The effect of Ramadan fasting on quiescent systemic lupus erythematosus (SLE) patients' disease activity, health quality of life and lipid profile: a pilot study.

SLE is a common autoimmune disease with considerable morbidity. Ramadan fasting is a religious custom Muslims regularly practice. We aimed to evaluate the effect of Ramadan fasting on SLE patients' disease activity, health quality of life and lipid profile. We conducted this case control study as a pilot study in 40 quiescent SLE patients, 21 cases who decided to fast and 19 controls who decided not to have Ramadan fasting between August and November 2009 in lupus unit of Rheumatology Research Center in Tehran University of Medical Sciences, Iran. They were assessed for SLE Disease Activity Index, lipid profile and quality of life with Short-Form 36 (SF-36) Health Survey, 1 day before Ramadan, the day after and 3 months after Ramadan fasting. After 24.1 ± 5.4 (mean ± SD) days of fasting, anti-ds DNA increased for 0.34 ± 0.41 mmol/dL in cases versus 0.07 ± 0.31 in controls (P = 0.026). Likewise C3 increased more dramatically in cases (16.8 ± 17.5 vs. 2.3 ± 13.2 mg/dL, P = 0.006). Three months after fasting, anti-ds DNA was still increased 0.28 ± 0.46 mmol/dL in cases while a 0.02 ± 0.43 mmol/dL drop in controls was detected (P = 0.04). On the contrary, C3 returned to baseline. These changes were not accompanied with significant changes in disease activity and health quality of life. Ramadan fasting had no effect on lipid profile except for delayed total cholesterol decrease in cases in comparison with controls (16.4 ± 29.4 decrease vs. 4.6 ± 23.9 mg/dL decrease, P = 0.018). Ramadan fasting probably has no detrimental effect on SLE patients' disease activity and their quality of life in the quiescent phase of disease.

Prevalence and risk factors of five most common upper extremity disorders in diabetics.

BACKGROUND: In addition to macrovascular and along with other microvascular complications, diabetic patients suffer from some common musculoskeletal complications. The aim of this study was to assess the prevalence of five musculoskeletal disorders of upper extremity including shoulder capsulitis (SC), limited joint mobility (LJM), Dupuytren's contracture (DC), carpal tunnel syndrome (CTS), and trigger finger (TF) as well as identify their related risk factors in diabetic patients. METHODS: We recruited 432 types 1 or 2 diabetic patients and evaluated them for the presence of musculoskeletal disorders and their-related risk factors in 2012-13. The patients were examined by an endocrinologist and then suspected subjects evaluated by a rheumatologist for defining final diagnosis. RESULTS: The most prevalent musculoskeletal disorder of upper extremity was SC (8.79%), followed by CTS (8.56%), LJM (6.94%), DC (7.4%), and TF (6.71%). Advanced age, female sex, smoking, and duration of diabetes were associated with the appearance of SC; female sex and duration of diabetes with CTS; advanced age and smoking with LJM; advanced age, duration of diabetes and history of foot ulcer with DC; and history of laser photocoagulation was associated with TF. CONCLUSIONS: The results show lower prevalence of upper musculoskeletal disorders and different associated risk factors in our diabetic population in comparison with previous studies on other populations.