Publications by authors named "Tikly M"

Article Synopsis
  • Pulmonary complications are a significant health issue for patients with idiopathic inflammatory myopathies (IIMs) in South Africa, causing high morbidity and mortality rates.
  • A study reviewed clinical records of adult IIM patients with respiratory issues in a tertiary care facility, revealing that most patients suffered from dermatomyositis and exhibited symptoms like dyspnoea and dry cough.
  • Interstitial lung disease (ILD) emerged as the most common complication, with associations found between respiratory symptoms and poorer lung function outcomes over time.
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  • * Results showed that while many lab tests and medications were available, there were significant regional differences in access, particularly in East and West Africa.
  • * Key issues identified included long turnaround times for test results and patients often having to self-fund medical expenses, which hindered timely diagnosis and treatment.
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Objective: To assess the unmet needs of South Africans with axial spondyloarthritis (axSpA) focusing on the patient journey, functional disability, and health-related quality of life.

Methods: One hundred forty-six South African axSpA patients completed the International Map of Axial Spondyloarthritis (IMAS) online survey. Patient journey, functional disability, activities of daily living, and psychological stress were analyzed in relation to socio-demographic characteristics, disease activity, diagnostic delay, extra-musculoskeletal manifestations, and drug therapy.

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Introduction Comorbidities in systemic lupus erythematosus (SLE) impact negatively on health-related quality of life (HRQoL) and life expectancy. We investigated the frequency and spectrum of comorbidities in privately insured South Africans with SLE. Methods The data of SLE patients based on International Classification of Diseases, Tenth Revision (ICD-10) codes and insured with Discovery Health Medical Scheme (DHMS), South Africa, aged ≥16 years at diagnosis and with ≥6 months of follow-up were reviewed.

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Background And Objectives: In SSc, ILD is a major cause of morbidity and mortality. We aimed to investigate the performance of DLCO (diffusing capacity of lung carbon monoxide) and FVC (forced vital capacity) delta change (Δ) and baseline values in predicting the development of SSc-ILD.

Methods: Longitudinal data of DLCO, FVC, and ILD on the HRCT of SSc patients from the EUSTAR database were evaluated at baseline (t) and after 12 (±4) (t) and 24 (±4) (t) months.

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  • Systemic lupus erythematosus (SLE) significantly affects African American women, who experience more severe symptoms and higher mortality rates compared to women of other races, with health disparities linked to socioeconomic factors.
  • The role of racism, described as an unmeasured factor affecting health outcomes, has become more recognized in relation to SLE, highlighting the need for addressing structural injustices in healthcare.
  • A framework for individual and national actions is proposed to tackle these disparities, advocating for healthcare as a fundamental human right and suggesting collaborative efforts to mitigate the impact of racism in healthcare access and treatment.
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Background Osteoporosis is a common comorbidity associated with rheumatoid arthritis (RA). The aim of this study was to determine the risk factors and possible predictors of osteoporosis in black patients with RA. Methods A retrospective study of 120 randomly selected RA patients attending an arthritis clinic in Johannesburg, South Africa, was carried out, in which 60 patients were with and 60 without osteoporosis.

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Background: Rheumatoid arthritis (RA) occurs across the globe in different ethnic populations. Most RA patients harbor anti-modified protein antibodies (AMPA); however, it is unclear whether differences exist in autoantibody responses at different geographic locations and between different ethnic groups, which could provide new clues regarding factors underlying autoantibody development. We therefore investigated AMPA prevalence and association with HLA DRB1 alleles and smoking in four ethnically diverse populations on four different continents.

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Background: Idiopathic inflammatory myopathies (IIM) are rare diseases for which there is a paucity of data in Africa. We undertook a retrospective records review of clinical and laboratory features of patients with IIM attending a tertiary service in Gauteng, South Africa.

Materials And Methods: Case records of patients seen between January 1990 and December 2019 and fulfilling the Bohan and Peter criteria for IIM were reviewed for demographics, clinical features, special investigations and drug therapy.

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The complex pathogenesis of rheumatoid arthritis (RA) is not fully understood, with few studies exploring the genomic contribution to RA in patients from Africa. We report a genome-wide association study (GWAS) of South-Eastern Bantu-Speaking South Africans (SEBSSAs) with seropositive RA (n = 531) and population controls (n = 2653). Association testing was performed using PLINK (logistic regression assuming an additive model) with sex, age, smoking and the first three principal components as covariates.

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Background: Psoriasis is associated with a high prevalence of cardiovascular disease in Caucasians, but only a few studies from sub-Saharan Africa have investigated the prevalence of cardiovascular disease in patients with psoriasis. Abdominal aortic calcification (AAC) is a strong predictor of future cardiovascular events and all-cause mortality in the general population. We investigated the prevalence and risk factors for AAC in a predominantly non-Caucasian cohort of South African patients with psoriasis.

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Article Synopsis
  • * Despite the potential insights from large datasets, computational challenges can arise, prompting the need for dependable data analysis methods.
  • * This study presents the nf-rnaSeqCount pipeline, which automates RNA sequencing data analysis using Nextflow and Singularity, streamlining the process for generating read count matrices for differential gene expression studies.
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Objective: Comorbidities contribute both to morbidity and mortality in rheumatoid arthritis (RA). The aim of the current study was to investigate the prevalence and spectrum of comorbidities in South Africans with established RA.

Methods: A retrospective, consecutive case record review of 500 Black South African patients with established disease of ≥5 years attending a tertiary rheumatology service was performed.

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Purpose: To determine the anticipated reduction of baseline angle of esotropia and identify predictors of change following botulinum neurotoxin (BNT) injections in large-angle infantile esotropia.

Methods: This was a prospective, longitudinal study of children <10 years of age diagnosed with infantile esotropia of >30 and given either 1, 2, or 3 BNT injections. Post-injection change from baseline deviation was recorded, and predictors of reduction were analyzed.

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  • The study aimed to test the reliability of Laser Speckle Contrast Analysis (LASCA) for assessing blood flow in the fingertips of Black South African patients with systemic sclerosis (SSc).
  • It involved evaluating 40 SSc patients (mostly females) to measure fingertip blood perfusion by three operators of varying experience.
  • Results showed strong agreement between operators, indicating that LASCA is a reliable method for measuring microvascular function in this demographic.
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Objective: To compare the cost implications of botulinum neurotoxin (BNT) injection to surgery in infantile esotropia (IE) in a public/government funded hospital.

Methods And Analysis: A simple costing comparison was undertaken for a randomised clinical trial in IE. Patients were randomised to receive either BNT or standard surgery.

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Historically, rheumatic diseases have not received much attention in Africa, particularly in sub-Saharan Africa, possibly owing to a focus on the overwhelming incidence of infectious diseases and the decreased life span of the general population in this region. Global attention and support, together with better health policies and planning, have improved outcomes for many infectious diseases; thus, increasing attention is being turned to chronic non-communicable diseases. Rheumatic diseases were previously considered to be rare among Africans but there is now a growing interest in these conditions, particularly as the number of rheumatologists on the continent increases.

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Systematic studies on connective tissue disorders are scarce in sub-Saharan Africa. Our aim was to analyse the published clinical data on systemic sclerosis (SSc) in sub-Saharan Africa. A systematic review was carried out in accordance with the PRISMA guidelines.

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Article Synopsis
  • The study compares botulinum neurotoxin (BNT) injections with surgical intervention as first-line treatments for large-angle essential infantile esotropia (IE) in children.
  • It found that while surgery had a significantly higher success rate (complete response) than BNT injections, it also took much longer to perform.
  • BNT injections were shown to be a safe and effective alternative for younger children (≤24 months) and those with smaller angles of esotropia (≤60 PD), especially in resource-limited settings.
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  • The study aims to assess how rheumatology services in Africa have changed due to the COVID-19 pandemic, using an online survey of rheumatologists across the continent.
  • A total of 554 responses were collected from 20 African countries, revealing that many rheumatologists shifted toward virtual consultations while some still held face-to-face appointments with protective measures.
  • The findings highlight significant regional differences in the adaptation to the pandemic, including the creation of national guidelines and the availability of COVID-19 registries for rheumatology.
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Objectives: To develop recommendations for the management of rheumatic and musculoskeletal diseases (RMDs) during the COVID-19 pandemic.

Method: A task force comprising of 25 rheumatologists from the 5 regions of the continent was formed and operated through a hub-and-spoke model with a central working committee (CWC) and 4 subgroups. The subgroups championed separate scopes of the clinical questions and formulated preliminary statements of recommendations which were processed centrally in the CWC.

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Takayasu arteritis (TA) is a rare large vessel vasculitis that particularly affects women of child-bearing age. Management of pregnant patients with TA is often challenging due to the cardiovascular and cerebrovascular complications of the disease. We report two new cases of pregnancy in patients with TA and review all published cases from sub-Saharan Africa.

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