Comparative Study for Carrot Juice and Selenium Supplement in Many Physiological and Biochemical Parameters in Patients with Rheumatoid Arthritis in Kirkuk City

Carrot juice is a critical source of vitamins, selenium, and β-carotene, which is suggested to protect from Rheumatoid Arthritis (RA). The present study aimed to show the effect of carrot juice supplementation compared to selenium tablet supplementation, so our study includes (44) blood samples belonging to young men with RA. All patients aged (20-45) years, 44 blood samples were obtained before treatment at week (0), twenty-four men with RA were supplied with fresh carrot juice. The other group of 20 patients was given an artificial selenium supplement for 21 days as well, and the results were analyzed.The samples were collected from Kirkuk hospital, and external specialized clinical from October/2019 to September /2020; experimental groups were divided into three groups: Group 1 : (44) men Rheumatoid arthritis (RA) before treatment, Group 2: (24) men with RA+ Carrot juice, Group 3: (20) men with RA +Selenium Tab, We reach to following results: the patients who have RA consumption Carrot juice and patients take up Se tab. show significant decrease respectively in RBCs, WBCs, ERS, and RF compared with the Rheumatoid arthritis group, so as the results show a significant decrease in Leptin, IL-6, C-Reactive Protein, and TNF-α concentrations in comparison with the Rheumatoid arthritis group. In contrast, we found a significant increase in GSH, Selenium concentrations, and VD3 in men with RA administration carrot juice and patients' consumption Se tab. Respectively compared with the RA group and, finally, our finding shows no difference in Ceruloplasmin in experimental groups.

Prevalence and risk factors of moderate to severe hepatic steatosis in patients with rheumatoid arthritis: an ultrasonography cross-sectional case–control study

Background: The independent association between hepatic steatosis and rheumatoid arthritis is poorly defined. Methods: The presence of moderate to severe steatosis was assessed, using liver ultrasonography, in 364 consecutive non-diabetic subjects (223 patients with rheumatoid arthritis and 141 age- and sex-matched healthy controls). Adjusted multiple regression analysis was performed to explore the association between rheumatoid arthritis and moderate to severe steatosis in the overall sample and identify independent risk factors in the rheumatoid arthritis subgroup. Results: The prevalence of moderate to severe steatosis in the overall sample was 31.3%, with a significantly higher prevalence in patients with rheumatoid arthritis than healthy controls (38.7% versus 19.7%, p < 0.0001). After adjustment for sex, age, cholesterol, triglycerides, body mass index, waist, hypertension and smoke, rheumatoid arthritis remained significantly associated with moderate to severe steatosis [odds ratio (95% confidence interval) = 2.24 (1.31, 3.84); p = 0.003]. In the rheumatoid arthritis group, male sex, higher body mass index, higher triglycerides concentrations and higher cumulative dosage of methotrexate [odds ratio (95% confidence interval) = 1.11 (1.01, 1.23); p = 0.026] were significantly associated with moderate to severe steatosis, while systemic inflammation, disease activity, use of steroids and biologics were not. Conclusion: Rheumatoid arthritis is independently associated with moderate to severe steatosis, with male sex, higher body mass index and cumulative dose of methotrexate being predisposing factors. Further prospective studies are warranted to confirm our findings and to investigate the effect of steatosis on liver outcomes in the rheumatoid arthritis population.

Radiographic changes in TMJ in relation to serology and disease activity in RA patients

Objectives: This study was undertaken as an attempt to assess radiographic temporomandibular joint (TMJ) changes in relation to rheumatoid factor (RF), anticitrullinated protein (ACCP) antibodies and disease activity score 28 (DAS28) in rheumatoid arthritis (RA) patients to find the best predictor of rheumatoid affection of the TMJ with the ultimate goal of maintaining TMJ function and preventing joint damage. Methods: 20 Rheumatoid Arthritis patients as well as 20 volunteers were included in this study. RA group were assessed for RF, ACCP, DAS28. Both groups were assessed by CBCT for TMJ dimensions and radiographic osteoarthritic changes. All data were statistically analyzed. Results: Rheumatoid Arthritis group showed significantly less condylar height and more radiographic osteoarthritic changes than the control group. RF showed no significant correlation with either TMJ measurements or TMJ radiographic osteoarthritic changes. ACCP showed significant inverse correlation with condylar height and anteroposterior (AP) dimensions, but non-significant relation with mediolateral dimension and radiographic osteoarthritic changes. DAS28 showed significant inverse correlation with condylar AP and mediolateral dimensions. It also showed significant correlation with flattening of the TMJ condylar head and flattening of the articular fossa. Patients with high and moderate disease activity showed significantly smaller AP TMJ dimension than patients with low disease activity. Disease activity showed statistically significant direct correlation with all osteoarthritic changes except for erosions of the glenoid fossa and condyle. Conclusion: Disease Activity Score28 score and disease activity are strong indicators of TMJ affection in RA patients when compared to RF and ACCP. ACCP is a better indicator of changes in condylar measurements than TMJ osteoarthritic changes. While RF is the least efficient indicator of TMJ involvement in RA patients.

Possible Modulation of Vascular Function Measures in Rheumatoid Arthritis by Homocysteine

The effect of homocysteine on cardiovascular diseases is still equivocal, especially in rheumatoid arthritis patients. In this investigation, the association between homocysteine with blood flow and vascular resistance in rheumatoid arthritis was examined. Serum levels of homocysteine were determined in thirty-one rheumatoid arthritis patients and nineteen apparently healthy subjects using ELISA. Additionally, strain-gauge plethysmography was used to determine both forearm blood flow and vascular function at rest and after occlusion. Forearm occlusion blood flow (patients: 21.9 ± 6.55 versus control: 25.5 ± 6.10ml/100mL/min) was lower (p < 0.05) while occlusion vascular resistance (patients: 4.77 ± 2.08 versus controls 3.05 ± 0.96U) was greater (p < 0.01) in rheumatoid arthritis than in the controls. Level of serum homocysteine was similar (p = 0.803) in rheumatoid arthritis group and healthy group. In addition, level of serum homocysteine was correlated with resting blood flow (r = −0.41; p < 0.02) and resting vascular resistance (r = 0.31, p < 0.05) in the patients group. The study confirms altered vascular function in rheumatoid arthritis. Uniquely, the results show that homocysteine was related to resting, but not postischemia, vascular measures. These relationships indicate that homocysteine might impact the vasculature in rheumatoid arthritis.

Risk Factors and Early Detection of Diabetes Mellitus in Early Rheumatoid Arthritis WomenBackground: Patients with rheumatoid arthritis show predominance of metabolic disorder characterized by overweight, central obesity, dyslipidemia and impaired glucose

Background: Patients with rheumatoid arthritis show predominance of metabolic disorder characterized by overweight, central obesity, dyslipidemia, and impaired glucose tolerance, specifically, few studies have explained insulin resistance in this disease.Objective: The aim of the present study is to examine insulin resistance and the risk of developing diabetes mellitus in middle age Iraqi women with early rheumatoid arthritis.Patients and methods: This work involved seventy female with early rheumatoid arthritis. Who was attending to the National Diabetic Center (NDC) of Al-Mustansiriya University and 35 healthy subjects as a control group. From all subjects blood sample was drawn in fasting state to measure the biochemical parameters which including plasma glucose level and fasting insulin concentrations. Other measurements (RF and anti-CCP) were made by routine methods. Homeostasis model of assessment insulin resistance (HOMA-IR) by using the formula HOMA model Insulin sensitivity was calculated in RA patients and healthy control.Results: Results revealed a highly significant in the level of the rheumatoid factor (RF), anti-CCP and fasting insulin, and HOMA-IR when compared the patient group with the control group. While a significant increase in the level of FBG in the RA group than the control group. Also, there was a positive correlation with high significance among, Anti-CCP, and RF with HOMA-IR in the rheumatoid arthritis group. Conclusions: This study shows that patient with rheumatoid arthritis have abnormal insulin secretion with a high value of IR than a group of healthy control and these patients may be at risk of diabetic mellitus. عوامل الخطر والتشخيص المبكر لداء السكري للنساء حديثات الاصابة بألتهاب المفاصل الروماتويدي محمد حسن علي د.عـبير جبـار حسن أيناس جبار حسن الخلاصة: خلفية البحث:يكون المرضى الذين يعانون من التهاب المفاصل الروماتويدي عرضة للاصابة بمتلازمة التمثيل بالغذائي والعوامل المرتبطة بها مثل زيادة الوزن، وقلة دهون الدم أو ضعف تحمل الجلوكوز، وهناك بعض الدراسات بينت ان هولاء المرضى يكونون معرضون لمقاومة الانسولين . الهدف: صممت هذه الدراسة لفحص مقاومة الانسولين وخطر الإصابة بداء السكري عند النساء العراقيات المصابات حديثا بالتهاب المفاصل الروماتويدي. طرق العمل: شملت الدراسة سبعين أنثى مصابات حديثا بالتهاب المفاصل الروماتويدي و 35 من النساء المتطوعات كمجموعة ضابطة. تم سحب عينة الدم من الجميع في حالة الصيام لقياس المعلمات البيوكيميائية بما في ذلك مستوى الجلوكوز ، تركيزالأنسولين وقياسات أخرى مثل (RF and anti-CCP). وايضا تم حساب المقاومة للانسولين (HOMA-IR). النتائج أظهرت النتائج وجود زيادة معنوية في مستوى العامل الروماتويدي (RF) وتركيز الانسولين مقاومة الانسولين (HOMA-IR) عند مقارنة مجموعة المرضى مع مجموعة السيطرة. في حين أن زيادة كبيرة في مستوى السكر الصائم في مجموعة المرضى مقارنة بالمجموعة الضابطة. أيضا كان هناك علاقة إيجابية مؤثرة بين، Anti-CCP, and RF و HOMA-IR في مجموعة مرضى التهاب المفاصل الروماتويدي. الاستنتاجات: اظهرت نتائج هذه الدراسة أن المرضى بالتهاب المفاصل الروماتويدي يكون لديهم إفراز الأنسولين غير طبيعي وبالتالي تظهر لديهم مقاومة للانسولين ويكونون عرضة لخطر الاصابة بمرض السكري. الكلمات المفتاحية: مقاومة الانسولين, داء السكري, التهاب المفاصل الروماتويدي.

Comparison of Physical Activity Levels in Rheumatic Diseases

Objectives: The aim of this study was to evaluate levels of physical activity in patients with rheumatoid arthritis, osteoarthritis and fibromyalgia and to compare the results with both healthy subjects and each other. Methods: A group of 50 rheumatoid arthritis patients, 95 osteoarthritis patients, 82 fibromyalgia patients and 110 healthy subjects were included in this study. Physical activity levels were assessed by the International Physical Activity Questionnaire (IPAQ). Results: There were significant differences in walking and total physical activity scores in IPAQ between the rheumatoid arthritis (RA), osteoarthritis (OA), fibromyalgia (FMS) patients and the control group (p<0.05). 36.6% of the fibromyalgia group, 28.4% of the osteoarthritis group, 38% of the rheumatoid arthritis group and 22.7% of the healthy subjects were found to be inactive. 45.1% of the fibromyalgia group, 42.1% of the osteoarthritis group, 46% of the rheumatoid arthritis group and 36.4% of the healthy subjects were found to be insufficiently active. Conclusion: As a result, when compared to healthy people, physical activity levels were significantly decreased in patients with rheumatoid arthritis, osteoarthritis, fibromyalgia. The decreases in the physical activity levels were clearer in patients with rheumatoid arthritis than in patients with osteoarthritis and fibromyalgia. Recommending regular physical activity should be integral to rheumatic disease management and walking offers a potentially accessible, inexpensive, and acceptable physical activity intervention.

An Evaluation of Non-Surgical Periodontal Therapy in Patients with Rheumatoid Arthritis

aim of this study was to evaluate the efficacy of periodontal scaling and oral hygiene instruction for patients with mild chronic periodontitis and rheumatoid arthritis through clinical periodontal parameters and laboratory tests for CRP (C- reactive protein) and ESR (erythrocyte sedimentation rate). Twelve individuals with rheumatoid arthritis and 12 healthy individuals were evaluated, with a mean age of 45.38 and 46.75 respectively, all female and with mild, chronic periodontitis. The participants were evaluated clinically and periapical radiographs were taken (T1), after which periodontal treatment was instituted. After ninety days (T2), new clinical and laboratory data were obtained. Probing depth, bleeding index, and plaque indexes were observed in both groups, and the results demonstrated reductions but no statistical differences. Laboratory tests for CRP and ESR produced higher values for the rheumatoid arthritis group with T1- T2 reductions on the average, but the values were still higher than in the health group. We conclude that periodontal therapy in patients with rheumatoid arthritis and mild chronic periodontitis showed a improvement in the periodontal clinical parameters and laboratory tests that were evaluated.

Increased Chitotriosidase Activities in Patients with Rheumatoid Arthritis: A Possible Novel Marker?

Background: Chitotriosidase and YKL-40 are well-known in humans as Glyco_18 domain-containing proteins that are the common feature of mammalian chitinases and chitinaselike proteins. Previously, increased levels of YKL-40 were found correlated with the disease activity of rheumatoid arthritis. However, serum chitotriosidase activity in rheumatoid arthritis is not known yet. The aim of this study was to determine YKL-40 and chitotriosidase in patients with rheu - matoid arthritis and to compare these markers with traditi - onal ones such as C-reactive protein and erythrocyte sedimentation rate. Methods: Chitotriosidase, YKL-40 and C-reactive protein were measured in serum samples from 27 patients with rheumatoid arthritis and 27 healthy people. Chitotriosidase, YKL-40, C-reactive protein, and erythrocyte sedimentation rate were determined by a fluorometer, ELISA, nephelometer, and Western Green method, respectively. Results: Serum chitotriosidase activities and YKL-40 levels were higher in rheumatoid arthritis group than in control. A significant positive correlation was found between chitotriosidase and YKL-40. In ROC analysis, the areas under curves for chitotriosidase, C-reactive protein, erythrocyte sedimentation rate, and YKL-40 were 0.96, 0.84, 0.76, and 0.65, respectively. Area under the curve for chitotriosidase was significantly higher than the area for erythrocyte sedimentation rate (p=0.005) and for YKL-40 (p=0.0001), but not for Creactive protein (p=0.055). Conclusions: Serum chitotriosidase was significantly in creas - ed in patients with rheumatoid arthritis. Among all the param - eters evaluated, chitotriosidase was the most sensitive and specific one. Comprehensive studies covering larger populations are needed to elucidate the relationship bet ween chitinases, in particular chitotriosidase and rheumatoid arthritis.

Childhood trauma, dissociation in patients with fibromyalgia and rheumatoid arthritis

IntroductionThe contribution of childhood trauma and dissociation to the unknown pathophysiology of fibromyalgia has been the subject of considerable debate.ObjectivesTo assess and compare the relationship of childhood trauma and somatoform dissociation between patients with fibromyalgia and rheumatoid arthritis both of which are characterized by chronic pain and disability.AimsEarly life and prolonged trauma may affect brain modulatory circuitry of pain and emotions. The findings of relationship between traumatic events, dissociation and fibromyalgia can lead to a better understanding of the etiology and suggest new treatment modalities.MethodsThirty-one patients with fibromyalgia and 19 patients with rheumatoid arthritis were enrolled in the study. All participants were asked to fill in the Childhood Trauma Questionnaire, Somatoform Dissociation Questionnaire and Dissociation Questionnaire.ResultsPhysical neglect score was higher in fibromyalgia group than rheumatoid arthritis group (p < 0.05) although there was no significant difference between two groups in other subscores of childhood trauma and the rest of the dissociation scores. Total trauma scores were positively correlated with dissociation scores in fibromyalgia group whereas this correlation was not seen in rheumatoid group.ConclusionsAmong childhood trauma types, physical neglect seems to have a more important role in fibromyalgia than rheumatoid arthritis. Fibromyalgia may be related to early life stress or prolonged trauma, affecting brain modulatory circuitry of pain and emotions in genetically susceptible individuals.