title: Rheumatoid arthritis clinical features and management strategies at an urban tertiary facility in Pakistan.
abstract: OBJECTIVE
  To determine the presentation patterns, biologically vulnerable patient groups and treatment strategies of rheumatoid arthritis.
  
  
  METHODS
  The retrospective study was conducted at the Rheumatology Clinic of Liaquat National Hospital and Medical College, Karachi, and comprised data of rheumatology patients who presented between September 2006 and September 2012. After screening all the files, rheumatoid arthritis cases were identified. Data collection was done using a questionnaire that included patient demographics, co-morbidities, clinical manifestations and drug therapy. SPSS 13 was used for statistical analysis.
  
  
  RESULTS
  Of the 2300 files screened, 500(21.7%) related to patients of rheumatoid arthritis. The mean age at presentation of these 500 patients was 41±15 years. There were 367(73.4%) women and they presented at an earlier age compared to men (p<0.024). Erosions were present in 198(40%) patients on X-rays and 22(4.4%) had joint deformities. Seropositive rheumatoid arthritis was associated with higher erythrocyte sedimentation rate levels (p<0.014), but did not differ from seronegative rheumatoid arthritis in terms of Disease Activity Score-28 levels (p<0.21).
  
  
  CONCLUSIONS
  The skewed gender distribution was likely an effect of rheumatoid arthritis biology rather than due to issues of healthcare accessibility. Seronegative RA is likely to present late though it is as destructive as the seropositive disease.
authors.forename: Rehan
authors.initials: R
authors.lastname: Rais
authors.forename: Mohammad
authors.initials: M
authors.lastname: Saeed
authors.forename: Rimsha
authors.initials: R
authors.lastname: Haider
authors.forename: Zahra
authors.initials: Z
authors.lastname: Jassani
authors.forename: Amir
authors.initials: A
authors.lastname: Riaz
authors.forename: Tahira
authors.initials: T
authors.lastname: Perveen
mesh_terms: D000328:Adult; D001172:Arthritis, Rheumatoid / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D019468:Disease Management; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010154:Pakistan; D012189:Retrospective Studies; D012737:Sex Factors; D062606:Tertiary Care Centers