Split vs single-dose oral methotrexate in rheumatoid arthritis: a randomized controlled trial (SMART study).

Objective: Pharmacokinetic evidence suggests split dose of oral methotrexate increases bioavailability, but unproven to improve efficacy. Thus, we planned to compare clinical response of split vs single-dose oral methotrexate in rheumatoid arthritis (RA).

Methods: This pragmatic, open-label (blinded assessor) randomized controlled trial was conducted across six university hospitals in India and enrolled patients with seropositive RA with active disease (TJC ≥ 4 and SJC ≥ 2).

Utilizing Biowaste-Soil Consortia for Efficient Isolation of Cellulose-Producing Bacteria and Evaluation of Bacterial Cellulose.

This study presents an efficient, low-cost method for isolating a bacterial cellulose (BC) producer from a biowaste-soil consortium. Soil is a natural reservoir of diverse microorganisms, which, when combined with biowaste (vegetables and fruits), creates an ideal environment for enrichment and isolation of cellulose-producing bacteria. This synergistic consortium fosters the dominance of cellulose producers and increases the likelihood of isolating high-yield strains in a shorter enrichment cycle, thus reducing screening time.

Modified Partial Radial to Axillary Nerve Transfer.

Background: Nerve transfers are routinely performed in patients with brachial plexus injuries because these patients have limited alternative solutions secondary to their severe injury with substantial functional limitations. Nerve transfers offer distinct advantages over other surgical options, as they are able not only to bypass the zone of injury but also to decrease regeneration time because of the proximity of the motor end plate to the repair site. It is for this latter reason that a nerve transfer should be considered for an isolated axillary nerve injury, in which a full recovery is of paramount importance for shoulder function.

Neutrophil Z Is a Novel Marker to Differentiate Disease Flares From Bacterial Infections in Febrile SLE Patients.

Aim And Objectives: To assess the role of newer biomarkers like neutrophil Z, myeloid-related protein 8/14 (MRP 8/14), IL-6, sCD14, and neutrophil CD64 (nCD64) to distinguish flare from infection in febrile lupus patients.

Methods: In this prospective multicentric observational study to determine the etiology of fever in febrile lupus patients, in addition to routine tests, serum procalcitonin, neutrophil X, neutrophil Y, and neutrophil Z were done. sCD14, MRP8/14, and IL-6 were done by ELISA.

Valorization of Pomace Waste for the Production of Cellulose by Komagataeibacter diospyri RSA4.

In this study, the mixed extract of pomace waste of sweet lime, apple, and pineapple was used as a culture media for the production of cellulose by Komagataeibacter diospyri RSA4. Maximum cellulose yield was found at an inoculum age (48 h), inoculum size (6% v/v), pH (4.0), temperature (30°C), incubation period (15 days), and media:flask volume (1:2.

The First-Ever Investigation of SNP rs119461977 in SECISBP2/SBP2 Gene and its Implications for Hypothyroidism: A Novel Case-Control Research.

Hypothyroidism is one of the most prevalent endocrine disorders worldwide. Various genes are involved in thyroid hormone production, regulation, and metabolism. SBP2 is required for the adequate assembly of selenoproteins, which are further required for thyroid hormone metabolism.

A preliminary report to discern the association of SNPs rs1505287 and rs4858608 of THRB gene and their haplotype analysis with hypothyroidism and hyperthyroidism among Indian population: A case-control study.

Thyroid hormone receptors are a subtype of nuclear receptors that are necessary for the actions of thyroid hormones and play a crucial role in regulating the negative feedback mechanism of the hypothalamus-pituitary-thyroid (HPT) axis. The thyroid hormone receptor beta (THRB) is present in two isoforms, both of which are expressed in several tissues across the body. The current study aims to demonstrate a correlation between two single nucleotide polymorphisms (SNPs), namely rs1505287 (G > A) and rs4858608 (T > G), of the THRB gene and the occurrence of hypothyroidism and hyperthyroidism among the Indian population.

Impact of rs2046045 SNP in PDE8B on TSH Levels: Insights into Genetic Susceptibility to Hypothyroidism.

Hypothyroidism is the most prevalent thyroid disorder and leads to adverse effects on the human body. Serum thyroid stimulating hormone (TSH) values have been related to polymorphisms in multiple genes that may be involved in the regulation of thyroid function. The single nucleotide polymorphism (SNP) rs2046045 is situated in the intron region of the phosphodiesterase 8B (PDE8B) gene, which encodes a high-affinity cyclic adenosine monophosphate (cAMP)-specific phosphodiesterase widely expressed in thyroid tissue.

Valorization of papaya fruit peel waste for the production of nanocellulose by Novacetimonas hansenii BMK-3.

Nanocellulose is the renewable biopolymer produced in nature by different bacteria. The widespread use of nanocellulose in industrial processes increases the demand for this valuable biomaterial. To overcome the high cost of producing nanocellulose using the Hestrin-Schramm medium, alternative agricultural waste has been studied as a potential low-cost supply.

Early diagnosis of lupus: A possibilty. A multicentric study from SLE Special Interest Group (SIG) of Indian Rheumatology Association (IRA).

Introduction: Systemic Lupus Erythematosus (SLE) warrants an early diagnosis and prompt management. Delay in diagnosis can result in repeated flares, permanent damage, and even death. There is a large variability in the time taken to diagnose SLE across the world.

Infrared thermogram image guided discontinuous appearances of hyaluronic acid for classification of arthritic knee joints.

The liveliness of a human potentially depends on his/her smooth movability. To accomplish the work of daily life, the joints of the body need to be healthy. However, the occurrence of Rheumatoid arthritis and Osteoarthritis has a significant prevalence towards the immovability of humankind.

A novel cost-effective methodology for the screening of nanocellulose producing micro-organisms.

In this paper, the work has been done to develop a cost-effective methodology, for the isolation of the potential producer of bacterial nanocellulose. No report is available in the literature, on the use of gram flour and table sugar for the screening of nanocellulose-producing isolates. Since commercially used, Hestrin-Schramm medium is expensive for the isolation of nanocellulose-producing micro-organisms, the possibility of using gram flour-table sugar medium was investigated in this work.

Management of Open Fractures of the Extremities and Pediatrics.

The modern management of open fractures was established after the foundational work of Gustilo and Anderson, but we continue to strive to determine the optimal treatment of open fractures to diminish the risk of infection. The ideal timing of antibiotics, presentation to the operating room, and timing of procedures such as flap coverage continue to be investigated with incremental changes recommended over the years. This article aims to provide the most recent review of the literature regarding the timing and management of both upper and lower extremity open fractures, pediatric open fractures, current topics of controversy, and the data supporting current treatment recommendations.

Failure after operative repair is higher for ballistic femoral neck fractures than for closed, blunt-injury fractures: a multicenter retrospective cohort study.

Introduction: The purpose of this study was to describe the outcomes after operative repair of ballistic femoral neck fractures. To better highlight the devastating nature of these injuries, we compared a cohort of ballistic femoral neck fractures to a cohort of young, closed, blunt-injury femoral neck fractures treated with open reduction and internal fixation (ORIF).

Methods: Retrospective chart review identified all patients presenting with ballistic femoral neck fractures treated at three academic trauma centers between January 2016 and December 2021, as well as patients aged ≤50 with closed, blunt-injury femoral neck fractures who received ORIF.

Pattern of disease expression in SLE patients with antiphospholipid antibodies: data from Indian Systemic Lupus Erythematosus Inception cohort (INSPIRE).

Antiphospholipid antibodies (APLA) are present in one-third of systemic lupus erythematosus (SLE) patients, and they are associated with both criteria and non-criteria manifestations. We studied the prevalence, clinical associations, and impact on mortality of APLA in SLE patients from India. Among the Indian SLE inception cohort (INSPIRE), patients who had data on all five routinely performed APLAs [lupus anticoagulant (LA), IgG and IgM anticardiolipin antibody (aCL) and anti-β2-glycoprotein I(β2GPI)] at enrolment were selected.

Gastrointestinal manifestations in systemic lupus erythematosus: data from an Indian multi-institutional inception (INSPIRE) cohort.

Objectives: To study the prevalence, correlates, and outcomes of GI manifestations in a prospectively enrolled nationwide cohort of SLE in India (INSPIRE).

Methods: It is an observational cohort study with analysis of the baseline database of the INSPIRE cohort with early outcomes assessed till 10 April 2023. Cases with GI manifestations as per the BILAG index were selected, pertinent clinical and laboratory data were retrieved for analysis.

Negative impact of Interleukin-9 on synovial regulatory T cells in rheumatoid arthritis.

In Rheumatoid Arthritis (RA), regulatory T cells (Tregs) have been found to be enriched in the synovial fluid. Despite their accumulation, they are unable to suppress synovial inflammation. Recently, we showed the synovial enrichment of interleukin-9 (IL-9) producing helper T cells and its positive correlation with disease activity.

Human Motor Endplate Survival after Chronic Peripheral Nerve Injury.

Objective: Degeneration of motor endplates (MEPs) in denervated muscle is thought to be a key factor limiting functional regeneration after peripheral nerve injury (PNI) in humans. However, there is currently no paradigm to determine MEP status in denervated human muscle to estimate likelihood of reinnervation success. Here, we present a quantitative analysis of MEP status in biopsies of denervated muscles taken during nerve repair surgery and ensuing functional recovery.