Efficacy of Argane Oil on Metabolic Syndrome in a Moroccan Knee Osteoarthritis Population.

Five medical conditions which characterize metabolic syndrome are abdominal obesity, elevated blood pressure, elevated fasting plasma glucose, high serum triglycerides, and low highdensity lipoproteins cholesterol. When a patient has any three of the five above conditions, he is known to have metabolic syndrome, and these conditions represent a key element in cardiovascular diseases. On the other hand, knee osteoarthritis is a degenerative disease which was shown to be affected by some of the parameters of metabolic syndrome. Edible Argane oil is used in Moroccan folk medicine against several health conditions, such as knee osteoarthritis, though, evidence-based medical data about the above health benefit from Argane oil treatment are lacking. In the present clinical controlled study, we have found that consumption of Argane oil by 38 patients who have knee osteoarthritis and metabolic syndrome can improve several of their metabolic syndrome parameters and decrease their blood lipid atherogenic ratios. The present clinical study, to the best of our knowledge, is the first one to show that Argane oil consumption could be a therapeutic preventive tool against key cardiovascular risk factors of metabolic syndrome in knee osteoarthritis patients.

Does Metabolic Syndrome or its Individual Components Affect Pain and Function in Knee Osteoarthritis Women?

BACKGROUND: Current studies and research support the role of metabolic syndrome (MetS) in knee osteoarthritis (OA). However, few studies have focused on its impact on knee OA parameters. The aim of this study was to investigate if metabolic syndrome or its individual components affect the intensity of pain, functional disability, and radiographic severity in knee osteoarthritis women. MATERIALS AND METHODS: We conducted a cross sectional study including confirmed radiographic knee osteoarthritis according to Kellgren and Lawrence scale, with and without metabolic syndrome according to the National Cholesterol Education Program Adult Treatment Panel III criteria. The two groups were compared for pain Visual Analogue Scale (VAS), Lequesne index, Womac function, and radiological grade after adjusting for significant covariates. Multiple regression analysis was used to identify the independent effects of each specific component for metabolic syndrome on knee osteoarthritis parameters. RESULTS: One hundred thirty women were included. The mean age was 56.68 ±8.07 [34-75] years, and the mean BMI was 32.54±2.92 [23-37] kg/m2. The prevalence of metabolic syndrome was 48.5%. Women with and without metabolic syndrome had similar knee osteoarthritis parameters. However, accumulation of MetS components was associated with higher level of pain (OR = 3.7, CI = [1.5-5.9], p=0.001), independently of age and BMI. Multiple regression analyses showed, after adjusting for all covariates, that hyperglycemia had a positive impact on pain (p=0.009), waist circumference was positively associated with Lequesne index (p=0.04), high triglycerides level was significantly associated with increased pain (p=0.04) and higher Lequesne score (p=0.05), and Systolic blood pressure was positively correlated with Lequesne index (p=0.01). CONCLUSION: In addition to weight reduction, appropriate treatment of metabolic syndrome needs to become an important management strategy for knee pain and functional impairment.

Gonococcal polyarthritis with sternoclavicular joint involvement in pregnant woman: a case report.

Pregnancy is one of conditions that increase the risk of gonococcal arthritis which result from blood dissemination of neisseria gonorrhoeae. A 20-year-old africain female patient (in the second trimester of pregnancy), was admitted to hospital because of fever, asymmetric joint swollen affecting the hands, wrists, left ankle, and right sternoclavicular joint. Laboratory findings (erythrocyte sedimentation rate was 117 mm in first hour, The serum C-reactive protein level was 152 mg/L) the gram stain of genital sample was positif of neisseria gonorrhoeae and trichomonas vaginalis. With antibiotics, outcome of pregnancy was timely and uneventful. Patients should be educated about the mode of transmission of gonorrhea. Sexual partners should also be treated to prevent dissemination and gonococcal re-infection.

A rare location of sacral tuberculosis: A report of three cases.

Tuberculosis remains one of the most common infectious diseases in the world. Vertebral tuberculosis is the commonest form of bone and joint tuberculosis; however, isolated sacral tuberculosis is rare. This atypical presentation may lead to a delay in diagnosis and treatment. We report three cases of sacral tuberculosis diagnosed in young women, aged 30, 23, and 35 years old, respectively. Lombosciatic pain was the main symptom in all cases. All patients had a biological assessment, plain radiographs, and CT scan. However, magnetic resonance imaging was done in only two cases. All patients underwent surgical sacral biopsy, and the diagnosis of tuberculosis was confirmed by histology in all cases. The evolution was satisfactory with the adjunction of antituberculous chemotherapy in all cases. Spinal tuberculosis should be the first and foremost differential diagnosis in the presence of atypical clinical and radiological features of a sacral lesion, particularly in developing countries. Early diagnosis and treatment could prevent or minimize the neurological morbidity in such cases.

A successful treatment of juvenile idiopathic arthritis with rituximab: A report of two cases.

Juvenile idiopathic arthritis (JIA) is defined as arthritis of unknown cause that starts before 16 years of age and lasts at least 6 weeks. It is the most common chronic inflammatory disease in childhood and often persists through adulthood and can lead to severe disability. Biologics are an important therapeutic option for treating patients with JIA. The efficiency of rituximab has not been proven for this indication. Its use has rarely been reported in the literature. We report two new cases of severe and refractory polyarticular JIA with positive rheumatoid factor affecting two African females aged 17 and 18 years successfully treated with rituximab. According to our experience, the use of rituximab in the treatment of JIA, especially in severe polyarticular forms with positive rheumatoid factor, might be a good alternative. Larger therapeutic trials should be conducted in this direction in order to prove the effectiveness of this biotherapy for this indication.

A rare association of rheumatoid arthritis and primary biliary cirrhosis treated with rituximab: a case report.

INTRODUCTION: Primary biliary cirrhosis is an autoimmune disease that tends to progress to fibrosis and cirrhosis with hepatic failure. Primary biliary cirrhosis is often associated with other non- hepatic autoimmune diseases. An association with rheumatoid arthritis has been suggested to coexist in 1.8% to 5.6% of patients with primary biliary cirrhosis, but data supporting this association are scarce. The etiologic and pathogenetic mechanisms are not yet fully understood and several factors have been implicated. The therapeutic management must consider the two pathologies. CASE PRESENTATION: We describe the case of a 60-year-old Moroccan woman with severe erosive rheumatoid arthritis and primary biliary cirrhosis treated with rituximab. During treatment, we observed a good clinical and biological response of her rheumatoid arthritis but persistent abnormal liver function tests. CONCLUSION: B cells seem to play a major role in the pathogenesis of both rheumatoid arthritis and primary biliary cirrhosis. Additional studies are necessary to better determine the therapeutic role of rituximab in both diseases.