Online ISSN: 2515-8260

Keywords : Arthritis


“RHEUMATOLOGICAL MANIFESTATIONS IN LEPROSY”

Dr Mohak Agarwal, Dr Rohit Kothari, Dr Priya Garg, Dr Shreya Deoghare, Dr Kirti Deo Dr Anushka Rakesh

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 1, Pages 3095-3105

Leprosy (Hansen's disease) is caused by Mycobacterium leprae,through respiratory root and affects skin and nerves predominantly. This nerve injury can induce a lack of pain sensitivity, motor dysfunction and can ultimately lead to limb loss. Neuropathy causes post-traumatic septic arthritis and neuropathic joints. Acute and chronic joint involvement as  symmetric polyarthritis mimicking rheumatoid arthritis (RA) with or without lepra reaction has been reported. Leprosy appears in rheumatology as primary arthritis, a concomitant infection, or a treatment outcome. Joint pain and arthritis occur during reactive inflammation. Hansen's disease may also cause rheumatoid-like erosive deforming arthritis in large and small joints.
A descriptive cross-sectional study was undertaken in the Department of Dermatology and Venereology. The study included all leprosy cases but excluded patients with other types of arthritis. Patients with coagulopathy, connective tissue disorders, and collagen vascular disorders were excluded.
The mean age of 100 study participants was 41.30 years (SD - 19.23 years), 76% were male, 24% female. Most study participants had ulcers on their feet. 24 had left foot ulcers and 17 on the right. Lesions were also present on medial malleolus, hand, lower limbs, etc. 56% had no leprosy reaction, 24% type 2, and 20% type 1. Polyarthritis was the most prevalent rheumatological manifestation (34%), followed by tenosynovitis (32%). Some patients had enthesitis (16%), oligoarthritis (15%), dactylitis (12%), etc. Most lepromatous and tuberculoid leprosy patients had increased ESR and CRP.
Borderline and lepromatous leprosy often causes symmetrical polyarthritis, oligoarthritis, enthesitis, and dactylitis. Leprosy is rare in outpatient rheumatology, but rheumatologists must know this crucial differential diagnosis. Dermatologists should be involved when anti lepromatous medications to prevent unnecessary antirheumatic therapy.

A hospital-based outcome assessment of Primary TKR in Severe fixed flexion deformity of knee compared with TKR in knees without fixed flexion deformity (FFD): A comparative study

Dr. Anurag Chandrakar; Dr. Shashimant Chavan; Dr. Rupesh Kumar Gupta

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 8, Pages 910-916

Aim: The aim of the present study was to know the functional outcome of Primary TKR in Severe fixed flexion deformity of knee compared with TKR in knees without fixed flexion deformity (FFD).
Methods: This was a prospective study of the Department of Orthopaedics, Shri Shankaracharya Institute of Medical Sciences, Bhilai, Chhattisgarh, India for the period of 1 year. Patients with and without severe flexion deformity of knees underwent primary TKR. Total of 120 knees were taken for the study with 90 with FFD of more than 30 degree and 30 were without FFD which were kept as a control. This study includes both inflammatory and non-inflammatory arthritis.
Results: In 100 patients, there were 30 bilateral cases and 90 unilateral cases with a total of 120 knees. 66 knees were inflammatory arthritis and 34 with non-inflammatory arthritis. There were 45 females and 55 male patients. Average age of the patients was 59.6 years (28-75 years). Average follow up was 1.5 years (1-3 years). In Primary TKR in FFD - Average FFD was 44 degree, Pre-operative average KSS-pain score was 27.5 and functional score was 15, post operatively KSS pain score was 82.7 and function score was 79.1. In Primary TKR in no FFD - Pre-operative average KSS-pain score was 31 and functional score was 24, post operatively KSS pain score was 85.3 and function score was 80.2.
Conclusion: There was no significant difference in postoperative KSS- pain and functional score, in patients with no FFD was comparable with patients with FFD. TKA is successful in correcting flexion deformity, although the amount of correction obtained depended on the degree of preoperative flexion deformity.

Ankle Arthrodesis For Tuberculosis of Ankle Joint

Mizanur Rahaman Sk, Bibin Selvin, Shubham Taori, Tushar Chaudhari, Abhishek singh Bhadauria

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 6420-6426

Introduction: Among extrapulmonary infections, tuberculosis of the ankle joint is very uncommon. Early diagnosis of tuberculosis of the ankle joint is quite difficult because of its uncommon site, non-specific sign & symptoms, and negligence 
Case report: A 38-year-old female presented with right ankle pain and swelling for 3 months with a history of twisting injury to the right ankle 3 months back. She had no history of infection in the past ( at least for the last 1-2 years). The only complaint she had was recurrent pain and swelling of the right ankle joint for which she was being managed conservatively for the last 3 months. When she came to the outpatient clinic, presented with a swollen and tender right ankle joint and she was afebrile. Magnetic resonance imaging was not sufficient to conclude the diagnosis. TB arthritis was diagnosed by diagnostic arthroscopy. Eventually, anti-TB therapy eradicated the infection 
Conclusion: Early biopsy and synovial fluid for a polymerase chain reaction, gene Xpert should be performed in all suspicious cases to confirm the diagnosis and management

Bilayer Drug Delivery: A Promising Role In Rheumatoid Arthritis

Urvashi Negi, Kapil Kalra, Vinita Chauhan, Saumya Mishra, Abhishek Chauhan

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 8541-8545

Bilayer tablet is an advanced form of tablet design and it’s very useful in treatment of chronic diseases and their associated adverse disorders. It’s also helpful in treatment where more than one drug is indulged eg. Diabetic, Rheumatoid arthritis. Now a day’s many type of marketed bilayer preparation are available which shows a tremendous result to treat chronic disease. Bilayer tablets are used to control different types of successful drug release rate. In this review we discussed on the rheumatoid arthritis, possible treatment, how to bi-layer tablet helpful in RA treatment, bilayer formulation methods, etc. pharmaceutical incompatibility, sustain release, immediate release

Carbon Nanotubes In Treatment Of Arthritis: An Overview

Manvendra Singh; Pallavi Nayak; Vijay Mishra

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 7, Pages 4366-4372

Arthritis is a type of joint dysfunction that includes one or more joint inflammation like rheumatoid or psoriatic arthritis, and associated autoimmune disorders. The biggest concern about arthritis is that the discomfort is always persistent and may be confined to the injured joint due to swelling that happens throughout the joint, trauma to the joint induced by illness, regular wear and tear, muscle strains triggered by vigorous action toward hard sore joints and exhaustion, which in effect contributes to inflexibility, immobility and muscle weakening. Carbon nanotubes with unusual physicochemical properties (cell membrane penetration, large surface area and drug payload, biocompatibility, simple surface alteration, photoluminescence properties and non-immunogenicity) are employed to conquer the challenges of inflammation.