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دراسة التغايرات النسجية والمناعية لمرضى اللشمانيا الجلدية في محافظة ديالى == Study The Histological And Immunological Variation of Cutaneous Leishmaniasis Patients In Diyala Province
Author name:
منى حميد احمد العزاوي
Supervisor name:
اسراء قاسم العبيدي
General topic:
Biology
Specific topic:
Microbiology - Parasites
Degree:
Master
University:
University of Diyala - College Of Education For Pure Sciences - Department Of Biology
Language:
Arabic
University location:
Diyala
First pages:
24T2649 - p.pdf
Abstract:
اجريت الدراسة الحالية على المرضى المصابين بداء اللشمانيا الجلدية والمراجعين لبعض المستشفيات والمراكز الصحية في محافظة ديالى للمدة من تشرين الاول 2013 ولغاية نيسان 2014. اذ بلغ عدد المصابين باللشمانيا الجلدية 115 مصابا وبمختلف المراحل العمرية يضاف لهم 25شخ | The present study was conducted on patients that infected with cutaneous leishmaniasis reviewing to some hospitals and health centers in Diyala province for the period from October 2013 to April 2014.The number of patients with cutaneous leishmaniasis was 115 in different ages in addition to them 25 person as a control group (uninfected). The proportion of infected women with cutaneous leishmaniasis ulcers was higher 56.522% than males 43.47%, the age group ten years and less was more group that being infected with rate 47.83% while the age group that rang from 71 to 80 was the less categories being infected in percentage 0.87% with a significant differences in the level of improbability less than 0.05. The presence of multiple ulcers was high 71.304% than single ulcers 28.696%. The presence of ulcers that length 1 cm and less (64%) more than other with more than 1 cm (36%) with statistically significant. The cutaneous ulcers were distributed on different areas of the body, the injuries on face was more 36.242% with anumber of 54 cases followed by upper limbs in rate 33.557% with anumber of 36 cases, the sore shoulder came latter with apercentage 1.342% in a significant differences at the level of improbability less than 0.05. The percentage incidence of cutaneous leishmaniasis was rise in kids and students in rats 33.043%, 39.130% respectively in a comparison with earners, housewives and of officers their percentages were 24.349% and 3.478% consecutively in statistically differences at 0.05 probability. The diagnosis of cutaneous leishmaniasis infections was done depending on clinical diagnosis based on the characteristics of the morphological and pathological ulcers, culture methods, impression smears and histopathological diagnosis. Clinical diagnosis for the cutaneous ulcer was recorded 100% percentage in comparison with culture method 10.435% versus 74.782%. percentage to positive smears, while the result of positive histopathological diagnosis was 88.571% on vision of promastigote of Leishmania parasite on semisolid medium while a adoption of existence amastigote from as appositive result of smears and histopathological method of the tissue biopsies taken from ulcer. The histopathological method was high efficiency supported clinical diagnosis when compared to other methods this rise in the diagnosis ratio has been demonstrated in significant differences in statistical probability less than 0.05.A study of amain impacts of histopathological changes in cutaneous ulcers on the infected skin layers at the level of light microscopy was also conducted. These pathological effects were in epidermis of skin including hyperkeratosis, pseudoepitheliomatous epidermal changes, ulcers and emergence of a dark colour, thickening in this layer accompanied suppurations and desquamation of chronic cases. As for the dermis layer, the inflammatory cells were infiltrate include plasma cells, macrophages, lymphocytes and eoisophils, disturbance in the order of layers especially in acute ulcers was taken, while the pathological effects were more in chronic ulcers as observed granulomatous inflammation and necrosis. The amastigote from were presence inside and outside the phagocytic cells.Aswell as some immunological changes that associated with the infection were studied in patients therapists by Pentostame (Sodium Stubogluconate) medication and uninfected control group by measuring the levelsof some cytokines IFN - ?, TNF - ?, IL - 12, IL - 17A and the chemokine MCP - 1. The level of IFN - ? was elevated in serum of cutaneous leishmaniasis patients and reached to 54.118±1.740 pg/ml, then the level was decreased during therapy and recorded 34.421±0.984 pg/ml after 1 - 3 dose a then dropped more after 4doses and more 22.489±0.795 pg/ml compared to uninfected control group 5.092±0.805 pg/ml. As well as the case of TNF - ? which rose their concentration in serum of CL patients and reached to 98.145±2.925 pg/ml, then decrease after treatment 71.507±2.901 pg /ml, 48.381±2.379 pg/ml after 1 - 3dose and more of treatment respectively, while the mean of TNF - ? in control group was 13.173±1.388 pg/ml.An increase in the level of IL - 12 was observed in the group of CL patients 845.598±16.273 pg/ml then the level was dropped during treatment and recorded 619.164±20.209 pg/ml, 495.578±27.038 pg/ml respectively but in control the concentration was 160.222±11.761 pg/ml. IL - 17A level was elevated in CL patients 227.268±5.027 pg/ml and decreased during therapy reach to 170.512±5.481, 126.443 ± 5.565 pg/ml after 1 - 3 doses and four doses and more respectively. The concentration of MCP - 1 chemokine was increased in CL patients 111.0397± 6.985 pg/ml then dropped during treatment 71.084± 2.636 pg/ml after 1 - 3 doses then dropped more 49.543± 2.167 pg /ml after four doses and more while they were in control 12.268 ± 1.609 pg/ml. The results of statistical analysis showed significant differences between these cytokines and their groups at the level of probability less than 0.05.
