Prevalence of Osteoporosis in 100 Iraqi Patients with Systemic Lupus Erythematosus: A Case Control Study

Back ground: In recent years, survival of patients with systemic lupus erythematous (SLE) has raised significantly so long-term complications, as osteoporosis, are currently of major importance. Objective: To assess the prevalence of osteoporosis in Iraqi patients with SLE. Patients and Methods: This case control study was conducted on 100 SLE patients and 100 healthy controls matched in age, sex, and body mass index. Bone mineral density (BMD) obtained at the lumber spine (L1-L4) and right and left femurs using dual energy X-ray absorptiometry (DXA) machine (Dexxum). Osteoporosis was diagnosed according to WHO guidelines criteria for diagnosis of osteoporosis and Z-scores was used in premenopausal women and men younger than 50 years. Results: Mean age of SLE patients was 32.01±10.14 years and 32.46±6.29 years in the control group. Females represented 91% of patients and 92% of controls. The mean BMI of patients was 27.41±6.04 kg/m2 compared to 28.8±5.26 kg/m2 of controls. There was no statistical significant differences between both groups in demographic characteristics (P>0.05). BMD at lumbar spine was significantly lower in SLE patients than controls (82(82%) vs 61(61%), p< 0.001, OR (95%CI): 3.04(1.59-5.81).Of those patients with low BMD, 46% had osteoporosis. Additionally, BMD at total femur was significantly lower in SLE patients than controls (59 (59%) vs 24(24%), p<0.001, OR (95%CI): 4.56(2.48-8.37). Of those patients with low BMD at total femur, 15 (15%) had osteoporosis. Multiple logistic regression analysis showed non-significant association between low BMD in SLE patients and various baseline characteristics (P>0.05). Conclusions: Prevalence of osteoporosis in Iraqi patients with SLE was 46% at lumbar spine and 15 % at total femur. This may suggest to do early screening for low BMD in patients with SLE for early diagnosis and appropriate treatment. Keywords: SLE, Osteoporosis, Dual x-ray absorptiometry, Bone mineral densit

Prevalence and Predictors of Pulmonary Arterial Hypertension in a Sample of Iraqi Patients with Systemic Sclerosis: A Cross-Sectional Study

Background: Pulmonary arterial hypertension (PAH) is now the most frequent cause of death in systemic sclerosis (SSc). Aims: The aims of the present study were to evaluate the prevalence of pulmonary arterial hypertension (PAH) and predictors in SSc among Iraqi patients. Materials and Methods: A cross-sectional study conducted on 56 patients with SSc diagnosed according to the criteria developed by the American College of Rheumatology. Baseline characteristics [age, sex, body mass index (BMI), duration of SSc, type of SSc, duration of Raynaud’s phenomenon, and presence of telangiectasia] were documented.  Antiscleroderma 70 (anti-SCL70) and anticentromere antibodies were measured. Doppler echocardiography was done to diagnose PAH. A risk score was obtained from 7 criteria, namely: Anti-Centromere Ab, Limited disease type, short duration of Raynaud's phenomena (<2.5 years), older age group (40+ years), absence of Telangiectasia, female gender, and absence of anti SCL70 Ab.  Results: We found that PAH was present in 11 (19.6%) SSc patients with a 95% confidence interval of (9.2% to 30.0%). Risk score in addition to anti-centromere antibodies were enough to diagnose PAH with accuracy level of 89.3%. Conclusions: PAH in SSc occurs in significant proportion of patients. Risk score and anti-centromere antibodies had high accuracy level in predicting PAH. Screening of patients with SSc for PAH will help in early diagnosis and appropriate timely therapeutic intervention before significant endorgan damage occurs. Key words Systemic sclerosis. Connective  tissue. Pulmonary hypertension

Effect of age on some renal function tests, uric acid, and gamma glutamyl transferase (GGT) in sample of Iraqi men over 40 years

Background: The prevalence of some aging markers that is part of metabolic syndrome elements are increasing worldwide, and the renal function is a major goal of this syndrome. Aim: To correlate the age with some renal function tests (blood urea and serum creatinine), serum uric acid (S.UA) and serum gamma glutamyl transferase (S.GGT).Material and methods: This study involve 127 men apparently healthy (≥ 40 years old) were analyzed for blood urea, serum creatinine, uric acid and gamma glutamyl transferase by the spectrophotometer methods by use the previously prepared kits from linear chemicals company.. Results: The mean age of men was (55.535±10.738)years. The men under study were divided into four groups according to age: 46 men (36.22%) their age range were ≥40 years, 33 cases (25.984%), 28 case (22.047%) and 20 others (15.748%) were (50-59), (60-69) and (≥70) years respectively. The mean ± Std. Deviation of variables in study were B. urea (42.387±3.682) mg/dl, S. creatinine (1.004±0.158) mg/dl, S.UA (6.216±0.829) mg/dl, and S.GGT (28.844±7.741) U/l. Older age was significantly associated with increased in B. urea and S. creatinine, while no significant association was found between age and S.UA and S.GGT in Iraqi men at (P ≤0.05 for all factors).Conclusions: older men are more liable to have higher B. urea and S. creatinine, with no relation between age and the levels of both uric acid and GGT in serum of Iraqi men under study

Effect of obesity on renal function test, uric acid, and gamma glutamyl transferase (GGT) in sample of Iraqi men

The prevalence of both obesity and other elements of metabolic syndrome (Met.S) are increasing worldwide, and the renal function is a major goal of this syndrome. Met.S is associated with a risk of  renal injury, as well as all cause and cardiovascular disease (CVD)[1]. As obesity is related with the development of end-stage renal disease (ESRD)[2].Aim: This study was to correlate Body Mass Index (BMI) with some serum renal function, (blood urea, serum creatinine) and serum uric acid (S.UA) and serum gamma glutamyl transferase (GGT)

Perspectives for the treatment of brucellosis in the 21st century: the Ioannina recommendations.

Brucellosis is probably the commonest anthropozoonotic infection worldwide [1-3], but remains in various aspects an enigma in the 21st century [4]. Brucella melitensis remains the major cause of human disease worldwide, followed by B. abortus and B. suis, while rare but persisting cases of B. canis human infection and disease by novel Brucella pathogens of marine mammals have also emerged. The disease is re-emerging as a significant cause of travel-related disease [5] and represents an index of poor socioeconomic status (Figure 1). Its treatment is largely based even today on the principles applied half a century ago by pioneer researchers [6] and few modifications have been made in the following years, despite the emergence of new antibiotic classes and different therapeutic approaches [7]