scholarly journals RHEUMATOID ARTHRITIS;

2019 ◽  
Vol 26 (02) ◽  
Author(s):  
Khadija Kiran ◽  
Uzma Jamil ◽  
Amtul Huda Sobhi ◽  
Zuhair Bhatti

Objectives: Objective of our study is to measure the concentration and role of Malondialdehydein determining the oxidative stress in rheumatoid arthritis patients in comparison with healthy individuals. Study Design: Cross sectional study. Setting: Department of physiology Gujranwala Medical College and Shalamar Medical College, Lahore. Period: From October 2016 to October 2017. Methodology: 180 patients of age 49 to 70 years of either gender. The approval for conducting experimental study was taken from ethical committee and consent information was taken from the patient on prescribed Performa. Data was analyzed on SPSS Version 23 related to study. Continuous variables were presented as mean and standard deviation like age and serum MDA concentration. Categorical variables were presented as numbers and percentages like gender. Post operative chi square test was applied and p- value less than or equal to 0.05 was considered as significant. Results: Total 180 person (n=180) of either genderwere included in this study. The study group was divided into two equal groups. Group A (RA group) consists of 90 patients (n=90) based on clinically and laboratory based criteria while group B (control group) consists of 90 (n=90) normal healthy individuals. The serum MDA levels in the RA patients were 3.97±1.03 nmoles/ml and it was 1.59±0.32 n moles/ml in control patients. The difference was statistically significant (t=20.87, p=0.001). Conclusion: The observations of our study showed statistically significant raised serum Malondialdehyde level as compared to control group which shows that raised serum MDA is an indicator of oxidative stress in rheumatoid arthritis patients.  

Author(s):  
Ella Nissan ◽  
Abdulla Watad ◽  
Arnon D. Cohen ◽  
Kassem Sharif ◽  
Johnatan Nissan ◽  
...  

Polymyositis (PM) and dermatomyositis (DM) are autoimmune-mediated multisystemic myopathies, characterized mainly by proximal muscle weakness. A connection between epilepsy and PM/DM has not been reported previously. Our study aim is to evaluate this association. A case–control study was conducted, enrolling a total of 12,278 patients with 2085 cases (17.0%) and 10,193 subjects in the control group (83.0%). Student’s t-test was used to evaluate continuous variables, while the chi-square test was applied for the distribution of categorical variables. Log-rank test, Kaplan–Meier curves and multivariate Cox proportional hazards method were performed for the analysis regarding survival. Of the studied 2085 cases, 1475 subjects (70.7%) were diagnosed with DM, and 610 patients (29.3%) with PM. Participants enrolled as cases had a significantly higher rate of epilepsy (n = 48 [2.3%]) as compared to controls (n = 141 [1.4%], p < 0.0005). Using multivariable logistic regression analysis, PM was found only to be significantly associated with epilepsy (OR 2.2 [95%CI 1.36 to 3.55], p = 0.0014), whereas a non-significant positive trend was noted in DM (OR 1.51 [95%CI 0.99 to 2.30], p = 0.0547). Our data suggest that PM is associated with a higher rate of epilepsy compared to controls. Physicians should be aware of this comorbidity in patients with immune-mediated myopathies.


2020 ◽  
Author(s):  
Arithi Mutembei ◽  
Festus K. Mutai ◽  
Damaris Mwololo ◽  
John Muriuki ◽  
Mark Obonyo ◽  
...  

AbstractIntroductionLeptospirosis is a neglected bacterial zoonotic infection caused by spirochetes of Leptospira genus. Humans get infected through direct or indirect contact with urine of infected animals or environment. It accounts for more than 300,000 severe cases annually worldwide with case fatality rates of over 30%. Costs of diagnosis and treatment for human and animals, disruption of international trade of animals and products, reduced productivity and reproductivity in animals constitute economic importance. In Kenya, leptospirosis burden is significant but under-diagnosis and under-reporting affects the awareness of the disease. This study aimed to determine and compare the sero-prevalence and factors associated with Leptospira spp. in the two counties.MethodsWe conducted a cross-sectional study that involved apparently healthy people of at least 5 years of age in randomly selected households in Garissa and Tana River Counties. Blood samples were collected and tested for Leptospira spp antibodies using IgM ELISA. Standardized structured questionnaires were administered to collect socio-demographic and exposure information. We calculated frequencies and proportions for categorical variables and odds ratios (OR) and 95% confidence interval (CI) to evaluate association between sero-positivity and exposure factors. We used Wilcoxon test to evaluate statistical difference in sero-positivity for continuous variables and calculated test statistic (H) and p-value.ResultsA total of 952 subjects were recruited into the study – these included 482 persons from Garissa and 470 from Tana River. The overall sero-prevalence was 26% [(244/952); (CI: 23% to 29%)]. Garissa County had significantly higher Leptospira spp. seroprevalence (31%, n = 147; CI: 27% to 35%) compared to Tana River County (21 %, n = 97; CI: 17% to 25%). Being a female (OR=1.6, CI: 1.2-2.2) and engaging in pastoralism (OR=2.7, CI: 1.8-3.9) were significantly associated with higher odds of Leptospira spp. seropositivity compared to being a male or working in irrigated areas. The mean altitude of residence of sero-positive patients was 73m ± 21 SD (standard deviation) above sea level and that for sero-negative was 80m ± 22 SD (H=35, p-value = 0.00).ConclusionThis study determined the seroprevalence and risk factors for Leptospira spp. exposure in Garissa and Tana River Counties, Kenya. Females in pastoral communities experience high burden of the disease. Enhanced surveillance in humans and animals and further research is required to understand the complex and multifactorial drivers of leptospirosis transmission in the two Counties.


2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Neide Tomimura Costa ◽  
Tatiana Mayumi Veiga Iriyoda ◽  
Ana Paula Kallaur ◽  
Francieli Delongui ◽  
Daniela Frizon Alfieri ◽  
...  

The aim of this study was to evaluate the involvement of TNF-αand insulin resistance (IR) in the inflammatory process, oxidative stress, and disease activity in patients with rheumatoid arthritis (RA). This cross-sectional study included 270 subjects (control group,n=97) and RA patients (n=173). RA patients were divided into four groups: the first group without IR and not using antitumor necrosis factor-α(TNF-) (G1, IR− TNF−); the second group without IR and using anti-TNF-α(G2,IR-TNF+); the third group with IR and not using anti-TNF-α(G3, IR+TNF-); and the fourth group with IR and using anti-TNF-α(G4, IR+ TNF+). G3 and G4 had higher (p<0.05) advanced oxidation protein products (AOPPs) and oxidative stress index (OSI) compared to G1. G4 group presented higher (p<0.05) AOPPs and OSI than G2. TRAP was significantly lower in G3 compared to G1. Plasma TNF-αlevels were significantly higher in G4 and G2 compared to G1 (p<0.0001) and G3 (p<0.0001andp<0.01, resp.). The presence of insulin resistance was robustly associated with both oxidative stress and TNF-αlevels. More studies are warranted to verify if IR can be involved in therapeutic failure with TNF-αinhibitors. This trial is registered with Brazilian Clinical Trials Registry Register numberRBR-2jvj92.


2019 ◽  
Vol 26 (08) ◽  
pp. 1229-1232
Author(s):  
Khadija Kiran ◽  
Amtul Huda ◽  
Zuhair Bhatti

To investigate the role of IL-21 as diagnostic marker in diagnosis of rheumatoid arthritis. Study Design: Cross sectional study. Setting: Department of Physiology and Orthopedic Gujranwala Medical College, Gujranwala. Period: October 2017 to October 2018 in one year duration. Materials and Methods: A total of 150 patients were included in the study, main variables assessed in this study were positive predictive value negative predictive value, sensitivity, specificity and accuracy of IL-21 in diagnosis of rheumatoid arthritis. SPSS version 23 was used to analyze the data. P value less than or equal to 0.05 was taken as significant. Study was started after permission from hospital ethical committee and patients were informed in detail about disease and procedure to be done. Non probability consecutive sampling was used. Results: The estimated sensitivity was 93.6%. The estimated specificity was 50%. Positive predictive value was 96.3% and negative predictive value was 35.7%. The overall accuracy was 90.6% for diagnosing rheumatoid arthritis. Conclusion: IL-21 induces MMP3 in rheumatoid arthritis patients, identification of IL-21 from synovium of patients indicates the presence of rheumatoid arthritis. We observed 90.6% diagnostic accuracy of IL-21 for rheumatoid patients taking RA factor as gold standard of diagnostic tool.


2018 ◽  
Vol 25 (08) ◽  
pp. 1168-1172
Author(s):  
Uzma Jamil ◽  
Anam Mukhtar ◽  
Shaista Hussain ◽  
Farida Munawar

Objectives: To investigate serum uric as an indicator of fetomaternal complicationsin women with late pregnancy. Study Design: Cross sectional study. Setting: Shalamar Medicaland Dental College Lahore ethical committee. Period: One year from October 2016 to October2017. Methodology: Continuous variables were presented as mean and standard deviationlike age and Serum malonaladehyde concentration; categorical variables were presented asnumbers and percentages like intra uterine growth restriction, Mild to moderate and sever preeclampsia and fetal distress. One way ANOVA, independent sample t test and chi square testwere applied to check significance of results, p value less than or equal to 0.05 was consideredas significant. Results: Overall, 100% (n=400) patients were included in this study. The meanage of the patients was 25.81±4.33 years. The age difference was not statistically significant,in groups (p=0.383). The mean serum uric acid levels of the patients for maturity (weeks)36, 37, 38, 39 and 40 was 247.96±2.52 (nmol/l), 253.95±2.04 (nmol/l), 261.19±3.15 (nmol/l),263.95±2.75 (nmol/l) and 296.19±2.55 (nmol/l) respectively. The differences were statisticallysignificant (p=0.000). Fetal distress, number with rising levels were (n=23) 71.8%, number withno change in levels were (n=3) 9.4% and number with falling levels were (n=6) 18.8%. Thedifferences were statistically significant. (p=0.000). Conclusion: The observations of our studyconcluded that serial increase of serum uric acid from 36th week to 40th week was observedin pregnancy induced hypertion patients, and raised serum level of uric acid had significantrelation with fetomaternal complications. like Fetal distress, preeclampsia, and intrauterinegrowth retardation. So serum uric acid can be used an indicator for fetometernal complicationsin late pregnancy.


2021 ◽  
pp. 67-70
Author(s):  
Rahul Ranjan ◽  
Md Shoeb Alam ◽  
V N Jha

INTRODUCTION: Rheumatoid arthritis (RA) is a chronic, systemic, inammatory autoimmune disease that initially affects small joints, progressing to larger joints, and eventually the skin, eyes, heart, kidneys, and lungs. This study was conducted to determine the usefulness of antiCCP antibodies and Rheumatoid Factor (RF) in diagnosis of Rheumatoid Arthritis and to estimate the diagnostic value of anti-CCP antibodies compared with Rheumatoid Factor (RF) in the diagnosis of Rheumatoid Arthritis. MATERIALS AND METHODS: This study was conducted in the Department of Medicine and it was a cross sectional study. A total of 86 patients presented with clinically suspected rheumatoid arthritis who attended the OPD Medicine were consecutively recruited. The present study was conducted on patients with clinically suspected rheumatoid arthritis from Department of Medicine, Darbhanga Medical College & Hospital, Laheriasarai, Bihar over a period of 12 months. RESULT: Anti-CCP antibody was not signicantly associated with the disease activity (p value =0.36). Anti-CCP antibody was signicantly associated with radiological defects whereby majority of patients with radiological defects (n=21/30; 70%) were positive for anti-CCPantibody (p value=0.03). Anti-CCP antibody was not signicantly associated with the incidence of rheumatoid nodule (p value =0.750). Anti-CCP antibody was not signicantly associated with extra-articular manifestation (p value =0.398). There is no signicant association between anti-CCPantibody and incidence of pulmonary involvement (p value =0.367). CONCLUSION: Combined use of RF and anti-CCP is a better prognostic and diagnostic tool than conventional RF tests alone. Uses of anti-CCP in clinical practice contribute to enhance the ability of rheumatologists to make judicious treatment decision. The usage of anti-CCP antibody is useful in the detection of early disease as evidenced by signicant association between anti-CCPantibody, RF, and radiological involvement in our study.


Author(s):  
Mayukh Mukherjee ◽  
Suhrita Paul ◽  
Manasi Basu Banerjee ◽  
Sayanti Ghatak ◽  
Santanu Guha ◽  
...  

Introduction: Clopidogrel is an antiplatelet agent used to prevent platelet aggregation and further blockage of coronary arteries in Acute Coronary Syndrome (ACS) patients. Inadequate response to clopidogrel has been demonstrated in some patients that might lead to re-infarction even when receiving standard doses of clopidogrel. Aim: To demonstrate the presence of resistance to standard oral doses of clopidogrel in a tertiary care hospital located in eastern India. Materials and Methods: It was a descriptive cross-sectional study conducted from January 2015 to June 2016, in Medical College Kolkata, (previously known as Calcutta Medical College), India. Total 32 patients, previously not on any antiplatelet therapy, presenting with biomarker positive ACS were evaluated. The patients were given clopidogrel (300 mg) along with aspirin (325 mg) on presentation followed by clopidogrel (75 mg) and aspirin (75 mg) once daily. Blood samples were collected after 24-48 hours of administering the above mentioned doses orally. A 3.2% citrate was used as anti-coagulant. Platelet Rich Plasma (PRP) and Platelet Poor Plasma (PPP) were prepared from this blood samples by centrifugation. Platelet aggregation was studied by adding 10 μM Adenosine Diphosphate (ADP) in that PRP and it was compared with PPP in Light Transmittance Aggregometer (LTA). Platelet aggregation ≥50% in presence of 10 μM ADP was termed as Clopidogrel Resistance (CR). Differences between groups were assessed with Chi-square test and Fisher-exact test for categorical variables. The p-value of <0.05 was considered to be statistically significant. Results: Mean age of the study participants was 60.7 years, and 23 (71.8%) out of 32 patients were male while 9 (28.2%) were female. Total 7 (21.8%) of the patients were found to be resistant to standard doses of clopidogrel. A 3 (60%) out of 5 patients with positive family history of Cardiovascular Diseases (CVD) showed CR (p-value=0.025). Incidences of CR was higher among women 3 (33.3%) and in patients receiving thrombolysis 4 (28.5%). Though these percentages were high but not statistically significant. Conclusion: In this study, 21.8% ACS patients showed resistance to the antiplatelet effects of clopidogrel in the conventional dose. A long term prospective Randomised Controlled Trials (RCT) with larger sample size is required to give an insight into this problem.


2021 ◽  
Vol 6 (2) ◽  
pp. 1517-1521
Author(s):  
Rajneesh Jha ◽  
Ram Kumar Mehata ◽  
Puru Koirala

Introduction: Tuberculosis is a common infection in our community. Tubercular pleural effusion is the second most common form of extrapulmonary tuberculosis. Among the several causes of exudative pleural effusison tubercular remains the most common form in clinical practice. The aim of this study was to evaluate the significance of lymphocyte-neutrophil ratio(LN ratio) in cases of exudative effusion for diagnosis of tubercular effusion. Methods: This was a hospital based cross sectional studydone in Patients at tertiary care hospital from 1st September 2020 to 1st april 2021after taking ethical clearance from institutional reviw committee. Convienience samplingwas done. Statistical Analysis of data like percentages and frequencies  were used for categorical variables. Mean and SD (standard deviation) were used for describing continuous variables. Inferential statistical tools like Chi-Square test and Student’s t-test were used. P-value of <0.05 was considered statistically significant. Results: out of 200 cases 75% were tubercular pleural effusion and these cases were found have high levels of LN ratio (0.89 ± 0.11 for females and 0.97 ± 0.14 for males) and ADA (137.79 ± 44.61for females and 147.61 ± 51.64 for males) and more than 90% sensitivity and specificity of LN ratio and ADA level. Conclusion: Exudative pleural fluid L/N ratio >0.75 is an efficient means of diagnosing tuberculous pleural effusion and its combination with ADA level gives us more accuracy and surety about the diagnosis of tubercular pleural effusion.


2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S31-S31
Author(s):  
Rachael A Lee ◽  
Daniel Vo ◽  
Joanna Zurko ◽  
Russell Griffin ◽  
J Martin Rodriguez ◽  
...  

Abstract Background Enterococcal bloodstream infections (EBSI) have been attributed with significant morbidity and mortality. The objective of this study was to determine whether IDC is associated with improved mortality in patients hospitalized with EBSI. Methods This is a cross-sectional study of patients admitted to the University of Alabama Health System between January 1, 2015 and June 30, 2016 who had EBSI. Patients who died within 2 days of hospitalization were excluded. Categorical variables were analyzed with chi-square or Fisher’s exact test and continuous variables were analyzed with a t-test or Wilcoxon rank-sums test when appropriate. A P-value &lt; 0.05 was considered significant. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CI) for factors associated with 30-day in-hospital mortality. Results A total of 213 patients met the case definition. One hundred and thirty-four (63%) received IDC. Baseline patient demographics and comorbidities were similar in both groups. Patients with IDC were more likely to have repeated blood cultures (99% vs. 72%, P &lt; 0.001), echocardiogram performed (77% vs. 46%, P &lt; 0.001), and interventions for source control (19% vs 6%, P = 0.01). Patients without IDC were more likely to have inappropriate antibiotic treatment or no antibiotics (20% vs. 0%, P &lt; 0.001) as well as inappropriate duration of therapy (54% vs. 10%, P &lt; 0.001). There were no differences in the rates of recurrent bacteremia or readmission within 60 days. Patients who did not receive IDC had higher 30-day in-hospital mortality (27% vs. 13%, P = 0.02). Having an echocardiogram (OR 2.75, 95% CI 1.36–5.55), surgical intervention (OR 3.11, 95% CI 1.07–9.05) and an IV catheter (OR 3.90, 95% CI 1.39–10.88) were associated with increased likelihood of IDC while inappropriate duration of antibiotics was associated with an 87% decreased likelihood of IDC (OR 0.13, 95% CI 0.06–0.29). The strongest association observed with 30-day mortality was inappropriate duration of antibiotics (OR 4.93, 95% CI 1.93–12.61). Conclusion IDC was associated with reduced 30-day in-hospital mortality in patients with EBSI. Although further investigation is warranted, the results of this study suggest that early involvement of ID specialists in EBSI may lead to better outcomes. Disclosures All authors: No reported disclosures.


2020 ◽  
Vol 7 (6) ◽  
pp. 936
Author(s):  
Poonam Gupta ◽  
Dipesh Agarwal ◽  
Ajeet Kumar Chaurasia ◽  
Arvind Gupta

Background: Subclinical renal dysfunction and microalbuminuria are common in rheumatoid arthritis patients particularly with long standing disease and with severe disease activity. Despite the degree of interest shown in detection of microalbuminuria and its prognostic implications, the determinants of elevated urinary albumin excretion have not been studied well. This study was done to assess the subclinical renal involvement in Rheumatoid Arthritis (RA) patients.Methods: This cross-sectional study involving 50 patients attending attending the out-patient departments of Swaroop Rani Nehru Hospital, MLN Medical College, Prayagraj, U.P diagnosed with RA by modified ACR criteria (2010).Results: The mean age of the cases was 41.96 years (SD 10.80), of them 74% were females and 26% were males. MA was found in 15 patients (30%), of them. In MA positive group, mean ESR was 69.46±27.14, and CRP positive patients were 13 (86%), RA Factor positive patients were 12 (80%) and as compared to 31.28±5.03, 11 (32%), 14 (40%) respectively in MA negative group (p <0.05 in all cases). Microalbuminuria was significantly correlated with ESR, CRP and RA factor (p value <0.05).Conclusions: Presence of microalbuminuria indicates severe disease activity and long-standing rheumatoid arthritis. Microalbuminuria was found to be significantly correlated with disease activity in rheumatoid arthritis as assessed by ESR, CRP, RA Factor and anti CCP.


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