Correlation of systemic lupus erythematosus disease activity (SLEDAI) with serum level of albumin in lupus patients

Introduction: Systemic lupus erythematosus (SLE) is a common type of rheumatologic disease. Currently there is no universally accepted "gold standard" to measure disease activity. An inexpensive and clinically reliable serological marker for disease activity would therefore be useful to guide treatment and gauge responses to treatment; however, such a marker remains elusive. Objectives: The aim of this study is to investigate the correlation of systemic lupus erythematosus disease activity index (SLEDAI) with serum level of albumin in lupus patients. Patients and Methods: The SLEDAI criteria were obtained by reviewing clinical records and Serum albumin, dsDNA, C3 and C4 were measured in lupus patients, and also demographic data including the patients’ age, and duration of disease were also collected. Results: In this study, 60 patients (54 females and 6 males) age 31.10 ±6.63 years were enrolled. A significant negative correlation was observed between serum albumin and SLEDAI (P=0.001, r=-0.42), however, no significant correlation was found between serum albumin with anti-dsDNA (P=0.73, r=0.04), C3 (P=0.33, r=0.14) and C4 (P=0.74, r=-0.05). There was also a direct significant relationship between SLEDAI with anti-dsDNA (P=0.02, r= 0.31) and inverse correlations with C3 (P=0.007, r=-0.40) and C4 level (P=0.02, r=-0.31). Multiple linear regression analysis revealed that serum albumin is the most important factor in predicting SLEDAI among other factors including anti-dsDNA, C3 and C4 (β=0.64, P=0.001). SLEDAI was higher in systemic lupus erythematosus (SLE) patients with hypoalbuminemia compared to SLE patients without hypoalbuminemia (P=0.003). Conclusion: We found a significant negative relationship between serum albumin and SLEDAI, and also the fact that SLEDAI was significantly higher in SLE patients with hypoalbuminemia than in those without hypoalbuminemia.

Evaluation the Effects of Alpha-tocopherol in Comparison with N-acetylcystein for Prevention of Contrast Induced Nephropathy (CIN) in CKD Patients

INTRODUCTION

Contrast induced nephropathy (CIN), a well-known complication of using radio contrast media, dramatically increases the likelihood of patient morbidity and mortality following coronary angiography. As there is no specific treatment for CIN, prevention could be the best strategy to address this issue. Since now, the only approved preventing strategy was hydration with normal saline while antioxidant agents as a new yet unapproved remedy for this purpose could be applied .The present study was conducted to examine the effect of alpha tocopherol in CIN prevention.

METHODS

This prospective controlled trial was carried out on 201 patients with chronic kidney disease (eGFR < 60 cc/min) underwent coronary angiography. We assigned three groups of CKD patients: 72 patients who received prophylaxis administration with isotonic saline (Group A), 66 patients with isotonic saline plus N-acetylcysteine (1200mg twice a day) for 2 days (Group B) and 63 patients who received isotonic saline plus daily alpha tocopherol (600 IU once daily from one day before till 2 days after angiography) for 4 days (Group C). The contrast media in all three groups was nonionic iso-osmolal agent, Visipaque.

RESULTS

Even though CIN didn't developed in any of the three aforementioned groups but there was statistically significant reduction in eGFR from baseline in all three groups (P < .001). Moreover, We found no statistically significant difference in GFR reduction between three studied groups.

CONCLUSION

Administration of alpha tocopherol has no additive beneficial effect over isotonic saline in CIN prevention in CKD patients.

Serum ACE Level in Sarcoidosis Patients with Typical and Atypical HRCT Manifestation

BACKGROUND

Sarcoidosis is an inflammatory disease that affects multiple organs. Before widespread use of computed tomography (CT), the severity of sarcoidosis was assessed based on chest X-ray abnormalities. HRCT can distinguish between active inflammatory changes and irreversible fibrosis. In this study, we analyzed different ACE levels in 148 patients diagnosed with sarcoidosis.

MATERIAL/METHODS

We categorized these patients based on their HRCT results into four groups: 1) patients diagnosed with chronic disease; 2) patients diagnosed with non-chronic disease; 3) patients who exhibited typical HRCT changes; and 4) patients who exhibited atypical HRCT changes. Afterward the mean ACE level of each group was calculated and compared.

RESULT

The HRCT scans of chronic sarcoidosis patients tended to show more atypical sarcoidosis patterns. Moreover, there was a reverse correlation between chronicity and ACE level (P-value <0.05).

CONCLUSIONS

HRCT is another modality which would be useful when the diagnosis of sarcoidosis is not definite.

Fluconazole versus ketoconazole in the treatment of tinea versicolor

BACKGROUND

A number of effective topical therapies are available for the treatment of tinea versicolor (TV). However, topical antifungals are difficult to apply to a large body surface area and for this reason TV is perhaps more easily treated with systemic agents.

METHODS

A total of 128 patients with TV, aged 15-55 years, were entered into a randomized, double-blind, clinical trial comparing the efficacy and tolerance of two regimens of oral treatment for TV. The patients were randomly divided in two groups: group 1 received two 150 mg capsules of fluconazole in a single dose repeated weekly for 2 weeks; and group 2 received two 200 mg tablets of ketoconazole in a single dose repeated weekly for 2 weeks. Diagnosis of TV was made clinically by direct KOH preparation and Wood's lamp examination.

RESULTS

Of 128 patients, 100 completed the study and no major side-effects were noted between the two treatment regimens. Results of the study showed no significant differences in efficacy, safety and tolerability between the two treatment regimens. The maximal cure rate was achieved at 8 weeks from the start of treatment and decreased slightly afterwards.

CONCLUSIONS

Fluconazole and ketoconazole demonstrated similar efficacy in the treatment of TV. We also demonstrated a lack of correlation between mycological cure and hypopigmentation at the end of treatment (2 weeks) and the usefulness of Wood's lamp examination in detecting cure of TV.