OX40/OX4OL in systemic lupus erythematosus: association with disease activity and lupus nephritis

To evaluate the role of OX40/OX40L as markers of disease activity and nephritis in SLE patients. The study included forty SLE patients [38 females and 2 males]. They underwent full history taking, clinical examination, and routine laboratory investigations. Their disease activity was assessed according to the SLEDAI. Twenty age and sex matched subjects were included as controls. Patients were divided into two groups; first group included 20 patients with biopsy proven lupus nephritis [LN] and the second group included 20 patients without evidence of renal involvement. We assessed the percentage of OX40+CD4+lyrnphocytes by flowcytometry and serum soluble OX40L by ELISA in patients and controls. The percentage of OX40+CD4+ lymphocytes in SLE patients was significantly higher than controls. There was a highly significant increase in the percentage of OX40+CD4+lymphocytes among the patients with nephritis as compared to the patients without nephritis. It correlated significantly with s.creatinine and SLEDAI. Soluble serum OX40L was significantly higher in SLE patients as compared to controls and the level in patients with LN was statistically higher when compared to patients without LN. It showed positive significant correlation with s.creatinine but did not correlate with the SLEDAI. Our results suggest that the interaction between OX40 and its ligand play an important role in the pathogenesis of SLE. The expression of OX40 on CD4+T cells and the level of OX40L may act as markers of LN. Furthermore, measurements of the percentage OX40+CD4+T cells may serve as an indicator of disease activity in SLE patients

Increased prevalence of human papilloma virus type 5 in patients with psoriasis: relation to PUVA therapy or disease severity?

Introduction: Psoriatic skin colonization by Human Papilloma Virus [HPV] seems to be restricted mainly to HPV-5 which is a ubiquitous virus that replicates at a high rate in hyper-reactive psoriatic keratinocytes. The aim of the present study was to determine whether the increased prevalence of HPV-5 DNA in psoriatic lesions is related to PUVA [Psoralen and Ultraviolet A] treatment or to disease severity

Subjects and Methods: Thirty psoriatic patients were enrolled in the study after their informed consent. Patients were divided into two groups; group I patients [n =16] had no history of PUVA exposure during the past 6 months, while group II patients [n = 14] are on PUVA treatment. The calculated Psoriasis Area and Severity Index [PASI] score for patients varied between 8 and 66. Among the thirty patients, 22 had severe psoriasis with PASI score >20, five patients had moderate psoriasis with PASI score from 10 to 20 and three patients had mild psoriasis with PASI score < 10. Six patients of group I were on methotrexate treatment. Skin scales from lesions were collected from each patient. A type-specific nested PCR was performed using two sets of primers designed to detect the HPV-5 E6 gene. PCR reactions were done in Light Cycler to achieve optimal sensitivity

Results: In the present study 57% of psoriatic patients had HPV-5 infection in psoriatic lesion. Results showed statistically non significant difference between the two groups of patients regarding the presence of HPV-5 [P>0.05], while the difference between patients with severe psoriasis [PASI > 20] and patients with mild to moderate psoriasis [PASI

Acetaminophen versus diclofenac sodium after pediatric tonsillectomy

Providing adequate postoperative analgesia to children undergoing adenotonsillectoiny is often a challenge. Failure to control pain after this commonely performed procedure leads to decrease oral in-take, dehydration and greater risk of heamorrage from healing surgical wounds. Our aim was to compare the effectiveness of acetaminophen versus diclofenac sodium as common analgesics after pediatric tonsillectomy and adenoidectoniy [T and A].Eighty eight children ages 4 to l2years scheduled for T and A in a prospective. randomized and double-blind study. The Wong-Baker FACES pain rating scale was used to help children quantify their level of pain after surgery. The level of pain, quantity of pain medication required, presence Of side effects and the percentage of a normal diet consumed was recorded For 10 postoperative days. The results showed no difference [p] 0.05, all time Points in the level of postoperative pain reported by the parents and children in the two groups. The diclofenac sodium group tended to have increased problems with nausea, vomiting, and constipation, but these differences did not reach statistical significance. Children in the acetaminophen group consumed a significantly higher percentage of a normal diet on the first 10 postoperative days [p < 0.5, all time points]. We concluded that there was no difference in the level of pain control Provided by the Wong-Baker FACES pain rating scale. Postoperative oral Intake was significantly higher in children treated with acetaminophen