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December 2014 Volume 9 | Issue 4
Page Nos. 161-230
Online since Wednesday, July 13, 2016
Accessed 32,569 times.
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EDITORIAL |
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Deflazacort in rheumatology: Where does it stand? |
p. 161 |
Mithun C Mohan, Oscar Gonzalez-Perez, Cesar Ramos-Remus, Vinod Ravindran DOI:10.1016/j.injr.2014.09.004 |
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ORIGINAL ARTICLES |
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Prevalence and risk factors for hand osteoarthritis |
p. 163 |
Biswadip Ghosh, Manish Gupta, Shamash Mandal, Satyabrata Ganguly, Alakendu Ghosh DOI:10.1016/j.injr.2014.06.006 Introduction: Hand osteoarthritis (OA) is a highly prevalent disease with a significant physical and social burden. Thus we decided to find out prevalence of hand OA in the patients above 40 year of age who presented to us with either hand symptoms or knee OA. Methods: Postero-anterior hand radiographs were taken of both hands to confirm the diagnosis of hand OA. Fifteen joints were evaluated for the presence of osteophytes, joint space narrowing, sclerosis, and cysts. 358 patients attending Rheumatology OPD of two tertiary care centers in Eastern India in one year participated in study.
Results: Ninety nine (27.65%) of 358 subjects had radiological hand OA. Among the 222 patients with knee OA 90 (40.5%) patients had hand OA. Nine (6.6%) of 136 patients with hand symptoms alone had hand OA. Overall 212 (59.21%) of 358 patients had symptoms in hand joints and of them 49 (23.2%) patients had hand OA positive. Female sex, older age, BMI >25, family history of OA or diabetes mellitus increased the risk of radiological hand OA. Knee OA increased the risk of hand OA both symptomatic and asymptomatic. Conclusion: Hand OA is common and a good quality X ray of hand is an initial investigation to diagnose hand OA. Presence of Knee OA increases risk of hand OA. |
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Deflazacort alleviate pro-inflammatory cytokines expression, oxidative stress and histopathological alterations in collagen induced arthritis in Wistar rats |
p. 167 |
Neha , MdMeraj Ansari, Haider A Khan DOI:10.1016/j.injr.2014.06.007 Objectives: Glucocorticoids are important and frequently used class of anti-inflammatory drugs. Deflazacort (DFZ) is a glucocorticoid and an oxazolone derivative of prednisolone. As it has high anti-inflammatory and immunosuppressive potency, we studied inhibitory effect of DFZ on mediators regulating the pro-inflammatory response and oxidative stress induced in arthritis. Methods: Female Wistar rats were immunized intradermally by collagen type II to induce collagen induced arthritis. Arthritic rats were treated with DFZ orally (6 mg kg-1 body weight) until 28 days after the onset of clinical symptoms of disease. The effect of DFZ treatment in the rats was monitored by clinical scoring, biochemical parameters, immu- nohistochemistry and histopathological evaluation.
Results: Deflazacort significantly decreased the level of articular elastase, nitric oxide and lipid peroxidation whereas significantly increased the activity of catalase, superoxide dismutase and glutathione. Deflazacort down-regulated expression of pro-inflammatory molecules like TNF-a and COX-2. Histopathological evaluation revealed significant reduc- tion of synovial hyperplasia and cellular infiltration in synovial membrane in DFZ treated group as compared to the diseased group.
Conclusions: This suggests that DFZ significantly down-regulates the expression of pro-in- flammatory molecules such as TNF-a and COX-2 and alleviates the oxidative stress which make it a viable therapeutic option for treatment of arthritis. |
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ARTICLES |
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Pioneer in rheumatology: Sir Alfred Baring Garrod (13.5.1819-28.12.1907) |
p. 177 |
VR Joshi, VB Poojary |
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ORIGINAL ARTICLES |
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Association of HLA-E*01:01/*01:03 polymorphism with methotrexate-based treatment response in South Indian rheumatoid arthritis patients |
p. 178 |
Christina Mary Mariaselvam, Aparna Sundaresh, Arij Ben Chaaben, Sofiane Salah, Catherine Fortier, Dominique Charron, Rajagopal Krishnamoorthy, Ryad Tamouza, Vir Singh Negi DOI:10.1016/j.injr.2014.08.002 Objectives: Non-classical HLA-E molecules may influence the disease susceptibility and phenotype including treatment response in chronic inflammatory disorders such as Rheumatoid Arthritis (RA) by virtue of their capacity to modulate innate immune pro- cesses. This study was carried out to investigate the role of HLA-E polymorphism in RA susceptibility, clinical and serological phenotype as well as treatment response.
Methods: Genomic DNA from 221 RA patients and 200 healthy controls (HC) were typed for HLA-E rs2844724 (C/T) and rs1264457 (HLA-E*01:01/*01:03) single nucleotide polymorphisms (SNPs) using the TaqMan 5'nuclease assay consisting of allele-specific fluorogenic oligo- nucleotide probes.
Results: Our study did not find any association between HLA-E polymorphism and RA susceptibility or disease phenotype. However, it was observed that the frequency of HLA- E*01:03 allele was higher in all RA cases (Pc ¼ 0.03,OR ¼ 3.02, 95% CI ¼ 1.06e9.39), young onset RA (YORA) (Pc ¼ 0.03, OR ¼ 3.20, 95% CI ¼ 1.11e9.98) and female RA (Pc ¼ 0.04, OR ¼ 3.04, 95% CI ¼ 1.06e9.46) patients who responded well (good responders) to a com- bination of non-biological disease modifying anti rheumatic drugs (DMARDs), metho- trexate (MTX) and hydroxychloroquine (HCQ) as compared to non-responders. Moreover, the frequency of rs2844724 T allele and TT genotype was observed to be higher in patients with low titers of rheumatoid factor (RF) than those with high titers (90% vs. 77% and 79% vs. 59% respectively), although the difference did not reach statistical significance. Conclusion: The results of our study suggest that HLA-E rs1264457 may influence the patient response to treatment with methotrexate-based DMARD therapy. Thus, it may be a useful genetic marker for treatment response in patients with RA. |
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REVIEW ARTICLES |
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BehcΈ et's syndrome: New insights into pathogenesis and management |
p. 184 |
Yesim Ozguler, Hasan Yazici DOI:10.1016/j.injr.2014.10.001 Behcet's syndrome (BS) is a multisystem vasculitis with an unknown etiology and an unique geographic distribution. The pathogenesis of BS is complex and currently not fully understood. Since the 1970's there have been different attempts to classify BS within the specific group of diseases such as spondyloarthritis, autoimmune and more recently autoinflammatory disease. However current evidence suggests that BS does not easily fit into any one of these diseases and we propose the possibility that the construct we take as BS might represent more than one disease.
The management of BS usually depends on clinical presentation and organ involve- ment. Traditional immunosuppressives and concomitant use of corticosteroids have been the main therapeutic choice for many years. There is growing experience with biologic therapeutics especially with tumor necrosis factor-alpha (TNF-alpha) antagonists in the management of refractory eye, gastrointestinal and neurologic involvement in BS.
In this review we have proposed a different perspective about the disease mechanisms of BS and have summarized the current management strategies in BS in the light of available evidence. |
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Rheumatology training in India: Problems and solutions |
p. 192 |
Ramnath Misra DOI:10.1016/j.injr.2014.10.230 |
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ARTICLES |
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RheumaWhiz 2014 |
p. 195 |
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EDITORIAL |
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Rheumatology quiz |
p. 196 |
Vivek Arya, Varun Dhir DOI:10.1016/j.injr.2014.09.006 |
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International publications of interest from India (June-August 2014) |
p. 197 |
Vivek Arya DOI:10.1016/j.injr.2014.09.005 |
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Designing randomised controlled trials in rheumatology - What, why, and how |
p. 200 |
Tamilarasu Kadhiravan DOI:10.1016/j.injr.2014.07.005 Randomised controlled trials (RCTs) have become the workhorse for evaluating efficacy of various healthcare interventions. The basic plan is to compare the outcome experience of two or more prognostically similar groups of patients with study intervention being the only difference between them. It involves key elements such as random allocation, concealment of allocation, and blinding to guard against design-related biases. This article explains these key features and the steps involved in designing an RCT in the context of rheumatological diseases. |
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IMAGES IN RHEUMATOLOGY |
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KlippeleTrenaunay syndrome |
p. 207 |
Rasmi Ranjan Sahoo, Manoj Kumar Parida, Sampathkumar Saravana Sukriya, Sanjaya Kumar Behera, Sarit Sekhar Pattnaik, Bidyut Kumar Das DOI:10.1016/j.injr.2014.07.002 |
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Rheumatology reviews |
p. 209 |
Sukhbir Uppal DOI:10.1016/j.injr.2014.10.231 |
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LETTER TO THE EDITOR |
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A rare presentation of childhood Takayasu's arteritis e PRES |
p. 218 |
S Sham, S Rajeswari, R Ravichandran, M Madheshwaran DOI:10.1016/j.injr.2014.04.005 |
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Celiac disease in rheumatoid arthritis: A cross-sectional study in Iran |
p. 220 |
Alireza Jafari Nezhad, Amir Hassankhani, Alireza Amir Maafi, Siamak Geranmayeh DOI:10.1016/j.injr.2014.05.004 |
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Jugular foramen syndrome: A rare neurological manifestation of Wegener's granulomatosis |
p. 222 |
Kavitha Mohanasundaram, Hema Shankar, S Sriram, S Balameena, S Rajeswari, R Lakshminarasimhan DOI:10.1016/j.injr.2014.05.004 |
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Reflex sympathetic dystrophy of the knee during pregnancy |
p. 224 |
K Ben Abdelghani, K Maatallah, L Souabni, S Kassab, A Laatar, L Zakraoui DOI:10.1016/j.injr.2014.06.008 |
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Comparison study between primary Sjogren's syndrome and secondary Sjogren's syndrome Associated with rheumatoid arthritis |
p. 226 |
Chatelus Emanuel, Christelle Sordet, Gottenberg Jacques Eric, Jean Sibilia DOI:10.1016/j.injr.2014.07.001 |
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Indo-UK Rheumatology Fellowship: Report 1 |
p. 228 |
Jyoti Ranjan Parida DOI:10.1016/j.injr.2014.11.001 |
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Indo-UK Rheumatology Fellowship: Report 2 |
p. 229 |
N Sajjan Shenoy DOI:10.1016/j.injr.2014.11.002 |
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