Rheumatoid arthritis is a chronic multisystem disease of unknown cause. It affects the people in their prime of life, predominantly between the ages of 20-50 years with unpredictable course. Sudard is used in the ayurvedic system of medicine for the treatment of inflammation and pain associated with rheumatoid arthritis, osteoarthritis, frozen shoulder, sciatica, ankylosing spondylitis and chronic backache. Our study was aimed to evaluate efficacy of sudard using different animal models such as formalin (2% v/v)-induced acute inflammation, carrageen (1% v/v)-induced polyarthritis, adjuvantinduced arthritis, effect on subacute inflammation by sponge implantation technique and analgesic activity by Eddy’s hot plate method. The results indicate that the formulation sudard possesses good anti-inflammatory, anti-arthritic and analgesic activities in the experimental animal models.

Microbes reach the synovial cavity either directly during bacteraemia or by transport within lymphoid cells or monocots. This may stimulate the immune system excessively, triggering arthritis. Some forms of ReA correspond to slow infectious orthritis due to the persistence of microbes and some to an infection triggered arthritis linked to an extra-articular site of infection.

Background: Apoptosis disruptions play substantial roles in pathogenesis of arthritis and its symptoms. Cytokines and their intracellular signaling have pivotal roles in arthritis pathophysiology. This study aimed to investigate the relationship between synovial Interleukin-6 (IL-6), nuclear factor kappa-B (NF-ĸ B), and fractalkine (FKN) in the changes of edema and apoptosis during adjuvantinduced knee arthritis. Methods: A total of 240 male Wistar rats were divided into different groups. Arthritis was evoked and the knee edema changes were evaluated by Vernier caliper. Synovial IL-6 was assayed by rat standard ELISA kit. Levels of NF-ĸ B, fractalkine, and apoptotic indicators in the synovium were evaluated by Western blot method. Results were expressed as Mean± SEM. To analyze within-group variations, repeated measures ANOVA, followed by post hoc Tukey’ s test was used (SPSS, 16). Independent samples t test was used to designate significant differences in knee diameter, synovial level of IL-6, apoptotic markers, NF-ĸ B, and FKN between groups. Significance level was set at P≤ 0. 05. Results: The injection of Complete Freund's Adjuvant (CFA) caused intense knee edema (P< 0. 001), which was reduced by implementing anti-IL-6 (P< 0. 001), anti-FKN (P< 0. 001), Inh-NF-ĸ B (P< 0. 001), and anti-FKN+ Inh NF-kB (P< 0. 001). The results indicated elevated levels of apoptotic markers during the acute phase (P = 0. 010), along with an increase in IL-6 (P< 0. 001), NF-ĸ B (P< 0. 001), and FKN (P= 0. 030). Although IL-6 (P< 0. 001), NF-ĸ B (P= 0. 001), and FKN (P= 0. 007) levels elevation continued during the chronic phase, the apoptosis markers decreased in this phase (P= 0. 050). The findings revealed that Anti-IL-6 treatment during different phases of the study could change the synovial NF-ĸ B and FKN. Conclusion: It seems that time-dependent variations in apoptotic markers level may be involved in pathogenesis of adjuvant-induced knee arthritis. In conclusion, synovial IL-6 through NF-ĸ B-FKN pathway can play an important role in this process.

A number of patients with inflammatory arthritis due to inadequate clinical or laboratory data do not fulfill diagnostic criteria for a clinical disease categories. These patients with initial diagnosis of undifferentiated arthritis (UA) may remit or progress to a definite well- defined condition such as rheumatoid arthritis (RA) or remain as UA with persistence of inflammatory arthritis. The main objective in the evaluation of these patients is focused on differentiating self-limiting arthritis from those who progress to chronic destructive arthritis such as RA. The study reviews the background data regarding the associated factors of progressive diseases among patients with recent-onset arthritis as well as the evaluation and decision in the management of this population. At present, the major goal should be focused on the early identification of patients, who have progressive course and initiation of appropriate therapy by using Disease Modifying Anti Rheumatic Drugs, (DMARDs) as early as possible to achieve clinical remission.

Background: Changes in patients’,Bone Mineral Density (BMD) is one of the problems in patients with rheumatoid arthritis, which can be due to the use of corticosteroid drugs to reduce patients’,symptoms or the aging process in patients. Objective: In this study, we decided to compare BMD in patients with psoriatic arthritis and rheumatoid arthritis. Methods: This study as a cross-sectional descriptive-analytical study was performed to evaluate BMD in patients with psoriatic arthritis (n=59) and rheumatoid arthritis (n=41) who were referred to Rasoul Akram Hospital in Tehran between 2016 and 2020. All patients were assessed by bone density scan (Dual-Energy X-ray Absorptiometry or DEXA scan) to determine T-score at the two spine and femur sites. Results: In rheumatoid arthritis and psoriatic arthritis groups, the Mean±, SD spine T-score was-1. 11±, 0. 18 and-1. 38±, 0. 48, respectively, which did not show a significant difference between the two groups (P=0. 556). Similarly, in the two groups with rheumatoid arthritis and psoriatic arthritis, the Mean±, SD femur T-score was-1. 36±, 0. 17 and-1. 78±, 0. 61, respectively, which did not show a significant difference between the two groups (P=0. 451). Considering the underlying parameters, including age, sex, and duration of the disease, the lack of differences in the values of spine and femur T-scores between the two groups was still evident. Conclusion: The change in BMD was equal in both rheumatoid arthritis and psoriatic arthritis that is not affected by gender, age, or duration of disease.