عرض: 25 50 75 100 النتائج

نتائج البحث: 25 من أصل 2,001

نسبة حدوث النزف بعد الولادة في حالات الولادات الطبيعية, الاصطناعية, القيصرية الطارئة والغير طارئة في مستشفى الزهراء التعليمي لسنه 2015 == The Incidence Of Postpartum Hemorrhage After Spontaneous And Induced Vaginal Delivery Versus Elective And Emergency Caesarian Section At Al - Zahraa Teaching Hospital In 2015

اسم المؤلف: اسراء علي عباس
اسم المشرف: ازهار موسى الطريحي
الموضوع العام: الطب
السنة: 2015
الموضوع الدقيق: النسائية والتوليد
الدرجة: دبلوم عالي
اللغة: الانكليزية
مكان الجامعة: النجف
الكلمات الدلالية:
  • حدوث النزف بعد الولاده في حالات الولادات الطبيعيه
  • الاصطناعيه
  • القيصريهالطارئه والغير طارئه في مستشفى الزهراء التعليمي لسنه
الصفحات الاولى:
المستخلص: خلال هذا البحث تم رصد حدوث النزف المهبلي بعد الولاده ومقارنته بين اربع مجاميع من المريضات اللاتي دخلن الى مستشفى الزهراء التعليمي من فتره الثاني من اذار الى الثاني من اب وكان عدد المريضات 9674 مريضه وكان عدد الولادات الطبيعيه 6137 منها 1352 كان عن طريق تح | The labour records of the patients admitted to the labour word and obstetrics word and theater in Al Zahra teaching hospital (9674 patients) during period of 5 months from 2nd of March to the 2nd of August, consequence study to compare the incidence of postpartum haemorrhage after : 1 - Spontaneous labour2 - Induced labour 3 - Elective caesarian section4 - Emergency caesarian sectionObjective : To compare the incidence of haemorrhage and risk factors among certain group of patients and to discover which group is more liable to develop PPH.Study design : Cross sectional studyMethodology : Estimating the blood loss for assessment of PPH by gravimetric method and collection of soaked packs method, evaluate the severity of bleeding and put the women in the proper PPH category to do the proper management plans.Finding and conclusion : The finding of our research is the incidence of PPH is 1.64% among all types of labour (159 patients had PPH during this period) and the main risk factor for PPH in study is the primigravidas in induced or augmented labour.Practical implication : These finding indicate that PPH is another complication of induction that needed to be taken into account when induction in being considered

دراسة مستوى الهيبسيدين ومستقبلات الترانسفرين في عينات من المرضى العراقيين المصابين بحالات فقر دم نقص الحديد واضطرابات زيادة الحديد في الدم == Study Of Hepcidin Level And Transferrin Level In Samples Of Iraqi Patients With Iron Overload And Iron Deficiency Disorders

اسم المؤلف: داليا نايف جاسم
اسم المشرف: علاء الدين مظفر زبير القاسم
الموضوع العام: الطب
السنة: 2015
الموضوع الدقيق: الامراض - الدم
الدرجة: ماجستير
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: The circulating peptide hepcidin is secreted mainly by the liver as an 84 - amino acid precursor that is subsequently processed and secreted as a 25 - amino acid peptide form. It is considered the "master regulator" of iron metabolism.Transferrin receptor is a carrier protein for transferrin. It is needed for the import of iron into the cell and is regulated in response to intracellular iron concentration. It imports iron by internalizing the transferrin - iron complex through receptor - mediated endocytosis. This study addresses the physiological role of hepcidin in vivo and investigates the role of hepcidin as an erythroid regulator, contributing to the modulation of iron absorption by the intestine and iron release by the macrophages in the situation of anemia with normal or increased iron stores. Measuring the transferrin receptor level and it's relation to hepcidin is another part of the data involved in this study.Methods : This study included 64 Iraqi patients, 34 of them have iron deficiency anemia and the other 30 are iron overload patients. They attended the National Center of Hematology and Thalassemia center in Al - Karama Teaching Hospital during the period from October 2014 until April 2015 together with 30 healthy controls. Information regarding age, sex and clinical presentation were recorded. ELISA technique used to measure hepcidin and transferrin receptors level in patients and healthy control groups.Results : ? Mean serum hepcidin level in iron deficiency anemia patients was (205.3ng/ml) while in iron overload patients was (6.7ng/ml).? Mean serum level of transferrin receptors in iron deficiency anemia was (11006.3ng/ml) and in iron overload was (604.5ng/ml).Conclusion : ? The mean level of serum hepcidin in thirty iron deficiency anemia patients is high. Its elevation represented an acute phase response. While in thirty patients with iron overload, hepcidin mean level was low mainly due to stress erythropoiesis.? The current study result addresses the usefulness of soluble transferrin receptor for assessing high iron status in population and how soluble transferrin receptor is useful in the evaluation of anemic patients.

العلاقة بين تجارب الطفولة السيئة والمطاوعة على الصحة بعد البلوغ في بغداد == The Relationship Of Adverse Childhood Experiences And Resilience To Adult's Health In Baghdad City

اسم المؤلف: اميل فاروق الشاوي
اسم المشرف: رياض خضير لفتة | صالح الحسناوي
الموضوع العام: الطب
السنة: 2015
الموضوع الدقيق: طب المجتمع
الدرجة: دكتوراه
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: تجارب الطفولة السيئة تشير الى اكثر مصادر الاجهاد شيوعا وشدة التي يعاني منها الاطفال في حياتهم المبكرة. من هذه الخبرات الاساءة، الاهمال، العنف بين الابوين او مقدمي الرعاية والعنف المجتمعي. وتبين ان الاجهاد الطويل في الطفولة له اثار طيلة الحياة على صحة | Adverse Childhood Experiences refer to some of the most intensive and frequently occurring sources of stress that children may suffer early in life. Such experiences include multiple types of abuse; neglect; violence between parents or caregivers and community violence exposure. It has been shown that prolonged stress in childhood has life - long consequences for a person's health and well - being; it may lead to serious problems such as alcoholism, depression, eating disorders, heart diseases, cancer, and other chronic diseases. Resilience is the ability to manage crises, difficult situations and developmental tasks. Research on resilience has identified several factors that strengthen the power and resources of children as well as promote their abilities to cope successfully with crises and internal and external problems. This cross - sectional study was conducted to estimate the effect of adverse childhood experiences and resilient factors on adults’ heath. It was done during the period from January 2013 through January 2014. The study sample was drawn from Baghdad City. Multistage sampling technique was used to choose 13 primary health care centers and eight colleges from three universities in Baghdad; the questionnaire was filled through a direct interview with the participants. In addition to that, teachers of seven primary schools and two secondary schools were chosen by a convenient method. A total of 1040 subjects were surveyed and 1000 responded. Their age ranged between 18 to 59 years (32.08±11.169). Females constituted a higher proportion (58.3%) of the study sample, 60% of this sample had university/diploma as the highest level of education. The results showed (during childhood) that seeing or hearing a parent or household member in home being yelled at, screamed at, sworn at, insulted or humiliated was reported in 469 (46.9%). A parent, guardian or other household member yelled, screamed or swear at, insulted or humiliated them was registered in 387 (38.7%). A parent, guardian or other household member spanked, slapped, kicked, punched the subjects was seen in 335 (33.5%). father's death (when the subject's age was 15 years or less) was reported in 104 (10.4%) of the participants, and 74.8 % of the subjects like to be the kind of people their parents were. The multiple linear regression models demonstrated that being in the fourth quartile (highest quartile) of household dysfunction - abuse score is expected to significantly increase depression symptoms score by a mean of (10.4) compared to subjects in the lowest (first quartile) of household dysfunction - abuse score, being in the fourth quartile of family bonding score is expected to significantly decrease depression symptoms score by a mean of ( - 22.5) compared to subjects in the first quartile, the same is correct for self - esteem score which increases by a mean of (21.484) for the fourth quartile of family bonding score compared to subjects with lowest (first quartile) after adjusting other explanatory variables. Logistic regression model showed that being in a higher level of family bonding (fourth quartile) is expected to reduce the risk of having chronic physical diseases by almost the half (odds ratio =0.57) and being exposed to a high level of household dysfunction and abuse (fourth quartile) is expected to increase the risk of having chronic physical diseases by 81%. A positive history of suicidal attempts showed a strong positive association with mean score of household dysfunction and abuse. Family bonding during childhood appears to be the most important resilient factor that protects adults against sedative or narcotic usage, mental disorders, suicide attempts, and chronic physical diseases during adulthood. Higher levels of exposure to adverse childhood experiences have a positive association with substances usage, suicide attempts, symptoms of mental disorders and chronic physical diseases in adulthood.

التغيرات الكيما حيوية في مصل الدم لتراكيز الهيبسيدين والانترلوكين - 6 نسبة لحالة الحديد قبل وبعد العلاج الكيميائي عند المرضى البالغين المصابين بسرطان الدم النيقاني الحاد == Biochemical Changes In Hepcidin And IL - 6 Concentrations Relative To Iron Status In Patients With Acute Myeloid Leukemia Before And After Treatment

اسم المؤلف: هبة عمار محمد
اسم المشرف: ختام عبد الوهاب علي | علاء فاضل علوان
الموضوع العام: الطب
السنة: 2015
الدرجة: ماجستير
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: هدف الدراسة : لتعيين العلاقة بين هرمون الهبيسيدين (hepcidin) (الهرمون المنظم لتوازن الحديد في الجسم والانترلوكين - 6 ( (interlukin - 6و علاقتها ببعض المتغيرات الكيميائية الحياتية عند المرضى المصابين بابيضاض الدم النيقاني الحاد ((AML قبل وبعد اكمال الجرعة الك | Acute myeloid leukemia (AML) is a clonal, malignant disease of hematopoietic tissues characterized by the accumulation of abnormal blast cells, especially in bone marrow, and impaired production of normal blood cells. The statistics show that this disease in men is more prevalent than women and this type of leukemia is increasing with age. Objectives : To assess biochemical changes related to iron status in acute myeloid leukemia pre and post course of chemotherapy and evaluate a relationship between serum hepcidin and IL - 6 in patients with acute myeloid leukemia pre and post chemotherapy and compare their levels to controls and their contribution on the pathogenesis of AML.Patients, Materials and Methods : The present study conducted at the National Center of Hematology and Baghdad Teaching Hospital in the Medical City from February 2014 to June 2014.The study included Fifty - eight (58) patients (30 male and 28 female) diagnosed with acute myeloid leukemia the age of patients range (15 - 65 years). Forty three (43)patients continued the study (24 male and 19 female) divided into two groups : Group (1) Patients with AML before starting chemotherapy. Group (2) the patients after 4 weeks of chemotherapy. Patient's treatment was done according to international protocol used in acute myeloid leukemia and called (3+7) where Doxorubicin was given from the first day to third day and Cyatrabine (Ara - C) was given from the first day to seventh day.Evaluationwas done on day (28) from starting chemotherapy to assess response of patients through bone marrow aspiration.All patients were subjected to complete history and physical examination. Diagnosis of AML patients was established by complete blood count and blood film, bone morrow aspiration and biopsy, hepcidin, interlukine - 6, C - reactive protein, ferritin, iron, total iron binding capacity, alkaline phosphstase, direct bilirubin were done for all patients.Forty - three (43) healthy subjects (24 male and 19 female) were enrolled in the study mainly from medical staff and their families. They were age and sex matched to patients group and considered as controls as ( Group 3).Results : • Serum hipcidin levels were significantly higher in(AML)patients (Group 2) compared to newly diagnosed(Group 1) and to healthy subjects ( P<0.0001).• Serum (IL - 6) levels were higher but not significant in(Group 1) compared to (Group 2) and significantly with healthy controls(P<0.214 and P<0.0001 respectively).• A significant increase in mean of serum ferritin levels were observed in (Group 2) compared to newly diagnosed patients (Group 1)(P<0.002) and the levels were significantly higher in newly diagnosed group compared to healthy controls (P<0.015).• Patients with (AML) during remission show significant decrease in levels of iron compared to newly diagnosed group(P<0.0001),while levels in healthy controls was higher values than both (Group 2) and (Group 1) (P<0.0001).• Total iron binding capacity (TIBC ) levels showed a significant decrease in (Group 2) after treatment compared to (Group 1) before treatment(P<0.0001) but the levels were significantly higher in healthy controls compared to (Group 1) and (Group 2) (P<0.0001).• Mean serum ALP levels showed highly increase in (Group 2) patients when compared to patients before treatment (Group 1)( P<0.0001), but the difference is not significantly higher between the newly diagnosis and controls (P<0.687).• A significant increase in mean serum direct bilirubin levels were observed in (Group 2) patients when compared to (Group 1) and healthy controls(P<0.0001).• Regarded to CRP levels in AML patients before and after treatment, the CRP levels increased in AML patients after treatment than newly diagnosed AML patients.Conclusions : Hepcidin and Interlukin - 6 may be used asprognostic for acute myeloid leukemia and also can play an important role in pathogenesis of AML.

تقييم نسبة الاديبونيكتين والانترلوكين - 6 واضداد البروتين الستروليني في مصل الدم وتركيب الجسم مع الكثافة الكتلوية للعظم لدى المرضى المصابين بالفصال العظمي العقدي == Evaluation Of Serum Adiponectin , Interleukin - 6 , Anti - Cyclic Citrulinated Peptide And Body Mass Index With Bone Mineral Density In Nodal Osteoarthritis Patients

اسم المؤلف: مصطفى سالم خلف
اسم المشرف: عدنان فاضل النجار | عباس طعمة جودة الخزاعي
الموضوع العام: الطب
السنة: 2015
الدرجة: ماجستير
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: الفصا العظمي العقدي هو واحد من انواع التهاب المفاصل الموضعي. هو مرض المفصل التنكسي او الانحلالي, ويشمل الغضروف المفصلي والعظم تحت الغضروف, وهو يعتبر نوع من انواع امراض المناعة الذاتية. السبب الرئيسي للفصال العظمي العقدي غير معروف لكن هناك اسباب متنوعة مثل | Nodal osteoarthritis (NOA) is one type of the localised osteoarthritis that mostly occurs with postmenopausal women. It is degenerative joint disease, including articular cartilage and subchondral bone, it consider type of autoimmune diseases. The main cause of NOA is unknown but there are variety of causes like hereditary and metabolic, may initiate processes leading to loss of cartilage. The cartilage loss process usually lead to induce the immune system to release many of immune factors like cytokines , these factors lead to generation of immune response and inflammation in the joint. The NOA mostly occurs with postmenopausal women. It affects the smaller joint. Over several years, firm knobbly swellings form on the finger joints. These are caused by osteophytes so lead to bony enlargement and are known as Heberden's nodes when they are at the end joints of fingers (distal interphalangeal joints) or Bouchard's nodes when they are at the mid - finger joints (proximal interphalangeal joints). Once the nodes are fully formed, and not necessarily painful, they do limit the movement of the fingers significantly. NOA leads to the formation of bunions, rendering them red or swollen. Some people notice these physical changes before they experience any pain, but in advance cases, many of Symptoms may include like joint pain, stiffness and sometimes an effusion. When bone surfaces become less well protected by cartilage, bone may be exposed and damaged. As a result of decreased movement secondary to pain, regional muscles may atrophy, and ligaments may become more lax.Many studies have been done about inflammatory and biochemical markers in NOA and they found conflicting results. Objective1 - To evaluate serum adiponectin , interleukin - 6 (IL - 6) , anti cyclic citrullinated peptide (ACCP) and bone mineral density (BMD) in NOA.2 - To asses the CRP , RF and ESR in NOA.3 - To asses effect of age , gender , effect of BMI , smoking habit and duration of disease in NOA.Material and Method This study performed during the period from November 2013 to February 2014. These subjects were selected from patients attending the Rheumatology & Rehabilitation Consultation Unit at Al - Yarmouk Teaching Hospital. Patients and controls with hypertension, diabetes mellitus, malignancy, chronic disease of kidney, liver and any patients taken drugs that might effect the results have been excluded from the study.The laboratory tests were done in Al - Yarmouk teaching hospital laboratories and the laboratory research unit in collage of medicine / department of medical biochemistry. Subjects80 subjects (60 patients & 20 healthy controls) were enrolled in this study : A. First group : Patients with Nodal Osteoarthritis (NOA), No. = 60 (female =49 & male =11), rang of age (40 - 88) years.B. Second group : Healthy control group who had no history or clinical evidence of NOA or any other chronic disease like hypertension, DM and other chronic disease that might effect on the study data, No. 20 (female = 15 & male =5 ), rang of age (48 - 82) years.The patients were diagnosed as NOA according to the 2013 American College of Rheumatology (ACR) criteria, also the patients were diagnosed as normal, osteopenia and osteoporosis according to the 2013 American College of Rheumatology (ACR) criteria by measured of BMD (T - score) Normal : T - score (more than or equal - 1), Osteopenia : T - score ( - 1.1 - - 2.5) and Osteoporosis : T - score (less than - 2.5). The patients BMI were measured and determined as Normal (18 - 24.9 kg/m2), Over weight (24.9 - 29.9 Kg/m2), Obese grade - I (29.9 - 34.9 kg/m2) and Obese grade - II (more than 34.9 kg/m2) according to WHO 2012.MethodsELISA technique was used for the determination of serum adiponectin, IL - 6 and ACCP. Measurement of serum uric acid was done by spectrophotometric instrument. qualitative serological tests were used for determination of the CRP and RF also ESR determination were done in hospital laboratory. The BMI was determined by WHO equation's (2012) (weight/ (length) 2), also the BMD was determined by DXA scan according to ACR limits.Results obtained were subjected to statistical analysis by using SPSS and Excel program.ResultsLevels of serum adiponectin, IL - 6, CRP, ESR and BMI were significantly increased in NOA patients most than healthy controls, also the BMD (T - score) significantly decreased in NOA patients than healthy controls. But the age, gender, serum ACCP and uric acid were not significantly changed in NOA patients compared with healthy controls. Study of age, gende , BMI and duration of disease, found that they did not effect any parameters studied in NOA patients, only serum ACCP level was found to be significantly increased in females than males. Serum adiponectin level and CRP were significantly increased more in osteoporosis than osteopenia and normal. CRP was significantly increased in smoker than non smoker NOA patients.This study showed negative correlation between serum adiponectin and BMD, positive correlation between serum adiponectin and ESR, serum adiponctin and IL - 6 and IL - 6 and ESR in NOA patients. This study illustrated change in the status of the inflammatory markers like adiponectin, IL - 6 and other parameters in NOA disease. It illustrated effect of some of the factors like age, gender, BMI, BMD, smoking habit and duration of disease on development of NOA disease and on the status of the parameters studied. Also this study illustrated some correlation between the parameters in NOA patients.

المرضى المصابين بالمتلازمة الشريانية الحاد Vaspin and Omentin - 1 : تقييم مستويات == Evaluation Of Serum Vaspin And Omentin - 1 Levels In Patients With Acute Coronary Syndrome

اسم المؤلف: مشتاق عبد هنيدي الطائي
اسم المشرف: ولاء احمد الجدة | عباس ناجي الشريفي
الموضوع العام: الطب
السنة: 2015
الدرجة: ماجستير
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: Acute coronary syndrome (ACS) is an insufficient supply of the myocardium with oxygenated blood in which atherosclerosis is an essential cause of myocardial ischemia. Adipokine biomarkers plays an essential role in the atherosclerosis and hence coronary artery disease. Serum Vaspin, Omentin - 1 and troponin I Fast are the biomarkers that believed to be independently associated with acute coronary syndrome.Objective : The study was carried out to evaluate : serum Vaspin,Omentin - 1 and Troponin I Fast in patients with acute coronary syndrome [ST - Elevation Myocardial Infarction(STEMI), Non - ST - segment Elevation Myocardial Infarction (NSTEMI),and Unstable Angina pectoris (UA)], that may help in guiding the diagnosis and treatment.Subjects, Materials and Methods : The study include a total (100) individuals; (75) patients with acute coronary syndrome (ACS) and (25) healthy control.A total number of 75 patients with acute coronary syndrome (ACS) (50 male ,25 female ) as : 25 patients with STEMI (22 male and 3 female) 25 patients NSTEMI(16 male and 9 female ) and 25 patients with unstable angina UA(12 male and13 female)were enrolled in this study all taken from Coronary Care Unit (CCU)at AL - Yarmouk Teaching Hospital.Each patient was clinically examined by the consultant cardiologist and the diagnosis was achieved by electrocardiograph (ECG), and cardiac enzyme levels.Venous blood sample (ten milliliters) was drawn from each patient and control after (10 - 12) hours overnight fasting, using a 10 ml disposable syringe between 9.00 and 11.00 A.M.The sample was divided into two portions one for testing Hb concentration and the other part was centrifuged to obtain serum, to be used for measuring the following variables : serum vaspin, serum omentin - 1 and Troponin I Fast, total cholesterol, triglyceride, High density lipoprotein cholesterol and low - density lipoprotein cholesterol, fasting blood sugar, serum creatinine and uric acid.Body mass index was calculated according to the following equation : BMI=weight/height2, also blood pressure was measured.Results : Serum vaspin and omentin - 1 levels were significantly lower in patients groups in comparison with control group, while serum Troponin I fast, total cholesterol, and low density lipoprotein cholesterol levels were significantly higher in patients with coronary artery disease than controls. Negatively significant correlation was found between serum vaspin and omentin - 1 with (BMI, total cholesterol and troponin I Fast).Conclusion : Serum Vaspin and Omentin - 1 levels were lower in acute coronary syndrome patients in comparison with control group, serum vaspin and omentin - 1 showed significant changes with the development and progression of acute coronary syndrome and would be valuable in the assessment of patients with acute coronary syndrome.Vaspin and Omentin - 1 may be used as a predictor of ACS.

دور الهرمون مثبت الكالسيوم (الاوستيوكالسين) والهرمون شبيه الانسولين IGF - 1 في مصل الدم على هشاشة العظام لدى المصابات بداء السكري بعد سن الياس == The Role Of Osteocalcin And Insulin Like Growth Factor 1 (IGF - 1) On Osteoporosis In Diabetic Postmenopausal Women

اسم المؤلف: حيدر رضا محمد سعيد
اسم المشرف: نهلة مجيد الصقال | عبد الكريم يحيى السامرائي
الموضوع العام: الطب
السنة: 2015
الدرجة: ماجستير
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: Osteoporosis is a systemic disease of the skeleton that characterized by low bone mass and alteration in micro - architecture of bone tissue, which leads to an increase in brittleness with the ensuing predisposition of bone fracture. Global statistics show that women are more exposed to this disease than men and in particular at menopause. Like osteoporosis, type 2 diabetes mellitus (T2DM) is also greatly related to aging populations, and causes substantial morbidity and in some cases mortality. Diabetes mellitus could affect skeletal system and bone metabolism through multiple pathways and it has been considered as a major risk factor of osteoporosis.Objective : The aim of the study is to evaluate the usefulness of osteocalcin (OC), insulin - like growth factor I (IGF - 1) and bone mineral density (BMD) in postmenopausal women with type2 diabetes mellitus with or without osteoporosis and to compare the results of them with that of healthy control, in addition on studying role in the pathochemistry of osteoporosis and their validation as biomarkers of osteoporosis.Subjects & Methods : The study was performed during December 2013 to April 2014. Subjects were selected from outpatients attended National Diabetic Center (NDC)/ AL - Mustansiriyhiah University.Eighty - six (86) postmenopausal women aging (50 - 72) were included in this study. Subjects were divided into three group (I) included (25) healthy postmenopausal women without osteoporosis and diabetes mellitus (controls), Group (II) included (30) diabetic postmenopausal women without osteoporosis, Group (III) included (31) diabetic postmenopausal women with osteoporosis.Osteoporosis was diagnosed by measuring bone mineral density (BMD) by Dual energy X - ray absorptiometry (DXA). Also the levels of Fasting blood glucose (FBG), Calcium and phosphorus alkaline phosphatase (ALP) by spectrophotometer were measured in addition to measuring HbA1c level by NycoCard device using boronate assay affinity. While serum osteocalcin was measured using (ELISA) technique and IGF - 1 was measured using immunoradiometric assay. patients with malignant diseases, hyperthyroidism, hyperparathyroidism, osteomalacia, renal and hepatic diseases were excluded in addition to patients with chronic treatment with antiacids, estrogen, adrenal or anabolic steroids, anticonvulsants and anti - coagulants. Meanwhile, we ensured that all patients are not alcohol addiction and not smokers (passive & active).ResultsBone mineral density (BMD) was lower significantly in diabetic type II postmenopausal women with osteoporosis compared to diabetic type II postmenopausal women without osteoporosis and control group (0.68±0.04 g/cm2) , ( 0.87±0.03 g/cm2) , (0.89 ± 0.04 g/cm2), (P<0.001) respectively.The mean serum OC was lower significantly in diabetic type II postmenopausal women with osteoporosis group compared to diabetic type II postmenopausal women without osteoporosis group and control group (22.3±5.92 ng/ml), (27.2±5.96ng/ml), (27.3 ±3.49ng/ml) (P<0.001) respectively. Also the mean serum IGF - 1 was lower significantly in diabetic type II postmenopausal women with osteoporosis group compared to diabetic type II postmenopausal women without osteoporosis group and control group (46.6±8.41ng/ml), (65±8.48ng/ml), (88.2 ± 9.91ng/ml) (P<0.001) respectively.The mean of Fasting Blood Glucose was higher significantly in diabetic type II postmenopausal women with osteoporosis group compared to diabetic type II postmenopausal women without osteoporosis group, and control group (204.4±15.29 mg/dl), (187.2±13.45 mg/dl) , (93 ± 7.79 mg/dl) (P<0.001) respectively.The mean HbA1c was higher significantly in diabetic type II postmenopausal women with osteoporosis group compared to diabetic type II postmenopausal women without osteoporosis group, and control group (8±0.5), (7.5±0.53), (5.2 ± 0.33), (P<0.001) respectively.Also results showed no significant change in levels of calcium, phosphorus and alkaline phosphatase in the serum of diabetic type II postmenopausal women with osteoporosis group, compared to diabetic type II postmenopausal women without osteoporosis group and control group.There was a significant positively correlation between BMD with serum osteocalcin (r=0.43, P<0.001) and a strong positively significant correlation between BMD with serum IGF - 1(r=0.706, P<0.001). Also there was a significant negative correlation between BMD with HbA1c ( r= - 0.339, P=0.001), FBG(r= - 0.457, P<0.005) and Age (r= - 0.466, P<0.001).Also there was a positively significant correlation between serum osteocalcin with IGF - 1 (r= 0.34,p=0.007) and serum osteocalcin with BMD (r=0.43, P<0.001).Simultaneously there was a positively significant correlation between serum IGF - 1 and ostocalcin (r=0.34,p=0.007) and a positively significant correlation between serum IGF - 1 and BMD( (r=0.706, P<0.001). Also there was a negatively significant correlation between serum IGF - 1 with HbA1c (r= - 0.332,p=0.009), FBG(r= - 0.345,p=0.005) and Age (r= - 0.496, P<0.001).Conculsion Assessing the circulating levels of osteocalin and IGF - 1 may provide very useful information to diagnose or predict osteoporosis in Type 2 diabetic postmenopausal women.

دور ال Inhibin - B,FSH وهرمون التستيستيرون في الذكور المصابين بالعقم == Role Of INHIBIN - B Hormone, Follicular Stimulating Hormone, And Testosterone In Infertile Men

اسم المؤلف: احمد عبد الرحيم ابراهيم ضاحي
اسم المشرف: شذى الخطيب | صباح مهدي حسين
الموضوع العام: الطب
السنة: 2015
الدرجة: ماجستير
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: تقييم مستوى هرمون الانهبين.ب. وهرمون المحفز للجريب والتيستوستيرون واللوتيني وهرمون الحليب والاستراديول في مصل والسائل المنوي للاشخاص العقيمين ومعرفة ايهم فائدة اكثر للتشخيص المبكر للعقم بعد مقارنة النتائج مع الاشخاص الاصحاء.المكانوقد اجريت هذه الدراسة خ

قياس وتفسير وامكانية الاستخدام السريري لتشتت فترات QT والمعلمات لتخطيط صدى القلب في مرضى مرض القلب الاقفاري == Measurement, Interpretation, And Use Of Clinical Potential Of QT Dispersion And Intervals With Echocardiographic Parameters In Patients With Ischemic Heart Disease

اسم المؤلف: فراس عبد الودود عبد العزيز
اسم المشرف: تقي علي موسى الموسوي الواجدي | بسام طالب فائق الكيلاني
الموضوع العام: الطب
السنة: 2015
الموضوع الدقيق: الفيزياء الطبية
الدرجة: دكتوراه
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: اجري تخطيط القلب الكهربائي واخذت نتائج فحص الايكو لاربعة وخمسون مريض (اناث وذكور)، عمرهم المتوسط كان 51,1 ± 6,7 سنة؛ المدى كان يتراوح بين 35 - 66 سنة. المرضى الذي جندوا في الدراسة الحالية صنفوا الى اربع مجموعات : مرضى القلب الاقفاري الشرايين التاجية لوحده | ECG traces were recorded and echo findings were obtained for 54 patient (females were 15 and males were 39), their mean age was 51.1 ± 6.7 years; the range was 35 - 66 years. Patients that were recruited in the present study were classified into four groups : Patients with Ischemic Heart Disease (IHD) alone were labeled as group 1, Patients with IHD and Hypertension (HT) were labeled as group 2, Patients with IHD and diabetes mellitus (DM) were labeled as group 3, and Patients with IHD, HT, and DM were labeled as group 4. Fourteen age - matched apparently healthy subjects (mean age 48.6 ± 4.0 years) were chosen for comparison with group 1 patients. Patients' ECGs didn't show clear IHD before Treadmill test. Patients who showed clear ischemic changes within the treadmill test or during the rest time after completion of the treadmill test were sent to echo unit for structural / functional assessment of their hearts. Before stress test, simultaneous resting 12 lead ECG, arterial blood pressure, heart rate, height and weight of the patients were measured, age were recorded, smoking habit, and history of any cardiovascular disease. QT (The time interval measured from Q - wave onset the end of the T - wave), QT peak (The time interval measured from the Q - wave onset to the peak of the T - wave), TpTe (The time interval measured from the peak to the end of the T - wave)intervals were measured manually by tangent method on resting ECG. The dispersion of QT, QTp, TpTe intervals determined by the difference between minimal and maximal of these above measured intervals within 12 leads. The measured QT intervals were corrected for the subject's heart rate by using the standard Bazett's formula. In comparison with healthy subjects, QT dispersion (QTd) and QT peak dispersion (QTpd) of patients in group 1 were significantly higher (by 29% and 25% respectively) relative to their counterpart dispersion of healthy subjects, Tpeak - Tend dispersion (TpTed) of patients in group 1 was significant lower by 57% than TpTed of healthy subjects, QT interval and QTp interval of patients in group 1 was significantly longer (by 5% and 18% respectively) relative to their counterpart intervals of healthy subjects, in contrast, TpTe interval of patients in group 1 was significantly lower (by 27%) relative to their counterpart in healthy subjects. QT - intervals of patients in group 2, 3, and 4 are significantly higher (by 2%,4%, 3%) respectively than patients in group 1. QTp interval of group 3 was significantly higher than group 1, 2, and 4 by (4%, 6%, 4% respectively). No significant differences were observed in QTp interval among group 1, 2, and 4. TpTe interval of group 2, group 3, and group 4 patients were significantly longer by (16%, 6%, 14%) respectively relative to the TpTe interval in patients of group 1. QTd of patients in group 4 is significantly higher by (30%) than QTd of patients in group 1. QTp dispersion of group 4 is significantly higher by (26%) relative to QTp dispersion of group 1. TpTed of group 2 and group 4 were significantly higher (62% and 46% respectively) than TpTed of patients in group 1. LVMI of patients in group 2 and 4 were significantly higher (by 38% and 51% respectively) over the LVMI in patients of group 1. RWT of patients in group 2 and 4 were significantly higher (by 13% and 17% respectively) over the RWT of patients in group 1. PWT of patients in group 2, 3, and 4 was significantly higher (by 15%, 18%, and 21% respectively) over their PWT counterpart of patients in group 1. IVSTS was found to be significantly higher by (19% and 20%) of patients in group 2 and 4 respectively relative to patients in group 1. IVSTD was significantly higher by 24% in patients of group 4 only relative to the IVSTD of patients in group 1. IVSTS and IVSTD were significantly correlated with the QTd and QTpd in group 1. In group 2 patients RWT and PWT were significantly correlated with QTd and QTpd and IVSTD was significantly correlated with QT, QTp, and TpTe interval. In group 3 patients, IVSTD, ARD, and BMI were found to be significantly correlated with QTd and QTpd. significant correlation also was found in this group between RWT and QTp interval and IVSTS was correlated significantly with the QT and QTp intervals in group 4 patients.

الاختلال الانبساطي الوظيفي للبطين الايسر عند مرضى داء السكري من النوع الثاني == The Left Ventricular Diastolic Dysfunction In Asymptomatic Type 2 Diabetes Mellitus Patients

اسم المؤلف: الاء سعد عادل
اسم المشرف: اسماعيل ابراهيم حسين القرغولي | عباس ناجي مسلم الشريفي
الموضوع العام: الطب
السنة: 2015
الموضوع الدقيق: الطب
الدرجة: ماجستير
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: نسبة الاختلال الانبساطي الوظيفي للبطين الايسر عند مرضى داء السكري من النوع الثاني والكشف عنها بواسطة فحص الدوبلر النسيجي هدف الدراسة : للبحث عن نسبة الاختلال الانبساطي الوظيفي للبطين الايسر والذي يعد كعامل خطورة على وظائف القلب والاوعية الدموية عند مرضى | Our study about the left ventricular diastolic dysfunction in asymptomatic type 2 diabetic patients, detected by 2 - D and tissue Doppler echocardiography. Type 2 diabetes mellitus (T2DM) is the most common chronic disease, with several complications, affecting all systems and ages. The trends towards improving the longevity in diabetes are achieved by the glycemic control and prevention of complication. Left ventricular diastolic dysfunction (LVDDX) refers to mechanical abnormalities that impede effective volume filling during diastole. It has been described as an early sign of diabetic cardiomyopathy preceding the systolic damage. It can lead progressively to heart failure and is linked to increased mortality.Objective : The aim of this study is to estimate the percentage of left ventricular diastolic dysfunction in asymptomatic patients with type 2 diabetes mellitus detected by 2 - D and tissue Doppler echocardiography.Setting : This study is conducted by the department of physiology, college of medicine, Al - Mustansirirya university in cooperation with the unit of Echocardiography at Al - Yarmouk Teaching Hospital in Baghdad during the period from November 2013 to July 2014. Patients and methods : A total number of 130 subject were examined, where 38 were excluded and only 92 were included in this study, about 46 healthy subjects (control group) (with mean age of 47.07±7.6 year) and 46 patients with T2DM (with mean age of 49.39±5.7 year).Main outcome measures : The plan of the study consisted of the following steps : 1. History interview2. Physical examination3. Physical measurements including : body mass index (BMI), neck circumference (NC), waist circumference (WC), hip circumference (HC) , mid thigh circumference (MTC) calculation by measuring tape.4. Electrocardiography5. Conventional echocardiography and TDI6. Blood sample for hemoglobin A1C (HbA1c), fasting blood sugar (FBS), lipid profile.Results : Our study showed structural and functional changes in the left ventricle in a sample of diabetic patients. Diastolic dysfunction presents in 69.6% of diabetic patients, 41% were males and 59% were females. The mean age of the diabetic patients was 49±5.7 year. The mean duration of diabetes in asymptomatic normotensive type 2 diabetic patients was 7.6 ± 6.4 year. By TDI the diabetic patients in comparison to control group show lower E` average velocity (8.9±1.9 Vs 10.7±1.6 cm/sec)(P<0.0001), higher E/E` average ratio (7.4±1.7 Vs 6.4±1.3cm/sec) (P<0.04), lower E`/A` ratio (0.8±0.3 Vs 1.02±0.3)(P<0.004). While by conventional echo the diabetic patients show lower E velocity (63.7±13.4 Vs 72±19.9cm/sec) (P<0.01) and lower E/A ratio (0.9±0.3 Vs 1.17±0.4) (P<0.0001). Biochemical analysis show lower HDL (1.1±0.2mmol/l)(P<0.0001) and higher TG/HDL (1.8±1.4)(P=0.025). The study showed that diabetic patients had higher BMI 30.6±5.5 kg/m2 (P=0.052), higher neck circumference (40.4±3.9 cm) (P=0.034) and higher waist circumference (105.7±11.7 cm)(P<0.0001). All other values were not significant. Our study revealed that the highest percentage of LV diastolic dysfunction found in the group of diabetic patient with the highest duration of type 2 DM disease. The study revealed some correlations between some parameters of the study like : the duration of T2DM was positively correlated with A velocity (r= 0.29, p= 0.048), FBS was negatively correlated with A velocity (r= - 0.39, p= 0.008), FBS was negatively correlated with LVEDD (r= - 0.29, p= 0.049), FBS was negatively correlated with neck circumference (r= - 0.48, p= 0.0008), HDL was negatively correlated with IVS thickness (r= - 0.567, p= 0.00003) and mid - thigh circumference was positively correlated with A` average velocity (r= - 0.39, p= 0.008)Conclusion : 1. Type - 2 diabetes Mellitus is associated with a higher percentage of left ventricular diastolic dysfunction which is increased with the increased duration of DM. 2. Tissue Doppler echocardiography is a valuable tool in detecting LV diastolic dysfunction in asymptomatic normotensive diabetic patients with non significant features on conventional echocardiography.3. TDI is more sensitive and specific in detecting LV diastolic dysfunction in asymptomatic type 2 DM than pulsed wave flow Doppler.

دراسة تاثير اديبونكتين على هيكل كبد الفئران وعلاقته بالنظام الغذائي وكمية الدهون في الجسم == A Study Of Adiponectin Effects On The Mice Liver Architecture In Relation To Dietary Intake And Body Fat Content

اسم المؤلف: غسان علي عبد الحسین
اسم المشرف: سلمان شفیق سلمان | عماد غانم قاسم
الموضوع العام: الطب
السنة: 2015
الموضوع الدقيق: التشريح والانسجة والاجنة
الدرجة: دكتوراه
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: يعتبر مرض الكبد الدهني غير الكحولي الاضطراب المزمن الاكثر شيوعا في الكبد واصبح تشخيصه في ازدياد مع زيادة وباء السمنة العالمي وقد تم تصميم الدراسة الحالية لدراسة الفوائد المحتملة للاديبونيكتين على النماذج الحيوانية من مرض.تم تطوير نموذجين من اضطراب الكبد | Non - alcoholic fatty liver disease is the most common chronic liver disorder whose prevalence has been on the rise with the worldwide increasing pandemic of obesity. The current study was designed to study potential benefits of the adipokine (adiponectin) on animal models of non - alcoholic fatty liver disease.Two models of the disorder were developed using two different approaches. In experiment 1 (25 mice, last 8 weeks), fatty change was induced using high fructose intake to simulate human - like diet induced obesity and fatty liver disease. In experiment 2 (25 mice, last 3 weeks), fatty liver damage was induced by using methionine - choline deficient diet. Animal body weights, absolute and relative liver weight, food consumption and fructose water consumption were recorded. Visceral (epididymal) fat and liver tissue were studied using routine hematoxylin and eosin staining and histochemical stains including Masson trichrome, Periodic acid schiff and reticulin stains. Morphological and morphometric changes were compared between animals treated with adiponectin, untreated diseased animals, and control healthy animals and a non - alcoholic steatosis activity score was used to evaluate the severity of liver damage. Random blood sugar and serum lipid levels were also included as biochemical metabolic parameters.High fructose intake resulted in larger visceral fat depots and weight gain, effects that were combated by adiponectin treatment despite increased food intake. Hepatic steatosis, inflammation, pyknotic pictures and fibrosis were reduced in adiponectin treated animals resulting in a lower activity score. Random blood sugar levels were normal in all animal groups but were significantly lower in adiponectin treated groups. TG and VLDL were alleviated with adiponectin treatment.Methionine - choline deficient diet resulted in emaciation of animals, much reduced visceral fat depots but a more severe form of liver fatty damage over a shorter period of time when compared to high fructose obese animal models. Weight loss was worsened after adiponectin treatment. Hepatic steatosis, inflammatory foci, ballooning degeneration and fibrosis were all exaggerated but remained significantly less severe with less activity score in adiponectin treated animals. Random blood sugar levels were normal in all animal groups but were significantly higher after adiponectin treatment. TG and VLDL was alleviated with adiponectin treatment.Adiponectin affects appetite, food consumption and body composition in healthy animals and animal models of non - alcoholic fatty liver disease through different mechanisms. It has beneficial effects in reducing body weight in obese animals but can modulate weight loss in lean animals on methionine - choline deficient diet. Adiponectin has autocrine/paracrine effects on visceral adipose tissue and can correct the dyslipidemic picture of fatty liver disease. The antisteatotic and antifibrotic effects of adiponectin carry greater therapeutic potentials in obesity - related liver disease.

تشخيص مصلي وجزيئي لفيروس الحلا البشري النوع السادس المصاحب لبعض سرطانات الدم == Serological And Molecular Detection Of Human Herpesvirus Type 6 Associated With Certain Hematologic Malignancies

اسم المؤلف: هديل محمد فياض
اسم المشرف: علاء فاضل علوان | داود سلمان داود
الموضوع العام: الطب
السنة: 2015
الموضوع الدقيق: الاحياء المجهرية
الدرجة: دكتوراه
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: Human herpesvirus 6 (HHV - 6) is largely ubiquitous double stranded DNA viruses within the betaherpesvirinae subfamily and of the genus Roseolovirus.HHV - 6A and HHV - 6B infects very high percentage of population around the world, primarily during childhood through respiratory droplets. HHV - 6 has been found out in many types of cancers : lymphomas, leukemia, cervical cancer, and brain tumors.This cross - sectional case control study was carried out in Baghdad Teaching Hospital and National Center of Hematology - AL - Mustansiriyah University - Baghdad, for the period from 1 September 2013 to 1 April 2015.The aims of the study were to explore the seropositivity rate of HHV - 6 antibodies among Iraqi patients with different hematological malignancies using different laboratory assays, beside, the molecular determination of plasma viral DNA load by quantitative polymerase chain reaction (qPCR).The study included 109 patients with different hematological malignancies; 24 patients with acute lymphoblastic leukemia (ALL), 30 patients with acute myeloid leukemia (AML), 11 patients with Hodgkin lymphoma (HL), 39 patients with non hodgkin lymphoma (NHL) and 5 patients with chronic lymphocytic leukemia(CLL). All patients were newly diagnosed and enrolled before receiving chemotherapy. The age range was between 14 - 80 years. Fifty three (48.6%) and 56 (51.4%) patients were males and females, respectively. The diagnosis of their malignancies was based on either bone marrow aspirate biopsy and lymph node biopsy as well as cytochemical investigations. Additionally, 59 apparently healthy blood donors were enrolled as control group. The age range was between 18 - 59 years, twenty eight (47.4%) and 31 (52.6%) were males and females, respectively.The serum anti - HHV - 6 IgG was detected by indirect immunofluorescent technique (IFAT) as well as by enzyme linked immunosorbant assay (ELISA).While, the serum anti - HHV - 6 IgM was detected by ELISA only. The detection and quantification of plasma viral DNAemia was carried out by quantitative polymerase chain reaction. Serological as well as molecular assays were done in Central Public Health Laboratory in Baghdad. The highest IFAT positivity rate was among patients with CLL (100%), followed by patients with AML (83.3%), and the least positivity rate was among patients with NHL (64.1%) compared to that of healthy control. Generally, the total anti - HHV - 6 IgG by IFAT was insignificantly higher among patients compared to healthy controls (74.3% vs 61.0%, p=0.074). The anti - HHV - 6 IgG positivity rates by ELISA were insignificantly higher in all groups of haematological malignancies except in patients with AML in whom it was significantly higher compared to healthy controls (96.7% vs 72.9%, p= 0.007 ). A part from AML, the highest anti - HHV - 6 IgG by ELISA was among patients with ALL (87.5%) followed by patients with NHL (84.6%), and the least was among patients with CLL (80.0%) compared to healthy control. Generally, the total anti - HHV - 6 IgG positivity rate detected by ELISA was significantly higher compared to IFAT in patients (p= 0.013) as well as in healthy control (p= 0.0005).The results of anti - HHV - 6 IgM positivity rate as detected by ELISA was significantly higher in patients with AML (36.7%, p=0.0004), and patients with HL (27.7%, p= 0.038) compared to healthy controls (6.8%). Whereas, other groups of hematological malignancies showed insignificantly higher positivity rate versus control group. However, the highest positivity rate was among patients with AML (36.7%), and the least positivity rate was among patients with CLL (0%). Generally, the total ELISA anti - HHV - 6 IgM positivity rate was significantly higher in patients versus healthy controls (22.0% vs 6.8%, p= 0.011). The results of PCR showed that 5 out of 109 patients had detectable HHV - 6 DNA in the plasma. The highest detection rate was among patients with HL (27.3%), followed by patients with ALL (4.2%), and then patients with AML (3.3%), while the virus was not detected in other disease categories as well as in healthy controls. The plasma viral load (mean ± SD) among the three Hodgkin lymphoma patients was 1.4± 0.3*102 particle/milliliter.The study concluded that the seropositivity rate of HHV - 6 infection is highly prevalent among Iraqi patients with hematological malignancies compared to healthy population. However, primary or reactivation infection as determined by anti - HHV - 6 IgM in patients as well as healthy individuals is relatively low. Furthermore, the HHV - 6 DNA detection rate as well as plasma viral load among malignant patients before receiving immunosuppressive treatment were low.

دراسة Toll like receptors(TLR2& ( 4 ومؤشرات حيوية مختارة في المرضى المصابين بسرطان المثانة == Study Of Toll Like Receptors (TLR - 2 And 4) And Selected Biomarkers In Bladder Cancer Patients

اسم المؤلف: هدى سعدون البياتي
اسم المشرف: ميسون علي سليم | ناهي يوسف ياسين | عصام سلمان العزاوي
الموضوع العام: الطب
السنة: 2015
الموضوع الدقيق: الاحياء المجهرية
الدرجة: دكتوراه
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: Worldwide, cancers of the urinary bladder are complex and involve genetic abnormalities and may be due to different environmental chemical carcinogens, as well as chronic infection like Schistosomiasis, all these will allow normal transitional cells to become cancerous which are typically transitional cell carcinoma(TCC).This study was conducted at AL - Yarmouk and Baghdad Teaching Hospitals in Baghdad from June 2013 to April 2014, of which urine and bladder tissue were taken from 57 bladder cancer patients and 80 controls to assess Interleukin - 8 (IL - 8), Matrix MetalloPeptidase - 9 (MMP - 9), Bladder Cancer - Associated Protein (BLCA - 4),Toll - Like Receptors (TLR - 2and TL - R4) level among them and to evaluate their roles in cancer development.One hundred thirty seven Iraqi individual were divided to 28(20.43%) newly diagnosed and 29(21.16%) recurrent bladder cancer patients (relapse), 40(29.19%) apparently healthy volunteers and 40(29.19%) autopsies (apparently normal urothelium), of whom urinesample and tissue biopsy were collected, clinical diagnosis of patients carried out by cystoscopic and histopathological examination, the mean ±SD age of bladder cancer patients were (63± 9.3) with (M : F ratio7.1 : 1).Predominant cancer type was Transitional cell carcinoma (TCC). According to risk factors of bladder cancer, out of 57 bladder cancer patients, 34(59.64%), 29(50.87%), 9(15.78%), 7(12.28%), 6(10.52%) were smoker, had UTI, history of Schistosomiasis, family history ofcancer and stones respectively. In this study 30 patients had non - muscle invasive bladder cancer, most of them (21) had newly diagnosed tumors, and only 9 had recurrent disease, as well as, 27 patients with muscle - invasive bladder tumor, just 7 had newly diagnosed tumors and 20 with recurrent disease.According to the result of ELISA technique, the mean±SD urine level IL - 8(pg/ml) for recurrent bladder cancer patients was 359.6±170.1pg/ml, for newly diagnosed was 265.95±139.09pg/ml and for healthy volunteers was 62.04±37.66pg/ml. The mean ±SD concentration of urine MMP - 9(pg/ml) was 7368.3±1730.19pg/ml for recurrent, 6176.8±2366.9 pg/ml for newly diagnosed and 1131.53±1554.80 pg/ml for healthy volunteers. Mean±SD Level of urine BLCA - 4 (ng/ml) for recurrent was 1.45± 0.26 ng/ml, for newly diagnosed was 1.30± 0.22 ng/ml and for healthy volunteers was 1.02±0.067 ng/ml. Urine level of these markers was significantly higher in recurrence group when compared with newly diagnosed and these levels decreased in normal volunteers which was statistically significance (P<0.001 for IL - 8, MMP - 9and BLCA - 4),also there was a significant increase in urine IL - 8 level according to grade(P=0.0002) and muscle invasion(P= 0.0009) as well as BLCA - 4 showed this significant increase in high grade(P=0.0001), and muscle invasion(P=0.0001),but no significant difference was found in the level of urine MMP - 9 with grade(P=0.23) and muscle invasion(P =0.069)In comparison, IL - 8 and MMP - 9 IHC staining of bladder tissue, showed low expression in cancerous tissue with no significant difference between cancer and normal urothelium(P=0.140 for IL - 8, P=0.265 for MMP - 9 ), and unrelated to grade, muscle invasion and recurrence.Significant increase in TLR - 2 and TLR - 4 expression in bladder cancer tissue than in normal urothelium (P=0.0001 for each), and according to grade and muscle invasion, TLR - 2 showed significant over expression in high grade than low grade (40.7%vs36.6%) with P=0.018, muscle invasion than non - muscle invasion (44.4%vs33.3%) with P value of 0.02, while TLR - 4 was none significantly correlated with grade andmuscle invasion. As well as, there was no correlation between these receptors with tumor recurrence.In regard to risk factors, Smoking, schistosomiasis and family history showed correlation with study marker in different manner as, IL - 8 was significantly highly expressed in smoking associated bladder cancer group, as well as patients with family history of bladder cancer showed high expression IL - 8, for Schistosoma associated TCC patients and UTI they demonstrated a statistically significant high expression of TLR - 2 p= (0.0001).From this study we conclude that urine IL - 8, MMP - 9and BLCA - 4 measured by ELISA showed specificity in diagnosis of bladder cancer, besides that, urine IL - 8, MMP - 9 and BLCA - 4 have a role in discrimination between newly diagnosed vs recurrent, with a significant association between urine IL - 8 with BLCA - 4 (P= 0.0001) and IL - 8 with MMP - 9 (P= 0.005) in patients with recurrent bladder cancer. Urine IL - 8 and BLCA - 4 concentration were statistically with significant increase in high grade than low grade and muscle invasion than non - muscle invasion, On the other hand, bladder cancer cells over express TLR - 2 and TLR - 4,while TLR - 2 showed correlation with high grade and muscle invasion,TLR4 did not show such correlation. Lastly, IL - 8 and MMP - 9 staining showed low expression in tumor tissue of different grades, stages and groups.

دراسة بكتريولوجية على التفاقم الحاد لمرضى الانسداد الرئوي المزمن == Bacteriological Study On Acute Exacerbation Of Chronic Obstructive Pulmonary Disease (COPD) Patients

اسم المؤلف: هبة اسماعيل علي العزي
اسم المشرف: عروبة خالد عباس | عبد الحميد القصير
الموضوع العام: الطب
السنة: 2015
الموضوع الدقيق: الاحياء المجهرية
الدرجة: ماجستير
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: لا يزال مرض الانسداد الرئوي المزمن مشكلة رئيسية في مجال الصحة العامة. ويرتبط التفاقم الحاد مع فقدان سريع في وظيفة الرئة وخلل في نوعية الحياة وهي من الاسباب الرئيسية للامراضية والوفيات في مرضى الانسداد الرئوي المزمن. تعتبر العدوى البكتيريا هي من الاسباب | Chronic obstructive pulmonary disease remains a main problem in public health. The acute exacerbations are related with rapid loss in lung function and defect in the quality of life and are the main causes of morbidity and mortality in COPD. This study was carried out to isolate and identify the bacteria that cause acute exacerbation in chronic obstructive pulmonary disease and sensitivity of isolated bacteria for most of the antibiotics currently in use.Eighty sputum specimens from patients were included in this study and their age was range forty and above , during the period from January 2015 to June 2015 from three places Al - Yarmouk Teaching Hospital, Medical City Hospital and Medical Al khademeain Emamaain City.Bacteria were identified in 52 (65%) while the patient is not specified any reasoned in 28 patients (35%) patients. The diagnosis of bacteria through culture and microscopic examinations and biochemical tests necessary for diagnosis and then the diagnosis has been confirmed of isolation by the Vitek method for each bacterium, the percentages were as follows : Streptococcus pneumoniae was the most frequently isolated bacteria, which recovered from 21 (26.25%) patients. Followed by Klebsiella pneumoniae, Escherichia coli, Pseudomonas spp., which isolated from (7.5%, 7.5%, and 5%) of patients respectively, while (3.75%) for each of Acinetobacter baumannii & Staphylococcus aureus. The proportion of Stenotrophomonas maltophilia was (2.5%) while the proportion (1.25%) for each of Enterobacter cloacae, Leclercia adecarboxylata, Moraxella catarrhalis & Raoultella ornithinolytica.Through the search three cases were infected with Mycobacterium tuberculosis diagnosed by direct Acid Fast Stain test and their percentage was (3.75%).Sensitivity of bacterial isolates to antibiotics Carbapenems and Doxycycline and Chloramphenicol were the most effective against tested bacteria in vitro while Erythromycin, Tetracycline, and Amoxicillin were the least sensitive

دراسة مناعية وجزيئية لخمج القرنية بحمة الحلا - 1 (حمة الهربس البسيط - 1) == Immunological And Molecular Study Of Herpes Simplex Virus - 1 Keratitis

اسم المؤلف: نهاية كاظم سالم
اسم المشرف: عبد العظيم ياسين عبود البراك | فائز اسماعيل الشكرجي
الموضوع العام: الطب
السنة: 2015
الدرجة: ماجستير
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: يمثل التهاب القرنية (Keratitis) مشكلة كبيرة قد تؤدي الى فقدان البصر احيانا نتيجة لخدش القرنية او فقدان الوضوحية في القرنية بعد اختفاء الالتهاب, ويعتبر فايروس الحلا (الهربس) البسيط - 1Herpes Simplex Virus - 1(HSV - 1))) هو من اهم العوامل المسببة لمرض التهاب ال | Keratitis is a medical term referring to inflammation of the cornea. It is a serious problem, resulting in everlasting loss of vision as a secondary effect to corneal scarring or loss of clarity of the cornea after the inflammation has disappeared. Most common microbes causing viral corneal keratitis is Herpes Simplex Virus - 1 (HSV - 1). HSV - 1 is a double stranded DNA (dsDNA) virus belongs to the Herpesiviridae. It affects the majority of peoples and its infections have been frequently without clinical manifestation. Ocular HSV - 1 infections caused multiple pathologies with possibly the most damaging being herpetic stromal keratitis (HSK). This study aimed to evaluate the abilities of the immunological and molecular indicators to diagnose herpetic keratitis in the infected and contralateral eye of patients, as well as to assess the immune status of both eyes by using tears and corneal scraping. Fifty - two patients with herpetic keratitis involved in this study, they attended the outpatient clinics / Ibn - AL - Haithum Teaching Hospital from March 2014 until December 2014. For the purpose of comparison, thirty, apparently healthy age matched control subjects were also included. Tears were collected from infected eyes of the 52 patients and from 16 out of the 52 patients contralateral eyes as well as from 30 controls. Corneal scraping had been obtained from 16 patient's infected eyes with corneal ulcers (epithelial ulcers) out of the total patients (52) with herpetic keratitis. Indirect immunofluorescence assay technique (IFA) was applied to measure levels of immunoglobulins (sIgA and IgG) in tears specific to HSV - 1. Realtime - polymerase chain reaction RT - PCR test was used to diagnose HSV - 1 in corneal scraping and tears of patients and control subjects. Interlukin - 17 (IL - 17A), tumor necrosis factor - alpha (TNF - ?) and interferon - gamma (IFN - ?) were measured in tear samples from patients and control subjects by the ELISA sandwich method. In tear samples; results of RT - PCR showed that 39/52 (75%) of the total patient's infected eyes were positive, 12/16 contralateral eyes were positive (75%). Corneal scraping and tear samples were taken from 16 patients with corneal ulcer, tear samples 14/16 (87.5%) positive result, while the corneal scraping samples were 16/16 (100%) positive, this indicates clearly that the cornea scraping is more appropriate and sensitive sample to detect HSV - 1 than tear. All controls were RT - PCR negative. IFA results of IgA and IgG in tears of infected and contralateral eyes were found to be more than the concentration in tears of control eyes with a highly significant p - value (0.0001). Comparison between the infected and the contralateral eyes indicates that both patients' eyes expressed a significant humoral immune response against HSV - 1. Although there were high significant differences between both the mean value of tears IL - 17A in infected and contralateral eyes with control, while the comparison between patient both eyes gave non - significant difference. The mean of tears TNF - ? and IFN - ? concentration in infected eyes of patients as compared to control was found to be highly significant (p= 0.0001). In this study we compared between patients infected eye with control to evaluate the performance of different markers in tear as HSV - 1specific sIgA, HSV - 1 specific IgG, IL - 17, TNF - ? and IFN - ? by using statistical test called Receiver Operating Characteristic (ROC) curve, the sensitivity for all studied parameters ranged from 80% - 96%.At the same time the comparisons between patient contralateral eyes and controls also revealed a high sensitivity range for these parameters ranged from 81% - 100%.These findings proved the ability of these markers in confirming diagnosis of HSV - 1 keratitis. In conclusion, the high percentage of RT - PCR results for corneal scraping sample indicate that this sample and by using this technique is more appropriate and sensitive to detect HSV - 1 than tear samples and detect the shedding of virus in both eyes of the same patients. Both patient eyes indicated that they were a good source for HSV - 1 diagnosis. In spite of the high sensitivity of all studied markers and their diagnostic ability, TNF - ? showed a higher sensitivity. To assess the immunological status of Herpetic keratitis patients, the studied markers TNF - ?, IFN - ? and IL - 17 were evaluated and showed a highly significant differences which indicated there was an active inflammatory condition combined with HSV - 1 infection and finally it can be concluded that both humoral and cellular branches of immune responses were involved in this disease.

دراسة جزيئية ومناعية لدى عينة من مرضى التدرن الرئوي == Molecular And Immunological Study In A Sample Of Pulmonary Tuberculosis Patients

اسم المؤلف: مي يحيى عبد الحسين
اسم المشرف: عروبة خالد عباس | احمد اسمر منخي
الموضوع العام: الطب
السنة: 2015
الموضوع الدقيق: الاحياء المجهرية
الدرجة: ماجستير
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: يعتبر مرض السل الرئوي tuberculosis الذي تسببه بكترياMycobacterium tuberculosis من الامراض المعدية والشائعة واحد الاسباب الرئيسية لحالات الوفاة في العالم, ولاهميته اجريت هذه الدراسة لتسليط الضوء اكثر حول التشخيص المناعي للمرض وعلاقته بالتشخيص الجزيئي.تضم | Tuberculosis (TB) is caused by Mycobacterium tuberculosis; which consider as one of the most common, infectious diseases and major causes of morbidity and mortality worldwide. A prospective study was conducted to diagnose disease by immunological methods and its association with molecular diagnosis.The study included immunological diagnosis by Quantiferon - TB Gold In Tube Test, estimation the serum levels of IFN - ?, TNF - ? and IL - 10 in TB patients and control by a sandwich ELISA test using commercially available kits, in addition to molecular diagnosis by using Gene Xpert MTB/RIF assay, conventional bacteriological tests such as smear microscopy by Ziehl - Neelsen stain for sputum samples. Furthermore, estimation of ESR and WBCs.Fifty TB patients attending the National Reference Laboratory of Tuberculosis /Baghdad from the period between April to July 2014 were recruited in this study. For the purpose of comparison, 50 control samples (respiratory disease and healthy) matched by age and gender were also included.All TB patients' samples were positive by smear microscopy. The results revealed that there were significance differences between AFB scoring and G - Xpert results (p Forty five samples of TB patients with significance difference (p?0.01) were positively detected by Quantiferon - TB Gold Test.The mean serum level of QFT among TB patient and control (3.54 IU/ml vs. 0.866 IU/ml and 0.556 IU/ml), IL - 10 (53.02 Pg/ml vs. 22.24 pg/ml and 7.51 pg/ml) and TNF - ? (74.34 Pg/ml vs. 49.12 Pg/ml and 27.81 pg/ ml) were significantly higher in TB patients as compared to controls (P?0.05).In conclusion, high levels of IFN - ?, TNF - ? and IL - 10 in TB patients serum indicate an important role of theses cytokines in the pathogenesis of tuberculosis, so they could be considered as a good biomarkers for diagnosis and considered as a target for future therapy. The present study revealed significant difference in the WBCs and ESR values between TB patients and control (P?0.05)

دراسة خمج فيروس الكبد نمط جي HGV في مرضى الثلاسيميا المصابين وغير المصابين بفيروس الكبد سي (HCV) واهميته السريرية

اسم المؤلف: مريم صبري ابراهيم
اسم المشرف: اروى هادي الحمداني | اشنا جمال فائق
الموضوع العام: الطب
السنة: 2015
الدرجة: ماجستير
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: المرضى المصابين بفقر دم البحر الابيض المتوسط هم اكثر عرضة للاصابة بالالتهابات الفيروسية المنقولة دمويا. التهاب الكبد الفيروسي نمط جي (HGV)هو فيروس رنوي(RNA) مرتبط بالتهاب الكبد الفيروسي الحاد والمزمن. التهاب الكبد الفيروسي نمط سيHCV) ) والتهاب الكبد الفير | Thalassemia patients are at increased risk of infection with parentally transmitted viral agents. The hepatitis G virus (HGV) is an RNA virus, which is associated with acute or chronic hepatitis. Hepatitis G virus (HGV) and hepatitis C virus (HCV) infections may have a role in complicating the clinical outcome in patients with thalassemia. This study was designed to investigate the prevalence and clinical importance of HGV infection in thalassemia patients with or without hepatitis C virus (HCV) co - infection, furthermore to sequence and analyze phylogentic of HGV clones. One hundred fifty four thalassemia patients (56.5% male, 43.5% female) with a mean age of 22.84±6.06 years were involved in this study that was conducted in the period between Feb. to May, 2014. Anti - HCV antibody was determined by Enzyme Linked Immunosorbent Assay (ELISA) and confirmed by western blot. Then, HCV - RNA was detected in 53.2% of anti - HCV positive thalassemia patients. HGV antibodies were evaluated by ELISA. Also, the HGV viremia was analyzed in patients with thalassemia by reverse transcription polymerase chain reaction (RT - PCR) protocol. Results obtained showed that the anti - E2 - HGV were found in 16 out of 154 (10.4%) thalassemia patients with significant decrease in its prevalence with increasing age, while HGV viremia was diagnosed in 28 out of 154 (18.2%) patients with thalassemia. No association of HGV infection was found with gender, age and frequency of blood transfusion.According to HCV and HGV infection status, thalassemia patients were categorized into four subgroups : subgroup I (HGV infection), subgroup II (HCV infection), subgroup III (co - infection of HCV and HGV), and subgroup IV (thalassemia patients with neither HCV nor HGV infection). Seven point one percent (7.1%) of thalassemia patients were found to be co - infected with HCV and HGV.In all thalassemia subgroups, liver transaminases; alanine transaminase (ALT) and aspartate transaminase (AST), alkaline phosphatase (ALP), and total serum bilirubin (TSB) were determined, in addition to measure serum ferritin levels by VIDAS. HCV infection shows significant increase in ALT level while in HGV is not. Co - infection with HCV and HGV decrease ALT levels when compared with infection with HCV alone, so HGV infection is suggested to have no role in increasing the severity of liver diseases in the thalassemia patients. In HGV infection, there were significant increase in ALP levels and significant decrease in ferritin levels than other subgroups in the study. However, HGV infection shows no significant differences in AST and TSB than other subgroups. The results of genotyping in 12 randomly selected patients showed presence of genotype 2 and genotype 5 with percentage of 91.7% and 8.3% respectively. The diagnosis of prevalence of HGV and HCV in patients with thalassemia in Iraq emphasized the importance of these lymphotropic viral hepatitis infections in pathogenesis and outcome of thalassemia patients.

مؤشرات جزيئية حول مقاومة الزوائف الزنجارية المرتبطة بخمج المجاري البولية للمضادات الحيوية == Molecular Markers Of Antibiotics Resistance Of Pseudomonas Aeruginosa Associated With Urinary Tract Infections

اسم المؤلف: كريم عليوي حمادي سليمان
اسم المشرف: عامر رشيد النجار
الموضوع العام: الطب
السنة: 2015
الموضوع الدقيق: الاحياء المجهرية
الدرجة: دكتوراه
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: الزوائف الزنجارية : وهي بكتريا سالبة لصيغة الكرام والمنتشرة بشكل واسع في البيئة مثل التربة والمياه. وهذه البكتريا تتسبب في كثير من الالتهابات مثل التهاب المجاري البولية والتهاب الحروق وهي بكتريا انتهازية. وتشكل تهديد لحياة المصابين بالمجاري البولية وخاص | Pseudomonas aeruginosa is a Gram |( - ve) bacteria, widely presents in the environment such as soil, water, its incubation period (1 - 3) days, generation time 1 - 2 hrs. This bacteria causes many infections such as (UTI), and burn infections. It is an opportunistic pathogen, life threating for immune compromised patients such as diabetic patients. Pseudomonas aeruginosa is a nosocomial pathogen, and it is ranking the second among Gram ( - ve) hospitals acquiring pathogen. Its antibiotic resistance increased due to acquiring many antibiotics resistance genes. The spread of these genes among bacteria is via plasmids. Plasmid profiling of Ps. aeruginosa isolates by gel electrophoresis is a best technique for detection of plasmid content. Through this study, which was carried out in two main teaching hospitals, the diabetic center and private labs in Baghdad, during the period from January to October 2014. A total of (620) urine specimens were collected during (9) months. Urine specimens from inpatients were (420 / 620, 67.75%) and from out patients were (200 / 620, 32.25%). Urine specimens from Dialysis unit were (280 / 620, 45.1%) and from burn units were (140 / 620, 22.5%). The male represented (n = 334, 52.38%) while female were (n = 286, 46.20%). The positive cultures of urine samples obtained from hospitalized patients were (72 / 420, 17.1%) while for urine samples obtained from out patients (n = 40 / 200, 20%) were positive culture. A total of (112) positive culture out of (620) collected with (18.06%) percentage. A total of (30) bacterial isolates were tested by using disc diffusion method for susceptibility test forward to (15) antibiotics. Ps. aeruginosa isolates showed highest resistance to gentamicin (87.5%) while the lowest resistant toward meropenem, and imipenem with resistance percentage (16.7% and 8.0%) respectively.The occurrence of multi - drug resistance in (30) selected isolates were grouped as follows to (MDR) for those isolates which showed resistance to at least (3) antibiotics which was found to be (5 / 30, 6.6%). While (XDR) referred to those isolates which showed resistance to (4 - 5) antibiotics with (19 / 30, 63.3%). In related to (PDR) which referred to isolates that showed resistance to more than 5 with (6 / 30, 20%). The extracted plasmid DNA were resolved by gel electrophoresis for detection of plasmid content for (20) isolates including (10) isolates from inpatients, and (10) isolates from out patients. The selection of these isolates were grouped according to their antibiotic resistance pattern and the number of plasmids that they carried. The results showed that out of (20) there were (12 / 20, 60%) had no plasmid. While the remaining (8 / 20, 40%) had plasmids with different sizes and numbers. By using PCR technique the most common kinds of genes such as bla CTX - M, bla OXA, which encoded extended spectrum ? - lactamase (ESBLS) and those for metallo ? - lactamase such as bla IMP, were investigated with specific primers. Five isolates were selected depending on the numbers of plasmids which they carried and their resistance to antibiotics.

دراسة مؤشرات مناعية وبايوكيميائية مختارة لمرضى السكري النوع الثاني المصحوب وغير المصحوب باعتلال الكلى ذات الادرار قليل الزلال == Study Of Selected Immunological And Biochemical Markers In Type 2 Diabetes With And Without Microalbuminuric Nephropathy

اسم المؤلف: علي ناصر محمد علي
اسم المشرف: عبد العظيم ياسين عبود البراك | حازم عبد الرزاق عبد الوهاب
الموضوع العام: الطب
السنة: 2015
الموضوع الدقيق: الاحياء المجهرية
الدرجة: دكتوراه
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: Diabetic Nephropathy (DN) is a common complication of diabetic diseases occuring all over the world including Iraq. This type of microvascular complication of diabetes mellitus represents the most common reason of end stage renal disease (ESRD) in the world which considers the main reason for hemodialysis, kidney transplantation and death in developed countries. For this reason the assessment of some biomarkers as an early predicator before onset of microalbuminuria stage of diabetic nephropathy and the correlations between these biomarkers with microalbuminuria were carried out.This study was achieved at AL - Yarmouk Teaching Hospital and the Diabetes National Center /AL - Mustansiriyah University/Baghdad from January 2013 to September 2014. The study involved ninety individuals, twenty volunteers selected from the local community; apparently healthy (group I), 40 type 2 diabetics with normal urinary albumin to creatinine ratio (UACR) (<30 mg/g) (group II), and 30 type 2 diabetic patients with abnormal UACR (? 30 - 300 mg/g) (group III). Mean of diabetes duration (D.D.) in group II is about 4 years and in group III is about 8 years. The mean age for group I, II and III were 53, 55 and 58 years respectively. The concentration was measured of each microalbuminuria by turbidmeteric method, estimated glomerular filtration rate (eGFR) by using chronic kidney diseases - epidemiology equation, glycated heamoglobin (HbA1c) by using high performance liquid chromatography (HPLC), both fasting blood sugar (FBS) and creatinine (serum and urine) by using colorimeteric method, body weight by using body mass index (BMI) and all of IL - 18, IL - 12 IL - 4, IFN - ? and urinary vitamin binding protein (VDBP) by using ELISA method in three groups.The present study showed that there is inverse correlation between UACR and eGFR. The cause of this inverse correlation is that the decline in renal function of diabetics can be predicted accurately by using both UACR to show the increase in microalbuminuria while eGFR show a measure of the decrease in the ability of kidney for filtration.The difference of FBS mean between group I and II and group I and III was significant (P= 0.000 for both). The P - value between II and III groups was significant (P= 0.024). The difference of HbA1c mean between group I and II, group I and III and group II and III was significant (P=0. 000 for all). These results were expected as high HbA1c level is in consequence of high FBS. The difference of BMI mean between group I and II, group I and III and group II and III was not significant (P= 0.870, 0.885 and 0.968 respectively). Because the BMI levels were approximately constant in three groups. The difference of D.D. between group II and III was significant (P= 0.000).There was no significant correlation in group II between urinary albumin to creatinine ratio with each of diabetic duration, glycated haemoglobin, fasting blood sugar and body mass index (r=0.219 with P=0.244, r=0.039 with P=0.840, r=0.080 with P=0.673 and r= - 0.126 with P= 0.506 respectively); but there was positively significant correlation between urinary albumin to creatinine ratio with each diabetic duration, HbA1c and fasting blood sugar in group III (r=0.298 with P=0.043, r=0.869 with P=0.000 and r=0.518 with P=0.003 respectively) which may be due to the chronic nature of the disease in this group that require these risk factors to initiation; however, the correlation was non significant between UACR and BMI (r= - 0.127 with P=0.228) in group III.The difference of S.Cr. among I and II groups, I and III groups and II and III groups were not significant (P= 0.998, P= 0.331 and P= 0.145 respectively).The correlation was not significant in group II between serum creatinine with each of diabetic duration, glycated haemoglobin, fasting blood sugar and body mass index (r= - 0.140 with P=0.462, r= - 0.124 with P=0.515, r=0.168 with P=0.374 and r=0.007 with P= 0.969 respectively). Also, there was no significant correlation in group III between S. Cr. with each D.D., HbA1c, FBS and BMI (r=0.187 with P=0.077, r=0.109 with P=0.220 and r=0.175 with P=0.124 respectively). The reason of these results backs to that S. Cr. level is not increased as the podocytes remain intact in the diabetics with and without microalbuminuria.The difference of eGFR between group I and II was not significant (P= 0.303). The difference between group I and III and group II and III was significant (P= 0.001 and 0.010 respectively). The correlation was not significant in group II between eGFR with each of diabetic duration, glycated haemoglobin, fasting blood sugar and body mass index (r=0.121 with P=0.524, r= - 0.180 with P=0.341, r= - 0.310 with P=0.096 and r=0.021 with P= 0.911 respectively). Also, there was no a significant correlation in group III between eGFR with each diabetic duration, HbA1c, FBS and BMI (r= - 0.179 with P=0.07, r= - 0.188 with P=0.061, r= - 0.123 with P=0.388 and r= - 0.112 with P=0.557 respectively). The reason of these results back to that eGFR level is at the normal range in group II and slightly beneath the normal range in group III in consequence of the podocytes remain intact in the diabetics with and without microalbuminuria.The difference of urinary VDBP level between group I and II, group I and III and group II and III was significant (P= 0.000 for all). The correlation between urinary albumin to creatinine ratio levels and VDBP level (r=0.963) with P - value 0.000 which was positively significant in group III. The correlationbetween eGFR and VDBP was - 0.524 with P - value 0.003 which is inversely significant in group III. The reason of this inverse correlation may be similar to the reason of inverse correlation between eGFR and UACR, as the cubilin - megalin receptors are common receptors for albumin and vitamin D binding protein. Otherwise, the correlation between urinary VDBP and eGFR in the group I was a weak negative with non significant P - value (r= - 0.188, P=0. 428). The reason of this non significant correlation is that the cubilin - megalin receptors are not damaged by inflammatory process to elevate VDBP in urine; also the podocytes in glomeruli are intact from the damage by inflammatory process, so the eGFR was at the normal range in the control group.The correlation was a positive between HbA1c and VDBP levels in group II and group III (r=0.579, P=0. 001 and r=0.686, P=0.000 respectively). This positive correlation was explained on the basis that deterioration of sugar level control lead to increase the proinflammatory cytokines that damage cubilin - megalin receptors then VDBP increase in urine.The difference of serum IL - 18 level between group I and II, group I and III and group II and III was significant (P=0.000 for all).The correlation between urinary albumin to creatinine ratio and IL - 18 was 0.983 with P - value 0.000 which was positively significant in group III. This may back to damage the cubilin - megalin receptors by IL - 18 action that lead to increase of UACR in urine. In other words, the correlation between serum creatinine and serum IL - 18 in group III was not significant (r=0.041 with P= 0.830). This may back to that podocytes remain intact in this early stage of diabetic nephropathy. There is a significant positive correlation between serum IL - 18 levels and HbA1c levels in group II and group III (r=0.641, P=0.000 and r=0.721, P=0.000 respectively). These two positive correlations support the suggestion of choosing serum IL - 18 as an excellent biomarker for avoidance an early stage of the disease.The difference of IFN - ? levels between group I and group II, between group I and group III and between group II and group III were not significant as follows : (P=0.640, P=0.292 and P=0.522 respectively). The correlation between UACR and IFN - ? (r=0.047) with P - value 0.830 which was not significant in group III which means that IFN - ? is not a good biomarker for prediction of the microalbuminuria as an early stage of DN.The difference of IL - 12 level between group I and group II, between group I and group III and between group II and group III were not significant (0.884, 0.431 and 0.439) respectively. The correlation between UACR and IL - 12 (r=0.190) with P - value 0.314 which was not significant in group III.The difference of IL - 4 levels between group I and group II, between group I and group III and between group II and group III were not significant (0.943, 0.704 and 0.648 respectively). The correlation between UACR and IL - 4 (r=0.169) with P - value 0.371 which was not significant in group III.These results of IFN - ?, IL - 12 and IL - 4 might lead to conclude that both cytokines can’t be selected as a biomarker for an early detection of DN. Finally from the all presented data it can be concluded that IL - 18 and VDBP are considered more sensitive and more efficient than a classic diagnostic method (UACR and eGFR) for avoidance and detection the early stage of DN.

مميزات التحويرات المناعية للريسفراترول المستخلص من قشور العنب الاحمر على التهاب الكبد المحدث باستخدام ديكالاكتوزامين والذيفان المعوي نوع ب للمكورات العنقودية == Immunmodulatory Properties Of Resveratrol Extracted From Skin Of Red Grape On Acute Liver Injury Induced By D - Galactoseamine And Staphylococcus Enterotoxin B

اسم المؤلف: صباح زيارة كاظم المالكي
اسم المشرف: عبد العظيم ياسين عبود البراك | متزي نكاركاتي
الموضوع العام: الطب
السنة: 2015
الموضوع الدقيق: الاحياء المجهرية
الدرجة: دكتوراه
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: تعتبر اصابة الكبد الحاد احد الامراض ذو الاعراض السريرية التي تتصف بارتشاح الخلايا اللمفية الى الكبد وتجمع السوائل وارتفاع انزايمات الكبد مثل ناقل امين الاسبارتات Aspartate aminotransferase(AST) في مصل الدم. هنالك الكثير من الاسباب التي تؤدي الى حدوث ضرر | Acute Liver Injury is a vital clinical syndrome characterized by infiltration of lymphocytes in the liver, fluid accumulation, and elevation of liver enzymes such as Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in the serum. There are many causes of liver injury, but in this particular study Staphylococcal Enterotoxin B (SEB) was used to induce acute liver injury in mice, it is previously known that (SEB) it act as superantigen that bind with T cell receptor variable region beta chain (VB8), and MHC II of Antigen Presenting Cells (APCs), which leads to activation of T - cells, and huge secretion of pro - inflammatory cytokines, all of these events cause an acute liver injury lead to liver failure, and death. In the last few decades the importance of some natural products appeared, in which these botanicals have an anti - inflammatory properties. Resveratrol is one of these botanicals with an anti - inflammatory effects, which was used as treatment in this study.This study was particularly intended to study the influence of Resveratrol on acute liver injury induced by Staphylococcus Enterotoxin B, lead to liver failure which includes estimation of aspartate aminotransferase levels (AST), histopathological analysis, immune cell counts of liver and spleen, in addition, study whether resveratrol has the ability to cause immunological changes on different immune cells that lead to suppress acute liver injury by using flowcytometry technique,these cells are inflammatory cells carrying CD3+ T cells, CD4+ T cells, CD8+ T cells, NK1.1+ T cells, CD44+ T cells, and suppressive cells such as Myeloid Derived Suppressor Cells (MDSCs), T regulatory cell (FOXP3), as anit - inflammatory markers. Furthermore evaluate the pro - inflammatory, and anti - inflammatory cytokines by using Bio - plex. Also to determine the molecular mechanism in which resveratrol can lead to induce changes in microRNAs (miRNAs) by microarray analysis. Finally validation (miRNAs) resulting from microarray analysis and genes of interest associated with these miRNAs by Real time polymearase chain reaction (RT - PCR).After sixteen hours blood samples were collected to determine AST levels in differents groups using Nanodrop, (Fisher - USA), after sixty hours animals sacrificing organs (liver, spleen) were collected afterward liver samples in 10% formalin were sent for histopathological study, liver immune cells were isolated for counts and molecular study (microarray analysis and quantitive (RT - PCR) total RNA was isolated from liver immune cells for microarray analysis then preparation of complementary Deoxyribonucleic acid (cDNA) by Reverse transcriptase PCR. Validation of the microarray analysis data was achieved by Real time PCR. Spleen immune cells were collected afterward for flowcytometric analysis of CD3+, CD4+, CD8+, NK1.1+, CD44+ T cells, MDSCs, and T regulatory cells using cell surface staining and intra cellular staining.This study showed that Resveratrol oppose the effect of SEB induced acute liver injury through decrease AST concentrations (P< 0.0001). Also Resveratrol 50mg/Kg body weight led to cause reduction in the size of the spleen, compared to SEB+ Vehicle group. Histopathology study reported that resveratrol led to decrease of hepatic necrosis up to 10% in comparison to vehicle group with 60% of hepatic necrosis and decrease in the inflammatory response represented by immune cells as in liver immune cell counts which showed a significant decrease (P< 0.014) after 50mg/ Kg body weight of Resveratrol treatment. Spleen immune cell counts result reported a significant decrease (P<0.013) in the total cells when Resveratrol was used as treatment compared to disease group. Regarding to Flowcytometric analysis, it was found that Resveratrol significantly decrease the absolute count of CD3+, CD4+, CD8+, NK1.1+, CD44+, Foxp3+ T cells in C57BL/6 mice (P< 0.0019, P< 0.001, P< 0.009, P< 0.002, P< 0.03, and P< 0.03 respectively). While MDSCs result reported significant increase with P< 0.01 in absolute cell counts after Resveratrol treatment. Depending on the Bio - plex data showed significant decrease in serum concentrations of inflammatory cytokines IL - 1?, IL - 1?, IL - 3, IL - 5, IL - 12p(40), IL - 12p(70), IL - 13, IFN?, MIP - 1?, MIP - 1?, KC and Rantes cytokines with significant P values (0.009, 0.004, 0.034, 0.004, 0.0009, 0.01, 0.0007, 0.009, 0.0037, 0.0001, 0.0035, 0.006 respectively), while anti - inflammatory cytokines IL - 6, IL - 10 and G - CSF c showed a significant increase in the serum concentration after Resveratrol treatment with a P values of, 0.012, 0.02 and 0.001 respectively. Microarray analysis results recognized 451 miRNAs with P< 0.05, according to fold change expression, 78 miRNAs have fold change greater than - 1.5 fold of expression in Resveratrol treatment group (downregulated), while 87 miRNAs have fold change greater than 1.5 fold of expression (upregulated). According to the ingenuity tools predicted target gene for some of these miRNAs by using miRNA.org database, the database showed that miR - 130a - 3p with - 2.28 fold expression have direct relation of binding with CSF1 gene, Real time PCR results confirmed the results obtained from microarray analysis, the result of miR - 130a - 3p showed a significant decrease of relative fold expression with P< 0.013, and Colony Stimulating Factor - 1 CSF1 (M - CSF) relative expression increased significantly after resveratrol treatment with P< 0.0001. From all of previous data, it can be concluded that Resveratrol can counteract acute liver injury induced by SEB, by decrease AST concentration. Resveratrol acts as an anti - inflammatory compound due to decrease of immune cell numbers, decrease of inflammatory markers, and increase of anti - inflammatory markers. miR - 130a - 3p with inflammatory properties downregulated after resveratrol treatment. Finally Resveratrol treatment increased relative fold expression of CSF1(M - CSF); gene which play a role in the MDSCs proliferation

دراسة معظم السمات المناعية وتحديد البكتريا الابرز في مرض التهاب السحايا باستعمال تقنية البي سي ار == Study Some Immunological Aspects And Determination Of Most Prominent Bacteria In Meningitis Patients By Using Real Time Pcr

اسم المؤلف: شيماء عبد الرضا حميد
اسم المشرف: زينب فاضل عاشور | دريد قاسم الشريف
الموضوع العام: الطب
السنة: 2015
الدرجة: ماجستير
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: Meningitis, which is inflammation of the membranes that surround the brain and spinal cord and can occur at any age, it is caused by infectious microorganisms include (Bacteria, Viruses, Fungi, and Parasites) and non infectious include (Drugs, Carcinoma and Inflammatory disorder), also requires early treatment with aggressive use of potent antimicrobials; otherwise the outcome almost ends fatally.The predominant causes of bacterial meningitis are streptococcus pneumoniae, Haemophilus influenzae type b (Hib) and Neisseria meningitides.This prospective study includes 40 cases of meningitis which have been admitted to the Baghdad Teaching Hospital and Child Welfare Teaching Hospital during the period from May to November/ 2014.The detection of meningitis causative agent were specified by using the standard biochemical and microbiological methods such as : Determination of protein and sugar in Cerebrospinal fluid, Differential and cell count, growth on Culture media and morphological appearance on Gram's stain.Confirmative tests were also done for identification of meningitis causative agent; these tests included Procalcitonin, IL - 6, CRP, D. Dimer. These confirmative tests have been crowned by PCR technique, by employing the detection of the bacterial gene.The DNA of bacteria was extracted from CSF of meningitis patients and detection the type of bacteria gene by using multiplex PCR technique that using primers to amplify each ply, bexA and ctrA gene.Out of 40 samples, 28 (70%) were identified as bacterial meningitis and 12 (30%) as viral meningitis, the result of PCR reaction revealed unmistakably that 20 (71.4%) of 28 were detected the bacteria (S. pneumonia, H. influenzaetype b and N. meningitides) as a causative agent, while there were no detectable infectious agents in the (40) control group included in this study.Viral meningitis patients showed the number of lymphocytes (31.92 cell/ mm3) and neutrophils (1.00 cell/ mm3), while the highest number of lymphocytes and neutrophils in bacterial meningitis caused by S. pneumoniae (77.08 cell/ mm3) , (28.86 cell/ mm3) respectively, so that there was significant difference between cells (lymphocyte and neutrophil) with study group at P value = 0.010, P value = 0.013 respectively. In microbiological examination 22.5% of patients group (40) showed positive result of culture and 7.5% showed positive result of gram stain.In biochemical tests, the detection of Cerebrospinal fluid's protein and glucose level was done. The level of protein concentrations in bacterial meningitis with S. pneumoniae (103.08 mg/l), H. influenzae (65.14 mg/l) and in other bacteria was (124.44 mg/l) which is higher than the protein concentration in viral meningitis (42.25 mg/l), and these results showed highly significant difference at (P=0.010). Results of glucose's level determination showed that there were no significant difference among the studied groups (P =0.2). Results of glucose's level determination showed the presence of non significant difference among the studied groups, (60.92 mg/dl), (43, 57 mg/ dl), (51.00 mg/dl), (41.50 mg/dl) consecutively appeared in bacterial, viral.Interleukin - 6 and Procalcitonin levels were diagnosed by Enzyme Linked Immunosorbent Assay, while the plasma D. Dimer and erum C - Reactive protein was diagnosed by NaycoCard technique.The current results showed the presence of high concentration of IL - 6 among meningitis patients, high concentration of serum IL - 6 appeared in bacterial and viral meningitis (28.68 pg/ml) when compared with control group (2.194 pg/ml) (P =0.001), while CSF IL - 6 show high concentration in bothbacterial and viral meningitis but with no significant difference (579.24 pg/ml) (P =0.0001). The data of this study showed, there was correlation between IL - 6 levels and neutrophil in meningitis patients. Interleukin - 6 had significant correlation with neutrophil (P =0.009). While no significant correlation appeared between IL - 6 and Lymphocyte.Procalcitonin results showed high concentration in bacterial meningitis group compared with viral and control group with a highly significant differences (P =0.0001).The results of CRP shown no significant differences between bacterial and viral group, while the levels of D. Dimer appear significant differences in both groups when compared with control group.Current study indicated that PCR, Procalcitonin and D. Dimer played an important role in diagnosis of meningitis disease.

العلاقة بين مرض السكري المناعي الذاتي الكامن النمط الثاني للبالغين مع الخمج بالملوية البوابية == Association Between Latent Autoimmune Diabetes Of Adults In Type Ii Dm With Helicobacter Pylori Infection

اسم المؤلف: سيف علي مكلف
اسم المشرف: عروبة خالد عباس | مدين علي حسين
الموضوع العام: الطب
السنة: 2015
الدرجة: ماجستير
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: Latent Autoimmune Diabetes in Adults (LADA) is a form of diabetes which is less recognized and underdiagnosed type of diabetes which appears to have characteristics of both type 1 (autoimmune in nature) and type 2 diabetes (adult age at onset).Helicobacter pylori (H. pylori) infection has a worldwide distribution. The bacteria colonize more than half of the world population and consider the main cause of gastritis, peptic ulceration, gastric adenocarcinoma and gastric lymphoma. The host immune response is unable to clear the infection and may actually contribute to the associated pathogenesis, also the bacterial virulent factors had certain role in the pathogenicity of infection as it was stated by limited studies that the Cytotoxin associated gene A (CagA) protein and Vacuolating cytotoxin gene A (VacA) protein positive strains are possibly associated with severe infections.The present study was designed to find out the percent of LADA patients among group of type II Iraqi diabetic patients and the relation between LADA patients and H. pylori infection.The study was carried out on 350 type II patients attending the National Diabetes Center/ Al - Mustansirrhea University/ Baghdad Al - Yarmouk during the period May to October 2014 were recruited for this study. Diagnostic markers for LADA, namely, C - peptide levels by Radioimmunoassay and GAD autoantibodies by ELISA test were determined and other Various parameters such as, HbA1c levels, Anti - H.pylori IgG, Anti - CagA protein and Anti - VacA protein by ELISA test were evaluated and correlated with type 2 diabetes and 40 control, matched by age and gender were also included.57 patients of 350 of type II have low C - peptide level, from which, 40 patients have Anti - GAD65 positive and 17 patients have Anti - GAD65 negative.The percentage of LADA patients among type II diabetes was 11.4%.The mean serum levels of C - peptide of LADA patients, controls and type II diabetes (0.30 vs. 1.94 and 3.15ng/ml) were significantly lower in LADA patients as compared to controls and type II patients (p?0.05).Also the mean blood concentrations of HbA1c of LADA patients, type II and controls (8.5 vs. 7.5 and 5.2 %) were significantly higher in LADA patients as compared to type II patients and controls (p?0.05).The Higher frequency of anti - H. pylori IgG was in LADA patients when compared with patient's controls and healthy controls (59.6%, 21.3% and 19.1%) and the p - value (?0.05).In conclusion, Cytotoxic associated gene A protein (Cag A) protein is more frequency with H. pylori positive patients 36/47 (76.6%) indicate an important role of this virulence factor in the pathogenesis of H. pylori, so they could be considered as a good biomarker for discern the risk of developing serious gastroduodenal disease in the host, than Vacuolating cytotoxin A Protein (Vac A) which is less frequency than Cag A in H. pylori positive patients 16/47 (34%).

دراسة جزيئية للاصابات بفايروس الحليمي البشري وفايروس سرطان الغدد اللبنية البشري في المريضات المجراة لهن عملية استئصال الرحم الكامل == Molecular Study Of Human Papilloma Virus And Human Mammary Tumor Virus Infections Of Patients With Total Hysterectomy

اسم المؤلف: سري ظافر داود العزيز
اسم المشرف: سعد حسن محمد علي | بسام شهاب احمد
الموضوع العام: الطب
السنة: 2015
الدرجة: دكتوراه
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: Theoretically , the origin & mode of in - utero transmission of high risk Human PapillomaVirus (HR - HPV) types could be acquired hematogenously, by semen at fertilization or as asending infection in the genital tract. Viral Oncogenes E6 and E7 have ability to altered the Cyclin D1,p21 and p27 protein levels. Worldwide, Human Mammary Tumor Virus(HMTV) infection been described in hormonal responsive tissues.This research work is to study viruses in relaition to endometrial carcinoma in Iraqi patients.Materials and MethodsA retrospective study envolved seventy(70) cases (158 samples) of endometrial and cervical tissues collected from teaching laboratories in Medical City, Al - Yarmok Teaching Hospital and private laboratories related to the period from 2012 to 2014. Sections were made and subjected to chromogenic in - situ hybridization technique to detect the presence of High risk (HR) HPV 16/18 DNA and HMTV integrated DNA (provirus) and immunohistochemical technique to detect the presence of Cyclin D1,P21and P27.Results : The most commonly affected age group was ? 60 year 60.0% in malignant endometrial tumors, 40 - 49 years 36.0% in non - malignant endometrial tumors. Adenocarcinoma was the only histopathological type among endometrial cancer (100%) and the majority have well differentiated grade (90.0% ),and have (70%) T1b/IB stage.Hight risk HPV16/18 expression was detected 33.3% of malignant endometrial tumors, 20% in non - malignant endometrial tumors, andSUMMARY26.7% in control group. The higher rates of expression of HPV in cervical lesions was 40%.Most HPV16/18 infections revealed in both sites (cervix and endomertium) have Punctate DNA pattern.Cyclin D1 expression was mostly in 43.3% of malignant endometrial tumors and 33.3% was in cervical lesions. The significant correlation between Cyclin D1 expression and HR - HPV16/18 infection was reported only in malignant endometrial tumors groups. The highest P21 expression was 40.0% in malignant endometrial tumors and 44.0% in cervical lesions that reveals a significant association between p21 expression and HR - HPV16/18 infection. The highest rates of P27 expression were noticed among non - malignant endometrial tumors 24.0% and 32.0% in cervical lesions.While significant association of P27 expression with HR - HPV16/18 infection was only found in the cervical lesions among malignant endometrial tumors group.The distribution of integrated HMTV genome detected by Chromogenic in - situ hybridaztion (CISH) in the endometrial tissues was 16.7% in malignant endometrial tumor , 8% in non - malignant endometrial tumors, and 13.3% in the control tissues group while in the cervical lesions HMTV was detected in 13.3%. Significant correlations were found between HMTV infection and Cyclin D1 expression in the cervical lesions among malignant endometrial tumors group and p21 expression in the malignant endometrial tumors.ConclusionsHR - HPV16/18 may be associated with initiation of endometrial carcinogenesis events as well as play a role in the progression of such malignant tumors in addition ,these viruses could ascendingly be transmitted from lower part(cervix) to the upper part of the genital tractSUMMARY(endometrium) in some way or other.Cyclin D1 ,P21,and p27 could have sharing in early events of tumorgenesis in endometrial carcinoma and a significant correlations of Cyclin D1 ,p21& p27 expressions with HPV infection was observed among study group.Althought a relating low rates of HMTV infection were detected among different endometrial as well as cervical lesion in this Iraqi study,it might mark or shade alight in the way for further researches in this field to exposure more aspects of this newly studied virus among other hormonal dependent malignancy

دراسة التعبير المناعي النسيجي الكيميائي لبعض المعلمات المناعية في مختلف درجات سرطان البروستات == Study The Immunohistochemical Expression Of Some Immunological Markers In Different Grades Of Prostate Cancer

اسم المؤلف: حسن هادي زريج
اسم المشرف: زينب فاضل عاشور | وسن عبد الاله باقر
الموضوع العام: الطب
السنة: 2015
الموضوع الدقيق: الاحياء المجهرية
الدرجة: ماجستير
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: Prostate cancer is the most common malignancy and the second leading cause of cancer related death among males worldwide. Prostate cancer developed in prostate , a gland that is located below the bladder and just in front of rectum.Inflammation is a fundamental physiological process that can arise in any tissue in response to traumatic, infectiousor autoimmune injury. Transforming growth factor beta one (TGF - ?I) is a potential regulator of prostate cancer cell growth that signals through a heteromeric complex composed of type I and type II receptors.TGF - ?R II is an important receptor , because TGF - ? bind to receptor II to initiate it's signaling, then receptor II recruits receptor I to initiate signal transduction. Interleukin - 17 (IL - 17) is a pro - inflammatory cytokine produced by T - helper 17 (Th17) cells contributes toboth the processes by playing a dual role in the antitumor immunity. On one hand, IL - 17 encourages an antitumor cytotoxic T cell response leading to tumor regression. On the other hand, by promoting angiogenesis and egress of tumor cells from the primary focus, so IL - 17 promotes tumor growth.This study was carried out to establish the correlation between expression of Transforming growth factor beta one(TGF - ?I), Transforming growth factor beta receptor one (TGF - ?RI) and Transforming growth factor beta receptor two (TGF - ?RII) and prostate cancer progression. Also to establish the role of IL - 17 in prostate cancer development.The study consisted of 16 patients with poorly differentiated malignancy (PDM) ,whose age ranged (48 - 89) years, with mean age of (71.2) years , and 25 patients with moderately differentiated malignancy(MDM) , whose age ranged (31 - 83) years , with mean age of (66.6) years , and 46 patients with benign prostatic hyperplasia (BPH) , whose age ranged (27 - 85) years , with mean age of (64.3) years. Allpatients were diagnosed surgically by consultant physicians in Baghdad hospital for specialist surgeries , Al - Yarmook teaching hospital ,as well as AL - Hilla teaching hospital , and 20 normal tissue sample taken from cadaver, whose age ranged (17 - 28) years , with mean age of (21.8) years , where chosen as a control group. The work was conducted in Iraqi center for cancer and medical genetic researches. The study were performed during the period from March 2014 to December 2014).Immunohistochemistry (IHC) technique was used to detect the level of expression of TGF - ?I , TGF - ?RI , TGF - ?RII and IL - 17 protein in tissues of patients and healthy control groups.The current study revealed that there was significant difference in mean levels of TGF - ?I protein expression between each of poorly and moderately differentiated malignancy compared with healthy control subjects with P - value of 0.001 , but there was no significant difference in mean level of TGF - ?Iprotein expression between benign prostatic hyperplasia and healthy control subjects with P - value of 0.398. Also there was no significant difference between poorly and moderately differentiated malignancy in mean level of TGF - ?I protein expression.TGF - ?R1 protein was expressed in 3 (18.7%) and 14 (56%) of poorly and moderately differentiated malignancy respectively , with weak immunostaining reaction was the most frequent score. There was significant difference in mean level of TGF - ?RI protein expression among all studied groups. TGF - ?RII protein was expressed in 6 (37.5%) and 22 (88%) of poorly and moderately differentiated malignancy respectively ,with weak immunostaining reaction was the most frequent score. There was significant difference in mean level of TGF - ?RII protein expression among all studied groups.IL - 17 immunohistochemical expression was detected in tissues of all studied groups , the results showed that moderate immunostaining reaction was the most frequent score among them. There was significant difference in mean levels of IL - 17 protein expression among all studied groups.We concluded that there was statistically significant association between the loss ofexpression of TGF - ?1 signaling receptors, especially TGF - ?RI, andincreasing grades of malignancy in prostate cancer. These resultssuggest a potential mechanism for prostate cancer cells toescape the growth inhibitory effect of TGF - ? and thus, leadingto a more malignant phenotype.

دراسة التنميط الجيني لفيروس الSEN في متبرعي الدم الاصحاء ومرضى الثلاسيميا المصابين وغير المصابين بفيروس التهاب الكبد نمط ج واهميته السريرية == Genotypic Study Of SEN Virus In Healthy Blood Donors And Thalassemia Patients; With Or Without HCV Infection And Its Clinical Importance

اسم المؤلف: بشار منذر خزعل الزبيدي
اسم المشرف: اروى هادي الحمداني | اشنا جمال فائق
الموضوع العام: الطب
السنة: 2015
الدرجة: ماجستير
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: Blood transfusion is one of the most common routes of viral hepatitis transmission among population. There are several diseases need continuous blood transfusions to manage the patient's condition; one of these diseases is ?thalassemia, so these patients are at increased risk of infection with blood transfusion transmitted agents. SEN - Virus is a DNA virus which is associated with acute post - transfusion hepatitis and the prevalence with the clinical importance and also the genetic characterization are still much unknown in Iraq; therefore, this study was designed to investigate the occurrence and the clinical importance of SEN - virus infection in healthy blood donors and thalassemia patients with or without HCV infection and then the study of the genome sequencing and the phylogenetic analysis of SEN - V clones. One hundred and fifty eight thalassemia patients (57.6% male, 42.4% female), with mean age of 16.8±8.5 year, and one hundred and fifty healthy blood donors with randomly selected persons (58.7%male, 41.3% female), with mean age of 16.7±8.6 year. All these samples involved in this study that were conducted in the period between January to June 2015. SEN - V had been identified by DNA extraction, DNA amplification by nested conventional PCR and then Agarose gel electrophoresis amplified DNA bands detection; while HCV was identified by RNA extraction, RNA reverse transcription into complementary DNA, DNA amplification by nested conventional PCR and then Agarose gel electrophoresis amplified DNA bands detection. Liver transaminases (Aspartate Transaminase and Alanine Transaminase) were determined, in addition of measure of serum ferritin levels by VIDAS. SEN - V was detected in 68 out of 158 (43%) thalassemia patients and 16 out of 150 (10.7%) blood donors. HCV prevalence was (11.4%) in thalassemia patients. There was significant increase observed in the occurrence of SEN - V or HCV infection with age but there was no significant difference observed in the occurrence of both with gender. The most important (hepatotropic) SEN - V genotypes were SEN - V - D and SEN - V - H and there were patients infected with D genotype or H genotype alone, while there were patients co - infected with D and H. According to HCV and SEN - V co - infection status, patients and controls subdivided into six subgroups : subgroup I was thalassemia HCV RNA + and SENV DNA +, subgroup II was thalassemia HCV RNA + and SEN - V - , subgroup III was thalassemia HCV RNA - and SEN - V DNA +, subgroup IV was thalassemia HCV RNA - and SEN - V - , subgroup V was control SEN - V + and finally subgroup VI was control SEN - V - . Statistical analysis revealed that there was significant increase in AST and ALT levels in subgroup I when compared with the other subgroups - that showed the increasing relationship in the case of infection with both viruses - and there were no any significant differences in ferritin levels among these subgroups. Moreover, there were no significant differences between SEN - V - D, SEN - V - H and SEN - V - D and H co - infected samples in AST, ALT and ferritin among thalassemia patients and controls. The results from the study of gene sequencing and phylogenetic analysis of samples of amplified SEN - V - D and samples of amplified SEN - V - H DNA which were selected randomly from blood donors and thalassemia patients infected with D or H genotypes alone or together (co - infection), revealed that the most transmission route of SEN - V D and H was blood transfusion that is because there was (99%) gene similarity between blood donors and thalassemia patients, furthermore SEN - V - D or SEN - V - H sequences of the co - infected persons were the same sequences of D or H genotypes alone and with the observations of similarity with neighboring countries.
1 ... 67 68 69 70 71 ... 81