Purpose: To determine the prevalence of common sleep problems among patients with rheumatoid arthritis (RA) and their relationship with the disease activity and quality of life. Patients and methods: The study sample consisted of 101 patients who attended a rheumatology clinic at a university hospital between October 2015 and May 2016. All subjects were clinically examined and interviewed by physicians using a questionnaire. The collected information included sociodemographic characteristics, the patients’ medical histories, the Disease Activity Score (DAS28), the Berlin questionnaire to assess the risk of obstructive sleep apnea (OSA), the Epworth Sleepiness Scale to assess excessive daytime sleepiness (EDS), the Athens Insomnia Scale to assess insomnia, the International RLS Study Group score to diagnose restless legs syndrome (RLS), and the Health Assessment Questionnaire (HAQ) to assess the quality of life. Results: The mean age of the participants was 48.7±14.6 years, and 95% of the participants were females. Approximately 60% of the participants were in the remission/low category of disease activity, and the average DAS28 score was 3.3±0.8 years. The prevalence rates of insomnia, EDS, sleep disturbance, risk of OSA, and RLS were 63%, 20%, 20%, 37%, and 63%, respectively. Furthermore, the distribution of sleep disorders was not affected by the disease activity. The association between the HAQ and sleep disorders among the RA patients was not significant. Conclusion: Sleep disorders are common among RA patients and may require further attention by treating clinicians; nevertheless, these disorders are not associated with disease activity and do not affect the quality of life.

Granulomatosis with polyangiitis is a small vessel vasculitis with a wide spectrum of presentation, ranging from limited disease to life-threatening situation such as alveolar hemorrhage. Immunosuppression is the corner stone of the treatment and if left untreated, the death toll increases dramatically. We presented a case of granulomatosis with polyangiitis, presented with alveolar hemorrhage associated with COVID-19 infection. The patient admitted to the intensive care unit, received pulse steroids, plasmapheresis and intravenous immunoglobulin. She was not given further immunosuppression because of the coexisting COVID-19. Up to our knowledge, this is the first reported case of alveolar hemorrhage secondary to granulomatosis with polyangiitis coexisting with COVID-19 infection.

Background: The current systematic review and meta-analysis was conducted to estimate the prevalence of fibromyalgia syndrome (FMS) in Saudi Arabia. Methods: A PRISMA systematic search appraisal and meta-analysis were conducted. A systematic literature search of English publications in PubMed, Embase, PsycINFO, Web of Science, MEDLINE, and Google Scholar, was conducted up to December 2022. Generic, methodological and statistical data was extracted from the eligible studies. Meta-analysis was done using Comprehensive Meta-Analysis Software. The effect size estimates were calculated using the Fail-Safe N test. The funnel plot, Begg’s and Mazumdar’s rank correlation tests were employed to find any potential bias. The strength of the association between two variables is assessed using Kendall’s tau. A fixed-effects model for the meta-analysis. Results: The literature search yielded a total of 2479 studies. Eight papers were included in the final analysis with sample size ranging 40 to 1686. All studies were cross-sectional except two, which were retrospective. The total number of the participants recruited in the included articles was 4967 (1794 males and 3173 females); with age ranged between 20 and 79 years. There was high heterogeneity among studies articles (Q = 270.187; p-value 0.001); the tau value was 0.179. The pooled event rates and the 95% confidence intervals (CIs) for the prevalence of FMS in Saudi Arabia in a fixed-effects model was 13.4% (95% CI: 0.124–0.144). Conclusion: Our results clearly demonstrate that FMS is highly prevalent (13.4%) in Saudi Arabia. It also more common among women. The high prevalence of FMS in Saudi Arabia should be seriously considered and planners should take steps to reduce it.

Introduction: Post-Streptococcal Reactive Arthritis (PSRA) is defined as inflammatory arthritis of ≥1 joint associated with a recent group A streptococcal infection in a patient who does not fulfill the Jones criteria for the diagnosis of Acute Rheumatic Fever (ARF). Methods: In this narrative review, we conducted a systematic search on MEDLINE, EMBASE, Cochrane Library and Google Scholar using the words poststreptococcal reactive arthritis. The search covered the time period between 1982 and 2016. The purpose of this review is to summarize the current state of knowledge of PSRA with respect to the definition, epidemiology, clinical presentation and treatment. We also summarize the key differences between PSRA, reactive arthritis (ReA) and ARF. Results: PSRA has a bimodal age distribution at ages 8-14 and 21-37 years with an almost equal male to female ratio. Clinically, it causes acute asymmetrical non-migratory polyarthritis, however, tenosynovitis and small joint arthritis may occur. This disease entity can be associated with extraarticular manifestations, including erythema nodosum, uveitis and glomerulonephritis. The frequency of HLA-B27 in PSRA does not differ from that of the normal population, which suggests that it is a separate entity from ReA. Involvement of the axial skeleton, including sacroiliitis, is uncommon in PSRA. PSRA tends to occur within 10 days of a group A streptococcal infection, as opposed to the 2 to 3 weeks delay for ARF. PSRA can be associated with prolonged or recurrent arthritis, in contrast to ARF, in which arthritis usually lasts a few days to 3 weeks. Treatment usually involves NSAIDs or corticosteroids. Conclusion: We summarize clinical features that help differentiate PSRA from ARF and ReA. First-line treatment options include NSAIDs and corticosteroids. Most cases resolve spontaneously within a few weeks, but some cases are recurrent or prolonged. There are no published randomized controlled trials of PSRA.

Study Objectives:Although previous studies suggested an increased prevalence of obstructive sleep apnea (OSA) among patients with rheumatoid arthritis (RA), no existing large prospective study has ...

Fibromyalgia (FM) is a chronic, multifactorial pain condition. The latest literature suggests that genetic and environmental factors including continuous stress contribute significantly to FM's pathophysiology. In this study, we aimed to investigate the prevalence of FM among medical students as they are considered a population significantly at risk of developing the condition. This cross-sectional study was conducted at King Abdulaziz University. Medical students included in the study were recruited through a random stratified sampling method. A self-administered questionnaire was distributed to the participants; it included questions related to widespread pain index (WPI) and symptom severity scale (SSS) to assess the symptoms and diagnosis of FM, which were established based on the current diagnostic criteria. All first-year students were excluded from this research. A total of 450 participants were recruited for the study. Among them, 291 (64.7%) were females and 159 (35.3%) were males. Their ages ranged from 18 to 26 years, and the mean age was 21.52 years (SD: ±1.52). They came from different academic levels: 97 (21.6%) were in the second year, 79 (17.6%) were in the third year, 70 (15.6%) were in the fourth year, 99 (22%) were in the fifth year, and 105 (23.3%) were in the sixth year. The overall prevalence of FM was found to be 43 (9.6%). It was established based on the number of students who fulfilled the diagnostic criteria or were previously diagnosed with FM by a professional physician. FM is highly prevalent among medical students. Our findings demonstrate the likelihood of the influence of medical school on causing the condition, as it has a stressful education system with high academic expectations. We recommend that this issue be seriously addressed since FM leads to a significant burden on the students and can negatively affect their future medical practice.