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التشخيص والتوصيف الجزيئي لبكتريا Clostridium perfringens المعزوله من حالات مرضية سريرية في مدينة الحلة Molecular Diagnosis and Characterization of Clostridium Perfringens from Clinical Samples in Al - Hilla city

اسم المؤلف: علياء محمد حمود الشمري
اسم المشرف: علاء هاني الجراخ ميساء صالح الشكري
الموضوع العام: الطب
السنة: 2017
الموضوع الدقيق: الاحياء المجهرية
الدرجة: دكتوراه
اللغة: الانكليزية
مكان الجامعة: بابل
الصفحات الاولى:
المستخلص: تهدف هذه الدراسة لمعرفة وبائية بكترياC. Perfringens في العينات المؤخوذة في محافظة بابل. تم جمع 140عينة من الجروح العميقة من المرضى الداخلين في مستشفيات مدينة الحلة الرئيسية (مستشفى الحله التعليمي ومدينة مرجان الطبيه) والذين يعانون من مرض السكري المزمن وايضا من مرضى تعرضوا الى طلق ناري فضلا عن المرضى الذين يعانون من التهاب الخلوي اللاهوائي في الجلد(anaerobic cellulitis ) للفترة من شهر شباط ولغاية شهرتشرين الاول 2016. بالاضافه الى ذلك تم تشخيص وعزل بكترياC. perfringens بطرق مختلفة منها استخدام الطرق البكتيرية التقليدية من خلال طرق التنمية على الاوساط الزرعية الاختيارية لهذه البكتريا واظهرت النتائج الحصول على 3 (2.14%)عزلات كان عزل اثنان منها 1.42%)) من مرضى السكري المزمن اما العزله الثالثه (0.72%) فقد تم الحصول عليها من الذين تعرضوا لطلق ناري في حين لم يتم الحصول على عزلات من المرضى الذين يعانون من الالتهاب الخلوي اللاهوائي . وكذلك تم تاكيد التشخيص باستخدام المعلم الوراثي المستند على دور جين 16s rRNA وجين16S - 23S spacer rRNA حيث اظهرت النتائج, من اصل 140 عزلة فان 7 عزلات تعود لبكتريا C. perfringens. بالاضافة الى ذلك, تم التحري عن قابلية هذه البكتريا واختبار قابليتها على انتاج انزيم (phpspholipase C) ووجد ان جميع العزلات منتجة الى هذا الانزيم. كما تم الكشف عن حساسية عزلات البكتريا اللاهوائية تجاه 24 مضادا حيويا. بينت نتائج الدراسة ان جميع العزلات اظهرت حساسية عالية (100%) تجاه كل من penicillins .مثل benzypencillin, ,amoxicillin فضلا عن حساسيتها تجاه  - lactamase inhibitor مثل Ampicillin - sulbactam وحساسيه عالية لكل من metronidazole وaminoglycosidesومن ناحية اخرى، اظهرت جميع العزلات مقاومة عالية لكل من مضادات tetracyclin, Linezolid, levofloxacin, erthromycin بينما اظهرت هذه العزلات تغاير في درجات المقاومة تجاه مضادات pipracillin, Clindamycin, and Impenem.تم استخدام الطرق الوراثية في الكشف عن جينات المقاومة للمضادات الحياتية كجيناتM,Q,W,B) ) tet الخاصة بالكشف عن المقاومة للتتراسايكلين وجينات erm(A,B) للكشف عن المقاومة للكلندامايسين وجين nim للكشف عن المقاومة للمترونيدازول حيث اظهرت النتائج ان الجين tet M كان ذا سيادة عالية بنسبة 71.42 %تم استخدام طريقة التشخيص الجزيئي لتوكسينات البكتريا (alpha,epsilon, iota) للاستدلال على وجود جينات (cpa, etx, iap)، في C. perfringens وبنسبة 100%, 28.4%, 28.4% )) على التوالي.بالاضافة الى ذلك تم استخدام جينات cpa, etx and iap لقياس تعاقب القواعد النيتروجينية للمادة الوراثية للعزلات المدروسة فضلا عن تسجيلها في بنك الجينات العالمي ( ,(Gene Bank,اذ تم خلال هذه الدراسة ولاول مرة في العراق، الحصول على خمسة ارقام انضمام الى بنك الجينات العالمي (5 accession numbers)، حيث تم نشر هذه الارقام في بنك الجينات الامريكي gene bank - NCBI وهذه الارقام هي : جينiap : KY523199, KY523200 اما فيما يخص الجينetx فكانت الارقام هي : KY523201, KY523202 وفيما يخص الجين cpaفكان رقم الانضمام هو : . KY523203تعد هذه الدراسه انها اول دراسه في العراق تضمنت تحليل , دراسه تعاقب القواعد النايتروجينية للمادة الوراثية فضلا عن التسجيل في بنك الجينات العالمي لسموم عزلات محلية من بكتريا C.perfringens معزولة من عينات سريرية. | This cross sectional and hospital - based study aimed to studying the incidenceof Clostridium perfringens in clinical samples in Babylon province. A total of 140 wound swabs were taken from patients admitted to two main hospitals in Hilla city, Iraq (Hilla Teaching Hospital and Medical Marjan City), during the period from February to October 2016. Swabs were collected from diabetic patients, anaerobic cellulitis, and bullet wounds. These wound swab samples were subjected to different methods for identification of C. perfringens according to standard method. It was found that 3 (2.14%) C. perfringens isolates were recovered, of which 2 isolates (1.42%) were obtained from diabetic patients, 1 isolates (0.72 %) from bullet wounds, No isolates are recovered from the other clinical samples (cellulitis). Furthermore, molecular detection method was applied by using 16s rRNA, 16S - 23S intergenic spacer rRNA genes as a genetic marker for confirmation of detection of C. perfringens isolates,7 isolates of C. perfringens out of 140 are detected by using PCR with specific primer.The study also focuses on the ability of this bacteria to produce Phospholipase C and it was found that all isolates are positive for this enzyme (100%) . The results of antibiotic susceptibility testing using Vitek 2 system and disc diffusion method (DDT) of C. perfringens isolates (No.= 3) against 24 antibiotics showed that all isolates were highly sensitive to penicillins, (benzylpenicillin, and amoxicillin), all isolates (3/3) were sensitive to  - lactamase inhibitor such as Ampicillin - sulbactum. They were more susceptible to metronidazole and aminoglycosides in (3/3). On the other hand, all isolates were highly resistant to tetracycline, Linezolid ,levofloxacin, and erythromycin However, these isolates expressed different degree of susceptibility towards other antibiotics (Clindamycin, piperacillin and Imipenem). Molecular detection of C. perfringens of antibiotic resistance genes had been investigated and it had been found that tetracycline resistance gene tet M is the most commonly observed (71.42%) among ribosomal protection genes among C. perfringens isolates. While all isolates (7) gave negative results for other tetracycline resistance genes (tet W and Q, tet B, erm(A), erm(B),nim gens).Furthermore, detection of clostridial toxin (alpha, epsilon, iota toxins was applied using specific genes (cpa, etx, iap) and the results showed that the rate of the presence of these genes are : 100%, 28.8% and 28.4% respectively. The following genes : cpa, etx and iap were used for sequencing analysis, registration in gene bank - NCBI. Five accession numbers were obtained from registration of five sequences of these three genes at gene bank - NCBI : iap gene; accession numbers are : KY523199, KY523200etx gene; accession numbers are : KY523201, KY523202cpa gene; accession number is : KY523203. This is the first study in Iraq which employed analysis sequencing and registration in gene bank - NCBI, of clostriaial toxin of local isolates of C. perfringens obtained from clinical samples

تقييم دور بروتين عامل نمو بطانة الاوعية الدموية ونسبة الصوديوم, البوتاسيوم, والكالسيوم الى الكرياتينين في الادرار كفحص تشخيصي لمرضى ما قبل تسمم الحمل The Role of Vascular Endothelial Growth Factor and Urinary Sodium, Potassium, and Calcium to Creatinine Ratio as Diagnostic Tests in Pre - eclampsia

اسم المؤلف: غيث كامل جواد
اسم المشرف: حيدر هاشم الشلاه ملال محمد الجبوري
الموضوع العام: الطب
السنة: 2017
الدرجة: ماجستير
اللغة: الانكليزية
مكان الجامعة: بابل
الصفحات الاولى:
المستخلص: Preeclampsia is defined as hypertension associated with proteinuria arising de novo after the 20th week of gestation in a previously normotensive woman and resolving completely by the 6th postpartum week.It is a major cause of morbidity and mortality during pregnancy. There are many ways to diagnose the disease, based on clinical diagnosis and conduct some tests; screening tests measurement of the amount of protein found in the urine sample that had been collected for a period of twenty - four hours. In the present study, the ratio of (Na+, K+, and Ca++) to creatinine in the urine spot sample, in addition to the protein vascular endothelial growth factor in the serum were measured as an attempt to be used as screening or diagnostic tests for patients with pre - eclampsia. This study was carried out at Babylon Teaching Hospital for Gynecology and Pediatrics, in Babylon Province, Hilla City during the period between February 2016 till August 2016. This study included 88 women, 44 were patients diagnosed with preeclampsia in the second and third trimester and the other 44 were healthy pregnant women in the same period of pregnancy taken as a control. Cases with age over 135 year, BMI > 300, previous historyd of pre - eclampsia, family history of pre - eclampsia, multipled pregnancy and hydrops fetalis, pre - existing hypertension or renal disease, pre - existing vascular disease, and antiphospholipid syndrome were excluded. Serum levels of vascular endothelial growth factor were measured by using ELISA technique, while urine were collected to estimate calcium and creatinine by spectrophotometric method. Sodium and potassium by ion selective electrode technique. The ratio of sodium to creatinine, potassium to creatinine, and calcium to creatinine were calculated.Serum vascular endothelial growth factor level was significantly lower in patients with preeclampsia compared to control group (P value < 0.01).The sensitivity of VEGF to detect preeclampsia was (75%) while, it's specificity was (90.9%).Similarly, the urinary Na+/creatinine ratio and Ca++/ creatinine ratio was significantly lower in patients with pre - eclampsia compared to control groups (P value < 0.01). The sensitivity of urinary Na+/Creatinine ratio was (93%) and it's specificity was (70%). While the sensitivity of urinary Ca++/ creatinine ratio was (34%) and specificity was (97%).On the other hand, urinary K+/creatinine ratio was significantly higher in patients with pre - eclampsia compared to control groups (P value < 0.01).The sensitivity of urinary K+/creatinine ratio to detect pre - eclampsia was (77%) while, its specificity was (68%).This study concluded that urinary Na+/creatinine ratio can be used as a screening tests because of excellent sensitivity, however because of excellent specificity of vascular endothelial growth factor and urinary Ca++/creatinine ratio (90.9% and 97% respectively), they are convienent for diagnostic purpose.

دراسة فيروس نظير الانفلونزا وبكتريا المسبحيات القيحية مع التهاب الاذن الوسطى القيحي في الاطفال Study of Parainfluenza virus and Streptococcus pyogenes with suppurative otitis media in children

اسم المؤلف: ايام محمد صالح علي العامود
اسم المشرف: جواد كاظم طراد الخفاجي غانم عبود المولى
الموضوع العام: الطب
السنة: 2017
الموضوع الدقيق: الاحياء المجهرية
الدرجة: دكتوراه
اللغة: الانكليزية
مكان الجامعة: بابل
الصفحات الاولى:
المستخلص: هدفت هذه الدراسة الى التحري عن دور فيروس نظير الانفلونزا وبكتريا المسبحيات القيحية Streptococcus pyogenes في الاطفال الذين يعانون من التهاب الاذن الوسطى القيحي . جمعت 200 عينة (ثلاث مسحات لكل مريض تضمنت مسحة من افرازات الاذن ومسحة من افرازات الانف لدراسة الفيروس ومسحة من افرازات الاذن لدراسة البكتريا و50 عينة دم) من 50 مريض يعانون من التهاب الاذن الوسطى القيحي احيلوا الى مستشفى الحلة التعليمي في محافظة بابل للفترة من شباط (2016) لغاية ايار (2016). والذين يعانون من التهاب الاذن الوسطى. وتضمنت الدراسة 32 عينة ماخوذه من اشخاص اصحاء كمجموعة سيطرة وتم تقسيمهم الى ست مجاميع عمرية بنفس طريقة تقسيم مجاميع المرضى. شملت الدراسة اربعة اجزاء رئيسية : اولا التشخيص الفيروسي اعتمد على التقنيات المتقدمة (العزل الاولي باستخدام فحص التالق المناعي المباشر لتحديد وتمييز الانواع الثلاثة لفيروس نظير الانفلونزا 1,2, and 3 والتشخيص الجزيئي بواسطة استخدام فحص تفاعل سلسلة انزيم البلمرة بالوقت الحقيقي لتحديد وتمييز الانواع الاربعة للفيروس1,2,3, and 4 وتم استخدام المجهر الالكتروني النفاذ لمشاهدة جزيئة الفيروس . والجزء الثاني فحص البكتريا باستخدام فحوصات الكيموحيوية وفحص Vitek 2 system وتم التحري ايضا عن انزيم الهيمولايسين حيث كانت جميع العزلات منتجه لهذا الانزيم . التشخيص الجزيئي للكشف عن وجود الجين mga بواسطة تقنية سلسلة تفاعل انزيم البلمرة .الجزء الثالث شمل وجود الفيروس والبكتريا في عينات الاذن للمرضى المصابين بالتهاب الاذن الوسطى . الجزء الرابع تضمن دراسة مناعية لمعرفة دور الحركيات الخلوية IL - 6, TNF - α, IFN - α, CD8, and CD56))عند الاصابة بفيروس نظير الانفلونزا بواسطة فحص الامتصاصية المناعي المرتبط بالانزيم وباستخدام تقنية التالق المناعي المباشر لفيروس نظير الانفلونزا بانواعه الثلاثة (hPIV 1,2,3) كانت نسبة الاصابة 64% (اي 32 طفلا من اصل من اصل50) وعند استخدام فحص تفاعل سلسلة انزيم البلمرة بالوقت الحقيقي ( (RT - PCR وجد ان نسبة الاصابة بفيروس نظير الانفلونزا بانواعه الاربعة (hPIV_1,2,3 and 4) 44% ( اي 22 من 50) تضمنت الدراسة استخدام المجهر الالكتروني النفاذ لرؤية جزيئة فيروس نظير الانفلونزا في افرازات الاذن . اظهرت نتائج التشخيص البكتيري ان نسبة الاصابة بالمسبحيات القيحية هي 14%(7 من 50) بعد زرعها على وسط اكار الدم وحضنت لمدة 24 ساعة بدرجة 37 وتم فحصها بواسط المجهر الضوئي بعد تصبيغها بصبغة كرام , تم التشخيص بواسطة استخدام فحص Bacitracin sensitivity وفحص انتاج انزيم الهيمولايسين على وسط الدم بواسطة فحوصات الكيموحيوية وفحص Vitek 2 systemاظهر التشخيص الجزيئي للكشف عن وجود mga جين ان جميع العزلات تحتوي على هذا الجين اي نسبة 100% .كما اظهرت الدراسة ان نسبة وجود الفيروس مع البكتريا في في سوائل الاذن بنسبة (16%)( . 4 وكانت نسبة وجود الفيروس (72%) 18وشملت الدراسة ايضا فحص الحركيات الخلوية بواسطة فحص الامتصاصية المناعي المرتبط بالانزيم واظهرت النتائج ارتفاع مستوى السايتوكينات في مصل مرضى التهاب الاذن الوسطى مقارنة مع الاشخاص الاصحاء وكان اعلى مستوى لانترليوكين 6 في امصال مجموعة المرضى المصابين بفيروس نظير الانفلونزا للذكور والاناث هو) 88.24 )و (100.95) 1Pg/ml على التوالي . في حين كان اعلى مستوى لعامل النخر الورمي نوع الفا في امصال مجموعة المرضى المصابين بفيروس نظير الانفلونزا للذكور والاناث هو (99.35 ) و(109.81 ) Pg/ml على التوالي. وكان اعلى تركيز لانترفيرون الفا في امصال مجموعة المرضى المصابين بفيروس نظير الانفلونزا للذكور والاناث هو( 217.16) و(( 197.84 Pg/ml على التوالي . واظهرت النتائج ان تركيز الواسمين المناعيين CD8 وCD56 ان تركيزهما اعلى في مصل مرضى التهاب الاذن الوسطى مقارنة مع الاشخاص الاصحاء , اظهرت النتائج ان تركيز CD8 في امصال مجموعة المرضى المصابين بفيروس نظير الانفلونزا للذكور والاناث هو ((11.46±1.49 و(14.76±1.73) ng/ml على التوالي . في حين كان تركيز CD65 في امصال مجموعة المرضى المصابين بفيروس نظير الانفلونزا للذكور والاناث هو (12.82±1.62 )و (10.59±1.19) ng/ml على التوالي | This study aimed to detect the role of of parainfluenza virus and Streptococcus pyogenes in children suffering from suppurative otitis media. A total of two hundred sample (three swab for each patients include ear swabs , nasopharyngeal secretion for viral study and ear swab for bacterial study and 50blood sample) , were collected from 50 patients suffering from suppurative otitis media attending to AL - Hilla Teaching Hospital in Babylon - Iraq during the period from February 2016 to May 2016. The study includes 35 samples obtained from healthy subject as control group that classified to six group according to age in similar way of patient's with parainfluenza virus infection group years old The study includes four main parts .First one is the viral diagnosis based on relied diagnostic procedure ( Primary detection of parainfluenza virus in ear discharge by direct Immunofluorescence for parainfluenza virus 1, 2 and 3 types, molecular diagnosis by Real - Time PCR technique for the qualitative detection and differentiation of Parainfluenza Virus 1, 2, 3, 4 and diagnosis of parainfluenza virus by transmission electron microscope. The second part includes the bacterial diagnostic based on relied diagnosis procedure (using conventional biochemical reaction and commercial kit (Vitek 2 system). The heamolysis on blood agar was also observed in all isolates. Molecular detection of mga virulence gene for Streptococcus pyogenes was detected using conventional PCR technique. The third part is Co - infection between GAS and HPIV in OM specimens of children with suppurative OM. The fourth part is an immunological study to investigate the role of cytokines (IL - 6, TNF - α, IFN - α, CD8 and CD56) in HPIV infection by ELISA assay . Direct immunofluorescence for parainfluenza virus 1, 2 and 3 types antigen was positive in 64% (32 out of 50) , when we use Real - time reverse transcription PCR(RT - PCR) the percent of children infection with HPIV1, 2, 3, and 4 was 44% (22 out of 50). The study also include the use of transmission electron microscope for visualized the parainfluenza virus particle in ear swab. Streptococcus pyogenes isolates was detected in 14%(7 from 50) the isolate were confirmed after culturing on the blood agar and incubated for 24 hour at 37ºC, then microscopically by Grams̕̕ staining. Identification was done using commercially prepared bacitracin and the type of hemolysis on blood agar by primary biochemical test and confirmatory identification by vitek2 system compact. Molecular Identification of mga gene for Streptococcus pyogene showed that all Streptococcus pyogenes positive result 100%. The occurrence of Bacterial and viral co - infection in middle ear fluids which have been observed in 16% (4 out of 50 cases). HPIV was identified as a single agent in ear swab in 72%(18 out of 50). The study include estimation of some immunological parameter include (IL - 6, TNF - α, IFN - α , CD8 and CD56 ) using ELISA and revealed elevation the concentration of cytokines in sera of otitis media patients in comparison with healthy control groups. The concentration of IL - 6 is higher in sera of otitis media patients with parainfluenza virus than healthy control group. The high level of IL - 6 Pg/ml in otitis media patients for male and female was (88.24) and (100.91) Pg/ml respectively. Also level of TNF - α Pg/ml in otitis media patients for male and female was (99.3) and (109.8) Pg/ml respectively . The level of IFN - α Pg/ml in otitis media patients for male and female was (217.16 )and (197.84 )Pg/ml respectively. The results also show elevation concentration of CD8 and CD56 in sera of otitis media patients with parainfluenza virus than healthy control group. For CD8 ng/ml in otitis media patients for male and female was(11.46) and (14.76)ng/ml respectively. The level of CD56 ng/ml in otitis media patients for male and female was (12.82) and (10.59)ng/ml. respectively.

الكشف عن اللولبية البوابية في خزعة المعدة ودراسة مستوى P53 وطفرات مورثة Bax المرتبطة بالقرحة الهضمية Detection of Helicobacter pylori in Gastric Biopsy and Study the Level of P53 and Bax Gene Mutations Associated With Peptic Ulcer

اسم المؤلف: اصيل هاشم راضي السعبري
اسم المشرف: محمد صبري عبد الرزاق السعيد مشتاق عبد العظيم وتوت
الموضوع العام: الطب
السنة: 2017
الموضوع الدقيق: الاحياء المجهرية
الدرجة: دكتوراه
اللغة: الانكليزية
مكان الجامعة: بابل
الصفحات الاولى:
المستخلص: اللولبية البوابية هي بكتريا سالبة لصبغة كرام, الذي تصيب غالبية سكان العالم وتسبب امراض مختلفة مثل التهاب المعدة المزمن, القرحة الهضمية وسرطان المعدة. في حين ان غالبية الناس المصابين بالبكتريا اللولبية لا تظهر عليهم اعراض مرضية. ان العوامل الرئيسية التي تحدد تطور الامراض ذات الصلة بالبكتريا اللولبية قد تكون ضراوة البكتريا, وعوامل المضيف الوراثية والبيئية.الهدف من هذه الدراسة هو الكشف عن اللولبية البوابية في انسجة المعدة ودراسة عوامل الضراوة الرئيسية لهذا الممرض والعوامل الوراثية للمضيف في المرضى الذين يعانون من اعراض اصابات المعدة والاثني عشري. وتشمل الطرق الجزيئية ايضا تفاعل سلسلة البلمرة (PCR) للكشف عن جينات التشخيص والضراوة لبكتريا اللولبية البوابية وتقنية (SSCP) تم القيام بها للكشف عن الطفرات الجينية ل P53 وال Bax جين التي قد تترافق مع عدوى اللولبية البوابية.بلغ العدد الكلي للنماذج (الخزعات) المعوية 180 نموذج. فقط 92 خزعة معدة (51 ٪) اعطى نتيجة ايجابية لللوليبيات البوابية (Helicobacter pylori ) للتشخيص بواسطة التقنية الجزيئية, مع ذلك من بين هذه النتائج الايجابية 60% منها اعطى نتيجة ايجابية للزراع, التي تعتمد على الميزات الكيميائية الحيوية. كما تم اخذ 100 عينة مصل الدم من افراد اصحاء مع عدم وجود تاريخ عدوى بالبكتريا اللولبية كمجموعة سيطرة ونتائج اختبار الاجسام المضادة على اساس (اختبار المصلية) اعطت نتائج سلبية للبكتريا اللولبية.قد تم ملاحظة وجود تكرار عالي للولبية البوابية بالتهاب المعدة المزمن الذي يشكل 88٪ بينما التكرار القليل كان مقداره 3٫3٪ لسرطان المعدة في حين ان 8٫7٪ كان لقرحة الاثنى عشري. وقد كان التكرار العالي لعدوى اللولبية البوابية بين المصابين الذكور اكثر من الاناث, ويعود سبب ذلك لعدة عوامل مثل (متوسط العمر الاجتماعي والاقتصادي ونقص التغذية وسوء النظافة) ويعتبر التدخين احد العوامل الاضافية المرتبطة مع انتشار عدوى (اللولبية البوابية ) بسبب السلوكيات غير الصحية المرافقة للتدخين , والتي قد تشمل نقل البكتيريا من خلال اللعاب بين المدخنين. من جهة اخرى اظهرت النتائج ان معدل العدوى العالي للمجموعة العمرية (31 - 50) سنة الذي تم تسجيله كان 44٫6٪. علاوة على ذلك فان الكشف عن اللولبية البوابية بتقنية سلسلة تفاعل البلمرة PCR)) قد اجريت على جميع انواع خزعات المعدة وجين (ure C ) اضافة الى جين (ure A ) اللذان يستخدمان كعلامات للتشخيص التاكيدي للولبية البوابية من خلال استخدام (primers ) خاص لتقنية PCR. وضحت النتائج ان 84٫8٪ و73٫9٪ للولبية البوابية كانت ايجابية لكلا الجينين. للعينات التي اعطت نتائج ايجابية (للتضاعف الجيني amplification ) بواسطة (PCR ), كان 56 عينة ما يمثل (60٪) قد اعطت استجابة لنتائج الزرع. اضافة الى التضاعف بواسطة PCR لعلامات جين (ure C ) وجين (ure A ). اضافة الى ذلك ,المعدل الايجابي للولبية البوابية للخزعات تحت الاختبار كان 51٪ بالاعتماد على الكشف الجزيئي المباشر بواسطة (PCR) باستخدام جين (ure A) وجين (ure C ). علاوة على ذلك, تم فحص جين (cag A) لكل عينات اللولبية البوابية التي تم عزلها. اشارت النتائج الى ان65 عزلة (70٫6٪) كانت ايجابية لتضاعف (PCR ) للجين من نوع cagA) ) حيث ان عزلة 56 (60٫8٪) كانت ايجابية لتضخيم (PCR ) للجين من نوع (cag E ). من بين النتائج الايجابية التي تم عزلها 49 عزلة (53٫3٪) كانت قد اعطت نتائج ايجابية للجين من نوع (cag A ). كذلك وجد تكرار الجين (vac A ) مقداره في الدراسة الحالية 68٫5٪ (63/92). اضافة الى كل اللولبيات البوابية الايجابية لخزعة المعدة 49 (53٫3٪) اظهرت اشارة كاملة للجينات نوع (cagA, cagE وvacA (. بالنسبة للعينات المعدية المتبقية 27 عينة (30٫4٪) التي تحوي سلالات سلبية كانت سلبية للجين (cag E). وقد تم تحديد طفرات جين (p53) في الاكسونات 5 و6و 7 و8 باستخدام طريقة SSCP. ومع ذلك تم استخدام PCR لتضخيم الاكسونات 5 و6 و7 و8 للجين (p53) التي من المعروف انها بقع ساخنة طافرة .تحليل PCR - SSCP يكشف تعديلات في الجين (p53) في عدة اكسونات. حيث ان ستة عشر من التعديلات في الاكسون E5A , سبعة عشر التعديلات في الاكسون E5B6A, وكذلك سبعة عشر التعديلات في الاكسون E7 وتعديل واحد فقط في الاكسون E6B لكن لم يظهرتعديل في الاكسون E8 في الجين (p53). بنفس الاسلوب ان تحليل PCR - SSCP كشف عن تعديلات في جين bax في الاكسونات E1 وE4 وE6. ويظهر ذلك في الاشكال. فيما يخص الاكسون 1 في bax يمكن ملاحظة وجود 6 نماذج فقط تعطي طفرات موضع ايجابية للجين. قد يعزى ذلك الى اللولبية البوابية التي تحفز طفرة bax من خلال قابليتها على انتاج بروتين cag A الذي له القابلية على تغيير التسلسل الجيني والوظيفة. واستنتجنا الى ان التشخيص الجزيئي قدم دليلا توكيديا على وجود اللولبية البوابية في عينات المعدة. ايضا قد تؤثر السلالات الاكثر ضراوة على تحفيز طفرات جينية في جينات ال p53 وال bax. | Helicobacter pylori is a gram - negative bacteria which infects a majority of the world population. It causes various diseases such as chronic gastritis, peptic ulcer and gastric cancer. While majority of the people infected with H. pylori is asymptomatic. The main factors, which determine the development of H. pylori related diseases might be bacterial virulence, host genetic and environmental factors.The aim of this study is detection of H. pylori in gastric tissue and study the main virulence factors of this pathogen and host genetic factors in patients with gasteroduodenal manifestation. Molecular methods include polymerase chain reaction (PCR) for diagnosis and virulence genes of H. pylori and single strand confirmation polymorphism (SSCP) technique was done to detect the p53 and bax genes mutation may be associated with H. pylori infection. In this study, 180 patient were included, only 92 gastric biopsies (51%) gave positive for the presence of H. pylori diagnosed by direct molecular technique. Among these positive result, 60% gave positive results in cultivation based on biochemical features. In addition, 100 serum samples were taken from healthy individuals, with no history of H. pylori infection as a control group and the results of antibody based test (serological test) were negative for H. pylori.In this study, the high frequencies of H. pylori were observed for chronic gastritis, which constituted 88% while low frequencies were 3.3% for gastric cancer, whereas 8.7% for duodenal ulcer.Also, the highest frequencies of H. pylori infection were found in male patients in comparison to female. On the other hand, the results showed that the high significant infection percentage 44.6%, among age group ranging from 31 - 50 years. Moreover, detection of H. pylori by Polymerase Chain Reaction (PCR) technique is performed on all gastric biopsy. ure C as well as ure A genes are used as markers for confirmatory diagnosis of H. pylori through using specific primers of PCR technique. The results show that 84.8% and 73.9% of H. pylori are positive for both genes, respectively. Among samples with positive result for PCR amplification, 56 samples (60%) also had positive culture result. Besides, the PCR amplification of ureC and ureA markers. Also, the rate of positive H. pylori in the tested biopsies was 51% depending on direct molecular detection by PCR using the ureA and the ure C genes.In addition, cag A gene is investigated in all H. pylori isolates. The results show that 65 isolates (70.6%) are positive for PCR amplification of cagA gene whereas 56 isolates (60.8%) are positive for PCR amplification of cag E gene. Among of these positive isolates, 49 isolates (53.3%) give positive result for cag A gene. The frequency of the vacA gene found in the present study is 68.5% (63/92).Furthermore, among of all H. pylori positive gastric biopsy, 49 (53.3%) reveal full signals of cagA, cagE, and vacA. The remaining 27 (30.4%) gastric biopsies, harboring cagA - negative strains, are PCR negative for cagE.Mutations of the p53 gene in exons (5,6,7 and 8) are identified by PCR - SSCP method. However, PCR is used to amplify exons 5,6,7 and 8 of p53 gene which are known to be mutational hot spots. PCR - SSCP analysis has detected alterations in the p53 gene in several exons. Where sixteen alterations in exon E5A, nineteen alterations in exon E5B6A, seventeen alterations in exon E7 and only two in exon E6B but no alteration is seen in exon E8 of P53 gene.In the same way, PCR - SSCP analysis detected alterations in Bax gene where only 17% of positive samples gave alteration in the sequence of Bax gene in exons E1, E4 and E6. Regarding exon 1 of Bax gene, it was seen that only 6 samples gave positive gene locus mutation. It conclude that the molecular diagnosis gave an evidence and confirmatory guide on the existence of H. pylori in gastric samples. Also the more virulent strain may be affected on the stimulation of p53 and bax genes mutation.

التقييم السريري لمستوى تراكيز الهوموسيستين وحمض الفوليك وفيتامين ب - 12في امصال مرضى البهاق Clinical Evaluation of Homocysteine, Folic acid & B12 Concentration Levels in Sera of Vitiligo Patients

اسم المؤلف: محمد نوري ابراهيم
اسم المشرف: حيدر هاشم الشلاه محمد كاظم الحطاب
الموضوع العام: الطب
السنة: 2017
الدرجة: ماجستير
اللغة: الانكليزية
مكان الجامعة: بابل
الصفحات الاولى:
المستخلص: البهاق مرض مكتسب غير معد مجهول السبب وشائع في جميع انحاءالعالم ويحدث نتيجة الفقدان التدريجي لوظيفة الخلايا الصباغية التي تنتج الميلانين (الصبغة الجلدية) مما يؤدي الى فقدان الصبغة في الجسم او الشعر او الفم ولازالت مسببات هذا المرض غير مفهومة تماما فهناك العديد من النظريات التي تبين سبب ظهوره وواحدة من تلك النظريات تعزي سبب ظهورالبهاق الى الزيادة في (الهوموسيستين) والذي قد يشارك في تدمير الخلايا الصباغية ( الميلانوسايت) في الجلد عن طريق زيادة الجهد التاكسدي.ان هذه الدراسة تبحث دورالهوموسيستين وحمض الفوليك وفيتامين ب - ١٢ وتقييم هذه الادوار في التسبب او في انتشار هذا المرض ، وقد اجريت الدراسة في مدينة مرجان الطبية في العيادة الاستشارية الخارجية للامراض الجلدية في محافظة بابل /مدينة الحلة وقد تم جمع العينات في الفترة منذ نوفمبر 2015 حتى مارس 2016 وقد شملت ثمان وثمانون حالة : اربعة واربعون منهم مصابا بمرض البهاق واربع واربعون شخصا سليما وباعمار مختلفة. وقد تم استبعاد الاعمار فوق 40سنة ومن يزيد مؤشر كتلة الجسم لديهم عن 30 وكذلك المصابين بارتفاع ضغط الدم ومرضى السكري ومرضى فقر الدم الخبيث وداءالثعلبة والاشخاص الذين لديهم خللا في الغدة الدرقية والحوامل والمرضعات والمدخنين وشاربي القهوة. وقد تم قياس مستوى الهوموسيستين والفوليك وفيتامين ب - ١٢ في مصل الدم باستعمال الطريقة اللونية على جهازي ELISA و.TOSOH - 900تم التعبير عن النتائج من خلال استخدام المعدل والانحراف المعياري . وقد تم اجراء التحليلات الاحصائية باستخدام برنامج التحليل الاحصائي (SPSS 21) وتم اعتبار قيمة الاحتمالية0.05) ≤ p) لتكون ذات دلالة احصائية.كان مستوى الهوموسيستين في الدم اعلى لدى المرضى الذين يعانون من البهاق مقارنة بمجموعة الاشخاص الغير مصابين. وكان مستوى حمض الفوليك في مجموعة المرضى اقل بكثير مما كانت عليه مجموعة الاشخاص الغير مصابين على الرغم من ان مستوى حمض الفوليك كان طبيعيا. ولم يلاحظ اي اختلاف معتد به في مستوى فيتامين ب - ١٢ بين مرضى البهاق والاشخاص غير المصابين.اما فيما يتعلق بنشاط المرض فقد كان معدل الهوموسيستين في مجموعة المرضى الذين يعانون من مرض البهاق الفعال (النشط) اعلى مما كانت عليه في مجموعة الغير مصابين وكان متوسط مستوى الهوموسيستين في مصل الدم في مجموعة المرض النشط اعلى من تلك التي في مجموعة المرض المستقر. ان نتائج هذه الدراسة اظهرت ارتفاع مستوى الهوموسيستين قي المرضى الذين يعانون من مرض نشط ومستقر ولكن ليس في المرضى الذين تماثلوا للشفاء لافتا الى وجود علاقة وطيدة محتملة بين الهوموسيستين ونشاط المرض. وفي هذه الدراسة كانت هناك فروق ذات دلالة احصائية فيما يتعلق بمستوى حمض الفوليك في مصل الدم فكان في مجموعة المرضى الذين تماثلوا للشفاء اعلى بكثير مما كانت عليه مجموعة المرض المستقر واعلى من مجموعة المرض النشط بينما لم يكن هناك اختلاف يذكر في مستوي فيتامين ب - ١٢ فيما يتعلق بنشاط المرض. وفي الختام بينت هذه الدراسة الى ان من المحتمل ان تكون هناك صلة بين ارتفاع مستوى الهوموسيستين او قلة مستوى حمض الفوليك في مصل الدم وبين التسبب في مرض البهاق او نشاطه وقد تستخدم هذه العلامات البيولوجية لقياس نشاط المرض ومعرفة مراحله. | Vitiligo is a common, acquired, multifactorial and polygenic depigmenting disorder caused by the destruction of melanocytes. The exact etiopathogenesis is unknown. There has been conflicting reports on the association between the disease and the serum levels of homocysteine (Hcy) in vitiligo and its severity. Hcy may mediate melanocyte destruction via increased oxidative damage. In the present study homocysteine, folic acid and vitamin B12 were estimated to identify their role in the pathogenesis in vitiligo. This study was carried out in Marjan Medical City in the outpatient dermatology clinic in Babylon Province, Hilla City. All samples were collected from November 2015 till March 2016. This was a case control study which included 88 subjects, forty four were patients diagnosed with vitiligo and the other forty four were healthy subjects (controls). Cases over 40 years, BMI > 30, patients who clinically and laboratory diagnosed with hypertension, pernicious anemia, diabetes mellitus (D.M), alopecia areata, thyroid dysfunction, pregnancy and lactation, coffee drinkers and cigarettes smokers were excluded. Serum levels of folic acid, B12 and homocysteine were measured by using a colorimetric method technique. The results were expressed as mean ± standard error of mean. T - test, Annova test and the linear regression analysis Rho (ρ) were used for the determination of the level of significance. Statistical analysis was performed with Statistical Package for the Social Sciences (SPSS) version 21.0 software. A P value of ≤ 0.05 was considered to be statistically significant. The results of the present study demonstrate elevated serum homocysteine levels in extensive vitiligo. Elevation of homocysteine levels was observed in patients with active as well as stable disease, but not in patients with regressive disease, pointing to a possible relationship to vitiligo activity. Also in this study there was a statistically significant difference between active, stable and regressive activity regarding folic acid, on the contrary there was no significant difference regarding vitamin B12 in the activity of the disease. In conclusion, elevation of serum homcysteine level could be related to the pathogenesis and the activity of vitiligo and it could be used as a biomarker for the measurement of disease activity and in the prognosis of vitiligo

تقييم مستوى الفتوين ا لمرضى احتشاء العضله القلبيه الحاد في محافظة بابل Evaluation of Fetuin A level in patieints with Myocardial Infarction in Babylon Province

اسم المؤلف: دينا عائد محمد الخفاجي
اسم المشرف: حيدر هاشم الشلاه عدي جاسم الصالحي
الموضوع العام: الطب
السنة: 2017
الدرجة: ماجستير
اللغة: الانكليزية
مكان الجامعة: بابل
الصفحات الاولى:
المستخلص: احتشاء العضله القلبيه الحاد سبب المضعفات المرضيه والموت بشكل واسع في العالم. احتشاء العضله القلبيه موت الخلايا القلبيه التي تحدث بعد انعزالها عن الاوكسجين لفتره طويله. تم تقييم الخطورة لهذا المرض يتم عن طريق عوامل الخطورة والواسمات الحيويه للخطورة. وتمت دراسة عدد من عوامل الخطوره والواسمات الحيويه للخطوره لتقييم زيادتها او نقصانها المعنوي, قابليتها التنبؤيه للمرض, ومدى انتشارها في مجموعة الدراسه.تضمنت الدراسة 44 مريض تتراح اعمارهم من (45 - 80) سنة وتم تشخيصهم سريريا على انهم مصابين باحتشاء العضلة القلبية الحاد , تم الحصول عليهم من خلال رقودهم في وحدة العناية التاجية المركزة لمستشفى مدينة مرجان الطبية ومستشفى الحله لتعليمي بعد ان تم ادخالهم من قبل اطباء مختصين كونهم مصابين بمتلازمة الشرايين التاجية الحادة للفتره من 1/12/ 2015 لغاية 31/4/2016. بالاضافة الى هؤلاء تضمنت الدراسة 44 شخصا سليما ظاهريا وهم مجموعة السيطرة وقد روعي في الاختيار التطابق الديموغرافي بين المجموعتين كون الدراسه ذات بروتوكول يعنى بدراسة الحالات الافرادية ومقارنتها بحالات السيطرة. تم اجراء الفحوص المختبرية في مختبرات فرع الكيمياء السريرية في كلية طب/جامعة بابل.وبمقارنة مجموعة السيطرة مع مجموعة المرضى المصابين لوحظ قلة في مستوى الفتوين للمرضى مقازنه بمجموعة السيطرة( 0.05> p )،وزياده في مستوى T.Ch,LDLوHbA1c للمرضى مقارنة بمجموعة السيطرة(p>0.05). اما فيما يتعلق بالتنبؤبحدوث احتشاء العضله القلبيه الحاد وجد ان الاشخاص الذين لديهم مستوى HbA1c وT.Cholesterol عالي في مصل الدم يكونون عرضه للاصابه بالمرض لثلاث مرات.وقد تبين ان مستوى الFA في مصل الدم للمرضىيرتبط بشكل كبير مع نوع الاحتشاءالعضلي (STEMIوNSTEMI)وهذا يؤدي الى الايحاء بانه بامكانية دراستها كواسم حيوي تشخيصي لنوع الاحتشاء العضلي في الدراسات المستقبليه. | Acute myocardial infarction causes morbidity and mortality in wide areas of the world. It is the death of cardiac cells that occurs following prolonged cutoff of oxygen. The evaluation risk of this disease by the risk factor ,the study was aimed to evaluate the role of Fetuin A level in Acute myocardial infarction and to assess Fetuin A with some of risk markers .Risk assessment is done by using risk factors and risk markers. A number of risk factors and risk markers are evaluated in the present study to determine their significance, predictive ability in the studied population. A case control study was conducted between 1st December 2015and 31st April 2016, on 44 consecutive patients aged (45 - 80) years old, diagnosed by expert physicians to have Acute myocardial infarction admitted to the coronary care units of Merjan Medical City and Al - Hilla Teaching Hospital, in addition to other (44) subjects demographicaly matched without history of any coronary disease with similar risk factors considered as a control group.The sera obtained from the blood of patients and control group subjects were used to meacure the circulating level of Fetuin A, total cholesterol, LDL, albumin, urea, creatinine ,while the whole blood was used for HbA1c measurement, as they represent a group of risk markers of AMI. In comparison with the control group, the patients with acute myocardial infarction showed a significant decrease in fetuin A (P<0.05), and significant increase in total cholesterol ,LDL, and HbA1c(p< 0.05) .Regarding prediction of acute myocardial infarction , the study revealed that patients with myocardial infarction were three times more likely to have high HbA1c and total cholesterol. It was demonstrated that high serum fetuin - A level was not significantly correlated with HbAlc ,LDL, total cholesterol in acute myocardial infarction patients . However fetuin A serum level wuas significantly correlated with type of myocardial infarction (STEM and Non - STEMI).In conclusion the evidence of decreace level of Fetuin A in acute myocardial infarction could play arole in the development of pathogenesis acute myocardial infarction.

دراسة فعالية نبات عين البزون كعلاج طبيعي لمرض سرطان الدم المستحث في ذكور الفئران Study the Activity of Catharanthus Roseus as Natural Treatment for Induced Leukemia in Male Mice

اسم المؤلف: محمد عبود عياش
اسم المشرف: مفيد جليل عوض نسرين جلال محمد
الموضوع العام: الطب
السنة: 2017
الدرجة: ماجستير
اللغة: الانكليزية
مكان الجامعة: بابل
الصفحات الاولى:
المستخلص: Leukemia is cancer of blood - forming tissues, begin in the bone marrow characterized by highly elevated of abnormal proliferation and circulation of immature clonal hematopoietic cells. It can affect all ages around the world which in turn considered as one of public health problem.Plants considered as an important source for medical drugs manufacturing due to the presence of certain compounds with medicinal biological activity, therefore adopted in the preparation of a lot of medicines and medical drugs because of its' speed therapeutic influence and low of negative side effects which caused by chemically manufactured medications.The present study aimed to evaluate the activity and efficiency of vincristine and other important constituent in Catharanthus Roseus plant in treatment of leukemia through enhance and direct impact on some of the body's vital biological activities by using fresh crude plant as herbal medicine. This study is Cohort study design. It is monitoring, detection, and investigation study that included some of groups that completely under control; this study used in medicine, nursing, psychology and social sciences in addition to the Ecology. This study included (60) Albino male mice divided into four groups (15) mice for each. Group (A) was the control group, group (B) was mice feed orally with of C. Roseus plant, group (C) was leukemia induced mice by subcutaneous injection of (300mg/kg B.W benzene), and group (D) was Induced leukemia mice treated by oral feeding with C. Roseus plant. The experimental work was carried out in Clinical Biochemistry Department / College of Medicine / University of Babylon during the period from (October 2015 to August 2016).High - Performance Liquid Chromatography (HPLC) technique was used for measurement of Vincristine drug (VCR) in plant and vitamin D levels in mices' serum, Enzyme Linked Immunosorbent Assay (ELISA) had was used for the measurement of serum ferritin, UV - Vis Spectrophotometer was used for determination of GSH - Px and GST concentrations, while Graphite Furnace Atomic Absorption Spectrophotometer technique (GFAAS) was used for measurement of trace elements concentration of (Fe, Cu, Zn, Se). There were hematological and histopathology studies carried out by using special required equipment to make sure that leukemia disease was indeed occur.Hematological study included measurement of Hb levels and WBC count, while histopathology study included bone marrow, liver, kidney, spleen smear. Microscopic investigation for Chromosomal Aberration and Micronuclei were also had been done.Results showed that C. Roseus plant contain the concentration of vincristine drug up to 148μg/gm. There was highly significant increase of serum ferritin levels, GST activity, Iron and Copper concentration, and WBCs in leukemic group (C) (P<0.001) when compared with control group (A), while there were highly significant decrease of these parameters in group (B) as compared with the control (A) and (C) groups.Results also showed a highly significant decrease of GSH - Px activity, Vit.D levels, Zinc and Selenium concentration, and Hemoglobin levels in group (C) (P<0.001) when compared with the control group, while there were highly significant increase of these parameters in group (B) as compared with control and (C) groups. The present study found a positive correlation between Vit.D and GSH - Px activity, Ferritin and GST activity, while this study found a negative correlation between Ferritin and GSH - Px activity, serum Iron and Selenium concentration.The present study found positive effect of C.Roseus on abnormal parameters and support the biological system which was clear in group (D) which demonstrated that there were significant inhibitions to decrease or increase of these parameters than those in healthy control.

الانماط الجينية والبروتين الرابط للرتينول 4 في مرضى الاعتلال الكلوي السكري النوع الثاني Gene Polymorphism And Retinol Binding Protein 4 In Type 2 Diabetic Nephropathy Patients

اسم المؤلف: احمد جبار عباس
اسم المشرف: مها فاضل سميسم علاء حسين ال حيدر
الموضوع العام: الطب
السنة: 2017
الدرجة: ماجستير
اللغة: الانكليزية
مكان الجامعة: بابل
الصفحات الاولى:
المستخلص: داء السكري هو مرض ايضي له تاثير على ايض الكاربوهيدرات والدهون والبروتينات. ومن مضاعفات السكري اعتلال الكلية السكري، الذي يعد السبب الرئيسي للفشل الكلوي المزمن. الليبوكالينات هي عائلة من البروتينات التي تنقل الجزيئات الكارهة للماء صغيرة مثل السروئيدات | Diabetes mellitus (DM) is a metabolic disease involving carbohydrate, lipid, and protein metabolism. Diabetic nephropathy (DN) is the significant complication of diabetes, which is at the present time the major cause of chronic renal failure. The lipocalins are a family of proteins which transport small hydrophobic molecules such as steroids, retinoids, and lipids. Retinol binding protein 4 (RBP 4) is a member of the lipocalin family of proteins and it has a role in insulin resistance. A meta - analysis demonstrated a significant association between the polymorphism of glucose transporter1 gene with DN. The presence of endothelial nitric oxide synthase (eNOS) polymorphisms may contribute to a decreased eNOS activity and a lowered nitric oxide level, and has been reported to be a potential factor in the development and pathogenesis of DN. The study aimed the evaluation of lipid profiles and determination of their association with retinol binding protein 4 expression in diabetic patients, evaluation of gene expression of eNOS G894T polymorphism in diabetic patients to predict its relationship with nephropathy in future, and evaluation of gene level of GluT1 polymorphism in diabetic patients to predict its relationship with nephropathy in future. This study was conducted in Hilla city, from December 2015 to April 2016. The samples were collected from Babylon Center for Diabetes and Endocrinology in Marjan Teaching Hospital in Babylon / Hilla city.This study was included 160 subjects, who were (35 - 58) years old and BMI between (25 - 29.9) which were divided into groups : Control group 80 apparently healthy persons included 40 male control group (MC) and 40 females control group (FC). Eighty patients with diabetes mellitus type 2 include (40 males group (M)) and (40 females group (F)). Blood samples (10 ml) were taken from fasting subjects. Two milliliters of blood were put in EDTA tube used for the determination of HbA1c and genetic study and 8 milliliters of blood were put in plane tube and centrifuged to separated serum to measure (glucose, insulin, retinol binding protein 4 and lipid profile ( and insulin resistance was measured by equations. The results show : 1. There is a significant increase in the mean of fasting glucose, HbA1c, fasting insulin level, insulin resistance in groups M and F as compared to the control groups, (p<0.01), but there was no significant increase between two patient groups (p ? 0.05)2. The significant increase (P <0.01) in total cholesterol (TC), TG, LDL - C and VLDL - C, while serum HDL - C concentration was found significantly decrease (P<0.01) in patient groups as compared with the control groups, and no significant increase or decrease in lipid profiles in comparison between patients groups (P ? 0.05).3. There is significant increase (P< 0.01) in RBP4 between patients and control groups, and not significant (P?0.05) difference between patient groups.4. Group M shows significant positive correlations (r = 0.514, p= 0.0012 and r = 0.536, p = 0.0034) of RBP4 concentration with serum fasting insulin concentration and HOMA - IR respectively, in group F, the results show a significantly positive correlation (r = 0.502, p = 0.001 and r = 0.474, p = 0.02) between RBP4 concentration with serum fasting insulin concentration and HOMA - IR respectively.5. A significant positive correlations was found (r = 0.486, p 0.001; r = 0.388, p 0.013; r =0.385, p=0.014) for serum RBP4 concentration with TC, TG and LDL - C concentrations respectively, and significantly negative with HDL - C (r = - 0.424, p =0.006) in group M, also positive correlation (r = 0.443, p =0.004; r = 0.467, p = 0.002; r = 0.435, p = 0.005) of RBP4 with TC, TG, LDL - C respectively and negatively with HDL - C (r = - 0.453, P = 0.003) in group F.6. A significant increase (< 0.01) in non HDL - C between patients and control groups and no significant (?0.05) difference between patient groups.7. According to the results of genotyping, XbaI polymorphism wasidentified as homologous genotype XbaI ( - / - ) were 12 (30%) in the group M, 14 (35%) in the group F, 3(7.5%) in the group MC and in the group FC 2(5%), while individuals have heterozygous genotype XbaI ( - /+) were 7 (17.5%) in the group M, 10 (25%) in the group F, 10 (25%) in group MC and in the group FC 8(20%).8. A significant association between the frequency of XbaI ( - / - ) variant in group M in compared with group MC an odd ratio = 5.14 and confidence interval at 95% level of (1.36 - 19.4), and in group F in compared with group FC an odds ratio = 13.12 and confidence interval at 95% of (2.64 - 65.07). 9. According to the results of genotyping, G894T polymorphism for eNOS gene was identified as homologous genotype TT were 7 (17.5%) in group M, 9 (22.5%) in group F, 8 (20%) in group MC and 10 (25%) in group FC, while individuals have heterozygous genotype G/T were 21 (52.5%) in group M, 20 (50%) in group F, 6 (15%) in group MC and 7 (17.5%) in group FC.10. A significant frequency of GT variant in group M is compared with group MC with odds ratio = 7.58 and confidence at 95% level of (2.43 - 23.62), and in patients of group F as compared with group FC with odds ratio = 7.27 and confidence interval at 95% of (2.4 - 22.02).In conclusion, the RBP4 is associated in causing insulin resistance and lipid abnormalities. The high levels of Non HDL - C in diabetic patient contribute in progression of diabetic nephropathy. The GLUT1 polymorphism in diabetic type 2 patients specially patients with XbaI ( - / - ) and eNOS gene polymorphism G/T allele have a role in progression to diabetic nephropathy.

دراسة الملف المصلي وتقييم بعض الخصائص المناعية لدى مرضى الحزام الناري Serum Profile Study And Evaluation Of Some Immune Features Among Patients With Shingles

اسم المؤلف: زينب عبد النبي طليفح النصراوي
اسم المشرف: حبيب صاحب نهر محمد كاظم طاهر الحطاب
الموضوع العام: الطب
السنة: 2017
الموضوع الدقيق: الاحياء المجهرية
الدرجة: دكتوراه
اللغة: الانكليزية
مكان الجامعة: بابل
الصفحات الاولى:
المستخلص: اجريت الدراسة الحالية للفترة من 1شباط 2015 لغاية 3شباط 2016 وجمعت خلالها عينات المرضى المصابين بالحزام الناري من قسم الامراض الجلدية في العيادات الاستشارية في مستشفى مرجان التعليمي للتحري عن بعض الجوانب المناعية في المرضى, وكان العدد الكلي للمرضى 50 مريضا | This study was conducted during the period from 1st February 2015 to 3rd February 2016, and the samples were collected from dermatology department of the consultant clinic in Marjan Teaching Hospital to investigate certain immunological markers of patients with shingles. The total number of patients were whose their ages ranges were 14 - 80 years. Age group (40 - 61) years have the highest percentage of infection reaching 46%.The immunofluorescence test for Varicella Zoster virus - specific IgG showed 48 out 50 are positive(96%). The higher percentage of infection with shingles was in female (54%), while male patients the percentage was(46%).The results showed that patients with blood group (O+) have 50% of infection rate.When CD4 was investigated by ELISA test , the results showed that the mean± SD of serum level of CD4 in shingles patients and control group is (6.70± 0.97 and 9.36±2.02) ng/ml respectively. The concentration of CD4 was lower in patients with shingles than healthy control group, while concentration of CD8 and CD56were higher than healthy control group ( the mean± SD of serum level of CD8 in shingles patients and control group was 21.42±5.43 and19.11±3.29 ng /ml respectively, whereas the mean ± SD of CD56 concentration in shingles and control group were 107.58± 40.39 and 67.59 ± 36.31 ng/ml, respectively).The results also showed that the concentrations of IFN ? and TNF? were lower in patients with shingles compared with non - infected persons , as the following : the mean± SD of serum level of IFN ? in shingles patients and control group was 184.31±21.95 and 218.03±26.21 pg /ml respectively, and the mean ± SD of TNF? concentration in shingles and control group were 51.55± 5.14 and 62.35 ± 6.74 pg/ml, respectively. For IL 10, the concentration was higher in patients with shingles than that in the healthy control group; the mean± SD of serum level of IL 10 in shingles patients and control group was12.42±5.59 and 4.47±0.90 pg /ml respectively. This study was concluded following : • Gender represents a risk factor for the occurrence of shingles mainly at ages over 40 years old (higher in females than males).• Varicella Zoster virus specific IgG is a sensitive and specific test that can be used for the laboratory diagnosis of shingles.• Varicella Zoster virus reactivation has a suggested link with decreased level of soluble CD4 molecules and, for lesser extend with increased soluble CD8 and CD56 molecules in patients serum. • Blood group O+ might be consider as a risk factor for reactivation of VZV infection as the majority of patients were within this blood group.• A diminished role of the inflammatory TH1 cells in reactivated shingles patients is more likely as evident by the reduced concentration of IFN? and TNF? profiles. The Treg cells (CD4+ CD25+) seems to play a role in such reduction of TH1 proinflammatory cytokines as evident by the significant elevation of IL10 in shingles patients.

الاهمية الكيميائية الحياتية لنبتة العليق الاحمر كماسك طبيعي في حالة زيادة الحديد Biochemical Importance Of Rubus Idaeus As A Natural Chelator In Iron Overload Status

اسم المؤلف: حازم علي حسين
اسم المشرف: مفيد جليل عوض مؤيد عمران الغزالي
الموضوع العام: الطب
السنة: 2017
الدرجة: ماجستير
اللغة: الانكليزية
مكان الجامعة: بابل
الصفحات الاولى:
المستخلص: لمنع تراكم الحديد في الجسم، وخاصة لمرضى داء ترسب الاصبغة الدموية،او الذين يحتاجون الى نقل دم بصورة مستمرة، لابد من عمل مركب معه يعمل على استخراجه.نبتة العليق الاحمر تحتوي على كمية عالية من حامض التانيك وهو مركب متعدد الفينولات للنبات يعمل على مسك او حجز | To prevent iron overload, especially for those patient with hemochromatosis or those having chronic blood transfusion, iron must be chelated and excreted, Rubus Idaeus containing high quantity of tannic acid which is a plant polyphenol, chelate iron and excreted from the body. The present study aimed to evaluate the activity and efficiency of tannic acid in Rubus Idaeus fruit to reduce or eliminate iron overload through enhance direct impact on some of the body,s vital biological activities by using fresh crude plant as herbal medicine. This study is Cohort study designed. It is monitoring, detection, and investigation study that included some of groups that completely under control(control), and other group which induced iron overload , the iron overload group is subdivided to 5 groups, one of this sub gorups is treated with desferal(Deferroxamine),and the rest 3groups giving 3 different doses of pure fruit of Rubus Idaeus, while the least group is not treated with fruit or with desferalThe study included (60) Albino male mice divided into six groups with count (10) mice for each. First group was labeled as control (A). The other five groups received intra peritoneal injections of iron - dextran at a dose of 100 mg/kg/day B.w. (one dose every two days for 3 weeks) are the iron overload groups ,which are classified as a following : B1 group ,in which the iron overload induced mice treated with 100 mg/kg/day of Rubus Idaeus fruit, B2 group, in which the iron overload induced mice treated with 200 mg/kg/day of Rubus Idaeus fruit,B3 group ,in which the iron overload induced mice treated with 300 mg/kg/day of Rubus Idaeus fruit, group(C),in which the iron overload induced mice received 493mg/kg/day desferal by subcutaneous injection for 21 days beginning on the day following the first iron dextran injection, group (D) ,in which the iron overload induced mice neither received desferal nor Rubus Idaeus fruit. The experimental work was carried out in the animal house and in the Clinical Biochemistry Department / College of Medicine / Babylon University during the period from (October 2015 to August 2016). High - Performance Liquid Chromatography (HPLC) technique has been used for measurement of tannic acid in fruit in mice's serum. Enzyme Linked Immunosorbent Assay (ELISA) has been used for the measurement of serum ferritin, UV - Vis Spectrophotometer has been used for determination of GSH - Px and GST concentrations, while Graphite Furnace Atomic Absorption Spectrophotometer technique (GFAAS) has been used for concentration measurement of trace elements. There were hematological study have been carried out using special required equipment, protein analysis by electrophoresis has been used for mice's serum to detect protein changes for all groups. Results showed that Rubus Idaeus fruit contain good acceptable concentration of tannic acid up to (853 µg/gm),amount of trace element in the fruit plant was 14.12 ppm for Zinc,33.62 ppm for Iron,3.5ppm for copper(Cu),311.06 ppb for selenium(Se),40.13 ppb for chromium(Cr). Results also showed highly significant increase of Serum ferritin, hemoglobin levels, GST activity, Iron and Copper concentration, and decreased in chromium in iron overload group (D) (P<0.001) when compared with control group (A), while there were highly significant decrease of these parameters and increased chromium in group (B2) and group (C) as compared with control groups. Results also showed highly significant decrease of GSH - Px activity, Zinc and Selenium concentration, and increased in hemoglobin levels in group (D) (P<0.001) when compared with the control group, while there were highly significant increase of these parameters and decreased in hemoglobin level in group (B2) and (C)as compared with control and (A) groups. The study have been found positive effect of Rubus Idaeus on abnormal parameters and support the biological system which was clear in group (B2) and (C) which demonstrated that there were significant inhibitions to decrease or increase of these parameters than those in normal. The present study found that fruit of Rubus Idaeus in dose(200 mg/kg/day)in mouse(16.2mg/kg/day in human) gives more reasonable results than other 2 doses (100mg/kg,300mg/kg) in treatment of iron overload ,100mg/kg had no effect in reducing iron overload,300mg/kg chelate iron so more that causing anemia, while this study found a negative correlation between Ferritin and GSH - Px activity, serum chromium and Selenium concentration. Results also showed that there is a changes in protein bands in samples, new bands occurs in samples of induced iron overload group (D) due to increased production of iron regulating proteins. While these bands are absent in groups (A),(B2)

دراسة انزيم التيلومريز وجين الكلوتاثيون بيروكسيديز الاول في مرضى السكري النوع الاول Telomerase Enzyme And Glutathione Peroxidase1 Gene In Type 1 Diabetes Mellitus Patients

اسم المؤلف: دعاء مهدي هادي الحكاك
اسم المشرف: مها فاضل سميسم علي حسين البياتي
الموضوع العام: الطب
السنة: 2017
الدرجة: ماجستير
اللغة: الانكليزية
مكان الجامعة: بابل
الصفحات الاولى:
المستخلص: Type 1 diabetes is characterized by an immune - mediated depletion of ? - cells that results in lifelong dependence on exogenous insulin. Accumulating evidence suggests that oxidative cell injury caused by free radicals contributes to the development of type 1 diabetes mellitus (T1DM) complications and decreased efficiency of antioxidant defenses (both enzymatic and nonenzymatic) seems to correlate with the severity of pathological tissue changes in T1DM, So many studies have tended to analyze the genetic material that can be related to the occurrence of the disease. Different combinations of genetic defects of antioxidant enzyme are expected. This could readily provide an explanation of the heterogeneity of T1DM.The aim of this study is to assess the differences of GPX1 genotype in T1DM as compare with controls. And the effect of C/T at nucleotide 1050450codon 198 of GPX1 gene polymorphisms on serum glutathione peroxidase (GPX) and telomerase enzyme (TE) concentration in T1DM patients and controls. This study included (108) persons, their ages between (28 - 42 years) and body mass index in normal and overweight (68) of them were uncontrolled diabetes type 1 (HbA1c ? 6.5 %), (34) of them were male patients (M group), the other (34) were female patients (F group), and the other (40) apparently healthy as control group (20) male (MC group) with (20) female (FC group). The sera sample of all groups were used to measure the concentration of fasting blood glucose by using colorimetric methods and ELISA method for determination (TE), total antioxidant capacity (TAO - C), glutathione (GSH), and glutathione peroxidase1 enzyme, while whole blood samples from study subjects were used to measure HbA1c and extract DNA for the study of polymorphisms in GPx1 gene.The results of the present study showed1 - A significant increase in glucose, HbA1c in both male and female patients compared with controls group. (P < 0.0001) and (p< 0.05) respectively.2 - The study showed significant decrease (p? 0.001) in telomerase enzyme in both M and F as compare with MC and FC groups,3 - There was no significant association between M and F (P=0.106) and between MC and FC (P=0.327) regarding to gender.4 - The result showed that telomerase concentration significantly decrease with age (p - value<0.001) which indicated by negative correlation between telomerase concentration and age.5 - The result showed significant negative correlation between telomerase enzyme concentration and BMI in patients and controls.6 - The result showed significant decrease in TAO - C in patient as compared with control groups (P=<0.001)7 - GPX1 concentration significantly decreased in patient as compared with control groups (p - value <0.001 )8 - Significant increase in Glutathione concentration in patients as compared with controls (p - value <0.05)9 - Data on the genetic patterns were analyzed using polymerase chain reaction technique - RFLP revealed, were defined as : the codon 198 of Gpx1 genotyping have the homozygous wild - type (CC) Pro/Pro, the homozygous mutant (TT) Leu/Leu, and heterozygous (CT) Pro/Leu allele. There was significant difference between genotype distribution and frequency of alleles between the two groups of patients (M and F) versus (MC and FC) (odds ratio = 33, into confidence level of 95% : 1.65 to 656.26) and P value ( 0.0219) for M vs. MC, and (OR = 12.60, into the proportion of 95% confidence level : 1.93 to 82.08) and P value (0.0081) for F vs. FC. Also, the frequency of TT genotypes in GPX1gene in male and female were47% and 61.7% compare to control male(0%) and female(10%).10 - The allele frequency showed significant differences in all sample (p=0.0013), in male (0.14) and in female (0.0020).11 - There was significant difference in telomerase concentration (p= 0.001) and in glutathione peroxidase concentration (p< 0.0005) in patients group depending on different of the GPX1 genotyping.12 - Depending on GPX1 genotype there were significant differences in BMI in normal weight and in overweight between patient and control (p=0.0375) and (p<0.0018), respectively.In Conclusion, the TT genotype of The GPX1gene variants Pro 198 Leu may be risk factor to T1DM patients. TIDM significantly associated with glutathione peroxidase and telomerase level in patients with TT genotypes of GPX1 gene compared to those with CT and CC genotypes, and this may be considered as a risk factor for senescence and mortality in T1DM. patients, also there is significant negative correlation between telomerase enzyme and BMI in patients and controls.

التغيرات الحاصلة في نسب الانسولين والاحماض الصفراء والكوليسترول 7 الفا هيدروكسليز وفوق الاكسيد الفائق في مصل مرضى حصى المراره Serum Insulin, Bile Acid, Cholesterol 7 - Alpha Hydroxylase And Superoxide Dismutase Changes In Patients With Gallstone

اسم المؤلف: سماح سجاد كاظم الشمري
اسم المشرف: محمد عبيد المحمدي علي خير الله الشاعلي
الموضوع العام: الطب
السنة: 2017
الموضوع الدقيق: الفسلجة
الدرجة: ماجستير
اللغة: الانكليزية
مكان الجامعة: بابل
الصفحات الاولى:
المستخلص: يعتبر مرض حصى المرارةمن اكثر امراض الجهاز الهضمي شيوعا، ووتشكل عبئا كبيرا على انظمة الرعاية الصحية. معظم الناس (حوالي 80 ?) مع حصى المرارة ليس لديهم اعراض. وتشمل مضاعفات حصى المرارة التهاب المرارة والبنكرياس.الهدف من الدراسة : 1 - للتحقيق في العلاقة بين | A gallstone is a stone formed within the gallbladder out of bile components. Cholelithiasis or Gallstone disease (GD) is one of the most prevalent gastrointestinal diseases, with a substantial burden to health care systems. Most people (about 80%) with gallstones are asymptomatic. Complications of gallstones include inflammation of the gallbladder, pancreas. Objective 1. To investigate the association between serum level bile acid and cholesterol 7 - alpha hydroxylase and the development of gallstone disease. 2. To Evaluate the change serum level insulin changes and its effect on gallstone formation. 3. The determination of serum superoxide dismutase changes in patients with gallstone. Material and Methods In this study, one hundred sixty (160) patients with gallstone aged (20 - 70) years and one hundred sixty (160) age and sex match subject (control group) had involved in this study. The patients were intended to undergo surgical removal of gallbladder in Al - Hilla general teaching hospital during the period from November (2015) to May (2016). Blood samples were obtained from all patients prior to surgical treatment. Serum was obtained by usual methods and analyzed for insulin, insulin resistance Cholesterol 7 - alpha hydroxylase, Superoxide Dismutase, Bile acid (Deoxycholic acid and Chenodeoxycholic acid) and lipid profile {total cholesterol, triglyceride, high density lipoprotein - cholesterol and low density lipoprotein cholesterol}. And qualitative analysis of gallstone (Cholesterol stone, mixed stone, pigment stone), then these parameters compared with those of control groups. In addition, a demographic comparison regarding to the age, sex and body mass index between the patients and control groups was carried. Results The results of this study show higher significant percentage of gall stone in female (81%) than male (19%) in the patient group. There was an insignificant difference between male and female patients, according to age group (P<0.05). There is a higher significant (p>0.05) family history in the patients with gallstone compared with control subjects. Additionally, There is highly significant percent of female using oral contraception in pateints than control group (p > 0.01). Similarly, smoking, parity,Type 2 diabetes mellitus and Body Mass Index are found to be significantly higher inpatient group (p>0.01). This study demonstrate that insulin and insulin resistance are significant higher in sera of patients with gallstone as compared with the control group. (p>0.01) Regarding the cholesterol 7 - alpha hydroxylase, superoxide dismutase and Bile acids are found to be significantlylower in sera of patients with gallstone as compared with the control group, p< 0.01). It has also found that there are a higher significant difference in gallstone patients than control regarding total cholesterol, triglyceride, high density lipoprotein - cholesterol and low density lipoprotein cholesterol levels were significantly higher than that of control group (p>0.01). Meanwhile, all these parameters in the study are variated according to gender. However The qualitative analysis of stone that show cholesterol stone is more common than other types.Conclusions In this study the most studied parameters including of Insulin and insulin resistance, cholesterol 7 - alpha hydroxylase, superoxide dismutase and Bile acids, cholesterol, triglyceride, high density lipoprotein - cholesterol and low density lipoprotein cholesterol are significantly different in gallstone patients compared to control subjects and such differences are demographically affected depending on the age, sex, BMI, parity, contraceptive and smoking.