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Article
Determining Levels of Rheumatoid Factor (RF) and C - reactive protein (CRP) in a Blood Sample of Iraqi Patients with Rheumatoid Arthritis (RA)
تحديد مستويات عامل الروماتويد (RF) و بروتين سي الفعال (CRP) في عينة دم من المرضى العراقيين المصابين بالتهاب المفاصل الروماتويدي (RA)

Authors: Muataz Mohammed Al-Taee معتز محمد غازي --- Duaa Ibrahim Mohmood دعاء ابراهيم محمود --- Mahmood Muhammed ميادة محمود محمد
Journal: Al-Nisour Journal for Medical Sciences مجلة النسور للعلوم الطبية ISSN: 26640562 26640554 Year: 2019 Volume: 1 Issue: 1 Pages: 133-139
Publisher: Al-Nisour University College كلية النسور الجامعة

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Abstract

Rheumatoid arthritis (RA) is a common autoimmune disease characterized by chronic inflammation and joint destruction. The aim of this study was to investigate levels of Rheumatoid factor (RF) and C- Reactive protein in Iraqi RA patients. Blood samples were obtained from 50 RA patients (males and females) referred to Rheumatology consultation clinic in Baghdad teaching hospital, Medical city, with a mean age of 40.88±18.75 years. On the other hand, blood samples were obtained from 50 healthy controls with a mean age of 38.90±14.73 years. Results showed that Rheumatoid factor (RF) was detected in all serum samples taken from RA patients (100% positive results) with 100% negative results in healthy controls while C- Reactive protein (CRP) was detected in 70% of serum samples taken from the same patients.

)هو احد امراض المناعة الذاتية الشائعة والذي يسبب التهاب مزمن يصيب RA( التهاب المفاصل الروماتويدي )في CRP( )والبروتين سي الفعال RF( المفاصل .كان الهدف من هذه الدراسة هو التحقيق من مستويات العامل الروماتويدي مريض (ذكور و إناث )من 50 المرضى العراقيين المصابين بألتهاب المفاصل الروماتويدي .تم الحصول على عينات دم من سنة .من 18.75 ± 40.88 عيادات استشارية المفاصل في مستشفى بغداد التعليمي، مدينة الطب، بمتوسط عمر تتراوح مابين سنة .تم الكشف عن 14.73 ± 38.90 عينة ضبط صحيحة بمتوسط عمر 50 ناحية أخرى، تم الحصول على عينات الدم من )٪ نتائج إيجابية100( )في جميع عينات المصل المأخوذة من مرضى التهاب المفاصل الروماتويدي RF(العامل الروماتويدي ٪ من عينات 70 )في CRP( ٪ نتائج سلبية في عينات الضبط الصحيحة بينما تم الكشف عن البروتين سي الفعال 100مع المصل المأخوذة من نفس المرضى.


Article
Efficacy, Safety and Predictors of Response to Rituximab in Treatment of Iraqi Patients with Active Rheumatoid Arthritis

Authors: Sarah Tareq Abdulazeez --- Sami Salman --- Faiq I. Gorial
Journal: Al- Anbar Medical Journal مجلة الأنبار الطبية ISSN: PISSN: 27066207 / EISSN: 26643154 Year: 2019 Volume: 15 Issue: 1 Pages: 16-21
Publisher: University of Anbar جامعة الانبار

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Abstract

Background: Rituximab (RTX) is an anti-CD20 chimeric monoclonal antibody which effectivelydepletes B cells and is used for treating rheumatoid arthritis (RA).Objectives: To assess the efficacy and safety of RTX and to evaluate the predictors of responseto RTX in the treatment of Iraqi patients with active RA.Materials and methods: An open-labeled single group study that was conducted over 13 monthsin 65 patients with RA diagnosed according to a 1987 American College of Rheumatology (ACR)criteria. All patients were given 4 doses RTX by intravenous infusion over 6 months 1gm/dose.Each patient was followed at each visit of disease activity, including the Clinical Disease ActivityIndex (CDAI) and functional class (F Class). Also, we assess 9 different patients’ characteristics(age, gender, disease duration, the presence of RF, presence of ACPA, smoking status, previous useof TNF-blocker, the use of methotrexate and BMI) as predictors to RTX.Results: Data analysis showed significant improvement in CDAI (P value=0.005) and functionaldisability (P-value =0.001), and ESR (P-value =0.005) with RTX use over 6 months. The analysisalso showed that smoking has a negative correlation with response to treatment (p-value = 0.005).A better response was seen in RF-positive group. The other variables had no effects on the responseto treatment. The patients who switched from TNF-blocker were (29), and the patients who startedon RTX were 36 (either due to positive Purified Protein Derivative of a tuberculin test (PPD) orunavailability of TNF-blocker), results showed same RTX efficacy in both groups.Conclusion: RTX is effective both clinically (CDAI and F Class) and laboratory (ESR). It ismore effective in patients who are not smokers, and in those who are seropositive for RF. RTX isrelatively safe with few side effects, tolerable by most patients. The most common side effect is atransfusion reaction in the form of a sore throat.


Article
Study of HLA-class II Serotyping and cellular immunity CD4+T, CD8+T cells in Iraqi patients with Rheumatoid arthritis
دراسة التنميط المصلي لكريات الدم البيضاء و المناعة الخلوية للخلايا التائية المساعدة والسمية لدى المرضى العراقيين المصابين بالتهاب المفاصل الرثوي

Authors: Hanaa N. Abdulla هناء ناجي عبدالله --- Amina N. Al-Thuwan امنه نعمة الثويني --- Mohammed Ibrahim Nadir محمد ابراهين نادر
Journal: Al-Nisour Journal for Medical Sciences مجلة النسور للعلوم الطبية ISSN: 26640562 26640554 Year: 2019 Volume: 1 Issue: 1 Pages: 98-107
Publisher: Al-Nisour University College كلية النسور الجامعة

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Abstract

Rheumatoid arthritis is a complex polygenic disease whose environmental and genetic factors contribute to both of the predisposition and developing of disease. The current study was conducted to determine the frequency of human leukocyte antigen (HLA-DR, -DQ) and correlate to this variation with disease severity and detected on the role of cellular immune response in pathogenesis of rheumatoid arthritis. Fifty blood samples were collected from RA patients and 50 healthy control group with no history of inflammatory arthritis. The HLA class II (DR, DQ) estimated serologically by using micro lymphocytotoxicity test. The result indicated that a highly significant frequencies of HLA-DR4 and DR53 antigens were observed in RA as compared to healthy group (P<0.001). Our results revealed that there are significant higher frequencies of HLA-DQ3 antigen (P<0.001) in RA group as compared to control groups. Additionally, the percentage of CD8+ has been decreased in patients in comparison with healthy group, whereas the percentage of CD4+ T-cell has been slightly increased in patients in comparison with healthy control group with nonsignificant differences. The results of this study proved that nonsignificant correlation which was observed between cellular immune response (CD4 and CD8) among patients.

يعد التهاب المفاصل الرثوي مرض اضطراب مناعي ذاتي وتساهم العوامل البيئية والوراثية مساهمة شديدة في الاستعداد للإصابة بالمرض. اجريت الدراسة الحالية للتحري عن مستضدات الكرية البيضاء البشري النمط الثاني( HLA ,وعلاقتها في اختلاف شدة المرض والتحري عن دور الاستجابة المناعية الخلوية في Class-II- HLA-DR ,-DQ) عينة من الاشخاص 50 عينة دم من مرضى التهاب المفاصل الرثوي و 50 التسبب في التهاب المفاصل الرثوي. جمعت الاصحاء ظاهريا. تم قياس تنميط مستضدات الكريات البيضاء مصليا( ( باستخدام فحص سمية الخلايا HLA-DR,-DQ ). وأظهرت النتائج بأن هنالك زيادة معنوية في تكرار مستضدات الكريات البيضاء Lymphocytotoxicity اللمفاوية ( HLA DR4البشرية ( ( -) لدى مرضى التهاب المفاصل الرثوي مقارنة بالأصحاء DR53,HLA. فضلا عن P<0.001) وجود زيادة في تكرار مستضدات الكريات البيضاء البشرية (وبفارق عالي المعنوية في مرضى التهاب HLA-DQ3) المفاصل الرثوي مقارنة بالأصحاء( CD8+T . بالإضافة الى ذلك, انخفاض نسبة الخلايا التائية السمية ( P<0.001) ) لدى مرضى التهاب المفاصل الرثوي مقارنة مع مجموعة الأصحاء ، بينما اظهرت النتائج ارتفاعا في نسبة الخلايا cells CD4+Tcell التائية المساعدة ( ) لدى المرضى مقارنة بمجموعة الأصحاء. تؤكد نتائج الدراسة الحالية عدم وجود علاقة s معنوية بين الخلايا( .(CD4+T and CD8+T cells


Article
LOCAL EXPERIENCE OF TOTAL KNEE REPLACEMENT IN BASRAH

Authors: Thamer A Hamdan --- Khalil I Sadek --- Mohammed AbedYasir
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2019 Volume: 25 Issue: 1 Pages: 10-15
Publisher: Basrah University جامعة البصرة

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Abstract

LOCAL EXPERIENCE OF TOTAL KNEE REPLACEMENT IN BASRAH Thamer A Hamdan@, Khalil I Sadek# & Mohammed AbedYasir* @FRCS, FICS, FACS, FRCP, American Board of Neurological & Orthopedic Surgery, Professor of Orthopedic Surgery. #FICMS, Orthopedic specialist, Basrah Teaching Hospital. *CABHS Orthopedic specialist, Al-Sadr Teaching Hospital, Basrah, IRAQ. Abstract Total knee arthroplasty (TKA) represents a major advance in the treatment of degenerative joint disease providing excellent restoration of joint function and pain relief. This is a prospective study undertaken in the Department of Orthopedic Surgery in Basrah Teaching Hospital, from October 2009 to June 2011. Thirty-three patients who underwent primary total knee arthroplasty were included (25 females 75.7% and 8 males 24.2%). The diagnosis was osteoarthritis in 20 knees and rheumatoid arthritis in 13 knees. The operation included primary cemented TKA (25 cruciate-retaining and 8 cruciate-substituting), by anterior approach. The knee function was evaluated by knee society score system. Preoperative functional knee scores were uniformly poor and improved postoperatively with excellent results in 18 knees (54.54%), good in 9 knees (27.27%), fair in 5 knees (15.15%), and poor in 1 knee (3%). Thus, excellent and good results were achieved in 81.8% of the cases (27 of 33 knees). For knee scores, 2 knees (6%) were fair preoperatively and another 31 knees (93.9%) were poor. Post TKA results were excellent in 28 knees (84.84%), good in 5 knees (15.15%), fair in (0%) and poor in (0%). Excellent and good results were achieved in 100% of cases. The most common complications were superficial infection and deep venous thrombosis In conclusion, this study showed good outcome for total knee replacement surgery in our region. Excellent relief of pain, range of motion, and restoration of function. Keywords: Total Knee Replacement, Osteoarthritis, Rheumatoid arthritis, Basrah, Surgery.


Article
Study of IL-33 and IL-1R4 in Iraqi Rheumatoid Arthritis Female Patient's with and without Dyslipidemia Prone to Atherosclerosis

Journal: Ibn Al-Haitham Journal For Pure And Applied Science مجلة ابن الهيثم للعلوم الصرفة والتطبيقية ISSN: 16094042 Year: 2019 Volume: 32 Issue: 1 Pages: 48-56
Publisher: Baghdad University جامعة بغداد

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Abstract

This study is planned to find relationship between interleukin-33 (IL-33) with its receptorinterleukin-1 receptor 4 (IL-1R4), and assurance IL-33/IL-1R4 proportion as biomarker toatherosclerosisin rheumatoid arthritis (RA) Iraqi female’s patients with and withoutdyslipidemia. This study was attempted at Baghdad Teaching Hospital included 60 female’spatients with RA that were isolated into: 30 patients with dyslipidemia(G2), 30 patientswithout dyslipidemia(G3) and 30 individuals as control group (G1). Patients wereexperiencing treatment by methortexiene medication, analyzed by rheumatoid factor (RF) anderythrocyte sedimentation rate (ESR) tests. All patients and control groups age ranged from(30-55) years. The results show an increase in ESR, RF, IL-33, and IL-1R4 levels. In additionto decrease in IL-33/IL-1R4 ratio in the two patient’s groups when contrasted and controlgroup. The momentum examine inferred that the level of ESR, and IL-33 in RA Iraqi femalespatients with dyslipidemia were higher than that in RA Iraqi females patients withoutdyslipidemia, while the level of IL-33/IL-1R4 ratio in RA Iraqi females patients withdyslipidemia was lower than that in RA Iraqi females patients without dyslipidemia patients;in this manner the IL-33/IL-1R4 ratio may be used as a biomarker in diagnostic early porn toatherosclerosis in RA females patients with dyslipidemia.


Article
Combination of novel and tradition biomarkers to enhance diagnostic sensitivity and specificity for early diagnosis of rheumatoid arthritis and seronegative rheumatoid arthritis

Authors: Shatha Rouf Moustafa --- Evar Ali Taha
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2019 Volume: 23 Issue: 2 Pages: 247-258
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Abstract

Background and objective: Rheumatoid arthritis is an autoimmune disease. This study investigated the potential value of combining cartilage oligometric matrix protein, anti-cyclic citrullinated protein, and 14-3-3 eta protein with traditional biomarkers to reduce the diagnostic gap. Methods: This case-control study included 46 male and female patients and 42 age- and gender-matched adults as control group. The biomarkers were measured using ELISA technique.Results: Tests for anti-cyclic citrullinated protein and cartilage oligometric matrix protein are excellent tools to diagnose rheumatoid arthritis because anti-cyclic citrullinated protein and cartilage oligometric matrix protein are associated with the highest ROC area. The validity of the test for 14-3-3 eta protein, which is a good test to predict rheumatoid arthritis, ranks second. The optimum cut-off values for high cartilage oligometric matrix protein, high anti-cyclic citrullinated protein, and high 14-3-3 eta protein were ≥0.242µg/L, ≥0.566ng/L, and ≥0.145ng/L, respectively. 14-3-3η protein, cartilage oligometric matrix protein status as a parallel combination which is considered as a wonderful combination in classification criteria for rheumatoid arthritis. Parallel combination, both criteria two tests are positive, namely “high cartilage oligometric matrix protein (≥0.242) + high 14-3-3η protein (≥0.145)” was associated with a perfect test, that the patients have rheumatoid arthritis (sensitivity 100%, specificity 100%, accuracy 100%, positive predictive value at pre-test probability 50% and 90% = 100%). A positive test using this combination is 100% diagnostic and establishes a possible diagnosis of rheumatoid arthritis with 100%, while a negative test would exclude a possible diagnosis of rheumatoid arthritis with 100% confidence. Conclusion: Results confirmed that high serum level of cartilage oligometric matrix protein, anti-cyclic citrullinated protein, and 14-3-3 eta protein are significantly associated with increased risk for rheumatoid arthritis, demonstrating the potential value of combining these new biomarkers with traditional biomarkers to enhance diagnostic sensitivity and specificity and ultimately reduce the diagnostic gap.

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