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Papers by Sumaira Farman

Pakistan Armed Forces Medical Journal, Jun 22, 2023

An nk ky yl lo os si in ng g S Sp po on nd dy yl li it ti is s a an nd d P Ps so or ri ia at ti i... more An nk ky yl lo os si in ng g S Sp po on nd dy yl li it ti is s a an nd d P Ps so or ri ia at ti ic c A Ar rt th hr ri it ti is s

Journal of rheumatic diseases, Feb 23, 2024

Pakistan Armed Forces Medical Journal, Jun 21, 2023

Te er rm m E Ef ff fi ic ca ac cy y a an nd d S Sa af fe et ty y o of f S Su ub bc cu ut ta an ne... more Te er rm m E Ef ff fi ic ca ac cy y a an nd d S Sa af fe et ty y o of f S Su ub bc cu ut ta an ne eo ou us s

Aim: To evaluate the reach and potential effectiveness of teleteaching of health providers in pae... more Aim: To evaluate the reach and potential effectiveness of teleteaching of health providers in paediatric rheumatology by observing the pattern of sessions, attendance, and attendees' feedback in paediatric rheumatology teleteaching sessions across the Asia Pacific region. These were conducted by the Asia Pacific League of Associations for Rheumatology (APLAR) Paediatric Rheumatology Special Interest Group (Paeds Rheum SIG) as an APLAR academy activity. Methods: A retrospective, descriptive analysis of electronic records of synchronous telehealth sessions held between July 2021 to July 2023. These followed three formats: case-based webinars, single topic modular online course, and a hybrid one-day short course. The topics of sessions, attendees' registration details, specifically primary area of practice/specialty, geographic location, and their satisfaction as per feedback forms were noted. Results: Case-based webinars had an average attendance of 200 per webinar: majority adult rheumatologists, paediatric rheumatologists (PRs), or paediatricians. The modular course consisted of nine sessions with an average of 63 participants per session. Specialties comprised PRs, adult rheumatologists with immunologists, and general paediatricians. The one-day hybrid course had over 600 attendees. Attendees were adult rheumatologists, general physicians, paediatricians, and PRs. Although the majority (79.3%) of attendees from these sessions were from APLAR member nation organisations (MNOs), a significant percentage (20.7%) were from non-APLAR MNOs and even non-Asia Pacific regions. The attendees' feedback for all three formats showed a high level of satisfaction with case-based webinars being most favoured. Conclusions: Teleteaching in paediatric rheumatology has the potential to fulfill the dire need for improved expertise of health professionals managing children with rheumatic diseases. Case-based, interactive sessions of shorter duration and a blended hybrid format may garner the most attendance and best learning outcomes.

International Journal of Rheumatic Diseases, 2011

Leflunomide is a disease-modifying anti-rheumatic drug (DMARD) for rheumatoid arthritis (RA). It ... more Leflunomide is a disease-modifying anti-rheumatic drug (DMARD) for rheumatoid arthritis (RA). It has been widely studied in the West but there is no available local Pakistani data. To evaluate the efficacy and safety profile of leflunomide in Pakistani patients with RA, either alone or in combination with methotrexate. A prospective, non-comparator, open-label study in a setting of 'care as usual' was performed. In this study, 63 consecutive RA patients on leflunomide were enrolled. Leflunomide dose was started with full loading in 5 (8%), half loading in 39 (62%) and without loading in 19 (30%) patients. Methotrexate was also used in 20 (32%) patients. Primary end-point was 20% improvement in American College of Rheumatology response criteria (ACR-20). Safety was assessed by adverse events and abnormalities in laboratory parameters. Out of 63 patients, 54 (85.7%) were female. Mean age was 46 ± 12.6 years. Mean disease duration was 5.1 ± 4.5 years. Fifty-two (86.6%) patients achieved ACR-20 response at 6 months; 32 (53%) achieved ACR-50 response at 6 months; 20% experienced at least one adverse event, which resolved by reducing leflunomide dose. Only seven (11%) had raised liver enzymes from baseline. This prospective study conducted in the setting of a daily rheumatology practice shows that leflunomide is an effective and safe DMARD in treatment of RA in Pakistani patients.

Pakistan Journal of Medical Sciences, 2021

Objective: To identify factors causing diagnostic and therapeutic delay in patients with rheumato... more Objective: To identify factors causing diagnostic and therapeutic delay in patients with rheumatoid arthritis, and to evaluate relationship of diagnostic and therapeutic delay with disease outcome. Methods: This cross-sectional study was conducted in Rheumatology Department, Fatima Memorial Hospital, Lahore, Pakistan, from May 2018 to July 2018. In this study 102 patients fulfilling ACR/EULAR criteria 2010 were enrolled. Lag times were calculated in months: lag-1 (delay in initial medical consultation); lag-2 (delay in consulting rheumatologists); lag-3 (diagnostic delay); lag-4 (therapeutic delay). Disease activity and functional outcome were measured by DAS28, HAQ-DI respectively. Association of lag-3 and lag-4 with HAQ-DI and DAS28 was calculated by Pearson correlation. Results: Median (IQR) disease duration of study group was 6(2-10) years. Initial consultations were with; orthopedic surgeon 40(39.2%), general practitioner 27(26.5%), rheumatologist 13(12.7%), medical specialists...

Journal of Ayub Medical College Abbottabad

Granulomatosis with polyangiitis (GPA) is an uncommon pauci-immune small-vessel necrotising granu... more Granulomatosis with polyangiitis (GPA) is an uncommon pauci-immune small-vessel necrotising granulomatous vasculitis mostly seen in age 45–60 years. We present the case of a formerly healthy 44 years old male presenting with dysuria and intermittent urinary retention for 8 months, not responding to empirical antibiotic therapy and TURP. A prostate biopsy showed necrotising granulomatous prostatitis. Urinalysis demonstrated persistent pyuria and haematuria, but cultures showed no growth. Subsequently he complained of fever, cough, dyspnoea and skin ulcers. CT of the chest showed multiple cavitatory lesions and pleural effusion. On work up, c-ANCA was positive and a diagnosis of granulomatosis with polyangiitis was established. This depicts a rarely seen presentation of prostatitis as the initial feature of GPA.

International Journal of Rheumatic Diseases, 2021

Pakistan Journal of Zoology, 2015

Fibromyalgia syndrome (FMS) is characterized by musculoskeletal pain of unknown etiology and is o... more Fibromyalgia syndrome (FMS) is characterized by musculoskeletal pain of unknown etiology and is often accompanied by many psychological symptoms. This study is aimed at evaluating the importance of antioxidants (vitamin E, vitamin C and Nigella sativa seeds) therapy in management of this disease. Fifty female patients having mean age of 37.87±1.68 years suffering from FM were enrolled in the study. Role of oxidative stress was determined by measuring antioxidant enzymes including superoxide dismutase (SOD), glutathione peroxidase (GPx), antioxidant capacity by ABTS (2,2'- azinobis-(3-ethylbenzo-thiazoline-6-sulphonic diammonium salt) and ferric reducing antioxidant capacity (FRAP) assay in plasma and catalase in erythrocytes. The FM patients were also supplemented with antioxidants (Vitamin C, Vitamin E and Nigella sativa seeds) for two months to assess the impact on activity of FM with the help of VAS (visual analogue scale) (0 being no pain and 100 being severe pain).It was fo...

Journal of the College of Physicians and Surgeons--Pakistan : JCPSP, 2015

OBJECTIVE To determine the frequency of patients with early Rheumatoid Arthritis (RA) achieving d... more OBJECTIVE To determine the frequency of patients with early Rheumatoid Arthritis (RA) achieving disease remission and/or low disease activity after 6 months of treatment with conventional Disease Modifying Anti-Rheumatic Drugs (DMARDs) by using treat-to-target approach in routine clinical practice. STUDY DESIGN Descriptive study. PLACE AND DURATION OF STUDY Division of Rheumatology, Fatima Memorial Hospital (FMH), College of Medicine and Dentistry, Lahore, from March 2011 to February 2012. METHODOLOGY Patients with early RA defined as disease duration ² 1 year were enrolled by purposive sampling, diagnosed as per American College of Rheumatology (ACR) 1987 criteria. Treat-to-target approach was defined as per European League Against Rheumatism (EULAR) 2010 guidelines for treatment of RA with conventional DMARDs. Outcome measures of remission and low disease activity were defined as per DAS 28 score criteria. Patient response to treatment was also determined by EULAR response criteri...

Objective: To identify factors causing diagnostic and therapeutic delay in patients with rheumato... more Objective: To identify factors causing diagnostic and therapeutic delay in patients with rheumatoid arthritis, and to evaluate relationship of diagnostic and therapeutic delay with disease outcome. Methods: This cross-sectional study was conducted in Rheumatology Department, Fatima Memorial Hospital, Lahore, Pakistan, from May 2018 to July 2018. In this study 102 patients fulfilling ACR/EULAR criteria 2010 were enrolled. Lag times were calculated in months: lag-1 (delay in initial medical consultation); lag-2 (delay in consulting rheumatologists); lag-3 (diagnostic delay); lag-4 (therapeutic delay). Disease activity and functional outcome were measured by DAS28, HAQ-DI respectively. Association of lag-3 and lag-4 with HAQ-DI and DAS28 was calculated by Pearson correlation. Results: Median (IQR) disease duration of study group was 6(2-10) years. Initial consultations were with; orthopedic surgeon 40(39.2%), general practitioner 27(26.5%), rheumatologist 13(12.7%), medical specialists...

Journal of clinical medicine research, 2015

Organ transplantation has always been considered to be the standard therapeutic interventions in ... more Organ transplantation has always been considered to be the standard therapeutic interventions in patients with end-stage organ failure. In 2008, more than 29,000 organ transplants were performed in US. Survival rates among transplant recipients have greatly improved due to better understanding of transplant biology and more effective immunosuppressive agents. After transplant, the extent of the immune response is influenced by the amount of interleukin 2 (IL-2) being produced by the T-helper cells. Transplant immunosuppressive therapy primarily targets T cell-mediated graft rejection. Calcineurin inhibitor, which includes cyclosporine, pimecrolimus and tacrolimus, impairs calcineurin-induced up-regulation of IL-2 expression, resulting in increased susceptibility to invasive fungal diseases. This immunosuppressive state allows infectious complication, leading to a high mortality rate. Currently, overall mortality due to invasive fungal infections (IFIs) in solid organ transplant reci...

The Journal of Rheumatology, 2011

Objective.To determine the extent to which cognitive dysfunction (CD) observed in patients with s... more Objective.To determine the extent to which cognitive dysfunction (CD) observed in patients with systemic lupus erythematosus (SLE) exceeds that seen in a matched control group of patients with rheumatoid arthritis (RA), and to estimate the prevalence of CD in SLE in a community-based sample.Methods.A random subsample of 31 patients with SLE was compared to patients with RA matched by age, sex, and race and derived from the same patient population. Cognitive function was assessed by the Automated Neuropsychological Assessment Metrics (ANAM). The primary outcome was the total throughput score (number of correct responses divided by the time taken for those responses averaged over all subtests), adjusted for premorbid intelligence, neuromuscular efficiency, disease activity, damage, depression, fatigue, and health-related quality of life.Results.There were no statistically significant differences in mean throughput scores between patients in the SLE and RA groups in any subtest of the ...

International Journal of Rheumatic Diseases, 2020

To determine the prevalence of inflammatory back pain (IBP) and radiographic axial spondyloarthri... more To determine the prevalence of inflammatory back pain (IBP) and radiographic axial spondyloarthritis (SpA) in a semi‐urban community of Lahore, Pakistan.

Cureus

The objective of this study was to determine the involvement of the foot as the first manifestati... more The objective of this study was to determine the involvement of the foot as the first manifestation in rheumatoid arthritis (RA). Methods This study was conducted on 100 patients who presented to the outpatient department of the

Pakistan Journal of Medical Sciences

Objective: To determine the association of systemic lupus erythematosus disease activity index (S... more Objective: To determine the association of systemic lupus erythematosus disease activity index (SLEDAI) score in pediatric onset SLE (p-SLE) with clinical and laboratory parameters. Methods: This cross sectional observational study was conducted at Division of Rheumatology, Fatima Memorial Hospital, Lahore from November 2018 to January 2019. Total 23 patients diagnosed with p-SLE having onset of symptoms at ≤ 18 years of age, irrespective of their current age at presentation, of either gender, fulfilling criteria of 2012 Systemic Lupus International Collaborating Clinics (SLICC) criteria were enrolled. Patients’ clinical symptoms and laboratory parameters were reviewed, SLEDAI scores were calculated. Collected Data were entered in proforma and analyzed on SPSS version 23. Results: There were 91.3% females. Mean age at diagnosis was 11years ± 4years. At presentation patients had hematological involvement 69.6% followed by mucocutaneous symptoms 65.2% and renal involvement 21.6%. ANA ...

Pakistan Armed Forces Medical Journal, Jun 22, 2023

An nk ky yl lo os si in ng g S Sp po on nd dy yl li it ti is s a an nd d P Ps so or ri ia at ti i... more An nk ky yl lo os si in ng g S Sp po on nd dy yl li it ti is s a an nd d P Ps so or ri ia at ti ic c A Ar rt th hr ri it ti is s

Journal of rheumatic diseases, Feb 23, 2024

Pakistan Armed Forces Medical Journal, Jun 21, 2023

Te er rm m E Ef ff fi ic ca ac cy y a an nd d S Sa af fe et ty y o of f S Su ub bc cu ut ta an ne... more Te er rm m E Ef ff fi ic ca ac cy y a an nd d S Sa af fe et ty y o of f S Su ub bc cu ut ta an ne eo ou us s

Aim: To evaluate the reach and potential effectiveness of teleteaching of health providers in pae... more Aim: To evaluate the reach and potential effectiveness of teleteaching of health providers in paediatric rheumatology by observing the pattern of sessions, attendance, and attendees' feedback in paediatric rheumatology teleteaching sessions across the Asia Pacific region. These were conducted by the Asia Pacific League of Associations for Rheumatology (APLAR) Paediatric Rheumatology Special Interest Group (Paeds Rheum SIG) as an APLAR academy activity. Methods: A retrospective, descriptive analysis of electronic records of synchronous telehealth sessions held between July 2021 to July 2023. These followed three formats: case-based webinars, single topic modular online course, and a hybrid one-day short course. The topics of sessions, attendees' registration details, specifically primary area of practice/specialty, geographic location, and their satisfaction as per feedback forms were noted. Results: Case-based webinars had an average attendance of 200 per webinar: majority adult rheumatologists, paediatric rheumatologists (PRs), or paediatricians. The modular course consisted of nine sessions with an average of 63 participants per session. Specialties comprised PRs, adult rheumatologists with immunologists, and general paediatricians. The one-day hybrid course had over 600 attendees. Attendees were adult rheumatologists, general physicians, paediatricians, and PRs. Although the majority (79.3%) of attendees from these sessions were from APLAR member nation organisations (MNOs), a significant percentage (20.7%) were from non-APLAR MNOs and even non-Asia Pacific regions. The attendees' feedback for all three formats showed a high level of satisfaction with case-based webinars being most favoured. Conclusions: Teleteaching in paediatric rheumatology has the potential to fulfill the dire need for improved expertise of health professionals managing children with rheumatic diseases. Case-based, interactive sessions of shorter duration and a blended hybrid format may garner the most attendance and best learning outcomes.

International Journal of Rheumatic Diseases, 2011

Leflunomide is a disease-modifying anti-rheumatic drug (DMARD) for rheumatoid arthritis (RA). It ... more Leflunomide is a disease-modifying anti-rheumatic drug (DMARD) for rheumatoid arthritis (RA). It has been widely studied in the West but there is no available local Pakistani data. To evaluate the efficacy and safety profile of leflunomide in Pakistani patients with RA, either alone or in combination with methotrexate. A prospective, non-comparator, open-label study in a setting of 'care as usual' was performed. In this study, 63 consecutive RA patients on leflunomide were enrolled. Leflunomide dose was started with full loading in 5 (8%), half loading in 39 (62%) and without loading in 19 (30%) patients. Methotrexate was also used in 20 (32%) patients. Primary end-point was 20% improvement in American College of Rheumatology response criteria (ACR-20). Safety was assessed by adverse events and abnormalities in laboratory parameters. Out of 63 patients, 54 (85.7%) were female. Mean age was 46 ± 12.6 years. Mean disease duration was 5.1 ± 4.5 years. Fifty-two (86.6%) patients achieved ACR-20 response at 6 months; 32 (53%) achieved ACR-50 response at 6 months; 20% experienced at least one adverse event, which resolved by reducing leflunomide dose. Only seven (11%) had raised liver enzymes from baseline. This prospective study conducted in the setting of a daily rheumatology practice shows that leflunomide is an effective and safe DMARD in treatment of RA in Pakistani patients.

Pakistan Journal of Medical Sciences, 2021

Objective: To identify factors causing diagnostic and therapeutic delay in patients with rheumato... more Objective: To identify factors causing diagnostic and therapeutic delay in patients with rheumatoid arthritis, and to evaluate relationship of diagnostic and therapeutic delay with disease outcome. Methods: This cross-sectional study was conducted in Rheumatology Department, Fatima Memorial Hospital, Lahore, Pakistan, from May 2018 to July 2018. In this study 102 patients fulfilling ACR/EULAR criteria 2010 were enrolled. Lag times were calculated in months: lag-1 (delay in initial medical consultation); lag-2 (delay in consulting rheumatologists); lag-3 (diagnostic delay); lag-4 (therapeutic delay). Disease activity and functional outcome were measured by DAS28, HAQ-DI respectively. Association of lag-3 and lag-4 with HAQ-DI and DAS28 was calculated by Pearson correlation. Results: Median (IQR) disease duration of study group was 6(2-10) years. Initial consultations were with; orthopedic surgeon 40(39.2%), general practitioner 27(26.5%), rheumatologist 13(12.7%), medical specialists...

Journal of Ayub Medical College Abbottabad

Granulomatosis with polyangiitis (GPA) is an uncommon pauci-immune small-vessel necrotising granu... more Granulomatosis with polyangiitis (GPA) is an uncommon pauci-immune small-vessel necrotising granulomatous vasculitis mostly seen in age 45–60 years. We present the case of a formerly healthy 44 years old male presenting with dysuria and intermittent urinary retention for 8 months, not responding to empirical antibiotic therapy and TURP. A prostate biopsy showed necrotising granulomatous prostatitis. Urinalysis demonstrated persistent pyuria and haematuria, but cultures showed no growth. Subsequently he complained of fever, cough, dyspnoea and skin ulcers. CT of the chest showed multiple cavitatory lesions and pleural effusion. On work up, c-ANCA was positive and a diagnosis of granulomatosis with polyangiitis was established. This depicts a rarely seen presentation of prostatitis as the initial feature of GPA.

International Journal of Rheumatic Diseases, 2021

Pakistan Journal of Zoology, 2015

Fibromyalgia syndrome (FMS) is characterized by musculoskeletal pain of unknown etiology and is o... more Fibromyalgia syndrome (FMS) is characterized by musculoskeletal pain of unknown etiology and is often accompanied by many psychological symptoms. This study is aimed at evaluating the importance of antioxidants (vitamin E, vitamin C and Nigella sativa seeds) therapy in management of this disease. Fifty female patients having mean age of 37.87±1.68 years suffering from FM were enrolled in the study. Role of oxidative stress was determined by measuring antioxidant enzymes including superoxide dismutase (SOD), glutathione peroxidase (GPx), antioxidant capacity by ABTS (2,2'- azinobis-(3-ethylbenzo-thiazoline-6-sulphonic diammonium salt) and ferric reducing antioxidant capacity (FRAP) assay in plasma and catalase in erythrocytes. The FM patients were also supplemented with antioxidants (Vitamin C, Vitamin E and Nigella sativa seeds) for two months to assess the impact on activity of FM with the help of VAS (visual analogue scale) (0 being no pain and 100 being severe pain).It was fo...

Journal of the College of Physicians and Surgeons--Pakistan : JCPSP, 2015

OBJECTIVE To determine the frequency of patients with early Rheumatoid Arthritis (RA) achieving d... more OBJECTIVE To determine the frequency of patients with early Rheumatoid Arthritis (RA) achieving disease remission and/or low disease activity after 6 months of treatment with conventional Disease Modifying Anti-Rheumatic Drugs (DMARDs) by using treat-to-target approach in routine clinical practice. STUDY DESIGN Descriptive study. PLACE AND DURATION OF STUDY Division of Rheumatology, Fatima Memorial Hospital (FMH), College of Medicine and Dentistry, Lahore, from March 2011 to February 2012. METHODOLOGY Patients with early RA defined as disease duration ² 1 year were enrolled by purposive sampling, diagnosed as per American College of Rheumatology (ACR) 1987 criteria. Treat-to-target approach was defined as per European League Against Rheumatism (EULAR) 2010 guidelines for treatment of RA with conventional DMARDs. Outcome measures of remission and low disease activity were defined as per DAS 28 score criteria. Patient response to treatment was also determined by EULAR response criteri...

Objective: To identify factors causing diagnostic and therapeutic delay in patients with rheumato... more Objective: To identify factors causing diagnostic and therapeutic delay in patients with rheumatoid arthritis, and to evaluate relationship of diagnostic and therapeutic delay with disease outcome. Methods: This cross-sectional study was conducted in Rheumatology Department, Fatima Memorial Hospital, Lahore, Pakistan, from May 2018 to July 2018. In this study 102 patients fulfilling ACR/EULAR criteria 2010 were enrolled. Lag times were calculated in months: lag-1 (delay in initial medical consultation); lag-2 (delay in consulting rheumatologists); lag-3 (diagnostic delay); lag-4 (therapeutic delay). Disease activity and functional outcome were measured by DAS28, HAQ-DI respectively. Association of lag-3 and lag-4 with HAQ-DI and DAS28 was calculated by Pearson correlation. Results: Median (IQR) disease duration of study group was 6(2-10) years. Initial consultations were with; orthopedic surgeon 40(39.2%), general practitioner 27(26.5%), rheumatologist 13(12.7%), medical specialists...

Journal of clinical medicine research, 2015

Organ transplantation has always been considered to be the standard therapeutic interventions in ... more Organ transplantation has always been considered to be the standard therapeutic interventions in patients with end-stage organ failure. In 2008, more than 29,000 organ transplants were performed in US. Survival rates among transplant recipients have greatly improved due to better understanding of transplant biology and more effective immunosuppressive agents. After transplant, the extent of the immune response is influenced by the amount of interleukin 2 (IL-2) being produced by the T-helper cells. Transplant immunosuppressive therapy primarily targets T cell-mediated graft rejection. Calcineurin inhibitor, which includes cyclosporine, pimecrolimus and tacrolimus, impairs calcineurin-induced up-regulation of IL-2 expression, resulting in increased susceptibility to invasive fungal diseases. This immunosuppressive state allows infectious complication, leading to a high mortality rate. Currently, overall mortality due to invasive fungal infections (IFIs) in solid organ transplant reci...

The Journal of Rheumatology, 2011

Objective.To determine the extent to which cognitive dysfunction (CD) observed in patients with s... more Objective.To determine the extent to which cognitive dysfunction (CD) observed in patients with systemic lupus erythematosus (SLE) exceeds that seen in a matched control group of patients with rheumatoid arthritis (RA), and to estimate the prevalence of CD in SLE in a community-based sample.Methods.A random subsample of 31 patients with SLE was compared to patients with RA matched by age, sex, and race and derived from the same patient population. Cognitive function was assessed by the Automated Neuropsychological Assessment Metrics (ANAM). The primary outcome was the total throughput score (number of correct responses divided by the time taken for those responses averaged over all subtests), adjusted for premorbid intelligence, neuromuscular efficiency, disease activity, damage, depression, fatigue, and health-related quality of life.Results.There were no statistically significant differences in mean throughput scores between patients in the SLE and RA groups in any subtest of the ...

International Journal of Rheumatic Diseases, 2020

To determine the prevalence of inflammatory back pain (IBP) and radiographic axial spondyloarthri... more To determine the prevalence of inflammatory back pain (IBP) and radiographic axial spondyloarthritis (SpA) in a semi‐urban community of Lahore, Pakistan.

Cureus

The objective of this study was to determine the involvement of the foot as the first manifestati... more The objective of this study was to determine the involvement of the foot as the first manifestation in rheumatoid arthritis (RA). Methods This study was conducted on 100 patients who presented to the outpatient department of the

Pakistan Journal of Medical Sciences

Objective: To determine the association of systemic lupus erythematosus disease activity index (S... more Objective: To determine the association of systemic lupus erythematosus disease activity index (SLEDAI) score in pediatric onset SLE (p-SLE) with clinical and laboratory parameters. Methods: This cross sectional observational study was conducted at Division of Rheumatology, Fatima Memorial Hospital, Lahore from November 2018 to January 2019. Total 23 patients diagnosed with p-SLE having onset of symptoms at ≤ 18 years of age, irrespective of their current age at presentation, of either gender, fulfilling criteria of 2012 Systemic Lupus International Collaborating Clinics (SLICC) criteria were enrolled. Patients’ clinical symptoms and laboratory parameters were reviewed, SLEDAI scores were calculated. Collected Data were entered in proforma and analyzed on SPSS version 23. Results: There were 91.3% females. Mean age at diagnosis was 11years ± 4years. At presentation patients had hematological involvement 69.6% followed by mucocutaneous symptoms 65.2% and renal involvement 21.6%. ANA ...