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Background: Clinical patterns and disease activity burden of psoriatic arthritis (PsA) varies in different parts of the world. There are limited studies from the Indian subcontinent. Aims: To study the cutaneous and articular profile of PsA and describe their disease activity with validated outcome measures. Methods: Karnataka psoriatic arthritis cohort study is a multicenter, prospective, cross-sectional, observational study which included all consecutive PsA patients defined by Classification criteria for psoriatic arthritis (CASPAR) from 18 rheumatology centers. Results: A total of 549 PsA patients (M: F: 6:5), mean age 38.4 (±14) years were included. PsA preceded psoriasis in 81 (14.7%) while simultaneous onset was noted in 117 (21.5%). Plaque lesions (330 [78.8%]) and scalp (210 [49.2%]) were the most common type and site. Mild, moderate, and severe skin disease was noted in 480 (80%), 50 (9.3%), and 57 (10.6%) patients, respectively. Mean disease activity in PsA (DAPSA) was 18.8 (16.6); 100 (19.9%) were in remission. Low, moderate, and high joint disease activity was found in 145 (28.8%), 137 (27.2%), and 123 (24.5%), respectively. There was no correlation between skin and joint disease. Polyarthritis (216 [40.7%]) and oligoarthritis (202 [38.1%]) were the most frequent PsA subtypes. Those with a higher DAPSA (>28) were older (P = 0.02), had a shorter duration of psoriasis (P = 0.02) and higher psoriatic area and severity index scores (P = 0.0001). Conclusions: We report high articular disease activity in half while cutaneous disease activity was minimal in majority.

Coronavirus disease 2019 (COVID-19) pandemic can cause ocular manifestations which include conjunctivitis to retinal manifestations. A 41-year-old Asian Indian male presented with unilateral blurring, glare, and pain in the left eye (LE), 22 days after COVID-19 infection. He had been administered intravenous steroids followed by oral steroids. Eye evaluation showed corrected distance visual acuity of 20/20 in both the eyes (BEs). Anterior chamber showed inflammation in the LE, a day later in the right eye. Fundus examination of the BE showed retinal pigment epithelial changes with serous elevation suggestive of multifocal serous chorioretinopathy. A month later, he had improvement in his symptoms with no cells in BE with topical steroids with resolution of serous retinopathy. Bilateral anterior uveitis possibly represents an immune-mediated trigger of his clinically quiescent psoriasis causing first-ever uveitis episode, possibly due to COVID-19. Serous chorioretinopathy could be secondary to steroids following treatment of COVID-19-related sequelae.

Granulomatosis with polyangiitis (GPA) is an autoimmune granulomatous disease of unknown etiology; frequently associated with anti‐proteinase 3 antineutrophil cytoplasmic antibody (PR3‐ANCA). Although any organ can be involved, prostatic involvement in GPA is very rare. We present a male patient with GPA, 26 years old, with pulmonary manifestations and prostatic involvement who underwent exhaustive evaluation. The patient's laboratory tests and imaging scans showed evidence of lesions in multiple areas, including the prostate. Histopathological testing confirmed that the lesions were consistent with granulomatosis with polyangiitis. The patient was treated with oral steroids and rituximab and showed significant improvement. He was later maintained on azathioprine without any relapse. [ABSTRACT FROM AUTHOR]

Pyoderma gangrenosum (PG) is a rare autoinflammatory disorder falling under the spectrum of neutrophilic dermatosis, characterized by distinctive skin ulceration which is non‐infective, non‐neoplastic and usually with no primary vasculitis. PG lesions are notorious for relapse and hence require multiple trials of medications often with prolonged and concomitant use of steroids. Due to lack of evidence‐based studies on effective treatment options for PG, we have presented three isolated biopsy‐proven PG cases who were successfully treated with Tofacitinib, a Janus kinase/signal transducers and activators of transcription (JAK/STAT) pathway inhibitor, without relapse in follow up. [ABSTRACT FROM AUTHOR]

Aim: The aim of the present study was to assess the efficacy of articaine versus mepivacaine administered as different supplementary local anesthetic techniques after a failed inferior alveolar nerve block (IANB) with lidocaine in patients with irreversible pulpitis. Materials and Methods: A total of 120 patients were included in the study. Patients were given IANB with 2 ml of 2% lidocaine hydrochloride with 1:80,000 epinephrine. Patients who showed subjective symptoms of IANB but did not secure pulpal anesthesia were randomly allocated to one of the following four groups by random sampling for supplementary local anesthesia – Group 1: buccal infiltration (BI) with 4% articaine with 1:100,000 epinephrine, Group 2: four‑site intraligamentary (IL) injection with 4% articaine with 1:100,000 epinephrine, Group 3: BI with 2% mepivacaine with 1:100,000 epinephrine, and Group 4: four‑site IL injection with 2% mepivacaine with 1:100,000 epinephrine. Results: Group 1 – BI with articaine provided anesthesia success in 27 cases (90%, n = 30). Group 2 – IL injection with articaine provided anesthesia success in 20 cases (66.67%, n = 30). Group 3 – BI with mepivacaine provided anesthesia success in 21 cases (70%, n = 30). Group 4 – IL injection with mepivacaine provided anesthesia success in 15 cases (50%, n = 30). A significant difference between the four groups was found. Conclusion: In patients with a mandibular first molar exhibiting symptomatic irreversible pulpitis, block injection with lidocaine along with supplemental BI with articaine allowed more pain‑free treatments. Articaine showed better results when compared with mepivacaine. [ABSTRACT FROM AUTHOR]

Autoimmune rheumatic diseases usually occur in women of childbearing age. In the past, pregnancy in women with autoimmune rheumatic diseases was not considered safe and was discouraged because gestation could worsen maternal disease and vice versa, and the disease could negatively affect the gestational outcome. However, women with rheumatic diseases often wish to have children even when functional disability is present. The great improvement in the systematic approach to pregnancy over the past few decades has allowed an increasing number of affected women to fulfill their family plan. Women should be informed about potential risks related to their disease and also should be reassured that a good pregnancy outcome is possible if conception occurs when they are in a stable remission state, teratogenic medications have been properly withdrawn, and immunosuppressant drugs that are safe in pregnancy have been maintained to prevent disease flare. The interaction of pregnancy and the rheumatic diseases can vary from spontaneous improvement to flare of disease symptoms. Rheumatic diseases differ in regard to the occurrence of complications during pregnancy and to pregnancy outcome. This review describes the maternal course of systemic sclerosis, ankylosing spondylitis, polymyositis and dermatomyositis during pregnancy, fetal outcome, and therapy during pregnancy and postpartum. [ABSTRACT FROM AUTHOR]

This study highlights the collaborative research and authorship trend in the area of food science and technology in India. The present study has revealed that collaborative research was preferred to solo research in the area of food science in India and the degree of collaboration was found to be 0.91. The average number of authors per paper also showed an upward trend from 4.89 in 1994 to 8.2 in 2003. The publication pattern from different institutions has also been studied to determine the pattern of contributions from the different organizations and institutions. [ABSTRACT FROM AUTHOR]

Bibliometric analysis of 779 articles published, along with citations in five volumes 37(2000) to 41(2004) has been carried out. A similar study was also carried out for the maiden volume of the same journal for the year 1964. The number of contributions and their distribution in different volumes, authorship pattern, foreign and Indian authored contributions, institution wise contribution, citations, types of publications cited, geographical distribution of contributions national and International as well as physical growth of the journal have been studied. Results indicated an increase in the number of contributions in successive volumes with India being the major contributor both in the maiden volume as well as in the five volumes studied. The highest number of contributions is by the joint authors (two). The growth and popularity of the journal is showing a steady upward trend, though contributions from the developed nations form only 15% of the total. [ABSTRACT FROM AUTHOR]

Objective: Adalimumab is a well-established anti-tumor necrosis factor therapy for patients with ankylosing spondylitis (AS). An indigenously developed biosimilar adalimumab (bADA) (ZRC-3197; Exemptia) is approved for prescribing in India. In this article, we present the effectiveness and tolerability of this bADA in real-life Indian patients with AS from the Adalimumab Biosimilar Patient Registry (ASPIRE) (ISRCTN: 16838474)., Methods: ASPIRE is a postmarketing observational registry for evaluating the real-world experiences of patients with autoimmune inflammatory disorders across multiple centers in India who were prescribed 40 mg of Exemptia subcutaneously every fortnight. For this report, data available until 24 weeks of bADA treatment for patients with AS who were included in the registry were evaluated., Results: Data from 308 patients with AS from the registry (median age of 35.0 [range 17-68] years, 19% women) were analyzed. In analyzable patients with complete data, there was a gradual and significant decrease ( P < 0.001) in the primary disease outcome scores (the mean Bath Ankylosing Spondylitis Disease Activity Index [BASDAI] score [n = 107] improved from 6.2 ± 1.54 to 2.1 ± 0.64, and the median visual analogue scale [VAS] score [n = 101] improved from 8 to 2) after 24 weeks of bADA therapy. BASDAI score was lower than 4 in about 94% of patients after 24 weeks of therapy, and 95% of patients achieved BASDAI50 response. The overall global assessment for efficacy and tolerability was 'good' to 'excellent' for a majority of the patients (≥98%), as rated by physicians as well as patients. The therapy was tolerated well, and there were no new unexpected adverse reactions with the biosimilar's use during this study., Conclusion: This report demonstrates the tolerability and effectiveness of bADA (Exemptia) after its clinical use for 24 weeks in real-world patients with AS from Indian clinical practice., (© 2019 The Authors. ACR Open Rheumatology published by Wiley Periodicals, Inc. on behalf of American College of Rheumatology.)