Gout is a type of inflammatory arthritis with drastically increasing incidence since last twenty years. Increased serum uric acid levels and deposition of urate crystals in joints and soft tissues are known to stir-up the symptoms of gout. Patient's quality of life (Qol) suffers markedly due to inflammation, pain, restricted mobility, health economic burden and suboptimal therapeutics associated with gout. Related articles published between 2007 and 2018 were reviewed with the help of different databases including PubMed, Springer link, Medline, Google scholar and Science direct. To ensure the accuracy and credibility of data, articles published only in indexed journals were considered. Gout is a common metabolic disorder that is provoked by increased level of serum uric acid. Presence of other comorbidities i.e. hypertension, diabetes and cardiac diseases precipitate the rate of mortality. Number of gout patients is shown to increase in developed countries whereas developing countries remain at high risk category. The enormous increase in gout is due to chronicity, lack of awareness among patients, poor diagnosis, suboptimal treatment and economic burden. Risk factors associated with gout are well identified and pathophysiology is well-established hence, measures can be taken to improve diagnosis and to ensure cost effective options for the treatment. To curtail the global health burden and to improve patient quality of life there is need: to reduce exposure to risk factors, to promote awareness, to institute robust prophylactic measures, to modify lifestyle, to establish signs for early diagnosis and to develop optimized treatment strategies and policies.

Background: Numerous studies have investigated the role of apolipoprotein E (APOE) polymorphisms in coronary artery disease (CAD), but some controversies exist regarding the outcomes as the results were not consistent and remain uncertain. Therefore, the present meta-analysis was conducted to evaluate the association of APOE polymorphisms with coronary artery disease. Methods: All the relevant studies published in English language till August 2020 were identified by searching through various electronic databases. The complete data was independently extracted by the two researchers. The data were analyzed by using the Comprehensive Meta-Analysis program and MetaGenyo program. The pooled odds ratio was used to check the associations between CAD and APOE polymorphisms. The following genetic models were used to calculate the odds ratio: ε2 vs. ε3 and ε4 vs. ε3. Results: In the final analysis, we include 12 studies regarding the role of APOE polymorphism in CAD. The pooled odds ratio for ε4 allele was higher (OR 2.00; 95% and CI, 1.48–2.71). There is no statistical significant association for ε2 allele with CAD (OR 1.38; 95% CI, 1.18–1.62). This analysis showed no publication bias exists in the current meta-analysis. Conclusions: Our findings suggest that the apolipoprotein ε4 allele appears as a significant genetic risk factor for coronary artery disease while the ε2 allele is beneficial to alleviate the CAD risk. Trial registration: Registered with PROSPERO International Prospective Register of Systematic Reviews. PROSPERO registration number CRD42020190464

Rheumatoid arthritis (RA) is a systemic self-inflicted inflammatory disease that primarily affects middle-aged women. Globally, 1% of people live with RA. This review aims to provide updated information on the different aspects of RA, including its epidemiology, pathophysiology, diagnosis, treatment, and management. A web-based literature search was conducted through various databases, including PubMed, Google Scholar, and Science Direct, to identify the most relevant studies. Epidemiological studies have suggested that the prevalence and occurrence of RA have remained inconsistent across geographical areas in different periods. Many factors such as age, gender, inheritances, and environmental exposure can contribute to the severity of the disease. The acute form of RA usually presents with pain, and if left untreated, it can result in joint deformities and influence a patient’s quality of life (QoL). RA diagnosis is usually based on the manifestation of pain with inflammation. Currently, many therapeutic strategies are available for the cure of RA. The management of daily routine activities is required with treatment to curtail the damage, avoid future deformities, and ultimately minimize the aching trouble of the patient.

Background: COVID-19 is an emerging infectious disease and has reached a status of global health emergency. It is widespread in Pakistan causing morbidity and mortality amongst masses. Objectives: Undertaken study aims at investigating knowledge, attitude and practices of the people residing in Lahore, Pakistan whilst the global crisis with sparse data available previously. Methodology: Following lockdown announcement, an immediate online cross sectional study was conducted from the 31st March to 6 April 2020. Data was analyzed by using SPSS IBM version 22. 00. Results: A total of 316 responses were received. Our study has shown that people 95.80% were well familiar with COVID-19, informed via news channels 46.2%. 91.7% believed the virus is contagious, 95.8% reported that the virus is spread by the respiratory droplets, 89.2% believed that all ages are at risk while 62.3% believed it risky for geriatrics only. 60.4% believed in its prevention with 91.7% respondents agreeably quarantined themselves while 6.6% didn’t. 99.7% participants were aware of social/physical distancing and 75.6% found it affecting mental health i.e. cause anxiety, depression etc. 59.2% of respondents were optimistic expecting it to end soon while 32.3% were uncertain. 49.1% said they have diagnostic facility and 89.6% acknowledged efforts of researchers/healthcare providers (doctors, pharmacist, nurses, allied health professionals and paramedical staff) for the society. 94.3% believed that there is need of awareness regarding COVID-19. Conclusion: An ever increasing need of awareness amongst the local population regarding COVID-19 is needed. It will lend hands in preventing spread of COVID-19 with minimal secondary transmission. It is recommended that extensive survey studies are required that can provide supportive data in developing and implementing public health policies regarding COVID-19 pandemic. It would further control and arrest the spread of COVID-19 in country. Bangladesh Journal of Medical Science Vol.19(0) 2020 p. S 69-S 76