ABSTRACT
Objective: to evaluate matrix metalloproteinase-9gene expression in rheumatoid arthritis patients on disease modifying anti-rheumatic agents with the objective to further modify the current treatment regimen if indicated in order to prevent progression to deforming rheumatoid arthritis
Study Design: cross-sectional comparative study
Place and Duration of Study: cream Lab [Centre for Research in Experimental and Applied Medicine] and Department of Biochemistry and Molecular Biology, Army Medical College, in collaboration with Rheumatology Department at Military Hospital Rawalpindi from November 2015 to November 2016
Methodology: a total of 60 patients of both genders were taken, among which 30 were patients and 30 were controls. Non-probability purposive sampling technique was used. RNA was extracted from respective blood sample and cDNA was synthesised and after optimisation, expression analysis of matrix metalloproteinase-9gene was seen on real time PCR
Results: mean age of rheumatoid arthritis patients and healthy controls was 49.27 +/- 12.11and 42.10 +/- 9.02 years, respectively. Among controls, 50% were males [15] and 50% were females [15]; whereas, among patients, 30% [9] were males and 70% [21] were females. The mean cycle threshold [Ct] value of MMP-9expressions in patients was 27.9147 +/- 2.953; whereas, mean Ct of controls was 23.84 +/- 2.845. Down regulation of this gene was found in patients in comparison to controls
Conclusion: downregulation of matrix metalloproteinase-9was observed in patients as compared to controls indicating that current treatment regimen did not require further modification
ABSTRACT
Objective: To detect the anti cyclic citrullinated peptide [Anti-CCP] antibody in rheumatoid arthritis [RA] patients to determine its diagnostic value in Pakistani patients
Study Design: Cross sectional study
Place and Duration of Study: Military Hospital [MH] Rawalpindi, from January 2013 to June 2015
Material and Methods: A total of 58 patients with complications of rheumatoid arthritis were recruited in the study using convenient sampling technique after their informed consent. Age and gender of the patients were recorded. Blood was collected from the patients subjected to ELISA based detection of anti-CCP and latex agglutination test for detection of Rheumatoid Factor [RF]. Data obtained were analyzed using Microsoft excel 2010
Results: Among the fifty eight RA patients, 40% were males and 60% were females. Age ranged between 12 to 80 years [mean age 49.74 +/- 16.81 years] of the males RA patients and was higher as compared to females [mean age 43.2 +/- 16.70 years]. ELISA based detection of anti-CCP antibody showed that about 91 percent of RA patients were positive for anti CCP antibody. About 72% were positive for anti CCP antibody alone, 19 percent were positive for both anti-CCP and RF and 9 percent were positive for RF
Conclusion: The results concluded that a higher percentage of the RA patients are positive for anti-CCP antibody marking its importance as a diagnostic marker. Anti-CCP has more sensitivity as compared to RF in RA patients
ABSTRACT
Objective: To establish a clinical registry for Rheumatoid Arthritis and delineate the most common symptoms that rheumatoid arthritis [RA] patients experience in our set up
Study Design: Cross sectional study
Place and Duration of Study: Study was carried out at Military Hospital [MH] Rawalpindi at Rheumatology Department during the period of Jan 2013 to Jun 2015
Material and Methods: A clinical registry for Rheumatoid Arthritis was developed as per criteria jointly developed by American College of Rheumatology [ACR] along with European League against Rheumatism [EULAR] [2010]. Fifty-eight patients were registered after their informed consent and approval by Military Hospital [MH] Rawalpindi ethical committee. Age, gender and relevant clinical parameters of RA patients were recorded on case report forms and stored for analysis in the RA registry in Excel 2010. The figures were reported in frequencies and percentages
Results: Multiple joint pains [48.28%], fever [24.14%], morning stiffness of joints [22.41%] were the most common symptoms in RA patients. Other clinical manifestations included painful bilateral swollen joints [13.79%], pain in different parts of the body [10.34%], Raynaud's phenomenon [10.34%], malaise [8.62%], swollen body parts [8.62%], ulcers [8.62%], fatigue [6.90%], nodules on skin/elbow/interphalangeal joints [6.90%], deformities of fingers/ hand [3.45%], redness of eyes [3.45%], body rash [3.45%], inability to walk [3.45%], cervical lymphadenopathy [1.72%], stiffness of spine [1.72%] and myalgias [1.72%]
Conclusion: It is concluded that multiple joint pains, fever and morning stiffness of joints are the most common symptoms of RA patients
ABSTRACT
Objective: To analyze the acute phase reactants in patients suffering from rheumatoid arthritis [RA] and compare them to healthy controls
Study Design: Cross-sectional comparative study
Place and Duration of Study: This study was conducted at the department of Biochemistry and Molecular Biology Army Medical College, Rawalpindi in collaboration with Rheumatology department Military Hospital [MH] Rawalpindi and Military Hospital Laboratories, from Jan 2016 to Jun 2016
Material and Methods: Approval of this study was given by Ethical Review Committee, Army Medical College [AMC] Rawalpindi. Two groups i.e., group I: normal healthy subjects [n=100] and group II: rheumatoid arthritis patients [n=100] were included in the study. Demographic data: age, gender, ethnicity and marital status of the healthy subjects as well as RA patients was recorded on proforma. Blood sample was collected and patients were monitored for acute-phase response i.e. by evaluating the levels of C-reactive protein [CRP] and erythrocyte sedimentation rate [ESR]
Results: In this study 100 RA patients with 29 males and 71 females were enrolled. Hundred healthy controls included 50 males and 50 females. The mean CRP value of RA patients was 8.44 +/- 4.28mg/l i.e. higher as compared to that of controls whose mean CRP value was 6.2 +/- 4.6mg/l [p<0.001]
Among RA patients, the mean ESR value was 29.0 +/- 16.9mm/ hr of and among controls, the mean ESR value was 20.0 +/- 9.42 mm/hr [p<0.001]
Conclusion: Both CRP and ESR are important disease assessment biomarkers. They were significantly elevated among RA patients as compared to healthy subjects in our study. Moreover due to cost effectiveness these [CRP and ESR] are preferred tests for routine assessment. CRP and ESR provide the much desired information about RA activity and severity that cannot be provided by either of them alone