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Objectives To evaluate the musculoskeletal (MSK) symptoms experienced by SLE patients and determine how those symptoms relate to their health-related quality of life (HRQoL). Materials and methods This is a cross-sectional study that was carried out on 103 adult SLE patients. sociodemographic, clinical, and therapeutic data were recruited. They were asked to complete the following: Nordic Musculoskeletal, Short-Form McGill Pain, and Lupus QoL Questionnaires. Results The mean age was 30.81 ± 9.44 years. There was a total of 86 females and 17 males (F: M:5:1). Almost all the patients reported MSK symptoms (96.1%). The maximum number of patients reported pain in the right and left wrist and hand (64.1%, 63.1%, respectively). One-fourth (25.2%) described at least five bodily sites of MSK symptoms, while 70.9% had more than five sites of MSK symptoms. Most of the patients described the pain as discomforting (40.8%). Patients with MSK symptoms scored significantly worse in all domains. In addition, the QoL scores of patients with more than 5 body sites of MSK symptoms were significantly lower than those of patients with fewer than 5 sites of MSK symptoms. Conclusion SLE patients have a high MSK burden, and MSK symptoms have a negative impact on HRQoL in these patients.

Introduction Kawasaki disease (KD) is a rare systemic inflammatory disease that primarily affects children under the age of five. It is now recognized as the most prevalent cause of acquired heart diseases in children in developed countries. Objectives The aim of this study was to evaluate sleep disturbances in patients with KD and identify their prevalence and associations. Methods This cross-sectional analytic survey-based study was carried out on 262 participants (130 KD patients and 132 age- and sex-matched healthy controls). Participants were invited via social media groups. Sociodemographic data, clinical characteristics and therapeutic data of KD patients were collected. To identify the presence of sleep disturbances, all participants completed Children’s Sleep Habits Questionnaire (CSHQ). Results The median age for KD patients was 6 years, and 51.5% of them were female, the median age at disease onset was 2.5 years, and the median disease duration was 3 years. The sleep scores of patients with KD were significantly higher than those of the control group (55.72 ± 11.97 vs. 49.45 ± 8.54, p  < 0.001). The total duration of sleep did not exhibit any statistically significant difference between patients with KD and healthy controls ( p  = 0.399). KD patients exhibited significantly elevated scores in sleep onset delay, sleep duration, night wakings, parasomnias, and sleep-disordered breathing ( p  < 0.001). Additionally, they showed marginally higher scores in daytime sleepiness ( p  = 0.059). Younger age of KD patients was associated with higher rates of bedtime resistance ( p  < 0.001) and sleep anxiety ( p  = 0.005). Younger age at KD onset was associated significantly with higher rates of bedtime resistance ( p  = 0.009), sleep anxiety ( p  = 0.038), night wakings ( p  = 0.017), and worse sleep quality ( p  = 0.033). KD Patients who exhibited lethargy, and received corticosteroid medication had significantly higher sleep scores than those who did not. Conclusion Patients with KD experience higher sleep disturbance than their healthy counterparts. Young age, early disease onset, lethargy and corticosteroid administration are linked to poor sleep quality.

Introduction Chronic non-bacterial osteomyelitis (CNO) is a rare, non-infection- related inflammatory disorder that affects children and teens. Clinical manifestations of CNO range widely from moderate, time-limited, monofocal inflammation of the bone to extreme multifocal or chronically active inflammation of the bone. Objectives The main aim of this study was to explore the correlation between musculoskeletal (MSK) symptoms and health-related quality of life (HRQoL) in patients with CNO. Methods Children and adults with CNO and their parents were asked to answer a web-based survey. The survey consisted of multiple questions centered around demographic, clinical and therapeutic data, MSK discomfort form based on the Nordic MSK Questionnaire and HRQoL based on Pediatric Quality of Life Inventory-4 (PedsQL-4) and PedsQL rheumatology module. The inclusion criteria included diagnosis of CNO before the age of 18. Patients who had malignancies or any chronic rheumatic, MSK, neurological disease prior to CNO onset were excluded. Results There was a total of 68 participants, mostly females (66.2%), with median age 14 years and median disease duration 4.75 years. The median number of bones affected by CNO was 5 and ranged from 1 to 24 bones. Among the studied patients, 45 patients (66.2%) had MSK manifestations at the last month. The most commonly affected part was ankle and feet (26.5%). Regarding HRQoL, patients with MSK manifestations had lower scores than did patients without in PedsQL-4 ( p  < 0.001) including domains of physical functioning ( p  < 0.001), emotional functioning ( p  = 0.033), social functioning ( p  < 0.001) and school functioning ( p  = 0.007) in addition to lower scores in PedsQL rheumatology module ( p  < 0.001) including domains of pain and hurt ( p  < 0.001), daily activities ( p  < 0.001), treatment ( p  = 0.035), worry ( p  = 0.001) and communication ( p  < 0.001). Conclusion MSK manifestations have a negative impact on HRQoL in CNO patients. So, early identification and treatment are highly recommended.

Background and Objectives: The use of telemedicine (TM) has recently undergone rapid growth and proliferation. Professional stakeholders anticipate that TM will aid in the efficient allocation of limited resources in rheumatology care. The aim of the study was to evaluate the acceptance and willingness of Egyptian patients with autoimmune and rheumatic diseases (ARDs) to incorporate TM into rheumatological care and to assess their requirements and concerns regarding TM. Materials and Methods: A cross-sectional questionnaire-based study was conducted among Egyptian patients with ARDs. The questionnaire covered sociodemographic characteristics, clinical and therapeutic data, attitudes, barriers, and motivators towards TM. Results: The study included 189 patients with ARDs, with a mean age of 37 years (SD  =  11.71), and 88.4% were females. Participants were divided into two groups based on their acceptance of TM: the non-acceptant group (133, 70.4%) and the acceptant group (56, 29.6%). There was a significant difference in educational level (p = 0.001), chronic kidney and heart disease (p = 0.008 and 0.014, respectively) and hydroxychloroquine administration (p = 0.037) between the two groups. During the coronavirus disease 2019 (COVID-19) pandemic, 96 (50.8%) of participants used virtual rheumatology consultations, mainly using WhatsApp (64.6%). Approximately 87% would require assistance in operating TM technology. The preference for direct conversation with the rheumatologist and the need for physical examination were the main barriers to teleconsultation. Conclusions: TM is opposed by the vast majority of Egyptian patients with ARDs. They are concerned since it does not include a physical examination and prevents them from undergoing additional procedures such as ultrasound and blood testing. The majority of Egyptian patients with ARDs need help using TM technology, which is the most significant barrier to the spread of TM.

Background Herd immunity is necessary to contain the coronavirus disease 2019 (COVID-19) pandemic. Vaccination is the fastest and safest pandemic control strategy. Healthcare workers (HCWs) are essential in providing vaccination information. The aim of this study was to assess intent to be vaccinated against COVID-19 among HCWs in Egypt and to determine the factors that may influence their decision. Methods A questionnaire-based cross-sectional study was conducted among HCWs who care for patients in several hospitals in Delta region, Egypt. The questionnaire included sociodemographic, clinical, and occupational data, intention to receive the COVID-19 vaccine, and beliefs and attitudes towards COVID-19 and its vaccination. Results The study included 455 HCWs with a mean age of 36.55 years (SD = 10.31) and 80% were females. The acceptance rate for the COVID-19 vaccine was 70.5%, while hesitancy and resistancy were both 17.6 and 11.9% respectively. About one-third (33.4%) of the subjects had previously contracted COVID-19. Most participants believed that they had a higher risk of contracting COVID-19 (71.6%). More than 64% believed they were at risk for vaccination side effects. Fear of infection and being at high risk of infection were the main drivers for COVID-19 vaccination, while the major barriers were waiting for additional experience with these new vaccines and having doubts about the vaccines’ efficacy. Conclusions The acceptance of the COVID-19 vaccination among HCWs is very high. This crucial group needs to be the focus of educational initiatives and campaigns designed to increase public awareness of the safety and effectiveness of COVID-19 vaccination.

Background and objectives Hemodialysis (HD) patients struggle with musculoskeletal disorders. This study aimed to examine knee clinical and musculoskeletal ultrasonographic (MSUS) characteristics in HD patients and to evaluate the influence of age, gender, and HD duration. Materials and methods This cross-sectional descriptive study included 52 patients (104 knee joints) on regular HD for at least 6 months. Demographic, clinical, therapeutic, and laboratory data were collected. Chronic knee pain was assessed for duration, intensity, and laterality. Swelling, crepitus, and tenderness were assessed in both knees. EULAR-standardized knee MSUS evaluations were performed on all patients. The patients were then compared based on age, gender, and HD duration. Results The mean age of the patients was 52.4 ± 14.15 years, with 25 females and 27 males, median duration of HD was 3.5 years. Chronic knee pain was present in 31 of 104 knees (29.8%). The scanned 104 knee joints had at least one MSUS finding in 91 (87.5%): suprapatellar effusion in 57 (54.8%), synovial thickening in 13 (12.5%), abnormal cartilage morphology in 68 (65.4%), quadriceps tendon abnormalities in 58 (55.8%), patellar tendon abnormalities in 34 (32.7), medial meniscus abnormalities in 30 (28.8%), lateral meniscus abnormalities in 13 (12.5%), and Baker cyst in 5 (4.8%). MSUS abnormalities were significantly more prevalent in HD patients older than 40 years (94.9% vs. 65.4; p  < 0.001). Chronic Knee Pain was more prevalent in females than males (40% versus 20%, respectively). Regarding HD duration, quadriceps, and patellar tendons exhibited more MSUS abnormalities in patients with HD duration > 3 years (86.5% vs. 42.0% and 38.9% vs. 25%, respectively) compared to others. Conclusion MSUS findings of the knee are prevalent among HD patients, particularly those of female gender, older age, and longer duration of HD. These findings could be subclinical. Typically, the severity of suprapatellar effusion is related to additional structural abnormalities.

Background. Musculoskeletal pain is common in hemodialysis (HD) patients and may be related to articular or periarticular amyloid deposition. The shoulder is one of the most common afflicted joints, but not all causes of shoulder pain are detectable on radiography, and magnetic resonance imaging (MRI) is not always available. The aim of this study was to evaluate the validity of musculoskeletal ultrasound (MSUS) to properly detect shoulder disorders in HD patients by identifying US abnormalities in the shoulder and comparing them to those identified on MRI, with MRI serving as the gold standard test. Methods. This cross-sectional observational study was conducted on 28 HD patients (16 males and 12 females, mean age 46.89) with either unilateral or bilateral shoulder pain. Demographic data and clinical characteristics were recruited. All patients were subjected to clinical assessment, MSUS and MRI of both shoulders. Results. US abnormalities were prevalent in almost all patients. Supraspinatus tendinopathy was the most common abnormality in symptomatic shoulders (92.1%), followed by subacromial-subdeltoid (SASD) bursitis (65.8%), humoral erosions (57.9%), and acromioclavicular joint (ACJ) osteoarthritis (52.6%). MSUS shows high sensitivity and specificity when compared to MRI in all the studied shoulder pathologies except glenohumeral joint (GHJ) effusion (sensitivity, 33.3%) and infraspinatus tendinopathy (sensitivity, 58.3%). The percentage of agreement between MSUS and MRI in detecting biceps tenosynovitis was 82.14% (kappa, 0.64), subscapularis tendinopathy 83.93% (kappa, 0.654), supraspinatus tendinopathy 91.07% (kappa, 0.617), infraspinatus tendinopathy 82.14% (kappa, 0.470), SASD bursitis 80.36% (kappa, 0.569), humeral head erosions 82.14% (kappa, 0.635), GHJ effusion 82.14% (kappa, 0.352), and ACJ osteoarthritis 76.79% (kappa, 0.539). Conclusions. Shoulder problems are common in HD patients, even in people who do not have obvious shoulder complaints. MSUS is a valuable imaging technique that assists in the diagnosis of HD patients who report shoulder pain.

Background University students are more likely to experience stress, anxiety, and depression. All these factors are regarded as psychological contributors to fibromyalgia syndrome (FMS). Aim To investigate the prevalence and determinants of FMS among university students and its impact on their health-related quality of life (HRQoL). Methods This online survey-based study involved 2146 university students who were recruited from various faculties at several Egyptian universities. The participants’ demographics, medical history, academic pursuits, and sleep data were collected. To identify the existence of FMS, the 2016 updates to the 2010/2011 FMS diagnostic criteria were used. Additionally, the participants completed the Short-Form Health Survey-36 (SF-36). Results The mean age was 21.26 ± 2.015 years and 76% were females. Of 2146 students, 266 (12.4%) fulfilled the criteria of FMS. FMS group had a significantly lower age ( p  < 0.001) with predominant female gender (89.5% vs. 74.1%, p  < 0.001), positive family history of FMS (8.6% vs. 3.7%, p  < 0.001), previous history of traffic accident (10.2% vs. 6.8%, p  = 0.045), lower level of physical activity ( p  = 0.002),higher time spent in study per week ( p  = 0.002), lower sleep time ( p  = 0.002), with frequent walk up ( p  < 0.001) and snoring ( p  < 0.001) during sleep. Regarding HRQoL, students with FMS had significantly lower scores than students without in all domains. Conclusion FMS is prevalent among Egyptian university students and is linked to female gender, positive family history, lower levels of physical activity, and more time spent studying each week. FMS has a negative impact on HRQoL. Therefore, early detection and treatment are recommended.

PurposeTo evaluate the diagnostic value of diffusion tensor imaging (DTI) of renal cortex in assessment of lupus nephritis (LN) and prediction of its pathological subtypes.MethodsProspective study was performed upon 39 female patients with pathologically proven LN and 16 sex- and age-matched healthy controls. Patients and controls underwent DTI of kidney. Mean diffusivity (MD) and fractional anisotropy (FA) of renal cortex were calculated by two radiologists. LN patients were pathologically classified into either non-proliferative (n = 15) or proliferative (n = 24).ResultsMean MD of renal cortex in LN was significantly lower (p = 0.001) than that of controls with cut-off (2.16 and 2.2 X10−3mm2/s), area under curve (AUC) of (0.92, 0.94) and accuracy of (91%, 89%) for both observers. Mean FA of renal cortex in LN was significantly higher (p = 0.001) than that of controls with cut-off (0.20, 0.21), AUC of (0.86, 0.82) and accuracy of (86%, 84%) for both observers. Renal cortex MD and FA in non-proliferative LN were significantly different (p = 0.001) from that of proliferative LN for both observers. There was excellent inter-observer agreement of MD and FA (ICC = 0.96 and 0.81).ConclusionMD and FA of renal cortex may help to assess renal affection in LN patients and predict its pathological subtypes.

Background The public's willingness to be vaccinated will determine the success of the COVID-19 vaccination program. The aim of this study was to identify acceptance and hesitancy to receive COVID-19 vaccine among university students in Egypt, assess their level of knowledge about COVID-19 vaccine and identify factors that influence their intention towards COVID-19 vaccination. Methods A standardized and self-administered questionnaire was distributed among university students allover Egypt. The questionnaire included sociodemographic data, intention to receive COVID-19 vaccine, knowledge and beliefs about it and status of COVID-19 vaccination. Logistic regression analysis was used to determine factors associated with COVID-19 vaccine acceptancy. Results A total of 1071 of university students were involved, with a mean age of 20.51 years (SD = 1.66) and 68.2% were females. COVID-19 vaccination acceptability rate was 69.0% while hesitancy was 20.8% and resistancy was 10.2%. Median knowledge score of 4 out of 8 (IQR = 8). The main motivation for vaccine acceptance was fear of being infected (53.6%) and desire to get back to normal life (51.0%) while the main barriers against getting vaccinated were being afraid of serious side effects. Univariate regression analysis revealed an increasing likelihood of vaccine acceptancy associated with an active lifestyle (OR 1.35, 95% CI 1.04–1.75, p  = 0.025), a high knowledge score (OR 1.53, 95% CI 1.42–1.66, p  < 0.001), and positive vaccine beliefs. Conclusion There is a high rate of acceptability of COVID-19 vaccination among university students. Vaccine acceptability is associated with an active lifestyle, a high knowledge score and positive vaccine beliefs. Educational campaigns and efforts aiming to raise awareness about safety and efficacy of COVID-19 vaccines need to be directed to this important population.