Objective To estimate the types of hand deformities in patients with rheumatoid arthritis (RA). Methods: A group of 100 patients who had been admitted to the department of rheumatology and rehabilitation center in Sulaimany general hospital and those who had been attended to the rheumatology and rehabilitation center between June 2006 and January 2007 were included in this study.86% were females and 14% were males . Patients who had undergone articular surgery and patients below 16 years had been excluded. Results Hand deformities recorded in 47% of cases. The frequency of deformities was as follow; swan neck deformity (48.90%), boutonniere deformity (43.04%), Z deformity(59.5%), ulnar deviation of the metacarpophalangeal joints (MCPJ) (78.7%), radial deviation of the wrist (91.48%), subluxation of the wrist (27.6%), and subluxation of the MCPJ(36.17%).There was a significant correlation between disease duration and development of deformities,other factors that had been studied but had no effect on the development of deformities were rheumatoid factor positivity ;occupation of the patients ;effect of weather;and geographical distribution of the patients. Conclusion Rheumatoid arthritis is an important disease that affects the hands and cause deformities. Understanding these deformities is necessary for the proper management of these patients. This study is representative for RA related hand deformities and factors that contribute to their development.

Rheumatoid Arthritis --- Hand deformity.

BACKGROUND: Pathogenetic therapy of RA is a complex task,according to modern views on the development of* Dept. of Microbiology, Medical College, Al-Nahrain Univ. ** Dept. of Clinical Biochemistry, Medical College, Al-Nahrain Univ. *** Dept of Basic Science, College of Dentistry, Univ. of Baghdad. (1). autoimmune inflammation in RA, cytokineimbalance plays a great part in RA pathogenesis Rheumatoid arthritis is a chronic systemic inflammatory disease affects many tissues and organs, butprincipally attacks flexible (synovial) joints. Methotrexate is the most commonly used disease-modifyingantirheumatic drug for the treatment of rheumatoid arthritis. OBJECTIVE:The aim of this study was to evaluate the effect of methotrexate on serum levels of IL-1α and IL-8 inrheumatoid arthritis. SUBJECTS AND METHODS: Blood samples were collected from 50 patients with rheumatoid arthritis (25 patients without treatment and 25 patients are received methotraxate) and from 30 healthy age and sex matched individuals served ascontrols. Serum IL-1α and IL-8 were measured by means of enzyme-linked immune-sorbent assay.RESULTS: The present results showed that serum levels of IL-1α and IL-8 were significantly higher in RA patientsthan in healthy controls (P<0.01), furthermore, level of IL-1α was significantly decrease in patientstreated with methotraxate as compared to those patients who have received no treatment (P<0. 01). On theother hand serum level of IL-8 did not showed any significant differences between patients treated withmethotraxate and those patients without treatment (P>0. 05).CONCLUSION: These finding demonstrate that methotrexate turns out to be a good inhibitor for IL-α production. Inaddition, IL-1α and IL-8 may have a significant role in the pathogenesis of rheumatoid arthritis, and couldbe use a

rheumatoid arthritis --- methotrexate --- cytokines

Rheumatoid arthritis (RA) is a chronic, destructive autoimmune disease affecting the joints. With more sophisticated and effective therapies becoming available and with the understanding that early intervention is crucial in preventing irreversible joint damage. The main purpose of this observational study was to evaluate and detects a good genetic factors may be used in early detection of RA. A total of 40 patients with RA who were fulfilled four or more of the 1987 American College of Rheumatology (ACR), 20 patients with joints problems (JP), 20 RA patient relatives (PR) and 10 apparently healthy control individuals were included in this study. Human leukocyte antigen (HLA) genotyping was performed using Mr. Spot SSO system. The distribution of HLA class II genotypes in 20 RA patients and 30 control groups were studied. HLA-DRB1*04 was significantly most common genotypes in the RA patients (70%) compared to control groups (23.3%). While, the frequency of HLA-DRB1*11 was very high among controls (53.3%) compared to RA patients (25.0%), but the difference was not statistically significant. RA susceptibility in most Iraqi patients was associated with the HLA-DRB1*04 genotype. The HLA-DRB1*04 allele contributed significantly to the development of RA .HLA- Therefore, HLA-DRB1*04 allele appears to play an important pathogenic role in all subsets of RA.

التهاب المفاصل الرثوي هو من أمراض المناعة الذاتية المزمنة والمدمرة التي تؤثر على المفاصل بالعلاجِ المتطوّرِ والأكثرِ فعّالية الذي أصبح متوفرا وبالفَهْم بأنّ التدخّلِ المبكّرِ حاسمُ في مَنْع الضررِ المشتركِ الغير قابل للعكس فان من المهم والمهم جدا تشخيص التهاب المفاصل الرثوي في مرحلة مبكرة جدا ولتسهيل التشخيص في المراحل المبكرة من المرض، في كثير من الأحيان عندما لم يكن كل الأعراض السريرية واضحة للعيان، إن الغرض الرئيسي لهذه الدراسةِ هذه هو الكشف عن اختبار للعوامل الوراثية يمكن استخدامه في الكشف المبكر عن التهاب المفاصل الرثوي . شملت هذه الدراسة أربعين مريض يعانون من التهاب المفاصل الرثوي لديهم أربعة أو أكثر من العلامات المحددة من قبل الجمعية الأمريكية للروماتزم, 20 مريض يعانون من مشاكل في المفاصل، 20 شخص من أقارب المرضى الذين يعانون من التهاب المفاصل الرثوي و 10 أشخاص أصحاء كمجموعة سيطرة. كما تم استخدم تقنية مستر سبوت نظام SSO (التسلسل المتخصص أحادي النيوكليوتيدات) من أجل الكشف الوراثي عن مستضد كريات الدم البيض البشرية (HLA). تم دراسة التوزيع الوراثي لمستضد كريات الدم البيض البشرية (HLA) الصنف الثاني لعشرين من مرضى التهاب المفاصل الرثوي وثلاثين من مجاميع السيطرة، أثبتت هذه الدراسة أن HLA-DRB1 * 04 كان معنويا وأكثر شيوعا (70٪) بين المرضى بالمقارنة مع مجموعات السيطرة (23.3٪). في حين HLA-DRB1 * 11 كان موجودا في عدد صغير نسبيا من مرضى التهاب المفاصل الرثوي (25٪) بالمقارنة مع مجموعات السيطرة (53.3٪). ومع ذلك، لا توجد هنالك فروق معنوية. وجد ان الحساسية للإصابة بمرض التهاب المفاصل الرثوي في المرضى العراقيين مرتبط بوجود العامل الوراثي HLA-DRB1 04 * و أن أليل 04 * HLA-DRB1 ساهم بشكل كبير في تطوير التهاب المفاصل الرثوي، ولذلك، يبدو أن HLA-DRB1 * 04 أليل تلعب دورا هاما في التهاب المفاصل الرثوي.

Rheumatoid arthritis --- HLA.

Background: Patients with rheumatoid arthritis (RA) may have higher prevalence ofperiodontitis.Aim: To determine the prevalence of periodontal disease among rheumatoid arthritis patients.Patients and methods: Cross-sectional study was done on 250 patients, who were selected byfrom patients attending Duhok Center for Rheumatic Disease and Medical Rehabilitation.Periodontal health status of the patients based on probing pocket depth score, clinicalattachment loss, and disease activity score was determined. Validated questionnaire was usedto record smoking, body mass index, tooth brushing, duration of rheumatoid arthritis disease.Results: The age range of patients was 35-60 years. All rheumatoid arthritis patients havesome degree of periodontal diseases, 133(53.2%) with mild and 117(46.8%) with moderateperiodontitis.A significant prevalence of periodontal diseases occurred in patients with age group (40-54)years was 144 (57.6%) compared to younger age 46 (18.4%) and older age 60 (24%)respectively, p-value <0.001 The duration of diseases was more significant in intermediate (1year to 3 years) 125 (50%) compared to early (< 12 months) 45 (18%) and longer disease (>3 years) 80 (32%) p-value<0.001.Conclusion: All patients were suffering from some degree of periodontal diseases with nosignificant difference in severity between males and females.

الخلفية والأهداف: احتمالية ان يكون التهاب اللثة اكثر انتشارا في المرضى المصابين بالتهاب المفاصل.تهدف الدراسة الى ايجاد مدى انتشار امراض اللثة في المرضى المصابين بالتهاب المفاصل.طريقة البحث: تمت الدراسة على 250 من المرضى الدين تتراوح اعمارهم بين 30-60 الدين يراجعون مركز التاهيل الصحي لامراض المفاصل. مدى صحة الفم واللثة يعتمد على قياس عمق الجيوب اللثوية و مدى فعالية المرض.النتائج: انتشار امراض اللثة في المرضى المصابين بالتهاب المفاصل كانت 133(53.2%) التهاب لثة خفيف و 117 (46.8%) التهاب لثة متوسط . يوجد اختلاف معنوي في امراض اللثة في المرضى الذين تتراوح اعمارهم بين (40-54) سنة كانت 144 (57.6%) مقارنة بالاقل اعماراً 46 (18.4%) والاكبر أعماراً 60(24%). الاستنتاجات: توصلت الدراسة الى انه لا يوجد اختلاف معنوي في شدة امراض اللثة بين الجنسين ولو ان نسبة الاناث اكثر من نسبة الذ كور.

Periodontitis --- Rheumatoid arthritis

Background: Increased levels of specific proteins and Immunoglobulines have been detected in serum from patient with rheumatoid arthritis (RA).Objective: To clarify the clinical significance of specific serum proteins and Immunoglobulin in RA. Methods: Forty- two patients with sero-positive rheumatoid factor (group 1 and 2 according to disease activity progresses) and twenty age- matched healthy subjects were included in the study. Serum total proteins, Protein electrophoresis and Immunoglobulin level were evaluated. Results: Acute phase reactants in RA patients showed a significant increase in comparison to healthy subjects (P < 0.001). There was a significant difference in the levels of α- globulins, γ-Nglobulins, IgG and IgM in group 1 as compared to group 2.Conclusion: The prognostic value of serum specific proteins and Immunoglobulin in patients with RA is high, and can provide some help in predicting the outcome of joint inflammation.

rheumatoid arthritis --- specific proteins immunoglobulin