Abdurhman S Al-Arfaj

King Khalid University, Ebha, Minţaqat ‘Asīr, Saudi Arabia

Are you Abdurhman S Al-Arfaj?

Claim your profile

Publications (27)31.34 Total impact

  • Abdurhman S Al-Arfaj, Ahmad A Al-Boukai
    [Show abstract] [Hide abstract]
    ABSTRACT: The aim of the study was to characterize the pattern of radiographic changes in the hands and feet of rheumatoid arthritis in Saudi patients. The radiographs of hands and feet of rheumatoid arthritis patients attending rheumatology outpatient clinics of King Khalid University Hospital in Riyadh, Kingdom of Saudi Arabia, over the period extending from March to June 2001, were examined and reported for the presence of osteopenia, joint space narrowing, and erosions. Fifty-six rheumatoid arthritis patients were studied. Their mean age was 50 + 1.9 years, and mean disease duration was 9.07 + 0.84 years. Generalized osteopenia was seen in 16/56 (29%) and periarticular osteopenia in 38/56 (68%). Joint space narrowing was present in 9/56 (16%) of feet and 35/56 (63%) of hand x-rays. Erosions were seen in 3/56 (6%) of feet and in 22/56 (39%) of hand x-rays. Significant correlation was seen between joints space narrowing, joint erosions, and disease duration. Radiographic changes in hands and feet of Saudi rheumatoid arthritis patients are less severe than those reported from the West, and the pattern is also different with less affection of the feet.
    Saudi medical journal 08/2005; 26(7):1065-7. · 0.62 Impact Factor
  • Source
    A Alzeer, A Al-Arfaj
    Critical Care 03/2005; 9(Suppl 1). · 4.93 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: To investigate the effects of diclofenac alone or when combined with alpha-tocopherol on the oxidative activity of polymorphonuclear leukocytes (PMNs) in healthy and osteoarthritic (OA) patients. The study was carried out at the College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia, over the period 1999 to 2000. Twelve healthy controls and 12 osteoarthritic patients were recruited to the study. Twelve healthy controls and osteoarthritic patients were given diclofenac 50 mg thrice daily orally, initially for 5 days then alpha-tocopherol at 200 mg thrice daily orally, was added for another 5 days. Blood samples were drawn before the start of the study (pre-treatment) and at 5 days following treatment with diclofenac alone and 10 days following treatment with diclofenac and alpha-tocopherol. Chemiluminescence (CL) response was measured for whole blood and isolated polymorphonuclear leukocytes (PMNs) on all samples. Diclofenac enhanced CL response of whole blood and of PMNs of healthy controls when stimulated with phorbol myristate acetate (PMA) and opsonized zymosan (OPZ). Co-treatment with alpha-tocopherol resulted in no appreciable change in the CL response of whole blood when stimulated with PMA or OPZ but a further significant enhancement of CL response of isolated PMNs when these cells were stimulated by either PMA or OPZ. In osteoarthritic patients, diclofenac alone and when combined with alpha-tocopherol showed no significant change in CL response of whole blood. The CL response of PMNs from OA patients was decreased by diclofenac alone. However, this inhibitory effect was not observed when alpha-tocopherol was used together with diclofenac. The effect of diclofenac alone or in combination with alpha-tocopherol did not produce a consistent effect on the CL response of whole blood or isolated PMNs of healthy or osteoarthritic patients.
    Saudi medical journal 03/2004; 25(2):198-203. · 0.62 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The objective of the study was to identify the causes, outcome and prognosis of severe illness in patients with systemic lupus erythematosus (SLE) requiring intensive care unit (ICU) care in a University Hospital over a five-year period. The design was a cohort study. Forty-eight SLE patients requiring ICU management over a five-year period (January 1997-December 2001) were studied prospectively. Of 48 patients, 14 (29.2%) died, predominantly with multiorgan dysfunction syndrome (MODS). Patients whose APACHE II score was equal to or greater than 20 had higher mortality than those with APACHE score below 20 (60 versus 7.1%; and P < 0.01). All the 18 patients whose health status rated as 'good' survived, while 46.7% of 30 patients whose health rated as 'poor' died (P < 0.01). Patients who had thrombocytopenia associated with sepsis and/or disseminated intravascular coagulopathy (DIC) had the highest mortality (75%, five-year survival). In conclusion, SLE patients admitted to the ICU had a lower mortality rate than some of the previous reports. Patients with SLE with high APACHE score, > or =20, poor health status, thrombocytopenia and multiorgan dysfunction syndrome had poor prognosis in the ICU.
    Lupus 01/2004; 13(7):537-42. · 2.78 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: To find out the effect of combining allopurinol with non-steroidal anti-inflammatory drugs on carrageenan-induced rat paw edema. The study was carried out at the College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia, over the period 1999 to 2000. Male wistar rats were randomly divided into 12-16 rats in each group. Edema was induced by subplantar injection of 0.1 ml of carrageenan (10 mg/ml) and the resulting edema volume was measured by plethysmograph, 3 hours after the injections. Saline of 0.9% (0.1 ml/100 g) was administered to the first group serving as control. The second and third groups received variable concentration of allopurinol (12.5, 25, 50 mg/kg) and tenoxicam (0.0625, 0.125, 0.25 mg/kg) 30 minutes before carrageenan injection. The fourth group received a combination of tenoxicam and allopurinol. Similar procedures were carried out with respect to diclofenac at 1.25, 2.5, 5.0 mg/kg and indomethacin at 0.25, 0.5, 1.0 mg/kg. The activities of the drugs were expressed as percentage inhibition of edema. Pre-treatment of the rats with the 4 drugs individually resulted in dose-dependent reduction of volume of paw edema. The combination of allopurinol and diclofenac acted synergistically to reduce edema. A similar synergistic action was obtained when allopurinol was combined with indomethacin. By contrast, tenoxicam-allopurinol combination resulted in antagonistic action and produced an effect on edema, which was less than their individual inhibitory action. Combining allopurinol with either diclofenac or indomethacin produced synergistic inhibitory action on rat's paw edema. However, tenoxicam, when combined with allopurinol, produced antagonism.
    Saudi medical journal 10/2003; 24(9):936-40. · 0.62 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: To estimate the prevalence of musculoskeletal (MSK) pain in Al-Qaseem province in central Saudi Arabia. Over a period of 18 months extending from September 1993 through to the end of February 1995, a house-to-house survey was conducted in Al-Qaseem province and included 5,894 adults asking regarding musculoskeletal pain. We obtained a response from 5,823 (98.8%), 2,667 (45.8%) men, and 3,156 (54.2%) women. The mean age was 34.14 +/- 15.16 years. Musculoskeletal pain was reported by 1,477 (25.4%), 762 (13.1%) men and 715 (12.3%) women. Musculoskeletal pain was significantly correlated with age (r =0.454), married status (r=0.238), unemployment (r=0.122), lower educational attainment (r=0.347), frequent attendance at local doctor (r=0.703), consumption of medications for pain (r =0.551), and change in ability to work (r=0.492). We found no association with sex or body mass index. Musculoskeletal pain, although common in the community, is less prevalent than reported from Western countries, but has similar socio-medical consequences.
    Saudi medical journal 09/2003; 24(8):863-7. · 0.62 Impact Factor
  • Source
    Abdurhman S Al-Arfaj
    [Show abstract] [Hide abstract]
    ABSTRACT: To find out the relationship between radiographic osteoarthritis (OA) of the knee, generalized OA and serum cholesterol. Over a period of 7 months from September 1998 through to March 1999, 246 patients attending 14 primary care clinics in Northern Riyadh, Kingdom of Saudi Arabia, for different non-musculoskeletal complaints were recruited in the study. Their knees, hands and wrists were radiographed. Their ages, sex, weight, height, body mass index (BMI), fasting serum cholesterol, triglycerides and uric acid were recorded. There were 113 females and 133 males with average ages 46 14.2 and 51.54 16.0 years. One hundred and twenty-two (49.6%) cases of knee OA and 58 (23.6%) cases of generalized OA were found and analyzed for the association with serum cholesterol levels. Crude odds ratio (OR) for the relationship between knee OA and the third tertile of serum cholesterol was 2.33 (95% CI, 1.19-4.58) which on adjusting for age, sex, BMI, serum uric acid and triglycerides were 2.68 (95% CI, 2.00-3.64). For generalized OA, the crude odds ratio (OR) in relation to the third tertile of serum cholesterol was 1.65 (95% CI, 0.78-3.53), adjusted OR was 2.18 (95% CI, 1.55-3.15). The results showed an association between high serum cholesterol level and both knee and generalized OA.
    Saudi medical journal 08/2003; 24(7):745-7. · 0.62 Impact Factor
  • Ahmed A Al-Boukai, Abdurhman S Al-Arfaj
    [Show abstract] [Hide abstract]
    ABSTRACT: To describe the radiographic cervical spine changes in rheumatoid arthritis patients. Forty-nine patients (37 females and 12 males) diagnosed with rheumatoid arthritis at King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia, between June 1998 and June 2000, were studied for their radiographic cervical spine changes. Their mean age at disease onset was 41.4 +/- 13.4 years (range of 18-73) and mean duration of the disease was 9.1 +/- 6.28 years (range of 2-34). Their demographic data including rheumatoid factor status was obtained. Standard conventional radiographs of cervical spine were obtained to study the cervical spine changes. Cervical spine radiographic changes were found in 34 patients (27 females and 7 males), 10 had subluxation (7 with atlanto-axial subluxation, 2 with sub-axial subluxation, and one with lateral subluxation). No vertical impaction was seen. Erosion of odontoid process was seen in one patient. All were rheumatoid seropositive. Cervical spine changes in patients with rheumatoid arthritis are common, in particular subluxation in the upper cervical spine. Our study showed somewhat lesser prevalence of these changes. These were clinically correlated with disease duration, female sex, and rheumatoid factor, but were not statistically significant.
    Saudi medical journal 05/2003; 24(4):396-9. · 0.62 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The aim of this study was to estimate the prevalence of clinical osteoarthritis (OA) of the knee in Al-Qaseem, a central province in the Kingdom of Saudi Arabia (KSA). A house to house survey of randomly selected inhabitants of Al-Qaseem, KSA was conducted. A total of 10,406 persons were interviewed of whom 5,894 were above the age of 16 years. The study was carried out at King Khalid University Hospital and College of Medicine, Riyadh, KSA, from September 1993 to February 1995. They were questioned regarding musculoskeletal complaints, and those positively identified were interviewed further by a team of trained medical staff and later examined by trained doctors including rheumatologists. We found 766 (13%) cases of clinical OA of the knee in the 5,894 adult population (13%). The prevalence of OA increased with increasing age reaching 30.8% in those aged 46-55 years and 60.6% in the age group 66-75 years. The odds ratio (OR) for the association between clinical OA of the knee and age adjusted for sex and body mass index (BMI) was 1.0894 (95% CI, 1.08-1.09). The association of clinical OA of the knee with female sex was also significant [OR (adjused for age and BMI) was 1.261 (95% CI, 1.0456-1.5208)]. Clinical OA of the knee is common in this community, particularly in the older age groups.
    Saudi medical journal 04/2003; 24(3):291-3. · 0.62 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The aim of this study was to estimate the prevalence of back pain in the adult population of Al-Qaseem Central Province, Kingdom of Saudi Arabia and to find associated features and factors. A house-to-house survey covering 1,000 household in the towns and villages of Al-Qaseem province was carried out over a period of 18 months extending from September 1993 until the end of February 1995. A total of 5,894 adults, aged 16 years and above, were questioned by trained staff regarding back pain, and the demographic data in addition to general, medical and social history. A response was obtained in 5,743 (97.4%). Their mean age was 34.14 15.16 (range 16-99). Back pain was reported by 1,081 (18.8%), wherein 499 (8.8%) were men, and 574 (10%) were women. Back pain was more prevalent in married (23.3%) individuals than unmarried (6.4%). Adjusted odds ratio (OR) for back pain in married individuals was 1.88 (95% confidence intervals [CI] 1.49-2.37). Back pain was strongly correlated with age (correlation coefficient = 0.378 P < 0.01). It also showed significant correlation with weight and height, depression, family history of back pain, change in work ability, frequency of attendance at local doctor, use of medication and lower education level. The association with body mass index became evident only after comparing the heaviest 20th percentile to the lightest (OR 1.335 [95% CI, 1.279-1.402]). Certain occupational status (unemployed, farmers, professional workers and housewives) were associated with back pain. Back pain was relatively common in this largely unindustrialized community although its prevalence is lower than reported from some western countries.
    Saudi medical journal 02/2003; 24(2):170-3. · 0.62 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: To estimate the prevalence of mouth and genital ulceration in the community and its relationship to rheumatic diseases. A house to house survey was carried out over a period of 18 months extending from September 1993 to February 1995, on 5,894 individuals utilizing detailed questionnaires on symptoms of musculoskeletal diseases and associated symptoms including history of mouth, genital ulcers, eye symptoms, and skin changes. After the initial phase, a 2nd phase was completed by trained nurses and paramedical staff, the purpose of which was to explore in detail, the history of those responding positively to any of the questions in phase one. The 3rd stage was conducted by general practitioners and rheumatologist to interview and examine those identified in phase 2 at King Fahad Hospital, Buraidah, Kingdom of Saudi Arabia. We identified 7 (0.1%) cases of genital ulceration, 43 (0.7%) cases of mouth ulceration, 263 (4.5%) cases of reddish eye or blurred vision, and 124 (2.1%) cases of skin rashes. Only 2 cases had both mouth and genital ulceration in addition to eye disease, skin rash and musculoskeletal pain. There was significant correlation between mouth ulcers and skin rash, eye symptoms, genital ulcerations, male sex, single status, weight loss and backpain. The vast majority of mouth and genital ulcers are not associated with a known rheumatic disease.
    Saudi medical journal 02/2003; 24(1):76-8. · 0.62 Impact Factor
  • Source
    Abdurhman S Al-Arfaj
    [Show abstract] [Hide abstract]
    ABSTRACT: Objectives: In view of the many studies linking obesity and osteoarthritis, we sought in this study to find the relationship between osteoarthritis and one of the metabolic correlates of obesity which is serum triglycerides. Methods: This is a cross-sectional radiographic study to assess the relationship between serum triglyceride level, knee and generalized osteoarthritis (OA). Two hundred and eighty six patients were selected from fourteen primary clinics in Riyadh, Saudi Arabia. Their x-ray findings and serum triglycerides level were analyzed for the association between OA and hypertriglyceridemia. Results: We found a weak relationship between knee OA and the third triglyceride percentile (odds ratio (OR) 1.503 (95% CI, 0.718-3.145)), and generalized OA and third triglyceride percentile (OR 1.907 (95% CI, 0.662- 5.494) after adjusting for age, sex, BMI, uric acid and cholesterol. The relationship in females was stronger particularly for generalized OA (OR 2.483 (95% CI, 0.496-12.422)). However, none of the relationship reached statistical significance. Conclusion:The relationship between hypertriglyceridemia, knee and generalized OA is weak and statistically not significant.
    01/2003;
  • Source
    A S Al-Arfaj
    [Show abstract] [Hide abstract]
    ABSTRACT: The association between articular chondrocalcinosis and osteoarthritis was sought by studying 92 patients over the age of 60. Anteroposterior and lateral X-ray projections of knees, hands and wrists were studied for the presence of chondrocalcinosis and osteoarthritis. Of the 92 patients (60 males, 32 females), six had chondrocalcinosis of the knees; two of them also had it in the wrist. The six cases with chondrocalcinosis were compared to the 86 cases without, for the presence of osteoarthritis in the different compartments of the knees, intercarpal joints (IC) and metacarpophalangeal joints (MCP). We found an association between chondrocalcinosis and osteoarthritis of the lateral knee compartment (odd ratio (OR) 10.59, 95% CI 3.47-34.9), second MCP joint (OR 3.27 95% CI 1.44-8.93), third MCP joints (OR 6.92, 95% CI 1.99-25.54) and IC joint (OR 5.69, 95% CI 1.14-29.7). No association was found with overall knee OA, medial knee compartment OA or patellofemoral OA. In conclusion, chondrocalcinosis was associated with OA of the lateral knee compartment, second MCP, third MCP and IC joints.
    Clinical Rheumatology 12/2002; 21(6):493-6. · 2.04 Impact Factor
  • Source
    Abdurhman S Al-Arfaj, Amer Al-Boukai
    [Show abstract] [Hide abstract]
    ABSTRACT: We studied the radiographic evidence of osteoarthritis (OA) of the hands in 300 patients (167 male, 133 female) attending 14 primary care facilities for a variety of medical conditions. Radiographic OA was seen in 30.3% of males and 36.3% of females. Most commonly affected were the metacarpophalangeal joints, followed by the distal interphalangeal and carpometacarpophalangeal joints.
    Rheumatology International 10/2002; 22(5):208-12. · 2.21 Impact Factor
  • Source
    Abdurhman S Al-Arfaj
    [Show abstract] [Hide abstract]
    ABSTRACT: To determine the association between obesity and radiographic osteoarthritis (OA) of the knee and generalized OA. A cross-sectional survey of patients attending 14 primary clinics for a variety of medical complaints was conducted. They were consented, interviewed, examined and radiographed for the presence of knee and generalized OA. The association between OA and weight was then assessed. This study was carried out in 14 primary care clinics in North Riyadh, Kingdom of Saudi Arabia, between September 1998 through to March 1999. Two hundred and nineteen patients (118 males, 101 females) completed the study and their results were analyzed. We found a strong association between excess weight and knee OA in females [overall ratio (OR) 3.28 (95% confidence intervals (CI), 2.07-5.36)] and a weaker link with knee OA in males [OR 1.88 (95% CI, 1.24-2.92)]. Generalized OA was found to be associated with obesity in females only [OR 1.93 (95% CI, 1.09-3.43)]. Reporting of joint symptoms in patients with radiographic knee OA was also associated with obesity (P=0.0001). Excess weight is strongly associated with knee OA in females and symptoms of joint pain in all OA patients, with a weaker but still significant link with male knee OA and generalized OA in females.
    Saudi medical journal 09/2002; 23(8):938-42. · 0.62 Impact Factor
  • Source
    A Al-Arfaj, A A Al-Boukai
    [Show abstract] [Hide abstract]
    ABSTRACT: In this cross-sectional study we looked at the radiographic evidence of osteoarthritis (OA) of the knee in 300 randomly chosen patients attending 14 primary care facilities for different medical conditions. Radiographic OA was seen in 89 out of 167 males (53.3%) and in 81 out of 133 females (60.9%). The patella was involved with radiographic osteoarthritic changes in 80.7% and 87.8% of female and male OA patients, respectively. In most cases the medial compartment joint space was narrowed. Radiographic OA of the knee is very common in Saudi patients, especially in the patellofemoral compartment.
    Clinical Rheumatology 06/2002; 21(2):142-5. · 2.04 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Although systemic lupus erythematosus of varying severity has been seen in our clinics, there is no information regarding the prevalence of the disease among Saudi nationals. We conducted this study to determine the prevalence of systemic lupus erythematosus in Al-Qaseem region of the Kingdom of Saudi Arabia. A community survey of towns and villages in the Al-Qaseem area of central Saudi Arabia was conducted in 3 phases to determine the prevalence of systemic lupus erythematosus in the region. Of the 10,372 studied, 2 cases of systemic lupus erythematosus were identified using the criteria set for the diagnosis of systemic lupus erythematosus by the American College of Rheumatology. Based on that, the prevalence of systemic lupus erythematosus was estimated to be 19.28 per 100,000 population in the region. The estimated prevalence of systemic lupus erythematosus in Al-Qaseem area is similar to that found in western countries.
    Saudi medical journal 02/2002; 23(1):87-9. · 0.62 Impact Factor
  • A S Al-Arfaj
    [Show abstract] [Hide abstract]
    ABSTRACT: To determine the clinical characteristics of rheumatoid arthritis in Saudi Arabia in relation to human leukocyte antigen type. A group of 91 rheumatoid arthritis patients, 72 females and 19 males were studied for the various clinical, laboratory and radiological parameters along with human leukocyte antigen-DR phenotypes. Since human leukocyte antigen-DR10 was most commonly associated with rheumatoid arthritis in our population, we compared those patients with human leukocyte antigen-DR10 to those without. The comparison yielded differences in the presence of rheumatoid nodules, erosions, corticosteroid treatment, joint involvement at presentation, hemoglobin levels, and white cell count. Only the last 3 parameters showed a statistical significance. Human leukocyte antigen type of Saudi patients with rheumatoid arthritis influenced the course of the disease but only to a limited extent.
    Saudi medical journal 08/2001; 22(7):595-8. · 0.62 Impact Factor
  • Source
    A Al-Arfaj
    [Show abstract] [Hide abstract]
    ABSTRACT: A case is presented of Wegener's granulomatosis limited to the epididymis in a 32-year-old man. Tests for antineutrophils cytoplasmic antibodies were negative throughout. He showed excellent response to treatment with prednisolone, azathioprine and cotrimoxazole, following recurrence of his disease, after local complete excision. He remains free of disease 40 months after the discontinuation of all his treatment.
    International Journal of Urology 07/2001; 8(6):333-5. · 1.73 Impact Factor
  • Source
    A S Al-Arfaj
    [Show abstract] [Hide abstract]
    ABSTRACT: We present a case of lymphomatoid granulomatosis presenting in a 35-year-old Saudi lady with long survival. She responded to treatment with intermittent cyclophosphamide infusion in addition to corticosteroids. This is the first case of lymphomatoid granulomatosis to be reported in the Arab world. The prolonged survival and response to intermittent cyclophosphamide infusion is discussed.
    Saudi medical journal 07/2001; 22(6):541-3. · 0.62 Impact Factor