| Interventions |
Participants are screened and undergo a clinical examination and medical history. All participants are screened for pre-existing disease, such as hypertension, dyslipidemia, diabetes mellitus, and inflammatory bowel disease. Information on the use of medications, including meloxicam, salazosulfapyridine, methotrexatep, folic acid, etanercept, thalidomide, celebrex, and methylprednisolone is retrieved from the medical records. Participants are divided to one of two groups based on if they have a fissured tongue or not. Fissured tongue group (FT): Participants this in group are assessed at baseline, week 12 and week 24 (for follow up). Participants are assessed for their fissured tongue level. Participants have their pain levels assessed using the axial joint pain (AJP) and peripheral joint pain (PJP) levels scale and the visual analog scale (VAS). Participants also complete a morning stiff sale (SMS) that categorically lists the duration of morning stiffness as no stiffness. The axial and peripheral arthritis levels are assessed by physicians. Participants also undergo a physical examination and have a blood test to evaluate the complete blood cell count and measurement of blood levels of glucose, creatinine, electrolytes, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides, lipoprotein(a), antistreptolysin O (ASO), erythrocyte sedimentation rate(ESR), and C-reactive protein (CRP). Disease activity was evaluated with the erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP). Middle-finger-to-floor distance and occiput-to-wall distance was used to evaluate spinal flexibility. Plain radiographs of the axial and peripheral were obtained from participants to determine the progress of axial and peripheral arthritis. Non-fissue tongue group (NFT): Participants undergo the same testing as the fissured tongue group. The results from each group are compared to see if fissured tongues have an |