Bangladesh

Background: Juvenile idiopathic arthritis (JIA) is the most frequently encountered pediatric rheumatologic disorder with an unknown etiology. At present there is no published data regarding the frequency of uveitis in patients with JIA in Bangladesh. This study aimed to observe the frequency of JIA-associated uveitis (JIAU) and distribution of uveitis among different sub-categories of JIA at the Pediatric Rheumatology division, both outdoor and indoor patients, Department of Pediatrics, Bangabandhu Sheikh Mujib Medical University (BSMMU) in Bangladesh. Methods: This was a retrospective study of 1784 JIA patients at the Pediatric Rheumatology division, BSMMU from July 2010 to March 2023. Results: Among the 1784 enrolled JIA patients, we observed that 0.73% of cases had uveitis. Here, 61.5% of JIAU cases were male. Most of the cases (92.3%) had bilateral uveitis and only 7.7% cases had unilateral uveitis. Among JIAU patients, the majority were Oligo JIA (53.8%), followed by ERA 30.8%, Poly JIA RF(−) 7.7% and Systemic JIA 7.7% cases respectively. This study also revealed that 15.4% of JIAU patients had ANA positivity and 23% had HLA B-27 positivity. Here we also found ocular complications associated with uveitis such as band keratopathy (23.1%), posterior synechiae (15.4%) and cataract (15.4%). Conclusions: In this study, we observed only 0.73% of patients of JIA had developed uveitis which is lower than the frequency observed in other European studies. This study also showed various ocular complications amongst JIA-associated uveitis patients which signifies the importance of adherence to periodic ophthalmological follow-up to prevent these ocular complications.

关键词： JIA Uveitis HLA-B27 ANA BSMMU

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Efficacy of Folinic Acid in Comparison to Folic Acid for Reducing Side Effects of Methotrexate in Children with Juvenile Idiopathic Arthritis

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Open Journal of Pediatrics 2023年第2期13卷 170-180页

作者： Sazida islam Mohammad Zahirul islam Khan Kamrul Laila mohammed mahbubul islam Shahana A. Rahman Ibn Sina D. Lab and Consultation Center Dhaka Bangladesh Department of Paediatrics 250 Beded General Hospital Gopalganj Bangladesh Bangabandhu Sheikh Mujib Medical University Dhaka Bangladesh

Background: Methotrexate (MTX) is the most effective and commonly used disease-modifying anti-rheumatic drug in the management of juvenile idiopathic arthritis. Several patients develop side effects, which may lead to low quality of life and non-compliance to MTX. To reduce MTX-induced side effects, folic acid supplementation is prescribed by most rheumatologists. Even after that, some patients have symptoms while receiving MTX. Objectives: To assess the efficacy of folinic acid in comparison to folic acid for reducing the side effects of MTX in JIA patients. Material and methods: In this prospective observational study, newly diagnosed cases of JIA who would be getting MTX were included by purposive sampling. Data were collected using a predesigned questionnaire. Among 40 patients, 20 received folinic acid (Group A), and 20 received folic acid (Group B). Disease activity levels were assessed by JADAS-27 (Juvenile Arthritis Disease Activity Score). Contents from the MISS (MTX Intolerance severity score) questionnaire were used to assess the side effects. All patients were evaluated at baseline, 6th, and 12th weeks. Results: There were significant differences in the frequency of MTX-related adverse events between folinic acid (Group A) and folic acid (Group B). Group A patients only had nausea (10% and 15% in the 6th & 12th week respectively) and vomiting (5% at both follow-ups). On the other hand, in addition to nausea (70% and 95% in the 6th & 12th week) and vomiting (20% and 90% in the 6th & 12th week), folic acid group patients had restlessness, crying, and irritability. Self-discontinuation of MTX was present in the folic acid group (5% & 10% in the 6th & 12th week). Improvement of disease activity was more in the folinic acid group. Conclusion: The folinic acid group had significantly fewer side effects. Improvement of disease activity was more and compliance was also better among them. Methotrexate (MTX) is the most effective and commonly used disease-modifyin

关键词： Folinic Acid Folic Acid Adverse Events Disease Activity

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PERFORMANCE STUDIES OF A FINITE ELEMENT SOFTWARE FOR LINEAR ELASTICITY ANALYSIS

PERFORMANCE STUDIES OF A FINITE ELEMENT SOFTWARE FOR LINEAR ...

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The 2nd Session of 2008 Workshop of Pakistan Academy of Sciences

作者： Abul Mukid Mohammad Mukaddes mohammed mahbubul islam Department of Industrial and Production Engineering Shahjalal University of Science and TechnologySylhet Bangladesh

ADVENTURE on Windows is a collection of finite element modules including ADVENTUREolid ported to Microsoft Windows for use in a single CPU. It supports the iterative domain decomposition method with a preconditioner for the solution of linear equations. This paper analyzed 3 dimensional linear elastic stress problems and measured the performance of the finite element software ADVENTURE on Windows. A complete finite element analysis from CAD design to visualization was performed in this research successfully. Two simple models have been considered for the linear elastic problems. Computational results show the computation time, required memory, convergence criteria and some limitations of the software.

关键词： Finite Element Method Linear Stress Analysis ADVENTURE on Windows Domain Decomposition Method Balancing Domain Decomposition

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Thalidomide Is an Adjunct Therapy for the Refractory Systemic Juvenile Idiopathic Arthritis Patients in a Tertiary Hospital Study

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Open Journal of Rheumatology and Autoimmune Diseases 2023年第2期13卷 51-63页

作者： Md. Taiyabur Rahman Mujammel Haque Farhana Faria mohammed mahbubul islam Manik Kumar Talukder Mohammad Imnul islam Shahana Akhter Rahman Department of Paediatrics Bangabandhu Sheikh Mujib Medical University Dhaka Bangladesh

Background: Systemic JIA (sJIA) is one of the subtypes of JIA, which is most difficult to treat among all JIA cases. About 50% of sJIA cases did not respond to traditional disease modifying anti-rheumatic drugs (DMARDs)—metho-trexate (MTX). Thalidomide is an immunomodulating and anti-inflammatory drug that induces sustained improvement of refractory sJIA cases. Objectives: To evaluate the efficacy of thalidomide in refractory sJIA patients. Methods: This was a prospective interventional study carried out in the Paediatric Rheumatology and Immunology follow-up clinic run by the Department of Pediatrics, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from January 2019 to July 2020. Twenty-five sJIA patients who were refractory to conventional DMARDs were included in this study. These patients were prescribed thalidomide at a dose of 3 - 5 mg/kg/day for six months and efficacy was assessed by using juvenile arthritis disease activity score (JADAS 27) at 12th and 24th weeks of treatment. Result: Active joint counts and ESR improvement were observed in 90.69%, 97.67% and 69.84%, 100% of sJIA patients respectively at 12th and 24th weeks of treatment. Improvement of physicians and parent global assessment of VAS were 77.56%, 97.43% and 70.62% and 96.04% respectively at 12th and 24th weeks of treatment. Improvement of the total score of JADAS-27 was 77.51% at 12th week and 97.52% at 24th of week follow-up which was statistically significant. Somnolence, constipation and paresthesia were found as common adverse effect in this study. Conclusion: Efficacy of thalidomide was assessed by JADAS 27 criteria showed significant improvement in refractory sJIA patients in this study. It may be concluded that Thalidomide is safe and effective as an adjunct therapy of refractory sJIA patients.

关键词： Juvenile Idiopathic Arthritis Thalidomide Refractory sJIA

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