The effect of oral royal jelly on clinical disease activity index (CDAI) and morning stiffness in patients with rheumatoid arthritis (RA); A randomized double-blind, placebo-controlled trial

Background: Rheumatoid arthritis (RA) is a chronic inflammatory disease which can cause articular destruction and disability in patients. Current therapies are relatively effective and sometimes harmful. Royal Jelly with anti-inflammatory and anti-oxidative properties may be used as an adjunct therapy. The aim of this study was to assess the effect of Royal Jelly on Clinical Disease Activity Index (CDAI) and morning stiffness in patients with rheumatoid arthritis. Methods: According to American College of Rheumatology (ACR) 1987 classification criteria, 80 patients with RA, who had active disease (CDAI > 2.8), were randomly assigned to receive Royal Jelly or placebo beside background treatment for 3 months. Morning stiffness, tender joint count (TJC), swollen joint count (SJC), evaluator global assessment (EGA) and patient's global assessment (PGA) based on visual analogue scale (VAS) were determined before and after 3 months of intervention. The changes in aforementioned indexes were analyzed by SPSS software. Findings: 65 patients completed the study (35 in Royal Jelly and 30 in placebo group). The sex, age, residence, disease duration and drug consumption had no significant changes (P > 0.050). In the first group, CDAI (P = 0.012), SJC (P = 0.024), TJC (P = 0.027), and morning stiffness (P = 0.004) had significant statistical changes; but only changes in morning stiffness were statistically different between the two groups (P < 0.05). Conclusion: Royal Jelly has good effect on morning stiffness but not on CDAI and may be a suitable adjunct therapy. Further studies may demonstrate more significant results

Effect of anti-cyclic citrullinated peptide and HLA-DRB1 subtypes on clinical disease activity index in rheumatoid arthritis patients

Rheumatoid arthritis (RA) is a crippling disease with a global prevalence of approximately 0.5%-1% in adults. Genetic, environmental and immunologic factors contribute importantly to pathogenesis of RA. American College of Rheumatology (ACR) assists in early diagnosis of the disease. Aim: The aim of this study was to investigate the effects of HLA- DRB1 gene and anti-Cyclic Citrullinated Peptide (CCP) antibody on Clinical Disease Activity Index (CDAI) and to determine the frequency of HLA-DRB1 alleles in the patients with RA. Materials and Methods: In this descriptive-analytical study, 64 patients with RA referring rheumatology clinic of Hajar Hospital, Shahr-e-Kord, Iran were enrolled based on ACR criteria (1987) by convenience sampling. All patients were examined to assess primary CDAI and referred to laboratory for serologic tests [Rheumatoid Factor (RF) and anti-CCP]. After the patients’ DNA was extracted, HLA-DRB1 was determined per single specific primer-polymerase chain reaction by inno-train kits. The patients were re-examined six months later. Results: The most prevalent type of HLA-DRB1 in the studied patients was 04. In patients with HLA-DRB1 (04), HLA-DRB1 (01), and HLA-DRB1 (15), CDAI decreased pronouncedly after six months, but in other patients it did not (p<0.05). Of the patients, 81.3% had high titers of anti-CCP, but no association between anti-CCP and CDAI was found. Conclusion: RA could be a multifactorial disease. The patients with HLA-DRB1 (04), HLA-DRB1 (01) and HLA-DRB1 (15) showed a good response to routine treatments. The patients with HLA- DRB1 (04) are likely to have no decrease in secondary CDAI. High titers of anti-CCP in patients may indicate the severity of RA in the studied region and perhaps environmental, genetic and unknown or idiopathic factors are aetiologically crucia

The effect of HLADRB1 subtypes, on clinical diseases activity index in rheumatoid arthritis patients referred to rheumatology clinic of Shahrekord University of Medical Sciences

زمینه و هدف: بیماری آرتریت روماتویید (RA)، شایع ترین بیماری التهابی مفاصل است و در صورت عدم درمان مناسب می تواند منجر به ناتوانی قابل توجه فرد بیمار گردد. عوامل متعدد ژنتیکی، محیطی و ایمونولوژیک، در پاتوژنز این بیماری نقش دارند. هدف این مطالعه بررسی اثرات ژن HLA-DRB1 بر روی شاخص فعالیت بالینی بیماری (CDAI) در بیماران مبتلا به آرتریت روماتوئید و نیز تعیین فراوانی نسبی آلل های HLA-DRB1 در این بیماری می باشد. روش بررسی: در این مطالعه توصیفی تحلیلی تعداد 64 نفر از بیماران مبتلا به RA مراجعه کرده به کلینیک روماتولوژی بیمارستان هاجر شهرکرد به روش نمونه گیری در دسترس بر اساس معیار های کالج روماتولوژی آمریکا (ACR) سال 1987 و با نظر تشخیصی روماتولوژیست انتخاب گردیدند. پس از آن همه بیماران برای تعیین CDAIاولیه مورد معاینات بالینی قرار گرفتند. پس از استخراج DNA بیماران، با استفاده از روش فنل کلروفورم انواع زیر گروه های ژن HLA-DRB1 با استفاده از کیت های تخصصی و بر اساس متد SSP-PCR تعیین گردید. معاینه دوم بیماران 6 ماه بعد انجام شد و با تکمیل چک لیست مربوط به هر بیمار تجزیه و تحلیل داده ها با استفاده از تست های آماری کای اسکوئر و تی تست گروه های زوجی انجام شد. یافته ها: شایعترین HLA-DRB1 موجود در بیماران مورد مطالعه نوع 04* با فراوانی نسبی 3/31 درصد بود. در بیماران دارای 15*، 01*،04*HLA-DRB1، شاخص فعالیت بالینی شان بعد از 6 ماه واضحاً کاهش پیدا کرده (05/0>P)، ولی در سایر گروه های بیمار این نتایج دیده نشد (05/

Macracanthorhynchus hirudinaceus Eggs in Canine Coprolite from the Sasanian Era in Iran (4(th)/5(th) Century CE)

  Present paper is the second publication introducing the paleoparasitological findings from animal coprolites obtained from archeological site of Chehrabad salt mine in northwest-ern Iran. The current archeological site is located in northwest of Iran , dated to the Sas-sanian Era (4th/5th century CE).In the summer 2012 the carnivore coprolite was obtained within the layers in the mine and were thoroughly analyzed for parasites using TSP re-hydration technique. Eggs of Macracanthorhynchus hirudinaceuswere successfully retrieved from the examined coprolite and were confidently identified based on reliable references. Identifying of M.hirudinaceuseggs in paleofeces with clear appearance as demonstrated herein, is much due to appropriate preservation condition has been existed in the salt mine .The present finding could be regarded as the oldest acanthocephalan infection in Iran