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Article
Quantitative Ultrasound Versus Dual-Energy X-Ray Absorptiometry for Diagnosis of Osteoporosis in Iraqi Women with Rheumatoid Arthritis

Author: Nizar Abdulateef Jassim
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2009 Volume: 8 Issue: 2 Pages: 114-119
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT: BACKGROUND: Osteoporosis is a major co-morbidity in rheumatoid arthritis (RA). Bone mineral density (BMD) in adults can be assessed precisely by dual-energy x-ray absorptiometry (DXA). In recent years, quantitative ultrasound (QUS) technique has been used in radiation-free assessment of bone density by mean of ultrasound waves attenuated by bone. OBJECTIVE: The aim of study was to compare QUS to DXA in assessing BMD in patients with RA. PATIENTS AND METHODS: Fifty women with RA (diagnosed according to ACR criteria) of 2-12 years duration, their ages range from 30-72 years, who were seen at Osteoporosis Clinic in Baghdad Teaching Hospital were recruited. Sixty four percent were or had been receiving glucocorticoid treatment. All patients receiving disease modifying anti-rheumatic drugs (DMARDs). Lumbar spine BMD was measured by DXA, and QUS for calcaneum was performed in all patients. RESULT: T-scores measured by QUS were correlated significantly with lumbar spine BMD T-scores measured by DXA (p<0.0005). Bone mineral density T-scores were negatively correlated with age and disease duration. Patients taking glucocorticoids were associated with lower T-scores. CONCLUSION: The findings of this study support QUS as an alternative tool for assessing BMD in patients with RA.


Article
Validity of the Ratio of Serum Concentration of Interleukin 6 to Transforming Growth Factor-Beta1 in a Sample of Patients With Rheumatoid Arthritis

Author: Nizar Abdulateef Jassim
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2015 Volume: 14 Issue: 2 Pages: 296-301
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND: Interleukin 6 (IL-6), a pro-inflammatory cytokine, plays a key role in the development of rheumatoid arthritis (RA). Transforming growth factor-beta1 (TGF-β1) is an anti-inflammatory cytokine which is considered to be an important (down) regulator of inflammation in RA.OBJECTIVE:To evaluate serum concentration of IL6 to TGF-β1 ratio in a sample of Iraqi patients with RA. METHODS: A case control single center study was conducted for 11 months. A total of 50 patients with RA diagnosed according to the 1987 American College of Rheumatology (ACR) and 30 individuals matched in age and sex as control group were included. Serum concentration of IL-6 to TGF-β1 ratio and serum IL-17 were determined in both RA groups using enzyme-linked immunosorbent assay (ELISA). The cut off value was assessed by receiver operating characteristics (ROC) test and correlation by spearman's Rholinear correlation coefficient.RESULTS: Frequency of females was more than males in patients and controls (88% and 76.7% respectively). Ages of patients range between 20-70 years with a median 43.76 years while in controls, ages range between 20-60 years with a median 37.67 years. Serum concentration of IL-6 toTGF-β1 ratio was significantly more in patients than those in controls (p=0.018). Area under the curve (AUC) at value 0.686 was statistically significant (p=0.018) and had intermediate accuracy. Serum IL-6 to TGF- β1 ratio≥ 2.4pg/ml was the optimum cutoff value that can differentiate between RA and healthy controls with accuracy 71.9%. There was a significant positive linear correlation between IL-6 to TGF-β1 ratio and IL-17( r=0.56, p<0.001) and simple linear regression analysis showed that for each 1unit increase in IL6 to TGF-B1 ration there was a significant increase of 0.7 pcg/ml in IL-17(R2=0.467, P < 0.001)CONCLUSION: Serum concentration of IL6 to TGF-β1 ratio was significantly higher in Iraqi sample of RA patients compared to controls. This may help in early diagnosis of RA and suggest potentially an early effective treatment.


Article
Temporomandibular Joint Disorders among Patients with Juvenile Idiopathic Arthritis

Author: Zainab Shalan Khalaf *, Nadia Aftan Al-Rawi **, Nizar AbduLateef Jassim
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2017 Volume: 16 Issue: 1 Pages: 98-101
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND: Juvenile idiopathic arthritis (JIA) is an immune mediated chronic disease. In its most severe clinical form, JIA may show localized and/or systemic and oral complications. This may result in variable growth and developmental anomalies. As a result, it is not uncommon for JIA patients to present with skeletal Class II and open bite malocclusions.OBJECTIVE:This study was conducted to assess temporomandibular joint (TMJ) among patients with JIA.MATERIALS AND METHODS: A cross sectional study was conducted among JIA patients attending Baghdad Teaching Hospital from November 2014 to April 2015. All patients underwent a clinical evaluation of their TMJ condition. TMJ disorder was assessed by using Helkimo’s index (1974a), and distribution of TMJ disorders was assessed according to the age, gender, duration of illness and types of medication.RESULTS: The mean age of JIA patients was 17.59±9.63 years old and mean Illness duration of 8.45± 9.29 years. High percentage of patients (93.8%) presented with clinical dysfunction of TMJ (CDI). 22 patients with JIA (27.16%) presented with severe clinical dysfunction, 19 patients with JIA (23.46%) presented with moderate clinical dysfunction and 35 patients (43.21%) presented with mild clinical dysfunction of TMJ. No significant difference in mean value of CDI according to age and duration of illness. Females were affected by clinical dysfunctional index of TMJ more than males, but statistically non- significant. The highest mean value of CDI was among patients treated with prednisolone, while patients treated with combination of drugs were the least affected.CONCLUSION: This study confirms that patients with JIA have a high incidence of TMJ dysfunction. The systemic effect of disease may impact on development of TMJ and facial growth. Close supervision is required to JIA patients for orthodontic intervention need, regular dental care, and TMJ evaluation.


Article
Survey of Pap Smear in Women with Systemic Lupus Erythematosus

Author: Anwar Muhammed, Alaa Hazim, Nizar AbduLateef Jassim, Jasmine Hummadi
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2019 Volume: 18 Issue: 3 Pages: 242-248
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

BACKGROUND:Systemic lupus erythematosus (SLE) is a chronic multisystem autoimmune disorder affectingmainly young women during childbearing years.OBJECTIVE:To assess the prevalence of cervical dysplasia in a group of Iraqi women with SLE andstudy the relationship between results of Pap smear and HPV DNA test with disease activity,disease duration and use of immunosuppressant drugs.PATIENTS AND METHODS:A case controlled study was conducted on 55 women with SLE and 55 healthy controls. Fullhistory was taken and complete physical examination including extensive gynecologicalevaluation was done for both groups. High vaginal swab and culture, Pap smears and HPVPCR test were done to them.RESULTS:Patients with SLE were more likely to have cervical dysplasia than control (P=0.022) with2.1 folds increased risk. HPV infection was found to have no statistically significant differencebetween both studied groups (P>0.15). The C1N1 changes were significantly associated withhigh SLEDAI scores (P=0.030) and longer disease duration (P= 0.027). There was nosignificant correlation neither with the dose nor with the duration of use ofimmunosuppressant medications and Pap smear findings (P> 0.05).CONCLUSION:The prevalence of cervical dysplasia was higher in SLE patients than controls. Patients with SLEwere more likely to have abnormal Pap smear findings which significantly and directly associatedwith disease duration and disease activity than controls.


Article
Renal Involvement in 25 Patients with Systemic Sclerosis

Authors: Nizar Abdulateef Jassim --- Ziad Shafeek Al-Rawi --- Ali Abdumajeed Diab --- Ali Nazar Mohammed
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2009 Volume: 8 Issue: 1 Pages: 1-6
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Renal involvement is considered a poor prognostic factor and not frequently a cause of death in patients with scleroderma. Renal involvement can be divided into scleroderma renal crisis and non-renal crisis abnormalities.OBJECTIVE:To evaluate the frequency of renal involvement in 25 Iraqi patients with systemic sclerosis (SSc).METHODS:Twenty five patients with SSc (21 female and 4 male) were included in a case-controlled study. All patients fulfilled the American College of Rheumatology criteria for SSc. All patients were of diffuse type. Other types of SSc were excluded. All patients underwent measurement of blood pressure and investigations had been done for them which included: hemoglobin (Hb), white blood cell (WBC) count, platelet count, erythrocyte sedimentation rate (ESR), blood urea (BU), serum creatinine (SCr), general urine examination (GUE), and rheumatoid factor (RF). Same investigations were done for 25 healthy person (considered as control group).RESULT:All patients (100%) had Raynaud’s phenomenon, 23 patients (29%) had dysphagia, 21 patients (84%) had arthralgia, 10 patients (40%) had telangiectasia and 2 patients (8%) had subcutaneous calcification. Three patients (12%) had moderate hypertension. Fourteen patients (56%) had anemia, 2 patients (8%) had leukocytosis, 6 patients (24%) had elevated ESR, 1 patient (4%) had elevated BU, 1 patient (4%) had albuminuria and 4 patients (16%) had positive RF. Platelet count and SCr were normal in all patients. Only 1 patient (4%) had renal involvement in form of combination of azotemia, albuminuria and hypertension.CONCLUSION:Renal involvement in systemic sclerosis among Iraqi patients is rare.

Keywords

renal --- iraqi --- systemic sclerosis.

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