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Article
Prevalence of dyslipidemia and its association with disease activity in patients with rheumatoid arthritis attending Rizgary Teaching Hospital in Erbil City
انتشار عسر شحميات الدم وارتباطه بنشاط المرض في المرضى الذين يعانون من التهاب المفاصل الروماتويدي في مستشفى رزكاري التعليمي في مدينة أربيل

Authors: Niaz J. Al-Barzinjy --- Shnow Burhan Hameed
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2017 Volume: 21 Issue: 2 Pages: 1781-1788
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Background and objective: This study aimed to measure the prevalence of dyslipidemia in patients with rheumatoid arthritis compared with healthy control people and find out the correlation between dyslipidemia and disease activity.Methods: A prospective case-control was done. A total of 100 female patients with rheumatoid arthritis were included in the study. This study was conducted at the Rheumatology Out-patient Clinic in Rizgary Teaching Hospital, Erbil City over seven months from April 2013 to October 2013. Patients who fulfilling the 1987 revised American College of Rheumatology and 2010 American College of Rheumatology/European League against rheumatism classification criteria for rheumatoid arthritis and 100 healthy female age-matched controls with the mean age for both groups being 45. Fasting lipid profiles of cases and controls were estimated after an overnight fasting of 12 hours. Association between lipid profile and disease activity using disease activity score DAS 28, inflammatory markers (CRP and ESR) was also determined. Results: Rheumatoid arthritis patients showed a higher prevalence of associated dyslipidemia (47%) in comparison to control (5%), P = 0.004. There was a significant reduction in serum high density lipoproteins (P = 0.04), with significant elevation of serum total cholesterol, triglyceride, low density lipoprotein and very low density lipoprotein (P = 0.001, 0.004, 0.04 and 0.05, respectively) in comparison to controls. There was a significant relation between disease activity score 28 and serum high density lipoproteins (P <0.001) and there was a significant relation between ESR and triglyceride (P = 0.05).Conclusion: is frequent among the patients with rheumatoid arthritis and highly associated with active rheumatoid arthritis. Serum high density lipoproteins significantly reduced while other parameters of lipid profiles significantly increased in comparisons to control.


Article
Characterization of lymphocyte subsets as a tool of assessment of histological disease activity pattern in ulcerative colitis

Author: Hayder F. Ghazi
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2010 Volume: 52 Issue: 3 Pages: 304-308
Publisher: Baghdad University جامعة بغداد

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Background: In Ulcerative colitis (UC), the presence of a persistently elevated number of T cells in the inflamed area with respect to the activity of the disease suggesting bad prognosis. This study was done to evaluate cellular immune response in different disease activity patterns and its possible implication in evaluation of disease activity.Materials and methods: This study included Forty seven archived paraffin-embedded samples of ulcerative colitis; these samples diagnosed and graded for disease activity. Then dual immunofluorescence staining was used for phenotyping of lymphocytic infiltrate (CD3- CD19) and (CD4-CD8). A total and differential T cell as well as plasma cell count was recorded in these UC tissue samples. Non parametric Kruskal-Wallis test was used to compare the median cell counts among different study groups.Results: There is higher lymphocytic infiltrate for all types of cells when UC samples compared with control samples with highly statistical significant difference, T cells represents the major constituents of colonic mucosal infiltrate (86.89%) and about 75.79% were CD4 positive T cells. T-cell subsets and plasma cell have high statistical significant difference (p≤0.001) according to histological grade. Furthermore, with the histological grade the highest association found with T lymphocytes (r=0.944) followed by T helper (r=0.821), T cytotoxic (r=0.653) and B lymphocyte (r=0.237).Conclusions: Qualitative and semi quantitative characterization of lymphocytes subsets was useful in the assessment of different histological grades of UC disease activity.


Article
Co-Expression of Intestinal Lymphocyte Subpopulations in Ulcerative Colitis: An Analysis by Dual- Immunofluorescence Technique

Author: Haider F. Ghazi
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2009 Volume: 2 no.8, 9 Issue: 5 Pages: 725-731
Publisher: Kerbala University جامعة كربلاء

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background: Fluoresceins labelled monoclonal antibodies against cell surfaceantigens are able directly to examine the expression of multiple antigens on thesurface of lymphoid cells in Ulcerative colitis lesions.Materials and methods: Using dual-immunofluorescence for investigated thecoexpression of (CD3-CD19 and CD4-CD8) antigens on infiltrated lymphocytes of 47patients with ulcerative colitis and 10 subjects from control group. Total anddifferential T cells as well as plasma cell counts were recorded in all tissue samples.Non parametric Kruskal-Wallis test was used to compare the median cell countsamong different study groups.Results: T lymphocyte, T-cell subtype and plasma cell in UC were high with highlystatistical significant difference when compared with those in normal control subjectsT cell UC (301.39) Controls (35.48), T-helper 2 UC (228.41) Controls (24.75), Thelper1 UC (54.21) Controls (13.45) and plasma cell UC (45.46) Controls (12.94).Recorded values of were different and increased according to modified Geboeshistological grades of disease activity T lymphocytes (r=0.944) followed by T helper2 subtype (r=0.821), T helper 1 (r=0.653) and B lymphocyte (r=0.237).Conclusions: The increased number of lymphocyte subsets was found in the UClesions and correlated with different histological grades of disease activity.


Article
Prevalence of obesity in rheumatoid arthritis and its association with disease activity and latex positivity in a sample of patients in Erbil
انتشار السمنة في التهاب المفاصل الروماتويدي وارتباطه بنشاط المرض وإيجابية اللاتكس في عينة من المرضى في أربيل

Authors: Dashty Abass Al-Bustany --- Khadeeja Ramadhan Younis
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2017 Volume: 21 Issue: 2 Pages: 1726-1735
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Abstract

Background and objective: The prevalence of obesity is rising across the world and it is regarded as a major health concern which is thought to be associated with a number of chronic illnesses including rheumatoid arthritis. This study aimed to find out the prevalence of obesity in patients with rheumatoid arthritis and to apprehend the association of obesity with disease activity and latex positivity.Methods: One hundred twenty patients with rheumatoid arthritis who were regularly visiting Rizgary Teaching Hospital in Erbil were included in a cross-sectional study using specially designed mixed questionnaire. Body mass index and waist circumferences were measured, and their association with disease activity score 28 (DAS28) and clinical disease activity index (CDAI) were estimated. Furthermore, we evaluated their association with positive latex test.Results: There was increased frequency of obesity in rheumatoid arthritis patients, and there was a positive association between body mass index and waist circumference with disease activity measured by DAS28 and CDAI (P <0.001). There was no significant association between obesity and latex positivity which has been assessed separately for males and females (P = 0.898 and 0.086, respectively).Conclusion: Obesity is frequently found in rheumatoid arthritis patients. It is associated with higher disease activity, but not with the latex positivity in these patients.


Article
Validity and reliability of CDAI in comparison to DAS28 in Iraqi patients with active rheumatoid arthritis
صحة وموثوقية سي دي أي آي مقارنة ب دي اي اس 28 في المرضى العراقيين المصابين بالتهاب المفاصل الروماتويدي الفعال

Author: Faiq I. Gorial فائق ايشو كوريال
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2012 Volume: 54 Issue: 3 Pages: 230-232
Publisher: Baghdad University جامعة بغداد

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Background: Rheumatoid arthritis (RA) disease activity plays a central role in causing disability both directly and via indirect effects mediated through joint damage. Evaluation of RA disease activity is therefore important to predict the outcome and effectiveness of therapeutic interventions during follow-up. Clinical disease activity index (CDAI) is new simple tool for measurement of disease activity.Objectives: To assess validity and reliability of CDAI in comparison to disease activity score-28 joints (DAS28) in Iraqi patients with active RA.Patients and Methods: Sixty nine Iraqi RA patients were included in this study. All patients were fulfilling the ACR classification criteria and active. Full history was taken and complete clinical examination was done for all patients. Patients’ age, sex, duration of the disease, number of tender joints, number of swollen joints, patient’s and physician’s (evaluator) global assessment by visual analogue scale (VAS) (0–10 cm) were recorded. Laboratory analysis included erythrocyte sedimentation rate (ESR). CDAI and DAS28 were measured to assess disease activity.Results: Of 69 patients included in this study, there were 58 women and 11 men. Mean age of the patients was 45.65±12.26 years and mean duration of disease was 7.75±7.85 years. Mean DAS28 and CDAI were 5.86±1.24 and 30.07±14.07respectively.There was direct significant correlation between CDAI and DAS28 (r= 0.879, P< 0.001). Also we found good agreement between CDAI and DAS28 (Kappa = 0.795, P < 0.001). CDAI had sensitivity 90%, specificity 92%, Likelihood ratio (LR) 45.67, Area under the curve (AUC) 0.983 [95% confidence interval (CI) 0.933-1.000] (P value < 0.001).Conclusions: CDAI is a valid and reliable measure for assessment of Iraqi patients with active RA in comparison to DAS28.Key words: Clinical disease activity index, disease activity score 28 joints, rheumatoid arthritis activity

خلفية البحث: تلعب فعالية التهاب المفاصل الروماتويدي دورا رئيسا في التسبب في الإعاقة سواء بصورة مباشرة أو عبر آثار غير مباشرة من خلال ضرر المفصل. تقييم نشاط مرض التهاب المفاصل الروماتويدي مهم للتنبؤ بنتيجة وفعالية التدخلات العلاجية خلال فترة المتابعة .معيار نشاط المرض السريري (س د اي آي) هو أداة بسيطة جديدة لقياس فعالية المرضالهدف: : لتقييم صحة وموثوقية (سي دي اي آي) مقارنة بمعيار درجة فعالية مرض المفاصل (دي اي اس 28) في المرضى العراقيين الذين يعانون من التهاب المفاصل الروماتويدي الفعال.المرضى ومنهاج البحث: شملت الدراسة 69 مريضا عراقيا مصابا بالتهاب المفاصل الروماتويدي. وكان لجميع المرضى معايير التصنيف (أي سي آر) والمرض فعال. تم اخذ التاريخ الكامل، واجراء الفحص السريري الكامل لجميع المرضى. وسجلت اعمار المرضى، والجنس، ومدة المرض، وعدد المفاصل المتحسسة، وعدد المفاصل المتورمة،والتقييم العام للمريض والطبيب باستعمال معيار التماثل البصري( في اي اس) من (0-10 سم). وشملت التحاليل المختبرية معدل الترسيب لكريات الدم الحمراء.وتم قياس (سي دي أي آي و دي اي اس 28) لتقييم فعالية المرض.النتائج: من 69 مريضا ، كانت هناك 58 امرأة و 11 رجلا. وكان متوسط عمر المرضى هو 45.65 ± 12.26 سنة ومتوسط مدة المرض 7.75 ± 7.85 سنة.وكان معدل ( دي اي اس 28 و سي دي أي آي)5.86 ± 1.24 و 30.07 ± 14.07على الترتيب. وكان هناك ارتباط ذي جدوى مباشر بين (سي دي أي آي و دي اي اس 28 ) (R = 0.879، P <0.001). كما وجدنا اتفاقا جيدا بين ( سي دي أي آي و دي اي اس 28 ) (كابا = 0.795، P <0.001). وكانت حساسية سي دي أي آي 90٪، والنوعية 92٪، ونسبة الاحتمال 45.67، والمنطقة تحت المنحنى (AUC) 0،983 [فاصل الثقة 95٪ هو 0،933-1،000] (P قيمة <0.001).الاستنتاج:- سي دي أي آي هو مقياس صحيح وموثوق لتقييم المرضى العراقيين المصابين بالتهاب المفاصل الروماتويدي الفعال مقارنة ب دي اي اس 28.الكلمات المفتاحية: معيار فعالية المرض السريري, معيار فعالية المرض 28 مفصل, فعالية التهاب المفاصل الروماتويدي


Article
Effect of fibromyalgia syndrome (FMS) on disease activity (DAS28) score in patients with rheumatoid athritis(RA)
تأثير متلازمة الم الليف العضلي على نشاط المرض لدى الكرضى الذين يعانون من التهاب المفاصل الرثواني

Author: Abbas M.Ajeed لايوجد
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2011 Volume: 53 Issue: 4 Pages: 452-455
Publisher: Baghdad University جامعة بغداد


Article
Biochemical Studies on Synovial Fluid and Serum from Rheumatoid Arthritis Patients
دراسة كيموحيوية للسائل الزليلي ومصل الدم من المرضى المصابين بإلتهاب المفاصل الرثوي

Authors: Zahraa M. Hammodat زهراء حمودات --- Layla A. Mustafa ليلى احمد مصطفى
Journal: Rafidain journal of science مجلة علوم الرافدين ISSN: 16089391 Year: 2018 Volume: 27 Issue: 4E Pages: 37-46
Publisher: Mosul University جامعة الموصل

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Abstract

The research included biochemical studies on synovial fluid (SF) samples collected from (48) RA patients. Moreover, blood samples from (158) RA patients and (196) healthy as control were collected. These patients were divided according to disease activity score-28 (DAS-28) into two groups which comprise severe and moderate.Physical and chemical analysis of SF revealed of the presence of more than 1 ml, yellow green to gray color, cloudy to opaque, low viscosity, with large fat droplets, bloody fluid, low pH degree, low glucose level, high total protein and albumin levels. The results revealed that all RA patients had a positive rheumatoid factor (RF+) and the concentration of C- reactive protein (CRP) was found to be (36.73 ± 14.397 and 54.27 ± 17.856) mg/l in serum and SF respectively. Also, the level of Erythrocyte Sedimentation Rate (ESR) was found to be (54.85 ± 22.903) mm/hr.Additionally, there were low significant levels of hyaluronidase (Hylase) activity in SF when compared with the serum of RA patients. Also, there was a highly significant increase in levels of Hylase, alkaline phosphatase (ALP) and lactate dehydrogenase (LDH) in the serum of RA patients when compared with the serum of healthy control. Moreover, there were highly significant levels of CRP, ESR, Hylase, ALP and LDH in the serum of RA patients with severe when compared with a moderate. Also there were highly significant levels of CRP, ESR and ALP in the SF of RA patients with severe when compared with a moderate

شملت الدراسة جمع (48) عينة من السائل الزليلي من المرضى، فضلا عن ذلك تم جمع (158) عينة من الدم و (196) عينة دم من الأصحاء كمجموعة سيطرة. تم تقسيم المرضى حسب شدة فعالية المرض الى مجموعتين معتدلة وحادة. أظهرت النتائج ان حجم السائل الزليلي أكثر من واحد مليليتر، وهو ذو لون أصفر مخضر الى رمادي، ضبابي غير شفاف، وذو لزوجة قليلة مع وجود قطرات دهنية كبيرة ودم وإنخفاض في درجة الحامضية ومستوى الكلوكوز وإرتفاع لمستوى البروتين الكلي والألبومين. أظهرت النتائج أيضا أن جميع المرضى يمتلكون العامل الرثوي الأيجابي (RF+) و معدل تركيز البروتين التفاعلي– ثاء-(C-RP) في المصل والسائل الزليلي مساوية (36.73 ± 14.397 و 54.27 ± 17.856) ملغم/100 لتر على التوالي ومعدل الترسيب لكريات الدم الحمراء (54.85 ± 22.903) مليمتر/ساعة. كذلك لوحظ إنخفاض معنوي في مستوى فعالية إنزيم الهايلورونديز في السائل الزليلي مقارنة بمصل المرضى، بالمقابل لوحظ إرتفاع معنوي لمستوى فعالية إنزيم الهايلورونديز وإنزيم الفوسفاتيز القاعدي وإنزيم اللاكتيت ديهايدروجينيز في مصل المرضى مقارنة بمصل مجموعة الضبط. لوحظ أيضا ارتفاع معنوي لمستوى كل من البروتين التفاعلي– ثاء- ومعدل الترسيب لكريات الدم الحمراء والهايلورونديز والفوسفاتيز القاعدي وحامض السيالك في مصل المرضى بين شدة المرض الحادة والمعتدلة. فضلا عن ذلك لوحظ ارتفاع معنوي لمعدل الترسيب لكريات الدم الحمراء في السائل الزليلي للمرضى بين شدة المرض الحادة والمعتدلة.


Article
Immune response to heat shock protein 60 and its relations t enteric reactive arthritis

Authors: Abdal –Razak H. Ahmed --- Mohammed hadi --- Jabbar Salman Hussan
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2009 Volume: 2 no.8, 9 Issue: 5 Pages: 732-736
Publisher: Kerbala University جامعة كربلاء

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Abstract

background: according to the molecular mimicry hypothesis, heat shockprotein 60 (hsp60) is among the most conserved proteins that have beenimplicated as triggering agents in the pathogenesis of enteric reactive arthritis(ReA).Objective: In the present work, we aimed to determine the prevalence of anti-hsp60antibodies in sera of patient with enteric reactive arthritis.Methods: Forty-five patients with Reactive arthritis were enrolled in this study. Theywere 22(48.89%) males and 23(51.11%) females, the age rang was 20 - 40 year withmean (33.6 ± 10.6). All patients were outpatient visitor or hospitalized in the medicalCity hospital in Baghdad. They were diagnosed clinically by consultant rheumatologistwith the aid of some laboratory tests such as RF, CRP, E.S.R.The patients should be sero-negative (RF-negative) and fulfill Amor andEuropean Criteria to be included in this study. Patients were classified according todisease activity into three groups: sever moderat and mild by using (DAREA score).Thirty age and sex matched apparently healthy individual, were considered in thisstudy as a control group. ELISA was used to detect immune response against hsp60 inthe sera of each patients and controls. Wells of the micro titter plates were coated withhsp60 in coating buffer and anti hsp60 antibodies were assayed.Results: the mean age of patients was (33.6± 10.6) years and they were 23 femalesand 22 males with females to male ratio 1.05:1, the majority of patients 19(42.22%)present with high disease activity (sever) and 15(33.33%) patients were moderate andthe remainder 11 (24.44%) were mild disease group.The result of anti-hsp60 Abs detection showed that there was highly significantdifference between ReA patients and control groups. Also there was significantdifference between sever, moderate and mild among ReA patients.Conclusion: we concluded that bacterial hsp60 seems to be a major target of T-cellresponse in enteric ReA. and cross reactivity against autologous hsp60 has beendocumented as a triggering of enteric ReA.


Article
RELATIONSHIP OF PERIPHERAL BLOOD LYMPHOCYTES IMMUNE ALTERATION PHENOTYPE TO DISEASE ACTIVITY IN RHEUMATOID ARTHRITIS PATIENTS.
علاقة التغير المظهري المناعي لخلايا الدم اللمفية المحيطية مع مقياس فعالية المرض في المرضى المصابين بالتهاب المفاصل الرثوي

Authors: Abdul-Razak H. Ahmad عبد الرزاق حردان احمد --- Hayder F. Ghazi حيدر فيصل غازي
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2010 Volume: 8 Issue: 2 Pages: 10-17
Publisher: Al-Nahrain University جامعة النهرين

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Background: Rheumatoid arthritis (RA) is a systemic autoimmune disorder causing synovitis of diarthroidal joints in which activated T-lymphocytes has a prominent position in RA pathology and may be important in prediction of disease outcome. Objective: To evaluate cellular expression of certain activation marker on PBLs and their relevance to disease activity pattern of RA patients.Patients and methods: this study included forty six RA patients, seven patients with Osteo-arthritis (OA) and 10 apparently healthy individuals. The collection of our baseline data based on routine laboratory and clinical assessment of disease activity Score (DAS). Blood sample was taken from each subject in all groups, at the time of attendance. Lymphocytes were separated; slides were prepared fixed on charged slides, foiled, and kept at -20ºC until assayed. CD3 and CD54 expression was detected using Immunocytochemistry staining, while CD71was detected using direct immunoflouresence staining.Results: The results of CD3 and CD54 revealed a statistically higher percentage of expression in rheumatoid arthritis patients when compared with that of the apparently healthy and OA control groups. The CD71 showed statistically significant higher expression in minimum disease activity group without any correlation with clinical and laboratory disease activity indices. Conclusions: we provide further evidence of a T-cell differentiation defect in RA, which could explain some of the well-characterized immunologic features of the disease but it is not related to the disease activity state.Keywords: Rheumatoid arthritis, disease activity, lymphocytes activation, immunocytochemistry, immunofluorescence and CD marker.

خلفية الدراسة: إلتهاب المفاصل الرثوي هو احد امراض ذاتية المناعة يسبب التهاب الغشاء الزلالي للمفاصل ثنائية التركيب, حيث تلعب الخلايا اللمفية المنشطة دوراً مهماً في امراضية التهاب المفاصل الرثوي ولهذا يعتقد بان لها دور مهم في تنبؤ مآل المرض.هدف الدراسة: تقدير التعبير الخلوي لبعض دوال التنشيط في خلايا الدم اللمفية المحيطية وصلتها بنمط نشاط مرض إلتهاب المفاصل الرثوي.المواد وطرق العمل: صممت هذه الدراسه للتحري عن نسب اظهار دوال التغير المظهري المناعي في خلايا الدم اللمفية المحيطية في 46 مريض مصاب بالتهاب المفاصل الرثوي, 7 مرضى مصابين بالتهاب المفاصل العظمي و 10 اشخاص اصحاء ظاهرياً. جمعت المعلومات الاساسيه اعتماداً على التقييم المختبري والسريري لفعالية المرض. اخذت عينات الدم من كل الاشخاص ولجميع المجاميع في وقت استشارة الطبيب المعالج, فصلت الخلايا اللمفية وعدت منها مسحات على شرائح زجاجية مشحونه, حفظت بدرجة حراره -20ºم لحين وقت التحري. قيست نسبة اظهار المعلمات المناعية 3 و 54 قيست باستخدام طريقة التصبيغ المناعي الخلوي الكيميائي بينما المحدد المناعي 71 فقد قيس نسبة اظهاره باستخدام التصبيغ المناعي الخلوي المتآلق المباشر.النتائج: ان نتائج المحدد المناعي 3 و 54 قد اظهرت نسبة اظهار عالية في مرضى التهاب المفاصل الرثوي وبمعنوية احصائيه عالية مقارنة بمجموعتي السيطره الصحية والمصابة بالتهاب المفاصل العظمي. اما المحدد المناعي 71 فقد لوحظ فرق احصائي معنوي وبنسبه اظهار اعلى في المجموعة متدنية شدة المرض. عدم وجود اي ارتباط معياري مع دوال المرض المختبرية والسريرية.الاستنتاج: من نتائج هذه الدراسة, قدمنا ادلة اضافية للخلل التمايزي الحاصل في الخلايا التائيه في مرضى التهاب المفاصل الرثوي والتي من الممكن ان توضح مظاهر مناعية واضحة لهذا المرض والتي ليس لها علاقة بفعالية المرضمفتاح الكلمات: التهاب المفاصل الرثوي، فعالية المرض، تغير المناعي المظهري، تصبيغ مناعي كيميائي، تصبيغ مناعي متالق و محددات مناعية.

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