الفهرس 
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Abstract
Rheumatoid arthritis (RA) is a chronic, systemic inflammatory disorder that may affect many tissues and organs, but principally attacks synovial joints. The pathology of the disease process often leads to the destruction of articular cartilage and ankylosis of the joints. Rheumatoid arthritis can also produce diffuse inflammation in the lungs, pericardium, pleura, and sclera, and also nodular lesions, most common in subcutaneous tissue. Although the cause of rheumatoid arthritis is unknown, autoimmunity plays a pivotal role in both its chronicity and progression, and RA is considered a systemic autoimmune disease. Few prevalence studies performed in developing countries suggested significantly lower prevalences of about 0.1% to 0.5% (Anaya et al., 1989 and Spindler et al., 2002). In 1987 the prevalence of RA in the Middle East range from 0-0.5 case per 100,000 inhabitant , the prevalence in Egypt was 0.2 case per 100,000 inhabitant (Yelin et al., 1987). There were no studies done in Sohag governorate about the risk factors of RA , So that this study was done to determined these factors.
Aim of work:
To determine the demographic characteristics, risk factors and associated co- morbidities in patients with rheumatoid arthritis (RA) visiting the Rheumatology& Rehabilitation clinic of Sohag University Hospital.
Study Design:
This study was a case- control study. Two hundred cases who were known to have rheumatoid arthritis and come for follow up in Rheumatology& Rehabilitation clinic compared with another two hundred apparently healthy person as a control whom meet in other departments of the hospital for risk factors of (RA) as age group commonly affected, gender commonly affected, presence or absence of family history, whether the cases or the controls were smoker or not and detection of co-morbidities for both. Interviews were conducted by using a predesigned questionnaire (Appendix 1) which included demographic data as gender, age, marital status, occupation, residence, housing condition as regard the type of the floor of the house and socio-economic status, also it included obstetric history, breastfeeding and use of oral contraceptive pills. Other data include the body mass index, presence or absence of family history of RA and laboratory investigation as ( ESR, S.Creatinin, RF weather +ve or –ve and it’s titre and Anti CCP weather +ve or –ve and it’s titre ) which collected from patient’s files.
Results:
This study found that the disease was higher among patients with age more than 45 years (49.5% for cases compared to 40.5% for controls), no differences between both groups as regard the following age at menarche, marital status, parity, socio-economic status, occupation, use of contraception, breast feeding and smoking. But there were significant differences as regard the following duration of contraception use (59.4% of cases used it <5 years compared to 47.17% of controls and 23.4% used it >10 years compared to 15.09% of controls), tea consumption (87% of cases drink compared to 77.5% of controls), presence of family history (17% of cases with positive family history compared to 10% of controls) and obesity (41% of cases compared to 29.5% of controls).
Recommendations
The cause of RA is not known, The effort of primary prevention should be directed to prevention or modification of known risk factors. Recommendations of the present study include:
1. Improving housing condition and socio-economic status.
2. Use tea in moderation.
3. OCP if used shouldn’t be used for too short (< 5 years) or too long (>10 years) periods.
4. Special attention to person with positive family history to help early detection and proper treatment.
5. Urge obese individual to lose weight.
6. New studies about the age at onset, relation of the onset to pregnancy, stress and diet as a risk factors for RA.