Publisher: Medknow Publishers   (Total: 427 journals)

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Showing 1 - 200 of 427 Journals sorted alphabetically
Acta Medica Intl.     Open Access   (SJR: 0.101, CiteScore: 0)
Advanced Arab Academy of Audio-Vestibulogy J.     Open Access  
Advanced Biomedical Research     Open Access  
Advances in Human Biology     Open Access   (Followers: 5)
Advances in Skeletal Muscle Function Assessment     Open Access  
African J. for Infertility and Assisted Conception     Open Access   (Followers: 1)
African J. of Medical and Health Sciences     Open Access   (Followers: 3)
African J. of Paediatric Surgery     Open Access   (Followers: 7, SJR: 0.25, CiteScore: 1)
African J. of Trauma     Open Access   (Followers: 1)
Ain-Shams J. of Anaesthesiology     Open Access   (Followers: 2)
Al-Azhar Assiut Medical J.     Open Access   (Followers: 2)
Al-Basar Intl. J. of Ophthalmology     Open Access   (Followers: 1)
Alexandria J. of Pediatrics     Open Access   (Followers: 1)
Ancient Science of Life     Open Access   (Followers: 5)
Anesthesia : Essays and Researches     Open Access   (Followers: 10)
Annals of African Medicine     Open Access   (Followers: 2, SJR: 0.258, CiteScore: 1)
Annals of Bioanthropology     Open Access   (Followers: 5)
Annals of Cardiac Anaesthesia     Open Access   (Followers: 15, SJR: 0.308, CiteScore: 1)
Annals of Indian Academy of Neurology     Open Access   (Followers: 3, SJR: 0.434, CiteScore: 1)
Annals of Indian Academy of Otorhinolaryngology Head and Neck Surgery     Open Access  
Annals of Indian Psychiatry     Open Access  
Annals of Maxillofacial Surgery     Open Access   (Followers: 6)
Annals of Medical and Health Sciences Research     Open Access   (Followers: 7)
Annals of Nigerian Medicine     Open Access   (Followers: 1)
Annals of Pediatric Cardiology     Open Access   (Followers: 12, SJR: 0.352, CiteScore: 1)
Annals of Saudi Medicine     Open Access   (SJR: 0.238, CiteScore: 1)
Annals of Thoracic Medicine     Open Access   (Followers: 6, SJR: 0.524, CiteScore: 1)
Annals of Tropical Medicine and Public Health     Open Access   (Followers: 14, SJR: 0.152, CiteScore: 0)
Annals of Tropical Pathology     Open Access  
Apollo Medicine     Open Access  
APOS Trends in Orthodontics     Open Access   (Followers: 1)
Arab J. of Interventional Radiology     Open Access   (Followers: 1)
Archives of Cardiovascular Imaging     Open Access   (Followers: 2, SJR: 0.187, CiteScore: 0)
Archives of Intl. Surgery     Open Access   (Followers: 10, SJR: 0.302, CiteScore: 1)
Archives of Medicine and Health Sciences     Open Access   (Followers: 5)
Archives of Medicine and Surgery     Open Access   (Followers: 1)
Archives of Pharmacy Practice     Open Access   (Followers: 12, SJR: 0.102, CiteScore: 0)
Archives of Trauma Research     Open Access   (Followers: 4, SJR: 0.37, CiteScore: 2)
Asia Pacific J. of Clinical Trials : Nervous System Diseases     Open Access   (Followers: 1)
Asia-Pacific J. of Oncology Nursing     Open Access   (Followers: 5)
Asian J. of Andrology     Open Access   (Followers: 1, SJR: 0.856, CiteScore: 2)
Asian J. of Neurosurgery     Open Access   (Followers: 2)
Asian J. of Oncology     Open Access   (Followers: 2)
Asian J. of Transfusion Science     Open Access   (Followers: 1, SJR: 0.35, CiteScore: 1)
Asian Pacific J. of Reproduction     Open Access   (SJR: 0.227, CiteScore: 1)
Asian Pacific J. of Tropical Biomedicine     Open Access   (Followers: 2, SJR: 0.491, CiteScore: 2)
Asian Pacific J. of Tropical Medicine     Open Access   (Followers: 1, SJR: 0.561, CiteScore: 2)
Astrocyte     Open Access  
Avicenna J. of Medicine     Open Access   (Followers: 1)
AYU : An international quarterly journal of research in Ayurveda     Open Access   (Followers: 6)
Benha Medical J.     Open Access  
Biomedical and Biotechnology Research J.     Open Access   (Followers: 1)
BLDE University J. of Health Sciences     Open Access  
Brain Circulation     Open Access   (Followers: 1)
Bulletin of Faculty of Physical Therapy     Open Access   (Followers: 2)
Canadian J. of Rural Medicine     Full-text available via subscription   (Followers: 1, SJR: 0.202, CiteScore: 0)
Cancer Translational Medicine     Open Access   (Followers: 2)
Cardiology Plus     Open Access   (Followers: 1)
Chinese Medical J.     Open Access   (Followers: 10, SJR: 0.52, CiteScore: 1)
CHRISMED J. of Health and Research     Open Access   (Followers: 2)
Clinical Cancer Investigation J.     Open Access  
Clinical Dermatology Review     Open Access   (Followers: 5)
Clinical Trials in Degenerative Diseases     Open Access  
Clinical Trials in Orthopedic Disorders     Open Access   (Followers: 2)
Community Acquired Infection     Open Access  
Conservation and Society     Open Access   (Followers: 10, SJR: 0.811, CiteScore: 2)
Contemporary Clinical Dentistry     Open Access   (Followers: 5, SJR: 0.353, CiteScore: 1)
Current Medical Issues     Open Access   (Followers: 2)
CytoJ.     Open Access   (Followers: 3, SJR: 0.543, CiteScore: 1)
Delta J. of Ophthalmology     Open Access  
Dental Hypotheses     Open Access   (Followers: 5, SJR: 0.152, CiteScore: 0)
Dental Research J.     Open Access   (Followers: 14, SJR: 0.416, CiteScore: 1)
Dentistry and Medical Research     Open Access   (Followers: 1)
Digital Medicine     Open Access  
Drug Development and Therapeutics     Open Access  
Education for Health     Open Access   (Followers: 8, SJR: 0.242, CiteScore: 0)
Education in the Health Professions     Open Access   (Followers: 2)
Egyptian J. of Bronchology     Open Access  
Egyptian J. of Cardiothoracic Anesthesia     Open Access  
Egyptian J. of Cataract and Refractive Surgery     Open Access   (Followers: 1, SJR: 1.799, CiteScore: 2)
Egyptian J. of Chest Diseases and Tuberculosis     Open Access   (Followers: 3, SJR: 0.155, CiteScore: 0)
Egyptian J. of Dermatology and Venerology     Open Access   (Followers: 1)
Egyptian J. of Haematology     Open Access   (Followers: 1)
Egyptian J. of Internal Medicine     Open Access   (Followers: 1)
Egyptian J. of Obesity, Diabetes and Endocrinology     Open Access   (Followers: 1)
Egyptian J. of Otolaryngology     Open Access   (Followers: 2)
Egyptian J. of Psychiatry     Open Access   (Followers: 1)
Egyptian J. of Surgery     Open Access   (Followers: 1)
Egyptian Nursing J.     Open Access  
Egyptian Orthopaedic J.     Open Access   (Followers: 2)
Egyptian Pharmaceutical J.     Open Access   (Followers: 3)
Egyptian Retina J.     Open Access  
Egyptian Rheumatology and Rehabilitation     Open Access   (Followers: 2)
Endodontology     Open Access  
Endoscopic Ultrasound     Open Access   (SJR: 0.822, CiteScore: 2)
Environmental Disease     Open Access   (Followers: 4)
Eurasian J. of Pulmonology     Open Access  
European J. of Dentistry     Open Access   (Followers: 4, SJR: 0.749, CiteScore: 2)
European J. of General Dentistry     Open Access   (Followers: 2, SJR: 0.12, CiteScore: 0)
European J. of Prosthodontics     Open Access   (Followers: 4)
European J. of Psychology and Educational Studies     Open Access   (Followers: 11, SJR: 0.113, CiteScore: 0)
Fertility Science and Research     Open Access  
Formosan J. of Surgery     Open Access   (SJR: 0.112, CiteScore: 0)
Genome Integrity     Open Access   (Followers: 2, SJR: 0.153, CiteScore: 0)
Glioma     Open Access  
Global J. of Transfusion Medicine     Open Access   (Followers: 1)
Gynecology and Minimally Invasive Therapy     Open Access   (SJR: 0.311, CiteScore: 1)
Hamdan Medical J.     Open Access  
Heart and Mind     Open Access  
Heart India     Open Access   (Followers: 2)
Heart Views     Open Access   (Followers: 2)
Hepatitis B Annual     Open Access   (Followers: 3)
Ibnosina J. of Medicine and Biomedical Sciences     Open Access   (Followers: 1)
IJS Short Reports     Open Access  
Imam J. of Applied Sciences     Open Access  
Indian Dermatology Online J.     Open Access   (Followers: 3)
Indian J. of Allergy, Asthma and Immunology     Open Access   (Followers: 1)
Indian J. of Anaesthesia     Open Access   (Followers: 7, SJR: 0.478, CiteScore: 1)
Indian J. of Burns     Open Access   (Followers: 3)
Indian J. of Cancer     Open Access   (Followers: 1, SJR: 0.361, CiteScore: 1)
Indian J. of Cerebral Palsy     Open Access   (Followers: 1)
Indian J. of Community Medicine     Open Access   (Followers: 2, SJR: 0.37, CiteScore: 1)
Indian J. of Dental Research     Open Access   (Followers: 5, SJR: 0.266, CiteScore: 1)
Indian J. of Dental Sciences     Open Access  
Indian J. of Dentistry     Open Access   (Followers: 1)
Indian J. of Dermatology     Open Access   (Followers: 2, SJR: 0.468, CiteScore: 1)
Indian J. of Dermatology, Venereology and Leprology     Open Access   (Followers: 4, SJR: 0.445, CiteScore: 1)
Indian J. of Dermatopathology and Diagnostic Dermatology     Open Access  
Indian J. of Drugs in Dermatology     Open Access   (Followers: 1, SJR: 0.791, CiteScore: 1)
Indian J. of Endocrinology and Metabolism     Open Access   (Followers: 4, SJR: 0.568, CiteScore: 1)
Indian J. of Health Sciences and Biomedical Research KLEU     Open Access   (Followers: 3)
Indian J. of Medical and Paediatric Oncology     Open Access   (SJR: 0.425, CiteScore: 1)
Indian J. of Medical Microbiology     Open Access   (Followers: 2, SJR: 0.503, CiteScore: 1)
Indian J. of Medical Research     Open Access   (Followers: 4, SJR: 0.656, CiteScore: 1)
Indian J. of Medical Sciences     Open Access   (Followers: 3, SJR: 0.102, CiteScore: 0)
Indian J. of Multidisciplinary Dentistry     Open Access   (Followers: 1)
Indian J. of Nephrology     Open Access   (Followers: 2, SJR: 0.347, CiteScore: 1)
Indian J. of Nuclear Medicine     Open Access   (Followers: 2, SJR: 0.23, CiteScore: 0)
Indian J. of Occupational and Environmental Medicine     Open Access   (Followers: 3, SJR: 0.225, CiteScore: 1)
Indian J. of Ophthalmology     Open Access   (Followers: 5, SJR: 0.498, CiteScore: 1)
Indian J. of Oral Health and Research     Open Access  
Indian J. of Oral Sciences     Open Access   (Followers: 1)
Indian J. of Orthopaedics     Open Access   (Followers: 8, SJR: 0.392, CiteScore: 1)
Indian J. of Otology     Open Access   (Followers: 1, SJR: 0.199, CiteScore: 0)
Indian J. of Paediatric Dermatology     Open Access   (Followers: 2)
Indian J. of Pain     Open Access   (Followers: 2)
Indian J. of Palliative Care     Open Access   (Followers: 8, SJR: 0.454, CiteScore: 1)
Indian J. of Pathology and Microbiology     Open Access   (Followers: 4, SJR: 0.276, CiteScore: 1)
Indian J. of Pharmacology     Open Access   (SJR: 0.412, CiteScore: 1)
Indian J. of Psychiatry     Open Access   (Followers: 2, SJR: 0.408, CiteScore: 1)
Indian J. of Psychological Medicine     Open Access   (SJR: 0.368, CiteScore: 1)
Indian J. of Public Health     Open Access   (Followers: 1)
Indian J. of Radiology and Imaging     Open Access   (Followers: 5)
Indian J. of Research in Homoeopathy     Open Access   (Followers: 2)
Indian J. of Respiratory Care     Open Access   (Followers: 3)
Indian J. of Rheumatology     Open Access   (Followers: 1, SJR: 0.119, CiteScore: 0)
Indian J. of Sexually Transmitted Diseases and AIDS     Open Access   (Followers: 2, SJR: 0.34, CiteScore: 0)
Indian J. of Social Psychiatry     Open Access   (Followers: 1)
Indian J. of Transplantation     Open Access  
Indian J. of Urology     Open Access   (Followers: 5, SJR: 0.434, CiteScore: 1)
Indian J. of Vascular and Endovascular Surgery     Open Access   (Followers: 2)
Indian Spine J.     Open Access  
Industrial Psychiatry J.     Open Access   (Followers: 2)
Intervention     Open Access   (Followers: 2)
Intl. Archives of Health Sciences     Open Access  
Intl. J. of Abdominal Wall and Hernia Surgery     Open Access   (Followers: 1)
Intl. J. of Academic Medicine     Open Access  
Intl. J. of Advanced Medical and Health Research     Open Access  
Intl. J. of Applied and Basic Medical Research     Open Access  
Intl. J. of Clinical and Experimental Physiology     Open Access   (Followers: 1)
Intl. J. of Clinicopathological Correlation     Open Access   (Followers: 1)
Intl. J. of Community Dentistry     Open Access  
Intl. J. of Critical Illness and Injury Science     Open Access   (Followers: 1, SJR: 0.192, CiteScore: 0)
Intl. J. of Educational and Psychological Researches     Open Access   (Followers: 4)
Intl. J. of Environmental Health Engineering     Open Access   (Followers: 1)
Intl. J. of Forensic Odontology     Open Access   (Followers: 1)
Intl. J. of Green Pharmacy     Open Access   (Followers: 8, SJR: 0.142, CiteScore: 0)
Intl. J. of Growth Factors and Stem Cells in Dentistry     Open Access  
Intl. J. of Health & Allied Sciences     Open Access   (Followers: 3)
Intl. J. of Health System and Disaster Management     Open Access   (Followers: 3)
Intl. J. of Heart Rhythm     Open Access  
Intl. J. of Medicine and Public Health     Open Access   (Followers: 6)
Intl. J. of Mycobacteriology     Open Access   (SJR: 0.535, CiteScore: 1)
Intl. J. of Noncommunicable Diseases     Open Access  
Intl. J. of Nutrition, Pharmacology, Neurological Diseases     Open Access   (Followers: 4, SJR: 0.17, CiteScore: 0)
Intl. J. of Oral Health Sciences     Open Access   (Followers: 3)
Intl. J. of Orofacial Biology     Open Access   (Followers: 1)
Intl. J. of Orofacial Research     Open Access   (Followers: 2)
Intl. J. of Orthodontic Rehabilitation     Open Access   (Followers: 2)
Intl. J. of Pedodontic Rehabilitation     Open Access  
Intl. J. of Pharmaceutical Investigation     Open Access   (Followers: 2)
Intl. J. of Preventive Medicine     Open Access   (Followers: 1, SJR: 0.623, CiteScore: 1)
Intl. J. of Shoulder Surgery     Open Access   (Followers: 5, SJR: 0.653, CiteScore: 1)
Intl. J. of the Cardiovascular Academy     Open Access   (SJR: 0.105, CiteScore: 0)
Intl. J. of Trichology     Open Access   (SJR: 0.4, CiteScore: 1)
Intl. J. of Yoga     Open Access   (Followers: 16)
Intl. J. of Yoga : Philosophy, Psychology and Parapsychology     Open Access   (Followers: 7)
Iranian J. of Nursing and Midwifery Research     Open Access   (Followers: 3)
Iraqi J. of Hematology     Open Access  
J. of Academy of Medical Sciences     Open Access  

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Similar Journals
Journal Cover
Indian Journal of Rheumatology
Journal Prestige (SJR): 0.119
Number of Followers: 1  

  This is an Open Access Journal Open Access journal
ISSN (Print) 0973-3698 - ISSN (Online) 0973-3701
Published by Medknow Publishers Homepage  [427 journals]
  • Interleukin-6 and other cytokine blockade in COVID-19 hyperinflammation

    • Authors: Latika Gupta, Vikas Agarwal, Athimalaipet V Ramanan
      Pages: 65 - 69
      Abstract: Latika Gupta, Vikas Agarwal, Athimalaipet V Ramanan
      Indian Journal of Rheumatology 2020 15(2):65-69

      Citation: Indian Journal of Rheumatology 2020 15(2):65-69
      PubDate: Fri,29 May 2020
      DOI: 10.4103/injr.injr_64_20
      Issue No: Vol. 15, No. 2 (2020)
       
  • COVID-19: An update on vaccine development

    • Authors: Deepak Tripathi, Guohua Yi, Ramakrishna Vankayalapati
      Pages: 70 - 72
      Abstract: Deepak Tripathi, Guohua Yi, Ramakrishna Vankayalapati
      Indian Journal of Rheumatology 2020 15(2):70-72

      Citation: Indian Journal of Rheumatology 2020 15(2):70-72
      PubDate: Fri,29 May 2020
      DOI: 10.4103/0973-3698.285394
      Issue No: Vol. 15, No. 2 (2020)
       
  • Impact of ultrasonography-detected pes anserine bursitis on pain and
           function in patients with primary knee osteoarthritis

    • Authors: Mohamed Mortada, Yomna A Amer, Rabab S Zaghlol
      Pages: 73 - 78
      Abstract: Mohamed Mortada, Yomna A Amer, Rabab S Zaghlol
      Indian Journal of Rheumatology 2020 15(2):73-78
      Background: Pes anserine bursitis (PAB) is one of the most common causes of knee pain. Hence, this study aimed to compare the pain and function among all primary knee osteoarthritis (KOA) patients with or without ultrasonic-detected PAB and the associated clinical and radiological findings.Methods: A single-center cross-sectional study was conducted on 245 patients with primary KOA. The more symptomatic knee examined with musculoskeletal ultrasound (MSUS), were then categorized into two groups according to the presence of PAB; PAB was graded from 0 to 2 on a semi-quantitative scale. Radiological grades of Kellgren–Lawrence were recorded. Pain and functional status was assessed by visual analog scale (VAS), Health Assessment Questionnaire-II (HAQ-II), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC).Results: A total of 110 (44.9%) patients were diagnosed with PAB where 91 (82.7%) of them had Grade 1 and only 19 (17.3%) had Grade 2. The presence of PAB was statistically significant related (P < 0.05*) with age, VAS, HAQ-II, WOMAC subscales, synovitis, and radiographic Grades 3 and 4. However, there was no statistically significant difference (P ≥ 0.05) between KOA patients without PAB and KOA patients with PAB, regarding sex, body mass index, Baker cyst, and effusion.Conclusion: The presence of PAB on MUS is associated with increased pain and disability in KOA. MSUS should be more widely used to establish the association between PAB and symptom severity and disability among KOA patients.
      Citation: Indian Journal of Rheumatology 2020 15(2):73-78
      PubDate: Fri,29 May 2020
      DOI: 10.4103/injr.injr_185_19
      Issue No: Vol. 15, No. 2 (2020)
       
  • Prevalence of thyroid dysfunction in patients with systemic lupus
           erythematosus: A descriptive cross sectional study

    • Authors: Anasuya S Desai, Sara Chandy, Shine J Pakalomattom, Vineeta Shobha
      Pages: 79 - 83
      Abstract: Anasuya S Desai, Sara Chandy, Shine J Pakalomattom, Vineeta Shobha
      Indian Journal of Rheumatology 2020 15(2):79-83
      Background: Estimate of prevalence of thyroid dysfunction in systemic lupus erythematosus (SLE) patients from India is scarce. The present study evaluated the prevalence of thyroid dysfunction and anti-thyroid peroxidase (TPO) antibodies in SLE patients, and the most prominent clinical features of thyroid dysfunction were noted.Materials and Methods: This descriptive, cross-sectional study involved 100 adult patients diagnosed with SLE at a tertiary teaching hospital, Bengaluru, India. The study excluded patients on medications that are known to cause thyroid dysfunctions, those with a history of thyroidectomy, and those with other systemic autoimmune diseases.Results: Among the 100 recruited patients, 99 were females, and most (47%) belonged to the age group of 20–30 years, the median duration of lupus was 24 months. Thyroid dysfunction was observed in 42% (n = 42), and hypothyroidism was the most common thyroid abnormality. None of the patients had hyperthyroidism. Among the patients with thyroid dysfunction, the corresponding number of patients with clinical hypothyroidism and subclinical hypothyroidism were 71% (n = 30) and 29% (n = 12). Of 25 patients with elevated anti-TPO, 48% (n = 12) had clinical hypothyroidism, 20% (n = 5) had subclinical hypothyroidism, and 32% (n = 8) had normal thyroid-stimulating hormone and free T4. Most of the patients with thyroid dysfunction were newly diagnosed, and the predominant symptoms noted were fatigue (75%), hair loss (75%), and joint pain (63%).Conclusions: The prevalence of thyroid dysfunction was found to be higher in SLE than previously published cohorts in India and the rest of the world. It does not affect lupus activity.
      Citation: Indian Journal of Rheumatology 2020 15(2):79-83
      PubDate: Fri,29 May 2020
      DOI: 10.4103/injr.injr_165_19
      Issue No: Vol. 15, No. 2 (2020)
       
  • Impact of obesity on leptin, leptin receptor gene polymorphism, and some
           adipokines in egyptian patients with knee osteoarthritis

    • Authors: Adel A H. Abdel-Rahman, Hala E Hamouda, Ibrahim F Zeid, Amal M El-Barbary, Aya A Al-Ashwah
      Pages: 84 - 91
      Abstract: Adel A H. Abdel-Rahman, Hala E Hamouda, Ibrahim F Zeid, Amal M El-Barbary, Aya A Al-Ashwah
      Indian Journal of Rheumatology 2020 15(2):84-91
      Aim: The aim of this study was to investigate the role of leptin receptor (LEPR) gene polymorphism and adipokines in the pathogenesis of knee osteoarthritis (OA) in Egyptian female patients.Materials and Methods: Ninety-five Egyptian females were classified into three groups: group I (control): 32 healthy females, Group II: included 30 non obese knee osteoarthritic patients and Group III: included 33 obese knee osteoarthritic patients. Genotyping of rs1137101 at LEPR gene was analyzed using allelic discrimination assay by real-time polymerase chain reaction technique, and then, adipokines and nitric oxide (NO) levels were measured.Results: The frequency of GG genotype was found to be significantly higher in Group III when compared to Group II and controls (26% to 4%, 1%) (P < 0.001), while AA genotype was the most frequent in the control group (75%) (P < 0.001). rs1137101 was correlated with knee OA in the dominant genetic model (GG + GA vs. AA) in Group II (odds ratio = 8, 95% CI [2.6–24.2], P <.001). Moreover, there was a significant increase in serum levels of leptin, resistin, and NO with a concomitant decrease in adiponectin level in Group III as compared to the other two groups confirming the role of these adipokines in OA.Conclusion: Our findings suggested that the genetic variation in rs1137101 is involved in the pathogenesis of both obesity and knee OA in Egyptian female patients. In addition, it seems that adipokines and oxidative stress are important factors linking obesity, adiposity, and inflammation in OA.
      Citation: Indian Journal of Rheumatology 2020 15(2):84-91
      PubDate: Fri,29 May 2020
      DOI: 10.4103/injr.injr_71_19
      Issue No: Vol. 15, No. 2 (2020)
       
  • Rheumatology practice and training in India – A perspective from
           rheumatology consultants

    • Authors: Durga Prasanna Misra, Vinod Ravindran, Aman Sharma, Anupam Wakhlu, Vir Singh Negi, Ved Chaturvedi, Vikas Agarwal
      Pages: 92 - 99
      Abstract: Durga Prasanna Misra, Vinod Ravindran, Aman Sharma, Anupam Wakhlu, Vir Singh Negi, Ved Chaturvedi, Vikas Agarwal
      Indian Journal of Rheumatology 2020 15(2):92-99
      Background: We surveyed rheumatology consultants regarding their perceptions about rheumatology practice and training in India.Materials and Methods: A structured questionnaire was administered during two national rheumatology meetings to evaluate practice settings and demographic characteristics of patients seen. We also assessed perceptions regarding junior doctors, auxiliary health professionals (AHPs), ancillary facilities (daycare, intra-articular injections, musculoskeletal ultrasound [MSKUS]), and possible government-driven strategies for improving rheumatology care delivery.Results: The response rate was 56% (70/125); 68 complete responses were further analyzed. Most respondents were in the private sector (56/68), had been in practice for a mean of 11.5 (±8.4) years, attended to a mean of 150 (±91) patients every week, a majority of whom were educated upto intermediate level and belonged to the middle class. About 60% had junior doctors to assist them in care delivery; 82.5% (52/63) felt that junior doctors had limited competence in managing rheumatic diseases. More than 90% felt the need for AHPs in the clinic, although less than one-half had access to such personnel. Most utilized ancillary services like intra-articular injections (97%), daycare facilities for infusions (92%), and MSKUS (71%). More than 90% respondents felt that government-funded programs for the management of rheumatic diseases, coupled with a structured referral system, would be useful.Conclusion: Rheumatology practice in India may improve by better training junior doctors in skills related to rheumatology at the undergraduate and postgraduate internal medicine levels. The development of specialist AHPs may help enhance service delivery. Government programs for community management of rheumatic diseases and management guidelines suited to the needs of a developing economy majorly reliant on out-of-pocket expenditure for healthcare are significant areas for development.
      Citation: Indian Journal of Rheumatology 2020 15(2):92-99
      PubDate: Fri,29 May 2020
      DOI: 10.4103/injr.injr_42_20
      Issue No: Vol. 15, No. 2 (2020)
       
  • End of induction treatment outcomes with a novel cyclophosphamide-based
           regimen for severe lupus nephritis: Single-center experience from South
           India

    • Authors: V Jayaprakash, T Dineshkumar, J Dhanapriya, D Rajasekar, R Sakthirajan, T Balasubramaniyan, Anila A Kurien, N Gopalakrishnan
      Pages: 100 - 105
      Abstract: V Jayaprakash, T Dineshkumar, J Dhanapriya, D Rajasekar, R Sakthirajan, T Balasubramaniyan, Anila A Kurien, N Gopalakrishnan
      Indian Journal of Rheumatology 2020 15(2):100-105
      Background: Cyclophosphamide is commonly used along with pulse steroids for induction immunosuppression treatment of severe forms of lupus nephritis (LN). Renal outcome data for proliferative forms of LN treated with cyclophosphamide from the southern parts of Indian subcontinent are sparse.Subjects and Methods: It was an observational study done for 2 years. All patients with severe proliferative forms of LN were included. They were treated with fixed monthly single doses of 500 mg intravenous cyclophosphamide-based induction therapy along with pulse and oral steroids, as per protocol. Renal remission rates were assessed at the end of 6 months. Adverse events during the induction therapy were documented.Results: The study included 41 patients. Of them, 37 (90.24%) patients were female and 4 (9.75%) patients were male. Nephrotic syndrome was the most common renal presentation (53.66%). The most common histological class was Class IV A (75.61%). At the end of induction therapy, complete renal remission occurred in 31.7% of cases and partial remission in 34.14% of cases. Infections were the most common adverse events that occurred in 48.4% of cases.Conclusions: Renal remission was observed in 65.85% of cases. Fixed low-dose cyclophosphamide-based induction can also be given over a 6-month period. Younger age was a significant risk factor for poor renal outcomes. Failure to achieve renal remission was a risk factor for mortality.
      Citation: Indian Journal of Rheumatology 2020 15(2):100-105
      PubDate: Fri,29 May 2020
      DOI: 10.4103/injr.injr_160_19
      Issue No: Vol. 15, No. 2 (2020)
       
  • High-resolution esophageal manometry in systemic sclerosis in the indian
           population: An observational study

    • Authors: S Kartik, Dharmendra Kumar, Gaurav Sikri, Deepanjan Dey, AB Srinivasa, Binit Kumar
      Pages: 106 - 110
      Abstract: S Kartik, Dharmendra Kumar, Gaurav Sikri, Deepanjan Dey, AB Srinivasa, Binit Kumar
      Indian Journal of Rheumatology 2020 15(2):106-110
      Background: Systemic sclerosis (SSc) is a rare multisystemic autoimmune disorder in which the esophagus is the second most common organ to be affected after the skin, leading to dysmotility. Literature available on esophageal dysmotility in SSc is limited. Moreover, studies explaining the spectrum of esophageal dysmotility in the disease in the Indian population are sparse.Aim: The aim of this study was to characterize esophageal motility disorders in SSc using esophageal high-resolution manometry (HRM) in a representative of the Southwestern Indian population.Methods: Thirty-two SSc patients participated in the study. All of them met the inclusion and exclusion criteria and underwent esophageal HRM at the Gastrointestinal Physiology Laboratory, Department of Physiology, of our center. The findings were interpreted using the Chicago Classification v3.0 criteria.Results: Among patients of SSc with a mean age of 42.25 ± 10.45 years, 19 (59.38%) had “absent contractility (AC),” 3 (9.38%) had “ineffective esophageal motility (IEM),” 3 (9.38%) had “type I achalasia, 1 (3.13%) had “esophagogastric junction outflow obstruction,” and 6 (18.75%) had “normal” HRM findings. The HRM parameter of “basal lower esophageal sphincter pressure” differed significantly between “IEM type I achalasia” (P = 0.043) and “type I achalasia AC” groups (P = 0.032), while “median integral relaxation pressure” of “type I achalasia” groups showed significant difference with “normal, IEM, and AC” groups each (P < 0.001).Conclusions: The findings of the study suggest that varying degrees of esophageal motility disorders are present in SSc using HRM as defined by the Chicago Classification v3.0. Majority (59.38%) of patients had AC, but the rest of them showed other dysmotility patterns.
      Citation: Indian Journal of Rheumatology 2020 15(2):106-110
      PubDate: Fri,29 May 2020
      DOI: 10.4103/injr.injr_53_19
      Issue No: Vol. 15, No. 2 (2020)
       
  • Assessment of liver fibrosis by acoustic radiation force impulse
           elastography in rheumatic disease patients on long-term methotrexate
           treatment

    • Authors: Arindam Nandy Roy, Gayatri Senapathy, Vijay Kumar Bongu, Yarram Ashok Kumar, Syeda Sana Fatima, Regina Lata Thadigiri
      Pages: 111 - 115
      Abstract: Arindam Nandy Roy, Gayatri Senapathy, Vijay Kumar Bongu, Yarram Ashok Kumar, Syeda Sana Fatima, Regina Lata Thadigiri
      Indian Journal of Rheumatology 2020 15(2):111-115
      Background: Methotrexate treatment has been associated with liver fibrosis in patients with rheumatic disease. Liver biopsy has been the gold standard for staging liver fibrosis. Acoustic Radiation Force Impulse (ARFI) imaging is a new accurate, non-invasive method for staging liver fibrosis. Till date, no study has been conducted to evaluate the diagnostic value of ARFI in patients with rheumatic disease undergoing methotrexate treatment.Study Objective: To assess the degree of liver fibrosis with non-invasive ARFI and to compare the findings with the biochemical parameters in rheumatic disease patients taking methotrexate for long duration.Study Method: We reviewed the medical records of rheumatoid arthritis patients who were administered methotrexate for more than 2 years. A total of 151 patients with rheumatic disease, aged ≥ 18 years were enrolled into the study. In addition, 24 healthy subjects (controls) were recruited to compare the ARFI values with that of patients with rheumatic disease. On the day of the ARFI examination, a series of biochemical parameters were also assessed in the patient group. Pre-defined cut-off ARFI values were used to assess the stage of liver disease.Results: The mean ARFI value in the patient group was 1.14. The mean ARFI values of different rheumatic disease patients were 1.13 (0.0), 1.26 (0.19), 1.16 (0.15), 0.945 (0.21) for Rhupus, rheumatoid arthritis, psoriatic arthritis and Sjogren's syndrome, respectively. Biochemical abnormalities (ALT/AST) were seen in 33 (21.85%) patients. Three patients had ARFI abnormalities (1: cirrhosis and 2: early stage fibrosis). There was no correlation between the ARFI values / biochemical parameters and the cumulative dose of methotrexate. However, the ARFI values correlated with the aspartate aminotransferase (AST), alanine aminotransferase (ALT) and AST to platelet ratio index. Liver fibrosis is rare in rheumatoid arthritis patients treated with a high cumulative dose of methotrexate, and is not accurately detected in patients with liver enzyme abnormalities.Conclusion: Considering the risk and benefit ratio of liver biopsy, ARFI may be a useful non- invasive diagnostic tool for the monitoring hepatic toxicity in patients with rheumatic disease undergoing methotrexate treatment.
      Citation: Indian Journal of Rheumatology 2020 15(2):111-115
      PubDate: Fri,29 May 2020
      DOI: 10.4103/injr.injr_155_19
      Issue No: Vol. 15, No. 2 (2020)
       
  • Clinical Outcomes in Patients with Cardiac Lupus: A Retrospective Study

    • Authors: K Maria Koshy, Tarun George, Sohini Das, JV Punitha, Sudha Jasmine Rajan, Bijesh Yadav, Thambu David Sudarsanam, Vijay Prakash Turaka
      Pages: 116 - 121
      Abstract: K Maria Koshy, Tarun George, Sohini Das, JV Punitha, Sudha Jasmine Rajan, Bijesh Yadav, Thambu David Sudarsanam, Vijay Prakash Turaka
      Indian Journal of Rheumatology 2020 15(2):116-121
      Objectives: Systemic lupus erythematosus (SLE) is an autoimmune disease that can affect every organ system. The study aimed to analyze the clinical manifestations, laboratory findings, antibody associations, and clinical outcomes of patients with cardiac lupus.Materials and Methods: Biomedical records of patients admitted during 2014–2017 who had a diagnosis of SLE were reviewed. Using predetermined inclusion criteria patients with cardiac lupus were identified. Disease manifestations, antibody associations, and clinical outcomes were studied. The Cox proportional hazards model was used to study factors associated with mortality.Results: Over a 3-year period, a total of 372 were admitted with a diagnosis of SLE, out of which 59 patients with cardiac lupus were identified. The patients were predominantly female (86.4%), fever and breathlessness were most common symptoms and the median SLE disease activity index score was 18. Myocardial disease (66.1%), pericardial disease (30.5%), and pulmonary artery hypertension (23.7%) were the most common cardiac manifestations. The mean ejection fraction was 46% ±11.4% with left ventricular systolic dysfunction present in 65.5% (n = 36). The inpatient mortality rate was 22% (n = 13). An elevated serum creatinine, elevated creatine Kinase–muscle/brain, neutrophilic leukocytosis, left ventricular systolic dysfunction, noninitiation of hydroxychloroquine, and the presence of neuropsychiatric lupus predicted mortality. On follow-up, 12 of the 13 echocardiograms demonstrated normal findings.Conclusion: Cardiac disease affects a significant proportion of patients with lupus. A high mortality rate as evident from this study, highlights the importance of recognizing the cardiac complications of SLE. Clinicians should diligently search for the same, as early interventions could reduce mortality and morbidity.
      Citation: Indian Journal of Rheumatology 2020 15(2):116-121
      PubDate: Fri,29 May 2020
      DOI: 10.4103/injr.injr_127_19
      Issue No: Vol. 15, No. 2 (2020)
       
  • Coronavirus disease-19 and rheumatological disorders: A narrative review

    • Authors: Arghya Chattopadhyay, Debashish Mishra, Vikas Sharma, G SRSN K Naidu, Aman Sharma
      Pages: 122 - 129
      Abstract: Arghya Chattopadhyay, Debashish Mishra, Vikas Sharma, G SRSN K Naidu, Aman Sharma
      Indian Journal of Rheumatology 2020 15(2):122-129
      The global spread of coronavirus disease-19 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2, which originated from Wuhan, China, is likely to have an impact on the rheumatological practices due to a dilemma in both continuing and initiating immunosuppressive medications. We reviewed the risk stratification of patients with rheumatological disorders, the safety of various anti-rheumatological drugs, and the role of multiple drugs used by the rheumatologists in managing COVID-19. The score-based risk stratification is helpful in therapeutic decision-making such as self-isolation, continuation, or initiation of immunosuppressive therapy. Most of the immunosuppressive therapies need not be discontinued unless there is an overwhelming infection. The treatment interruption should not be made in fear, and there should be shared decision-making in consultation with the patient. The proposed role of different anti-rheumatic drugs such as hydroxychloroquine and tocilizumab in COVID-19 based on some initial uncontrolled trials and case reports will become clearer when the results of various ongoing well-planned studies become available.
      Citation: Indian Journal of Rheumatology 2020 15(2):122-129
      PubDate: Fri,29 May 2020
      DOI: 10.4103/injr.injr_73_20
      Issue No: Vol. 15, No. 2 (2020)
       
  • Tuberculosis is a significant problem in children on biologics for
           rheumatic illnesses: Results from a survey conducted among practicing
           rheumatologists in India

    • Authors: G Chengappa Kavadichanda, Latika Gupta, Suma Balan
      Pages: 130 - 133
      Abstract: G Chengappa Kavadichanda, Latika Gupta, Suma Balan
      Indian Journal of Rheumatology 2020 15(2):130-133
      Background: India is endemic for tuberculosis (TB) and the use of immunosuppressants is likely to accentuate the problem. Whilst steroids and conventional disease modifying anti-rheumatic drugs (DMARDs) are believed to increase the risk for tuberculosis, certain biologics such as B cell depleting agents and Interleukin-17 inhibitors are not perceived in the same light. Thus, an attempt was made to capture physicians' perspectives and patterns of biologic DMARDs use in paediatric rheumatology as well as their experience with the occurrence of Tuberculosis in children with rheumatic and musculoskeletal diseases (RMD). Methods: An electronic survey developed on an online cloud-based website (Survey Monkey®) was served to physicians practicing rheumatology in India. Eligible participants (physicians practicing rheumatology) had a week to voluntarily complete the three-minute long questionnaire. While factual set explored observations, opinion set of questions graded perspectives using the Likert scale. Descriptive statistics and figures were obtained from surveymonkey.com. Results: Of the 52 respondents, most of whom were practicing rheumatologists (86.5%), 23 (44.2%) recalled the occurrence of TB after starting biologics. Of these, 13 (25%) encountered this situation in more than one patient. Extra-pulmonary forms of TB were more common (26 of 42, 61.9%), though TB was reported more often while the patient was on biologics than after discontinuing them (n=20 versus 8). Screening strategies varied, with Mantoux, interferon gamma release assay and chest radiographs being used together by most (21, 40%) physicians. Nineteen (52.8%) believed that TB in this setting required longer therapy while 7 (20%) thought adverse drug effects were seen often. Equal number of respondents thought that TB induced diosease flares. Conclusion: TB occurs often in children with RMDs treated with bDMARDs in India. Extra-pulmonary forms are more common and consensus on screening strategies poor. Amongst physicians, there is a perceived risk of prolonged anti-tubercular therapy and adverse drug effects though not of disease flares induced by TB.
      Citation: Indian Journal of Rheumatology 2020 15(2):130-133
      PubDate: Fri,29 May 2020
      DOI: 10.4103/injr.injr_191_19
      Issue No: Vol. 15, No. 2 (2020)
       
  • Effect of repetitive transcranial magnetic stimulation in male patients of
           fibromyalgia

    • Authors: Vikas Kumar Tiwari, Srishti Nanda, Suvercha Arya, Uma Kumar, Renu Bhatia
      Pages: 134 - 140
      Abstract: Vikas Kumar Tiwari, Srishti Nanda, Suvercha Arya, Uma Kumar, Renu Bhatia
      Indian Journal of Rheumatology 2020 15(2):134-140
      Male patients with fibromyalgia are a rarely studied population, yet they remain refractory to conventional medication. Here, we report the effect of repetitive transcranial magnetic stimulation (rTMS) on pain status in four male patients (aged 40.3 ± 8.49 years, right-handed) with fibromyalgia. It was found that the pain intensity reported at baseline was 6.50 ± 1.29 on the 11-point numerical pain rating scale that changed to 2.00 ± 1.15 posttherapy. Minor headache was noted in the 1st week of the therapy. rTMS could be beneficial for pain relief in male patients with fibromyalgia. Future investigations may focus on investigating more treatment options, such as rTMS, for male patients with fibromyalgia.
      Citation: Indian Journal of Rheumatology 2020 15(2):134-140
      PubDate: Fri,29 May 2020
      DOI: 10.4103/injr.injr_163_19
      Issue No: Vol. 15, No. 2 (2020)
       
  • Immunoglobulin G4-related disease, constitutional symptoms, human
           leukocyte antigen b27 positivity, and sacroiliitis

    • Authors: Shallu Verma, Lubna Khurshid, Prasad Rao Voleti, Anand Narayan Malaviya
      Pages: 141 - 144
      Abstract: Shallu Verma, Lubna Khurshid, Prasad Rao Voleti, Anand Narayan Malaviya
      Indian Journal of Rheumatology 2020 15(2):141-144
      IgG4-related disease (IgG4-RD) is a relatively new clinical entity with protean manifestations that pose diagnostic difficulties especially so if the clinical features are atypical. Here we present a 55-year-old man with back-buttock pains, a knee and ankle arthritis with moderately severe constitutional symptoms. The acute phase reactants were high, and the test for HLA B27 was positive. Spondyloarthritis (SpA) was suspected but, because of the symptom-onset >45 years of age, infection and malignancy were also considered. Detailed investigations including a whole-body positron-emission tomography (PET) scan that showed hypermetabolic soft tissue thickening in the periaortic recess and at the base of the heart encasing root and ascending aorta. Fluorodeoxyglucose (FDG) uptake was also seen in the peripheral zones of the prostate, bilateral, parotid nodes, and in the right sacroiliac joint. A biopsy of the parotid gland nodule confirmed the diagnosis of IgG4-RD. The presence of features of inflammatory back-buttock pains, lower extremity oligoarthritis, good relief to non-steroidal anti-inflammatory drugs (NSAIDs), presence of HLA B27, and an acute involvement of the right sacroiliac joint were typical of spondyloarthritis. However, the moderately severe constitutional symptoms were not typical of SpA. Thus, this patient had both the IgG4-RD as well as SpA. Was the presence of HLA B27 incidental and the sacroiliitis was due to the infiltration of IgG4 cells or, he had true SpA with sacroiliitis and the IgG4 cell infiltration was incidental? This issue has been discussed in depth.
      Citation: Indian Journal of Rheumatology 2020 15(2):141-144
      PubDate: Fri,29 May 2020
      DOI: 10.4103/injr.injr_1_20
      Issue No: Vol. 15, No. 2 (2020)
       
  • Scurvy presenting as unilateral knee joint contracture

    • Authors: Harikrishnan Bhaskaran, Suma Balan
      Pages: 145 - 146
      Abstract: Harikrishnan Bhaskaran, Suma Balan
      Indian Journal of Rheumatology 2020 15(2):145-146

      Citation: Indian Journal of Rheumatology 2020 15(2):145-146
      PubDate: Fri,29 May 2020
      DOI: 10.4103/injr.injr_194_19
      Issue No: Vol. 15, No. 2 (2020)
       
  • Improving communications in healthcare

    • Authors: Vinod Ravindran
      Pages: 147 - 148
      Abstract: Vinod Ravindran
      Indian Journal of Rheumatology 2020 15(2):147-148

      Citation: Indian Journal of Rheumatology 2020 15(2):147-148
      PubDate: Fri,29 May 2020
      DOI: 10.4103/injr.injr_78_20
      Issue No: Vol. 15, No. 2 (2020)
       
 
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