Rheumatoid Arthritis UAE United Arab Emirates

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Many residents 'delay diagnosis by a year'
By Nina MuslimStaff ReporterPublished: June 22, 2008, 23:54
Paris/Dubai: A combination of drugs has been found to halt the progress or induce remission in rheumatoid arthritis, a crippling autoimmune disorder that affects the joints, European researchers have announced.
Speaking at a press conference during the European League Against Rheumatism (Eural) medical conference, researchers said a two-year study Combination of Methotrexate and Etanercept helped 50 per cent of more than 500 patients achieve clinical remission, in which they no longer showed symptoms.
A total of 80 per cent patients no longer showed signs of inflammation characteristic of the disorder in imaging tests. Fifty per cent patients achieved absence of symptoms, while 55 per cent patients were able to function normally in their daily activities.
Etanercept, marketed by Wyeth and AmGen as Enbrel, has a black box warning on it for increasing the risk of serious infections that can lead to death, such as tuberculosis and sepsis.
Prof. Paul Emery, president-elect of Eural who conducted the study, said it was important to start effective treatment as soon as possible to prevent damage.
"If you don't get it right at the beginning, you don't get right at the end," he said. "Once in remission, there is a good chance of stopping therapy."
Many patients in the UAE do not receive the most effective treatment early on. Dr. Humeira Badsha, specialist rheumatologist at Dubai Bone and Joint Centre, told Gulf News many in the UAE delayed diagnosis by more than a year.
"We have published in leading journals showing that the average patient here has a delay in diagnosis of more than 12 months and further delay in treatment of more than a year. Patients here feel that there is no effective treatment and hence try alternative forms of medicine before seeing a rheumatologist," she said.
She said treatment should occur within three months of onset of symptoms or disorder, adding a few patients who received early aggressive treatment were now effectively "cured" and in remission.
Rheumatoid arthritis (RA) is a chronic disease, which occurs when the immune system attacks the joints and causes inflammation in some organs, such as the lung and skin. It is life-shortening, causes disability and has been likened to cancer.
The prevalence rate for the disease is one per cent, with women three times more likely to be affected. A rheumatoid arthritis group in the UAE claims 19,500 women in the UAE have the disorder but does not explain how it came by the figure.
Dr Humeira said because the disease robbed people of their normal function and productivity, treatment for it should be considered essential and included under Dubai Health Funding plan. Treatment costs about Dh5,000 a month.
"Definitely it is essential. These diseases affect young people and cause disability. It is also shown that RA leads to shortened life span of more than 10 years. Specialists now know that RA is every bit as damaging as cancer, can shorten life span and place a huge burden on families."
The average patient has a delay in diagnosis of more than 12 months ... Patients here feel there is no effective treatment and hence try alternative forms of medicine before seeing a rheumatologist."

Treatment of arthritis. The role of cortisone, steroids

There are many cultural differences in patients' understanding of and acceptance of treatment. In the United States I was able to explain to patients that they needed a short course of prednisolone to rapidly control symptoms while other medications have time to work. No one likes to take steroids but patients ould accept my explanation and be willing to take short courses of treatments. However, in Dubai people have a deep distrust and fear of steroids. The moment I mention the medication I am greeted with expressions of suspicion.

The use of steroids is not just to control symptoms but for quick, effective reduction in inflammation. Steroids have received bad press because some patients are left on these medications at high doses for many months, sometimes years. In this situation it can cause weight gain, moon face, brittle bones, hypertension etc. In the short term it is rapidly effective, safe, and sometimes life saving. Hench, who discovered prednisolone won the Nobel prize for his discovery in 1947. One of the first people to be treated with prednisolone for arthritis was famous painter Raoul Dufy in Boston. The key to using steroids is lowest doses for shortest duration of time.

Osteoporosis Dubai UAE

7 Days, Dubai UAE
Last Updated : Friday 02 May, 2008 -

Osteoporosis has become one of the biggest health issues facing women in the Middle East. For Doctor Humeira Badsha, a specialist rheumatologist working at the Dubai Bone and Joint Centre, the statistics are a grave concern. “About 70 per cent of post menopausal women have a combination of osteoporosis and osteopenia. Osteoporosis is defined as having very weak bones, and osteopenia is moderately weak bones,” says Badsha.

This disease can ultimately lead to fractures, and a rapid decline in the quality of life. Although, the vast majority of women perceive osteoporosis to be limited to the older generation, a recent study carried out by the Dubai Bone and Joint Centre suggests otherwise.“We conducted a survey of 2,000 healthy people walking around a mall in the UAE. We checked the bone density and we found that amongst these 2,000 healthy adults, where the average age was 39 years, 30 per cent had a low bone mass,” says Badsha. Doctor Badsha points out that although low bone mass isn’t in itself osteoporosis, or osteopenia, it is nevertheless is a worrying trend.“Thirty per cent of young healthy adults walking about a mall having low bone mass is a shocking statistic,” she says. It seems that there is a concerning lack of awareness among women about osteoporosis. Experts like Doctor Badsha urge women to become more educated on the condition, understand the risks involved and take precautions to avoid developing osteoporosis. Doctor Badsha stresses that public awareness is key.“The more you reach out to people, the more we screen them and the more we see them coming in for treatment, and the more we save women from brittle bones,” she says.What are the consequences of osteoporosis?Osteoporosis bone fractures are responsible for considerable pain, decreased quality of life, lost workdays, and disability. Up to 30 per cent of patients suffering a hip fracture will require long term nursing home care, while some 20 per cent of women with a hip fracture will die in the subsequent year as an indirect result of the fracture. In addition, once a person has experienced a spine fracture due to osteoporosis, he or she is at very high risk of suffering another such fracture in the near future.How is osteoporosis prevented?The goal of osteoporosis treatment is the prevention of bone fractures by stopping bone loss and by increasing bone density and strength. Although early detection and timely treatment of osteoporosis can substantially decrease the risk of future fracture, none of the available treatments for osteoporosis are complete cures. In other words, it is difficult to completely rebuild bone that has been weakened by osteoporosis. Therefore, prevention of osteoporosis is as important as treatment.Here are five steps to bone health and osteoporosis prevention:>> Get your daily recommended amounts of calcium and vitamin D.>> Engage in regular weight-bearing exercise for stronger bones.>> Avoid smoking and excessive alcohol.>> Talk to your healthcare provider about bone health.>> When appropriate, have a bone density test and take medication.GET MORE INFORMATIONContact the Dubai Bone and Joint Centre on 04 330 2000 or visit www.dbaj.ae

Yoga for arthritis

Recently a small study showed the benefits of yoga for osteoarthritis. We have just completed the firts styudy of yoga for rheumatoid arthritis. the results were dramatic:

THE BENEFITS OF YOGA FOR RHEUMATOID ARTHRITIS: RESULTS OF A STRUCTURED 8 WEEK PROGRAM

Dr. Vishwas Chhabra 1, Dr. Humeira Badsha 2 Dr.Cathy Leibman3 Dr. Ayman Mofti 4 and Dr. Kok Ooi Kong 5

1. Prime Medical Center, Dubai, UAE 2. Dubai Bone and Joint Center, Dubai, UAE, 3. Emirates Arthritis Foundation, Dubai, UAE, 4. American Hospital, Dubai, UAE, 5. Tan Tock Seng Hospital, Singapore, Singapore.




ACKNOWLEDGEMENTS; This study was funded by the Emirates Arthritis Foundation. We would like to acknowledge Ms. Gemma Tapado for support in data entry and logistics and Freiburg Medical laboratory, Dubai, UAE for ESR testing.

Is it possible to cure arthritis?

Of course we all know that doctors do not cure anything. We TREAT illness and manage chronic problems like arthritis, diabetes, and hypertension. However, do you know that it is possible to CURE cancer in the early stages? I was talking to my friend, a breast cancer specialist this weekend. We both get upset and angry with those who claim to have 'natural' cures to everything in the world, including cancer and arthritis. What is true though, is that both cancer and arthritis can be CURED in early stages by conventional and new forms of therapy.

We have recently been treating early rheumatoid arthritis very aggressively and are finding that many patients go into remission and are able to come off ALL medications. I am currently following 5 patients who have no evidence of disease activity and are off all treatment for arthritis. Hence, the moral is still ... early diagnosis, early treatment.

Arthritis Research Dubai new treatments rheumatoid arthritis

We have successfully implemented research as part of the Rheumatology program at DBAJ. Soon we will conduct the first clinical trials in the region of a new and promising treatment for Rheumatoid arthritis. We have conducted a trial on the benefits of yoga for rheumatoid arthritis, as well as cross-sectional studies of arthritis patients. To participate or contribute to research in the region visit www.dbaj.ae

Arthritis Exercise

There are many different types of arthritis and hence many different forms of exercises may be beneficial to you. If you have back pain swimming is a great form of exercise. Back pain also responds to exercise with a qualified phyiotherapist. People who are overweight and have multiple painful joints, especially due to osteoarthritis, benefit from aqua aerobics. We have recently found a specially designed and structured yoga program to be extremely useful for patients with Rheumatoid arthritis. In Dubai and soon in Abu Dhabi, all of these forms of exercise programs have been given to patients free of charge through the Emirates Arthritis Foundation. Contact www.arthritis.ae for more information.