Prevalence of abnormal ankle-brachial index in Iraqi patients with systemic lupus erythematosus

Accelerated atherosclerosis is a well-recognized complication of systemic lupus erythematosus [SLE]. Its etiology is a multifactorial and several methods may be used to detect the presence and severity of peripheral arterial disease [PAD]. To assess ankle brachial index [ABI] in Iraqi patients with SLE, and to evaluate predictors of this relationship. Forty three Iraqi SLE patients and 50 healthy controls were included in this study. Full history was taken and complete clinical examination was done for all individuals in both groups. Disease characteristics [age, sex, body mass index [BMI, duration of disease, SLE disease activity index [SLEDAI], smoking history, family history, hypertension, hyperlipidemia, thrombosis, Raynaud's phenomenon and drugs used] were also documented. Laboratory analysis included complete blood count, general urine examination, serum lipid profile, fasting blood sugar, thyroid function tests, anti-double stranded deoxyribonucleic acid [anti-ds-DNA], complements components and anti-phospholipid anti-bodies. Individuals in both groups were assessed using the ABI. The ABI was measured using a contour wrapped 12cm cuff attached to a mercury sphygmomanometer and 5-10 MHz Doppler in the arms and legs; a ratio of

Screening of hepatitis B- and C- viral markers in Iraqi patients with proteinuria

Viral hepatitis may lead to nephropathy as one of its multiple extra hepatic manifestations. Symptomatic proteinuria as detected by dipstick, and qualitative urine collection are simple tests in practice as well as useful cardinal test of underlying renal abnormalities. The aim of this study was to elucidate the impact of hepatitis B virus [HBV] and/or hepatitis C virus [HCV] infections on the occurrence of symptomatic proteinuria amongst adults and pediatrics. A prospective study included [143] adult and pediatric Iraqi patients presented with symptomatic proteinuria, and 108 [age- and sex-matched] apparently healthy individuals [as control group] who were serologically screened for HBV and HCV markers using third generation Enzyme linked immunosorbent assay [ELISA] techniques, screening for HIV by ELISA and other related immunological and biochemical profile. It was found that the prevalence of hepatitis B surface antigen [HBsAg], anti hepatitis B core antibody [anti-HBc-IgM], anti hepatitis B surface antibody [anti-HBs] and anti hepatitis C antibody [anti-HCV] in the proteinuria group as compared to control group, were [7.0% vs. 0.9%, P<0.05] for HBsAg, [2.8% vs. 0%, P>0.05] for anti-HBc-IgM, [20.3% vs. 23.1%, P>0.05] for anti-HBs antibody, and [6.3% vs. 0%, P<0.01] for anti-HCV. Our study demonstrated a significant association between proteinuria and HCV, and HBV infection in the adult and pediatric population. The interpretation of serological patterns of viral hepatitis markers in patients with newly diagnosed proteinuria are important, it might suggest that detailed urinalysis and qualitative urine protein assessment is mandatory when managing patients with HCV or with HBV infections

Iron status in patients with chronic renal failure on haemodialysis

Anaemia is common in renal failure. Serum iron [SI], and the percentage of transferrin saturation [TSAT] reflect the amount of iron immediately available for haemoglobin [Hb] synthesis. Serum ferritin level reflects total body iron stores. Adequate iron stores are essential for achieving maximum benefit from recombinant human erythropoietin [Epo]. A low level of either of these indices may indicate the need for supplement iron to support erythropoiesis. Seventy Patients with end stage renal disease [ESRD] on regular haemodialysis [HD] were included in this study from three dialysis centers in Baghdad: We have collected data on, serum iron, total iron binding capacity [TIBC], TSAT, Serum ferritin, and blood film, was done. Fifty subjects were included in the control group. A44 patients [62.9%] were receiving regular parenteral Iron Dextran with Epo, and 26 patients [37.1%] were receiving irregular oral or intramuscular iron Dextran with Epo. According to the serum ferritin, 41 patients [58.6%] involved have serum ferritin level >300ng/ml, of them; the TSAT was > 20% in 27 patients while TSAT 11 g/dl in 11 patients where as 20% in three patients only, the Hb level was 20% in 21 patients [30%], while those who taking no or irregular iron therapy with Epo [26 patients] [37.1%], the STAT was >20% in 9 [12.9%] the difference was not statically significant. The serum ferritin in our study group was higher than that reported in other studies. Serum ferritin of 300 ng/ml, and TSAT of< 20% in our study group was significantly correlated with anaemia. Serur ferritin of < 300 ng/ml and a TSAT of < 20% were significantly associated

An echocardiographic study of valvular heart disease associated with systemic lupus erythematosuS

Valvular heart disease is the most important cardiac manifestation 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. 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. Abnormal valvular Echocardiographic findings were multiple valvular abnormalities found in 21 patients [37.5%], were distributed in three groups according of valvular involvement: [Groupl] 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. 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