Objective The present study aimed to evaluate the efficacy and safety of azilsartan (Azil) as “add-on” treatment with methotrexate (MTX) in patients with active rheumatoid arthritis (RA). MethodsThis single center, randomized, placebo-controlled, double-blind, pilot study included 64 patients with active RA. Patients received either placebo or Azil in addition to their currently used MTX doses for 90 days. The primary outcomes were DAS-28, SDAI, HAQ-DI, CDAI, EGA, and swollen and tender joints count. The secondary outcomes were the changes in the pain visual analogue scale (VAS-100), serum levels of TNF-α, IL-1β, IL-6, and anti-CCP, the lipid profile, and the markers of kidney and liver functions in the two groups at baseline and after 90 days. ResultsAfter 90 days, most clinical scores were significantly better in the Azil-treated group than in the placebo group. All inflammatory biomarkers were significantly improved after treatment with MTX + Azil compared to baseline and placebo group. No safety concerns were reported during the study period. Conclusions Azilsartan improved the effects of methotrexate on the clinical scores and certain inflammatory biomarkers of patients with active RA. Trial Registration The protocol was registered under the number 507/SA/1024 at the local clinical studies database, College of Medicine, Sulaimani University.

Lupus nephritis is one of the most serious manifestations of Systemic lupus erythematosis and it is a major cause of morbidity and mortality. The aim of this study is to compare males and females in lupus nephritis presentations. Material and Methods: A cross-sectional study performed on forty five patients with biopsy proven Lupus Nephritis including 32 females and 13 males. All patients assessed by questionnaire form and investigated for hematological, biochemical, immunological, serological, urinalysis, and 24hrs urinary protein excretion. Results: The current study shows female predominance 32(71.1%) compared with 13(28.9%) male. Class IV 15(33.3%) nephritis was the most common type followed by class III 9(20.9%).The male patients develop nephritis early in the course of Systemic lupus erythematosis than females, and they were more commonly had hypertension and edema, and the hematological, cardiovascular, pulmonary, and central nervous system were the most common extra renal manifestation in males while mucocutaneous manifestations were the commonest in females, and further more males had more proliferative type of Lupus nephritis than females. Conclusion:Males had more severe type of lupus nephritis than females. AnahtarKelimeler: Systemic lupus erythematosis, Lupus nephritis, sex. ÖZET Amaç:Lupus nefriti sistemik lupuseritematozusun en ciddi belirtilerinden biridir ve morbidite ve mortalitenin esas sebebidir. Bu çalışmanın amacı lupus nefriti olgularında erkek ve kadınlar arasında karşılaştırma yapmaktır. Materyal ve Metod:Biyopsi ile Lupus nefriti olduğu kanıtlanmış 45 hasta (32 kadın, 13 erkek) üzerinde kesitsel çalışma uygulandı. Tüm hastalara anket yapıldı. Hastalara biyokimyasal, immünolojik, serolojik, hematolojik tetkikler ve idrar tahlili yapıldı. 24 saatlik idrarda protein atılımına bakıldı. Bulgular:Yapılan çalışmaya göre kadınların (32, %71.1) erkeklere (13, %28.9) nazaran daha baskın olduğu görülmüştür. En yaygın tip olarak 4. sınıf nefriti (15, %33.3) sonrasında ise 3. sınıf nefriti (9, %20.9) görülmüştür.Sistemik lupuseritematozuslu erkek hastalar, kadınlardan daha erken bir dönemde nefriti geliştirmişlerdir.Erkeklerde daha yaygın hipertansiyon ve ödem vardı.Kadınlarda böbrek dışında en yaygın belirti mukokutanöziken erkeklerdehematolojik, kardiyovasküler, solunum ve merkezi sinir sistemi manifestasyonu görülür.Kadınlara nazaran erkeklerde daha fazla proliferatif tipte lupus nefriti gözlenmiştir. Sonuç:Erkeklerde kadınlara nazaran daha ciddi tipte lupus nefriti görülmüştür.

Purpose: To determine the value of Anti-CCP as predictor for disease activity in rheumatoid arthritis assessed by DAS-28, and to find the effect of smoking on disease activity in rheumatoid arthritis. Materials and Methods: One hundred patients with rheumatoid arthritis involved in this study, consisted of 88 female and 12 male who fulfilled the 2010 ACR-EULAR classification criteria for rheumatoid arthritis attending the rheumatology department in general hospital, or attended the center of rheumatology and rehabilitation in sulaimani city, for 6 months ( from October, 2012 to March, 2013). Thorough Demographic information of patients was recorded through history of age, sex, and history of smoking, disease duration, physical evaluation according to DAS-28. and serological test for RF and Anti-CCP. Results: There was highly significant association between DAS-28 and Anti-CCP value (p =0.0001). there was no significant correlation between DAS-28 and RF (p= 0.252),According to smoking there was highly significant association between smoking with Anti-CCP value and DAS-28 (p=0.003-0.0001) respectively while there was no significant association between smoking and RF(p=0.15). Conclusion: A highly significant correlation was found between Anti-CCP value and disease activity in rheumatoid arthritis, smoker patients had higher value of Anti-CCP compared to non-smoker patients. Smokers demonstrated a more active and severe disease activity compared to non-smokers.

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