Health Related Quality of Life among Osteoarthritis Patients: A Comparison of Traditional Non-Steroidal Anti-Inflammatory Drugs and Selective COX-2 Inhibitors in the United Arab Emirates Using the SF-36

Objectives: Osteoarthritis (OA) has a dramatic impact on patients’ health related quality of life (HRQoL). Chronic use of analgesics and anti-inflammatory medications for pain management may improve symptoms but on long term may affect HRQoL negatively. The objective of the present study was to compare the impact of two different classes of analgesics, traditional non-steroidal anti-inflammatory drugs (NSAIDs) and selective cyclo-oxygenase-2 (COX-2) inhibitors on HRQoL among osteoarthritis patients using the SF-36 questionnaire. Methods: Clinic based cross-sectional study conducted at Al-Qassimi Hospital, Sharjah, United Arab Emirates (UAE), over a period of six months. Ethical Approval was obtained from the ethics committee at Al-Qassimi Clinical Research Center. Total of 200 osteoarthritis patients fulfilling the inclusion and exclusion criteria were involved in the study. Patients’ demographics were collected from their medical records. The Medical Outcome Study Short-Form 36 (SF-36) questionnaire was used to measure patients’ HRQoL. SF-36 data were scored using health outcomes scoring software 4.5. Results: Mean age of the subjects was 62.19 ± 9.81 years with females constituting 151 (75.5%) of the patients. In general, females scored lower in most of the HRQoL domains compared to males and there was significant difference between the two groups in the mental health (p = 0.005) & mental component (p = 0.042) domains. Compared to selective COX-2 inhibitors, patients on NSAIDs scored higher on all domains of SF-36 except physical functioning. There was significant difference in mental health domain for patients treated with NSAIDs (p = 0.02). Celecoxib was only better than NSAIDs in osteoarthritis patients with more than one musculoskeletal disorders in the domain of bodily pain (p = 0.009). Conclusion: NSAIDs-treated patients did not differ significantly from celecoxib-treated patients in all domains of the SF-36 except for the mental health domain.

Quantities of comorbidities affects physical, but not mental health related quality of life in type 1 diabetes with confirmed polyneuropathy

BACKGROUND A large number of adults with long-term type 1 diabetes are affected by symmetrical peripheral neuropathy.These complications increase socioeconomic expenses and diminish the individual quality of life.The 36-Item Short Form Health Survey(SF-36)is a generic patient reported questionnaire,measuring mental and physical health related quality of life.We hypothesized that diabetic neuropathy would decrease physical and mental quality of life measured with SF-36,and that clinical appearance may be associated with the decline.AIM To investigate if diabetic neuropathy would decrease physical and mental quality of life measured with SF-36,and if clinical appearance may be associated with the decline.METHODS Forty-eight adults[age 50±9 years,10 females,disease duration 32(14-51)years]with verified diabetic symmetrical peripheral neuropathy and 21 healthy participants(age 51±6 years,6 females)underwent standardised nerve conduction testing and completed the SF-36 questionnaire.Furthermore,disease duration,number of comorbidities,both diabetes related and nondiabetes related,vibration perception threshold,number of hypoglycaemic events,HbA1c and administration way of insulin was notified.RESULTS In comparison to healthy subjects,patients’mental composite score was not significantly diminished(51.9±8.9 vs 53.1±5.5,P=0.558),while the physical composite score was(46.3±11.7 vs 54.6±3.3,P=0.002).As expected,the overall physical health related symptoms in patients were associated to total number of comorbidities(P<0.0001),comorbidities relation to diabetes(P=0.0002)and HbA1c(P=0.005)as well as comorbidities not related to diabetes(P=0.0006).CONCLUSION The finding of this study emphasises the importance of focusing on quality of life in adults with diabetes and especially in those with multiple comorbidities as well as the possibility of HbA1c as a biomarker for severe complication.

Functional and clinical outcome with modified lateral approach total hip arthroplasty in stiff hips with ankylosing spondylitis

BACKGROUND Ankylosing spondylitis at total hip arthroplasty(THA)has significant hip stiffness with flexion deformity,restricted mobility,and function.Range of movement(ROM)improvement with good functional outcome is seen following THA in these hips.The modified Hardinge approach without abductor compromise is helpful in these stiff hips with associated flexion deformity.AIM To assess improvement in ROM and functional outcomes with a modified lateral approach THA in ankylosing spondylitis with stiff hips.METHODS A total of 69 hips that underwent THA with a modified Hardinge approach in 40 patients were evaluated at a mean follow-up of 38.33 mo.All individuals ambulated with weight-bearing as tolerated and ROM exercises from the 1st postoperative day.Modified Harris hip score and ROM were assessed during follow-up.Quality of life assessments using the 36-item and 12-item short form health surveys were done along with clinical and functional outcomes at followup.SPSS 22.0 was used for statistical analysis.The correlation of ROM and functional score change was performed using Pearson’s correlation coefficient.RESULTS Sixty-nine hips with a significant decrease in ROM preoperatively with 32 clinically fused hips showed significant improvement in flexion range.The mean flexion in 69 hips improved from 29.35±31.38 degrees to 102.17±10.48 degrees.The mean difference of 72.82 with a P value<0.0001 was significant.In total,45 out of 69 hips had flexion deformity,with 13 hips having a deformity above 30 degrees.The flexion during the follow-up was below 90 degrees in 3 hips.Eleven hips had flexion of 90 degrees at follow-up,while the remaining 55 hips had flexion above 100 degrees.Modified Harris hip score improved from 17.03±6.02 to 90.66±7.23(P value<0.0001).The 36-item short form health survey at the follow-up indicated health status in 40 patients as excellent in 11,very good in 20,good in 5,fair in 3,and poor in 1.The mean mental health score was 84.10±11.58.Pain relief was good in all 69 hips.Altogether,28/40 patients(70%)had no pain,9 patients(22%)had occasional pain,and 3 patients(8%)had mild to moderate pain with unusual activity.Heterotopic ossification was seen in 21 hips with Brooker class 1 in 14 hips.CONCLUSION Modified Hardinge approach THA in ankylosing spondylitis with stiff hips with flexion deformity significantly improved ROM,Harris hip score,and quality of life indicated by the 36-item and 12-item short form health surveys.

抑郁对2型糖尿病患者生活质量的影响

目的探讨抑郁对2型糖尿病患者生活质量的影响。方法连续选择近期住院的2型糖尿病患者236例,利用Zung自评抑郁量表(SDS)和简明健康状况调查问卷(SF-36)进行评估。结果 236例2型糖尿病患者中有82例存在抑郁状态(SDS,抑郁指数≥0.5)为抑郁状态组,另外154例为无抑郁状态组。抑郁状态组的生理功能(PF)、生理职能(RP)、躯体疼痛(BP)、一般健康状况(GH)、精力(VT)、社会功能(SF)、情感职能(RE)、精神健康(MH)共8个维度评分均明显低于对照组(均P<0.01)。结论糖尿病合并抑郁患者的生活质量比非抑郁糖尿病患者明显下降,在控制糖尿病病情的同时,应注意调整患者的心理状态,改善患者的抑郁情绪,提高患者的生活质量。

基于社区人群的乙型肝炎病毒慢性感染者生存质量多中心调查

目的开展多中心的基于社区人群的慢性乙型肝炎(乙肝)病毒(Hepatitis B Virus,HBV)感染者的生存质量现状调查,分析影响因素。方法应用中文版简明健康调查问卷(Short Form 36 Health Survey Version 2,SF-36v2),对全国31个省(自治区,直辖市)发现的以社区人群为基础的1092名HBV携带者、666名慢性乙肝患者(Chronic Hepatitis B Patient,CHBP)和145名健康对照人群进行生存质量调查。使用卡方检验、Mann-whitney U检验、Kruskal-wallis秩和检验和多元线性回归进行数据分析。结果与对照组相比,HBV携带者在生存质量的8个维度得分、生理维度综合(Physical Component Summary,PCS)总分和心理维度综合(Mental Component Summary,MCS)总分差异无统计学意义(P>0.05);CHBP的生存质量的8个维度得分以及PCS和MCS均降低,差异有统计学意义(P<0.01)。PCS和MCS回归模型显示,家庭年收入、年龄、疾病诊断、地区和性别因素,是影响HBV感染者生存质量的主要因素。结论 CHBP的生存质量较正常人群明显降低。

西安市某高校大学生健康相关生活质量及其影响因素

目的了解西安市某高校大学生的生活质量及其影响因素,为高校和有关教育行政部门有针对性地开展心理干预和健康教育提供依据。方法采取多阶段分层整群抽样方法,抽取西安文理学院1 082名大学生,运用36条目简明健康量表第2版(SF-36v2)以及自行设计的一般情况调查问卷进行调查。结果大学生在情感职能(RE)、精神健康(MH)这两个维度和心理健康总测量(MCS)得分分别为41.98±9.75,46.46±8.17,44.54±7.83,低于47分。单因素分析显示不同年级、专业、性别、是否为独生子和来自农村或城市大学生在SF-36v2量表的8个不同维度、生活健康总测量(PCS)和MCS得分上存在着统计学差异。多因素分析显示,影响PCS得分的因素有同学间相处的融洽程度,父亲的职业(农民)、所学的专业、是否为单亲家庭、父亲的文化程度、是否为独生子;影响MCS得分的因素有同学间相处的融洽程度,对学校学习、生活环境满意度,父亲的职业(其他),所学专业与年级。结论大学生心理健康水平较低,MCS得分低于美国普通人群的平均水平(50分)。建议相关部门应重视大学生的心理健康状况,开展形式多样的心理教育和健康教育,改善学校学习、生活环境及软、硬件设施,锻炼学生的社会交往和适应能力,提高大学生的生活质量。

Acupuncture and moxibustion for the elderly patients with depression:A randomized controlled trial

Objective:To identify the effects of acupuncture and moxibustion therapy by soothing liver and regulating mind on the quality of life among the elders with depression.Methods:This was a single-blind,randomized,controlled trial of 75 elders with depression conducted in Guangdong Province,China,in January to December 2010.Eligible patients were randomly divided into three treatment groups.22 patients received acupuncture and moxibustion treatment of soothing liver and regulating mind[group A,in acupuncture procedure:Hegu(合谷L14),Taichong(太冲LR3),Baihui(百会GV20)and Yinting(印堂GV29)were selected,in moxibustion procedure,bilateral Geshu(膈俞BL17)and Danshu(胆俞BL19)were selected,the moxibustion cones was placed on the acupoints,five cones were given to each point.In intradermal needling procedure,Xinshu(心俞BL15),and Ganshu(肝俞BL18)were selected].28 patients received acupoint shallow puncturing treatment(group B,patients received the same acupoints as in the group A,with a 2-3 mm needling depth and no needle sensation was required.A shorter duration of moxibustion and only 1-2 mm of needle body was inserted into the points when intradermal needling).25 patients received non-acupoint shallow puncturing treatment(group C,patients received non-acupoint shallow puncturing at points 10 mm lateral to LI4 and LR3,10 mm left side of GV20 and GV29 in acupuncture procedure;10 mm lateral to BL17 and BL19 in moxibustion procedure;10 mm lateral to BL15 and BL18 in intradermal needling procedure,with the same manipulation method as that in the group B).In all three groups,the treatment was given twice a week for 12 weeks.The Short Form(36)Health Survey(SF36)and TCM Symptom Scale Score as clinical efficacy and quality of life were used to quantitatively assess patients'outcomes before and after treatment.Results:The TCM Symptom Scale scores showed significant differences between the group A and C,and between group B and C(both P<0.05),while there was no significant difference between group A and B(P>0.05).An item-by-item analysis of the SF36 showed the elders in group A obtained the highest scores at each time point after treatment(all P<0.05).Among the results,mental health and report health transition items showed no significant differences between the group A and group B at time point of after treatment(all P>0.05).Vitality and social functioning items at a month after treatment time point,social functioning and report:health transition items at 3 months after treatment time point,role emotional item at after treatment time point showed no significant differences between the group B and group C(all P>0.05).Conclusions:The therapeutic effect of acupuncture and moxibustion by soothing liver and regulating mind can obviously improve the quality of life of depression elders.