Objectives:To determine the hematological indices and ratios derived from them in patients with fibromyalgia and to correlate the scores of Fibromyalgia Impact Questionnaire Revised (FIQR) with the ratios.Methods:This case control study was performed in the College of Pharmacy at Hawler Medical University in Erbil-Iraq, from November 2016 to June 2017, and it included 40 healthy subjects (Group I) and 150 newly diagnosed FM (Group II). The American College of Rheumatology -10 (ACR-10) diagnostic criteria were used in the diagnosis of FM. The scores of the Revised Fibromyalgia Questionnaire Impact (FIQR), and tender points were calculated, and the hematological indices and ratios were determined.Results:Group II showed significantly higher mean values of hematological indices and the ratios of neutrophil to lymphocyte (NLR), derived neutrophil to lymphocyte (dNLR) and platelet to lymphocyte (PLR). Group II patients have a significant higher score of FIQR. A significant correlation between the total score of FIQR with the hematological ratios (F=4.143, R=0.355, R2=0.126, p=0.002) with a variability of 12.6%.Conclusion:We conclude that the hematological indices are significantly altered and they are significantly correlated with the total score of fibromyalgia impact questionnaire revised.

Dual-energy X-ray absorptiometry (DEXA) is a universal tool that can detect bone loss and diagnose osteoporosis. Long term of using certain drugs contributed to the etiopathology of bone loss. Proton pump inhibitors (PPIs) users are at risk of developing osteoporosis. This study aimed to prove the selectivity of PPIs in inducing bone loss in postmenopausal women by determining the T-score of the axial spine and femur bone. A total number of 215 menopausal women were recruited from a Teaching hospital and private clinics from August 2018 to November 2019. The participants were grouped into Group I, n=150 (had no PPIs treatment) and Group II, n=65 (had treatment with PPIs). All the participants were subjected to DEXA investigation. Group II patients showed significantly lower T-score of the femur bone, while Group I patients showed a significantly lower T-score of lumbar vertebrae. The percentage of Group II patients had a T-score – 2.5 in femur ward bone is 35.4%, while the percentage of Group I patients had a T score -2.5 in the lumbar-3 vertebrae is 35.3%. Moreover, PPIs users showed an acceleration of bone loss despite the age, duration of menopause, body mass index, and waist-to-height ratio. We conclude that PPIs users are at risk of developing bone mass loss in the femur more than in the lumbar vertebrae