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Spine degenerative surgeries are very common but carry multiple complications such as dural tears, CSF leak, pseudomeningocele and very rarely meningitis. Here we report such a case and discuss the possible causes, management and review of the literature.It’s a case of a 68-year-old man who underwent a posterior laminectomy that was complicated by a CSF leak and pseudomeningocele. Twelve days later the patient developed a severe bifrontal headache and then altered sensorium. CSF studies revealed severe meningitis with Pseudomonas stutzeri. It was multi-sensitive and after initiation of gram-negative coverage the patient markedly improved. However, the meningitis was further complicated by cerebral venous sinus thrombosis and he was also started on anticoagulation.Conclusion: Pseudomonas stutzeri has rarely been reported as a cause of meningitis and has never been reported post-laminectomy. Meningitis symptoms and signs could be obscured by the use of steroids in the postoperative period. Hence, it is of paramount importance to look for any subtle signs of infection in the postoperative period and question the use of high-dose steroids that could easily mask them.

Background: One of the common causes of chronic allograft nephropathy is nonadherence to medications, contributing to 30% of graft loss in the developed world. The non-adherence is attributed predominantly to pill burden.Once-daily dosing of tacrolimus instead of conventional twice-daily dosing may enhance adherence to medication and improve long-term outcomes. The present study is a retrospective analysis comparing the safety and effectiveness of De Novo (use from day 1) once daily (OD) Tacrolimus (extended-release capsules) to conventional twice-a-day (BD) tacrolimus, in renal transplant recipients operated at Suguna Hospital Bangalore India. Material and Methods: Records of 24 Transplant patients on De novo OD Tacrolimus were analyzed and compared retrospectively to 24 transplant patients treated De Novo with conventional BD tacrolimus on a regular follow-up for at least 2 yrs. post-transplant at our center. Results: Various parameters recorded till the last follow-up were analyzed and compared. The average weight of the cohort (64.6 kg vs. 66.6 kg), average tacrolimus dose (2.7 mg vs. 2.15 mg), average Tac dose/kg body weight (0.04 mg vs. 0.03 mg), average Sr.Creatinine, at Last, Follow up (1.2 mg/dl vs. 1.32 mg/dl) were comparable in both groups and were statistically insignificant (p > 0.05). However, there was a higher incidence of Post-Transplant Diabetes Mellitus (PTDM) noted in the Conventional BD Tacrolimus group (20.83%) compared to the OD Tacrolimus group (4.1%) and it was statistically significant (p = 0.17). The Infection rate of 41.67% in the conventional BD Tacrolimus group was much higher compared to the OD Tacrolimus group (4.17%) which was statistically significant (p = 0.01). There was 100% patient and graft survival at the end of two years in both groups. Tacrolimus Dose for OD and Conventional BD dosing were similar, unlike earlier studies recommending a 10% increase in dose for OD tacrolimus compared to BD dosing.Conclusion: OD Tacrolimus dose is comparable to conventional BD dose Tacrolimus in its safety and Efficacy; however, it scores over conventional BD dose Tacrolimus in terms of post-transplant infections and post-transplant diabetes mellitus (PTDM) and a more stable serum trough level. 

The post-harvest health and microbial safety of plant products and foods continue to be a global concern to farmers, consumers, regulatory agencies and food industries. A study was carried out to evaluate the pathogenicity of fungi associated with post-harvest rot of oranges, watermelons and bananas in Lafia, Nasarawa State, Nigeria. Healthy fruits inoculated with fungal spores obtained from rotted fruit tissues were incubated at ambient temperature conditions and observed daily for the appearance and development of tissue rot. Oranges and Watermelons had the highest number of fungal isolates (3) compared to banana (2). Fungi belonging to the genus Curvularia were the most isolated (37.50%), followed by both Aspergillus and Colletotrichum (25.00% respectively) and lastly Alternaria (12.50%). The highest tissue rot diameter of sweet orange (2.40 cm) was induced by Alternaria sp. followed by Curvularia geniculate (1.40 cm) and lastly Colletotrichum sp. (1.28 cm). The highest rot of banana fruit tissues was produced by A. niger (3.90 cm), followed by Curvularia geniculate (3.40 cm). Aspergillus sp. produced the highest tissue rot diameter on watermelon fruits (1.93 cm), followed by Colletotrichum sp. (1.30 cm) and lastly Curvularia geniculate (1.20 cm). Differences in the susceptibilities of different fruits to rot by fungal pathogens were significant (p ≤ 0.05). There is need for improved handling of fruits after harvest to prevent losses due to bacterial and fungal rots in the study area.

Purpose: The extrusion of implant material is a rare complication but has been reported in several cases following anterior cervical spine surgery. A posterior spontaneous percutaneous rod extrusion after rigid occipitocervical (OC) instrumentation (screw and rod construct) has not been reported yet. The authors discuss potential complications after cervical spine surgery and its clinical management.Methods: This is a case report of a 56-year-old patient after posterior OC spine surgery with initially unobserved implant failure and posterior percutaneous rod extrusion. The implant failure with a missing rod has been documented 4 years later during a routine follow-up visit.Results: At the four-year follow-up, the asymptomatic patient presented with a stable occipitocervical junction and an improved range of motion after generalized sepsis with an epidural spinal abscess, decompression and posterior OC instrumentation. A computed tomography scan of the implant failure of a broken rod was noticed two years postoperatively. The patient failed to return to the clinic. For years postoperatively he returned to the clinic and the broken rod could not be detectable in-situ on the X-rays anymore. Conclusion: The posterior percutaneous rod extrusion following an OC instrumentation not noticed by the patient, is a very rare complication that has not been described in the literature yet. Once seen back in the clinic, the patient unexpectedly reported an improved ROM without neck pain. Usually, revision surgery or implant removal is recommended if an implant failure is documented.

The World Health Organisation (WHO) defines anemia as a global public health problem. It is a medical condition in which the number of red blood cells or the hemoglobin concentration within them is below the physiological range. We present a case of a 40-year-old woman with Abnormal Uterine Bleeding (AUB) accompanied by malaise, weakness, and tachycardia. The patient reported heavy menstrual bleeding for the past 14 days. Speculum examination revealed that the bleeding was from the uterus. There were no pathological findings during a gynecological and transvaginal ultrasound examination. A complete blood count performed at the time of her arrival showed a low hemoglobin level of 24 g/L, a low hematocrit level of 7,4%, a mean corpuscular volume of 98,7 fL and a number of red blood cells 0,75 x 1012/L. Due to the severity of the anemia, she was given 6 units of red blood cell transfusion, 2 fresh frozen plasmas and tranexamic acid accompanied with calcium carbonate. The curettage was performed. The pathohistological finding was endometrium in proliferation. Afterward, the hemoglobin level increased to 90 g/L. Their past medical history revealed that she abused alcohol. On an abdominal CT scan, Alcohol-Related Liver Disease (ARLD) was confirmed. We should keep in mind that coagulopathy could be the underlying cause of abnormal uterine bleeding and that anemia must be analyzed for successful treatment. A multidisciplinary approach to anemia caused by AUB is required in cases of severe anemia.

Background: Stroke is the most common cause of permanent disability and the third most common cause of death in Palestine. We aimed to examine patterns of stroke presentation, causes, management and outcomes at the largest public Mistry of health hospitals in Palestine.Methods: Comprehensive data from all patients with acute ischemic stroke who were admitted to al-Shifa hospital between November 2021 and July 2022 and treated with alteplase alone or endovascular intervention with or without alteplase were prospectively collected and compare with acute ischemic stroke patients who were treated with medical care alone at Palestine medical complex hospital at 2018. Acute ischemic stroke presentation patterns, in-hospital evaluation and management, mortality, and morbidity were evaluated. Results: Medical care alone group: 138 patients with acute ischemic stroke, mean age was 65 ± 14 years and 49% were women. Most of the patients received antiplatelet therapy (98%), although none received thrombolysis. Only 17% received physical therapy evaluation. In-hospital mortality was 13%, and a modified ranking score of 0 -2 was in 44 patients (32%). Endovascular intervention with/without alteplase group: 56 patients with acute ischemic stroke. The mean age was 61 ± 12 years and 41% were women. All patients received brain computed tomography scans, although few received other investigations such as carotid Doppler (13%). Most patients with ischemic stroke received antiplatelet therapy (99%), although 39 patients (70%) received thrombolysis. Only 61% received physical therapy evaluation. In-hospital mortality was 7%. The modified ranking score 0 - 2: 32 patients (57%).Conclusion: This study conducted in Palestine showed that among patients with acute ischemic stroke, functional outcomes according to modified ranking score 0 - 2 were better by endovascular therapy with/without alteplase than with medical care alone.

Aim and objective:1.    To study the manifestations of fungal corneal ulcer in different age groups and sex 2.    To study the distribution of fungal corneal ulcer in relation to occupation3.    To know the effect of Natamycin and Fluconazole as anti-fungal agents.Materials and methods: This is a retrospective analysis of microbiology records of patients presenting with suspected microbial keratitis seen between January 2021 and June 2021. Patients with positive fungal cultures were analyzed in detail for the type of fungus isolated.Results: 90 patients with suspected microbial keratitis were reviewed. A microbiological diagnosis of mycotic keratitis was established 9 (10%) patients over a period of 6 months, based on positive fungal cultures. Filamentous fungi were isolated more often than yeasts. Aspergillus species followed by Fusarium species were the commonest filamentous fungi isolated. Conclusion: Over a period of 6 months, the cumulative incidence of mycotic keratitis was 10%. The pathogenic organisms most frequently responsible for mycotic keratitis were Aspergillus species. When beginning an empirical therapy for mycotic keratitis, etiological factors were helpful. Eight of the 90 patients with corneal ulcers who were admitted to the patient department for treatment had positive fungal cultures in Sabouraud’s media. The age range of 50 to 60 years had a high prevalence of illness. There were 90 total cases of corneal ulcers. Out of those there were 8 (8.8%) incidences of fungal ulcers. More men than women were impacted. Workers in agriculture are more impacted than others. The main cause of a fungus-induced corneal ulcer was trauma.Natamycin was the better option for the treatment of fungal keratitis. Filamentous fungi (Aspergillus species, fusarium, and curvularia) responded effectively to Natamycin 5% eyedrop.

Natural products are becoming increasingly important as an unlimited source for obtaining chemical substances with possible pharmacological potential. Current existing drugs for the treatment of cutaneous leishmaniosis produce major side effects; therefore the search for new drugs is justified. The stem bark of Zanthoxylum chiloperone var. Angustifolium Engl. (Rutaceae) is traditionally used in Paraguay for its antiparasitic properties. The leaf extract was evaluated for the first time to determine its leishmanicidal activity in BALB/c mice infected with amastigote forms of Leishmania amazonensis (PH8). The mice were treated orally with the extract at three concentrations (100, 50 and 10 mg/mL), intralesional (50 mg/mL), and subcutaneously using glucantime as a control (100 mg/mL). The percentage of decrease in parasite load was measured and with intralesional 50 mg/kg a reduction of 72% occurred, with the reference drug (Glucantime) a reduction of 62% was obtained with the same oral dose a reduction of 50%, while with an oral dose of 10 mg/mL the percentage of reduction was 55%. When the oral dose was increased to 100 mg/mL, the reduction percentage of the parasitic load was only 16%. These results indicated that the leaf extract of Z. chiloperone var. angustifolium Engl. at low oral concentrations (50 and 10 mg/mL) had very good activity against L. amazonensis, and it was even more efficacious intralesionally at 50 mg/mL but at the oral dose of 100 mg/kg has very reduced antiparasitic activity. This study showed the efficacy of the extract leaves of Z. chiloperone in reducing the parasite load in an in vivo test, so its use as a potential leishmanicidal could be suggested to develop and evaluate new drugs for the oral treatment of leishmaniosis disease with fewer side effects and lower cost.

The study aimed to examine the chemical composition of Acacia melanoxylon wood as a potential raw material for pulp and paper manufacturing. Samples of Acacia melanoxylon were taken systematically based on tree height at the bottom (10%), middle (50%), and top (90%) of market height. The sample was sorted, dried, milled, and sieved, and all chemical compositions were determined by the standards outlined in ASTM except cellulose and hemicellulose, which were determined by the Kurschner-Hoffer and alkali extraction methods, respectively. The results of the study showed that the overall average values of chemical composition along tree height levels were 45.02%, 21.94%, 23.79%, 5.52%, 3.24% and 0.48% for cellulose, hemicellulose, Klason lignin, hot-water solubility, alcohol-benzene extracts, and ash content, respectively. Except for hot-water extractives, the chemical composition of the bottom and top portions differed significantly. Generally, this study suggests that the chemical composition of Acacia melanoxylon wood is well suited for pulp and paper production.

Background: Having claimed lives, HIV/AIDS is still a significant global public health concern. Antiretroviral therapy (ART) is now widely available, and this rapid expansion of access is dramatically improving HIV epidemic survival rates worldwide.Objectives: The aim of this study was to identify the mortality risk factors and survival status of ART patients attending Hawassa Comprehensive Specialized Hospital in 2020.Methods: In a five-year retrospective cohort research, all patients seen between January 2015 and December 2019 were analyzed. The data were analyzed with SPSS 25.0. The Kaplan-Meier Log-rank model was employed to gauge the survival time of ART patients based on explanatory variables. Both bivariate and multivariate Cox proportional hazards regression models were employed to identify the independent causes of mortality.Results: Patients on ART had a 74% overall survival probability. With a median survival of 34 months, there are 0.135 deaths for every 100 person-years. Hemoglobin level (HR = 2.38; 95% CI = 3.3-6.3), WHO clinical stage III and IV (HR = 3; 95% CI = 2.2-9.5, p = 0.04), Age >=60 (HR = 1.6; 95% CI = 1.3-2, p = 0.04) and Functional status bed ridden (HR = 3.1; 95% CI = 1.2-9.4,p = 0.04) were all independent predictors of death among RVI patients.Conclusion: In comparison to trials conducted in wealthy countries, the survival rate of ART patients in this study was low. Patients who are anemic; WHO advanced clinical stage; old age, and functional status bedridden should be closely followed and monitored.

Background: One of the types of the complex control system is medico-biological, which includes a set of methods and measures aimed at assessing the health, and functional state of the athlete’s body, taking into account the reaction of his systems to various loads. CrossFit is a constantly varied and high-intensity functional training program in which with increasing the training load, the pulse rate increases.The context and purpose of the study: The research was aimed to find out the frequency of heart rate of adolescent judokas in the presence of CrossFit-trainings in the process of physical fitness, for which a pedagogical scientific experiment was held at the youth sports and cultural training center after V. Zakaryan (Hrazdan city). From the groups of 10-12-year-olds practicing judo at the sports school, one experimental and control group was formed, each with 10 athletes. During CrossFit-trainings “Tabata”, “AMRAP”, “21-15-9” and “WOD” methods were mainly used. Athletes’ pulse rate was measured manually at the wrist before training, during training, and immediately after training in order to control the athletes’ feelings toward the training load.Results: In the September-June period, with the implementation of the CrossFit-training program, the heart rate of athletes before training was on average 102,2 bpm, during training 158,3 bpm and immediately after training – 157,8 bpm.Conclusion: The indicators obtained as a result of the research correspond to the norms suggested in literature sources.

Invagination or intussusception is the protrusion of proximal intestinal segments through the distal segments, Transient Intussusception can be easily diagnosed by Abdominal CT.In this report, an incidentally found ‘’Duodeno-jejunal Invagination’’ tilted case, was presented with CT images.

Chronic thromboembolic pulmonary hypertension is a notoriously underdiagnosed cause of severe pulmonary hypertension. It is a form of precapillary pulmonary hypertension (PH) that results from intraluminal thrombus organization and fibrous formation which ultimately results in the complete obliteration of pulmonary arteries, resulting in increased pulmonary vascular resistance which leads to the development of pulmonary hypertension and as a result right heart failure. The mechanism involves the narrowing of the pulmonary artery which increases blood pressure within the lungs and impairs blood flow which increases the workload of the right side of the heart ultimately causing right heart failure. Pulmonary hypertension can also cause arrhythmias, blood clots, and bleeding in the lungs. Even though CTEPH is a deadly condition, among all forms of pulmonary hypertension, CTEPH is the only curable form. Echocardiography is the initial assessment tool for suspected PH. A right heart catheterization may be performed to confirm the presence of pulmonary hypertension. Confirmation of CTEPH requires a V/Q scan. Although ventilation/perfusion scintigraphy has a major role in the evaluation of patients with suspected CTEPH, nowadays CTA chest is being used widely as it produces much better-quality images compared to V/Q scan. Without treatment, the prognosis is very poor. Out of three treatment modalities such as; pulmonary endarterectomy (PEA) surgery, balloon pulmonary angioplasty (BPA), and medical therapy, surgery is the gold standard. The physician must be familiar with the disease entity, early diagnosis, and appropriate treatment to improve survival. Here we present a literature review on this topic.

Malignancy of the small bowel is exceedingly rare, accounting for 3% - 5% of all gastrointestinal malignancies [1-3]. However, in recent years because of improved diagnostic accuracy, the incidence of small bowel cancer is rising. It is estimated that 10, 470 new cases of primary SI cancer will be diagnosed in the US with 1450 cancer-related deaths [4]. The most frequent histologic types of small bowel malignant tumors include adenocarcinomas, carcinoids, lymphomas, and sarcomas. Adenocarcinoma of the small intestine is the second most common histologic type of SI cancer. The most frequent location of SI adenocarcinoma is the duodenum (57%), followed by the jejunum (29%) and ileum (13%) [5]. SI cancers are more common in men than women [6]. They occur more commonly in the African-American population and after 60 years of age [7].

The impact of culture on the communication of pain becomes visible in a comparative perspective when individuals with two different cultures meet.Regardless of the physiological cause, it is through lived experience, in social life, that it is decided how, where, when and for whom pain is to be communicated. Age and gender, situation and context as well as the type of pain are essential ingredients in communication. The communication is always adapted to expectations from those present, their own experiences of pain and the specific circumstances, the cause of the pain. The impact of culture on the communication of pain becomes visible in a comparative perspective when individuals with two different cultures meet.

Approximately 73.4% of global deaths are caused by chronic non-communicable diseases, among them, cardiovascular and cerebrovascular diseases, tumors, and chronic respiratory diseases ranked in the top 3 respectively [1]. An accumulating body of evidence showed that the risk of all-cause mortality in cancer patients with cardiovascular disease (CVD) was 3.78 times higher than that of those without CVD and 8.8% of cancer survivors died of CVD [2]. Heart failure (HF) is a serious manifestation or terminal stage of various heart diseases. Although myocardial damage and dysfunction are the main causes of HF, the cardiovascular injury caused by the tumor itself and the detrimental effect of cancer treatment also play an important role. More recently, the data has suggested that up to 25% - 30% of patients with HF have histories of cancer for about 10 years; and cancer also determines the prognosis of heart HF [3]. 

Specific quantification of therapeutic tissue stem cells (TSCs) is a major challenge. We recently described a computational simulation method for accurate and specific counting of TSCs. The method quantifies TSCs based on their unique asymmetric cell kinetics, which is rate-limiting for TSCs’ production of transiently-amplifying lineage-committed cells and terminally arrested cells during serial cell culture. Because of this basis, the new method is called kinetic stem cell (KSC) counting. Here, we report further validations of the specificity and clinical utility of KSC counting. First, we demonstrate its quantification of the expected increase in the hematopoietic stem cell (HSC) fraction of CD34+-selected preparations of human-mobilized peripheral blood cells, an approved treatment product routinely used for HSC transplantation therapies. Previously, we also used the KSC counting technology to define new mathematical algorithms with the potential for rapid determination of TSC-specific fractions without the need for serial culture. A second important HSC transplantation treatment, CD34+-selected umbilical cord blood (UCB) cells, was used to investigate this prediction. We show that, with an input of only simple population doubling time (PDT) data, the KSC counting-derived “Rabbit algorithms” can be used to rapidly determine the specific HSC fraction of CD34+-selected UCB cell preparations with a high degree of statistical confidence. The algorithms define the stem cell fraction half-life (SCFHL), a new parameter that projects stem cell numbers during expansion culture. These findings further validate KSC counting’s potential to meet the long-standing unmet need for a method to determine stem cell-specific dosage in stem cell medicine.

Percutaneous coronary angioplasty is a minimally invasive procedure aimed at unclogging a coronary artery with a low complication rate (with a serious complication rate of 3% to 7% and a mortality rate of 1.2%). Device entrapment during PCI is a rare but life-threatening complication that occurs in < 1% of PCIs and balloon entrapment comes second after coronary guidewires. We present the case of 68-years-old man, smoker, hypertensive and type2 diabetic that presents angina with evidence of ischemia on myocardial tomoscintigraphy and in whom the radial coronary angiography reveals a tight calcified mid LAD stenosis. During his PCI and after dilatation with an NC balloon 2.5 × 12 the latter refuses to deflate and remains trapped in the lesion with the appearance of pain and ST-elevation despite several attempts to dilute the product in the inflator and to burst it by overexpansion. Traction on the balloon resulted in the deep intubation of the guiding-catheter, which comes in contact with the trapped balloon, and the rupture of the latter’s hypotube, which remains inflated at the site of the lesion and mounted on the 0.014 guidewire. We put a second 0.014 guidewire distally in the LAD and twisted with the distal part of the first guidewire, then we introduced a second balloon 2.0 × 20 over the second guidewire until the distal part of the guiding-catheter and inflated to trap the stucked balloon. We gradually removed this emergency assembly that allowed us to retrieve the trapped balloon. The control injection revealed a thrombotic occlusion of the LAD treated by thrombectomy and anti-GPIIbIIIa followed by a DES 2.75 × 28 placement. The patient was discharged 48 hours later with a good LVEF. The possible balloon entrapment mechanisms are an acute recoil of a highly calcified lesion with compression of the incompletely deflated balloon, which seems to be the case in our patient, strangulation of the proximal balloon end by the guiding-catheter if the balloon is removed before complete deflation and break or bend of the hypotube. The solutions in case of undeflatable balloon entrapment are to dilute the product in the inflator, to burst it by overexpansion, to pierce it through a stiff guidewire (or through its other end on a Microcatheter or OTW balloon), to cut its outer part and let it empty passively, to introduce a second guide-wire and perform a Buddy-Balloon or to transfer the patient to Surgery. Material entrapment remains a rare but life-threatening complication, its eviction requires the choice of material size and gentle manipulations (small balloons in the event of a calcified lesion) and its management uses different techniques, the choice of which depends on the clinical and anatomical situation. 

Introduction: Atrial Septal Defect (ASD) is the most common congenital heart disease, accessible to percutaneous closure in 90% of cases. The closure procedure is performed usually under local anesthesia and TTE by femoral access. The association of OS-ASD with an azygos continuation of the inferior vena cava is very rare (< 0.1/1000 births) making femoral access impossible. Only a few cases are mentioned in the literature, here we describe the procedure as faithfully as possible. Important clinical finding: We present a case of a 32-years-old female candidate for percutaneous closure of OS-ASD with right cavity dilatation who present during her procedure an unusual guidewire path suspecting an azygos continuation of the inferior vena cava, confirmed by CT angiography, making impossible the closure via the femoral approach. Therapeutic intervention: After being confronted with the categorical patient refusal of the surgery, we performed successfully the procedure; one month later; under general sedation by internal jugular approach. We finished with manual compression before extubating the patient. Outcomes: The follow-up was favorable at the cost of a hematoma at the puncture site and brachial plexus compression, which regressed after 3 days. Conclusion: We opted for general anesthesia and intubation to guide the procedure by TEE. We placed it in the aorta, which gave us good stability to continue successfully the procedure. We underestimated the risk of complication at the puncture site, which could have been avoided by using a vascular suture device or more prolonged compression. Main takeaway lesson: Percutaneous closure is the reference treatment for OS-ASD. In case of is associated with an azygos continuation of the inferior vena cava, the right internal jugular vein remains a reasonable approach; it requires discussion and rigorous preparation by the whole team. The management of the puncture site in this situation remains delicate and requires great concentration. 

Introduction: Cardiovascular diseases are the leading cause of death in the world, headed by coronary artery disease, which is secondary to atherosclerosis. The latter recognizes classic risk factors such as diabetes, high blood pressure, tobacco, and dyslipidemia and other less classic factors such as chronic inflammation of rheumatoid arthritis. Many studies have highlighted the correlation between this chronic inflammation and clinical coronary disease but very few have focused on the anatomical correlation. Objective: To describe the correlation between the chronic biological inflammation of rheumatoid arthritis and anatomical coronary lesions on angiography. Method: This observational, retrospective, single-center study, including over 10 years, of patients with rheumatoid arthritis, confirmed the EULAR 2010 criteria and presented with coronary artery disease requiring coronary angiography. Patients with missing data or in whom coronary angiography was not done were excluded (n = 14). We divided then the patients according to the existence or not of chronic inflammation to study the impact of the latter on the existence (Stenosis < 50% vs. stenosis ≥ 50%), the extent (single vs. multivessel disease), and the severity of the coronary lesions (syntax score < 32 vs. ≥ 32). Results: 202 patients (49♂/153♀) aged between 30-75 years with a history of rheumatoid arthritis have had a coronary event requiring coronary angiography, were included; The mean ejection fraction at baseline was 57.3% +/- 5.8 (37 vs.-65%). 75% of them were ≥ 65 years old. 55% were diabetics, 61% with hypertension, 38% with dyslipidemia, and 19% were smokers. Chronic inflammation was diagnosed in 70% of them on non-specific parameters (ESR, CRP, fibrinogen, anemia, and rheumatoid factor). All patients had coronary angiography, which made it possible to identify the coronary lesions according to their existence (Stenosis < 50%: 51 patients vs. stenosis ≥ 50%: 151 patients), the extent (single: 86 patients vs. multivessel disease: 116 patients) and the severity of the coronary lesions (syntax score < 32: 142 patients vs. ≥ 32: 60 patients). Chronic inflammation of rheumatoid arthritis was correlated in bivariate and multivariate analysis (after excluding the impact of other risk factors) with the existence and extent of coronary lesions (p < 0.05) but not with their severity (p > 0.05). Discussion: The two limitations of this work are the monocentric nature of the study and the absence of specific inflammatory parameters such as anti-CCP antibodies. Strengths are anatomical correlations and multivariate analysis. Chronic inflammation apart from any influence of the various risk factors predisposes to the existence and extent of coronary lesions (p < 0.05). The severity of coronary lesions assessed by Syntax Score was not correlated with chronic inflammation, although other studies suggest that this inflammation is the cause of complex lesions.Interpretation: Rheumatoid arthritis is associated with an increase in cardiac morbidity and mortality. Atheromatous lesions are more frequent in those patients than the existence of classic cardiovascular risk factors would suggest. Several explanations could account for this risk: the inflammatory syndrome and its impact on the cardiovascular risk factors and the vessel and the deleterious effect of the treatments. This requires stricter screening and management of risk factors in rheumatoid arthritis.