Serum interferon-alpha predicts in-hospital mortality in patients hospitalised with acute severe lupus.

OBJECTIVES: Dysregulation of interferon-alpha (IFN-α) is considered central to the immunological abnormalities observed in SLE. Short-term mortality during high disease activity in lupus is up to 30%. Adenovirus vector-introduced IFN-α into a lupus-prone mouse causes the development of glomerulonephritis and death within weeks. We studied serum IFN-α as a biomarker of in-hospital mortality in patients of SLE with high disease activity. METHODS: Serum IFN-α (ELISA) was measured in patients hospitalised for acute severe lupus in a tertiary care rheumatology unit in India and the levels were compared between survivors and non-survivors. Serum IFN-α was compared with traditional clinical and serological markers associated with disease activity to assess which better prognosticates survival. RESULTS: In a cohort of 90 patients with a mean Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) of 19.3 (±5.5), the mean serum IFN-α was 88±144 pg/dL. Levels were undetectable in patients with inactive disease. SLEDAI, anti double stranded DNA (dsDNA) antibody titres and serum IFN-α levels were higher and serum complement (C3) lower in non-survivors (p=0.003, p=0.017, p<0.001, p=0.029, respectively). Serum IFN-α level of 140 pg/mL had a sensitivity of 86.7%, specificity of 94.6%, positive predictive value of 76% and negative predictive value of 83.3% (p<0.001) in predicting mortality. The area under the curve for predicting in-hospital mortality was 0.25 for C3, 0.72 for dsDNA, 0.77 for SLEDAI and 0.92 for serum IFN-α. CONCLUSIONS: Serum IFN-α was better in predicting in-hospital mortality compared with conventional measures of disease activity such as anti-dsDNA, complements and SLEDAI.

A Joint Consensus of Rheumatologists and Dermatologists on Early Detection and Effective Management of Psoriatic Arthritis: India's Perspective.

Psoriatic arthritis (PsA) is a chronic inflammatory disease with clinical manifestations, including inflammatory arthritis and the presence of psoriasis (PsO). The present consensus statement evaluated the early diagnosis and treatment approaches in the management of psoriasis and psoriatic arthritis by rheumatologists and dermatologists. For PAN India representation, a panel of eight rheumatologists and five dermatologists from different institutes in India were constituted. These thirteen experts were divided into two groups (rheumatologists group and dermatologist group) who received a set of questionnaires each for diagnosis and treatment approaches in the management of psoriasis and psoriatic arthritis. Based on the responses received, a panel discussion took place, where the experts identified the early diagnostic criteria for PsA considering: Clinical signs and symptoms, and questionnaire-based PsA screening, which includes Psoriasis Epidemiology Screening Tool (PEST) for dermatologists and Classification Criteria for Psoriatic Arthritis (CASPAR) for rheumatologists. The experts also recommended shift from conventional disease-modifying anti-rheumatic drugs (DMARDs) to biologics like secukinumab, when there is extensive skin involvement and TNF inhibitors when there is extensive joint involvement. Overall, the objective of the consensus was to assist rheumatologists and dermatologists in the early diagnosis and management of patients of PsA and PsO in their clinical practice.

Traditional System Versus DNA Barcoding in Identification of Bamboo Species: A Systematic Review.

Bamboo, a gramineous plant belonging to the family Poaceae, comprises of 1575 species from 116 genera across the globe. It has the ability to grow and evolve on degraded land and hence, can be utilized in the various applications as an alternative for plastic and wood. DNA barcoding, a long genomic sequence, identifies barcode region which shows species-specific nucleotide differences. This technology is considered as advanced molecular technique utilized for characterization and classification of the various species by applying distinctive molecular markers. Recent investigations revealed the potential application of various barcode regions such as matK, rbcL, rpoB, rpoC1, psbA-trnH, and ITS2, in identification of many bamboo species from different genus. In this review we comprehensively discussed the relevance of DNA barcoding as a tool in classification/identification of various bamboo species. We highlighted the methodology, how this advance technology overcomes the challenges associated with traditional methods along with prospects for future research.

Comparison of two different folic acid doses with methotrexate--a randomized controlled trial (FOLVARI Study).

INTRODUCTION: There is reasonable evidence that folic acid 5-10 mg per week leads to reduction in methotrexate (MTX) toxicity in rheumatoid arthritis (RA). However, this is based on studies conducted with lower MTX dosage than used currently. It is unclear whether higher doses of folic acid may be better in reducing toxicity. METHODS: This was a double-blind randomized controlled trial of 24 weeks duration. To be eligible, patients should have rheumatoid arthritis (1987 American College of Rheumatology criteria), be 18-75 years of age, not be on MTX and have active disease as defined by 'Modified Disease Activity Score using three variables' (DAS28(3)) > 3.2. MTX was started at 10 mg/week and escalated to 25 mg/week by 12 weeks. Folic acid was given at a dose of 10 mg (FA10) or 30 mg per week (FA30). Co-primary endpoints were incidence of toxicity (undesirable symptoms and laboratory abnormalities) and change in disease activity by 24 weeks. Intention-to-treat and per-protocol analyses were performed. RESULTS: Among 100 patients enrolled, 51 and 49 were randomized to FA10 and FA30 respectively. By 24 weeks, there were 6 patient withdrawals in either group and mean(±SD) dose of MTX was 22.8 ± 4.4 and 21.4 ± 4.6 mg per week (p = 0.1). Frequency of patients with undesirable symptoms was non-significantly lower by 7.4% (95% confidence interval -27.4 to 12.7%) in FA10 compared to FA30. There was also no difference in frequency of transaminitis (>Upper limit of normal (ULN)) (42.6, 45.7%, p = 0.7) or transminitis as per primary endpoint (>2xULN) (10.6, 8.7%, p = 1.0) or cytopenias (4.3, 4.3%, p = 0.9). There was no difference in the primary end-point of occurrence of any adverse effect (symptom or laboratory) in FA10 and FA30 (46.8, 54.3%, p = 0.5). At 24 weeks, DAS28(3) declined in both groups by a similar extent (-1.1 ± 1.0, -1.3 ± 1.0, p = 0.2) and 'European League Against Rheumatism' good or moderate response occurred in 56.9 and 67.4% (p = 0.3). CONCLUSIONS: Even with the high doses of MTX used in current practice, there was no additional benefit (or harm) of a higher dose of folic acid (30 mg/week) over a usual dose (10 mg/week). TRIAL REGISTRATION: Clinicaltrials.gov NCT01583959 Registered 15 March 2012.

Cervical myelocystocele: Case report and review of literature.

Dysraphisms involving cervical region are very rare and there are very few series describing their follow-up in literature. Here, we report a 6-year-old boy who underwent postnatal "cosmetic" repair of posterior cervical cystic lesion and presented to us with a large recurrence with syringohydromyelia and tethering. Tethered cord should be suspected in the presence of meningocele and intact neurology. Treatment protocols of such complicated cervical spinal dysraphisms should include intradural exploration and detethering, with an aim to prevent neurological deterioration in future.

Protective Effect of Rutin and Naringin on Sperm Quality in Streptozotocin (STZ) Induced Type 1 Diabetic Rats.

Oxidative stress is one of the important causes of the type 1 diabetes induced changes in the sperm quality. Bioflavonoids, Rutin 10 mg/Kg and Naringin 10 mg/Kg were evaluated for their protective effects on sperm parameters, oxidative stress, and histopathology of type 1 diabetic rats. Results demonstrated the reduction in sperm count, sperm motility and vitality in diabetic rats. Mass drug administration (MDA) levels were increased and superoxide dismutase (SOD) catalase levels were decreased. Histopathological changes were evident and in accordance with the above results. In the treatment groups, both Rutin and Naringin in combination with insulin treatment in diabetic rats produced protection from diabetes and improved all the sperm parameters, decreased the MDA levels and increased the SOD and catalase levels. Protection was evident in histological examination. Our data suggests that the possible protection of testicular tissue and reproduction from oxidative stress have been induced by type 1 diabetes mellitus.

Differential antioxidative enzyme responses of Jatropha curcas L. to chromium stress.

Chromium (Cr) tolerant and accumulation capability of Jatropha curcas L. was tested in Cr spiked soil amended with biosludge and biofertilizer. Plants were cultivated in soils containing 0, 25, 50, 100 and 250 mg kg(-1) of Cr for one year with and without amendment. Plant tissue analysis showed that combined application of biosludge and biofertilizer could significantly reduce Cr uptake and boost the plant biomass, whereas biofertilizer alone did not affect the uptake and plant growth. Antioxidative responses of catalase (CAT), ascorbate peroxidase (APX) and glutathione S-transferase (GST) were increased with increasing Cr concentration in plant. Hyperactivity of the CAT and GST indicated that antioxidant enzymes played an important role in protecting the plant from Cr toxicity. However, APX took a little part in detoxification of H(2)O(2) due to its sensitivity to Cr. Therefore, reduced APX activity was recorded. Reduced glutathione (GSH) activity was recorded in plant grown on/above 100 mg kg(-1) of Cr in soil. The study concludes that J. curcas could grow under chromium stress. Furthermore, the results encouraged that J. curcas is a suitable candidate for the restoration of Cr contaminated soils with the concomitant application of biosludge and biofertilizer.

Synthesis and anti-histaminic activity of some novel pyrimidines.

Novel pyrimidines were prepared by the condensation of chalcones of 4'-piperazine acetophenone with guanidine HCl. The structures of the synthesized compounds RP 1-5 were assigned on the basis of elemental analysis, IR, (1)H NMR and mass spectroscopy. These compounds were also screened for anti-histaminic activity. The recorded percentage of histamine inhibition showed a significant anti-histaminic activity when compared to the reference anti-histaminic drug mepiramine.

Effect of biosludge and biofertilizer amendment on growth of Jatropha curcas in heavy metal contaminated soils.

The pot experiments were conducted to evaluate the effect of different concentrations of arsenic, chromium and zinc contaminated soils, amended with biosludge and biofertilizer on the growth of Jatropha curcas which is a biodiesel crop. The results further showed that biosludge alone and in combination with biofertilizer significantly improved the survival rates and enhanced the growth of the plant. With the amendments, the plant was able to grow and survive upto 500, 250 and 4,000 mg kg(-1) of As, Cr and Zn contaminated soils, respectively. The results also showed that zinc enhanced the growth of J. curcas more as compared to other metals contaminated soils. The heavy metal accumulation in plant increased with increasing concentrations of heavy metals in soil, where as a significant reduction in the metal uptake in plant was observed, when amended with biosludge and biofertilizer and biosludge alone. It seems that the organic matter present in the biosludge acted as metal chelator thereby reducing the toxicity of metals to the plant. Findings suggest that plantation of J. curcas may be promoted in metal contaminated soils, degraded soils or wasteland suitably after amending with organic waste.