From the IRA
The OACON 2017
The First National Congress on Osteoarthritis (OACON 2017) was organized at Hotel Clarks Avadh, Lucknow, on September 23 and 24, 2017, under the chairmanship of Prof. Siddharth Das and Prof. G.K. Singh. Dr. Pooja Dhaon was the Organizing Secretary and Prof. R.N. Srivastava was the Scientific Chairman. It was the first conference on osteoarthritis (OA) in India, even though OA is the most common type of arthritis and is a more common occurrence than diabetes, blood pressure, and heart disease. Recently, the Government of India stated that OA is the fourth most common cause of disability in India, with a major economic burden on the society. The conference was organized under the aegis of Society for Osteoarthritis Research (SOAR), which is a charitable registered society working in the field of OA. The society has about 100 members, including rheumatologists, orthopedic surgeons, physicians, and basic scientists from all over India.
QUARTERLY HIGHLIGHTS
Dr C Balakrishnan, Consultant Rheumatologist, Hinduja hospital, Mumbai
Differences in the symptomatic phase preceding ACPA-positive and ACPA-negative RA: A longitudinal study in arthralgia during progression to clinical arthritis. Ann Rheum Dis. 2017 Oct;76(10):1751-1754.
Objective: Although anticitrullinated protein antibody (ACPA)-positive and ACPA-negative rheumatoid arthritis (RA) has different etiopathologies, the clinical presentation at the time of diagnosis is similar. This study evaluated whether there are phenotypic differences in the symptomatic pre-RA phase.
Methods: Patients with arthra lgia included in the Leiden clinically suspect arthralgia cohort who developed arthritis during follow-up were studied (n=67). Symptoms at symptom onset...
Patient's Perspective
FELLOWS’ CORNER
MY LIFE, MY TIMES
Interviewer: Dr Banwari Sharma, Interviewee: Dr Mahendranath
Que 1: What prompted you to take up rheumatology in your earlier days?
When I landed in the UK in 1978, it was a bad winter. I started working in acute medicine outside London. It had been very busy, with literally no time to study or relax. After 3–4 months, I decided to switch over to rheumatology as it was less stressful (I presumed). Even in 1978, rheumatology was neither a well-recognized nor a popular specialty in the UK. I decided to take up rheumatology as a career, and the prospect of being the first Rheumatologist of Karnataka was thrilling. I did work in some of the best rheumatology centers and with stalwarts. As I always wanted to come back to India, I returned in 1983 and started rheumatology practice in Bangalore.
Industry Desk
CLINICAL PEARLS
Pro calcitonin [PCT]: Pro-infection? Role in systemic Rheumatic diseases
Infections are one of the most common cause of morbidity and mortality in rheumatic diseases. Autoimmune disease and immunosuppression makes a patient more susceptible. Differentiating a disease flare from infection has always remained a challenge even with addition of more and more armamentorium. The two may have similar clinical and laboratory features, beside the fact that the infections may precipitate underlying rheumatic disease flare, adding to the dilemma. It may not always be possible to wait for cultures as the patient may not give enough time and the management of an infection versus disease flare is poles apart.
Procalcitonin, a 116 amino acid protein and a precursor of calcitonin, produced by parafollicular C cells of thyroid gland, usually undetectable in healthy individuals, for unknown reasons, is increased in patients with infections [1] Bacterial infections resulting in increased endotoxin and IL-1 beta stimulates PCT secretion whereas IFN- gamma tends to decrease it [4] Procalcitonin rises within 4 hours, peaks after 6 hours and plateaus between 8 to 24 hours. PCT has a half-life time of approximately 24 hours, independent of renal function[2].
Life is not All Medicine
African Safari
It was a clear bright day. We started early in the morning from the cottage we had taken right in the middle of the Savannah. We had moved in the night before to watch the animals, when they come out to graze. As soon as we entered the gate of the Safari, we were met by Giraffes feeding on the bushes. Soon two ostriches were seen chasing each other. Then the Wildebeests came out in herds. The zebras were seen in families, one foal was feeding, while the mare grazed nonchalantly, the proud stallion strutted about. I was beyond myself with excitement! I had never seen these animals before except on National Geographic channel on TV and here they were in flesh and blood, just meters away from me! My camera went click, click, click!!!