Binit Vaidya

• Doctor of Medicine
• CEO at National Center for Rheumatic Diseases, Kathmandu, Nepal

Background Understanding the burden of lower limb conditions (LLCs) is essential for effective health planning, yet data in low-resource settings like Nepal is scarce. LLCs, encompassing diverse issues such as pain, injuries and amputations, can profoundly impact mobility, well-being, and livelihoods. With limited healthcare access and growing non-...

Background Takayasu arteritis (TA) is an idiopathic, granulomatous, large-vessel arteritis that predominantly involves the aorta, its major branch arteries. Then objective is to evaluate the clinical features, angiographic findings and response of treatment Method 12 patients with TA were studied at the NCRD between 2018 and 2023 and were followed...

Background Knee osteoarthritis is one of the most commonly encountered joint disease with prevalence ranging upto 7.9%. There are various radiologic instruments to measure the disease severity of knee osteoarthritis. Kellgren Lawrence (KL grading) classification is commonly used radiographic tool to assess severity. High frequency musculoskeletal u...

This study aimed to assess COVID-19 vaccination-related AEs in patients with rheumatoid arthritis (RA), in the COVID-19 Vaccination in Autoimmune Diseases (COVAD)-2 study. An online international cross-sectional survey captured self-reported data on COVID-19 vaccination-related adverse events (AEs) in people with RA, autoimmune diseases (AIDs; rheu...

Objective The presence of comorbidities can substantially affect patients’ quality of life, but data regarding their impact on idiopathic inflammatory myopathies (IIMs) are limited. Methods We examined the prevalence of comorbidities in IIM patients, other autoimmune rheumatic diseases (oAIRDs), and healthy controls (HCs), using data from the self...

Notwithstanding the wealth of literature on COVID-19, studies focusing on young adults with autoimmune diseases (AD) are lacking. To determine early (within 7 days) and late (after 7 days) anti-SARS-CoV-2 vaccine-related adverse events (AEs), post-vaccine disease flares, COVID-19 severity and breakthrough infections (B-INFs) in young people with rh...

Background Idiopathic inflammatory myopathies (IIM) encompass a group of disorders characterized by muscle inflammation, weakness, and varying levels of systemic involvement. These conditions profoundly impact patients’ quality of life (QoL) due to their chronic nature, physical impairments, and accompanying mental health challenges. Recent literat...

Pyomyositis is a purulent infection of skeletal muscle that is mostly observed in tropical countries. Aseptic pyomyositis is a rare, potentially life-threatening disorder characterized by the formation of sterile pus in muscle. We present a case of 53-years old female, diagnosed case of seropositive rheumatoid arthritis, presented with pain and swe...

COVID-19 has been suggested as a possible trigger of disease flares in patients with rheumatoid arthritis (RA). However, factors associated with disease flares remain unknown. This study aimed to identify factors associated with breakthrough infection (BIs) and disease flares in patients with RA following COVID-19. We analysed data from RA patients...

Objectives To explore prevalence, characteristics and risk factors of COVID-19 breakthrough infections (BIs) in idiopathic inflammatory myopathies (IIM) using data from the COVID-19 Vaccination in Autoimmune Diseases (COVAD) study. Methods A validated patient self-reporting e-survey was circulated by the COVAD study group to collect data on COVID-...

Objectives: We investigated COVID-19 vaccine safety in pregnant and breastfeeding women with autoimmune diseases (AID) in the COVID-19 Vaccination in Autoimmune Diseases (COVAD) study. Methods: Delayed-onset (>7 days) vaccine-related adverse events (AE), disease flares (DF), and AID-related treatment modifications were analyzed upon diagnosis of...

Limited evidence on long-term COVID-19 vaccine safety in patients with idiopathic inflammatory myopathies (IIMs) continues to contribute to vaccine hesitancy. We studied delayed-onset vaccine adverse events (AEs) in patients with IIMs, other systemic autoimmune and inflammatory disorders (SAIDs), and healthy controls (HCs), using data from the seco...

Background Post COVID-19 syndrome (PCS) is an emerging cause of morbidity and poor quality of life in COVID-19 survivors [1, 2]. Objectives We aimed to assess the prevalence, risk factors, outcomes, and association with disease flares of PCS in patients with autoimmune rheumatic diseases (AIRDs) and non-rheumatic autoimmune diseases (nrAIDs), both...

Background Systemic lupus erythematosus (SLE) can result in impaired daily physical function through various mechanisms including active disease, chronic damage, and mental health symptoms that are common in the disease. However, the key drivers of reduced physical function are poorly understood, and no large-scale global studies investigating this...

Objectives: Disease flares in the post COVID-19 vaccination period represent a prominent concern, though risk factors are poorly understood. We studied these flares among patients with idiopathic inflammatory myopathies (IIMs) and other autoimmune rheumatic diseases (AIRDs). Methods: The COVAD-1 and -2 global surveys were circulated in early 202...

Dear Editor, Viral infections are known triggers of disease flares in idiopathic inflammatory myopathies (IIMs). Reports of post-COVID-19 exacerbation of IIMs suggest a possible role for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in precipitating IIM disease flares [1]. Recently, analysis of patients with pre-pandemic adult-onset...

Objective: Flares of autoimmune rheumatic disease (AIRDs) following COVID-19 vaccination are an outstanding concern in vaccine-hesitant individuals. Therefore, we investigated the incidence, predictors and patterns of flares following vaccination in individuals living with AIRDs using global COVID-19 Vaccination in Autoimmune Diseases (COVAD) surv...

Objective: COVID-19 vaccines have a favorable safety profile in patients with autoimmune rheumatic diseases (AIRDs) such as idiopathic inflammatory myopathies (IIMs), however hesitancy continues to persist among these patients.Therefore, we studied the prevalence, predictors, and reasons for hesitancy in patients with IIMs, other AIRDs, non-rheuma...

Objective COVID-19 vaccines have a favorable safety profile in patients with autoimmune rheumatic diseases (AIRDs) such as idiopathic inflammatory myopathies (IIMs), however hesitancy continues to persist among these patients. Therefore, we studied the prevalence, predictors, and reasons for hesitancy in patients with IIMs, other AIRDs, non-rheumat...

Dear Editor, Patients with idiopathic inflammatory myopathies (IIMs) represent a high-risk group for adverse pregnancy outcomes (APOs), and post COVID-19 vaccination disease flares have been speculated. However, data on vaccine-associated adverse events (ADEs) in the antenatal period and APOs in this vulnerable group are virtually non-existent, lim...

Vaccine hesitancy is considered a major barrier to achieving herd immunity against COVID-19. While multiple alternative and synergistic approaches including heterologous vaccination, booster doses, and antiviral drugs have been developed, equitable vaccine uptake remains the foremost strategy to manage pandemic. Although none of the currently appro...

Drug-induced arthritis is not an uncommon scenario. DPP-4 inhibitors could potentially cause adverse-events mediated by cytokine-induced inflammation leading to arthritis. The activity of the DPP-4 enzyme could be inversely related to the development of rheumatoid arthritis, explaining the increased inflammatory activity with its inhibition by a dr...

Severe coronavirus disease 2019 can be associated with progressive respiratory failure. In addition to respiratory support and other supportive care, use of corticosteroids has shown to improve outcome. Despite the use of steroids, a significant proportion of patients progressively worsen. Adjunct immunomodulators have been studied in addition to s...

Patients with gout in Nepal are usually attended by medical graduates, family medicine, internists, and orthopedic surgeons. The study aimed to evaluate knowledge, attitude, and practice (KAP) of point-of-care clinicians of Nepal regarding diagnosis and management of gout and assess the quality of treatment provided to the patients. A web-based des...

Background: Methotrexate is considered as the anchor drug for the treatment of rheumatoid arthritis. However, various adverse effects limit its use leading to frequent discontinuation of treatment. This study aimed to evaluate the common adverse effects of methotrexate in patients with rheumatoid arthritis. Methods: A prospective observational s...

Background: Undifferentiated inflammatory arthritis is a group of inflammatory joint diseases that do not fulfil the classification criteria for any other rheumatic or connective tissue disorders. This study aims to describe the clinical, demographic and serological features of undifferentiated inflammatory arthritis cases presenting at a tertiary...

Purpose The global health crisis created by coronavirus disease in 2019, ie, COVID-19, is of serious concern to rheumatologists. The relationship of rheumatic diseases, their therapies, and COVID-19 with multiple genuine and malicious information available online can influence the knowledge and attitudes of rheumatic patients. This Google Forms stu...

Background and Aims To study the prevalence of deranged metabolic parameters in patients with gout. Methods This was a prospective, cross-sectional observational study conducted at a tertiary level rheumatology center in Nepal. Patients over 18 years and diagnosed as gout using the ACR/EULAR 2015 classification criteria were included in the study....

Natural therapy modalities such as thermal therapy and balneotherapy are commonly being practiced for the management of chronic aches and pain all over the world. Nepal has many such natural hot water springs among which few are famous for therapeutic purposes. Thousands of people with some musculoskeletal problem visit those places in the hope of...

Objective To translate, cross‐culturally adapt and test the psychometric properties of the Revised Fibromyalgia Impact Questionnaire (FIQR) in Nepali language (Nepali FIQR). Methods The translation was performed following the methodological standards described by Beaton. Comprehensibility testing of the preliminary version was done in 40 fibromyal...

Objective. To examine the efficacy of vitamin E in methotrexate- (MTX-) induced transaminitis in patients with rheumatoid arthritis (RA). Methods. A case-control study was conducted at a tertiary rheumatology center for 12 months. Patients with RA on MTX and deranged aminotransferases were included. Patients with previous liver diseases, baseline t...

Introduction/objectives: The global health crisis created by Coronavirus Disease (COVID-19) can be a serious concern to rheumatologists. The relationship of rheumatic diseases, their therapies, and COVID-19 with multiple genuine and malicious information available online can influence the knowledge and attitude of rheumatic patients. This web-based...

Background: Gout is commonly associated with metabolic syndrome. Strong association between the serum uric acid level and microalbuminuria has also been observed in various studies. Aim: To observe the change in urinary microalbumin after urate-lowering treatment in patients with gout and microalbuminuria. Methodology. A prospective, observation...

Background: Among many self-reported outcome measures, Western Ontario and McMaster Universities Arthritis Index (WOMAC) is one of the commonly used indexes for osteoarthritis patients. Despite high prevalence of musculoskeletal problems in Nepal, there is no validated tool available in the local language. Thus, this study aimed to translate the E...

The pleiotropic effects of vitamin D on the various metabolic, anticancer, and immunomodulatory functions of the body based on the presence of vitamin D receptors (VDR) on various cell types has been recognized worldwide now. Of few understood mechanisms of immunomodulatory actions of vitamin D are the suppressive action on the maturation of antige...

Objective: To translate, cross-culturally adapt and validate the Health Assessment Questionnaire-Disability Index (HAQ-DI) in Nepali language (Nepali HAQ). Methods: Translation was done fulfilling the methodological standards described by Beaton. Comprehensibility testing of the preliminary version was done in 50 rheumatoid arthritis (RA) patien...

Background: World Health Organization defines childhood obesity as “one of the most serious public health challenges”. Low income countries like Nepal experience a burden of infectious diseases as well as rising incidence of noncommunicable diseases frequently associated with obesity. There is paucity of information on childhood obesity in Nepal. O...

Anti-phospholipid antibody syndrome is caused by the presence of specific antibodies against phospholipid-binding plasma proteins in serum of patient, with or without underlying autoimmune diseases, that causes prolongation of tests of coagulation. High index of clinical suspicion is required for diagnosis. Stroke or myocardial infarction in young,...

Introduction: In Nepal, adalimumab is the most common agent being used, but in a disease activity-based dose tapering to address the economic constraints. Another constraint is the high risk of reactivation of tuberculosis in countries with high burden, especially with the use of tumor necrosis factor blocking agents. Though there are recommendati...

Pachydermoperiostosis is a rare genetic disorder characterized by skin thickening, digital clubbing and periostitis. The pathogenesis is incompletely understood and there are no proven treatments for its manifestations. Although arthritis has been reported in 20–40% cases, most are non-inflammatory in nature and usually treated symptomatically with...

Cutaneous manifestations are second most common presenting feature of lupus. Discoid lupus erythematosus is the most common variant amongst all; lupus panniculitis being described in only 2-5% of cases. Most cases of cutaneous lupus are associated with autoantibodies and either precede or follow the systemic manifestations of lupus. There is no pro...

Early undifferentiated arthritis is a group of inflammatory joint disease of less than 3 months duration that do not classify under any of the specific rheumatic or connective tissue disorder. Previously, inflammatory arthritis used to be treated only when there was a clear evidence of damage or deformity occurring with it. Use of disease modifying...

Examination of urate crystal in synovial fluid (SF) remains the gold standard for diagnosis of gout, but is not universally available. SF uric acid (UA) level may be measured by the uricase method with an automated analyzer. The present study aimed to evaluate the utility of SF to serum UA ratio (SSR) for diagnosis of gout. A cross-sectional study...

Primary amoebic meningoencephalitis (PAM) is a rare, fulminating, hemorrhagic infection of the brain caused by Naegleria fowleri, a thermophilic, free-living amoeba. A 74-year male presented with sudden severe global headache and fever with features of anomic aphasia. Magnetic resonance imaging (MRI) suggested herpes encephalitis and acyclovir (IV)...

p> INTRODUCTION: Rheumatic diseases have been found to be associated with an increased risk of cardiovascular disease (CVD) and dyslipidemia. Constant state of inflammation among patients with active rheumatic diseases predispose to endothelial damage leading to increased risk of dyslipidemia and CVD. Dyslipidemias are being increasingly recognized...

Vitamin D deficiency is a highly prevalent condition worldwide. However, few studies have been conducted to examine the vitamin D status of laboratory personnel and the correlation between vitamin D deficiency and working conditions. The aim of the present study was to assess changes in serum 25-hydroxyvitamin D [25(OH)D] concentration with a weekl...

The age of onset of rheumatoid arthritis (RA) is an important outcome predictor. Northern countries report an age of RA onset of around 50 years, but apparently, variability exists across different geographical regions. The objective of the present study is to assess whether the age of onset of RA varies across latitudes worldwide. In a proof-of-co...

p> Back grounds and Aims: Microvascular involvement of nailfold often occurs in systemic rheumatic diseases, especially scleroderma and related conditions. Nailfold capillaroscopy is easily performed non-invasive, simple, repeatable, sensitive, safe and inexpensive method to examine nailfold architecture by microscope.The normal capillaries are thi...

Background and aims: Hypovitaminosis D is common in south-east Asian countries. Deficient vitamin-D level is likely to be associated with chronic muscular pains. We do not have data from our country regarding the magnitude of this problem. Methods: A prospective open labeled study at rheumatology opd from December 2009 to December 2012. Patients wi...

BACKGROUND: The main clinically useful serological markers in patients with Rheumatoid Arthritis are Rheumatoid Factor and Anti-citrullinated Protein Antibodies (ACPA) for both diagnosis and prediction of functional and radiographic outcomes. We do not have data from Nepalese patients about gender differences and association of these antibodies wit...

Background and Aims-To study the differences in clinical parameters between male and female patients with spondarthritis (SpA) in Nepalese population; to study the prevalence of HLA B27 phenotype in Nepalese patients with SpA and to study the differences in clinical parameters in relation to HLA B27 phenotype. Methods- This is cross sectional obser...

Objective To study vitamin D deficiency as the primary cause of musculoskeletal complaints in rheumatology clinic.Methods Adult patients presenting with ‘non-inflammatory’ musculoskeletal pain to our rheumatology clinic between May 2009 and April 2011 underwent estimation of serum 25-hydroxyvitamin D [25(OH)D] and those with level < 20 ng/ml were r...

MRI is the preferred modality to investigate seizure as diagnostic yield is higher and more specific due to its varied applications. Total of 160 brain MR images of patients suffering from seizure during one year period was evaluated. All seizure cases underwent specific protocol for imaging that targeted hippocampal/mesial temporal lobe imaging.

Prevalence and clinical significance of anti-cyclic citrullinated peptide (CCP) antibodies in Indian patients with juvenile idiopathic arthritis (JIA). Anti-CCP antibodies were determined by enzyme-linked immunosorbent assay (ELISA) in 78 patients with JIA which included all 3 major subtypes of the disease: pauciarticular, polyarticular afld system...

The study was aimed at identifying the association between two major risk factors for coronary artery disease (CAD), namely, type 2 diabetes and hyperlipidemia. Hyperlipidemia has a ocumented causative relation with CAD, but the major risk associated with diabetes may be due to the associated hyperlipidemia. Lipid profiles of 30 patients with type...

A total of 37 hypertensive patients of both sexes over 18 years of age and more than four years of duration after diagnosis and only those having evidence of left ventricular hypertrophy (LVH) by echocardiography (ECHO) were enrolled to analyze the diagnostic efficacy of electrocardiography in determining left ventricular hypertrophy in patients wi...