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Rheumatica Acta: Open Access
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This is an Open Access Journal

Open Access journal
ISSN (Online) 2640-799X
Published by Peertechz

[75 journals]

Are Leukocyte Esterase (LE) strip and Alpha-Defensin kit reliable enough
to diagnose peri-prosthetic joint infection, intra-operatively'
- Abstract: Background: Despite improvement in sterilization techniques, peri-prosthetic joint infection (PJI) is the most fearsome complication after hip and knee arthroplasties. Various strategies have been devised from time to time to diagnose and treat PJI. Recently, Leukocyte esterase and alpha-defensin are identified as markers of active infection in synovial fluid. Therefore, kits are designed to detect these two markers during surgery. If found reliable, these tests will increase the confidence of surgeons in situations, where the diagnosis of PJI is not established.Material and methods: This study was conducted on 132 patients in Lahore General Hospital; from August 2020 to December 2021. Leukocyte Esterase strip and Alpha-Defensin kit were used to detect infection in synovial samples taken just before performing arthrotomy, intra-operatively. Patients were divided into 2 groups, Group-A had 31 patients with peri-prosthetic joint infection (PJI) diagnosed as per Musculoskeletal Infection Society (MSIS) criteria, whereas in Group B 101 patients were present in whom PJI was not present. Synovial tissue and fluid samples were also sent to a laboratory for culture and histopathology; so that sensitivity and specificity of LE strips and Alpha-Defensin Kits could find out.Results: The mean age of patients in our study was 59.6 SD 11.90 years with a male to female ratio of 85:47. 31 patients were diagnosed as PJI after primary hip or knee arthroplasty based on serological investigations and culture of joint aspiration. The sensitivity and specificity of LE strips were 90.32% and 95.04%, whereas that of Alpha defensin was 93.54% and 100% respectively. The correlation coefficient between the LE strip test and synovial fluid polymorphonuclear neutrophils (PMN) counts was 0.811 and it was even higher when the Alpha-Defensin kit was used (0.845).Conclusion: Both LE and Alpha-Defensin kits are highly specific and sensitive in diagnosing PJI. Though Alpha-defensin is more accurate the cost-effectiveness of the LE strip makes it a more feasible option in diagnosing PJI, intra-operatively.
  PubDate: 21 May, 2022
Why does the new disease activity score (EgyDAS) of Rheumatoid Arthritis
not function'
- Abstract: The analysis of almost a century-long evolution of ideas about the criteria for the activity of Rheumatoid Arthritis showed that the developed complex indices for determination there of are far from perfect, in particular the Disease Activity Score 28 (DAS28), widely used in clinical practice [1]. Therefore, the recently developed new Disease Activity Score (EgyDAS) of Rheumatoid Arthritis [2] has attracted interest because it includes four laboratory markers of Rheumatoid Arthritis (RA) activity, as opposed to DAS28, which assesses only one laboratory marker.
  PubDate: 25 Jan, 2021
Evaluation of aerobic capacity and muscle function in a case series of
patients with relapsing polychondritis
- Abstract: Background: To evaluate aerobic capacity and muscle function in patients with Relapsing Polychondritis (RP). Methods: A cross-sectional single center study evaluated seven women with RP (McAdam criteria) that were compared to seven healthy control individuals matched for age, gender, and body mass index. Both groups performed a treadmill-graded maximal exercise. Aerobic capacity was assessed by peak oxygen uptake (VO2 peak), time at anaerobic Ventilatory Threshold (VAT) and Respiratory Compensation Point (RCP) and time-to-exhaustion. Muscle function was evaluated through the sit-to-stand and the timed up-and-go test.
  PubDate: 07 Apr, 2020
Value of ultrasound examination of the Leeds Enthesitis Index in
assessment of disease activity in psoriatic arthritis
- Abstract: Background: Enthesitis is a major feature of psoriatic arthritis. However, clinical assessment of enthesitis is known to lack accuracy and have poor interobserver reliability.Objective: This study aimed to determine the added value of the US assessment of enthesitis according to LEI over the clinical assessment in determination of PsA activity.Methods: A total of 75 consecutive PsA patients diagnosed according to Classification Criteria for Psoriatic Arthritis (CASPAR criteria) participated in the study. The LEI score was used to assess the enthesitis. All PsA patients underwent US assessment by the same sonographer who was blinded to the findings of the clinical examination. Grey scale US imaging was used to assess the longitudinal and transverse planes of the 6 entheseal points of the LEI.
  PubDate: 03 Mar, 2020
Can NMR (Nuclear Magnetic Resonance) spectroscopy serve as a diagnostic
tool for Rheumatoid Arthritis'
- Abstract: Rheumatoid arthritis (RA) is a general, chronic, systemic and autoimmune inflammatory disease. This disease represents the inflammatory response of the synovium resulting to hyperplasia of synovial cells along with associated destruction of cartilage, bone and ligaments, eventually leading to deformity of the joints. There is a considerable alteration observed in the metabolism. Chronic inflammation is responsible for altering the metabolism and also the metabolic profile of an individual patient with early inflammatory arthritis expects the following route of disease. These metabolic changes would identify biomarkers, which may be useful for the diagnostic purposes. NMR (nuclear magnetic resonance) spectroscopy based metabolomics studies of serum, urine and synovial fluid of RA were performed. These studies reflected the possibility of the development of metabolomics based diagnostic methods for RA. So, our question “Can NMR (Nuclear Magnetic Resonance) spectroscopy serve as a diagnostic tool for rheumatoid arthritis'” will definitely get an answer with the development of NMR based diagnostic method for RA.
  PubDate: 31 May, 2019
Usefulness of PCR for diagnosing Meningococcal Septic Arthritis
- Abstract: We report the case of a 60-year-old female patient who presented meningoencephalitis due to Neisseria meningitidis serogroup B in November 2018. She was admitted at the emergency department for febrile confusion lasting two days associated with one episode of vomiting.
  PubDate: 26 Aug, 2019

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