BACKGROUND & OBJECTIVE: SLE is one of systemic diseases, targeting young patients, so we try to study the one of factors that affected these patients. The aim of our study is to describe the body composition in Iraqi lupus patients, and assess the effect of the disease activity, disease duration, treatment, and patients’ social class in development of sarcopenia. PATIENTS & METHOD: Sixty women, age > 18years with SLE and 56 matched controls were studied. Disease activity measured by systemic lupus erythematosus disease activity index, and functional status measured by systemic lupus erythematosus quality of life questionnaire. Body mass index, waist circumference measured for patients and controls. Body composition analyzed by dual energy absorptiometry x-ray. RESULTS: Mean age for patients was 31.75±10.06 years, and mean disease duration was 19.62±10.76 months. No differences in body mass index, central obesity, lean mass percentage, fat mass percentage, appendicular lean mass index, and bone mineral density between patients and controls. Z score was lower in lupus patients as compared with controls (-1.61±0.8 for patients, -1.26±0.71 for control, p= 0.013). Treatment with azathioprine found to decrease the risk of sarcopenia (p= 0.046). Medical social class and working social class show lower risk for sarcopenia compared to unemployed class (p= 0.003, 0.002 respectively). However disease duration, disease activity, using prednisolone, and functional status had no effect. CONCLUSIONS: No significant differences in body mass index, fat mass percentage, lean mass percentage, and appendicular lean mass index in lupus patients and controls. Lupus patients have higher risk to loss their bone density.

Background: Three quarters of patients with non-diagnosed chest pain after a normal cardiac evaluation continue to complain from residual pain. By careful history taking and physical examination, number of those patient diagnosed to have musculoskeletal pain. The proper management will help to reduce the socio-economic consequences due to fear and anxiety of undiagnosed coronary artery diseases. Aim: To highlight one of the other differential diagnoses of ischemic chest pain. Patients and Method: Fifty patients with chest pain were involved. All these patient had chronic chest pain and normal all cardiac evaluations. These patients were examined by rheumatologist to reach the final diagnosis. Results: The mean age was 46.6±14 standard deviation. About 40% of the patients were complained from left side chest pain. The final diagnosis was either muscular pain, shoulder problem, cervical radicular pain, costochondritis, or fibromyalgia. Conclusion: Musculoskeletal chest pain is not uncommon and an important differential diagnosis of chest pain for patients presented to cardiac clinic. After exclusion of cardiac causes, a high index of suspension and an appropriate approach is recommended to diagnose and treat these conditions to improve patients' quality of life.

Objectives: Disability related to chronic low back pain (LBP) is a complex and multidimensional phenomenon all over the world. The prevalence of backache in middle age and elderly is up to 84%. This study aims to evaluate the associations of X-ray features of lumbar disk degeneration with severity of disability among patients with mechanical LBP. Patients and Methods: A cross-sectional study was conducted on a total of 300 patients with chronic mechanical LBP. Severity of disability was measured using Modified Oswestry Disability Index and intensity of backache was assessed using numeric rating scale (0–10). X-ray features of lumbar disc degeneration according to Lane classification and spondylolisthesis were assessed in lateral recumbent lumbar X-rays. Results: The mean age of our sample was 52.45±7.87 and 71.7% of involved patients were women. Most patients were recorded as overweight or obese. The findings of disk space narrowing were mild in 65.7%, moderate in 28.7%, and severe in 5.6%, where the presence of osteophytes were small in 76.9%, moderate in 20.5%, and large in 2.6%. Regarding disability, two-third of cases were focused on minimal disability, followed by moderate, severe, and crippled as (26%), (6%), and (2%), respectively. There was highly significant association between women and pain radiation to legs (p=0.004). Obesity and overweight had meaningless effects on all markers. Conclusions: The severity of disability was significantly more in women, high intensity of lower back pain, presence of pain radiating to legs, moderate/severe disk space narrowing on X-ray, and disk degenerative disease score on X-ray, while age, presence of osteophytes and spondylolisthesis, body mass index, and pain duration were not associated with severity of disability.

Objective: Psoriatic arthritis (PsA) is a chronic inflammatory arthropathy commonly associated with psoriasis, a large number of patients with PsA that has persistent inflammation may develop progressive joint damage and disability and have reduced life expectancy. This study aims to determine the associations of anti-cyclic citrullinated peptide (CCP) antibodies in adult patients with psoriasis and PsA.Methods: A case–control study was conducted at Baghdad teaching hospital, Units of Rheumatology and Dermatology, during the period from December 2016 to April 2017 including three groups; 40 patients with psoriasis, 40 patients with PsA fulfilling the CASPAR classification criteria, and 40 healthy control persons.Results: Two patients with psoriasis (5%) and 10 patients with PsA (25%) were seropositive for anti-CCP antibodies (ACPA). Healthy controls were negative for anti-CCPA. Regarding ACPA positivity, a significant difference was found between those three studied groups (p<0.001) and there was a significant difference between positive and negative ACPA in PsA patients regarding disease activity score (p=0.044).Conclusion: Positive ACPA were found more significant with PsA than in patients with psoriasis as well as associated with higher disease activity.

Diffuse idiopathic skeletal hyperostosis is a non-inflammatory disease characterised by calcification of soft tissues, mainly ligaments and enthuses, as well as by ossification of the anterior longitudinal ligament. To assess the relationship between Metabolic Syndrome and Diffuse Idiopathic Skeletal Hyperostosis among a sample of middle and old age Iraqis.A cross-sectional study was conducted from October 2018 to May 2019 at the Rheumatology Unit of Baghdad Teaching Hospital, Iraq and Basra Teaching Hospital, Iraq. A total of 282 patients were included in the study. Data were gathered using a pre-constructed data collection sheet for patients that evaluate: age, gender, occupation, education, smoking, weight, height, waist circumference, and body mass index were calculated. Clinical data about back pain, limitation in movement or any neurological symptoms were identified, serum lipid profiles (serum triglycerides, serum high-density lipoprotein), fasting blood sugar, haemoglobin A1c and serum uric acid were obtained. Diffuse Idiopathic Skeletal Hyperostosis was reported in 18 (6.4%) patients. High waist circumference was reported in 175 patients, high triglycerides found in 208 patients, while low HDL found in 162 patients. We reported 147 patients who had elevated blood pressure and 106 patients with elevated blood glucose. Diffuse Idiopathic Skeletal Hyperostosis was significantly more frequent in patients with metabolic syndrome compared to those with no metabolic syndrome, (9.2%) vs (3.1%). There is a significant association between diffuse idiopathic skeletal hyperostosis and metabolic syndrome among a sample of middle and old age Iraqi people.