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   2016| March  | Volume 11 | Issue 1  
    Online since August 4, 2016

 
 
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ORIGINAL ARTICLES
Comparative study of efficacy and safety of tapentadol versus etoricoxib in mild to moderate grades of chronic osteorthritis of knee
Manasi Banerjee, Shirsendu Mondal, Rathindranath Sarkar, Hindol Mondal, Kuntal Bhattacharya
March 2016, 11(1):21-25
DOI:10.1016/j.injr.2015.12.001  
Objectives: Chronic osteoarthritis of knee is very commonly encountered in clinical practice. Pain relief and restoration of physical function are the targets of therapy. This study aims to compare the efficacy and safety of tapentadol with etoricoxib in the management of osteoarthritis of knee. Methods: This is a randomised, open labelled, controlled study in which patients received either tablet tapentadol (100 mg twice daily) or etoricoxib (30 mg twice daily) for 12 weeks. Follow-up was done after 2nd, 4th, 8th and 12th weeks of initiation of treatment and also after 2 weeks of treatment completion. Assessment of improvement in pain perception on Visual Analogue Scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) sub-score for stiffness and physical function were performed. Results: 108 patients receiving tapentadol and 110 patients receiving etoricoixb were ana- lysed on Intention to Treat basis. Steady improvement was seen in VAS and WOMAC scores in both the groups, though there was no significant difference between the groups. Clinical Global Impression measured by physician showed significant difference between groups with greater number of patients experiencing at least satisfactory response at the end of the study in the tapentadol group ( p = 0.036). The total number of adverse events was less with tapentadol than etoricoxib. Conclusions: Tapentadol is as effective as etoricoxib in the management of mild to moderate grades of chronic osteoarthritis of knee with lower incidences of adverse effects.
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  600 112 3
Comparative study of DAS 28 ESR and DAS 28 CRP among rheumatoid arthritis patients in India
Adwitiya Das, Kuntal Bhattacharyya, Rathindra Nath Sarkar
March 2016, 11(1):26-31
DOI:10.1016/j.injr.2015.10.006  
Background: The Disease Activity Score (DAS) in rheumatoid arthritis (RA) involving 28 joints and using erythrocyte stimulation rate (ESR) is used frequently. But the inability of DAS 28 ESR to reflect short-term changes in disease activity has given rise to DAS 28 using C- reactive protein (CRP). The objective of the present study was to compare DAS 28 CRP with DAS 28 ESR. Methods: 294 patients of RA diagnosed as per ACR EULAR 2010 revised classification criteria for RA were included. New cutoff values of remission, low, moderate and high disease activity using DAS 28 CRP were defined. Result: There was a good correlation between DAS 28 ESR and DAS 28 CRP. On classifying the disease activity of the subjects according to new cutoff values of DAS 28 CRP, there was substantial agreement with classification according to DAS 28 ESR. Conclusion: DAS 28 CRP may be considered as an alternative to DAS 28 ESR.
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  404 164 2
Interleukin 1 receptor antagonist (IL1Ra) VNTR polymorphism influences circulatory IL1Ra levels and development of SLE in South Indian Tamils
Devaraju Panneer, Paul T Antony, Swaminathan Rathinam Palamalai, Vir Singh Negi
March 2016, 11(1):2-6
DOI:10.1016/j.injr.2015.10.003  
Background: Systemic lupus erythematosus (SLE) is a systemic autoimmune disease with complex aetiology. Genetic polymorphisms disrupting the functions of genes encoding anti- inflammatory cytokines such as IL1Ra may influence the disease activity and outcome in SLE. In this study, the IL1Ra VNTR polymorphism was tested for its influence on disease susceptibility, clinical and serological phenotypes of SLE in South Indian Tamils. Materials and methods : Three hundred SLE patients and 460 age, sex and ethnicity matched controls were genotyped for IL1Ra VNTR polymorphism by PCR. Serum IL1Ra was quantified by ELISA. Results: Genotyping revealed that the four and two repeats were the most frequent poly- morphic alleles in our subjects. The two repeat allele (A2) was more frequent in SLE (18%) than in controls (9%) and it conferred a significant risk to develop SLE [p = 0.0001, OR 2.36, 95% CI, 1.7-3.2]. However, incidence of heterozygous genotype (A1A2) was high among SLE patients (25%) and presence of which was observed to influence the development of SLE [p = 0.0001, OR 5.8, 95% CI, 3.2-9.5]. Quantification of serum IL1Ra revealed that the four repeat allele was associated with the normal production of the cytokine, whereas the other variants were associated with the reduced expression of the IL1Ra. Conclusion: IL1Ra VNTR polymorphism analysis in South Indian Tamil SLE patients revealed that the genotype A1A2 was associated with lupus susceptibility. The VNTR polymorphism encoding the allele with two repeats was associated with reduced circulatory concentration of IL1Ra in SLE patients, likely predisposing them to develop clinically severe form of the disease.
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  439 100 -
The effect of proteasome inhibitor (AM114) on apoptosis in IL-1b-treated peripheral blood macrophage cultured cells from rheumatoid arthritis patients
Selvarajan Chitraa, Ganesan Nalinia, T Srinivasan Lokeswari, Gopalakrishnan Rajasekhar
March 2016, 11(1):7-13
DOI:10.1016/j.injr.2015.10.005  
Objectives: Monocytes/macrophages play a central role in the innate immune response and inflammatory process. The induction of apoptosis by AM114 has been studied in many cancer cell lines but not in rheumatoid arthritis (RA) relevant cell types. Therefore, the objective of the study was to explore the effect of proteasome inhibitor (PI) AM114 on apoptosis in IL-1b-treated peripheral blood macrophage cultured cells (PBMCC) from RA patients in comparison with aspirin. Methods: The efficacy of AM114, with or without IL-1b-treated macrophages, was assessed by comparing with aspirin-treated cells. The induction of apoptosis was determined in IL-1b, treated (10 ng/mL) for 24 h, macrophages isolated from peripheral blood of RA patients. The cell viability was determined by MTT assay. The cell morphological assessment of apoptosis was determined using acridine orange ethidium bromide (AO/EtBr), Hoechst 33342, and rhodamine 123 assays. The activity of caspase-3 was determined by spectrofluorimetry in IL-1b-treated PBMCC exposed to AM114 and aspirin. Student's t-test was used to compare the different groups. Results: In the present study, the IC50 concentrations for induction of apoptosis by AM114 and aspirin were found to be at 0.88 mM/mL and 1120 mM/mL, respectively. The presence of apoptotic cells was detected by the presence of condensed form of nuclei, apoptotic bodies, cytoplasmic blebbing, and change in mitochondrial membrane potential. The caspase-3 activity was increased 0.7-fold in AM114 with IL-1b-treated cells than the unstimulated PI- treated cells. An increase of 0.5-fold in caspase-3 activity was observed in AM114-stimulated cells in comparison with aspirin-stimulated cells. Conclusions: The AM114 is efficacious than aspirin-treated IL-1b-treated PBMCC from RA patients by inducing apoptosis and increase in caspase-3 activity.
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  409 120 -
REVIEW ARTICLES
Discoveries of conventional synthetic disease modifying anti-rheumatic drugs - Serendipity or flawless reasoning?
Anand N Malaviya
March 2016, 11(1):32-38
DOI:10.1016/j.injr.2015.12.004  
Most of the conventional synthetic disease modifying anti-rheumatic drugs (csDMARDs) for treating rheumatoid arthritis (RA) were discovered serendipitously. Of course, discoveries do require serendipity, but it is not simply a random process or chance event. It is a process in which an unexpected event is seized upon by a creative mind that chooses to pay attention to the event, and unravels its mystery followed by its careful application for the benefit of mankind. Rheumatology is replete with such brilliant minds helping patients to come out from a hopeless illness and move towards a quality life that is almost as good as normal. In this short review, historical perspective of some of the older and current csDMARDs-related discoveries is described.
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  363 156 1
ORIGINAL ARTICLES
Endothelial progenitor cell biology in psoriatic arthritis patients in the absence of traditional cardiovascular risk
Inderjeet Verma, Ashit Syngle, Pawan Krishan
March 2016, 11(1):14-20
DOI:10.1016/j.injr.2015.11.001  
Introduction: Endothelial progenitor cells (EPCs) restore dysfunctional endothelium and protect against atherosclerotic vascular disease. EPC population has been assessed in a heterogeneous population with equivocal results in psoriatic arthritis (PsA) patients with confounding factors. The aim of this study was to investigate EPC population in PsA patients in the absence of traditional cardiovascular risk factors. Methods: 22 active PsA patients and 20 age- and sex-matched healthy controls were includ- ed. EPCs (CD34+/CD133+) were assessed by Flow Cytometry. Endothelial function was assessed by measuring flow-mediated dilatation (FMD%) and carotid intima-media thick- ness (CIMT) was assessed by ultrasonography. Inflammatory markers, i.e. erythrocyte sedimentation rate, C-reactive protein (CRP), tumor necrosis factor (TNF)-a, interleukin (IL)-6, and IL-1, were also assessed in all subjects. Results: EPC population was significantly lower in PsA patients compared with controls (mean 0.028% vs. 0.047%, p < 0.001). FMD and inflammatory markers were also significantly (p < 0.05) altered as compared to healthy controls, but there was no significant difference in CIMT (mean 0.65 vs. 0.56, p = 0.068). Specifically, CD34+CD133+cells correlated positively with FMD (r = 0.66, p = 0.002) and inversely correlated with CRP (r = -0.65, p = 0.002), TNF-a (r = -0.58, p = 0.01), IL-6 (r = -0.64, p = 0.003), disease activity measures (DAS-28 (r = -0.63, p = 0.004), and disease activity index for PsA (r = -0.53, p = 0.02)). Conclusions: EPC population is depleted in PsA patients in the absence of traditional cardio- vascular risk. Inflammation appears to play a key role in EPC depletion and the latter contributes to endothelial dysfunction in PsA.
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  363 56 -
REVIEW ARTICLES
Rheumatology Quiz
V Arya, V Dhir
March 2016, 11(1):39-39
DOI:10.1016/j.injr.2016.01.003  
Full text not available  [PDF]  [Mobile Full text]  [EPub]
  259 145 -
EDITORIAL
From the editor's desk
Vinod Ravindran
March 2016, 11(1):1-1
DOI:10.1016/j.injr.2016.01.001  
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  270 100 -
IMAGES IN RHEUMATOLOGY
Acro-osteolysis in a young patient: Think of pycnodysostosis!
Maroua Slouma, Kawther Ben Abdelghani, Selma Kassab, Selma Chekili, Ahmed Laatar, Leith Zakraoui
March 2016, 11(1):46-48
DOI:10.1016/j.injr.2015.09.008  
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  213 134 -
LETTER TO THE EDITOR
Cerebral venous thrombosis (CVT) in systemic lupus erythematous (SLE)
Sima Sedighy, Fatemeh Rezapour, Mehrdad Aghaie
March 2016, 11(1):57-59
DOI:10.1016/j.injr.2015.09.006  
Full text not available  [PDF]  [Mobile Full text]  [EPub]
  216 120 -
IMAGES IN RHEUMATOLOGY
Madelung's Deformity and bilateral rupture of triangular fibrocartilage
María Francisca Cegarra-Navarro, Alexandra Eleonor Castillo-Burns, José Antonio Díaz-Manzano, María Jesús Fernández-Ferrando
March 2016, 11(1):52-54
DOI:10.1016/j.injr.2015.11.002  
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  229 102 -
Mandibular resorption in systemic sclerosis
Kessavalou Sarala, Sadaksharam Jayachandran, Saravanan Senthil Kumar
March 2016, 11(1):55-56
DOI:10.1016/j.injr.2015.12.003  
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  219 102 -
LETTER TO THE EDITOR
A rare presentation of SLE
Harpreet Singh, Pranav Ish, Anuradha Subramaniam, Richa Dewan, Sumeet Singla, Shobhit Agarwal
March 2016, 11(1):61-63
DOI:10.1016/j.injr.2015.10.002  
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  223 89 -
REVIEW ARTICLES
International publications of interest from India

March 2016, 11(1):40-43
DOI:10.1016/j.injr.2016.01.002  
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  210 102 -
IMAGES IN RHEUMATOLOGY
An uncommon cause of ischemic stroke in systemic lupus erythematosus: Giant Lambl's excrescence
Maroua Slouma, Kawther Ben Abdelghani, Rami Tlili, Selma Kassab, Ahmed Laatar, Leith Zakraoui
March 2016, 11(1):49-51
DOI:10.1016/j.injr.2015.10.004  
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  229 74 -
LETTER TO THE EDITOR
Role of MRI in evaluation of asymmetric undifferentiated hand arthritis
Rakhee Kumar Paruchuri, Liza Rajasekhar, Vakati Sreedhar Reddy
March 2016, 11(1):60-61
DOI:10.1016/j.injr.2015.09.007  
Full text not available  [PDF]  [Mobile Full text]  [EPub]
  199 91 -
IMAGES IN RHEUMATOLOGY
Fracture odontoid process as the first presentation of calcium pyrophosphate deposition disease
Pui-Shan Julia Chan, Moon-Ho Leung
March 2016, 11(1):44-45
DOI:10.1016/j.injr.2015.09.001  
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  218 53 -
LETTER TO THE EDITOR
Comment on: Clinical and radiographic involvement of cervical spine in patients with psoriatic arthritis
N Subramanian
March 2016, 11(1):63-64
DOI:10.1016/j.injr.2015.09.005  
Full text not available  [PDF]  [Mobile Full text]  [EPub]
  201 67 -