Background:There are many clinical and laboratory parameters which have been proven to be associated with increased risk of pregnancy morbidity in patients with SLE and APS. This study was undertaken as there is a lacuna in explaining all the pregnancy related morbidity in this groupObjectives:Primary: Correlation of IgA anticardiolipin antibody with the risk for pregnancy morbidity in patients with APS/SLESecondary: Association of IgA Anticardiolipin antibody with the risk of thromboembolic eventsMethods:Patients diagnosed as SLE and/or Primary APS who are married and conceived atleast once were recruited and 3ml blood sample was obtained from them. Patients with history of recurrent infections, which could suggest probable IgA deficiency, were excluded. Demographic data including duration of illness, number of pregnancies, thromboembolic events, disease activity were noted. They were categorized into two different groups depending on whether they had a pregnancy morbidity or not. The blood samples were subjected to IgA Anticardiolipin assay by ELISA.Results:A total number of 186 patients were recruited with mean age 34.54(+/-7.32)years, mean duration of illness of 5.52(+/-4.31)yrs with a diagnosis of 76.88% SLE, 7.53% primary APS and 15.59% SLE with secondary APS. On assessment of disease activity, mean SLEDAI score was found to be 4.46+/-6.32. Out of the total, 14.71% patients had conceived once, 14.56% twice, 16.72% patients thrice and 18.41% had conceived more than three times. 36.56% patients had pregnancy morbidity (majority being pregnancy induced hypertension 14.52%, prematurity 11.29%, IUGR 10.22%, pre-ecclampsia in 3.76%, eclampsia 1.08%,), 19.35% patients had history of thromboembolic events (6.45% pulmonary embolism, 5.38% deep vein thrombosis, 3.76% visceral vessel thrombosis, 0.54% cortical vein thrombosis, 6.99% other vessel thrombosis). 33.87% patients had positivity for antiphospholipid antibodies with 27.82% lupus anticoagulant positive, 20.97% IgG Anticardiolipin positive and 17.35% anti-beta2 glycoprotein positive. IgA Anticardiolipin was found to be positive in 4.84%(n=9) out of which, 10.29% were in the group with pregnancy morbidity as against 1.69% without pregnancy morbidity. Out of the total positives titre in 37.5% were indeterminate, 25% low positive and 37.5% high positive. All patients who had high titre positivity had pregnancy morbidity. The positivity of IgA anticardiolipin in the patient group with thromboembolic events was 5.56%.IgA AnticardiolipinPregnancy morbidityNo pregnancy morbidityPositive7(10.29%)2(1.69%)Negative69(89.71%)116(98.31%)Conclusion:Among patients with SLE, APS or SLE and APS, the overall prevalence of IgA anticardiolipin antibody was found to be about 4.84%, which is much less as compared to the percentages reported by other groups[1] IgA Anticardiolipin antibody positivity was more in patients with pregnancy morbidity compared to patients without a pregnancy morbidity. In this study however, statistical significance was not reached. Similar studies with larg...
BackgroundInfluence of diet on inflammation, specially foods like fish oil, spices like turmeric, capsaicin, garlic etc. are reported in published literature. However, a well-designed study on this subject amongst Asian Indian patients is lacking.ObjectivesTo analyze whether the type and quantity of intake of various food constituents, with particular reference to Indian spices, makes an impact on the control of disease activity in patients with Rheumatoid arthritis(RA)MethodsPatients diagnosed as RA by the ACR 2010 criteria and receiving standard triple drug therapy in our clinic between June 2017 and June 2018, for at least one year were enrolled. Disease activity was assessed during the routine OPD visit. They were administered a food frequency questionnaire [1] pertaining to the quality as well as quantity of food and spice intake. Analysis was done using multivariate logistic regressionResultsA total of 400 patients were included with 86.75% females. 67.75% patients were in disease remission, 10% had mild disease activity and 22.25% moderate to high disease activity; only 18.09% were vegetarians and the rest consumed non-vegetarian food. Median age was 47.99years(SD 10.67),median duration of illness prior to presentation to our clinic was 7years(IQR 4,10), median ESR was 37mm/hr(IQR 23,52),median CRP was5.34mg/L(IQR 2.04,12.4), and median DAS28CRP was 2.07(IQR 1.64,2.97). Patients with DAS28CRP of <2.6 were compared with those >3.2. Statistically higher consumption of ginger, garlic, turmeric and coriander were noted amongst patients in remission. Similar results were obtained when patients with DAS28CRP of <1.4 were compared with DAS28CRP >5.1. Nonsignificant numerical differences were noted for intake of food constituents like wheat, total pulse, vegetables, fruit, milk and fishMultivariate logistic regression for the statistically significant variablesDAS28CRP <2.6DAS28CRP > 3.2Dietary itemsnQuantity in grams Median(IQR)nQuantity in gramsMedian(IQR)P valueginger 2444.17 (2.67, 6.67)802.08 (1.39, 3.33)0.0001garlic2534.17 (2,78, 6.67)782.08 (1.67, 3.33)0.0001turmeric2671.11 (0.71, 1.67)880.83 (0.51, 1.11)0.0003jeera2150.55 (0.37, 0.83)640.42 (0.28, 0.75)0.0138cinnamon640.42 (0.28, 0.55)240.35 (0.25, 0.52)0.7212cloves850.42 (0.28, 0.55)280.33 (0.2, 0.45)0.6754coriander2301.11 (0.67, 1.67)780.67 (0.48, 1.11)0.0001pepper1790.42 (0.33, 0.67)570.37 (0.28, 0.55)0.0351chilli2592.08 (1.67, 3.33)881.67 (1.02, 2.82)0.0023Table 1 Comparison between patients in remission with those having moderate/high disease activity Variables OR (95% CI) P - Value Ginger 0.62 (0.47, 0.81)<0.001 Garlic 0.61 (0.46, 0.79)<0.001 Turmeric 0.63 (0.46, 0.87)0.01 Jeera 0.75 (0.51, 1.09)0.13 Coriander 0.59 (0.41, 0.83)0.01 Pepper 0.82 (0.55, 1.21)0.3 Chilli 0.69 (0.53, 0.90)0.01ConclusionHigher consumption of Indian spices like ginger, garlic, turmeric and coriander were found to be associated with better control of disease activity and hence the inflammation, as evidenced by DAS28CRP in patients with Rheumatoid arthritis, receiving standa...
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