Arthritis in association with human immunodeficiency virus infection in Black African children: causal or coincidental?

OBJECTIVES: To compare human immunodeficiency virus (HIV)-infected and HIV-uninfected children with arthritis of unknown origin to determine whether the association between HIV infection and arthritis is causal or coincidental. METHOD: Retrospective review of 132 children with arthritis who were tested for HIV infection. RESULTS: Thirty-five (27%) of the children were HIV infected and the male to female ratio was 2.5:1 (P = 0.02). Arthritis was the presenting feature of HIV infection in 78% of these children. The remaining 97 (73%) were diagnosed as having juvenile idiopathic arthritis. 'Spondyloarthropathy-like' features were found in 34% of HIV-infected children compared with 5% of uninfected children. CONCLUSION: The high prevalence of HIV infection in 27% of children, the predominance of males and the increased prevalence of 'spondyloarthropathy-like' features, supports a causal relationship between HIV infection and arthritis.     

The spectrum of idiopathic inflammatory myopathies in South Africa

Clinical Rheumatology - There are many reports on idiopathic inflammatory myopathies (IIM) but little information from sub-Saharan Africa. We conducted a retrospective study of IIM in a...     

The impact of surgical treatment of obesity on the female fertility

As obesity is considered to be a pandemic of the twenty-first century, the bariatric surgery becomes more common through the global population. The adverse effects of obesity on fertility can be reversed through the bariatric surgery procedures. In this review, we presented the effects of bariatric surgery on hypothalamic-pituitary-ovarian axis and fertility, ovarian reserve, and contraception efficacy.     

Influence of Nutritionally Induced Anaemia on the Oestrous Cycle of Mice

Investigations were carried out to evaluate the probable effect of anaemia due to food restriction on the oestrous cycle of mice. Female mice were divided into four groups and maintained on normal and restricted diet for 21 days as follows: Group I, maintained on ad libitum food; Group II, 25% diet restriction (2.7 g/day/animal); Group III, 50% diet restriction (1.8 g/day/animal; Group IV, 75% diet restriction (0.9 g/day/animal). Following 21 days diest restriction, the starved mice exhibited weight loss. Haemoglobin concentration and plasma protein levels were found to be reduced in direct proportion to the degree of diet restriction. The red blood cell (RBC) count did not vary much. These observations suggest that diet restriction may interfere with haemoglobin synthesis. Underfed mice exhibited a significant reduction in the average number of oestrous cycles compared to that of normally fed mice. Thus a probable influence of anaemia on mouse oestrous cycle is evident.     

Moderate to severe hidradenitis suppurativa treated with biological therapies

Hidradenitis suppurativa is a debilitating disorder that can be difficult to manage with current conventional treatment strategies. Given its association with proinflammatory cytokines there has been interest in the use of novel biological monoclonal antibodies. We describe our experience with the use of these agents in six patients in whom conventional treatment had failed, with promising response noted in some patients. A growing number of studies now highlight the efficacy of these agents.     

Susceptible and protective associations of HLA DRB1*/DQB1* alleles and haplotypes with ischaemic stroke

Stroke has emerged as the second commonest cause of mortality worldwide and is a major public health problem. For the first time, we present here the association of human leucocyte antigen (HLA)‐DRB1*/DQB1* alleles and haplotypes with ischaemic stroke in South Indian patients. Ischaemic stroke (IS) cases and controls were genotyped for HLA‐DRB1*/DQB1* alleles by polymerase chain reaction sequence‐specific primers (PCR‐SSP) method. The frequencies of HLA class II alleles such as DRB1*04, DRB1*07, DRB1*11, DRB1*12, DRB1*13, DQB1*02 and DQB1*07 were high in IS patients than in the age‐ and gender‐matched controls, suggesting that the individuals with these alleles are susceptible to ischaemic stroke in South India. The frequencies of alleles such as DRB1*03, DRB1*10, DRB1*14, DQB1*04 and DQB1*05 were less in IS cases than in the controls, suggesting a protective association. Haplotypes DRB1*04‐DQB1*0301, DRB1*07‐DQB1*02, DRB1*07‐DQB1*0301, DRB1*11‐DQB1*0301 and DRB1*13‐DQB1*06 were found to be high in IS patients conferring susceptibility. The frequency of haplotype DRB1*10‐DQB1*05 was high in controls conferring protection. IS‐LVD and gender‐stratified analysis too confirmed these susceptible and protective associations. Thus, HLA‐DRB1*/DQB1* alleles and haplotypes strongly predispose South Indian population to ischaemic stroke. Further studies in different populations with large sample size or the meta‐analysis are needed to explain the exact mechanism of associations of HLA gene(s) with IS.     

Mesenchymal Stem Cell (MSCs) Therapy for Ischemic Heart Disease: A Promising Frontier

Although tremendous progress has been made in conventional treatment for ischemic heart disease, it still remains a major cause of death and disability. Cell-based therapeutics holds an exciting frontier of research for complete cardiac recuperation. The capacity of diverse stem and progenitor cells to stimulate cardiac renewal has been analysed, with promising results in both pre-clinical and clinical trials. Mesenchymal stem cells have been ascertained to have regenerative ability via a variety of mechanisms, including differentiation from the mesoderm lineage, immunomodulatory properties, and paracrine effects. Also, their availability, maintenance, and ability to replenish endogenous stem cell niches have rendered them suitable for front-line research. This review schemes to outline the use of mesenchymal stem cell therapeutics for ischemic heart disease, their characteristics, the potent mechanisms of mesenchymal stem cell-based heart regeneration, and highlight preclinical data. Additionally, we discuss the results of the clinical trials to date as well as ongoing clinical trials on ischemic heart disease.     

Serotonin and anaesthesia

Serotonin (5-hydroxytryptamine, 5-HT) is a monoamine neurotransmitter(Fig. 1) synthesized in serotonergic neurones in the centralnervous system (CNS), enterochromaffin cells in the gastrointestinaltract, and platelets. 5-HT is involved in a number of physiological systems of relevanceto the anaesthetist, including vascular reactivity, bronchomotortone, platelet aggregation, pain modulation, and nausea andvomiting. The exact sites and modes of action of 5-HT remainill-defined and elusive. Many patients presenting for anaesthesia are taking medicationswith 5-HT agonist or antagonist activity. There is the potentialfor interaction with drugs administered in the perioperativeperiod that modulate 5-HT activity. Toxic effects of excessiveCNS 5-HT concentrations can precipitate intensive care unit(ICU) admission.