Efficacy of cyclosporin: a in refractory rheumatoid arthritis

The aim of the study was to evaluate the efficacy of cyclosporin-A in patients of rheumatoid arthritis not responding to standard therapy early in the course of the disease. Design: A non-randomized controlled clinical trial. Place and Duration of Study: Outpatients Department of Abbasi Shaheed Hospital and Imam Clinic over a period of 18 months from March 1999 through September 2000. Materials and The study was carried out on 63 patients of both gender suffering with refractory rheumatoid arthritis for at least 3 months. Patients were divided into two groups A and B. Group-A was the experimental one, treated with cyclosporin-A in combination with methotrexate while Group-B was continued with methotrexate alone. Their pre and post assessments regarding recovery criteria and drug profile had been done in order to establish the efficacy of cyclosporin-A. The study showed a significant difference [p<.000 with a.05] after six months between treatment group and the controls, in the mean values of articular index [2.53 vs. 5.39], right grip [14.28 vs. 33.8 mmHg], left grip strengths [16.5 vs. 34.31 mmHg] and number of tender joints [26.9% vs. 38.6%]. Furthermore, a significant negative correlation between articular index at recruitment and visual analogue scale [VAS] of pain after 6 months of therapy was observed in experimental group. This study indicates that the combination of cyclosporin with methotrexate benefits rheumatoid arthritis patients refractory to methotrexate monotherapy. Cyclosporin was well tolerated by those having shorter duration of disease

Validity of a rapid serologic test for diagnosis of helicobacter pylori

The study was done to determine the sensitivity, specificity, positive and negative predictive values of a rapid serologic test for qualitative determination of Anti H. pylori IgG in human whole blood by chromatographic immunoassay in patients undergoing upper Gastrointestinal endoscopy. Design: Descriptive Sampling: Non-probability, purposive [presenting with upper GI symptoms for more than two weeks]. Site: Medical Unit II, Abbasi Shaheed Hospital. Duration: July 2002 - Feb 2003. Patients and Subjects: Thirty three patients [16 males; 17 females], age: 18 - 60 yrs, presenting with upper GI symptoms for two weeks or more and who agreed to undergo sure step WB/signify WB test and upper GI endoscopy. Method: A qualitative serologic test for detection of Anti H.pylori IgG was performed on whole blood of the patient who then underwent upper GI endoscopy and biopsy was taken from antrum of the stomach and sent for histopathology. Those who showed mucosal inflammation and presence of H. pylori [by Giemsa stain] were considered true positive. Sensitivity, specificity, negative and positive predictive values were determined. Result: For a rapid serologic test for detection of Anti H. pylori antibody in whole blood [sure step; signify] following results were obtained. Sensitivity - 89.47% Specificity - 78.57% Positive predictive value - 85.00% Negative predictive value - 84.60% Qualitative detection of IgG to H. pylori by rapid serologic test on human whole blood is a highly sensitive and specific method for detecting infection with H. pylori

Henoch-schoenlein purpura associatated with helicobacter pylori infection and duodenal ulcer

A 25 years old female presenting upper abdominal pain, retrosternal burning, joint pains and later developing palpable purpura over the lower limbs. Her upper gastrointestinal endoscopic studies indicated duodenal ulcer, antral gastritis and Helicobacter pylori infection. The findings of skin biopsy and immunofluorescence were consistent with Henoch-Schoenlein purpura. The eradication of H. pylori by pentaperazole, clarithromycin and amoxicillin subsided clinical manifestations. This case report and review of literature suggests that H. pylori infection may have a definitive etiological role in the causation of Henoch-Schoenlein purpura