From the IRA
A new state chapter of IRA in Puducherry, entitled ‘Puducherry Chapter of IRA,’ was formed in the presence of our esteemed President IRA Dr. Debashish Danda, Lt. Gen. Ved Chaturvedi, and other members.
Dr. RP Swaminathan (Dean, Academic JIPMER) was installed as President of the Chapter; Dr. VS Negi is Vice-President and Dr. Chanaveerappa B, the Treasurer.
A rheumatology CME was also held at JIPMER, during the formation of the IRA Puducherry Chapter.
1. IRA international travel fellowships: IRA will award 5 travel fellowships (2 for APLAR [Rs. 30,000 each], 2 for ACR [Rs. 50,000 each], and 1 for other meeting [maximum of Rs. 50,000] members less than 40 years of age who have an accepted paper to attend international rheumatology meetings). The priority would be in the order of oral paper, poster, quiz, etc. The last date of application is 15 June for APLAR and 15 August for ACR meeting. For the remaining meetings, applications can be sent after abstract acceptance. All applications should be sent to the Secretary, IRA.
2. CME: IRA is also going to conduct 6 CMEs in medical colleges in different parts of India where there have been no CMEs in the past. In addition to these, there will also be a single-theme IRA mid-term CME. Interested members can mail the Secretary, IRA.
QUARTERLY HIGHLIGHTS
Patient's Perspective
Patients’ perspectives on dietary influence of arthritis
A survey on the influence of diet on arthritis symptoms in patients with rheumatoid arthritis was done in a rheumatology clinic.The questionnaire was administered, and responses was recorded by a physiotherapist.
A total of 75 adult patients who were taking South Indian food were interviewed, among whom 47 patients had a worsening of symptoms due to a vegetarian diet.Twenty-eight patients (37 %) had a worsening of pain in the joints when they ate a nonvegetarian diet. None of them had any improvement in their symptoms with any type of food.
For vegetarian diets, potato tops the list, with 30 percent of the patients reporting worsening of joint pain and 22 percent reporting worsening due to the consumption of bitter gourd.Other vegetables that were reported to worsen symptoms were mushroom, cabbage, okra, and cauliflower.Dal was reported to worsen symptoms in 5 patients.
For nonvegetarian diets, fried chicken worsened symptoms in 50 percent and meat in 22 percent of the patients.Egg and fish contributed for the rest of the symptoms. Some of them reported worsening of pain with fried food. Other food items that were said to be reasons for exacerbation of symptoms included milk, yogurt, and cereals.
FELLOWS’ CORNER
MY LIFE, MY TIMES
Interviewer: Dr Banwari Sharma, Interviewee: Dr. Debashish Danda, President, IRA and HoD, Dept of Rheumatology, CMC Vellore
Que 1: What’s your number-one plan for IRA?
My number-one plan for IRA is to establish the IRA college and the two-year post-doctoral fellowship program, a long overdue dream of IRA, to overcome the acute shortage of trained rheumatologists in our country. The 2-year training program will have minimum standard guidelines, and it will be like a compressed DM program without diluting the quality. Although it is not an MCI or a university program, this will improve the standards of many fellowship programs already running across the country.
Interested centers will be inspected by the IRA college, and the IRA education cell will oversee infrastructure, faculty, syllabus, and the guidelines for selection of candidates, as well as the continuous evaluation process and final exit exam. There are several societies, such as Critical Care and Pediatric Immunology, that run such training programs.
Industry Desk
CLINICAL PEARLS
Urate lowering in gout: Allopurinol vs. Febuxostat
Gout is due to supersaturation (crystal formation) of urate in body fluids. Gout flares can be eliminated by maintaining low serum urate levels (<5 g/dL in tophaceous “severe” gout, and <6 g/dL in all other forms of gout).1 Gout is often a part of metabolic syndrome and is associated with increased cardiovascular mortality.2
Urate-lowering therapy is advised for recurrent gout attacks (>1 flare annually), radiological joint damage due to gout, gouty tophi, and renal disease (creatinine clearance <60 mL/minute/1.73 m2) or urolithiasis. Colchicine and NSAIDs prevent gout flares, but cannot prevent silent erosions and tophi deposition. Allopurinol has been the gold standard since its introduction 7 decades ago3.
Other drugs include uricosurics such as probenecid and benzbromarone; xanthine oxidase inhibitor febuxostat; uricase pegloticase and rasburicase. The latest uricosuric is lesinurad, which inhibits URAT1 (urate reabsorption in renal tubules).
