البحث — المستودع الرقمي العراقي

نتائج البحث: 13 من أصل 13

الاثار الجانبية الكبدية والدموية لجرعة منخفضة من الميثوتريكسيت 15 ملغم/ اسوبع لمرضى التهاب الفاصل الروماتويدي الذين عولجوا بالعلاج البيولوجي مع او بدون الستيرويد Hepatic and Hematological adverse effects of low dose (< 15 mg / week) Methotrexate in Rheumatoid Arthritis patients treated with Biological therapy with or without steroid

اسم المؤلف: عدي حاتم نايف

اسم المشرف: خضير زغير معيوف البدري

الموضوع العام: الطب

السنة: 2018

الموضوع الدقيق: الامراض - المفاصل

الدرجة: دبلوم عالي

الجامعة: جامعة بغداد - كلية الطب

اللغة: الانكليزية

مكان الجامعة: بغداد

انتشار نوبة الاكئاب العظمى عند النساء العراقيات المصابات بهشاشة العظم في فترة ما بعد انقطاع الطمث Prevalence of Major Depressive Disorder Among Postmenopausal Iraqi women with Osteoporosis

اسم المؤلف: سرى قاسم عباس

اسم المشرف: نزار عبد اللطيف جاسم

الموضوع العام: الطب

السنة: 2018

الموضوع الدقيق: الامراض - المفاصل

الدرجة: دبلوم عالي

الجامعة: جامعة بغداد - كلية الطب

اللغة: الانكليزية

مكان الجامعة: بغداد

الصفحات الاولى:

انتشار كتلة العضلة غير الطبيعي لدى المرضى العراقيين المصابين بفصال الركبة وتاثيرها على نوعية الحياة Prevalence of Abnormal Muscle Mass in Iraqi Patients With Knee Osteoarthritis and its Effect on Quality of Life

اسم المؤلف: رغد دريد يحيى

اسم المشرف: فائق ايشو كوريال

الموضوع العام: الطب

السنة: 2018

الموضوع الدقيق: الامراض - المفاصل

الدرجة: دبلوم عالي

الجامعة: جامعة بغداد - كلية الطب

اللغة: الانكليزية

مكان الجامعة: بغداد

الصفحات الاولى:

المستخلص: Age - related osteoarthritis is characterized by degradation of articular cartilage and substantial loss of matrix, as a consequence of senescence; Intra - articular cell senescence and cartilage matrix degradation, extraarticular loss of skeletal muscle mass and deteriorated proprioception contribute to development of osteoarthritis. Age - related degenerative loss of skeletal muscle mass and strength is referred to as Sarcopenia, skeletal muscle mass is the metabolically active body component, however, fat massis metabolically inactive, so that the changes of skeletal muscle mass and fat mass with aging can be one of the most relevant biomarkers of senescence.Aim of the study This study was conduc ted to assess the prevalence of abnormal muscle mass (sarcopenia) in Iraqi patients with knee osteoarthritis and to evaluate the effect of sarcopenia on knee osteoarthritis patient's quality of life.Patients and methods This was a cross sectional study conducted at Baghdad Teaching Hospital, Unit of Rheumatology during the period from august 2017 to the end of June 2018, a total of 150 Iraqi females aged 50 years old and older with knee osteoarthritis. Plain X - rays of the weight bearing bilateral knee joints were obtained from the anterio - posterior and lateral aspects with 30º of knee flexion, quality of life and disease impact assessment was done by using Western Ontario and McMaster Universities Osteoarthritis Index, Physical activity measurement was done by using The leisure - time Physical Activity Index. Assessment of sarcopenia was done by using a dual energy x - ray absorptiometry scan for the body composition analysis, fat mass, lean mass, and bone mineral density. Diagnosis of sarcopenia was made via measuring skeletal mass index which defined as appendicular skeletal muscle mass /height m², cut off point ≤ 5.6 kg/m² for female and handgrip strength was measured using a Dynamometer, cut off point < 20 kg. Body mass index (BMI) was measured. History of sociodemographic and medications including steroid and NSAIDs were taken.Results : The current study revealed that 14 (9.3%) of Iraqi women with knee osteoarthritis had sarcopenia. BMI appear to significantly predict sarcopenia (negative correlation), since the OR less than 1.0, both T score and Z predict sarcopenia (negative correlation) and T score appear to predict sarcopenia better than Z score (since the OR is lower in T score compared to Z score), LM and FMI negatively correlated with sarcopenia, gripe strength negatively correlated with sarcopenia.Age, menopausal duration, and sarcopenia appear to directly correlate with osteoporosis, while BMI, LM, FMI, negatively correlated with osteoporosis. Patients with sarcopenia had 7 folds increase risk of having osteoporosis. There was no significant association between WOMAC scoring (quality of life indicator) and sarcopenia and osteoporosis in women with knee osteoarthritis.

التاثيرات الصحية لداء الفقار المقسط على جودة الحياة والاداء الوظيفي للمرضى العراقيين Health - Related Quality of Life and Work Outcome in Iraqi Patients with Ankylosing Spondylitis

اسم المؤلف: نورا صباح مهدي

اسم المشرف: نزار عبد اللطيف جاسم

الموضوع العام: الطب

السنة: 2018

الموضوع الدقيق: الامراض - المفاصل

الدرجة: دبلوم عالي

الجامعة: جامعة بغداد - كلية الطب

اللغة: الانكليزية

مكان الجامعة: بغداد

الصفحات الاولى:

المستخلص: Background : Ankylosing Spondylitis (AS) is a chronic inflammatory rheumatic disease, mainly affecting the axial skeleton, and less frequently the peripheral joints, entheses as well as other extra - articular organs such as the eyes, heart and lungs. AS has a considerable effect on the individual’s healthrelated quality of life. Work disabled patients with AS experience a significantly reduced quality of life.Objective : To evaluate health - related quality of life and factors influencing it in patients with Ankylosing Spondylitis, as well as, to assess work outcome and its correlation with quality of life in AS patients.Patients and Methods : A case - control study was conducted at the Rheumatology Unit in Baghdad Teaching Hospital during the period from August 2017 to March 2018. A total of 168 patients (151 male : 17 female) with Ankylosing Spondylitis were enrolled in the study, all of them fulfilled the modified New York criteria for Ankylosing Spondylitis, and Assessment of Spondyloarthritis International Society (ASAS) classification criteria for axial spondyloarthropathy, and compared with 169 healthy controls (149 male : 20 female) matched for age and sex. Socio - demographic and clinical data of the patients and controls were collected. Health - related quality of life and work outcome were evaluated by the medical outcome survey short form - 36 (SF - 36) and work productivity and activity impairment - specific health problem (WPAI - SHP) scores respectively.Results : the mean age of the studied groups was 37.4 ± 9.4 years and 36.9 ± 9.5 years in Ankylosing Spondylitis and control groups, respectively. The median disease duration in AS patients was 11.3 ± 7.6. The quality of life in Ankylosing Spondylitis patients on all the scales of the short form 36 (SF - 36), was significantly worse than in the control group. Mental health quality of life was mostly affected than physical health overall. Role - physical was the most affected subscale of the short form - 36 (SF - 36). Male gender, smoking,fatigue, bath Ankylosing Spondylitis functional index (BASFI), treatment with biologics (anti - tumor necrosis factor) were significantly associated with the components of physical & mental health - related quality of life. Of 168 patients, 126 were employed (75%). Patients with Ankylosing Spondylitis reported work absenteeism loss, work productivity loss, overall work impairment, and daily activity impairment of 9.19%, 48.17%, 36.19%, 50.82% respectively. Work productivity and activity impairment - specific health problem (WPAI - SHP) summary scores were significantly correlated with all scores of quality of life (short form - 36).Conclusions : Ankylosing Spondylitis has negative impact on patients’ healthrelated quality of life, affecting both physical & mental health. Male gender, smoking, fatigue, poor functional status, treatment with biologics were the most associated factors with better or worse quality of life in patients with Ankylosing Spondylitis. AS has a significant effect on working conditions, quality of life has a direct relationship with a patient’s ability to work.

تقييم نوعية الحياة لدى المرضى العراقيين المصابين بمرض بهجت وعلاقتها مع فاعلية المرض Quality of life assessment in Iraqi patients with Behçet’s disease and its relationship with disease activity

اسم المؤلف: میس عجیل جبار

اسم المشرف: فائق ايشو كوريال

الموضوع العام: الطب

السنة: 2018

الموضوع الدقيق: الامراض - المفاصل

الدرجة: دبلوم عالي

الجامعة: جامعة بغداد - كلية الطب

اللغة: الانكليزية

مكان الجامعة: بغداد

الصفحات الاولى:

المستخلص: Behçet’s disease is a multisystem inflammatory disorder characterized by recurrent exacerbations affecting mucocutaneous tissues, eyes, blood vessels, and several other tissues. Among them, vascular and nervous system involvement are the most common causes of mortality in Behçet’s disease. The previous studies have shown that Quality of Life in patients with Behçet disease was negatively affected by the disease.Aim of the study : To evaluate Quality of Life in patients with Behçet’s disease compared with healthy controls, To assess the correlation of Quality of Life with organ involvements of Behçet’s disease and To assess the effect of demographic and clinical features of Behçet’s disease on Quality of Life. Patients and Methods : A case - control study was conducted at the Rheumatology Unit of Baghdad Teaching Hospital in Medical City from July 2017 to January 2018 . A total of seventy - one consecutive patients (45 male : 26 female) were classified as Behçet’s disease by fulfilling the International Study Group criteria 1990 for Behçet’s disease and compared with seventy - one healthy controls (45 male : 26 female) matched for age and gender. After acquiring their consent, findings were gathered using a preconstructed data collection sheet for patients and controls that evaluate Age, gender, smoking status, disease duration, age at disease onset, Behçet’s disease organ involvements were reported. Disease activity was assessed using Behçet's disease current activity form and health - related quality - of - life was evaluated using The Short Form - 36 (SF - 36) .Results : All the components of Short Form - 36 (SF - 36) , it’s summary scores and Total Short Form - 36 (Total SF - 36) score was significantly lower ( p - value <0.001 ) in patients compared to control . Patients with eye involvement had significantly higher Physical functioning (p - value = 0.023), role - physical ( p - value <0.001), and bodily pain (p - value <0.010) subscores when compared to those without eye involvement. Patients with skin involvement did not show a significant impairment in all SF - 36 subscales when compared to those without skin involvement. Behçet's disease Patients with articular involvement, Physical functioning (p - value = 0.027), bodily pain (p - value <0.001), and general health (p - value = 0.018) subscores are significantly impaired when compared to those without articular involvement .Behçet’s disease patients with myalgia, Physical functioning (p - value = 0.001), bodily pain (p - value = 0.018), and vitality (p - value = 0.038) subscores are significantly impaired when compared to those without myalgia. patients with Central nervous system involvement, physical functioning (p - value = 0.006), rolephysical (p - value <0.001), bodily pain (p - value = 0.001) , general health (p - value = 0.001) and vitality (p - value = 0.042) subscores are significantly impaired when compared to those without Central nervous system involvement. There are certain demographic and treatment modalities had a significant positive impact on Total SF - 36 score : Male gender (p - value = 0.020) , use of cyclosporine (p - value = 0.043 ), use of infliximab (p - value = 0.001), and use of adalimumab (p - value = 0.001) . While others had a significant negative impact on Total SF - 36 score : Disease duration (pvalue = 0.019) , Behçet’s Disease Current Activity Form (BDCAF) (p - value = 0.043 ), and use of Mycophenolate mofetil (p - value = 0.043 ).

تقييم نسبة خلايا الدم المتعادلة الى الخلايا اللمفاوية وعرض توزيع الصفائح الدموية كعلامات التهابية في عينة من المرضى العراقيين المصابين بمتلازمة الالم الليفي العضلي Evaluation of blood neutrophil - lymphocyte ratio and platelet distribution width as inflammatory markers in a sample of Iraqi patients with fibromyalgia

اسم المؤلف: فادية علي شعلان

اسم المشرف: زياد شفيق الراوي

الموضوع العام: الطب

السنة: 2018

الموضوع الدقيق: الامراض - المفاصل

الدرجة: دبلوم عالي

الجامعة: جامعة بغداد - كلية الطب

اللغة: الانكليزية

مكان الجامعة: بغداد

الصفحات الاولى:

المستخلص: Fibromyalgia syndrome is a diminished quality of life related to generalized body pain with physical and psychological symptoms that occurs in the absence of a clear pathologic cause. Neutrophil to lymphocyte ratio is a simple parameter to assess easily the inflammatory status of a subjects. Platelet distribution width is a regular parameter in blood routine examination which reflects variation of platelet size distribution. Mean platelet volume is a part of the complete blood count test and correlates with the platelets function and activation.Objective : To evaluate Neutrophil to lymphocyte ratio, Platelet distribution width and Mean platelet volume in patients with Fibromyalgia as an inflammatory markers.Patients and Methods : This case - controlled study was conducted at Baghdad Teaching Hospital, Unit of Rheumatology, from July 2017 till November 2017. A total of 100 Iraqi patients with Fibromyalgia diagnosed according to 2012 Canadian Guidelines in addition to 50 healthy subjects worked as a control group were recruited. Data were collected using a paper clinical research form through interview and questionnaires. It consisted of two parts : the first part for the demographic data and full history, the second part laboratory data when the samples collected and sent for laboratories to obtain Platelet distribution width and Mean platelet volume while Neutrophil/lymphocyte ratio was calculated manually.Results : The neutrophil to lymphocyte ratio was significantly higher among patients with fibromyalgia (2.18) compared to healthy controls (1.92) (p =0.033). The Mean platelet volume was significantly higher in patients with fibromyalgia (8.3) compared to healthy controls (8) (p =0.045). In contrast, the Platelet distribution width was significantly lower among patients with fibromyalgia (16.7) compared to healthy controls (17) (p=0.01). No statistically significant differences had been found in demographic variables. None of the tested parameters qualified as an acceptable test for predicting a diagnosis of fibromyalgia, since the Receiver operating characteristic area associated with any of them did not reach the minimum value of (0.65).Conclusions : The Neutrophil to lymphocyte ratio is significantly higher in fibromyalgia patients compared to the healthy controls. The Mean platelet volume is significantly higher in the patients compared to the controls. The Platelet distribution width was significantly lower among the patients compared to the healthy controls. None of these tested parameters qualified as an acceptable test for predicting a diagnosis of Fibromyalgia.

العلاقة بين الخصائص السريرية وبروز القرص القطني وانتقامة المثبت بفحص الرنين المغناطيسي The Relationship between Clinical Features and Magnetic Resonance Imaging Proven Lumbar Disc Bulging and Herniation

اسم المؤلف: ابان ناظم علي

اسم المشرف: خضير زغير معيوف البدري

الموضوع العام: الطب

السنة: 2018

الموضوع الدقيق: الامراض - المفاصل

الدرجة: دبلوم عالي

الجامعة: جامعة بغداد - كلية الطب

اللغة: الانكليزية

مكان الجامعة: بغداد

الصفحات الاولى:

المستخلص: Lumbar disc herniation is one of the commonest causes of low backpain. The Magnetic resonance imaging is a gold standard noninvasiveinvestigation for viewing lumbar anatomy and physiology in great details.Obesity is strongly linked to biomechanical changes that damage thespine and contribute to a range of spinal diseases including intervertebraldisc herniation.Aim of the studyTo evaluate the effects of body mass index and waist to hip ratio on thepresence, extent and severity of lumbar disc bulging and herniation as wellas to determine the relationship between clinical features and magneticresonance imaging proven lumbar disc bulging and herniation.Patients and methodsA cross - sectional study was conducted at Baghdad Teaching Hospital,Rheumatology Unit during the period from October 2017 to May 2018. Atotal of 100 patients with lumbar disc bulging and herniation proven by MRIwere included in this study. The patients were examined neurologically andtheir body mass index was calculated as well as the waist to hip ratio.ResultsThe magnetic resonance imaging findings demonstrated that (72%) ofthe studied group had disc bulge, (13%) had disc protrusion and (15%) haddisc extrusion with no cases of disc sequestration. Multiple discinvolvements were seen in (73%) of those patients. The correlation betweenbody mass index and the total disc bulge/extrusion score was statisticallysignificant. There was a significant association between neurological deficitand body mass index as well as between straight leg raising test, femoralVIstretch test, neurological deficit and the waist to hip ratio. On the other hand,there was no significant association between clinical features and nerve root compression for patients with both normal body mass index as well as overweight and obese ones, although the frequency of patients with positive clinical findings was higher in patients with nerve root compression but the difference did not reach the significant level (P - value >0.05). The sensitivity of straight leg raising test, femoral stretch test and crossed straight leg raising test were (39.6%), (25.3%) and (6.6%) respectively.ConclusionsThere is an increase in the likelihood of having lumbar disc herniation and its global severity in overweight and obese patients. The clinical findings were more severe in overweight and obese patients especially in patients with central obesity. There was no significant association between the clinical features and the nerve root compression in patients with both normal body mass index as well as overweight and obese ones. The type of disc displacement associated poorly with clinical signs and symptoms as well as with the obesity.

نسبة الصفيحات الدموية الى الخلايا اللمفاوية ونسبة الخلايا اللمفاوية الى الخلايا الوحيدة لدى عينة من المرضى العراقيين المصابين بمرض بهجت Platelet - Lymphocyte Ratio and Lymphocyte - Monocyte Ratio in a Sample of Iraqi Patients with Behçet’s Disease

اسم المؤلف: زهراء مصطفى كامل

اسم المشرف: فائق ايشو كوريال

الموضوع العام: الطب

السنة: 2018

الموضوع الدقيق: الامراض - المفاصل

الدرجة: دبلوم عالي

الجامعة: جامعة بغداد - كلية الطب

اللغة: الانكليزية

مكان الجامعة: بغداد

الصفحات الاولى:

عسر شحميات الدم اعتلال المفاصل الصدفي الفعال : دراسة حالة ضابط Dyslipidemia in Active Psoriatic Arthropathy Case Control Study

اسم المؤلف: منار هشام صابر

اسم المشرف: عبد اللطيف جاسم

الموضوع العام: الطب

السنة: 2018

الموضوع الدقيق: الامراض - المفاصل

الدرجة: دبلوم عالي

الجامعة: جامعة بغداد - كلية الطب

اللغة: الانكليزية

مكان الجامعة: بغداد

الصفحات الاولى:

المستخلص: Psoriasis is a chronic inflammatory skin condition characterized by scaly erythematous plaques on body surfaces. Psoriatic arthritis (PsA) is a unique, clinically heterogeneous type of inflammatory arthritis associated with skin psoriasis.Atherogenic dyslipidemia comprises a triad of increased blood concentrations of small, dense low‐density lipoprotein (LDL), decreased high‐density lipoprotein (HDL) particles, and increased triglycerides. Most recently, a relationship between psoriasis and increased risk of myocardial infarction, cerebrovascular disease, and peripheral vascular (cardiovascular) disease has been reported.Objectives : This study aimed to shed the light on dyslipidemia in psoriatic arthropathy patients and to determine any association between lipid abnormalities and disease activity.Patients and Methods : This study is a case control study which was conducted on 84 patients in Rheumatology and Dermatology department/ Baghdad Teaching hospital and 90 healthy controls for 8 months' period from August 2017 to April 2018. All patients with confirmed cases of Psoriatic arthritis according to CASPAR criteria. Data collected and analyzed according to patient history and Physical examination were including age, gender, body mass index, education level, occupation, smoking status, disease duration and disease activity score ,presence or history of dactylitis and enthesitis, history of diabetes, hypertension and hypercholesterolemia, cardiovascular diseases, and drug history of Disease - modifying antirheumatic drugs (DMARDs) and (anti - TNF agents), lipid lowering drug ,use of fish oil with its duration . Laboratory parameters were also taken including ESR and lipid profile.Results : Total number of the patient in this study was 84 and controls were ninety.The mean age was (42.6)years, 51% were male . There was no significant difference in age, gender and BMI between patients and control. Cholesterol, triglyceride and LDL were significantly higher in patients compared to controls p value <0.001 . There was no significant difference in the (Cholesterol, TG, HDL, LDL, and Atherogenic index) between low and moderate to high disease activity. There was direct significant correlation between cholesterol with TNFI duration p value (0.039 ) Conclusions Patients with psoriatic arthritis had elevated levels of cholesterol, TG, LDL and atherogenic index. There is a direct association between high level of cholesterol and the duration of TNF inhibitor treatment. The current study shows that, no relation between disease activity and lipidprofile abnormality

قرحة الضغط قرحة الفراش في عينة من المرضى العراقيين المصابيين باصابات الحبل الشوكي Pressure Ulcers in A Sample of Iraqi Patients with Spinal Cord Injury

اسم المؤلف: شهد عصام رؤوف

اسم المشرف: خضير زغير معيوف البدري

الموضوع العام: الطب

السنة: 2018

الموضوع الدقيق: الامراض - المفاصل

الدرجة: دبلوم عالي

الجامعة: جامعة بغداد - كلية الطب

اللغة: الانكليزية

مكان الجامعة: بغداد

الصفحات الاولى:

المستخلص: Pressure injury are most common preventable secondary complication of spinal cord injury and may lead to serious sequences include but not limited to infection , tissue loss and surgical intervention with all its complication in addition to psychological and financial burden on patients and their families.Aim of the studyTo determine the prevalence, grade, number and most common sites of pressure ulcer in people with spinal cord injury. Patients and method : This study carried out at Ibn Alkuff Spinal Cord Injury Rehabilitation Hospital (Baghdad) during the period from 1st of November 2017 to the 1st of July 2018. A total sample of 100 Iraqi patients were included in this descriptive cross sectional study, 85 males (85%) and 15 females (15%), mean age of 31.7 ± 14.6 (range : 5 - 81) years, and the median duration since injuries was 8 months with an interquartile range of 4 - 24 months. Full history was taken and complete clinical examination was done for all patients. Pressure ulcer was diagnosed by physical examination and graded according to classification system for pressure ulcer by the European Pressure Ulcer Advisory Panel (EPUAP). Special scale was included in this study to assess spinal cord injury impairment (American spinal injury association scale (ASIA).Results : Forty patients were having pressure ulcer. The sites of these ulcers were as following : 46.9% ulcers in the sacral region, 28.6% in the gluteal region, 8.2% in the thigh (lateral aspect), 6.1% in the heel and 10.2% ulcers in other sites. This study showed that pressure ulcers more frequent in ASIA score (A) followed by (B) and (C); (49.3%, 45.5% and 5.9%, respectively). The results showed no statistical significant association between age, gender, duration of spinal cord injury and causes of spinal cord injury in determining the presence of pressure ulcer (p=0.089, p=0.57, p=0.214 and p=0.57 respectively).Conclusions : Pressure ulcers are one of common secondary complication that occur in 40%of Iraqi patients with spinal cord injury with more frequency in ASIA scale A andB spinal cord injury especially in sacral area and most of them with one ulceronly.

اثار نمط اللباس المختلفة على كثافة معادن العظم في الشابات الاصحاء Effects of Different Dress Styles on Bone Mineral Density of Young Healthy Women

اسم المؤلف: هاشم خالد كاظم

اسم المشرف: محمد هادي العصامي

الموضوع العام: الطب

السنة: 2018

الموضوع الدقيق: الامراض - المفاصل

الدرجة: دبلوم عالي

الجامعة: جامعة بغداد - كلية الطب

اللغة: الانكليزية

مكان الجامعة: بغداد

الصفحات الاولى:

العلاقة بين مختلف مؤشرات فعالية المرض والحالة الوظيفية في عينة من المرضى العراقيين المصابين بالتهاب الفقار المقسط Correlation Among Different Disease Activity Parameters and Functional Status in a Sample of Iraqi Patients with Axial Spondyloarthritis

اسم المؤلف: اروى حمدان خضير

اسم المشرف: نزار عبد اللطيف جاسم

الموضوع العام: الطب

السنة: 2018

الموضوع الدقيق: الامراض - المفاصل

الدرجة: دبلوم عالي

الجامعة: جامعة بغداد - كلية الطب

اللغة: الانكليزية

مكان الجامعة: بغداد

الصفحات الاولى:

المستخلص: Background : Axial spondyloarthritis is an inflammatory rheumatic diseasethat comprises the whole spectrum of patients with radiographic sacroiliitis(ankylosing spondylitis or radiographic axial spondyloarthritis) and withoutradiographic sacroiliitis (non - radiographic axial spondyloarthritis). It ischaracterized predominantly by inflammatory back pain and involvement ofthe spine and sacroiliac joints. Disease activity scores like Bath AnkylosingSpondylitis Disease Activity Index and Ankylosing Spondylitis DiseaseActivity Score are used for monitoring the disease activity, while BathAnkylosing Spondylitis Functional Index is used to evaluate the functionalstate of the patients.Aim of the study : to assess the correlation among disease activity scoresand the functional status of patients with axial spondyloarthritis andevaluating the discriminative power of Ankylosing Spondylitis DiseaseActivity Score (ability to reflect disease activity).Patients and methods : A cross sectional study enrolled a total of 251patients with axial spondyloarthritis , all of them were fulfilling the modifiedNew York criteria for Ankylosing Spondylitis and Assessment ofSpondyloarthritis International Society classification criteria for diagnosingspondyloarthropathy. Demographic data, disease duration, type of treatment,Bath Ankylosing Spondylitis Disease Activity Index, AnkylosingSpondylitis Disease Activity Score and Bath Ankylosing SpondylitisFunctional Index were calculated for the patients. They were alsoinvestigated for C - reactive protein and erythrocyte sedimentation rate.VIIResults : The mean age of the patients was (37.2 ± 8)years, males constitute 90.4% of them and the median disease duration was 7 (0.25_42) years. The disease activity scores were positively correlated with each other and with Bath Ankylosing Spondylitis Functional Index with significant p values(<0.005). There was no significant difference between areas under the curve for both Bath Ankylosing Spondylitis Disease Activity Index & Ankylosing Spondylitis Disease Activity Score - Erythrocyte sedimentation rate(0.94 and 0.93 respectively) in comparison to Ankylosing Spondylitis Disease Activity Score - C - reactive protein with area under the curve 0.57, when using patient global assessment as a reference guide to evaluate the ability of the these scores to reflect disease activity.Conclusions : There was a positive correlation among disease activity scores and functional status measured by Bath Ankylosing Spondylitis Functional Index. Ankylosing Spondylitis Disease Activity Score - Erythrocyte sedimentation rate was as good as Bath Ankylosing Spondylitis Disease Activity Index in discrimination of disease activity, while Ankylosing Spondylitis Disease Activity Score - C - reactive protein showed less accuracy in reflecting disease activity.

تجربة المرضى مع العلاجات البيولوجية الوريدية للمرضى العراقيين المصابين بامراض المفاصل Patients Experience with Intravenous Biologic Therapies in Iraqi Patients with Rheumatologic Diseases

اسم المؤلف: ندى علي محمد

اسم المشرف: زياد شفيق الراوي

الموضوع العام: الطب

السنة: 2018

الموضوع الدقيق: الامراض - المفاصل

الدرجة: دبلوم عالي

الجامعة: جامعة بغداد - كلية الطب

اللغة: الانكليزية

مكان الجامعة: بغداد

الصفحات الاولى:

المستخلص: Intravenous and subcutaneous administration of biologic agents differs not only in routes of administration but also in dosing schedules, costs, onset of efficacy, and immunogenicity which are associated with patients‟ preferences and corresponding persistence in treatment utilization. Additionally, injection issues (depending on route of administration and agent type) have been shown to influence patients‟ utilization of biologic therapies.ObjectiveThe main objective of this study was to describe patients experience with intravenous (IV) biologics for specific rheumatologic conditions including rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis. Patients and Methods A cross - sectional study was conducted through interviews of 196 patients with the above mentioned autoimmune diseases who were currently receiving an IV biologics at Baghdad Teaching Hospital. Patients were asked to describe the advantages and disadvantages associated with their IV infusion experience. ResultsOn a 7 - point Likert scale (1= not at all satisfied; 7= very satisfied), 90.3% of patients rated satisfaction as 5, 6 or 7. The most frequently perceived benefit of IV therapy were related to Infusion center visits which act as an additional assessment to a regular doctor visit which was equals to 88.8% of patients. Fifty one percent of patientsexperienced t “No disadvantage” in receiving IV biologic therapy and 25% of patients reported that the duration of infusion takes too long as perceived disadvantages. The two most common reasons for preferring IV therapy were the less frequent dosing regimenreported by 81.6 % of patients and 54.1% of patients believes that the intravenous infusion was always effective and they have no experience with subcutaneous therapy.ConclusionsPatients using IV biologics are highly satisfied with their medications and their preferences are due to less frequent dosing, the perceived IV injection effectiveness and the easier to remember dosing when an appointment is scheduled for them.