Disease Burden Estimation of Lymphatic Filariasis in an Endemic Area.

Background: Anecdotal evidence collected by a community organization suggested high prevalence of lymphatic filariasis (LF) in Sitapur district, Uttar Pradesh. Village volunteers subsequently conducted a line listing in 13 villages of Pisawan block and recorded 261 cases of known LF complications, namely hydrocele and lymphedema. This being far higher than official projections, a block-wide cluster survey was conducted to estimate the disease burden more accurately. Methods: Cluster sampling techniques were applied, and 41 clusters selected within Pisawan block. Survey teams comprising one woman and man interviewed member of all households in the cluster, recording details of individuals suffering from hydrocele or lymphedema within them. Age and gender were noted, as well as duration of symptoms and details of any treatment availed. Results: A total of 1851 patients (1256 males and 595 females) were reported to have lymphedema, hydrocele, or both in the 6931 households surveyed. This equates to a prevalence rate of 4.95% (with 9.75% margin of error) in Pisawan block. With these calculations, an estimated 11,049 + 1077 patients with LF complications in Pisawan block, Sitapur, UP in 2016. Conclusions: The high prevalence rate of LF complications in Pisawan block is disconcerting, especially considering India's commitment to eliminate LF by 2020. Compliance with Mass Drug Administration (MDA) must be improved. Furthermore, the Morbidity Management and Disability Prevention (MMDP) component of the National Programme for Elimination of Lymphatic Filariasis (PELF) must be strengthened so that such patients can lead a productive life.

Comparison of patients with ankylosing spondylitis (AS) and non-radiographic axial spondyloarthritis (nr-axSpA) from a single rheumatology clinic in New Delhi.

AIM: Comparison of ankylosing spondylitis (AS) with non-radiographic axial spondyloarthritis (nr-axSpA) classified with the recent ASsessment of spondyloArthritis International Society (ASAS) criteria. PATIENTS & METHODS: This study included 288 patients clinically diagnosed as having spondyloarthritis (SpA) where a satisfactory radiograph of sacroiliac (S-I) joints was available. The AS and the nr-axSpA groups were compared for the various SpA-related variables. RESULTS: Of 288 axSpA patients, there were 187 with AS. Of the remaining 101 patients without radiographic sacroiliitis, S-I joint magnetic resonance imaging (MRI) was available in 72; 54 of them showed active sacroiliitis thus classified as nr-axSpA according to the ASAS criteria. The remaining 18 patients with normal MRI and the other 29 patients without MRI of the S-I joints (total 47 patients), were classified as nr-axSpA using the 'clinical arm' of the ASAS criteria. On comparing the 187 AS with 101 patients in the nr-axSpA group, the AS group showed significantly more males, longer disease duration, more axial symptoms at disease onset, higher Bath Ankylosing Spondylitis Metrology Index and more syndesmophytes. Biologicals were offered significantly more often to the AS group but methotrexate as monotherapy or in combination with other disease-modifying anti-rheumatic drugs was offered more often in nr-axSpA group. There was no statistically significant difference between AS and nr-axSpA in other SpA parameters. CONCLUSION: The differences brought out between AS and nr-axSpA groups show that they may not be the same disease. A prospective long-term follow-up of large cohorts may help in clarifying if nr-axSpA is simply an early stage in the spectrum of SpA evolving into AS over time or is there inherent difference between them.

Computer-aided treat to target (T2T) Approach for the Rheumatology Patient.

Since 2001,we had been using a document template with manual calculators to assess the disease status during each visit and based on that, formulate a proper treatment plan for our patients We had good outcomes but the process was laborious and slow. From 2007 onwards, we shifted to a rheumatology specific EMR with automatic calculators. This article compares outcomes of Rheum Aid® (a clinician developed EMR for rheumatology) supported "Objectified Assessment" and prescription writing on patients with rheumatic diseases versus previous use of an MS Word® document template and shows better turnover and patient satisfaction.