الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Juvenile idiopathic arthritis (JIA) is a chronic auto inflammatory disease of unknown etiology and is the most common cause of autoimmune musculoskeletal disease in children defined as a heterogeneous group of inflammatory arthritis occurring in those under 16 years of age and persists for more than six weeks, after exclusion of other causes.
A number of measures for the assessment of PRO in children with JIA have been developed over the years, including visual analog scales (VAS) for rating of child’s overall well-being and intensity of pain, and questionnaires for the evaluation of functional ability and health-related quality of life (HRQOL).
JAMAR consists of 15 items measuring the quality of life in children diagnosed with JIA.
44 patients who attended to the pediatric rheumatology clinic of Alexandria Pediatric Hospital were asked to fill the questionnaire and a follow- up questionnaire was done after 6 months.we found that 27 patients were females and 17 patients were males, the age at onset ranged from one year to thirteen years, The age of patients ranged from 3 to 16 years, 9 patients were diagnosed as RF negative Systemic onset JIA, 13 patients were diagnosed as ANA negative Oligo-aricular JIA, 2 patients were diagnosed as ANA positive Oligo aricular JIA, 16 patients were diagnosed as RF negative Polyarticular JIA and 4 patients were diagnosed as RF positive Polyarticular JIA.
In the current study the 1st assessment revealed weak points in the lines of management which have been taken in consideration, as there were 3 patients on MTX who developed side effects and non-compliance with this medication ,shifting to other group of medications (azathioprine and /or Leflunomide) showed marked improvement in the 2nd assessment .
The 2nd assessment revealed improvement in quality of life, school attendance, and decreased steroids dosage which proves that JAMAR is reliable and sensitive to change.
Regular use of the JAMAR enables keeping a flow sheet of patient’s course over time. A flow sheet may facilitate the recognition of possible changes in functional capacity, pain, fatigue, and psychological status from previous visits.
Results of this study revealed that the JAMAR questionnaire was valid, reliable and sensitive to change of the disease activity.