To investigate the role of IL-21 as diagnostic marker in diagnosis of rheumatoid arthritis. Study Design: Cross sectional study. Setting: Department of Physiology and Orthopedic Gujranwala Medical College, Gujranwala. Period: October 2017 to October 2018 in one year duration. Materials and Methods: A total of 150 patients were included in the study, main variables assessed in this study were positive predictive value negative predictive value, sensitivity, specificity and accuracy of IL-21 in diagnosis of rheumatoid arthritis. SPSS version 23 was used to analyze the data. P value less than or equal to 0.05 was taken as significant. Study was started after permission from hospital ethical committee and patients were informed in detail about disease and procedure to be done. Non probability consecutive sampling was used. Results: The estimated sensitivity was 93.6%. The estimated specificity was 50%. Positive predictive value was 96.3% and negative predictive value was 35.7%. The overall accuracy was 90.6% for diagnosing rheumatoid arthritis. Conclusion: IL-21 induces MMP3 in rheumatoid arthritis patients, identification of IL-21 from synovium of patients indicates the presence of rheumatoid arthritis. We observed 90.6% diagnostic accuracy of IL-21 for rheumatoid patients taking RA factor as gold standard of diagnostic tool.
Aim: To reassess the high specificity of alkaline phosphatase as a serum tumor marker in patients with osteosarcoma Study type: Retrospective cohort study Study place and duration: Department of Orthopedics, DHQ Hospital Gujranwala from January 2013 to June 2021 Methods: The medical record of 140 osteosarcoma patients were reviewed retrospectively, who received treatment for osteosarcoma during January 2015 and June 2021. According to clinical factors at diagnosis, the difference in prevalence of increased ALP was assessed using Fisher`s extract test and χ2 test. In the groups with normal and high level of serum ALP at presentation, the disease-free survival (DFS) and overall survival (OS) were compared using The Kaplan–Meier estimate. At presentation the prognostic ability of increased ALP was examined using Cox regression analyses. For determination of therapeutic steps and survival related changes in levels of ALP during therapy and survival related response of ALP to therapy, Linear Mixed model (fixed model) was used. Results: Sensitivity, specificity , Positive predictive value, negative predictive value, PLR, NLR and DOR of ALP in Metastatic osteosarcoma at 15 months follow up was 55.4%, 80.3%, 62.1%, 74.2%, 3.14, 0.864 and 5.241 respectively. Similarly, Sensitivity, specificity , Positive predictive value, negative predictive value, PLR, NLR and DOR of ALP in Metastatic osteosarcoma at 3 years follow up was 56.4%, 92.5%, 83.1%, 70.1%, 6.321, 0.632 and 8.543 respectively. Conclusion: ALP has been found to be a very important tumor marker having high specificity in patients with osteosarcoma. MeSH words: Osteosarcoma, Tumor, Biomarker, Alkaline Phosphatase, Metastasis, Sensitivity, Specificity
Objectives: Objective of our study is to measure the concentration and role of Malondialdehydein determining the oxidative stress in rheumatoid arthritis patients in comparison with healthy individuals. Study Design: Cross sectional study. Setting: Department of physiology Gujranwala Medical College and Shalamar Medical College, Lahore. Period: From October 2016 to October 2017. Methodology: 180 patients of age 49 to 70 years of either gender. The approval for conducting experimental study was taken from ethical committee and consent information was taken from the patient on prescribed Performa. Data was analyzed on SPSS Version 23 related to study. Continuous variables were presented as mean and standard deviation like age and serum MDA concentration. Categorical variables were presented as numbers and percentages like gender. Post operative chi square test was applied and p- value less than or equal to 0.05 was considered as significant. Results: Total 180 person (n=180) of either genderwere included in this study. The study group was divided into two equal groups. Group A (RA group) consists of 90 patients (n=90) based on clinically and laboratory based criteria while group B (control group) consists of 90 (n=90) normal healthy individuals. The serum MDA levels in the RA patients were 3.97±1.03 nmoles/ml and it was 1.59±0.32 n moles/ml in control patients. The difference was statistically significant (t=20.87, p=0.001). Conclusion: The observations of our study showed statistically significant raised serum Malondialdehyde level as compared to control group which shows that raised serum MDA is an indicator of oxidative stress in rheumatoid arthritis patients.
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