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العوامل المؤثرة على نوعية حياة المرضى المصابين بالجلطة الدماغية في مركز الفرات الاوسط للعلوم العصبية في مدينة النجف الاشرف == Factors Affecting Quality Of Life For Patients With Cerebrovascular Accident In Middle Euphrates Neuroscience Center In Al - Najaf Al - Ashraf City

اسم المؤلف: احمد صالح رضا القاضي
اسم المشرف: سحر ادهم علي
الموضوع العام: الطب
السنة: 2016
الموضوع الدقيق: التمريض
الدرجة: ماجستير
اللغة: الانكليزية
مكان الجامعة: بابل
الصفحات الاولى:
المستخلص: خلفية الدراسة : تعتبر الجلطة الدماغية سبب رئيسي مؤثر يقلل مستوى نوعية حياة المرضى. قياس نوعية الحياة للاشخاص الذين يعانون من امراض مزمنة يعطي رؤية واضحة لتحديد اثره على مقدمي الرعاية الصحية عندما تكون النتيجة غير ممكنه. العوامل المؤثرة على نوعية الحياة لم | Background : Cerebrovascular accident is a main leading cause affectedly decrease the level of quality of life of the patients. The measurement of quality of life for population with chronic diseases gives a clear view to determine the impact on health care providers when prognosis is not possible. Factors affecting the quality of life may be vary between different age categorize such as CVA young and old CVA patients, different factors have affected the quality of life, related to the following aspects : motor impairment, physical dysfunction or dependency in activity of daily living, the presence of depression ,cognitive impairment, and speech disturbances.The main aim of the study : To identify the factors affecting the quality of life for patients suffering from cerebrovascular accident.Design of the study : Descriptive cross - sectional study design was selected to achieve the objectives of this study the factors affecting quality of life for patients diagnosed with cerebrovascular accident in Middle Euphrates Neuroscience center in Al - Najaf Al - Ashraf City, for the period between 27 October 2015 and 30 August 2016.Setting : A unique center was selected to conduct the study, the outpatient department in Middle Euphrates Neuroscience center in Al Najaf Al Ashraf City are used to collect the data.Sample of the study : Non probability ( purposive sample ) from patients with CVA (N=80) were selected to find out the factors affecting quality of life for patients with cerebral vascular accident. Data was collected by using an assessment questionnaire which was adopted and developed by the researcher to assess the factors affecting the quality of life for patients with cerebrovascular accident. It is divided of three parts : demographical data as the first part, clinical information is the second part, while the specific CVA quality of life questionnaire which extended to 48 items distributed upon 12 main domains as (energy and activity, family relationship, speaking, movement, mood, personality, self - care, social role, thinking, in addition upper extremities functions, vision, and work / productive ) is the third part. Validity of the questionnaire obtain by (19) experts, who work in different fields to obtain the reability of the questionnaire alpha cronbach was used as a statistical method.The majority of the study sample were between (59 - 69) of age. The highest percentage of the study sample were males and were married. On the other hand the highest percentage of the sample were illiterate , housewives and urban area residents. The scores of the quality of life of the majority of the study sample were high effected regarding the following domains : (energy and activity), plus movement, moderate effect presented related to the family relationship, speaking, mood, self - management, social role, thinking, function of the upper extremities, vision, and job / productive, while low effect score recorded for personality.Conclusion : The overall quality of life level of the CVA patient who participate in the study was moderate. The QOL for patient with CVA were significantly effected related to their age, occupation, and educational level. Chronic diseases, type of CVA and it's duration play as highly effecting factors related to the patient's quality of life.Recommendation : Establishing structured program realizing the challenges that might face the post CVA patients because this long journey need special planned care to improve patient's quality of life by special rehabilitation unit, the unit services may be extended for the patient's family.

قياس تركيز الحديد والفرتين والارثروبويتين وفيتامين ب وحامض الفولك والبيروكسايديز الدرقي في مصل مرضى تضخم الغدة الدرقية حديثي التشخيص في محافظة بابل == Serum Iron,Ferritin,Thyroid Peroxidase ,B12,Erythropoietin And Folate Concentrations In Patients With Newly Diagnosed Hyperthyroidism In Babylon Province

اسم المؤلف: سالينا عبد العباس ناصر الشمري
اسم المشرف: محمد عبيد المحمدي | علاء صادق العواد
الموضوع العام: الطب
السنة: 2016
الموضوع الدقيق: الفسلجة
الدرجة: ماجستير
اللغة: الانكليزية
مكان الجامعة: بابل
الصفحات الاولى:
المستخلص: فرط نشاط الغده الدرقيه : هو مرض يصيب الغده الدرقيه وذلك نظرا لارتفاع هرمون تي ثلاثه وتي اربعه وهما هرمونات الدرقيه ولوحظ ان هذا المرض يصيب النساء بنسبه اعلى من الرجال بسبب التاثير الهرموني للاناث مما يجعلها الاكثر عرضه لهذا المرض,من علامات هذا المرض هي زيا | Background : Hyperthyroidism is endocrine disease that occur due to high levels of thyroid gland hormones and this disease affected female more than male due to hormonal effect, the female is more susceptible to this disease.Sign of disease including increase in metabolic rate of patient,sweating,increase pulse,enlargement of thyroid gland(goiter) which by this sign can diagnosis the patient.Objective : Evaluate serum erythropoietin and its relation with increase metabolic rate as well as hemopoiesis,evaluate serum folic acid and vitamin B12 and its role in hyperthyroidism ,evaluate the correlation of thyroid peroxidase with thyroid hormones and evaluate serum iron and ferritin.Materials and methods : This study was done from October/2015 till July/2016.The total number of patients group in this study was seventy man and women.their age ranged 26 - 65 years,58 women and 12 men who was in patients group and 35 female and 5 male in control group.Patients data in this study was history of hypertension ,parity ,age and sex. The difficulty in my research was in collection of spa icemen from patients.Result : The result which obtained from this study found that high significant increase in ferritin,thyroid peroxidase,folate and erythropoietin (p?0.01) in patients as compare to control group.High significant decrease in iron and B12(p?0.01) in patients group compare to control group. in case of the age found the 30 - 39 years more effected age among patients group and the female more effected with disease than male.Conclusion : From this study we conclude that thehyperthyroidism in female more than male due to hormonal effect. Reduce in iron due to high metabolic rate lead to decrease absorption of iron and B12 which lead to anemia.increase thyroid peroxidase which play a role in T3 and T4 synthesis.

Effect Of SNP rs198389 of BNP Gene On The Natriuretic Peptides Levels In Cardiovascular Patients

اسم المؤلف: Alaa Salman Idan Al - Ibrahimi
اسم المشرف: Monem M. Al | shok | Moaed E. Al | Gazally
الموضوع العام: الطب
السنة: 2016
الدرجة: ماجستير
اللغة: الانكليزية
مكان الجامعة: بابل
الصفحات الاولى:
المستخلص: Acute coronary syndrome (ACS) refers to any group of acute signs and symptoms attributed to sever obstruction of the coronary arteries. Acute coronary syndrome usually occurs because of one of three problems : ST elevation myocardial infarction, non - ST elevation myocardial infarction, and unstable angina. These types are named according to the results of the electrocardiogram (ECG). In addition to clinical and electrocardiogram (ECG) findings, several biochemical markers are considered in patients with chest pain to diagnose myocardial ischemia. Heart failure (HF) according to American College of Cardiology (ACC) and American Heart Association (AHA) is a complex clinical syndrome that can be caused by any structural or functional disorder in the heart that fails the capability of the ventricle to fill with or to eject blood. The diagnosis is often performed clinically on the basis of the presence of dyspnea, fatigue, signs of fluid overload, such as pulmonary crepitation, peripheral edema, and distension of jugular vein.B - type natriuretic peptide (BNP) and N - terminal pro - BNP (NT - proBNP) are secreted by human atrial and ventricular myocardium. The rise in BNP and NT - proBNP levels after ACS and HF correlates with infarct size and regional wall motion abnormalities. Echocardiography remains the most frequently used and usually the initial imaging test to evaluate all cardiovascular diseases related to a structural, functional, or hemodynamic abnormality of the heart or great vessels. This study is designed to investigate and assess the serum concentrations of BNP and NT - proBNP in patients with HF and ACS; In addition, almost equal number of males and females are chosen to control the effect of age and gender on the levels of BNP and NT - proBNP. Also, the study aims to evaluate the effect of BNP gene T - 381C (rs198389) polymorphism on the plasma human levels of BNP and NT - proBNP and compare the results that will obtain with healthy control.The present study was involved (70) patients, (35) of them with ACS and the other (35) with HF. The study also includes (22) subjects were taken as control group. The sera obtained from the blood of patients and control subjects were used to measure the concentrations of BNP and NT - proBNP, while whole blood samples from study subjects are used to extract DNA for the study of polymorphism in BNP gene.The results indicate both the ACS and HF groups have significantly higher levels of BNP and NT - proBNP when compared to control group, also HF patients have higher levels of both parameters than ACS patients, in all comparison (p

اكتفين ا كعلامة بيولوجية للحمل خارج الرحم والاجهاض المنسي == Activin A As A Biomarker For Ectopic Pregnancy And Missed Abortion

اسم المؤلف: مي حامد حسن
اسم المشرف: نورهان شاكر
الموضوع العام: الطب
السنة: 2016
الموضوع الدقيق: النسائية والتوليد
الدرجة: دبلوم عالي
اللغة: الانكليزية
مكان الجامعة: النجف
الصفحات الاولى:
المستخلص: Background : Activin A is a member of transforming growth factor B family that is secreted from ovary and placenta, however, in pregnancy the main source is the trophoblast.Aim of study : Activin A measurement to differentiate between intrauterine pregnancy and failed (missed abortion and ectopic) pregnancies.Study design : a Case control study.Setting : Department of Obstetrics and Gynecology in the College of Medicine Kufa University in Al Zahraa Teaching Hospital.Material and Methods : This study is a case control study consisting of 90 patients on three groups : Group 1 ectopic pregnancies (EP) (n=30) , Group 2 missed abortions (MA) (n=30) and Group 3 healthy viable intrauterine pregnancies (IUP) (n=30) were came to hospital with lower abdominal pain and\or vaginal bleeding or both between 6 - 8 weeks of gestation. Serum samples were sent at initial visit before treatment for measurement of activin A using ELISA test.Results : Activin A concentrations were significantly lower in women with EP (n = 30, mean value of 89.9 pg/mL) and women with MA (n = 30, mean value of 164.9 pg/mL) compared to IUP (n = 30, mean value of 334.5pg/mL); P < 0.001. Activin A can discriminate an ectopic pregnancy from viable pregnancies also, it was able to discriminate a MA from an EP.Conclusion : In this study activin A could be considered a promising biomarker for the discrimination between an IUP and a failed pregnancy (MA or EP).

العلاقة بين البروتين التفاعلي عالي الدقة في حالات سمدمية الحمل مع او بدون تخلف نمو الجنين == Associationbetween Highly Sensitive C - Reactive Protein Level In Cases Of Preeclampsia With Or Without Intrauterine - Growth Restriction

اسم المؤلف: روسم جاسم محمد
اسم المشرف: الاء محمد صادق
الموضوع العام: الطب
السنة: 2016
الموضوع الدقيق: النسائية والتوليد
الدرجة: دبلوم عالي
اللغة: الانكليزية
مكان الجامعة: النجف
الكلمات الدلالية:
  • العلاقة بين البروتين التفاعلي عالي الدقة في حالات سمدمية الحمل مع او بدون تخلف نمو الجنين
الصفحات الاولى:
المستخلص: سمدم?ةالحملھوخلل?ص?بتقر?با 4% منالنساءاثناءالحملوتترتبعل?ھمخاطركث?رةبالنسبةل?موالطفل. نعرفتسممالحملعللىانھا?صابةالحد?ثةغ?رالمسبوقةبارتفاعضغطالدماثناءالحملبعدا?سبوع 20 منالحملوالمصحوبةبوجودبروت?نفيالبول.البروت?نالتفاعليعاليالدقةھومؤشرك?م?ائيبامكانناق?اسھف | Preeclampsia is a hypertensive disorder that affects 4% of pregnant women , in which the exact cause cannot identified it is one of the major causes of maternal and fetal morbidity and mortality as it causes death of more than 6300 women annually , also it puts a burden on perinatal outcome as prematurity and Intrauterine growth restriction.Continuous search for predictive markers of severe PE is important and can be used to target high risk women for effective preventive treatment.Aim of study : to evaluate that Highly Sensitive C - Reactive Protein can be used as maker for severity of PE and whether it can be used to predict development of Intrauterine growth restrictionPatients and methods : this is convenient a cross - sectional study includes 80 pregnant women with their age 18 - 35 years , their gestational age 32 - 40 weeks , admitted to AL - Zahraa teaching hospital , whose diagnosed as PE based on BP and proteinurea. Full history and clinical examination were performed, venous blood aspirated for each women for biochemical analysis, Liver functions tests, Renal function tests Highly Sensitive C - Reactive Protein, and Doppler ultrasound.Results : The patients divided into those with mild PE and severe PE, with or without IUGR. No significant difference between the level of hsCRP and the severity of PE as p value was(0.779), but there is significant difference between the presence of IUGR and the level of hsCRP when it is 2mg/L as the p value was(0.020).Conclusion : We conclude that s.hsCRP is not sign

دراسة علاقة طول عنق الرحم المقاس بالسونار الداخلي مزامنة مع كمية السائل الامنيوسي في توقع وقت حدوث الولادة المبكرة خلال سبعة ايام من تمزق غشاء السائل الامنيوسي المبكر == Transvaginal Cervical Length & Amniotic Fluid Index : Can They Predict Delivery Latency Following Preterm Premature Rupture Of Membrane

اسم المؤلف: وسن غائب حسون غائب
اسم المشرف: امال منير مبارك
الموضوع العام: الطب
السنة: 2016
الموضوع الدقيق: النسائية والتوليد
الدرجة: دبلوم عالي
اللغة: الانكليزية
مكان الجامعة: النجف
الكلمات الدلالية:
  • علاقه طول عنق الرحم المقاس بالسونار الداخلي مزامنة مع كمية السائل الامنيوسي في توقع حدوث الولادة المبكرة خلال سبعة ايام من تمزق غشاء السائل الامنيوسي المبكر
الصفحات الاولى:
المستخلص: توقع حدوث الولادة عند الحوامل المصابات بتمزق غشاء السائل الامنيوسي المبكريساعد الحامل على تهيئه نفسها لدخول المستشفى لاجراء اللازم لها واعطاءالجرعةالمنشطةلرئة الطفل وادخاله الى وحده العناية المركزة لحديثي الولادة.هدف الدراسة : تهدف الدراسة الى قياس طول عن | Patients with PPROM are often hospitalized for a prolonged period of time and deliver premature infants who frequently require neonatal intensive care. These women and their infants contribute significantly to obstetric &neonatal health care costs. The prediction of delivery latency could help direct the need for specific interventions such as hospitalization, intensive monitoring, timing of antenatal steroids.Objective : To determine whether transvaginal CL, AFI,or a combination of both can predict delivery latency within 7 days in women presenting with PPROM.Methods and Study Design : This was a prospective observational study of TVCL measurements in 80 singleton pregnancies with PPROM between 24 - 34 weeks. Transvaginal ultrasonography was performed with TOSHIBA SSA - 340A(Tokyo - Japan) apparatus 7.5MHz transvaginal probe, to measure the CL&AFI. Delivery latency was defined as the period from the initial TVCL after PPROM to delivery of the baby with our primary outcome being delivery within 7 days of TVCL. The independent predictability of significant characteristics for delivery within 7 days was determined using multiple logistic regression.Sensitivity, specificity, and predictive values were used to determin, whether the presence of a short TVCL, AFI or a combination of both affected the risk of delivery within 7 days.Result : Our study in women with PPROM show the validity of CL in predicting labor when the cut off value2cm the sensitivity=52.6%, specificity=69%, PPV=60.6%, NPV =61.7% and Accuracy=61.25%.The validity of AFI when the cut off value 5cm the sensitivity=71.1%, specificity=50%, PPV=56.3%, NPV=65.6% and Accuracy=60%.With combination of CL&AFI in predicting time of labor after PPROM the sensitivity=50%, specificity=92.8%, PPV=86.4%, NPV=67.2% and Accuracy 72.5%.In women with PPROM the rate of gestational age ? 30 weeks that labored within 7 days 44.7% and those labored more than 7 days 55.3%.Also the rate of gestational age >30 weeks that delivered within and after 7 days are 50%.According to the parity we found the mean value of those delivered within 7 days are 1.24 and those after 7 days are 1.28.Conclusion : Our study shows there is increase in positive predictive value when combination of AFI and CL in prediction of time of labour so women with AFI?5 and CL?2 had 86.4% risk of delivery within 7 days after PPROM. Also the study found there was no significant association between gestational age, or parity with the prediction time of labor.

تاثير كل من عقار الروزوفاستاتين وعقار الاتورفاستاتين على مؤشرات نسب السكر المصاحبة للسمنة المحدثة في الفئران == Effects Of Atorvastatin Versus Rosuvastatin On Glycaemic Indices In Diet Induced Obese Mice

اسم المؤلف: نورس لطيف وهاب
اسم المشرف: علي اسماعيل عبد الله محمد | حيدر مطير القريشي
الموضوع العام: الطب
السنة: 2016
الموضوع الدقيق: الادوية والسموم
الدرجة: ماجستير
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: Numerous interventional cardiovascular disease outcome studies have resulted in statins being an essential factor of cardiovascular primary and secondary prevention strategies.In recent years there was ahigh concern that statin use is associated with diabetes new onset which is strong, independent risk factor for cardiovascular (CV) and cerebrovascular outcomes ,several studies resulted in conflicting results regarding different statin types & dose effect on glycemic control. Atorvastatin which is the most widely used statin worldwide and rosuvastatin the most efficacious ;they have different structural characteristics that have been speculated to have influence on diabetes onset.Aim of the study : The present study aims at investigating the effect of different doses of atorvastatin and rosuvastatin on glycaemic indices and metabolic disorders on mice model of diet induced obesity. Materials and method : The animals were divided into two groups : one served as control that received normal regular chow & the other group received high fat diet for the whole 12 weeks of experiment.After eight weeks of HFD feeding ;group (2) farther subdivided into five groups(12 mice in each) ; the first group received HFD only ,the second group received single daily dose / po of 20mg /kg rosuvastatin ,the third group received single daily dose / po of 40mg /kg rosuvastatin ,the fourth group received single daily dose / po of 20mg /kg atorvastatin ,and the fifth group received single daily dose / po of 40mg /kg atorvastatin for the last four weeks of experiment.Body weight ,food intake, lipid profile ,glycaemic indices were taken at baseline ,before treatment and after treatment.At the end of experiment ,animals were sacrificed , plasma & tissue sample were collected for biochemical analysis and histological observations.Results : Results of the present study shows that high fat diet feeding resulted in obesity development and metabolic abnormality like; hyperglycemia ,hyperinsulinemia ,insulin resistance , dyslipidemia and moderate to severe hepatic steatohepetitis compared to control group. and treatment resulted in significant improvement in lipid profile ,reduction in food intake ,body weight ,also associated with improvement in insulin sensitivity , hepatic steatohepetitis and reduction in insulin secretion.twenty mg/kg dose of atorvastatin showed better influence on glycaemic indices and comparable influence on hepatic picture over fourty mg/kg does while twenty mg/kg dose of rosuvastatin resulted in deterioration of glycaemic indices and no apparent improvement in hepatic steatosis. Unlike group that received 40 mg /kg rosuvastatin which showed significant improvement in all related metabolic disorders. Conclusion : Feeding mice with high calories diet for 2 month result in induction of obesity and disturbance of metabolic parameters. Treatment with rosuvastatin or atorvastatin has good impact on bodyweight , metabolic derangements &hepatic steatosis in obese mice. Both drugs seems to improve lipid profile in dose dependent manner, however their effects on glycaemic indices has different attitude. It is seems that rosuvastatin, especially at high dose, has better impact on glycaemic indices than atorvastatin and this might attributed to the difference in their pharmacokinetic properties

تاثير استخدام عقار الميتفورمين منفردا او مع عقار السيتاكلبتين على مستويات الاومنتين - 1 لدى مرضى داء السكري من النوع الثاني == Effects Of Metformin Alone Or In Combination With Sitagliptin On Serum Omentin - 1 Levels In Patients With Type - 2 Diabetes Mellitus

اسم المؤلف: ميقات طالب حمادة
اسم المشرف: حيدر مطير خليل القريشي | عبد الكريم يحيى السامرائي
الموضوع العام: الطب
السنة: 2016
الموضوع الدقيق: الادوية والسموم
الدرجة: ماجستير
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: الخلفية : داء السكري يشير الى مجموعة من امراض الايض مع ارتفاع مستوى سكر الدم. يمثل النوع الثاني من داء السكري ما نسبته 90 - 95% من جميع حالات السكري. يمثل النقص في الانسولين ومقاومة الانسولين وغيرها من الاضطرابات الهرمونية المشاكل الاساسية لمرضى السكري من ال | Background : Diabetes mellitus (DM) describes chronic metabolic disorders with hyperglycemia. Type II DM (T2DM) represents for approximately 90 - 95% of all diabetic types. A combination of insulin deficiency, insulin resistance and other hormonal irregularities are key problems with T2DM. Adipose tissue can be classified into two types : the brown and white adipose tissues. The white type is considered an important secretory organ which produces many bioactive molecules, collectively termed adipokines. Recently, a new adipokine named omentin - 1, has been identified and it was found that individuals with impairment in glucose homeostasis and newly diagnosed T2DM showed a lower serum omentin - 1 level. However, the effects of antidiabetes drugs on serum omentin - 1 level had not been studied extensively.Objective : The current study was design to measure serum omentin - 1 in T2DM as comparing with control subjects, also to study the effect of three months therapy with metformin and/or sitagliptin (when added to ongoing metformin therapy) on serum omentin - 1 levels in addition to other parameters.Method : This study was carried out on thirty healthy control subjects, and sixty three T2DM patients. The patients enrolled in the current study were divided into two groups. First group : included thirty one of newly diagnosed T2DM patients, started treatment with metformin. Second group : included thirty two patients with T2DM, already on ongoing metformin therapy and started treatment with sitagliptin. All patients received their treatment for three months duration, and blood samples were collected from them at the beginning of the study and after three months of starting treatment to measure the possible change in the studied parameters which include : fasting blood glucose (FBG), postprandial blood glucose (PBG), Glycosylated haemoglobin (HbA1c), serum level of insulin, insulin resistance (IR), serum omentin - 1 levels, lipid profile, body mass index (BMI) as well as blood pressure. Results : The results showed that baseline level of serum omentin - 1 in the newly diagnosed T2DM was significantly lower than matched control subjects. The level of omentin - 1 was significantly reduced after three months duration of treatment in sitagliptin group with no significant change in metformin group. FBG, HbA1c and PBG were decreased significantly after three months in metformin group, while in sitagliptin group, only HbA1c and PBG were decreased significantly after three months. In both groups, and after three months duration of treatment, there were no significant changes in serum level of insulin, IR, TG, VLDL - C, HDL - C, BMI, and blood pressure.Conclusion : In newly diagnosed patients with T2DM, serum omentin - 1 was reduced compared to age and BMI matched healthy subjects. Three months treatment with sitagliptin resulted in a significant reduction in omentin - 1 levels compared with baseline values. However, three months treatment with metformin had no significant effect on serum omentin - 1 level compared with pre - treatment value

تاثير استخدام عقار الكلورال هيدريت منفردا او استعماله مجتمعا مع عقار الديازيبام كمهدئ عند قياس الاداء السمعي الدماغي عند الاطفال == Chloral Hydrate Alone Or In Combination With Diazepam As A Sedative For Auditory Brainstem Response Testing In A Pediatric

اسم المؤلف: مريم محمد حميد مصطفى
اسم المشرف: حيدر مطير خليل القريشي | حيدر وهاب السرحان
الموضوع العام: الطب
السنة: 2016
الموضوع الدقيق: الادوية والسموم
الدرجة: ماجستير
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: اجريت الدراسة الحالية لبحث تاثير استخدام الكلورال هيدريت منفردا او استعماله مع الديازيبام كمهدئ عند قياس الاداء السمعي الدماغي عند الاطفال من اجل تقييم ما اذا كان اضافة الديازيبام له تاثير ايجابي او سلبي.اعتمدت الدراسة الحاليه على160 متطوعا من الاطفال ال | Background : children usually need sedation for diagnostic and therapeutic interventions. It is well known that pediatrics age groups are at higher risk for sedation - related complications than adults. Auditory brainstem response testing is one of the important diagnostic procedure that usually need sedation in order to preformed in children. Chloral hydrate is a hypnotic agent used since 1832 with low incidence of adverse events; whoever, despite the world wide use it is being abandoned due to bitter test, long time of sedation onset, vomiting and mild sedation. Rectally diazepam, on the other hand, produces higher and fast concentration in CSF with greater rate of success but probably with higher adverse events. Aim of the study : were to compare the sedative effect of chloral hydrate with chloral hydrate diazepam combination as well as their related adverse effects in children underwentg auditory brainstem response testing. Methods : in this randomized clinical study, 160 child underwent sedation for auditory brainstem response test participated. They were divided equally and randomly into 4 groups. Group A : Received 20 mg/Kg oral chloral hydrate as sedative, Group B : Received 20 mg/Kg oral chloral hydrate plus 0.5 mg/Kg diazepam rectally, Group C : Received 40 mg/Kg oral chloral hydrate as sedative, and Group D : Received 40 mg/Kg oral chloral hydrate plus 0.5 mg/Kg diazepam rectally. At the beginning, blood pressure, respiratory rates, peripheral oxygen saturation recorded, and then re - recorded immediately after drug administration and at (3, 5, 10, 20, …. min). Ramsay sedation scale used for assessment of the sedation level which measured every 10 min. Results : This study shown the beneficial use of chloral hydrate in combination with diazepam as sedation in ABR test (in groups D) by increased in the sedated number (p<0.05), decreased in the requirement of chloral hydrate re - dose, increased in the number of children whom completed ABR test (p<0.05) without significant differences on side effects or vital signs compared with the others three groups. 4.3. Conclusion : From this study we concluded that : • Used of oral chloral hydrate in dose (20mg/kg) alone not sufficient as sedative in paediatrics for ABR test.• Used of oral chloral hydrate dose (20mg/kg) in combination with rectal diazepam (0.5 mg/kg) better than used it alone as sedative in paediatrics for ABR test.• Used of oral chloral hydrate dose (40mg/kg) in combination with rectal diazepam (0.5 mg/kg) was the best sedative in paediatrics for ABR test. • Used of Chloral hydrate diazepam combination in ABR test of paediatrics increased the number of the sedated children, decreased the requirement of chloral hydrate re - dose, and increased the number of completed ABR test, with less complication

عزل وتحديد هوية فيروس الحصبة في علاقته ببعض الجوانب المناعية من الاشخاص النازحين الملقحين في محافظة بابل == Isolation And Identification Of Measles Virus In Relation To Some Immunological Aspects From The Vaccinated Displaced Individuals In Babylon Governorate

اسم المؤلف: ليث احمد عمران كيف الكيف
اسم المشرف: محمد عبد كاظم حسن السعدي | يونس عبد الرضا كحيوش الخفاجي
الموضوع العام: الطب
السنة: 2016
الموضوع الدقيق: الاحياء المجهرية
الدرجة: ماجستير
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: اجريت الدراسة لتقييم مناعة المجتمع لكلا النازحين والمقيمين الملقحين بلقاح فيروس الحصبة ضد خمج الحصبة في محافظة بابل. لذا تضمنت هذه الدراسة معايرة الحالة المناعية في امصال النازحين والمقيمين محافظة بابل مع عزل وتشخيص فيروس الحصبة من الحالات المشتبه بها. ت | The study was conducted to evaluate the herd immunity for both the displaced and residents vaccinated with measles virus vaccine against measles infection in Babylon governorate. Therefore this study includes the evaluation of the immune status in sera of Babylon governorate displaced and residents with specific aspect for isolation and identification of measles virus from suspected cases. The immune response was evaluated by means of ELISA test (enzyme linked immunosorbet assay) for titration of IgM and IgG immunoglobulin level, in addition to evaluation of perforin level in the sera of 90 measles vaccinated individuals included in this study (50 displaced and 40 residents) from different areas in Babylon governorate, that were collected during the period extent from January up to April of 2016. Data about individuals were fixed according to information of formula including age, sex, geographical location, place displace of displaced and the vaccination date. Successful virus isolation from suspected cases on two types of cells culture included Vero cells line and chicken embryo fibroblast was carried. The titer of the isolated virus on Vero cell line reached (105.8 TCID50 / 0.1ml),which was higher than the titer of the virus isolated on CEF which reach (105.4 TCID50 / 0.1ml) after the third passage of the virus. The isolated virus was confirmed by indirect immunofluorescence technique.The age of subjects included in this study ranged from <1 year up to 24 years old. The results revealed that 15 (30%) have positive IgM index in sera of displaced, whereas residents sera sample shown only 6 (15%) positivity. Howover, all 90 (100%) subjects of both groups showed positive IgG index. The results of the present study showed that there were no significant difference of perforin level in sera of refugees and residents at p<0.05.Assaying of immune response against measles virus by measuring IgM immunoglobulin in sera of vaccinated displaced and resident with measles vaccine reflected a highly significant difference between two groups which reached 0.43 mIU/ml in sera of displaced in comparison with residents sera which reached 0.34 mIU/ml. The result showed also high significant differences in IgM between females and males. The females sera IgM levels of displaced and residents were higher than its level in males sera which reached 0.47 mIU/ml and 0.35 mIU/ml, respectively, in comparison with male sera level which reached 0.40 mIU/ml and 0.32 mIU/ml, respectively. According to age group, the highest IgM value was recorded in displaced and residents sera in age group 10 - 14years (0.50 mIU/ml) and 5 - 9years (0.36 mIU/ml) respec - tively. Whereas the lowest IgM serum value was detected in age group <1 year (0.34 mIU/ml) and 15 - 19years (0.31 mIU/ml) for displaced and residents subjects. According to geographical location, the highest IgM level was detected in sera of displaced from Tal Afar city (0.44 mIU/ml) followed by displaced from Ramadi (0.41 mIU/ml) and the lowest IgM value was detected in sera of displaced from Mosul city (0.33 mIU/ml). Whereas the highest IgM value in sera of residents in the subjects of Al - Mahaweel city (0.37 mIU/ml) followed by subjects of Hilla and Al - Qasem city (0.29 mIU/ml and 0.28 mIU/ml) respectively. For IgG serum immunoglobulin the results revealed that there was no difference in significant levels in both group population. But according to age groups significant difference between displaced and residents was detected at p <0.05 in which the 1 - 4 years old showed the highest IgG serum level in both group (1.98 mIU/ml and 2.18 mIU/ml) respectively. While the lowest IgG sera value was recorded in displaced age group of < 1 year old (0.60 mIU/ml) compared with residents age group of 20 - 24 years old (1.65 mIU/ml).It could be concluded that the results showed that the displaced do not have any effect on the residents of the province of Babylon for measles as a result of the good immunization by Babil Health directorate following to the Ministry of Health.

تاثير استخدام عقار الميتفورمين منفردا او استعماله مجتمعا مع عقار كلكلزايد على مستوى الاومنتين - 1 - في مرضى داء السكري من النوع الثاني == Effects Of Metformin Alone Or In Combination With Gliclazide On Serum Omentin - 1 Levels In Patients With Type 2 Diabetes Mellitus

اسم المؤلف: سمر محمد غني سليمان
اسم المشرف: علي اسماعيل عبد الله محمد | حيدر فاضل الربيعي
الموضوع العام: الطب
السنة: 2016
الموضوع الدقيق: الادوية والسموم
الدرجة: ماجستير
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: اجريت الدراسة الحالية لبحث التاثير العلاجي لاستخدام عقار الميتفورمين منفردا او استعماله مجتمعا مع عقار كلكلزايد على مستوى الاومنتين - 1 - باالاضافة الى المؤشرات الحيوية الاخرى في مرضى داء السكري من النوع الثاني من اجل تقييم ما اذا كان الجمع بين العقارين ( | Background : Omentin is a newly identified adipokine, which is highly expressed in visceral adipose tissue, in which omentin - 1 is the main isoform in human circulation, associated with cardio - metabolic disturbances. So considering the impact of anti - diabetic drug on omentin - 1 levels may provide adjuvant strategy to protect diabetic patients against clinical hazards.Aim of the study : The present study aimed to investigate the influence of treatment with metformin alone or in combination with gliclazide on the level of serum omentin - 1, in addition to the other biomarkers adopted in the study in order to evaluate whether the combined therapy (metformin plus gliclazide) ameliorate or adversely effects on some cardiac protector markers of metformin among recently diagnosed patients with type 2 diabetes mellitus.Methods : A total number of 100 recently diagnosed patients with type 2 diabetes mellitus were enrolled in the present study from December 2014 until June 2015. Sixty eight patients completed the 12 weeks course of treatment; divided into two equal groups based on treatment regimen in which group1 treated with metformin and group2 treated with metformin plus gliclazide. Thirty two patients did not complete the course of the treatment for unknown reasons and considered as default. In addition to 31 healthy volunteers were randomly chosen and considered as Control Group. In which all the participants in the study underwent detection of blood pressure, pulse rate, weight, height & BMI in addition to the estimation of the levels of others biochemical analysis as glycemic indices, lipid profile & serum omentin - 1at the beginning of the study & after 12 weeks of treatment regimen.Results : The results of this study shown the beneficial amelioration of metformin on some markers that affect CVS represented as significant reduction in BMI (p<0.05), modest improvement in lipid profile with modest elevation in HDL level & lowering blood pressure, significant reduction in the levels of blood glucose & HbA1C (p<0.05), improves insulin sensitivity, reduced insulin resistance, and elevation of serum omentin - 1 level among newly diagnosed type 2 diabetic patients (group1). Furthermore, the results of current study are revealed that adding of gliclazide to metformin in treatment of type 2 diabetic patients might influence the documented beneficial effects of metformin on cardiovascular system at least by adversely changing the levels of serum omentin - 1 among group 2. Conclusions : Adding of gliclazide to metformin in treatment of patients with type 2 DM might extend the therapeutic action of metformin in regarding much better controlling of glycemic indices, insulin sensitivity and lipid profile. But, at the same time, it might attenuate some of beneficial effects of metformin on cardiovascular system at least by adversely influence on body weight and serum omentin - 1 levels.

تاثير استخدام عقار النكلوزمايد بالمقارنة مع عقار المتفورمين على وزن الجسم ومؤشرات السكر في السمنة المحدثة عند الفئران == Effects Of Use Of Niclosamide Drug In Comparison With Metformin Drug On Body Weight And Glycemic Indices In High Fat Diet Induced Obese Mice

اسم المؤلف: خالد دهان صليبي
اسم المشرف: علي اسماعيل عبد الله محمد | خالد جمعة خليل
الموضوع العام: الطب
السنة: 2016
الموضوع الدقيق: الادوية والسموم
الدرجة: ماجستير
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: في ستينيات القرن الماضي كان هناك نوع من العلاجات تستخدم للسيطرة على وزن الجسم او لتخفيفه , تلك المواد تعمل على تثبيط عضيات المايتوكوندريا من انتاج الطاقة وتحويل مجرى تفاعلات الاكسدة نحو انتاج الحرارة بدلا عن الطاقة وبذلك تحفز من زيادة اكسدة الشحوم ومادة ا | Background : Obesity is a state of excessive accumulation of fat tissue in the body , increasing energy expenditure is good way to manage obesity and the related complications. Mitochondrial uncouplers increase energy expenditure , they used before for weight controlling programs because these compounds uncouple mitochondria from generating ATP , moreover stimulate lipid and glucose oxidation preventing lipid accumulation in excess caloric intake conditions specially. Niclosamide an old drug introduced in 1960s as anthelmintic and had FDA approval for the treatment of most of tapeworm infections. It is well known mitochondrial uncoupler.Aim of the study : The present study aimed to investigate the influence of trial of the use of niclosamide in comparison to effect of metformin and their combination on body weight , glycemic indices and lipid profile in high fat diet induced obese mice.Materials and methods : The animals firstly divided to two groups one fed with normal regular mouse chow (30 mice) and the 2nd fed with high fat diet (60%kcal) for 2.5 months(100 mice) 10 mice from each group sacrificed at beginning of study represent baseline values and another 10 mice from each group sacrificed after 2.5 months to assess effect of high fat diet on study parameters. The group that fed with high fat diet further subdivided to 4 groups after 2.5 month of high fat diet feeding each 20 mice , 10 mice from each group sacrificed before treatment represent pretreatment values. Before treatment there are 5 groups assigned as group 1 fed normal regular mouse chow till the end of study , group 2 fed high fat diet without treatment till the end of study , group 3 fed with high fat diet till the end of study and treated with niclosamide for one month (150mg/kg) after obesity induction by high fat diet , group 4 fed with high fat diet till the end and treated by metformin (300mg/kg) for one month and finally group 5 fed with high fat diet till the end of study and treated by combination of niclosamide and metformin (150mg/kg , 300mg/kg respectively). blood samples taken from tail vein to evaluate the study parameters at baseline and after obesity induction by high fat diet (after 2.5 months) and after treatment ,then animals were sacrificed and livers were taken for histopathological observations.Results : The results of this study shown that the animals fed with high fat diet show metabolic disturbances manifested by significant increase (P < 0.05) in body weight , fasting insulin & fasting plasma glucose. Lipid profile show significant changes (P < 0.05)(cholesterol , triglycerides ,low density lipoproteins increased while high density lipoproteins decreased ) as compared to control group. High fat diet group also show impaired glucose tolerance , impaired insulin sensitivity and obvious liver structural changes manifested by sever steatosis.Treatment with niclosamide show improvement in all metabolic disturbances induced by obesity ; body Weight , fasting insulin and fasting plasma glucose reduced significantly (P < 0.05). Lipid profile parameters improved ; cholesterol , triglycerides , low density lipoproteins reduced significantly (P < 0.05) by one month treatment with niclosamide and high density lipoproteins increased significantly (P < 0.05) as compared to their baseline values before treatment, Glucose and insulin tolerance improved. It is nice to mention the influence of niclosamide in this study was comparable to metformin in all evaluated parameters.Combination of both drugs show favorable improvement in metabolic disturbances induced by obesity rather than each drug when used alone specially on liver histopathological changes.Combination of both drugs show significant reduction (P < 0.05) in body weight ,fasting plasma glucose and fasting plasma insulin. Lipid profile parameters improved significantly (P < 0.05) , glucose and insulin tolerance improved.Liver histopathological changes ameliorated to higher extent and become the closet to normal liver tissue morphology.Conclusions : The result suggest niclosamide have good antidiabetic action and can ameliorate the metabolic changes induced by obesity significantly. Its action is comparable to that of well known antidiabetic drug metformin. Niclosamide has favorable effect on body weight and can reduce body weight. Its combination with metformin show better improvement in metabolic disturbances induced by obesity and it has very good hepatoprotective effect against liver histopathological changes induced by high fat diet.

تاثيرات السيتاكولين ,الجنسنك واستخدامهما معا على الذاكرة العملية والاداء الحركي النفسي == Effects Of Citicoline, Ginseng, And Their Combination On Psychomotor Performance And Working Memory

اسم المؤلف: تيسير لطيف علي
اسم المشرف: حيدر القريشي
الموضوع العام: الطب
السنة: 2016
الموضوع الدقيق: الادوية والسموم
الدرجة: ماجستير
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: اساس الدراسة : اجريت الدراسة الحالية لتقييم التاثير العلاجي لعقار السيتاكولين والجنسنك واستخدامهما معا على الذاكرة القصيرة المدى والاداء الحسي الحركي, وذلك من خلال دراسة الاثار المركزية والطرفية للعقارين على مقاييس الاداء الحسي الحركي , الذاكرة العمليه , | Citicoline is one of components that present in the human brain, which act to protect the neurons and enhance memory and other cognitive functions due to its choline in their structure which play an important role in the biological membrane biosynthesis. On other hand Ginseng is an herbal plant is known for its therapeutic medical importance, it's used for different purposes in medical fields, that is effective against many diseases, act as a tonic and provide energy with significant reduction in mental and physical fatigue.Aims of the study To evaluate the central effects of Panax Ginseng and/or citicoline on normal healthy volunteers.Material and Method The subjects are randomly divided into four groups for assessment of central effects of Panax Ginseng and /or citicoline compared with placebo. The evaluation of the central effects was done by using the Leeds psychomotor battery tester for evaluating the psychomotor performance, workshop test was used to evaluate working memory function.The enrolled volunteers were randomly divided into the following groups : First group regarded as control group that treated with 500 mg/day of starch capsule as a single dose, second group, received Panax Ginseng capsule 500 mg /day, a third group received citicoline capsule 500 mg/day and the fourth group received Panax Ginseng capsule 500 mg/day plus citicoline capsule 500 mg/day as a single dose. All participants are followed for two consecutive weeks from starting treatments.ResultsIn the present study the placebo didn't have any central effect and MDA serum levels were not significantly change. Panax Ginseng has statistically significant effect on the most parameters of the psychomotor performance, working memory performance, as well as reduction of MDA serum levels. On the other hand, citicoline has statistically a significant effects on most parameters of the psychomotor and working memory function with statistically significant reduction of MDA serum levels.The combination of Panax Ginseng and citicoline have a highly statistically significant effect on all psychomotor performance, working memory performance and statistically significant reduction in the oxidative stress marker (MDA). ConclusionResults of the present study showed that combined effects of citicoline plus Panax Ginseng on central function produced more statistically significant effects on psychomotor performances, CFFF and working memory function than either Panax Ginseng or citicoline when they used alone, in addition to the combined effects of citicoline plus Panax Ginseng have a more significant effect on the oxidative stress,during mental stress.

تقييم وحدات الرعاية المركزة لحديثي الولادة في ردهات الولادة لمستشفيات بغداد == Evaluation Of Neonatal Intensive Care Units At Maternity Wards In Baghdad Hospitals

اسم المؤلف: بشرى احمد عبد اللطيف
اسم المشرف: جمال محمود الخضيري
الموضوع العام: الطب
السنة: 2016
الموضوع الدقيق: طب المجتمع
الدرجة: ماجستير
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: تتباين انظمة الرعاية لحديثي الولادة المطبقة ولكنها كلها تعتمد على وحدات الخدج الموجودة في مختلف بلدان العالم النامية والمتقدمة.انجزت هذه الدراسة المقطعية التقويمية في وحدات حديثي الولادة لردهات الولادة في مستشفيات بغداد (الكرخ والرصافة) مستثنين وحدات ال | Neonatal health care is provided via a variety of neonatal care units that are available globally both in different developing and developed countries.A cross - sectional evaluation study was conducted in all accessible fifteen neonatal intensive care units in Baghdad (Kharkh and Rosafa) maternity wards, excluding paediatric hospitals, during the period from November 2013 till the end of March 2014.The study aims : 1. Health care evaluation in neonatal intensive care units of maternity wards in Baghdad hospitals in terms of input (human and non - human resources) and outcome.2. Identifying causes of admissions and causes of deaths occurring in neonatal intensive care units The study consisted of two parts : A structure evaluation is using a check list to assess availability of human and non - human resources, covering infrastructure, manpower, equipment, and supplies; and an outcome evaluation study using hospital registration records review for causes of admission and causes of death in neonatal intensive care units during the year 2013.It was found that the mean number of specialist doctors in neonatal intensive care units was 2.1 and with standard deviation ±1.3, and college nurse was 2.2, with standard deviation of ±4.004, pharmacist was 0.4 with standard deviation of± 0.516 and for supplementary staff 1.5 with standard deviation of± 0.516.More than half 54% of nurses had no training in neonatal care.Concerning the availability of general equipment it was adequate except for computers 40%.Air conditioning, lighting and windows in addition to safe water supply was good 100% but ventilation was poor 67%, hand washing area was not always present 60% and free elbow operated water tubes were available in 6.7%. Availability of neonatal intensive care units special area was adequate for storage area 85.7% gowning area78.6%, while all the remaining areas were poorly available (resting room, examining room, mother room, boiling and autoclave room, area for mixing intravenous fluid and medication).Neonatal intensive care units were narrow and area/incubator ranging from 2.28m2 to 4.36m2/ incubator. Number of incubators was 246 with patient/ incubator ratio 53.6 : 1 and 27% of Neonatal intensive care units had no regular maintenance for incubators. Large Neonatal intensive care units >25 incubators were overcrowded, having below standards area/incubator, incubators covers only two third of neonatal care. Still up to one third of Neonatal intensive care units are getting their oxygen supply by cylinders, not pipes. Most equipment for individual use were poorly available. Most of Neonatal intensive care units emergency (cupboard) drugs and supplies were sufficiently available round the clock. Total admissions to Neonatal intensive care units were 13195 neonates. Male neonate's admissions 60% were higher than females 40%. Main causes of admission were Respiratory distress syndrome 43%, prematurity and low birth weight 19.4%, and Transient tachypnea 17.4%; birth asphyxia 4%, and hypoglycemia 3.8%, Congenital anomalies 3.7%, Neonatal jaundice 3%, while meconium aspiration and septicemia were the lowest1%. From all these admissions 74% were discharged well, (6%) were referred, while those discharged against medical advice were (4%) and the rest (16%) died. The main causes of death in Neonatal intensive care units were Respiratory distress syndrome 34%, prematurity and low birth weight 31% congenital anomalies 12%, birth asphyxia 8%, septicemia 4%, meconium aspiration 1% and 10% due to other unclassified causes. From this evaluation study, it can be concluded that there were Neonatal intensive care units with under staffing, undertraining and poor designing. Respiratory distress syndrome and prematurity were the main neonatal health problems.

تاثير عقار الميتفورمين, الكاناكلفلوزين او اجتماعهما معا على بعض المؤشرات الكيميائيه في الفئران ذوات السمنه المحدثه == Effect Of Metformin, Canagliflozin & Their Combination On Certain Biochemical Parameters In Diet Induced Obese Mice

اسم المؤلف: اسماء عبد الوهاب احمد
اسم المشرف: علي اسماعيل عبد الله محمد | خالد جمعه خليل
الموضوع العام: الطب
السنة: 2016
الموضوع الدقيق: الادوية والسموم
الدرجة: ماجستير
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: تعرف السمنه ب ترسب الدهون وخاصه في منطقه البطن الذي يرتبط ارتباطا وثيقا بالنظام الغذئي الناجم عن مرض خطير مثل السكري , اضطراب الدهون في الدم وارتفاع ضغط الدم التي توثر على صحه الانسان. ميتفورمين له تاثير ايجابي على التغيرات الايضيه الناتجه عن السمنه. علا | Background : Obesity is defined as the deposition of fat, especially in abdominal regions, which is closely related to serious diet - induced diseases such as type2 diabetes, dyslipidemia, and hypertension that affect human health. metformin has favorable influence on metabolic changes induced by obesity. Furthermore; treatment with metformin has good hepatoprotective effects against fatty changes induced by high fat diet. Moreover, it's interesting to mention that canagliflozin has comparable therapeutic effects to metformin on obesity induced metabolic disturbance but, unfortunately, it has not significant therapeutic impact on obesity induced hepatic steatosis. Interestingly, it has been found in the present study that use of metformin and canagliflozin in combination has superior promising impact on obesity induced metabolic and pathological changes.Aim of the study : The present study investigated the influence of metformin, canagliflozin, & their combination on body weight, food intake, glycemic indices, insulin sensitivity, and lipid profiles in diet - induced obese mice Materials and methods : The animals were divided into two groups.The first group feed with normal chow served as normal group {n=10}. The second group feed with high fat diet serve as high fat diet group {n=40} for two and half months and after the induction of obesity, then further subdivides into four groups. Group I : still feed with normal chow serve as control group{n=10}. Group II : received no drug(s) but only feeding with high fat diet, which serves as high fat diet group{n=10}. Group III : received a single dose of canagliflozin {10 mg/kg/po}, daily for 4 weeks by gavage method serves as canagliflozin group{n=10}. Group IV : received single dose of metformin {300 mg/ kg, po}, daily for 4 weeks by gavage method serves as metformin group{n=10}. Group V : received single dose of both canagliflozin {10mg/ kg, po} and metformin{300mg/kg, po}, daily for 4 weeks by gavage method serves as combination group{n=10}.At the end of the study, blood samples were taken for biochemical analysis, then animals were sacrificed and livers were taken for histopathological examination. Results : Mice feeding with high fat calorie content 60% for two and half months showed a significant increase in body weight, food intake, glycemic indices, homeostasis model assessment - insulin resistance (HOMA - IR), fasting plasma insulin and lipid profiles with important histopathological alterations. While, treatment with metformin - canagliflozin combination elicited a significant decrease in the all study and biochemical parameters with significant histopathological changes characterized by complete improvement on hepatic tissues. In comparison to metformin treatment also showed significant decrease in all study & biochemical parameters with good protective effect against obesity - induced hepatic steotosis. Whereas, canagliflozin also showed a significant decrease in all study and biochemical parameters with no significant improvement on hepatic tissue but the main thing that observed with canagliflozin is a superior effect on body weight with respect to metformin.Conclusion : treatment with metformin - canagliflozin combination provides a significant hepatoprotective effects against fatty changes induced by high fat diet. Moreover, this combination has favorable influence on metabolic changes induced by obesity. Whereas, each drugs alone show good improvement on many parameters including body weight, glycemic indices, insulin sensitivity, and lipid profiles with better improvement of hepatic tissue associated with metformin in contrast to canagliflozin that shows no significant improvement in hepatic tissue but, the excellent reduction in body weight seen in canagliflozin with respect to metformin.

استهلاك الجسم للاوكسجين اثناء عملية التروية القلبية - الرئوية باستخدام ماكنة القلب والرئة الصناعية عند درجات الحرارة الاعتيادية والمنخفضة == Correction Of QT, QTp, And Tpte Intervals To Heart Rate

اسم المؤلف: همام عبد الرحمن ابراهيم العبيدي
اسم المشرف: نبا عبد اللطيف رشيد ناجي | احمد عبودي نعمة المحمودي
الموضوع العام: الطب
السنة: 2016
الموضوع الدقيق: الفيزياء الطبية
الدرجة: ماجستير
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: This study was conducted in pursuit of gaining a better understanding of the importance of hypothermia for cardiac surgery, and for CABG in particular. Most of the cardiac surgeons worldwide are accustomed to the use of mild hypothermia (32 - 35)°C for CABG procedures. Studies showed however that the risks of exposing the patient to mild hypothermia are similar to the risks endured during moderate hypothermia (28 - 32)°C. Objectives This study sought to weigh the benefits of mild hypothermia and moderate hypothermia against that of normothermia (35 - 37)°C concerning their impact on tissue oxygen consumption. Design This study is Prospective, randomized, comparative and purely observational and does not involve any intervention to the patient beyond the standard normal management. Setting At the department of physiology, college of medicine, Al - Mustansiriyah university in cooperation with the Iraqi Center for Heart Diseases and Ibn Al - Bitar Specialized Cardiac Surgery Center, in Baghdad, between December 2014 and April 2015. Patients, materials and methods Seventy patients, (55) males and (15) females, undergoing coronary artery bypass grafting surgery (CABG) were included in this study. Patients were allocated into three groups according to the surgeon's preferences; viz (normothermia, mild hypothermia and moderate hypothermia). Systemic complications associated with hypothermia were investigated via chemical analysis of the blood samples for renal and liver functions. Blood samples were collected two times during CPB from the arterial and venous ports of the oxygenator and were immediately analyzed to determine oxygen consumption and oxygen delivery. Results The decrease in the temperature for the hypothermic groups showed similar values of oxygen delivery (DO2) to that of normothermia (3537)°C at the same period during CPB. There were no noticeable changes between normothermia and mild hypothermia (32 - 35)°C. However, for moderate hypothermia (28 - 32)°C, there was a remarkable decrease in the oxygen consumption (VO2). The biochemical analysis for renal and liver functions in the normothermia and moderate hypothermia groups showed no significant differences between preoperative and postoperative results. However, in the group with mild hypothermia there was a significant change in results. Conclusion Moderate hypothermia rather than mild hypothermia proves to be of more benefit to the tissues when compared to normothermic conditions, as it significantly reduces tissue oxygen consumption. Moreover, even normothermia was found to be superior to mild hypothermia due to the latter's adverse effects on renal and liver functions while it maintains similar results with regards to oxygen consumption.

التعدد الشكلي للمستقبل الثاني لعامل الورم التنخري والجين المحفز للـ CD4 والانترلوكين 37 في تقييم التهاب المفاصل الرثوي == Tumor Necrosis Factor Receptor II, Cd4 Enhancer Gene Polymorphisms And IL - 37 In Assessment Of Rheumatoid Arthritis

اسم المؤلف: وسناء جمعة محمد
اسم المشرف: محمد شمخي جبر | باسم شهاب احمد
الموضوع العام: الطب
السنة: 2016
الموضوع الدقيق: الاحياء المجهرية
الدرجة: دكتوراه
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: التهاب المفاصل الرثوي (Rheumatoid Arthritis) مرض جهازي التهابي مزمن يصيب المفاصل وتحديدا الاغشية الزلالية والتراكيب المفصلية، والذي يحدث للعديد من الناس وبنسبة تقارب 0.5 الى 1% من السكان في العالم. لوحظ خلال الدراسات الوبائية لمرض التهاب المفاصل الرثوي | Rheumatoid arthritis (RA) one of the most common systemic autoimmune diseases characterized by chronic joint inflammation and subsequent joint destruction. To date, it well known that RA is characteristic of the expansion of the synovium and infiltration of the inflammatory cells coupled with destruction of adjacent articular cartilage and bone. This is strongly dependent on CD4 T cell. CD4 Cells stimulate monocytes, macrophages, synovial fibroblasts, and other cells to produce cytokines such as tumor necrosis factor - ? (TNF - ?, interleukin - 1 (IL - 1), IL - 6, IL - 15, IL - 17 and metalloproteinases that produce tissue damage. TNF is a major inflammatory cytokine contributing to the pathogenesis of RA, which provides rational for development of anti - TNF biological agents in the treatment of RA.Recently have shown that IL - 37 is a key cytokine in regulating inflammatory response, mainly by inhibiting the expression, production, and function of proinflammatory cytokines. Objectives This study planned to evaluate the association of TNFRII and CD4 enhancer genes polymorphisms in development and severity of RA in Iraqi patients, evaluate IL - 37 in patients with RA and investigate the correlation between IL - 37 levels with disease activity and relation of inflammatory parameters (ESR, CRP, ACPA, and RF) with TNFRII, CD4 enhancer genes polymorphisms.Patients and methods This study was performed during the period from May to September 2015. The patients were attending the out patients' Clinic in Medical City/Baghdad Teaching hospital/rheumatology unit and the laboratory ELISA tests were done in nursing home hospital laboratory, polymerase chain reaction (RFLP) analysis was performed in the specialist private molecular laboratory (ASCO Lab) in Al - Harthia / Baghdad. Fifty patients and 50 apparently healthy control individuals, Patients received disease modifying anti rheumatic drugs (DMARDs) and newly diagnosed patients.The diagnosis of RA patients has performed under the supervision of rheumatic disease consultant physician at the consultation clinic of Baghdad teaching hospital of the medical city. Blood samples had taken from RA patients to measure (ESR), white blood cells count and hemoglobin. Also, analyze the serum levels of ACPA, RF screen CRP and estimate the levels of IL - 37 in patients and healthy individuals using ELISA test kits. TNFRII and CD4 enhancer genes polymorphisms genotyping had achieved by polymerase chain reaction restriction fragment length (PCR - RFLP).Results The results showed the estimation of RF by screening test revealed that its mean level was high among RA patients (168.87+31.62) in comparison with apparently healthy control (4.96+0.71) with highly significant difference (p<0.01). There was a higher positivity of Anti CCP in the patients sera (114.85+21.06) in comparison with apparently healthy control (1.71+0.13) (P<0.01). while the estimation of CRP showed that its level was higher among sera of RA patients (38.39+4.31) in comparison with healthy control group (16.49+2.51) (P<0.01). Furthermore, the ESR level in RA patients were higher than apparently healthy individuals (52.96+3.68) and (10.44+0.74) respectively with significance (P<0.01).The frequencies of the MM, MR, RR genotypes of TNFRII gene polymorphisms were 60%, 32%, 8% in RA patients and 52%, 42%, 6% in controls. There were no significant differences in the genotypes frequencies polymorphisms of the TNFRII 196 MR polymorphism between apparently healthy control and RA. The frequencies of AA, AG, GG genotypes of CD4 10845 A/G in patients was 36%, 42%, 22% and 8%, 44%, 48% in control group. There were significant differences in the genotypes frequencies polymorphisms of the CD4 10845A/G polymorphisms between apparently healthy control and RA patients (p<0.01). AA genotype were significantly more likely to develop RA (OR=1.355). There was significant increase in disease activity and severity in patients carries AA genotype (p<0.01).IL - 37 levels were elevated markedly in RA patients (101.31+10.41) compared with apparently healthy control (43.90+0.91) (p<0.01). More importantly, IL - 37 showed a significant correlation with disease activity (CRP) in RA patients (p<0.05). Also, IL - 37 show non - significant relationship with (MM, MR, RR) exon6 TNFRII in RA patients compared with controls, and non - significant difference between level of IL - 37 with CD4 10845 A/G genotypes compared with healthy control.Conclusion All findings suggested that TNFRII - 196R genotypes not associated with RA diagnosis. In addition, genetic polymorphisms at the CD4 enhancer gene are one of important factors that associated with susceptibility and severity of RA and can serve as a genetic marker for the risk of development of RA.

دورا محتملا لفيروس ابشتاين بار في عملية تسرطن الغدة الدرقية الحليمية == A Possible Role Of Epstein - Barrvirus In Carcinogenesis Of Papillary Thyroid Carcinoma

اسم المؤلف: هند علي خميس
اسم المشرف: عامر رشيد النجار | سعد حسن محمد علي
الموضوع العام: الطب
السنة: 2016
الموضوع الدقيق: الاحياء المجهرية
الدرجة: دكتوراه
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: This study was designed as a retrospective research. A total number of (90) formalin - fixed, paraffin embedded tissues were studied. Malignant and normal thyroid tumors tissue blocks were collected from the archives of histopathology laboratories of different general hospital including ALYarmouk Teaching Hospital (Baghdad), Baghdad Medical City Teaching Hospital as well as many private laboratories in Baghdad, during the period from May 2013 to May 2014. These cases include ? Thirty tissue specimens from patients with papillary thyroid cancer. ? Thirty tissue specimens with benign thyroid lesions as control thyroid tissues group. ? Thirty (30) thyroid specimens were obtained from the normal thyroid tissues from the same those totally - thyroidectimized patients for thyroid papillary cancer (PTC) and have served as the second control group for this study. This study was therefore a paired case - control design. The sections were stained by hemotaxyline and eosin staining so as to confirm the diagnosis and assure that the intervening sections ( that were specified for the in situ hybridization and Immunohistochemistry study have containing the questioned tissues from papillary thyroid cancers and benign thyroid tissues (control group).After histopathological sectioning of these thyroid gland tumors and staining by Hematoxylin and Eosin, a final definitive diagnosis was done by histopathologist consultant. The practical part of this study was designed in four pathways : 1. Molecular detection of Epstein - Barr virus in those tissue blocks were performed by using ultra - sensitive version of in situ hybridization (ISH) for detection of EBV - EBERs. 2. To perform immunohistochemical study to demonstrate EBV - latent gene (LMP1, EBNA - 2) in the papillary thyroid cancer compared to control group. 3. To perform immunohistochemical screening study to demonstrate the over expression state of p53 - tumor suppressor gene in those tissues with papillary thyroid cancer compared to control group. 4. To perform immunohistochemical screening study to detected the CD8 and CD56 in tissues with papillary thyroid cancers compared to control group. The obtained results are summarized as follows : 1. The mean age of patients with papillary thyroid cancer and simple nodular goiter was (39.87&41.13) years respectively, with standard deviation ±(11.773,9.243) years. 2. In this study, the percentage of the females with papillary thyroid cancer was higher (86.7%; 26 cases) than the percentage of their PTC - male counter parts (13.3%; 4 cases). The patients whom sub totally thyroidectimized for simple noduler goiters , the percentage of females was also higher (73.3%; 22 cases) than the percentage of their male counter parts with simple noduler goiters ( 26.7%; 8cases). Female / male ratios of the patients with PTC and simple noduler goiters were 6.5 and 2.75 respectively. 3. The percentage of EBV results in the total group of PTC was (50%) while the percentage in the total group of normal thyroid tissue was (26.7%) and lastly in the total simple nodular goiter group was (10.0%). 4. The positivity rate of EBV EBERs - ISH technique in the total group of PTC was (30%), where as its percentage in NTT tissues was (16.7%) and in SNG tissues was (3.3%). 5. The percentage of positive - EBNA - 2 IHC technique in the total group of PTC was (20%), where as its percentage in NTT tissues was (10.0%) and in SNG tissues was (6.7%). 6. The percentage of positive - EBV - LMP - 1 - IHC technique in the total group of PTC was (43.3%), where as its percentage in NTT tissues was (20.0%) and in SNG tissues was (6.7%). 7. Mutated P53 - protein was detected in 28 cases (70%) of the studied cases. Twelve cases (30.0 %) showed negative IHC reactions. 8. The highest total percentage of CD8 - IHC reactions (21 cases; 70%) was found in those with papillary thyroid cancer followed by normal thyroid tissues cases ( 5 cases; 16.7%) and then ( 2 cases : 6.7%) in simple nodular goiter. 9. It was found that the highest percentage of CD56 - IHC reactions was in those with normal thyroid tissues (25 cases; 83.3%) followed by an equal percentages of CD56 - IHC reactions in either thyroid papillary or simple nodular goiter (2 positive cases; 6.7%, each). 10. The importance of CD56 marker has been found to play a role or it may be better to be used as a negative - diagnostic biomarker for papillary thyroid cancer in differentiating it from other malignancies as well as benign lesions of the thyroid gland, individually as well as in combination with other markers for clinical evaluation of those patients. 11. The evident high mutated p53 - over expression, as reflected by abnormal gene product, among papillary thyroid cancer patients indicates for a pivotal role of such genetic mutation in their carcinogenesis as well as could be useful in the clinical evaluation of patients with papillary thyroid cancer, too. 12. The high coexistence of p53 - mutation with EBV in PTC could point for participation of EBV - transformation genes in the p53 activation in high proportion of PTC. 13.The high percentage of CD8 lymphocytes in EBV - positive PTC as compared to their EBV - negative counterparts could reflect the participation of specific cellular immunity against both, the papillary thyroid cancers and this EBV infection during the initiation and progression of EBV - associated papillary thyroid cancers.

دور الايبشتاين بار فايرس كعامل محتمل لتقدم سرطان الدم اللمفاوي المزمن == Molecular Characterization Of Metallo ? - Lactamase (MBL) Genes

اسم المؤلف: لمى عامر ياسر
اسم المشرف: عامر رشيد النجار | داود سلمان داود
الموضوع العام: الطب
السنة: 2016
الموضوع الدقيق: الاحياء المجهرية
الدرجة: دكتوراه
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: Epstein Barr virus (EBV) is ubiquitous virus which infects the majority of the human population and is the causative agent of infectious monocleosis and a variety of B - cell tumors including Hodgkin lymphoma, Burkitt lymphoma, human immunodeficiency virus - associated lymphomas and post - transplant lymphoproliferative disorders , this virus expressed many protein and it is associated with a variety of B - cell tumors. Recently many studies have suggested a causal relationship between EBV and chronic lymphocytic leukemia (CLL). A prospective study of thirty samples of formalin - fixed, paraffin - embedded tissue of bone marrow aspirates samples and blood from newly diagnosis BCLL of 30 patients and our control included : 1) 20 bone marrow of patients who they have hematological disease other than leukemia as control. 2) Blood serum from healthy controls to study the level of IL - 10 and IL - 8. The present study conducted at Baghdad Teaching hospitals and the National Center of Hematology from September 2013 to Jun 2014. In this study we investigated the association between EBV and CLL. The detection of EBV encoded RNAs (EBER1,EBER2) by in situ hybridization and also latent membrane protein - 1 (LMP - 1) and EBV nuclear antigen - 2(EBNA2) by immunohistochemistry and detection for the level of Interleukin n (8 and 10) in the serum of CLL patients by ELISA. In situ hybridization study revealed that all the controls were negative for EBERs and 46.7% patients were found to be EBERs positive. There was a correlation between positive EBERs and tumors stage and also EBERs and IL10 and with LMP - 1 and EBNA - 2. Immuno - histochemical method was used to demonstrate the rate of (LMP - 1 and EBNA - 2) in CLL patients where a positive results of EBNA2 and LMP1were found in (43.3 % and 56.6s %), respectively in CLL patient group. All controls were negative with an exception of two patients were LMP1 positive. Enzyme linked immunosorbent assay test (ELISA) was used to detect the level of IL - 8 and IL - 10 in serum of newly diagnosed of CLL patients. Interleukin 8 was significantly higher in CLL cases group (33.1 pg/ml) compared to control group.On the other hand It was found that high increase in IL - 10 level ,in CLL patients when compared with controls. Conclusion : It can be concluded that there is a significant relationship between EBV and Chronic lymphocytic leukemia, mainly EBERs, also the association of significant increase in IL - 10 and IL - 8 with CLL.

دور الانترلوكين RA - 1 والسكليروستين والخلية التائية المستجيبة CD4 في مصل مرضى التهاب المفاصل الرثوي == Role Of Serum IL - 1RA, Sclerostin And Effector T - Cell (CD4) In Rheumatoid Arthritis Patients

اسم المؤلف: سنن ثائر عبد الوهاب
اسم المشرف: حيدر صباح كاظم | علاء الدين مظفر زبير
الموضوع العام: الطب
السنة: 2016
الموضوع الدقيق: الاحياء المجهرية
الدرجة: دكتوراه
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: التهاب المفاصل الرثوي هو احد امراض المناعة الذاتية الاكثر شيوعا والذي يتميز بالتهاب المفاصل المزمن والذي يؤدي فيما بعد الى تدمير المفاصل.لا يزال مرض التهاب المفاصل الرثوي يعرف على انه سمة من التوسع في الغشاء الزليلي وارتشاح الخلايا الالتهابية اضافة الى | Rheumatoid arthritis (RA) is one of the most common systemic autoimmune diseases characterized by chronic joint inflammation and subsequent joint destruction. It is well known that RA is characterized by the expansion of the synovium and infiltration of the inflammatory cells coupled with destruction of adjacent articular cartilage and bone. This is strongly dependent on CD4 T cell. CD4 Cells stimulate monocytes, macrophages, synovial fibroblasts, and other cells to produce cytokines such as tumor necrosis factor - ? (TNF - ?), interleukin - 1 (IL - 1), IL - 6, IL - 15, IL - 17 and metalloproteinases that produce tissue damage. TNF is a major inflammatory cytokine contributing to the pathogenesis of RA, which provides rational for development of anti - TNF biological agents in the treatment of RA.Wnt pathway (a complex protein network) important in control of the bone formation through the regulation of osteoblast activity, and sclerostin is an important in the regulator of the Wnt pathway by blocking Wnt binding to its receptor and thereby inhibiting bone formation. Blockage of Wnt antagonists such as sclerostin will trigger repair or even healing of bone erosion.Recently have shown that IL - 1Ra has been given therapeutically in several experimental models of arthritis with weak effect in RA. This study planned to evaluate the frequencies of CD4+CD25+ Treg cells in Iraqi patients treated with RA under treatment with biological therapy (Etanercept). The level of serum sclerostin, serum level of IL - 1RA, and investigate the correlation between serum sclerostin and Treg expression. Correlate the level of serum sclerostin and Treg expression with disease activity by (CDAI or DAS28).This study was performed during the period from January 2016 to May 2016.The patients were attending the out patients' Clinic in Medical City/Baghdad Teaching hospital/Rheumatology Unit and the laboratory Enzyme Linked Immunosorbent Assay tests were done in Bio - technology center at the University of Al Nahrain, flow cytometery analysis was performed in the private laboratory (Al Rawabi Laboratory) at Yarmouk/Baghdad. Thirty patients and 30 apparently healthy control individuals were included in this study, Patients under treatment of etanercept.The diagnosis of RA patients has performed under the rheumatologist consultant at the consultation clinic of Baghdad Teaching Hospital of the medical city. Blood samples had taken from RA patients to measure Erythrocyte Sedimentation Rate, Complete Blood Picture, Rheumatoid Factor and High - Density Lipoprotein. Also, analyze the serum levels of Anti - Citrullinated Protein Antibodies and estimate the levels of sclerostin and IL - 1RAin patients and healthy individuals using Enzyme Linked Immunosorbent Assay test kits. CD4+CD25+ Treg cells had achieved by flow cytometery analysis.The results showed the reduction in Treg cells in patients (0.00264 ± 0.002) % under biological therapy than control group (0.026 ± 0.012) % with significant difference (p< 0.05). Also body mass index showed significant difference between patients (32.10 ± 5.81) kg/m2 and control group (28.84 ± 4.67) kg/m2 (p< 0.05). The results showed that sclerostin level higher in healthy (1.072 ± 0.59) ng/ml than patients (0.801 ± 0.28) ng/ml which showed significant difference (p<0.05). Furthermore IL - 1RA serum level was higher in healthy (0.979 ± 0.34) ng/L than patients (0.633 ± 0.35) ng/L with significant difference (p<0.05). Anti - Cyclic Citrullinated Peptide results showed non - significant difference between patients and healthy control. Treg cells is reduction in the patients with RA. Sclerostin and IL - 1RA levels are low in patients treated with etanercept.

تقدير مستويات السايتوكينات (الحركيات الخلوية) المولدة للالتهاب والمضادة للالتهاب لدى مرضى فصال العظام في الركبة قبل وبعد الحقن بالبلازما الغنية بالصفيحات الدموية == Estimation Of Pro - Inflammatory And Anti - Inflammatory Cytokines In Patients With Knee Osteoarthrosis Before And After Injection With Platelets - Rich Plasma (Prp)

اسم المؤلف: حسنين خضير عبد العباس
اسم المشرف: عبد العظيم ياسين عبود البراك | سامر محمد رضا عنون | زيد وجيه رؤوف الشهواني
الموضوع العام: الطب
السنة: 2016
الموضوع الدقيق: الاحياء المجهرية
الدرجة: دكتوراه
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: التهاب العظام والمفاصل Osteoarthrosis)) او فصال العظام او ما يعرف بالاسم الشائع السوفان هو مرض يحدث في غضروف المفصل الذي يعمل على عدم احتكاك عظام المفصل ,مما يؤدي الى تقليل هذه الحماية ضد الاحتكاك فتصبح حركة المفصل بها خشونة ومصحوبة بالالام عند استخدام ا | Osteoarthrosis (OA) are defined as a progressive architecture destruction of the joints compared to slow healing of these joints which leads to reduce protection against degeneration and the movement of the joint is associated with by the roughness and accompanied by pain when using the joint. Often this disease affect the knee joint, it may affect any other joint in the body, especially those that carry weights such as leg hinges the pelvis, elbow and spine. The aim of this study is to evaluate the efficacy of platelets - rich plasma injection in osteoarthritis knee and the estimation of the biological and immunological markers associated with the treatment. This study involved 50 patients suffering from inflammation of the knee joint under supervision of speiclist of orthopedic ,most of these patients attended Al - Shaheed Firooz hospital in wasit Governorate and specialty private clinics of orthopedic and Rheumatology in the district during the period from April 2015 until October 2015.The age of patients was about 35 - 65 years; 31 females and 19 males with 25 healthy matching group. All patients were injected into the knee joint by a specialist physician with two injections during two months with platelets - rich plasma (PRP)after its preparation from the same patient's blood in sterile conditions. This was done after the signing of the patient or one of his relatives on the written consent to conduct the injection process after explaining and clarifying the principle of injection and the purpose. The level of pain of patients group was measured by Visual Analogue Scale (VAS). The enzyme linked immunnosorbant assay ELISA method to determine the level of some of cytokines in serum of patients group (interleukin - 1beta, tumor necrosis factor - alpha,IL - 10,IL - 8 and Transforming growth factor - B1) in addition to measuring the concentration of C - Reactive protein (CRP).The rate of Erythrocyte Sedimentation Rate (ESR) was also estimated. All were done to all patients groups before and after injections with PRP in addition to healthy group. Statistical analysis showed no significant differences between males and females (54.5±1.2 males, 53.2±2.1 females). The study showed significant decrease in the mean of the Visual Analogue Scale (VAS) of patients before and after two months of injections with (PRP) 8.46 ± 0.104, 5.98 ± 0.129, , respectively, with highly significant differences (P=000.0) , also the study showed that there was no significant differences in VAS between age groups (30?s, 40?s, 50?s , 60?s) before and after injections with PRP (7.5,8.0 ,8.38 ,9.05), (5.0,5.55,5.69,6.7) respectively. The study also showed a difference in the mean for inflammatory marker C. Reactive protein concentration before and after injections with PRP 7.156± 0.328 µg/ml, 5.384± 0.196 respectively, in comparison with healthy group with highly significant differences (P=0.000).The study also showed a difference in the mean of ESR before and after injections with PRP (35.66± 0.879 mm/1hr, 23.7±0.856) respectively, with in comparison with healthy group highly significant differences (P=0.000).The mean of Interleukin 1 - Beta(IL - 1?) was decline after injections with PRP from 13.220±0.295, pg/ml to 9.622 ± 0.273 pg/ml in comparison with healthy group with highly significant differences (P=0.000). Also a decline in the mean of Tumor necrosis factor - alpha (TNF - ?) after injections with PRP from 62.384±0.927 pg/ml to 55.36 ± 1.121 pg/ml in comparison with healthy group with highly significant differences (P=0.000). The study also demonstrates a decrease in the mean of Interleukin - 8 (IL - 8) before and after injections with PRP (41.092±0.808 pg/ml, 35.93 ± 0.813pg/ml) respectively in comparison with healthy group with highly significant differences (P=0.000). An increase in the mean of Interleukin - 10(IL - 10) after injections with PRP from 5.108±0.291 pg/ml to 6.734±0.330pg/ml, in comparison with healthy group with highly significant differences (P=0.000). The final parameter in this study was demonstrated an increase in the mean of Transforming growth factor - ?1 (TGF - ?1) before and after injections with PRP (111.544±6.960, 149.212±7.540pg/ml) respectively in comparison with healthy group with highly significant differences (P=0.000). Association was obtained between VAS score and C. RP as well as ESR after treatment. PRP treatment also has an impact on increasing the level of anti - inflammatory IL - 10 and TGF - ?1 on one side and the decreasing level of pro - inflammatory IL - 1?, TNF - ?,IL - 8 (catabolic marker) on the other side these results suggest the inhibition of catabolic process demonstrated by reducing of VAS scores and the efficacy of effectiveness plasma rich platelets (PRP) treatment of osteoarthrosis.

Immunological Status Of Seminal Plasma For Bodybuilders On Androgenic Anabolic Steroid Hormones == Immunological Status Of Seminal Plasma For Bodybuilders On Androgenic Anabolic Steroid Hormones

اسم المؤلف: Anwar M. Rasheed Abdulhussein
اسم المشرف: Dr.Abduladheem Y. Abbood AL.Barra
الموضوع العام: الطب
السنة: 2016
الموضوع الدقيق: الطب
الدرجة: ماجستير
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: Exercises done by bodybuilder have great benefit for the general health and muscle size and performance. Anabolic androgenic steroid hormones are commonly used by bodybuilders to increase muscle mass and strength depending on its mode of action to increase the level of nitrogen retention in muscle, insulin like growth factor IGF - 1 increase in muscle tissue and seminal fluid. IGF - 1 responsible for Cell proliferation, growth and inhibiting apoptosis activity. Also AAS generally has an immunmodulatory impact on cytokines interactions as well as infertility. This study was designed to estimate the changes in cytokines in seminal plasma, sperm count in the seminal fluid and estimation of testosterone concentration in serum due to the impact of androgenic anabolic steroids hormones in bodybuildrs. Eighty male volunteers their age groups are ranging from 21 - 35 years. They were divided into three groups; the first group 27 age matched volunteers apparently healthy (healthy control group) , Second group 27 bodybuilders players attending the sport club with androgen anabolic steroid hormone abuse (AAS) (steroid group), and the third group 26 bodybuilder players attending this sport club in Baghdad without AAS uptake (fitness group ). A blood sample and seminal fluid were obtained from each individual involved in this study. Blood, serum and seminal plasma were prepared from these samples were obtained and applied for estimation of testosterone level by using enzyme immuno - florescent technology. Anti - sperm Ab test by heamo - aglutenation method was used to exclude the positive cases from this study.Heparinized blood was used for estimation of neutrophil phagocytic activity Sperm count was done for each seminal fluid sample, cytokines were estimated by sandwich ELISA method, in seminal plasma, these cytokines are IL - 6, IL - 10,IL17a,TNF - ? and INF - ?. The bodybuilders with AAS uptake showed a significant reduction in sperm count (P=0.00), fitness group sperm count showed slight nonsignificant decrease compared to healthy control group (P=0.7). Serum testosterone level in the AAS uptake group showed a significant decline compared with fitness and healthy control groups (P= 0.00). Exercise alone increases the level of IL - 6 (P=0.00), while exercise with AAS uptake decreases the level of IL - 6 (P=0.06). The fitness group showed highly significant increases in TNF alpha (P =0. 00). IL - 10 as an anti - inflammatory cytokine shows a high level in the AAS uptake group compared to the healthy group (0.04). IL - 17 as an inflammatory cytokine showed high significant increase in steroid group and fitness group (P=0.00), which indicate that both exercises with and without AAS uptake increases the level of IL - 17 secretion(P= 0.02) separately or in combination. Phagocytosis of AAS uptake group showed a highly significant decline (P= 0.00).The correlation results showed that there is a complex network interactions between the studied cytokines. The Phagocytic activity of the AAS uptake group showed a strong correlation with both IL - 6 and IL - 10 levels. IL - 10 as a suppresser cytokine has a significant correlation with TNF - alpha, INF - gamma and IL - 17A while, IL - 10 showed a negative correlation with IL - 6. IL - 17 which act as an inflammatory cytokine has a significant correlation with all cytokines except IL6 and phagocytic activity. Generally seminal plasma cytokine network may be under the effect of immune regulation mechanism and cytokine inactions as well as, the impact of steroids uptakes. In general the final impact of AAS uptake on bodybuilders immunity are declining in phagocytosis and an increase in IL - 10 which act as suppressor to the Th1 immune response and increase of IL - 17 which has a role in increasing the inflammatory response so, these results suggest that AAS abuse players may be more liable for infection and decrease in sperm count which may cause temporary or permanent infertility.

دراسة المقاومة المتعددة للمضادات الحيوية لعصيات التدرن لدى مرضى التدرن الرئوي == A Study On Drug Resistance Of Mycobacterium Tuberculosis Isolated From Pulmonary Tuberculosis Patients

اسم المؤلف: انمار ليث طالب الحسني
اسم المشرف: عامر رشيد النجار | احمد اسمر منخي
الموضوع العام: الطب
السنة: 2016
الموضوع الدقيق: الاحياء المجهرية
الدرجة: ماجستير
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: تعتبر عزلات جراثيم التدرن المقاومه للادوية من المشاكل الرئيسية في معالجة مرضى التدرن حول العالم. , ولاهميته اجريت هذه الدراسة لتسليط الضوء اكثر حول الحساسيه الدوائية بواسطة الطرق المختبرية التقليدية وعلى الوسط الصلب ومقارنته مع الطرق التشخيصية المختبرية ا | Drug resistant tuberculosis remained as major problems in the treatment of tuberculosis patients in the world. A prospective study was conducted to evaluate drug susceptibility testing (DST) by classical methods on solid media as compared with advance and molecular Laboratory diagnostic methods (Bactec MGIT 960 and GeneXpert MTB - RIF ). The study included the estimation of the first line anti - TB drugs, including (Rifampicin,Isonizid,Streptomycin and Etambutol) by solid media (Lowenstein - Jensen medium) and Bactec MGIT 960 system. In addition, the use of rapid molecular diagnostic method by GeneXpert MTB/RIF assay. Seventy five TB patients attending the National Reference Laboratory of Tuberculosis /medical city - Baghdad from December 2015 to June 2016 were included in this study. Patients were classified into two main groups : selected MDR patients, which were referred from different hospitals and health respiratory center in Iraq, represented 46 in order to compare different laboratory methods to detect of DST isolates, while 29 were randomly isolated and identified , the study matched by age and gender were also included. This study revealed that the drug resistance tuberculosis to Rifampicin was 47 (62.7%), Isonizid 41 (54.7%), Streptomycin 42 (56.0%) and Ethambutol 38 (50.7%). Respectively , on the golden stander in which solid media were used.The molecular and advance technique (GeneXpert and Bactec MGIT 960) as applied to estimation of drug resistance tuberculosis, the results of drug susceptibility testing (DST), as showed highly sensitivity and Accuracy, when compared with golden stander( LJ media) especially in detected of primary drugs (Rifampicin and Isoniazid) and showed lower sensitivity and accuracy to detected of the secondary drugs (Streptomycin and Ethambutol). The Multiple drug resistance (MDR - TB) case from selective samples was found to be almost similar to that found in other countries of the middle east and other regions in the world. While in the randomly identified samples, the rate of MDR - TB was lower than the referred (previously treated) cases.The GeneXpert MTB - RIF system is rapid molecular methods that used in many countries to identify of MTB and Rifampicin detected during 2 hours only, that used in this study. The high Rifampicin resistance and other drugs of local isolates could be due to abuse of the drug,defaulter and relapse of retreating cases (previously treated).

الكشف عن طفر الجين عامل النمو البشراوي الثاني (HER2) في سرطان الخلايا الانتقالية باستعمال طريقة اللونية في موقع التهجين == The Detection Of HER2 Gene Mutation In Transitional Cell Carcinoma Using CISH Method

اسم المؤلف: عمار عيسى مهدي
اسم المشرف: احمد تركي عبيد | هادي محمد علي الموسوي
الموضوع العام: الطب
السنة: 2016
الموضوع الدقيق: الامراض السريرية
الدرجة: ماجستير
اللغة: الانكليزية
مكان الجامعة: بابل
الصفحات الاولى:
المستخلص: يعتبر سرطان المثانة واحدا من اكثر انواع الاورام السرطانية التي تصيب الجهاز البولي حيث انه يعتبر ثاني ورابع الاكثر شيوعا للذكور في العراق والولايات المتحدة على التوالي وايضا يعتبر العاشر والحادي الاكثر شيوعا للاناث في العراق والولايات المتحدة على التوالي. | The urinary bladder cancers are among the common types of cancer of the urinary tract. It is regarded as the second and the fourth most common cancer types for males in Iraq and in the United State of America (USA) respectively and as tenth and eleventh most common cancer types for females in both Iraq and USA respectively. Urothelial Carcinoma is epithelial tumor of urinary bladder (95% of urinary bladder tumor) and it shows wide range of tumor that begins from papilloma and carcinoma in situ to invasive cancer. The patients with urinary bladder cancer that are presented in non - muscle invasive type or muscle invasive type show different rates of HER2 gene amplification (specially for invasive muscle type). Epidermal growth factor receptor (EGFR, also called HER or type I ErbB tyrosine kinase receptors) family is composed of four receptor member which include HER1 (ErbB1 or EGFR), HER2/neu (ErbB2 or C - ErbB2) , ErbB3 ( HER3), and ErbB4 (HER4). HER2/neu protein is glycoprotein produced by HER2 gene which lies in 17q21 (long arm of chromosome 17). This glycoprotein is normally found in lung, breast, urinary bladder, prostate and stomach, and its cytoplasmic portion has enzymatic function (tyrosine kinase activity). This receptor is responsible for the cell survival, normal cell growing and inhibition of apoptosis. HER2/neu protein overexpression is measured by IHC when the result of IHC is equivocal to HER2/neu protein (+ 2). Then, HER2 gene amplification is measured by using an accurate and more practical CISH method. The aims of this study are tried to detect the percentage of HER2 gene amplification in the urothelial carcinoma and distribution of HER2 gene amplification with clinical criteria (age , sex, grade, stage, and location of tumor) of the patients that had urothelial carcinoma of bladder.This study contained retrospective (30 cases) and prospective (20 cases) and was conducted in Al - Hilla Surgical Teaching Hospital and the period of the study extended from October /2015 to August/2016. Clinical data of patients include age, gender , clinical features, and type of bladder biopsy ( endoscopic resection or cystectomy) are taken with paraffin blocks.The practical part of the study was done in the laboratory of the department of pathology / College of Medicine/Babylon university. It included 50 patients with bladder cancer (35 males and 15 females ) with two groups (10 cases is positive and 10 cases is negative). It included 50 patients who were diagnosed with transitional cell carcinoma of urinary bladder with mean age ± SD ( 66.04 ± 10.148 ) years old ranging between 42 - 83 years old. Also, Positive and negative control slides applied with each run CISH method (+ve control of breast tissue that treated by immnohistochemical procedure ( score +3) and the same tissue were applied by removing HER2/neu probe).Fifty patients who were diagnosed with transitional cell carcinoma of bladder and their biopsies of bladder ( taken from endoscopic biopsy or cystectomy). Then, paraffin - embedding procedure was prepared on tissues biopsy and then, hematoxylin and eosin staining (H. and E. staining) procedure was done. Finally, manual CISH was done on both cases(positive and negative cases) and bladder cancer blocks. This CISH method detected her2 amplification according to ASCO/CAP/2013 scoring system. The results showed that age group 61 - 70 years was the highest positive HER2 amplification (64.7%) among other age groups 51 - 60 years (11.8%) and 71 - 80 years old (23.5%), there was a significant association between these age groups with HER2 amplification , p? 0.05. Sex group displayed that 52.9% of male and 47.1% of female who had positive HER2 amplification and there was no significant difference between sex groups with HER2 amplification, p > 0.05. Other results showed that positive HER2 amplification was highest in grade 3 (88.2%) of transitional cell carcinoma when compared to grade 2 (11.8) and grade 1 (0%) and there was significant association between cancer grading system with HER2 amplification, p? 0.05. MIBC and NMIBC of staging cancer system showed 82.4% and 17.6% positive HER2 amplification respectively with a significant difference between them ( p value ? 0.05). Also, other result of the histological types of transitional cell carcinoma revealed 88.2% and 11.8% (positive HER2 amplification) of papillary and flat shape respectively with a significant correlation between them ( p value ? 0.05). The HER2 gene amplification was correlated with grade and stage of bladder carcinoma which showed high amplification in high grade and stage. The HER2 gene amplification was not correlated with the sex of the patients, but more cases of HER2 gene amplification were recorded in males; while there was a correlation with age group specifically (61 - 70 years old). The HER2 gene amplification was associated with aggressive behavior of blabber carcinoma. The CISH method application in HER2 gene amplification was flexible and applical.

التوصيف الجزيئي لعوامل الضراوة المرتبطة باصابات بكتريا المكورات العنقودية السالبة للتخثير والمعزولة من المصابين بالتهاب المجاري البولية في محافظة بابل == Molecular Characterization Of Some Virulence Associated Factors For Coagulase - Negative Staphylococci Isolated From Urinary Tract Infection In Babylon Province

اسم المؤلف: سارة هاشم داخل الحلي
اسم المشرف: محمد صبري عبد الرزاق السعيد | جواد كاظم الخفاجي
الموضوع العام: الطب
السنة: 2016
الموضوع الدقيق: الاحياء المجهرية
الدرجة: ماجستير
اللغة: الانكليزية
مكان الجامعة: بابل
الصفحات الاولى:
المستخلص: يهدف هذا البحث الى دراسة بكتريا المكورات العنقودية السلبية التخثر, وشملت الدراسة جمع120 عينة ادرار من المرضى المصابين بالتهاب المجاري البولية من الاشخاص المراجعين والراقدين في مستشفى بابل للنسائية والاطفال ومستشفى الحلة التعليمي وللفترة من كانون الاول 201 | This work aims to study coagulase - negative Staphylococci, which included 120 urine sample were obtained from patients suffering from urinary tract infection; who attained to Babylon Maternity and Pediatrics Hospital, and Al - Hilla General Teaching Hospital, during the period from December 2015 to March 2016), they were diagnosed as having UTI by the Urologists. The samples were analyzed for any signs of infection and immediately inoculated on blood and MacConkey agar media plates. All plates were incubated aerobically at 37 ?C for 24 - 48 hrs.Results of morphological and biochemical characterization revealed that out of total of 120 urine samples, 110 showed positive culture, among them 37 isolates are belonged to coagulase - negative Staphylococci, other 73 isolates belonged to other bacterial genera.Molecular detection of coagulase gene (coa) was done for all CoNS isolates. The results showed that 28/37 isolates (75.67%) were positive for this marker, distributed as follows : S. epidermidis gave 15 isolates, S. saprophyticus gave 9 isolates and S. haemolyticus gave 4 isolates.Also, molecular investigation of fnb A and B genes are carried out for all CoNS isolates by using specific PCR markers. 13/37 isolates (35%) were positive for fnb A gene, as 6/13 of S. epidermidis, 5/13 of S.saprophyticus and 2/13 of S. haemolyticus have this gene in their genome. On the other hand, only 4/37 isolates gave positive result for fnb B gene; as 2 isolates of both S. saprophyticus and S. epidermidis have this gene in their genome.Moreover, sec gene also was investigated in CoNS isolates. The results showed that all CoNS isolates are free from this gene.Regarding urease enzyme production, S. epidermidis and S.saprophyticus isolates were found to be urease positive, while S.haemolyticus isolates display urease negative.To demonstrate the ability of bacteria to form struvite stone, urine samples obtained from healthy individuals were used. It was found that struvite stone was formed by S. epidermidis and S. saprophyticus isolates.Moreover, susceptibility to 10 antibiotics were tested by using disc diffusion test (DDT). S. epidermidis was showed 100% resistance for each Methicilline, Ceftriaxone, Ceftazidime and Cefoxitin. Also, it show high resistance 94%, 88%, 88%, 76%, and 59% for Impenem, Gentamycin, Pipracillin, Ciprofloxacin and Amikacin respectively. However, S. epidermidis showed low resistance (6%) for Vancomycin. So, all S. saprophyticus isolates showed high resistance (100%) to each Pipracilline, Ceftriaxone, Methicillin, Ceftazidime and Ciprofloxacin. It showed high resistance (92%) for each Vancomycin and Imipenem, and (83%), (75%), (75%) for Cefoxitin, Gentamycin and Amikacin respectively. In addition to that, all S. haemolyticus was showed (100%) resistance for each Ceftriaxone, Pipracillin, Methicilline, Ceftazidime and Cefoxitin. Also, showed high resistance (75%), (63%) and (50%) for Gentamycin, Amikacin and Ciprofloxacin respectively. While it was showed low resistance (13%) to Vancomycin.
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