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Article
An Echocardiographic Study of Valvular Heart Disease Associated with Systemic Lupus Erythematosus

Author: Safa Ez-Aldeen Al-Mukhtar
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2006 Volume: 5 Issue: 4 Pages: 396-405
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT:BACKGROUND:Valvular heart disease is the most important cardiacmanifestation of systemic lupus erythematosus (SLE). We performed a study to determine the relation of valvular disease to other clinical features of lupus, the type and the incidence of valvular heart disease in SLE patients.METHODS:We performed transthoracic echocardiography (TTE) and rheumatologic evaluations in 56 patients with systemic lupus erythematosus. The echocardiographic findings were compared with those in 40 healthy volunteers.RESULT:Abnormal valvular Echocardiographic findings were multiple valvular abnormalities found in 21 patients (37.5%), were distributed in three groups according of valvular involvement: (Group1) included patients with anatomical and functional valvular involvement (AFVI) in seven patients (12.5%). (Group2) included patients with anatomical valvular involvement without Doppler detected valve dysfunction (AVI) in 11 patients (19.6%). (Group3) included patients with functional abnormalities (stenosis or regurgitation) without valvular thickening (FVI) in three patients (5.3%). Positive antiphospholipids antibody (aPLs) was found in a total of 29 patients (51.7%), of those 17 patients (58.6%) had valvular echocardiographic abnormalities and four patients (14.8%) of the 27 patients with negative aPLs had abnormal echocardiographic findings.CONCLUSIONS:Valvular heart disease is common in patients with SLE, valvular abnormalities were correlated with the aPLs in patients with SLE. Echocardiography is an excellent tool for the diagnosis and follows up of valvular abnormalities in patients with SLE.


Article
The Role of Plasma Lipoprotein and Carotid Doppler in Detecting Premature Atherosclerosis Among Iraqi Patients with Systemic Lupus Erythematosus

Author: Khudhir Zghayer Mayouf Al-Bidri
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2008 Volume: 7 Issue: 2 Pages: 147-151
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT:BACKGROUND:Cardio vascular involvement is fatal and critical complication of the systemic lupus erythematosus. Serum lipid profile and carotid Doppler studies can be used to evaluate premature atherosclerosis among patients with systemic lupus erythematosus .OBJECTIVE:The purpose of this study was to detect premature atherosclerosis among Iraqi patients with systemic lupus erythematosus by estimation of fasting serum lipid profiles and Doppler Carotid studies.PATIENTS AND METHODS:Fifty Iraqi patients (45 females and 5 males) who fulfilled the American College of Rheumatology (ACR) 1997 revised criteria for classification of SLE were studied . Another 50 healthy (45 females and 5 males) individuals matched for age and sex were collected from relatives and accompanying persons with patients attending the Rheumatology Clinic and studied serving a control group.Full history was taken and complete clinical examination was done for all patients and control group .The levels of serum cholesterol , low and high density lipoprotein and triglycerides were estimated and Doppler studies for common carotid arteries were done for individuals in both groups.The patients were classified according to clinical presentation to four groups:Group 1: Patients with mucocutaneous and musculoskeletal manifestation only.Group 2 : Patients with mucocutanous,musculoskeletal manifestation and serositis.Group 3: Patients with mucocutanous, musculoskeletal, serositis and lupus nephritis without cerebritis.Group 4: Patients with Mucocutanous , musculoskeletal, serositis and lupus cerebritis without nephritis.RESULTS:There were no significant differences in total cholesterol level in group 1 patients compared to control group, but there were significant differences in group 2,3,4 patients compared to control group.There were significant differences in cholesterol, low density lipoproteins (LDL),high density lipoproteins (HDL),and triglyceride (TG) levels between SLE patients compared to control group which is positively correlated with disease duration .There were no significant differences in intimal media thickness(IMT)in group1and2 compared to control group but there were significant differences in IMT in group 3 and 4 compared to control group and the significant differences in IMT were positively correlated with disease duration.CONCLUSION:The results showed that SLE patients mostly have hyperlipidemia as well as ultrasonic markers of atherosclerosis.


Article
The Role of Oxidative Stress in the Pathogenesis of Systemic Lupus Erythmatosus (SLE) Among Some Iraqi Patients

Author: Ihab Ibrahim AbdulWahab
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2007 Volume: 6 Issue: 4 Pages: 286-288
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND AND OBJECTIVE:Systemic Lupus Erythematosus (SLE) is a chronic progressive autoimmune disorder with a wide spectrum of clinical and immunological abnormalities, predominantly developed in women of childbearing age, oxidative stress has been postulated in many pathological conditions including atherosclerosis , inflammatory conditions and some autoimmune disease such as multiple sclerosis , rheumatoid arthritis and Systemic Lupus Erythematosus (SLE).The present study was conducted to support the idea of oxidative stressduring the pathogenesis of (SLE) among some Iraqi patients, comparing it with healthy controls group matched for the same sex and age .PATIENTS AND METHODS:Twenty-three Iraqi Arab patients (21 females and 2 males) with Systemic Lupus Erythmatosus (SLE) admitted to Baghdad Teaching Hospital were included in the present study ,and have been compared with 13 healthy controls .The patients group were diagnosed as having SLE according to the basis of the revised criteria of the American College of Rheumatology ,Analysis of the parameters of oxidative stress , serum malondialdehyde (MDA) and glutathion (GSH) was performed in all patients before starting any type of drug treatment and their levels were compared with those belong to healthy controls.RESULTS:The results presented in this study showed elevated serum MDA concentration in the SLE patients group compared to healthy control ; however , this elevation failed to reach the statistically significant (P<0.05).Significant variation was also demonstrated in serum levels of glutathione between both patients group , in which serum GSH level was significantly lower in the diseased group compared to healthy controls ( P<0.05).CONCLUSION:Oxidative stress mechanism can be proposed as a cause and / or consequence in the pathogenesis of SLE , supporting the theory of free radical –induced tissue damage in this respect.


Article
The Association Of Autoimmune Thyroiditis With Systemic Lupus Erythematosus
العلاقة بين التهاب الغدة المناعي مع داء الذؤابة الأحمراري

Author: Wesal Salman Abdulmuhsin وصال سلمان عبدالمحسن
Journal: Thi-Qar Medical Journal مجلة ذي قار الطبية ISSN: 19929218 Year: 2010 Volume: 4 Issue: 2 Pages: 53-58
Publisher: Thi-Qar University جامعة ذي قار

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Abstract

ABSTRACT: We determined the degree of ovelap between autoimmune thyroiditis disease and Systemic Lupus Erythematosis (SLE). Fourty one SLE patients with twenty age- and sex-matched controls were included in this study. Twenty-one (51%) of the SLE patients had anti thyroglobulin (anti-TG) antibodies. Ten SLE patients had elevated TSH levels, usually in association with the presence of anti-TG. These results suggest that SLE is associated with autoimmune thyroiditis and that many patients with SLE have minor hypothyroidism.

الخلاصة: حددت درجة التداخل بين التهاب الغدة المناعي مع داء الذؤابة الأحمراري تضمنت الدراسة 41 مريضامصابا بداء الذؤابة الأحمراري مقارنة بمجموعة سيطرة .كان (51%) 21 منهم يحملون مضاد الثايروكلوبيولين وكان لعشرة مستويات عالية من الهرمون المحفز للدرقية مع حملهم لمضاد الثايروكلوبيولين . من هذه النتائج يتبين وجود علاقة بين التهاب الغدة المناعي مع داء الذؤابة الأحمراري حيث ان العديد من مرضى داء الذؤابة الأحمراري يعانون من انخفاض طفيف بأفراز الغدة الدرقية.


Article
Association of Autoimmune Thyroiditis and Systemic Lupus Erythematosus

Author: Wisal Salman Abd
Journal: Al-Nahrain Journal of Science مجلة النهرين للعلوم ISSN: (print)26635453,(online)26635461 Year: 2012 Volume: 15 Issue: 4 Pages: 179-182
Publisher: Al-Nahrain University جامعة النهرين

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Abstract

This study was designed to investigate the relationship between Systemic Lupus Erythematosus (SLE) and autoimmune thyroiditis disease. Forty one SLE patients diagnosed by latex agglutination test with twenty age and sex matched controls were included in this study. Results revealed that twenty one (51%) of SLE patients had antithyroglobuline antibody and ten of the SLE had elevated TSH. These results suggests that there was an association between SLE and autoimmune thyroiditis

صممت هذه الدراسة للتحري عن العلاقة بين التهاب الغدة المناعي مع داء الذؤابة الأحمراري.تضمنت الدراسة 41 مريضا مصابا بداء الذؤابة الأحمراري مقارنة بمجموعة سيطرة.أظهرت النتائج 21 مريضاً (51%) منهم يحملون ضد الثايروكلوبيولين وكان لعشرة مستويات عالية من الهرمون المحفز للدرقية مع حملهم لمضاد الثايروكلوبيولين.هذه النتائج تبين وجود علاقة بين التهاب الغدة المناعي مع داء الذؤابة الأحمراري.


Article
Oral manifestations, oral health status and saliva composition changes in a sample of Iraqi systemic lupus erythematosus patients

Authors: Noor S. Mohammed نور محمد --- Taghreed F. Zaidan تغريد زيدان
Journal: Journal of baghdad college of dentistry مجلة كلية طب الاسنان بغداد ISSN: 16800087 Year: 2012 Volume: 24 Issue: special issue 2 Pages: 65-69
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease associated with significantmorbidity and mortality. Sicca symptoms are frequent in SLE which may be related to concomitant occurrence ofSjögren's syndrome (SS). The aims of study were to determine prevalence of oral manifestations andtempromandibular joint disorders, and to find a correlation between the changes in saliva flow rate, pH andcomposition with the incidence of dental caries in SLE patients.Subjects, materials and methods: One hundred and two individuals were enrolled in this study; 52 of them were SLEpatients; and 50 were healthy control individuals matched in age and gender. The assessment of dental status wasmade according to the decay missing filling teeth (DMFT) index; the gingival inflammation was assessed using thecriteria of gingival index; Clinical pocket depth was measured with periodontal probe type William, and wholeunstimulated saliva samples have been collected from each subject for biochemical analysis. Also, salivary flow rateand pH were measured. After centrifugation, the supernatant of saliva was aspirated for biochemical analysis.Results: Oral ulceration was the most prominent orofacial manifestations of SLE patients followed byTempromandibular joint (TMJ) disorders and facial skin rash then oral vesicles& bullae, oral lichen planus and finallyoral petechiae & purpura. Salivary flow rate and salivary pH were significantly lower in SLE patients than in the controlsubjects. Oral hygiene index (DMFT index, gingival index, Clinical pocket depth) were significantly higher in SLEpatients than in the control subjects .Salivary calcium, sodium, chloride, and total protein were significantly higheramong SLE patients than in the control subjects. While salivary potassium and inorganic phosphorus were significantlylower among SLE patients than in the control subjects. In addition, there was a highly significant positive linearcorrelation between age of SLE patients and DMFT, and between age and clinical pocket depth; and a highlysignificant negative linear correlation between salivary flow rate and salivary calcium in SLE patients. Also there washighly significant positive linear correlation between DMFT and salivary calcium, and between DMFT and salivarychloride.Conclusions: Oral manifestations are common in Iraqi SLE patients. Changes in salivary flow rate, pH, salivarycomposition, and increased dental caries may serve as potential markers of the extent of autoimmune mediatedsalivary gland dysfunction which is similar to Sjogren’s syndrome


Article
Correlation between Interleukin-4 and Interleukin-6 and auto antibodies in Systemic Lupus Erythematosus.

Author: Sajid N. Abdualkader* MBChB د. ساجد نادر عبد القادر
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2009 Volume: 51 Issue: 4 Pages: 416-418
Publisher: Baghdad University جامعة بغداد

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Summary:Background: There is a general acceptance which illustrated that auto antibodies act as a central immunological disturbance in most of the auto immune diseases, among these auto immune disease lies the SLEPatients and Methods: Thirty five patients with SLE were compared to twenty age and sex matched, control subjects and studied for the presence of auto antibodies, plus IL-4 and IL-6 using Elisa method and immune fluorescent method (for ANA only)Results: Data showed that IL-6 detectable levels were statistically significant in patients with positive anti ds-DNA, but not significant statistically in ANA positive patients although it was detected in 24 (70.6%) of positive ANA patients, while there was no statistically significant correlation between IL-4 detectable level and autoantibodies production.Conclusion: There is apparently a positive correlation between IL-6 and anti ds DNA production in lupus patients.Key words: Autoantibodies, Interleukin-4, Interleukin-6, systemic lupus erythematosus


Article
Human Leukocyte Antigens Assosiation with Systemic Lupus Arythematosus In Iraqi Patients

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Background: The etiology of Systemic lupus erythematosus seems to be multifactorial including environmental as well as genetic factors. The genetic predisposition was supported by the occurrence of Systemic lupus erythematosus in more than one member of a family as well as in identical twins.Aim of the study: To determine the human leukocyte antigen typing class I (A and B) in patients with Systemic Lupus Erythematousus disease. Methods: Patients group consisted of 44 Iraqi Arab Muslims patients with Systemic lupus erythematosus disease who presented to Baghdad Medical City from January 2010 to January 2012 from Baghdad Province. The second control group consisted from 80 Iraqi Arab Muslims volunteers from hospital employees and their relatives. Human leukocyte antigen typing done for them using serological method by microlymphocytotoxicity test.Results: A total of 44 patients with Systemic lupus erythematosus were studied. Patients' age ranged from 6 to 65 years with a mean of 29.61 ± 12.78. The other control group, their ages ranged from 16 to 55 years with a mean of 31.35 ± 10.02 . Females were more than males in both groups. Human leukocyte antigen typing of Systemic lupus erythematosus patients showed A2( 16, 36.36, 0.20), A3( 14, 31.82, 0.17), B4(10, 22.73, 0.12) , B12 (10, 22.73, 0.12) and B21(10, 22.73, 0.12) were the highest absolute numbers, phenotype frequencies and genotype frequencies respectively. There was a significant difference in between SLE patients and control group in the following alleles (A1, A28, A36, A43,B 6, B12, B14, B15, B16, B35, B42, B53).Conclusions: Genetic factors do have a role in the development and expression of Systemic lupus erythematosus . human leukocyte antigen -A28 , A36, B12 and B21 had an association with Systemic lupus erythematosus Iraqi patients.Key words: Human Leukocyte Antigens, Systemic Lupus Erythematosus , Tissue typing


Article
Frequency of Anti Lactoferrin Antibodies in Patients With Systemic Lupus Erythematosus and Rheumatoid Arthriti

Authors: Nahla Ghanim Abdul–Majeed --- Mahmood Raheem Al-Rubaye --- Najeha Ahmed Ameen --- leen Khalooq Mustafa Kamil
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2014 Volume: 13 Issue: 4 Pages: 571-577
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT: BACKGROUND: Lactoferrin is a multifunctional iron-binding protein present in several mucosal secretions as well as in secondary granules of polymorphonuclear leukocytes.Anti-Lactoferrin antibodies, which belong to antineutrophil cytoplasmic antibodies have been described in several immunomediated diseases, including Systemic Lupus Erythematosus and in patients with Rheumatoid Arthritis and others, with conflicting results regarding either their prevalence or clinical associations.OBJECTIVE:Detection of anti-Lactoferrin antibodies in Systemic Lupus Erythematosis and Rheumatoid Arthritis patients and studying its association to disease activity in comparison to healthy controls.PATIENT& METHODS :The study involved 74 Systemic Lupus Erythematosis patients, 40 Rheumatoid Arthritis patients who were referred to Immunological Department in Teaching laboratory Medical City during period of (1st of January – 31st of June) 2011 and 30 apparently healthy individual. Antinuclear antibody, complement C1q, rheumatoid factor and lactoferrin antibody were detected by enzyme-linked immunosorbent assay technique While double stranded DNA was detected by indirect immunofluorescent technique and complements (C3, C4) by single radial immune diffusion.RESULTS: Anti-lactoferrin Ab was detected in 14(18.9%) SLE patients, 4 (8.9%) Rheumatoid arthritis patients. Both C3&C4 levels were decreased significantly in Systemic lupus with positive anti lactoferrin Ab level in comparison to healthy controls( p value 0.024). In this regard Circulating immune complex was positive in 38(51.3%) systemic lupus patients only 12(31.5%) had positive lactoferrin antibody level, (p value 0.004).double stranded DNA was detected in 41(55.4%) Systemic lupus patients only 7(17.0%) of them had positive lactoferrin Ab level. Anti -Lactoferrin Abs showed neither a significant correlation with Rheumatoid factor IgG& IgM ( P value 0.159 ) nor with rheumatoid factor IgA ( P value 0. 857). CONCLUSION: Anti-lactoferrin antibodies could be detected in patients with Rheumatoid Arthritis and more often in patients with Systemic Lupus with significant correlation to decrease complements levels in comparison to healthy control.


Article
Frequency of Antineutrophil Cytoplasmic Antibodies (ANCA) in Some Autoimmune Diseases

Authors: Husam M. Abbas --- Falah S. Manhal
Journal: Iraqi Journal of Pharmaceutical Sciences المجلة العراقية للعلوم الصيدلانية ISSN: 16833597 Year: 2009 Volume: 18 Issue: 2 Pages: 55-60
Publisher: Baghdad University جامعة بغداد

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Anti-Neutrophil Cytoplasmic Antibodies (ANCA) are a heterogeneous group of autoantibodies with a broad spectrum of clinically associated diseases. The diagnostic value is established for Proteinase 3 (PR3)-ANCA as well as Myeloperoxidase (MPO)-ANCA. To estimate the frequency of anti-neutrophile cytoplasmic antibodies (ANCA) in sera from a group of Iraqi patients with some autoimmune diseases compared with a healthy control group. Serum samples were collected from one hundred patient, 47 males and 53 females; with age range of 16-70 years; 20 specimens from patients with systemic lupus erythematosus (SLE), 30 from patients with ulcerative colitis (UC), and 50 from patients with rheumatoid arthritis (RA). A group of 40 apparently healthy blood donors was included as controls. ANCA were checked using enzyme-linked immunosorbent assay (ELISA). Positive ANCA was detected in sera of 18 (18%) patients with autoimmune disorders. Anti-PR3 was detected in 6 (12%) patients with RA, and in 4(13.4%) patients with UC. Anti-MPO was detected in 3(6%) patients with RA and in 5(16.6%) patients with UC. All serum samples of patients with SLE showed negative ANCA. There were no ANCAs detected in sera from healthy individuals. Mean of serum anti-PR3 (U/ml) among the studied groups was 2.057 in RA, 2.209 in SLE, and 2.283 in UC, and 1.739 in control group. Statistical analysis revealed that differences in the anti-PR3 between RA, UC and controls were highly significant (P > 0.01), whereas just significant with SLE (P> 0.05). Mean of serum of anti-MPO (U/ml) among the studied groups was 0.711 in RA, 0.695 in SLE, and 1.170 in UC, and 0.652 in control group. Statistical analysis revealed that the differences in the anti-MPO between RA and SLE, controls were non significant (P < 0.05), whereas highly significance with UC (P> 0.01).It was concluded that ANCA markers might play a role in the inflammatory process and they are important factors for the clinical course, and prognosis in the patients with autoimmunity. However, ANCA in autoimmune disorders must be interpreted cautiously with particular attention paid to laboratory technique, the size, age and genetic background of the populations studied.

الأجسام السايتوبلازمية المضادة للخلايا المتعادلة هي مجموعة مختلفة من الاجسام الذاتية ذات طيف واسع من الامراض المرتبطة سريريا .تم اجراء هذه الدراسة للفترة من تشرين الثاني 2006 لغاية شباط 2007 لغرض تقدير نسبة تكرار الاجسام السايتوبلازمية المضادة للخلايا المتعادلة (ANCA) في أمصال مجموعة من المرضى العراقيين المصابين ببعض الأمراض ذاتية المناعة مقارنة بالمجموعة الضابطة للأصحاء . تم جمع 100 عينة مصل من المرضى (47 ذكور و 53 أناث بمعدل عمري 16-70 سنة) ، 20 عينة من المصابين بداء الذئاب الحماموي المجموعي ، و30 من المصابين بالتهاب القولون التقرحي ، و50 عينة من المصابين بالتهاب المفاصل الرثوي . جمعت 40 عينة مصل من بعض المتبرعين الأصحاء في مصرف الدم كمجموعة ضابطة . تم التحري عن وجودANCA باستخدام تقنية المقايسة المناعية الإنزيمية (ELISA) . تم تشخيص هذه الاجسام المضادة في 18 (18%) من كل المرضى . ظهر anti-PR3 في 6 (12%) من المصابين بالتهاب المفاصل الرثوي وفي 4(13.4%) في مرضى التهاب القولون . ظهر anti-MPO في 3 (6%) من مرضى التهاب المفاصل الرثوي ، و (16.6%)5 من مرضى التها ب القولون. كانت النتائج سالبة في داء الذئاب الحماموي المجموعي. لم تظهر هذه الاجسام في المجموعة الضابطة . ظهر من خلال هذه الدراسة ان متوسط anti-PR3 (وحدة / سم 3) بين المجاميع التي درست كان 2.057 في التهاب المفاصلالرثوي ، 2.209 في داء الذئاب الحماموي المجموعي ، و 2.283 في التهاب القولون التقرحي ، و1.739 في المجموعة الضابطة . أظهر التحليل الإحصائي بان الاختلاف في anti-PR3 بين التهاب المفاصل والتهاب القولون التقرحي مقارنة بالمجموعة الضابطة كان معنويا بشكل عال P) < 0.01 ) ، في حين كان الاختلاف معنويا فقط في داء الذئاب P) < 0.05 ) . ظهر كذلك ان متوسط anti-MPO (وحدة / سم 3) كان 0.711 في التهاب المفاصل ، و 0.695 في داءالذئاب الحماموي ، و 1.170 في التهاب القولون التقرحي ، و 0.652 في المجموعة الضابطة . ظهر كذلك ان الاختلاف في النتائج بين التهاب المفاصل وداء الذئاب الحماموي ومجموعة السيطرة كان غير معنوي P) > 0.05 ) في حين كان الاختلاف معنويا بشكل عال مع التهاب القولون التقرحي P) < 0.01 ) . يستنتج من هذه الدراسة بان الأجسام السايتوبلازمية المضادة للخلايا المتعادلة ((ANCA قد تلعب دورا في العملية الالتهابية وتحديد المسار السريري ومصير المرضى المصابين بامراض المناعة الذاتية . ولكن وجود هذه الاجسام المضادة يجب ان يشخص بحذر في امراض المناعة الذاتية مع تركيز الانتباه على تقنية الفحص و عدد واعمار المرضى وخلفيتهم الوراثية.

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