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دراسة التعبير المناعي النسيجي الكيميائي للدالتين p53 وKi - 67 لنخاع العظم في الورم النقوي المتعدد == Immunohistochemical study of the bone marrow expression of the proliferation index Ki - 67 and P53 oncogene in patient with multiple myeloma

اسم المؤلف: منى عبد المعين عبد الله
اسم المشرف: عبد الكريم محمد جعفر | عادل ربيع السعداوي
الموضوع العام: الطب
السنة: 2014
الموضوع الدقيق: الامراض - الدم
الدرجة: ماجستير
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: الخلاصةخلفية عن الدراسة : الورم النقوي المتعدد مقرها هو نخاع العظم ، يتميز بكون خلية البلازما الورميه , متعددة البؤر المرتبطة البروتين - M في المصل و/ او البول. يمتد الطيف السريري للمرض من لا اعراض الى الاشكال العدوانية واضطرابات بسبب ترسب سلاسل المناعي غير طبيعية في الانسجة.تعطيل الوظائف للورم القامع الجين p53 هوخطوره رئيسيه في التسرطن او تطور العديد من الاورام الخبيثه، هذا يرجع الى الطفرات الوراثيه ملزمة وتعطيل او تدهور من البروتينات الفيروسية او الخلوية. Ki - 67 هو الاجسام المضادة وحيدة النسيلة بالكشف عن مستضد النووي الذي يرتبط بشكل صارم مع تكاثر الخلايا.الهدف من الدراسة : للتحري عن وجود تعبير بروتيني للدالتين Ki - 67 وP53 باستخدام التقنية المناعية النسيجية الكيميائية في خزع نقي العظم لمرضى الورم النقوي المتعدد وتقييم نتائج هذه التقنية وتحليلها ومقارنتها مع مختلف المعلمات المرضية والنتائج المختبرية والسريرية.المواد والاساليب : هذه دراسة مستعرضة باثر رجعي حيث تحلل قطع نخاع العظم المغمورة في البارافين والموجودة في الارشيف (لمرضى تم تشخيصهم حديثا ولم يتلقوا اي علاج) مقارنة مع السجلات السريرية وسجلات تحاليل الدم الى 50 مريض مصاب بورم نخاع العظم (29 من الذكور و21 من الاناث) تم الحصول عليها من قسم امراض الدم في المختبرات التعليمية في مدينة الطب والمسجلة من نيسان 2012 الى نيسان 2014 جمعت ايضا قطع نخاع العظم المغمورة بالبارافين الى عشرين فرد تحكم او سيطرة ((12 ذكور و8 اناث) (متطابقة بالجنس والعمر)) جنبا الى جنب مع جميع تقارير فحص الدم . صبغ نخاع العظم بالصبغه المناعيه النسيجيه الكيمياويه p53 وكذلك Ki - 67.النتائج : كان هناك ارتباط خطي ايجابي كبير بين زيادة التعبير البروتيني p53 وتقدم المراحل السريرية للمرض. كان هناك ارتباط خطي ايجابي كبير بين زيادة التعبير البروتيني P53 وانخفاض نضج خلايا البلازما.كان هناك احصائية معنوية مترافقة ظاهرة بوضوح من المرضى الذين يعانون من ارتفاع مؤشر التكاثري مع المرحلة السريرية المتقدمة (المرحلة الثالثة) من هذا المرض من المرضى الذين يعانون من انخفاض مؤشر التكاثري.في الوقت نفسه، كان هناك ارتباط خطي ايجابي كبير بين درجة Ki - 67وتقدم المرحلة السريرية للمرض. وترتبط نسبة اكبر بكثير من المرضى الذين يعانون من ارتفاع مؤشر التكاثري Ki - 67 مع زيادة في نسبة خلايا البلازما في نخاع العظام من المرضى الذين يعانون من انخفاض زيادة في نسبة خلايا البلازما. وترتبط نسبة اكبر بكثير من المرضى الذين يعانون Ki - 67 مؤشر التكاثري عالية مع عدم النضوج الشكلي لخلية البلازما من المرضى الذين يعانون ناضجة التشكل لخلية البلازما. في الوقت نفسه، كان هناك ارتباط خطي ايجابي كبير بين زيادة 67Ki - وانخفاض نضج خلايا البلازما. وترتبط نسبة اكبر بكثير من المرضى الذين يعانون 67Ki - مؤشر التكاثري عالية مع نمط زيادة النمط المنتشر لتسرب خلايا البلازما في نخاع العظم من نمط غير منتشر.الاستنتاجات : المرضى الذين لديهم زيادة وتقدم المراحل السريرية او عدم النضوج الشكلي لخلايا البلازما في نخاع العظم تكون لديهم زيادة كبيرة في التعبير البروتيني p53و التي تحمل تطورات سيئه.المرضى الذين لديهم زيادة كبيرة في التعبير البروتيني Ki - 67 يكون لديهم تقدم المراحل السريرية, زيادة في نسبة خلايا البلازما او عدم النضوج الشكلي او زيادة النمط المنتشر لتسرب خلايا البلازما في نخاع العظم.التعبير البروتيني للدالتين p53 , وKi - 67 معتمدة كاحد العوامل التكهنية للمرض في الورم النقوي المتعدد مع التشخيص السلبي الذي قد يكون مرشحا للخطر - اعتمدت العلاجات. | Background : Multiple myeloma is a bone marrow based, multifocal plasma cell neoplasm associated with an M - protein in serum and/or urine.The disease spans a clinical spectrum from asymptomatic to aggressive forms and disorders due to deposition of abnormal immunoglobulin chains in tissues.P53 tumor suppressor gene functional inactivation is a key step in carcinogenesis or progression of many human malignancies. This is due to either gene mutations, binding and inactivation, or degradation by viral or cellular proteins.Ki - 67 is a monoclonal antibody that detects a nuclear antigen that is strictly associated with cell proliferation. Aim of the study : 1. To study the changes in P53 oncogene protein expression and proliferation index (Ki - 67 PI) in patients with multiple myeloma.2. To investigate the correlation of P53 oncogene protein expression and proliferation index (Ki - 67 PI) with various pathological, laboratory and clinical parameters.Materials and methods : This is a retrospective cross - sectional study; where by archival paraffin - embedded tissue blocks along with the clinical and hematological records of fifty patients with multiple myeloma (29 males and 21 females) were obtained from the Department of Hematology of the Medical City Teaching Laboratories during the period from April 2012 to April 2014. Paraffin - embedded tissue blocks of twenty control individuals with anemia (12 males and 8 females; age and sex matched) along with their hematological reports were also collected and collected. Bone marrow immunohistochemical staining for P53 and Ki - 67 was done.Results : There was a significant positive linear correlation between increasing scores of p53 and advancing clinical stages of disease. There was a significant positive linear correlation between increasing scores of p53 and decreasing maturity of plasma cells.A significantly larger percent of patients with high proliferative index were associated with advanced clinical stage (stage III) of the disease than patients with low proliferative index. At the same time, there was a significant positive linear correlation between Ki - 67 score and advancing clinical stage of the disease. A significantly larger percent of patients with high proliferative index for Ki - 67 are associated with high plasma cell burden in the bone marrow than patients with low plasma cell burden. A significantly larger percent of patients with high Ki - 67 proliferative index are associated with less mature plasma cell morphology than patients with mature plasma cell morphology. At same time, there was a significant positive linear correlation between increasing Ki - 67 scores and decreasing maturity of plasma cells. A significantly larger percent of patients with high Ki - 67 proliferative index are associated with diffuse BM infiltration pattern than the non - diffuse pattern.Conclusions : 1 - Patients with advanced clinical stages and immature plasma cell morphology had a higher p53 scores which confer bad prognosis.2 - Higher Ki - 67 proliferative index in Patients with advanced clinical stages, high plasma cell burden, immature plasma cell morphology, and diffuse pattern of infiltration.3 - p53 and Ki - 67 expression by IHC can readily identify myeloma patients with an adverse prognosis who may be candidates for risk - adopted therapie

العلاقة بين النتائج السريرية ونتائج التصوير بالرنين المغناطيسي في عينة من المرضى العراقيين الذين لديهم تدلي القرص بين الفقرات القطنية == Correlation Between Clinical Finding And Magnetic Resonance Imaging In a sample of Iraqi patients with Lumbar Disc Prolapse

اسم المؤلف: نورس نوري كعيد
اسم المشرف: خضير زغير معيوف البدري | ليث احمد خلف
الموضوع العام: الطب
السنة: 2014
الموضوع الدقيق: الاشعة التشخيصية
الدرجة: دبلوم عالي
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: Lumbar disc prolapse is one of the common causes of low back pain seen in the working population. There are contradictory reports regarding the clinical significance of various magnetic resonance imaging (MRI) findings observed in these patients.Objective : To find out the correlation of clinical features and magnetic resonance imaging (MRI) findings in determining the level of lumbar disc herniation.Patients and Methods : This study was conducted in department of radiology Baghdad teaching hospital from15thaugust 2013 to 15th august 2014 , the total number of patients with prolapse intervertebral disc was 100, the clinical level of disc herniation was determined depending on clinical findings (dermatomal distribution, pin - prick test , SLR Test , knee reflex And Ankle reflex ) and correlated with MRI findings (direction and location of disc herniation and nerve root compression).For both data entry and data analysis Statistical package for social science version 18 (SPSS18) was used. P - value of < 0.05 considered significant.11AbstractResults : Total 100 patients were studied during the12 months period. Out of 100 patient (52%) were male while (48%)were female. Age range was from 17 - 70 years, mean age was 38.9 ±11.4 .Maximum patients were in the age group range from17 - 34 (37%) followed by 35 - 45 years (33%).The duration of symptoms was ranging from 2 months to 2 years. The duration of symptoms was less than 1 year in 57% of patients and while 43% in 1 - 2 years group. The average duration in female patients was 1.1 years and in male patients was 11.23 monthon MRI the commonest nerve compression grade was grade 1 (contact) , when we comparing clinical test grade with nerve compression grade it was found that clinical test grade show very strong association with nerve compression grade .on MRI most disc herniation direction was posterolateral (61%)and (39%)central direction , when we test if there is association between the direction of disc herniation and whether there is nerve root compression we found strong relationship with p - value equal 0.003 .The level of disc herniation was determined on clinical basis as well as on MRI. These findings were compared and correlated for single level disc like L4 - L5 and L5 - S1 and for multiple levels. We found out the sensitivity, specificity and predictive values of clinical features and applied chi square test.In case of L4 - L5 level disc herniation, the sensitivity of all clinical features was 70.5% and positive predictive value was 80%, while the specificity was12Abstract62.5% and negative predictive value was 50%. The chi square value was significant with P value of 0.001.In case of L5 - S1 level disc herniation, the sensitivity and specificity of clinical features as a whole were 71.7% and 62% respectively. The positive predictive value was 55% and negative predictive value was 77.5% with significant chi square test of P value of 0.001.In case of L4 - L5 &L5 - S1 levels disc herniations the sensitivity and specificity of clinical features as a whole were 43% and 91.05% respectively. The positive predictive value and negative predictive value were 27% and 95.5% respectively with significant chi square test of P value of 0.028.Conclusion : This study shows that the lower lumbar discs are affected more than other disc site. In addition, there are strong association between nerve compression grade with severity of symptoms and signs so as the grade increase so also symptoms and signs increase.Also we found strong relationship between the direction of herniation and nerve root compression, so the posterolateral herniation direction compress root more often than central one .Finally, the clinical features should be correlated with MRI findings in determining the level of disc herniation. There is excellent correlation between the clinical features and MRI findings in case of single and multiple level disc herniation, when it is lying posterolaterally at L4 - L5 level or L5 - S1 level.

الدلالة السريرية للزيادة في كل من الاقراص الدموية والمستضاد السرطاني (125) كاداة تنبؤ بالاورام الخبيثة في الكتلة النسائية الحوضية == CLINICAL SIGNIFICANCE OF THROMBOCYTOSIS AND CA125 AS PREDICTOR OF MALIGNANCY IN GYNAECOLOGICAL PELVIC MASS

اسم المؤلف: عبير مكي خليل
اسم المشرف: نجمة محمود الخزعلي
الموضوع العام: الطب
السنة: 2014
الموضوع الدقيق: النسائية والتوليد
الدرجة: دبلوم عالي
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: الهدف من الدراسه : تحديد كل من الزيادة في عدد الصفائح الدموية (>450X 10 9 / مايكروليتر) ومستوى المستضاد السرطاني 125 (> 35 وحدة/مل) كادوات تنبؤية مفيدة لتاكيد خبثية الكتلة النسائية الحوضية.طريقة العمل : دراسه انية مستندة على حالات سريرية وحالات ضابطه غير متشابه اجريت على 110 امراة والتي تم تسجيلهم في هذه الدراسة ومقسمين الى مجموعتين ، 60 امراة وهي المجموعة الضابطه (خالين من الكتلة الحوضية) والتي اعتبرت كدواخل مختارة في الدراسة. في حين المجموعة الاخرى تضمنت 50 امراة فوق 15 سنة مع كتلة نسائية حوضية وقد خضعن الى عمليات جراحية استكشافية وباستخدم مختلف الطرق التسخيصية مثل الفحص السرير وتنقنيات التصوير بـ (الامواج فوق الصوتية والمفراس الحلوزني والرنين المغناطيسي) والفحوصات المختبرية (عدد الصفائح الدموية ، المستضاد السرطاني 125 والنسيج المرضي)وان بياناتهم قد خضت الى تحليل الاحصائي لمعرفة الحساسيه وفاصل الثقه والدقه والقيمه التنبئيه السالبه والموجبه .محل اجراء الدراسه : قسم النسائية والتوليد في مستفى بغداد التعليمي / كلية الطب - جامعة بغداد .النتائج : قد اختبر كل من المستضاد السرطاني 125 في الدم وعدد الصفائح الدموية لمعرفة مدى صدق استخدامهما كتحليل تنبؤي بتشخيص الخبيثة في الكتلة النسائية الحوضية وان كلا التحليلين اظهرا صدقا عاليا في التشخيص اذ كان مساحة استقبال خاصية التشغيل > 0.95 وقد اظهر المستضاد السرطاني 125 هامش الصدق الاعلى مساحة استقبال خاصية التشغيل > 0.017 .وان كلا مساحة استقبال خصائص التشغيل ROC كانا ذا ذلالة اعلى من 0.5 للمساحة المرتبطة باختبار الشك (الغموض).لقد كانت افضل قيمة قطعية لعدد الصفائح الدموية هي (≥ 385) وان كل الدراسات توصلت الى ان ان كل حالة مع عدد صفائح دموية (≥ 385) هي خبيثة بينما كل حالة تحت هذه القيمة القطعية هي سليمة او معافى.وان اختبار المستضاد السرطاني 125 في الدم يكون سالبا في اعلى حالات الحساسية (100%) للقيمة القطعية (27.1≥ ) والتي يجب ان يتم استثناء احتمالية تشخيصها كورم خبيث في مقابل اعتبارها حالة سليمة وموثوقة (100%) وان اعلى قيمة قطعية هي (≥ 41.7) والتي هي ايضا ذات موثوقية (100%) ولذلك فهي (100%) تمثل القيمة القطعية للتشخيص.الاستنتاج : ان ازدياد كلا عدد الكريات الدموية (≥385X10 9 / مايكروليتر) ومستوى المستضاد السرطاني 125 في الدم (≥ 41.7وحدة /مل) هما ادوات تنبؤ مفيدة لاثبات خبثية الكتلة النسائية الحوضية. | Objective : We attempted to determine the increasing of platelet counts (> 450.000 /microliter) and CA125 serum level (> 35 U/mL) as useful tools for predicting and confirming malignancy in gynaecological pelvic mass.Patients and methods : A prospective unmatched hospital based case - control study carried out about One hundred & ten women were enrolled in our study, divided into two group 60 women were control group (free of gynaecological pelvic mass) which were considered as “eligible entrants” into the study. Other group include 50 women above 15 years old with gynaecological pelvic mass were all candidate for laparotomy and using different diagnostic methods like clinical examination, imaging techniques (U/S, CT scan and MRI) and laboratory test (platelet count, CA125 and Histopathology). The data of those were subjected to statistical analysis (sensitivity, specificity, accuracy, NPV and PPV) which calculated to considered if it is statistically significant or not. Setting : Obstetrics And Gynaecology Department At Baghdad Teaching Hospital / College Of Medicine - Baghdad University.Results : Serum CA125 and blood platelets count were tested for validity when used as a test to predict a diagnosis of malignancy in gynaecological pelvic mass differentiating it from benign gynaecological pelvic mass. Both tests showed a very high validity in diagnosis (ROC area >0.95), with serum CA125 showing a marginally higher validity (ROC area larger by 0.017 only). Both ROC areas were significantly higher than the 0.5 area associated with an equivocal test.Platelets counts had a perfect cut - off value of ≥385.000 All study subjects with a blood platelets count equal or greater than 385.000 were malignant, while everybody below this cut - off value was healthy.For serum CA125 testing negative at the highest sensitivity (100% sensitive) cut - off value of (≥ 27.1( would excluded a possible diagnosis of malignancy in favor of being healthy with 100% confidence. The optimum cut - off value is ≥41.7, which is also the 100% specific and thus 100% diagnostic cut - off value.Conclusion : Both blood platelet count (≥ 385 X 103microlitter) & serum level of CA125 (≥ 41.7 U/mL) are useful predictor tools to confirm malignancy in gynaecological pelvic mass

ترداد المشيمة المتقدمة والنتائج الناجمة عنها في مستشفى بغداد التعليمي == The Frequency of Placenta Previa and its Outcome in Baghdad teaching Hospital

اسم المؤلف: نضال عبد الرزاق حسين
اسم المشرف: عفراء محجوب النداوي
الموضوع العام: الطب
السنة: 2014
الموضوع الدقيق: النسائية والتوليد
الدرجة: دبلوم عالي
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: Placenta praevia is the implantation of the placenta partially or wholly in the lower segment of the uterus. It is graded in two ways, as either grade 1 - 4 or minor/major. It is a major cause of obstetrical hemorrhage which leads to increase in maternal morbidity & perinatal mortality, its incidence is still rising worldwide.Objectives : To determine the frequency and outcome of placenta previa at Baghdad teaching hospital Patients and methods : A prospective observational study was carried out during the period between 1st October 2013 and 31 January 2014 at Baghdad Teaching Hospital, medical city complex. During the study period, total number of deliveries was 4128, of them 2322 were delivered by cesarean section and 1806 were vaginal deliveries. Of all those, 92 pregnant ladies who had placenta previa diagnosed ultrasonographically& confirmed during cesarean delivery had placenta previa and were included. Pregnant ladies with normally situated placenta were excluded from the study. Data were collected through Detailed history taking, and clinical examinations of patients. Preparations and interventional procedures included cross matching of at least 6 pints of blood & preparation of fresh frozen plasma and cryoprecipitate, Single course of antenatal corticosteroids was given. All cases in this study where delivered by ceserean section. All mothers were monitored for signs of complication like disseminated intravascular coagulation DIC during and after surgery and for post - partum hemorrhage. Official agreements and verbal consent of all women were obtained prior to participation. Statistical analysis performed by using the statistical package for social sciences and appropriate statistical tests were used with the aid of expert statician.Results : There were 92 women who had placenta previa out of 4128, and the proportion of placenta previa was 2.2%, The mean age of the studied group was 32.2 ± 5.9 (range : 20 - 44) years. More than half (56.3%) of the studied group were gravida 5 or more. Nulliparous were only 3 patients (3.3%). History of miscarriage was found in 23 patients (25%). One or more previous cesarean sections were found in 78 (84.8%) patients. At time of delivery 72 (78.3%) patients were at < 37 weeks of gestation and 20 patients (21.7%) were at ≥ 37 weeks. Cesarean sections were performed in 61 patients (66.3%).Caeserian hysterectomy was conducted in 31 patients (33.7%), internal artery ligation was performed in 7 patients (7.6%), uterine artery ligation in 5 patients (5.4%). Morbidly adherent placenta was the more frequent cause of hysterectomy in 18 patients represented (58.1%) and bleeding in 13 patients (41.9%). Conclusion : In the present study the incidence of placenta previa was increased with the advancing age, particularly > 35 years, the incidence of placenta previa was highest in the multiparous group than nulliparous and directly associated with parity and gravidity. Previous caesarean section was an important and significant risk factor and none of the cases died

فايروس البارفو بي تسعة عشر وعلاقته بنوبة انعدام التنسج في الاطفال المصابين بابيضاض اللمفاويات الحاد == PARVOVIRUS B19 ASSOCIATED APLASTIC CRISISIN CHILDREN WITH ACUTE LYMPHOBLASTIC LEUKEMIA

اسم المؤلف: اقبال معافي عبد لله المساري
اسم المشرف: شذى فاروق عبد الله | مازن فیصل فرحان الجادري
الموضوع العام: الطب
السنة: 2014
الموضوع الدقيق: الاحياء المجهرية
الدرجة: ماجستير
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: Parvovirus B19 is a small single - stranded DNA virus and the only member of the species Parvoviridaeknown to infect humans. The virus exhibits a strong tropism for erythroid progenitor cells using the erythrocyte globoside P antigen as a surface viral receptor. In the setting of shortened red blood cell survival, mild pancytopenia characterized by transient and spontaneous recovery in healthy subjects. Nevertheless; severe aplastic anemia associated with parvovirus B19 infection may precede or be associated with acutelymphoblastic leukemia (ALL) that has been described in a number of reports.The attenuated immune response in these patients may obscure the serologic and clinical manifestations of infection. Infection may mimic a leukemic relapse or therapy - induced cytopenia, and may lead to hospital admission, frequent blood sampling, renewed bone marrow aspirates, multiple transfusions of red blood cells (RBCs) or platelets, and cessation of maintenance chemotherapy for up to 3 weeks in children with ALL.Materials & Methods : A cross sectional study involved forty five patients with ALL were currently attending department of oncology in Children'sWelfare Teaching Hospital in medical city of Baghdad between December 2012 and April 2013.Twenty one patient who newly diagnosed with ALL and 24 who underwent chemotherapy.Their age ranged from 8 months to 15 years with mean age ±SD equal to6.54±4.2 years. Compared to forty five of apparently healthy children who were already under pre operative screening tests. They included in this study as a control group, age and sex were matched.The practical part of this study performs the followings : 1 - Serological detection of parvovirus B19 specific antibodies (IgM and IgG) in patients’ serum using enzyme linked immunosorbant assay (ELISA).2 - Molecular detection of parvovirus B19 - DNA using Real - time PCR for viral load measurement.3 - Other tests : include hematological tests which were done routinely for patient assessment.ResultsB19 - IgM was detected in 7 out of 45 patients tested (15.6%) compared to 2 out of 45 (4.4%) apparently healthy children whom belong to control group. No Statistical significant difference was observed (P - value >0.05) and the risk of parvovirusB19 infection in children with ALL was 3.96 times (odds ratio).B19 - IgG was detected in 18 out of 45 patients (40%) compared to 6 out of 45 (13.3%) of apparently healthy children. Statistical significant difference was clearly noticed (P - value < 0.05).Four out of 21(19.05%) children whom newly diagnosed with ALL had acute parvovirus B19 infection compared to 3 out of 24 (12.5%) children on maintenance chemotherapy gave positive parvovirusB19 - IgM.Parvovirus B19 IgG antibodies were detected in 8 out of 21(38.1%) 0f newly diagnosed children with ALL compared to 10 out of 24 (41.7%) children on maintenance chemotherapy.The correlation between parvovirus B19 IgG - and IgM - Antibodies among study groups shows that 4 out of 45 (8.9%) was detected to be positive in children with ALL group compared to control group which revealed no detectable combined B19 IgG/IgM antibodies.Parvovirus B19 - DNA was detected in 6 out of 45(13.3%) compared to none detectable DNA signals among the control group. All cases with positive parvovirus B19 nucleic acid signals were underwent maintenance chemotherapy which were represented in 6 out of 24(25%), statistical significant difference were noticed among study cases. The viral load was ranged from (65x103 - 106 copies/ml) with mean of (36x104 copies/ml).In newly diagnosed ALL cases, only one case (4.7%) had IgM/IgG antibodies and 3 out of 21 cases (14.3%) gave IgM positive antibodies. While children on maintenance chemotherapy ,a combined IgM/IgG were detected in 3 cases out of 24(12.5%), 3 cases with both IgG and B19 DNA signal detection and only two (8.3%) children on maintenance chemotherapy gave positive B19 DNA signal (P - value < 0.05).The effect of B19 infection on blood parameters during recent, prior and absent infection for studied groups showed that the mean values of hemoglobin were 8.5±1.8, 6.5±2.5 and 8.5±2(g/dl) in children with ALL who were proved to have positive IgG, IgM and B19 DNA respectively compared to12.8±0.7 among control group (P<0.05). Other blood parameters showed a decreased RBC count which were estimated in cases with positive anti B19 IgG was 3±0.7 anti B19 IgM was 2.5±0.9whereas, mean RBC count was2.9±0.6 in association with B19 cases DNA detected signals (P<0.05). Furthermore, acute B19 - infection associated with a decreased WBC count among ALL cases with (p<0.05), a remarkable decrease in platelets count was appeared in cases with acute B19 infection (P<0.05).Regarding clinical symptoms and signs associated with B19 infection, 2 out of 7 (28.6%) cases with peticheal rash had acute infection with B19 virus, 3 out of 7 (42.9%) ALL cases with acute B19 infection complained from Arthralgia and 8 out of 18(44.4%) cases had non - specific fever and proved to have acute B19 infection, one ALL case with positive B19 IgM and/or B19 DNA out of 3 (33.3%) with bilateral cervical lymphadenopathy, 5 out of 6 (83.3%) cases with acute B19 infection had hepatosplenomegaly.Based on the sample studied, 15% of true B19 - IgM was identified by ELISA test compared to13% of true B19 - DNA signal detection by real time - PCR, whereas 100% of correctly no detectable B19 - DNA signal was identified in healthy control using real time - PCR, compared to 95% of negative B19 - IgM in serum level among control group using ELISA.A child who has a detected B19 - DNA signal by real time - PCR has a 100% chance of having acute infection compared to 77% chance of using ELISA test.Conclusions The study results are consistent with previous studies which appear that children who suffering from ALL are at increased risk of B19 infection. The use of real time PCR detects high B19 - DNA viral load. Notable percentage ofpersistent B19 infection was recorded among children with ALL who are receiving ongoing treatment, in addition, most of acute B19 infected ALL cases were asymptomatic. Acute B19 - infection was shown to be an important cause of anemia and cytopenia in children with ALL.Recommendation : Further follow up studies are necessary to clarify the role

علاقة معامل ضغط الدم الشرياني للكاحل نسبة للعضد بعمل البطين الايسر للمصابين بمرض قصورالشرايين التاجية == RELATION OF ANKLE BRACHIAL INDEX TO THE LEFT VENTRICULAR FUNCTION IN PATIENTS WITH CORONARY ARTERY DISEASE

اسم المؤلف: محاسن محمد عبد المجيد
اسم المشرف: نجيب حسن محمد | هلال بهجت الصفار
الموضوع العام: الطب
السنة: 2014
الموضوع الدقيق: الفسلجة
الدرجة: ماجستير
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: يعد تصلب الشرايين من اهم العوامل المتسببة في مرض الشرايين التاجية ويعد فحص قياس ضغط الدم الشرياني الانقباضي للكاحل نسبة للعضد من الفحوصات الامنة وطريقة اجراءه سهلة وبسيطة لتشخيص امراض الشرايين الطرفية .حيث استخدم في وقت لاحق كمؤشر على تصلب الشرايين في مواقع اخرى للاوعية الدموية. ويعد فحص صدى القلب ( الايكو) من الفحوصات الامنة واداة تشخيصية ويوفر امكانية لتقييم وظائف القلب.الهدف من هذه الدراسة هو : 1) تقييم فائدة ودقة فحص قياس ضغط الدم الشرياني للكاحل نسبة للعضد في تشخيص الخلل في عمل البطين الايسر. 2) تحديد نوع اختلال عمل البطين الايسر في المرضى الذين لديهم نتائج غير طبيعية في فحص قياس ضغط الدم الشرياني للكاحل نسبة للعضد سواء اكان الاختلال في عمل البطين الايسر انقباضي او انبساطي او كليهما. 3) ايجاد علاقة فحص قياس ضغط الدم الشرياني للكاحل نسبة للعضد بشدة وعدد الشرايين التاجية المصابة بالتضييق الشرياني لدى مرضى قصور الشرايين التاجية.ثمانون (80) شخصا مصابون بقصور الشرايين التاجية كما هو موثق عن طريق فحص تصوير الشرايين التاجية (قسطرة الشرايين التاجية) من كلا الجنسين شاركوا في هذه الدراسة للفترة من كانون الاول 2013 الى ايار عام 2014 حيث اجريت هذه الدراسة في المركز العراقي لامراض القلب / مستشفى غازي الحريرى التعليمي. تم اخذ عينة من المرضى المحالين الى المركز العراقي اما لغرض اجراء فحص تصوير الشرايين التاجية (قسطرة الشرايين التاجية) او لاجراء عملية التمييل للشريان التاجي ومن المرضى الراقدين في قسم جراحة القلب في المركز لاجراء عملية مجازة الشريان التاجي.المرضى خضعوا للفحص السريري , القياسات الفيزياوية للجسم (الطول والوزن ومعامل كتلة الجسم ومحيط الورك، ومحيط الخصر ونسبة الخصر الى الورك) وقياس ضغط الدم ثم فحص قياس ضغط الدم الشرياني للكاحل نسبة للعضد وتم حساب قيمة معامله بقسمة ادنى قيمة لضغط الدم الانقباضي للكاحل ( ضغط الانقباضي لشريان ظهر القدم اوشريان الظنبوب الخلفي ) على اعلى قيمة لضغط الدم الشرياني للعضد. وقد حسب المعامل لكل ساق على حدة، وادنى القيمتين استخدمت لتحديد قيمة معامل فحص قياس ضغط الدم الشرياني للكاحل نسبة للعضد للمريض باستخدام جهاز hand - held 8MHz Doppler كما واجري فحص تخطيط صدى القلب لكل مريض M - mode, Doppler , tissue Doppler ثم ارسل المرضى لاجراء فحص تصوير الشرايين التاجية ( القسطرة). صنف المرضى الى ثلاث مجموعات وفقا لنتائج فحص قياس ضغط الدم الشرياني للكاحل نسبة للعضد : المجموعة الاولى ذات النتائج الغير طبيعية المنخفضة ) 0.79±0.12) ؛ تتالف من تسعة وعشرين (29) من المرضى)20 رجلا و9 امراة بمتوسط عمر مقداره 58 ± 6 سنة) والمجموعة الثانية ذات النتائج الغير طبيعية العالية (1.43±0.05 )؛ تتالف من ثلاثة عشر (13) من المرضى(10 رجال و3 امراة بمتوسط عمر مقداره 56 ± 6 سنة والمجموعة الثالثة تمثلت بالمرضى اصحاب النتائج الطبيعية للفحص (1.03±0.10) والذي يمثل مجموعة السيطرة؛ تتالف من ثمانية وثلاثين (38) من المرضى (27 رجلا و11 امراة بمتوسط عمر مقداره 58 ± 7 سنة).كما واظهرت نتائج هذه الدراسة بخصوص المقارنة بين الاختلال الوظيفي الانقباضي للبطين الايسر فقد سجلت نتائج نسبة الكسر القذفي (EF%) انخفاضا ملحوضا في المجموعتين الاولى والثانية مقارنة بالمجموعة الثالثة وكذلك اظهرت النتائج انخفاضا ملحوظا في التقصر التجزيئي FS٪ .بالاضافة الى ذلك تبين بان هنالك تباين ملحوظ في الاختلال الوظيفي الانبساطي للبطين الايسر عند المقارنة بين المجموعة الاولى والثانية مع المجموعة الثالثة حيث سجل تباطؤا ملحوظا في عامل الوقت التباطؤي (DT) مع زيادة ملحوظة في عامل E/Em في حين لم تظهر النتائج تباينا ملحوظا في عامل سرعة موجة E وEm ونسبة E/ A وIVRT.فيما يخص مؤشر معامل اداء عضلة القلب (MPI) بينت الدراسة زيادة كبيرة في المعامل لدى المجموعتين الاولى والثانية مقارنة بالمجموعة الثالثة كما واظهرت نتائج هذه الدراسة ان الذكور اكثر عرضة للاصابة بقصور الشرايين التاجية من الاناث . وتبين من النتائج ان هنالك ازدياد في نسبة عدد الشرايين التاجية المصابة بالتضيق من شريان واحد الى شريانين الى ثلاثة شرايين في المجموعتين الاولى والثانية مقارنة بالمجموعة الثالثة خصوصا لدى المرضى المصابيين بداء السكري حيث تزداد نسبة الشرايين المصابة بالتضيق لديهم اكثر من باقي المرضى. واستنتجت هذه الدراسة ان فحص الضغط الشرياني للكاحل نسبة للعضد يكشف عن وجود علاقة ويعطي فكرة وانطباع عن وظائف البطين الايسر الانقباضي وعن عدد الشرايين التاجية المصابة بالتضييق الشرياني لدى المرضى المصابيين بقصور الشرايين التاجية. | Measurement of the ankle - brachial index (ABI) represents sensitive, specific, noninvasive, safe and simple objective way to diagnose peripheral arterial diseases. Coronary artery disease (CAD) is most commonly due to atherosclerotic occlusion of the coronary arteries. It was shown that the ABI is an indicator of coronary atherosclerosis in addition to other vascular sites and can serve as a prognostic marker and a predictor for cardiovascular events and functional impairment, even in the asymptomatic patients.The aim of this study is to : 1) Prove the usefulness and the accuracy of ABI in the assessment of left ventricular dysfunction. 2) Determine the type of left ventricular dysfunction whether systolic, diastolic or combined in patient with abnormal ABI. 3) Determine the relationship between ABI with the angiographic extent of coronary artery disease. Eighty (80) patients of either sex with coronary artery disease proved by coronary angiography included in this study. They are selected from those referred to the Iraqi Center for Heart Disease for either diagnostic coronary angiography or for percutaneous coronary intervention and from those admitted to the surgical department for coronary artery bypass graft. Each patient is submitted for Medical history and clinical examination, anthropometric measurements (height, weight, waist circumference and hip circumference to calculate body mass index and waist to hip ratio), systolic ankle - brachial index test and echocardiography examination in addition to coronary angiography. The systolic blood pressure (SBp) is measured at the right and left brachial, dorsalis pedis and posterior tibial arteries using Doppler probe. The ABI for each leg was calculated by dividing the lowest value of either ankle SBP (dorsalis pedis or posterior tibial) by the highest value of either brachial SBP where the lower of the two values was considered to define the patient ABI. Then after that, Transthoracic M - mode, pulsed - wave Doppler and tissue Doppler echocardiography are performed for all participants to obtain measurements to assess left ventricular function and interpreted with the ABI results. This study was conducted from December 2013 till May 2014 at Iraqi Center for Heart Disease / Ghazi Al - Hariry Teaching Hospital.The patients are classified according to the normal cut off values of the ABI (0.9< ABI ≤1.30) : Group І with abnormally low ABI (0.79±0.12) including twenty nine (29) patients (20 men and 9 women with a mean age of 58 ± 6 years), Group ІІ with abnormally high ABI (1.43±0.05); composed of thirteen (13) patients (10 men and 3 women with a mean age of 56 ± 6 years) and Group ІІІ with normal ABI (1.03±0.10) which represents the control group; composed of thirty eight (38) patients (27 men and 11 women with a mean age of 58.93 ±7.85years).The results of this study reveal that male gender being involved by CAD more than females among the studied groups (69 %, 84 % and 71 % respectively with p < 0.05). Regarding left ventricular systolic function, the results account a statistically significant decrease in the left ventricular ejection fraction (EF %) among low and high ABI Groups when compared to that of normal ABI Group (53.4±14.7 and 42.6±10.4 vs. 63.1±8.9 respectively. Diastolic dysfunction when assessed by pulsed wave Doppler the results reveal a statistically significant comparison between abnormal ABI Groups (low and high ABI Group) and with those of normal ABI Group in the prolongation of the deceleration time (DT) (171 and 149vs.195) respectively, decreases in the Ea velocity(0.09 ± 0.03 and0.07 ± 0.02 vs. 0.10 ± 0.03) respectively and increasing E/Ea ratio (10.32 and 10.61 vs. 7.76 ) while there are no significant differences between abnormal ABI Groups (low and high ABI Groups) with those of normal ABI Group; regarding Peak E,A waves velocity, E/ A ratio and isovolumic relaxation time (IVRT). Moreover myocardial performance index (MPI) there is statistically significant increase in the MPI in low and high ABI Groups when compared to normal ABI Group (0.64 and 0.64 vs. 0.40). Concerning the number of coronary arteries involved as obtained from coronary angiography, this study reports increasing frequency from single vessel, two vessels to three vessels involvement in the abnormal ABI groups when compared to the normal ABI Group particularly in those patients with diabetes mellitus, more coronary vessels are involved. In conclusion, apart from that an abnormal ABI (<0.9 and > 1.4) serves as an indicator and predictor for coronary artery disease, it is associated with left ventricular systolic and diastolic dysfunction. In addition, ABI is a useful bedside predictor for the extent of coronary artery disease

دور التصو ر المقطعي عديم التباين منخفض الجرعة في توقع نجاح علاج تفتيت حصاة الكلية بالموجات الصادمة من خراج الجسم == Role of Low Dose Noncontrast Computed Tomography in Predicting the Success of Extracorporeal Shock Wave Lithotripsy Treatment of Renal Stone

اسم المؤلف: احمد عباس محمد
اسم المشرف: ليث احمد خلف | عادل حفظي حمودي
الموضوع العام: الطب
السنة: 2014
الموضوع الدقيق: الاشعة التشخيصية
الدرجة: دبلوم عالي
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: Currently, extracorporeal shock wave lithotripsy (ESWL) is the most common mode of therapy for small renal stones. Many studies have attempted to correlate the radiographic findings of non - contrast computed tomography (NCCT) with ESWL success and prospective assessment of patients with renal calculi.Objective : To assess the role of low dose non - contrast computed tomography in predicting the success of extracorporeal shock wave lithotripsy for renal stone treatment.Patients and Methods : A prospective study was conducted at Al - Shaheed Ghazi Al - Hariri teaching hospital in Baghdad medical city during the period from the 15th of December 2013 to the 30th of July 2014. Fifty patients who met the inclusion criteria and agreed to participate in this study were recruited . Data collected using a pre constructed data collection form in which the demographics and clinical data were reported. Stone characteristics were based on the pre - treatment non - contrast CT scanning reviewed and reported by one urologist and one radiologist. Diagnosis of renal stone was made by a specialist urologist depending on the clinical features and proved by urinalysis , KUB, Ultrasound and the non - contrast CT images. The SSD was calculated by measuring the 90° distance from the center of the stone to the skin .Patients received one session of ESWL and followed up for two weeks. Successful treatment considered if there was complete clearance of the stone with no residual fragments (stone - free) or presence of gravels less than 4 mm . Those who failed received another session 2 week after the first one. Data wereXIIanalysed using the statistical package for social sciences (SPSS) version 21, and appropriate statistical tests were used to assess the significance which set at ≤ 0.05 to be significant.Results : The age of the studied group ranged (23 - 74) years with a mean of (41.5± 12.5) years. Only 20% of the patients aged 30 years or less. Male to female ratio was (2.3 : 1). After the 1st session , 40% of patients had successful treatment and they became stone free. After the second session, the overall response rate (successful ESWL) was (66%). Success of treatment was significantly affected by the initial stone size . patients with successful treatment had the lower stone area (96.4 ± 34.4 mm2) compared to (150.8 ± 81.2 mm2) in those with unsuccessful treatment , (P=0.016). Stone density showed an inverse correlation with the success rate, the mean stone density was the lower among those with successful treatment (640.3 ± 301.2) HU , (P<0.001). Multiple logistic regression showed that stone size and density were the most significant predictors for successful treatment. Patients characteristics (age and sex), site of the stone and SSD didn’t reach the statistical significance for prediction (P>0.05) .Conclusion : Non - contrast Computed Tomography (NCCT) is a noninvasive and useful for obtaining a lot of information about the patient and renal calculi and can predict the success of ESWL. Stone density and size were significant predictors of the outcome of ESWL . Lower stone density and size predicted by NCCT associated with higher success rate of ESWL.

شمول مفصل الورك لدى عينة من المرضى العراقيين المصابين بالتهاب المفاصل الروماتويدي == Hip Joint Involvement in a Sample of Adult Iraqi Patients with Rheumatoid Arthritis

اسم المؤلف: حيدر ثامر محمد
اسم المشرف: خضير زغير معيوف البدري
الموضوع العام: الطب
السنة: 2014
الموضوع الدقيق: الامراض - المفاصل
الدرجة: دبلوم عالي
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: التهاب المفاصل الروماتويدي هو مرض التهابي مجموعي مزمن يستهدف المفاصل الزليلية بشكل اساسي. يؤثر هذا المرض على كل الفئات العرقية في جميع انحاء العالم وتسببه عوامل متعددة. اذا ترك هذا المرض بدون علاج، فانه عادة ما ينتج عنه التدمير التدريجي للمفصل والعجز الكبير للمريض. قد يتاثر مفصل الورك لدى 10% الى 40% من مرضى التهاب المفاصل الروماتويدي وتشتمل العلامات الشعاعية لشمول مفصل الورك على تضيق مساحة المفصل وانصباب وتقرحات وتبارز الحق والنخر اللاوعائي لراس عظم الفخذ. الاهدافلتقدير تواترشمول مفصل الورك ولتقييم الترابط بين شمول مفصل الورك ومختلف الميزات للمرضى العراقيين البالغين المصابين بالتهاب المفاصل الروماتويدي .المرضى وطريقة البحثشملت الدراسة المقطعية 60 مريضا عراقيا بالغا مستوفيا لمعايير الكلية الامريكية للمفاصل لتصنيف التهاب المفاصل الروماتويدي لسنة 1987 . تم استبعاد المرضى الذين يعانون من امراض وحالات اخرى التي قد تؤثر على مفصل الورك. تم جمع بيانات المرضى بما في ذلك : العمر، الجنس، الوزن، الطول، مؤشر كتلة الجسم، مدة المرض، التاريخ العائلي للمريض، التاريخ الدوائي للمرض، تشوهات اليد، العلامات الدالة على شمول مفصل الورك، بروتين سي التفاعلي، العامل الروماتويدي، مضاد الببتيد الموسوم بالسترولين. تم تقييم فعالية المرض لكل مريض وفقا لنقاط مؤشر فعالية المرض السريرية واجراء فحص الاشعة السينية للحوض (منظر امامي _خلفي) والتصوير بالرنين المغناطيسي لمفصل الورك.النتائجشملت الدراسة (60) مريضا بالتهاب المفاصل الروماتويدي, بلغ عدد الذكور 48 وعدد الاناث 12.كان متوسط اعمار المرضى (46.2 ± 11.6) سنوات وكان متوسط مدة المرض ( 8.8 ± 0.92) سنوات. وجد شمول مفصل الورك في (17) مصابا يمثلون (28.3%) : في كلا الطرفين عند 14مريض (23.3%) وفي طرف واحد عند 3 مرضى (5%) .اظهرت الدراسة ان المرضى الذين لديهم شمول مفصل الورك كانوا اصغر سنا من اولئك الذين لم يوجد لديهم شمول. كما اظهرت الدراسة بان هناك علاقة ذات جدوى احصائية بين شمول مفصل الورك مع : مدة المرض, فعاليته, تشوهات اليد والنتيجة الموجبة لفحص العامل الروماتويدي وفحص مضاد الببتيد الموسوم بالسترولين.لم يلاحظ وجود علاقة ذات جدوى احصائية بين شمول مفصل الورك للمصابين بمرض التهاب المفاصل الروماتويدي مع : الجنس ومؤشر كتلة الجسم والتاريخ العائلي.الاستنتاجاتلدى عينة من المرضى العراقيين البالغين المصابين بالتهاب المفاصل الروماتويدي، وجد ان نسبة شمول مفصل الورك هي 28.3% : في كلا الطرفين بنسبة 23.3% وفي طرف واحد بنسبة 5%.اوضحت الدراسة ان شمول مفصل الورك يرتبط بعلاقة ذات جدوى احصائية مع مدة المرض، فعاليته، تشوهات اليد والنتيجة الموجبة لفحص العامل الروماتويدي وفحص مضاد الببتيد الموسوم بالسترولين. لم يلاحظ وجود علاقة ذات جدوى احصائية مع : الجنس ومؤشر كتلة الجسم والتاريخ العائلي للمريض. | Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease that mainly targets the synovial joints. It affects all ethnic groups with worldwide distribution and multifactorial etiology. If left untreated, it commonly results in progressive joint destruction and significant disability. The hip joint may be affected in 10% to 40% of patients with rheumatoid arthritis. Radiographic evidence of hip joint involvement includes concentric joint space narrowing, effusion, erosions, acetabular prortrusion and avascular necrosis of femoral heads.Objectives To estimate the frequency of hip joint involvement and the correlations of hip joint involvement with variable characteristic features of adult Iraqi patients with RA.Patients and methods : A cross sectional study was conducted on 60 adult Iraqi patients who fulfill the American college of rheumatology criteria for the classification of RA. Data of the Patients were obtained , including : : age, gender, weight, height, body mass index (BMI), duration of illness, family history of RA, drug history, hand deformities, symptoms suggestive of hip joint involvement, CRP (C - Reactive Protein), RF (Rheumatoid Factor) and ACPA (Anti - Citrullinated Peptide Antibody). Disease activity for each patient was assessed according to clinical disease activity index score (CDAI). Anteroposterior pelvic x - ray and MRI of hip joints were obtained for all patients.Results Sixty adult Iraqi patients with RA were enrolled in this study, there were 48 women and 12 men. Mean age of them was 46.2±11.6 years and mean duration of disease was 8.8±0.92 years. Hip joint involvement was found in 17 patients representing (28.3%) of them, bilateral in 14 patients (23.3%) and unilateral in 3 patients (5%). The study revealed that patients with hip joint involvement were younger than those without and hip joint involvement was significantly correlated with disease duration, disease activity, hand deformity and seropositivity for RF and ACPA. This study revealed no significant correlation of hip joint involvement with the gender of the patient, BMI and family history.Conclusions Hip joint involvement occurred in 28.3% in a sample of Iraqi patients with RA, bilateral in 23.3% and unilateral in 5%. Hip joint involvement was significantly associated with : disease duration, disease activity, hand deformity and seropositivity for RF and ACPA, but there were no significant correlations with gender of the patients, BMI and family history.

تاثير بعض مضادات الالتهاب اللاستيرويدية على الاباضة في النساء اللواتي يعانين من الالام العضلية البسيطة : دراسة سريرية == Effects of Some Non Steroidal Anti - inflammatory Drugs on Ovulation in Women with Mild Musculoskeletal Pain(A Clinical Study

اسم المؤلف: بسمان قاسم شريف
اسم المشرف: احمد محمود الزهيري | سامي سلمان شهاب
الموضوع العام: الطب
السنة: 2014
الموضوع الدقيق: الادوية والسموم
الدرجة: ماجستير
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: تعتبر الادوية المضادة للالتهابات اللاستيرويدية من اكثر الادوية استعمالا ولدواع مختلفة فهي تستخدم كمسكنات وكخافضات حرارة ومضادات للالتهابات وحالات اخرى عديدة وهي رهن الاستعمال لما لا يزيد على قرن من الزمان . وتمتاز هذه الادوية بانها متوفرة للاستعمال بدون وصفة طبية ويتعاطاها الملايين من المرضى في كافة انحاء العالم. ولان هذه الادوية تستعمل على نطاق واسع كعوامل مضادة للالتهابات وتستعمل بجرعات عالية احيانا ولفترات طويلة ولكافة الفئات العمريه وان عددا كبيرا من مستخدميها هن نساء في عمر الانجاب, فان الدراسة الحالية صممت للتحري عن تاثيرات كل من ادوية الدايكلوفيناك والنابروكسين والاتيروكوكسب على الاباضة ومستوى هرمون البروجسترون في النساء. هذا وقد تم اختيار المشاركات في هذه الدراسة من بين النساء في عمر الانجاب كمتبرعات.علما ان المشاركات كن من المريضات اللاتي راجعن العيادة الاستشارية في شعبة المفاصل في مستشفى بغداد التعليمي وقد تم اختيارهن على اساس ان الدورة الشهرية لديهن منتظمة ولا يعانين من اية مشاكل في هذا الجانب وقد راجعن العياده بسبب وجود الام بسيطة وقد تم تشخيصها وتم اعطاءهن احد الادوية المستعملة في الدراسة. كان عدد المتبرعات المشاركات في الدراسة 75 امراه تم تقسيمهن الى ثلاثة مجاميع بشكل عشوائي (مجموعة الدايكلوفيناك - مجموعة النابروكسين - مجموعة الاتيروكوكسب) وقد خضعت كافة المشاركات في الدراسة الى فترة علاج لمدة عشرة ايام بين اليوم العاشر واليوم العشرين من الدورة الشهرية .و قبل بدء العلاج تم اخذ عينة من الدم لغرض اجراء فحص مستوى هرمون البيروجسترون وكذلك تم اجراء فحص التصوير بالموجات فوق الصوتية لقياس قطر الحويصلة المبيضية الاكبر. وبعد مرور عشرة ايام (نهاية فترة المعالجة) وعند مراجعة المرضى مرة اخرى تم اجراء فحص التصوير بالموجات فوق الصوتية للتحري عن مصير الحويصلة المبيضية وكذلك اخذ عينة جديدة من الدم لتكرار الفحص الاولي والمقارنة. اما بخصوص المجموعة الرابعة (مجموعة السيطرة ) فقد كن من النساء العاديات (غير المرضى) ولم يتناولن اي عقار واجريت لهن نفس الفحوصات وفي نفس المواعيد لاجل المقارنة مع مجاميع العلاج. الدراسة الحالية خلصت الى النتائج التالية : 1. ايقاف او تاخير الاباضة بشكل محسوس في المرضى اللائي تناولن كل من الدايكلوفيناك - نابروكسين - اتيروكوكسيب مقارنة بمجموعة السيطرة.2. اتضح بان الدواء الاكثر فعالية في ايقاف الاباضة كان دواء الدايكلوفيناك وبنسبة عالية مقارنة بالادوية الاخرى المستعملة (نابروكسين - اتيروكوكسب).3. انخفاض محسوس في مستوى هرمون البروجسترون عن المستوى الطبيعي المتوقع ومقارنة بمجموعة السيطرة.4. ان تحول قسم من الحويصلات المبيضية الى اكياس في بعض المشاركات في الدراسة في نهاية فترة العلاج قد اختفت في الدورة التالية.ان النتائج الجديدة اعلاه لها اهمية مباشرة ويمكن على ضوئها ان نحذر من الاضرار المحتملة لاستعمال هذه الادوية على الخصوبة في النساء اللائي هن في عمر الانجاب وتؤكد ان هذه التاثيرات يجب ان تؤخذ في نظر الاعتبار من قبل الاطباء عند صرفها لنساء يخططن لانجاب اطفال .ومن جهه اخرى ان هذه النتائج تشكل مساهمة متواضعة صوب التوجه لانتاج مانع حمل وقائي امن اكثر من الادوية المتداولة لهذا الغرض في الوقت الحاضر . | NSAIDs are popular and used for variable conditions, being analgesics, antipyretics and anti - inflammatory agents for more than a century. They are sold without a prescription and taken by millions of patients every day all over the world. Since they are used on a large scale as an anti - inflammatory agents & are given in doses that are consider high as compared to doses used in conditions other than inflammation and because many of NSAIDs users are females at child bearing age, so the present study was conducted to investigate the effects of diclofenac, naproxen & etoricoxib on ovulation & progesterone level in women. Adults women ( at fertile age ) were chosen as volunteers to take part in this study. They were normal visitors to the Rheumatology consultation clinic in Baghdad Hospital, suffering from minor aches & were diagnosed & received one of the three test drugs included in the study. Volunteers (75 females) were divided randomly in to three groups ( diclofenac group, naproxen group & etoricoxib group ). Treatment with the above drugs was for ten days starting at day ten after the onset of the period. A blood sample was taken from each patients for hormonal analysis together with an ultra sonsography to assess the mean diameter of the dominant follicle. At day twenty the patient came back for another ultra sonography & to give a blood sample for another check for progesterone level. A fourth group served as controls, who received no treatment ( volunteers ). The present study presents several new findings : 1. A significant inhibition of ovulation have been observed in patients teated with diclofenac , naproxen & etoricoxib.2. Diclofenac was the highest inhibitor of ovulation compared to the other two drugs ( naproxen & etoricoxib ). 3. A significant decrease in progesterone level in all three groups in compared to the control group.4. Functional cysts have been observed in one third of patients by the end of the treatment period with diclofenac, naproxen & etoricoxib due to unruptured follicles ( disappeared at the next cycle ).The above new findings have a direct implication & importance in relation to conditions where NSAIDs ( diclofenac, naproxen & eroricoxib ) used and may serve as an alarm of the harmful effects of these drugs on female fertility & these effects should be taken into consideration in females planning to have a child. In the other hand, the above results may open the door for looking for an emergency contraceptive tablet safer than those at use nowadays

مقارنة فحص جذع الدماغ السمعي مع الفحوصات السمعية الاخرى عند الاطفال الفاقدين السمع == Comparison Between Auditory Brainstem Response with Other Behavioral Methods in Children with Hearing Loss

اسم المؤلف: منتهى جبار علي
اسم المشرف: وجدان فاضل السعيدي
الموضوع العام: الطب
السنة: 2014
الموضوع الدقيق: الفيزياء الطبية
الدرجة: ماجستير
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: هناك دائما حاجة لقياسات تقيم السمع وتحديدعتبة السمع للمرضى الذي لايتجابون مع الاختبارات(السمعية) السلوكية.الهدف من هذه الدراسة, تقيم دقة جهاز فحص استجابة جذع الدماغ ( ABR) Auditary Brain stem Response في تقدير حالة فقدان السمع بالمقارنة مع الاختبارات السلوكية وهما فحص الساحة السمعية (Free Field ) للصغار بعمر(اقل من سنتين) وفحص تخطيط السمع (Pure Tone Audiogram ),اكثر من سنتين. تم فحص مائة واحدى وعشرون طفلا (242) اذن , من المرضى المصابين بفقدان السمع او تاخر النطق باعمار تتراوح بين 1 - 9سنة, وكانت نسبة الاناث 51 ,والذكور 70 .اجريت مقارنة بين نتائج فحص جذع الدماغ وفحص الساحة السمعية في المجموعة الاولى ,بالاضافة الى نتائج فحص جذع الدماغ مع تخطيط السمع في المجموعة الثانية. كانت النسب المئوية لنتائج فحص فقدان السمع المقاسة بواسطة جذع الدماغ الى فحصي الساحة السمعية وتخطيط السمع هي : - 84 % و100 % على التوالي في حالات فقدان السمع الشديد جدا ((profound. وانخفضت نسبة فحص جذع الدماغ الى 57% مع تخطيط السمع و31 % الى فحص المساحة السمعية من فقدان السمع الشديد severe الى السمع الطبيعي. لايمكن الاعتماد فقط على نتائج فحص جذع الدماغ ضمن الترددات ((2 - 4Hz لتقيم عتبة السمع.ولكن يمكن ان يكون جزء ضروري من الفحوصات السمعية.

مستخلصات الشاي تاثيرها الذاتي او الاضافي على حياة خلايا السرطان : دراسة داخل وخارج الانبوب == Herbal Tea : Its Own Or Additive Effect On The Survival Of Cancer Cell Line : An In Vitro And Ex Vivo Study

اسم المؤلف: هدى غسان حميد
اسم المشرف: مروان صالح النمر | ناهي يوسف ياسين
الموضوع العام: الطب
السنة: 2014
الموضوع الدقيق: الادوية والسموم
الدرجة: ماجستير
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: اجريت هذه الدراسة في فرع الفارماكولوجي في كلية الطب في الجامعة المستنصرية بالتعاون مع مركز ابحاث السرطان والوراثة\الجامعةالمستنصرية خلال الفترة من شهر كانون الثاني - شهراب لسنة 2014. الدراسة اقرت من قبل مجلس كلية الطب. صممت هذه الدراسة لتوضيح فعالية نبات ا | This study was conducted in the Department of Pharmacology at College of Medicine with incorporation of the Iraqi Center for Cancer and Medical Genetic Research at Al - Mustansiriya University, Baghdad, Iraq during 2014. This study was designed to elucidate the anti - cancer effect of Camellia sinensis by using four types of tea (black, green, white and oolong). Two experimental cancer models applied in this study; cancer cell lines (In vitro) and mice - bearing tumor (ex vivo). Several methodological and extracted aqueous and organic solvents were used to extract the tea. Microwave assisted extraction using distilled water as a solvent is applied in this study as the yield of bioactive substances are higher than other methods and organic solvents. The antioxidant activity was evaluated through the quantification of total flavonoids, total polyphenolic compound (bioflavanoids), total flavonols, reducing power, and proanthocyanidines. The scavenging property against reactive nitrogen species also was studied. The result showed that the different tea types contain approximately the same quantity of phenolic compounds; the only significant difference was in the proanthocyanidins level, which is a class of flavanols, found in high quantity in green tea compared with other tea extracts. Moreover, a significant scavenging property of peroxynitrite radical observed with all tea extracts. The extracts of black, green and oolong tea prevented or halted nitric oxide generation whereas the white extract tea promoted its generation, that is, a nitric oxide donor. The in vitro cytotoxic activity of Camellia sinensis in form of black, green, white and oolong tea was evaluated against four different types of cell lines. These are the AMN3 mammary cell carcinoma, Rhabdomyosarcoma, HeLa cells and Rat embryo fibroblast cells). The results showed greater effect of green and black tea over white tea and oolong tea against mammary cell carcinoma while the results of rhabdomyosarcoma cell line, which is an aggressive cancer cell, revealed a significant inhibitory effect of the growth of these cells by white and oolong tea extracts. All four types show almost equal percent of growth inhibition on HeLa cell line with the white tea been the most significant. A significant inhibitory effect of all tea extracts against the growth of rat embryo fibroblast cells indicated that the cytotoxic effect of the Camellia sinensis extended to normal cells and not specific to cancer cell. In addition, the antitumor effect of tea extracts was investigated (ex vivo) on BALB - c mice bearing - tumor. The volume, shape and color of the tumor masses were examined, in addition to measurement of the tissue malondialdehyde level as a biomarker of the lipid peroxidation, total tumor protein measurement and a histopathological study were done. The white tea showed antitumor effect by attenuating all the biomarkers of tumorogenesis. Herbal tea extracts induced DNA damage in term of separation the double strands molecule of calf thymus double stands DNA and human genomic DNA which may partly explained anti - cancer effect. We concluded that white tea extract is a promising nutrient that ameliorates the histopathological changes in mice bearing mammary tumor via generation reactive oxygen species by the evidence of activation lipid peroxidation process. Camellia sinensis plant can induce non harmful effect on DNA

تاثيرات استخدام عقار الفيراباميل وعقار السايكلوسبورين في حالة اعتلال عضلة القلب الناتج من استخدام عقار الدوكسوروبسين : في الفئران المختبرية == Effects Of Verapamil,Labetalol And Cyclosporine Use In The Condition Of Cardiotoxicity Resulted From Doxorubicin Use : Animal Model Study

اسم المؤلف: محـمد عبد العزيز محـمد
اسم المشرف: حيدر مطير خليل القريشي | خالد جمعة خليل
الموضوع العام: الطب
السنة: 2014
الموضوع الدقيق: الادوية والسموم
الدرجة: ماجستير
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: Doxorubicin is a member of anthracycline antibiotic that widely used in the treatment of different types of cancer such as hematological malignances, solid tumors, and different organ tumors, doxorubicin is very efficient in the treatment of cancer. But the use of doxorubicin is limited by the side effect of doxorubicin on the same organ, the most important organ that affected by doxorubicin is the heart, the toxicity of doxorubicin in the heart, the use of doxorubicin due to the cardiotoxicity that induced by doxorubicin will lead to cardiomyopathy and in the final result of these cardiotoxicity lead to congestive heart failure that occurred secondary to the cardiotoxicity may appear after long period of termination of treatment by doxorubicin.ObjectivesThe aim of the present study its investigate the possible modulation effect of drugs (verapamil, cyclosporine, labetalol) on the cardiotoxicity that induced by doxorubicin drug. Animals and methods forty Dwale - Spargue male rats where enrolled in this study, the animals divided into groups, (5) rats in each group and assigned as I,II,III,IV,V,VI,VII,VIII.Group I : received physiological saline (5ml/kg), orally, daily for ten days and served as the control.Group II : received a single dose of doxorubicin (15mg/kg), intraperitoneal and was sacrificed after 48 hours which served as doxorubicin group.Group III : received verapamil (5mg/kg), orally daily for ten days and on day eight, one hour after drug administration, a single dose of doxorubicin (15mg/kg), intraperitoneal were given.Group IV : received cyclosporine (0.5mg/kg), orally daily for ten days, and on day eight, one hour after drug administration, a single dose of doxorubicin (15mg/kg, intraperitoneal) was given.Group V : received cyclosporine (1mg/kg), orally daily for ten days ,and on day eight ,one hour after drug administration a single dose of doxorubicin (15mg/kg),intraperitoneal was given. Group VI : received both of verapamil (5mg/kg,orally) and cyclosporine (0.5mg/kg,orally) one hour apart, daily for ten days ,and on day eight, one hour after drug administration ,a single dose of doxorubicin (15mg/kg), intraperitoneal was given.Group VII : received labetalol (0.5mg/kg), orally daily for ten days, and on day eight, one hour after drug administration, a single dose of doxorubicin (15mg/kg, intraperitoneal) was given. Group VIII : received labetalol (1mg/kg, orally),daily for ten days ,and on day eight ,one hour after drug administration ,a single dose of doxorubicin (15mg/kg), intraperitoneal was given.Serum MDA, LDH, Troponin I, and interleukine - 17. Were measured and histopathological changes also viewed?ResultsThe results in this study showed an increase in the cardiac biomarkers in the doxorubicin group compared to the control group, the cardiac biomarkers that measured are LDH, MDA, Troponin I, interleukine - 17. Also the results showed histopathalogical changes in cardiac tissue in doxorubicin group as compared to the control group, also the results showed the pre - treatment with verapamil, cyclosporine low dose, cyclosporine high dose, combination of verapamil and cyclosporine low dose, labetalol low dose, labetalol high dose showed decreasing in the cardiac biomarkers MDA, LDH, Troponin I, interleukine - 17 to a significant amount compared to the doxorubicin group, also showed histopathlogical improvement in cardiac tissue. Conclusions Doxorubicin drug used as antineoplastic agent will produce a toxic effect on the cardiac tissue, this toxic effect will limit the use of doxorubicin, cyclosporine, labetalol and verapamil produced differential effects and protection from Doxorubicin induced cardio toxicity via amelioration of cardiac biomarkers and histopathological changes

تقييم نظام المعلومات الصحي في العراق == Assessment Of The National Health Information System In Iraq

اسم المؤلف: ثائر عيسى مراد
اسم المشرف: مازن غازي جاسم الربيعي | امجد داود نيازي
الموضوع العام: الطب
السنة: 2014
الموضوع الدقيق: طب المجتمع
الدرجة: ماجستير
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: تعتبر الاحصائيات الصحية الرصينة ضرورة لاتخاذ القرارات السليمة في كل مستويات النظام الصحي. ولكن في الحقيقة ان نظم المعلومات الصحية في معظم البلدان تعتبر غير كافية لتوفير المعلومات اللا زمة لدعم الادارة الصحية ولهذا فان معظم النظم الحالية تعتبر كعائق اداري | Sound health statistics are essential for health decision - making at all levels of the health system. Unfortunately, health information systems in most countries are inadequate in providing the needed management support and the current systems are therefore widely seen as management obstacles rather than as tools, the current study is an attempt to assess the health information system in Iraq with recognizing the strengths, weaknesses and gaps in addition to assessment of the structure and performance of this system; it also attempts to assess the behavioral, technical and organizational determinants affecting the health information system performance. A cross - sectional study was conducted for the assessment process and the levels of the assessment included the ministry of health (national level), the health directorates (provincial level), the districts related to the health directorates reaching to the health centers level, as well as the hospitals related to the health directorates, in addition to the ministry of planning and the ministry of interior. In addition to ministry of health (central level) a total of six governorates were selected by simple random sampling including the capital Baghdad with a seven districts were selected from those governorates also by simple random sampling and a total of twenty six health centers were selected from those districts, as well a total of seven hospitals were included in the study from all governorate and they were selected according to convenience. The interview has been done by using the health metrics network assessment tool version 4, in addition to a complementary assessment tools which are the PRISM package tools that were used at the district and primary health center levels. Based on the data collected and according to the health metric network assessment tool findings the overall health information system has laid in the adequate state (65.96%) with most of its comprising components function poorly. Data dissemination and use and data management categories were the weakest with a score of 50% and 53.3% respectively, while for the resources category it was found to be adequate 63.3%, and for that of HIS indicators, data sources and information product categories they were 73.3%, 66% and 69.6% respectively. For that of the PRISM tools and the findings obtained by them from the collected data the results revealed that a low data quality in term of accuracy with 29.03% at the facility level and 55.35% at the district level, while the completeness rate was excellent with a score 96.38% at the facility level and 98.23% at the district level, for that of the timeliness it was 70.43% timeliness at the district level. The information use for a given feedback at the facility was 50% and at the district was 82.12% and for observed meeting records it was 50% for the facility and 41.6% for the district level. For that of the functionality a 34.61and 67.30% of the facilities reported having a reminder mechanism for data completeness process and meeting a deadline for submitting monthly reports respectively, Data analysis was better at the district 85.71% than at the facility 81.7%, Data display were present in all of the facilities and districts. For the technical determinant the results showed 57%, 85.7%, 71.4% and 100% of the district respondents felt that the form is complex and difficult to follow, data software is a user - friendly, information technology is easy to manage and a comprehensive picture of the health system performance is captured by the system respectively,85.7% believed that the information system collecting information from some vertical programs and one district reported of no collection at all, in addition to that 100% reported the absence of a software that integrates data from different information systems and the available information technology doesn&#39;t provide full access procedure to district and senior managers. Regarding the behavioral determinants the results revealed that overall mean confidence for the information system tasks is 69.41% while for that of the task competence the overall mean competence level is 37.1%. Knowledge of checking data quality, knowledge of health information system rationale and problem solving showed results of 35.32% 37.68% and 2.98% respectively, and that of motivation level was 43.4%. Organizational determinants results revealed that the management functions at facility and district levels were almost absent, while for the perceived promotion of a culture of information it showed a total score of 63.96% and rewarding for a good performance was 56.83%. The activities for promotion of a culture of information are a 25% at the facility level and 28.75% at the district level. And that of supervision quality at the facility were (72.80%). Availability of resources revealed that 100% of the facilities have two or more computers and calculators respectively while only 57.7% have an internet access. Access to the electricity and water supply is very high, No facility reported of running out in registers in the last 12 months. Finally, the current study shows the importance for the need of further attention to be drawn to HIS, in addition to that, increasing the awareness and well coordinated efforts that need to be done to overcome weaknesses and to provide a well functioning HIS enabling for evidence based decision making and action provision in the health system.

تقييم استخدام الروزوفاستاتين والتلميسرتان في حالة تسمم عضلة القلب الحاد المحدث من استخدام الدوكسوروبيسيبن في الجرذان المختبرية == Evaluation The Usage Of Rosuvastatin And Telmisartan In Doxorubicin Induced Acute Cardiotoxicity In Rats

اسم المؤلف: ايهاب اياد احمد
اسم المشرف: علي اسماعيل عبد الله محمد | خالد جمعة خليل
الموضوع العام: الطب
السنة: 2014
الموضوع الدقيق: الادوية والسموم
الدرجة: ماجستير
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: اجريت الدراسة الحالية لتقييم التاثيرالعلاجي لاستخدام الروزوفاستاتين والتلمسارتان في التقليل من سمية القلب المحدثة من عقار الدوكسوروبسين في الجرذان المختبريةباستخدام الطرق الكيميائية الحيوية والنسيجية ومقارنة تاثير الاستخدام المزدوج بفعالية استخدام كل م | Background : Doxorubicin, an anthracycline antibiotic is a powerful antineoplastic drug, but its therapeutic usefulness is limited by its cardiotoxicity. Aim of the study : The present study investigated the influence of pretreatment with rosuvastatin and telmisartan alone or in combination in different doses on doxorubicin induced acute cardiotoxicity in rats using biochemical and histological approaches. Materials and methods : The animals were divided into eight groups of 5 animals each. The first group received no drug(s) po but a single dose of distilled water (7.5 ml/kg, ip) on day eight, which serves as the control group. The second group received no drug(s) po but a single dose of doxorubicin (15 mg/kg, ip) on day eight, and serves as doxorubicin only received group. The third and sixth group received rosuvastatin (2 , 10) mg/kg/day respectively for nine successive days, and on day eight, one hour after drug administration, a single dose of doxorubicin (15 mg/kg, ip) was given. The fourth and seventh group received telmisartan (2 , 4) mg/kg/day respectively for nine successive days, and on day eight, one hour after drug administration, a single dose of doxorubicin (15 mg/kg, ip) was given. The fifth and eighth group received both drugs, where the fifth group received both of rosuvastatin (2 mg/kg, po) and telmisartan (2 mg/kg, po), 1 hour apart, daily for nine successive days, and on day eight, one hour after drug administration, a single dose of doxorubicin (15 mg/kg, ip) was given. While the eighth group received both of rosuvastatin (10 mg/kg, po) and telmisartan (4 mg/kg, po), 1 hour apart, daily for nine successive days, and on day eight, one hour after drug administration, a single dose of doxorubicin (15 mg/kg, ip) was given.At day ten of the study, blood samples were taken for biochemical analysis, then animals were sacrificed and hearts were taken for histopathological observations. Results : Rats treated with doxorubicin showed cardiotoxicity as evidenced by significant elevation of serum cardiac troponin (CTn - I) level, lactate dehydrogenase (LDH) activity, serum malondialdehyde (MDA) level, and interluekine 17 (IL - 17) level associated with important histopathological alterations while pre - treatment with rosuvastatin and telmisartan elicited a significant decrease in the activities of all markers measured in comparison with doxorubicin treated group with pronounced resolution of Dox induced cardiac histological changes to a milder picture.Conclusion : These results suggest pretreatment with rosuvastatin and telmisartan alone or in combination provide a significant protective effect against acute - doxorubicin induced cardiotoxicity in rats represented by biochemical markers and histological approaches.

مستوى الدلائل الكيمياحياتية ومعاملات الاورام في التمييز بين سائل الاستسقاء السرطاني الخبيث وسائل الاستسقاء غير السرطاني == The Level Of Biochemical Parameters And Tumour Markers In The Differentiation Between Malignant From Non - Malignant Ascitic Fluid

اسم المؤلف: عبد الله علي محمد
اسم المشرف: ناصر محمد فهد الربيعي | رباح هياب سريح
الموضوع العام: الطب
السنة: 2014
الدرجة: ماجستير
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: الاستسقاء هو مصطلح يطلق على الجهاز الهضمي لتراكم السوائل في التجويف البريتوني (البطني) الناجمة عن كل من الامراض غير الخبيثة مثل تليف الكبد، والتهاب الصفاق السلي... الخ، والامراض الخبيثة مثل سرطان غشاء البطن المنتشر، وسرطان الثدي وسرطان المبيض. لقد تم | Ascites is a gastroenterological term for an accumulation of fluid in the peritoneal cavity caused by both non - malignant disease such as cirrhosis, tuberculous peritonitis..etc, and by malignant disease such as metastatic adenocarcinoma, breast cancer and ovarian cancer. The work in this thesis was done to evaluate the role of the multiple biochemical parameters and group of tumour markers in the differentiation between malignant ascites from non - malignant ascites. A number of parameters were obtained from (60) sixty patients : (30) thirty with malignant ascites and (30) thirty with non - malignant ascites (as controls), all patients admitted to the department of gastroenterology in Medical City - Baghdad Teaching Hospital, Oncology Teaching Hospital and Al - Amal Hospital between December 2013 and July 2014. The biochemical parameters and tumour markers which have been measured in the present study included : total protein, albumin, uric acid, calcium(Ca++), carcinoembryonic antigen(CEA),cancer antigen(CA19 - 9), cancer antigen(CA15 - 3), cancer antigen(CA125) and ? - human chorionic gonadotropin (? - hCG).The statistical analysis for the data obtained in the present study showed : 1 - Highly significant increase of CA15 - 3, ? - hCG and ascitic fluid/serum (A/S) total protein ratio in malignant ascitic fluid while there is significant decrease of serum ascites albumin gradient (SAAG) and serum ascites cholesterol gradient (SACG) in malignant ascites compared with non - malignant ascites patients (p<0.0005, p<0.0005, p<0.05, p<0.0005 and p<0.005 respectively). Thus the level of these parameters in ascitic fluid could be used as a good parameters in differentiation between malignant ascites from non - malignant ascites patients.2 - Significant increase in serum CA15 - 3 and ? - hCG level in malignant ascites patients compared to non - malignant ascites (p<0.05 and p<0.0005 respectively). 3 - Significant increase of CEA, CA19 - 9, total protein, albumin, uric acid and Ca++ level in ascitic fluid of malignant ascites patients compared to non - malignant ascites (p<0.0005, p<0.005, p<0.005, p<0.005, p<0.05 and p<0.05 respectively), thus the level of these parameters in ascitic fluid could be used as a helpful parameters in differentiation between malignant ascites from non - malignant ascites patients. 4 - Significant increase in serum of CEA, CA19 - 9, albumin, uric acid and Ca++ level in malignant ascites patients compared to non - malignant ascites (p<0.05, p<0.05, p<0.05, p<0.05 and p<0.05 respectively) while there is no significant differences in serum total protein level of malignant ascites compared to non - malignant ascites (p>0.05). 5 - CA125 level in ascitic fluid and serum of malignant ascites patients shows no significant increase compared to non - malignant ascites (p>0.05 and p>0.05 respectively), therefor CA125 test in ascitic fluid cannot be used as a parameter in differentiation between malignant ascites from non - malignant ascites patients.CA15 - 3, ? - hCG, (A/S) total protein ratio, SAAG and SACG can be considered as a good parameters in differentiation of malignant from non - malignant ascites, while CEA, CA19 - 9, total protein, albumin,Ca++ and uric acid level in spite of their increase in malignant ascitic fluid but this increase is not considered as a diagnostic factor and can be used as a helpful parameters in the differentiation between malignant from non - malignant ascites. CA125 has no useful role in diagnosis or differentiation between malignant from non - malignant ascites.

هرمون اللبتين والاستقلاب : دراسة كيميانسيجية وكيمياحيوية شاملة في الحيوانات الطبيعية والمصابة بالسكري == Leptin And The Metabolism : A Comprehensive Histochemical And Biochemical Study In Healthy And Diabetic Animals

اسم المؤلف: سامح سمیر موسى عكیلة
اسم المشرف: سلمان شفیق سلمان | سامیة عباس علیوي
الموضوع العام: الطب
السنة: 2014
الموضوع الدقيق: التشريح والانسجة والاجنة
الدرجة: دكتوراه
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: The adipocytokine leptin is a major player in the pathogenesis of diabetes mellitus and obesity. Since its discovery around 20 years ago, leptin has been; and still is; the subject of extensive research.The current study was designed to examine the effects of physiological doses of leptin on major organs involved in metabolism. The anatomical, histochemical, physiological, and biochemical effects of leptin were studied in healthy animals and in animal models of type 1 and type 2 diabetes.Eighty male albino mice were divided into three groups. The first group (A) consisted of healthy non - obese non - diabetic animals, a subgroup (A1) of which received leptin therapy to study its effects under normal conditions without metabolic disturbances. In the second group (B), a model of diet induced obesity and insulin resistance was developed using a combination of high fat diet and low dose streptozocin injection. In one subgroup (B1), the effects of leptin were studied under dietary manipulation after the discontinuation of high fat diet. In other subgroups, leptin effects were examined with continuous HFD with (B3) and without (B2) concomitant metformin therapy. The third group animals (C) represented a type 1 DM model developed by high dose streptozocin injection. A subgroup (C3) served as model control, not receiving any hormonal therapy. The others two subgroups received leptin treatment with (C2) and without (C1) concomitant insulin therapy.Statistical parameters for the study included the body weight, food and caloric consumption, adiposity index and specific organ weights and weight ratios. The epididymal fat pad, liver and pancreas were examined for gross anatomical and histological changes. Adipose tissue and some pancreatic sections were stained with H&E, liver sections were stained with periodic acid schiff stain, other pancreatic sections were stained with modified Gomori's aldehyde fuchsin. Random blood sugar and serum lipid levels and insulin tolerance test were also studied as biochemical parameters.Leptin therapy in healthy non - obese animals resulted in a reduction in food consumption, body weight, adiposity index and white fat pads weight. It also caused a reduction in the diameter and surface area of epididymal adipocytes. Serum TGL and LDL levels were significantly reduced. iiiThe same effects were seen in group B animals that underwent dieting or received metformin, but not in ones receiving leptin alone. Animal models of type 1 DM showed a moderate response to leptin therapy alone but the response was dramatically enhanced when treatment was combined with insulin. Sever weight loss and polyphagia of type 1 DM were greatly ameliorated by leptin therapy and there was an improvement in fat pad weights and adipocyte measurements. The hepatic glycogen content and insulin sensitivity were greater in animals treated with leptin (A1), on diet and leptin (B1) or metformin (B3) and in animals on leptin with insulin (C1). This was associated with significantly lower levels of random blood sugar. The pancreatic islet surface area was markedly reduced while the ? - cell/ ? - cell ratio was increased in treated animals.Leptin therapy can alter body weight and adiposity index by affecting appetite and food consumption via central and peripheral mechanisms involving the control of feeding behavior and manipulating the processes involved in carbohydrate and lipid metabolism. It can also correct the metabolic disturbances of type 2 DM but requires the concomitant use of metformin and/or the manipulation of dietary content of fat and carbohydrates. Much of its influence arises from its ability to enhance insulin sensitivity.Leptin also has a sparing effect on hepatic glycogen, favoring in turn the use of fatty acids for energy expenditure. Leptin effects on blood glucose are insulin dependent in most cases but can be insulin - independent in type 1 DM by utilizing alternative metabolic pathways for energy expenditure and interacting with hyperglycemia - inducing hormones.

ظهور المؤشرات في الثدي الطبيعي المحيط بسرطان الثدي في عينة من النساء العراقيات

اسم المؤلف: احمد فاخر حميد
الموضوع العام: الطب
السنة: 2014
الموضوع الدقيق: التشريح والانسجة والاجنة
الدرجة: ماجستير
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:

تقييم دور مؤشرات حيوية مختارة لدى مرضى التصلب المتعدد == Assessment Of The Role Of Selected Biomarkers In Multiple Sclerosis Patients

اسم المؤلف: ميساء نجاح امين
اسم المشرف: عبد العظيم ياسين عبود البراك | سرمد عبد الرسول الماشطة
الموضوع العام: الطب
السنة: 2014
الدرجة: ماجستير
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: التصلب المتعدد (MS) هو من امراض الجهاز العصبي المركزي الاكثر شيوعا الذي يسبب الاعاقه الدائمه لدى الشباب البالغين. بناء على ادلة غير مباشرة قوية، يعتبر مرض التصلب المتعدد اضطراب المناعة الذاتية لعضو محدد ولكن لا يزال هناك الكثير يجب ان يفهم عن كيفيه نشوء ا | Multiple sclerosis (MS) is the most common disease of the central nervous system that causes permanent disability in young adults. Based on strong circumstantial evidence, MS is considered to be an organ - specific autoimmune disorder, but much remains to be understood about the initiation of the disease. It seems unlikely that MS results from a single causative event, but rather the disease develop in a genetically susceptible population as a result of environmental exposures. The present study was planned to determine the serum levels of IL - 17A, IL - 21 and Myelin Oligodendrocyte Glycoprotein (MOG) in patients and control subjects by a sandwich ELISA test using commercially available kits. Vitamin D total was measured in a group of patients and control subjects by cobas e 411 analyzers which is an automated multichannel analyzer for immunological analysis by the use of electrochemiluminescence (ECL) technology.Forty Iraqi MS patients attending the Consultation Clinic for Multiple Sclerosis / Baghdad Teaching Hospital during the period January 2013 - July 2013 were recruited for this study. For the purpose of comparison, 40 control subjects matched by age and gender were also included.The mean serum level of MOG in patient and control (554.85 vs. 315.20pg/ml) and IL - 17A (11.42 vs. 8.33pg/ml) was significantly higher in MS patients as compared to controls, while the mean serum level of IL - 21 (176.164 vs. 75.714pg/ml) was not significantly higher in MS patients as compared to controls. The mean serum level of vitamin D (n=20) (10.38 vs. 13.06ng/ml) was not significantly lower in MS patients as compared to controls. There was a positive correlation between MOG with IL - 17A and between MOG with IL - 21. These results might illustrate the synergism of action between antibody and T cell response in MS patients. A positive correlation was also detected between IL - 17A and IL21 in MS patients.A significant negative correlation was detected between Vitamin D with MOG. A negative correlation was recorded between Vitamin D and IL - 17A in patients. Also negative correlation was recorded between vitamin D and IL - 21 in MS patients. In conclusion, higher level of IL - 17A and MOG in MS serum indicates an important role of this cytokine and MOG as an auto antigen in the pathogenesis of multiple sclerosis and demyelination process, so they could be considered as a good biomarkers for diagnosis and considered as a target for future therapy.

تقييم sFas ligand, sFas وcaspase - 3 في المرضى المصابين بمرض ابيضاض الدم النقياني المزمن == Assessment Of Soluble Fas, Soluble Fas Ligand And Caspase - 3 In Patients With Chronic Myeloid Leukemia

اسم المؤلف: سحر راضي ياسر
اسم المشرف: ميسون علي سليم | بسام فرنسيس متي
الموضوع العام: الطب
السنة: 2014
الدرجة: ماجستير
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: ابيضاض الدم النقياني المزمن هو اضطراب التكاثر النقي النسيلي للخلايا الجذعية ويتميز بواسطة فلادلفيا كروموسوم وهو انتقال متبادل بين كروموسوم 9 و22. الجين المسرطن المتحد الجديد المتولد على كروموسوم 22 كنتيجة للانتقال يسمى BCR - ABL gene. في اغلبية المرضى, هذ | Chronic myeloid leukemia (CML) is a clonal myeloproliferative disorder of the haemopoietic stem cell, defined by the Philadelphia chromosome (Ph) - reciprocal translocation between chromosomes 9 and 22. The novel fusion oncogenes generated on chromosome 22 as a result of this translocation are called BCR - ABL gene. In the majority of patients, this oncogene transcribes a 210 - kDa constitutively active protein tyrosine kinase, often referred to as p210BCR - ABL, which is necessary for the transformation of the disease. The introduction of tyrosine kinase inhibitor (TKI) - imatinib mesylate (IM) - marked a major advance in CML treatment in terms of efficacy and tolerability and has now become the first line of therapy. In CML, besides genetic change during which a normal cell is transformed into a malignant one, evasion of apoptosis (programm cell death PCD) is one of the essential changes in a cell that cause malignant transformation. So ‘Evading apoptosis’ has been recognized as one of the six hallmarks of cancers, as reduced apoptosis or its resistance plays a vital role in carcinogenesis. Soluble receptors (sFas) that act as decoys, binding FasL and preventing association with transmembrane Fas. So production of sFas in tumor patients may be a key mechanism to inhibit Fas - mediated apoptosis. Soluble FasL competes with the membrane - bound counterpart; however, it can act even as an antagonist preventing apoptosis induction by the membrane integrated form of the ligand. Recently, caspase - 3 has been demonstrated to play an important role in determining the cellular sensitivity to diverse apoptotic stimuli, also it is involved in a number of non - apoptotic events. So the aims of the study were to estimate the level of serum sFas, sFas ligand & caspase - 3 in patients with chronic myeloid leukemia at time of diagnosis (newly diagnosed), then after receiving imatinib myselate treatment with optimal response and compare them with healthy control. It was a prospective study, included 56 Iraqi CML patients (25 were males and 31 were females with Age ranged from 15 - 78 years) attending to Baghdad teaching hospital/hematology department between November 2012 up to June 2013, were categorized by fluorescence in situ hybridization analysis (FISH) for Ph chromosome into two stages, newly diagnosed CML patients (FISH Ph cells result ? 90% ) not received any treatment and optimally treated (complete cytogenetic response (CCgR) = FISH Ph cells result < 1% or by major molecular response (MMoR) = BCR - ABL : ABL ?0.10% by International Scale, on RT - Q - PCR) with imatinib mesylate 400 mg/day at least 1 year. Then used an ELISA technique to assess serum level of sFas, sFas Ligand (sFasL) & Caspase - 3 for each patients of CML, and compared them with 28 apparently healthy volunteers used as control. The controls were age and sex matched with the patients, they were not taken medication and with no history of chronic illness and/or acute infection. As well as, they were nonsmoker and nondrinker. For patients the inclusion criteria including all patients were free of fever and other chronic illness such as diabetes mellitus, hypertension and infection; also they had no history of smoking and drinking of alcohol. And the exclusion criteria including patients suffering from any chronic, debilitating disease and other blood disorders were not taken.The observed results revealed the following : ? Patients were included in the study, male : female ratio was 0.8 : 1with mean age 42.6± 14.0.? The mean± SD serum of sFas levels (pg/ml) for the newly diagnosed and optimally responded of CML was 1163.6±231.5 and 1021.7±360.6 respectively.? The mean± SD serum of sFas Ligand levels (pg/ml) for the newly diagnosed and optimally responded of CML was 216.9±165.7 and 147.7±91 respectively. ? The median serum of Caspase - 3 (ng/ml) for the newly diagnosed and optimally treated cases was 0.421 and 0.361 respectively. ? The mean± SD serum of sFas and sFas Ligand levels (pg/ml) for the healthy group was 970.1±361.7, 152.5±98 consequently. The median serum of Caspase - 3 (ng/ml) for the healthy group was 0.314.? Serum sFas level was increased in newly diagnosed compare with optimal responder and healthy control group. Also serum sFas level in optimal responder group was increase when compared with healthy control group. The differences observed were no statistical significance (P=0.09).? Serum sFasL level was increased in newly diagnosed patients of CML when compared with optimal responder and healthy control group. But serum sFasL level in optimal responder group was decreased when compared with healthy control group. The differences observed were non statistical significance (P=0.07).? Serum Caspase - 3 level showed statistically significant (P ?0.001) increase in newly diagnosed when compared with healthy control group. While it was in optimal responder group was statistically increased (not significant P=0.13) when compared with healthy control group. And its level was increased in newly diagnosed compare with responder group which was statistically significant (P= 0.04).Finally, this study concluded that increase in sFas and sFas Ligand &Caspase - 3 in newly diagnosed CML patients compared with optimally and healthy control groups. Also concluded that Caspase - 3 was a good confirmed test to diagnose newly CML cases

دراسة التنميط الجيني لفيروس تي تي في مرضى الثلاسيميا المصابين وغير المصابين بفيروس التهاب الكبد نمط ج

اسم المؤلف: ابتسام نايف عودة الجبالي
اسم المشرف: اروى هادي الحمداني
الموضوع العام: الطب
السنة: 2014
الدرجة: ماجستير
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: ما زال الكثيرون لا يعرفون الاهمية السريرية لفيروس تي تي الذى رشح كاحد فايروسات التهاب الكبد انماط A - G)).ان فيروس تي تي يصيب المرضى المعرضين لخطر الحقن ونقل الدم المتكرر، كما في المرضى المصابين بفقر دم البحر الابيض المتوسط(? - Thalassemia major). تمت هذة | Much is still unknown about the clinical significance of TT virus (TTV) that has been reported as a candidate for non A - G hepatitis virus. TTV infects patients at risk for parenteral exposure and chronic blood transfusion, such as those with ? - thalassemia major. This study was designed to investigate the prevalence and clinical importance of TTV infection in thalassemia patients with or without hepatitis C virus (HCV) co - infection, furthermore to sequence and analyse phylogentic of TTV clones.One hundred fifty four thalassemia patients (64.3% male, 35.7% female) with a mean age of 23.8±6.8 years were involved in this study that was conducted in the period between Feb. to Dec. 2013. TTV DNA was detected using Real time PCR. Furthermore, conventional PCR was done for sequencing and phylogenetic analysis using N22 region from open reading frame 1 (ORF1). Anti - HCV antibody was determined by Enzyme Linked Immunosorbent Assay (ELISA) and confirmed by western blot. Then, HCV core antigen was detected in those anti - HCV Abs seropositive samples. Liver transaminases (ALT, AST) were determined, in addition to measure serum ferritin levels by VIDAS ferritin. TTV was detected in 45 of 154 (29.2%) of thalassemia patients with predominance of males than females (64.4% vs. 35.6%). The prevalence rate of anti - HCV Abs were 54.5% with significant increase in females than males (p<0.05).Out of these 84 samples, 59 (70.2%) were positive by HCV core Ag assay and related significantly to frequency of blood transfusion. According to HCV and TTV infection status, patients were categorized into six groups : Anti - HCVAb+ HCV core Ag + TTV+, Anti - HCVAb+ HCV core Ag + TTV - , Anti - HCVAb+ HCV core Ag - TTV+, Anti - HCVAb+ HCV core - TTV - , Anti - HCVAb - TTV+, Anti - HCVAb - TTV - . The increased levels of ALT, AST and ferritin in the HCV and TTV infected group were not significantly different from those in the TTV and HCV negative groups. Co - infection of TTV and HCV were significantly increase ALT levels compared to infection with HCV alone. No association of TTV infection was found with gender, age and frequency of blood transfusion.The results of genotyping in 12 randomly selected patients showed the presence of equal percentage of genotype 1 (G1) and genotype 2 (G2) 50% for each one, with homology between them 79.0%. Other TTV genotypes were not identified in the present study suggesting that G1and G2 are predominant in this area. Mixed infection of the same patient with multiple TTV genotypes was observed. The results concluded that TTV is moderately present in Iraqi thalassemia patients, with G1 and G2 were predominant. Patients co - infected with HCV and TTV had a significantly higher serum ALT level than those without TTV infection, so TTV infection is suggested to have a role in increasing the severity of liver diseases in the thalassemia patients when co - infected with HCV.

تاثير معايير النطف ونضوج مادة الصبغين على نتائج عملية الحقن المجهري == Impact of Sperm Parameters And Sperm Chromatin Maturity On Intracytoplasmic Sperm Injection Outcome

اسم المؤلف: هند عبد الكاظم
اسم المشرف: يحيى كاظم السلطاني
الموضوع العام: الطب
السنة: 2014
الموضوع الدقيق: الفسلجة
الدرجة: دكتوراه
اللغة: الانكليزية
مكان الجامعة: النجف
الصفحات الاولى:
المستخلص: يعتبر العقم من المشاكل المتعلقة بصحة الانسان ويؤثرعلى سدس الازواج في عمر الانجاب تقريبا. يعد الذكر مسؤلا عن خمسين بالمئه من مجموع الحالات.الوظيفه الرئيسيه لتقنيات الانجاب المعان هي علاج العقم بما فيها حالات العقم الذكري وزيادة فرص الحمل من خلال التغلب عل | Infertility is a health concern affecting nearly 17% of young couples in their reproductive age. Male factor infertility accounts for 50% of all cases. The key responsibility of assisted reproductive technologies (ART) is the management of male infertility by bypassing seminal fluid disorders. Defective Sperm parameters were responsible for deciding the fertility potential and related to pregnancy rate in vivo as well as in vitro.Today, the classic seminal fluid analysis is found to be of limited importance in describing a couple’s fertility status. There is now clinical evidence to show that damage to human sperm DNA may adversely affect reproductive outcomes and the spermatozoa of infertile men possess substantially more DNA damage than do spermatozoa of fertile men and there appears to be a threshold of sperm DNA damage beyond which embryo development and pregnancy are impaired.In view of that, the aims of the present study were : Evaluation of the influence of defective sperm parameters including concentration, morphology and motility on intracytoplasmic sperm injection (ICSI) outcome represented by fertilization rate, cleavage rate, embryo quality and pregnancy rate. Assessment of the sperm chromatin maturity in infertile men using acidic aniline blue stain and compare it with that of men with normal spermiogram. Discovering the relationship between sperm chromatin status and the semen parameters in infertile males. Finding the relationship between sperm chromatin status and ICSI outcome.This study included 60 infertile couples complaining from either primary or secondary infertility attended the clinics of infertility treatment center and underwent intracytoplasmic sperm injection.They were classified according to their spermiogram to normozoospermic group (N), whose female partner had bilateral tubal block, oligoasthenoteratozoospermic group (OAT) and finally, asthenoteratozoospermic group (AT). The female partners of the last two groups had normal reproductive function according to gynecological examination and laboratory investigations. All female partners included in this study were less than 35 years old to minimize the influence of advanced maternal age on ICSI outcome. Seminal fluid analysis were done for all and aniline blue stain was used in this study to evaluate sperm chromatin integrity. The main results of this study showed that infertile couples with impaired sperm parameters show high percentage of positive aniline blue stain i.e., sperm chromatin maturity defect and it is significantly higher than that in couples with normal spermiogram. The best cut off point of positive chromatin percentage associated with pregnancy was 40% i.e., when sperm chromatin abnormality exceeds 40% as detected by aniline blue staining method; the pregnancy rate start to regress. No significant differences in fertilization rate, cleavage rate, embryo quality and pregnancy rate were found among studied groups.No significant difference in ICSI outcome including pregnancy rate between couples with high percentage of sperm chromatin damage ?30% and those with low percentage of sperm chromatin damage < 30% were found. So the main conclusions are : Defective sperm parameters and chromatin immaturity are significantly associated with each other.Forty percent is the threshold of sperm chromatin immaturity after which ICSI outcome deteriorate and depending 30% as a threshold in this study revealed no significant difference in ICSI outcome among studied groups. Intracytoplasmic sperm injection has corrective and therapeutic role for defective sperm parameters and shows a unique capability to treat the most difficult cases of male infertility.

تقييم جهاز كتلة غاز الزفير كوسيلة لفحص وظائف الرئتين عند العراقيين الاصحاء == Evaluation of Expiratory Gas Mass Device As A Measure of Lung Function Test In Healthy Iraqi Subjects

اسم المؤلف: نبراس حسين عبد الساده الحسناوي
اسم المشرف: يسار محمد حسن الشماع | باسم متعب هادي زوين
الموضوع العام: الطب
السنة: 2014
الموضوع الدقيق: الفسلجة
الدرجة: ماجستير
اللغة: الانكليزية
مكان الجامعة: النجف
الصفحات الاولى:
المستخلص: تعد فحوصات وظائف الرئتين من الوسائل المفيدة جدا لاغراض التشخيص والمتابعة والبحث العلمي للاصحاء ومرضى الجهاز التنفسي. وابسط تلك الفحوصات واكثرها معلومة هو الفحص السبايرومتري الذي يتضمن قياس السعة الحيوية القسرية (FVC) , وحجم الزفير القسري في الثانية الا | Lung function tests are very useful diagnostic, follow up and research measures for healthy and respiratory compromised subjects. The simplest, yet the most informative, lung function tests are the spirometric tests.They involve the forced vital capacity (FVC), the forced expiratory volume in first second (FEV1) and the forced expiratory volume ratio (FEV%). Several types of devices are used to perform spirometric tests based on the measurement of lung volumes and their subdivisions. Lung volumes, hence, are represented by the volume of expired air. There was a controversy about the difference between body and ambient temperatures which may extremely affect gas volume , but this is thought to be solved by temperature correction. Temperature correction, however, may not be the precise solution in extremely fluctuating environmental temperatures. A fixed amount of expired gas has a constant mass despite the changes in pressure or volume as is implied by the law of conservation of mass in a closed system by Antoine Lavoisier. The aim of this study is to construct and evaluate a simple device called expiratory gas mass device as a reliable, reproducible, accurate and convenient tool to substitute Vitalograph spirometer as a measure of lung function in healthy Iraqi subjects and testing the hypothesis that expired gas mass could significantly and acceptably alternate or conjugate its volume as measures of lung function. The design of the study is a cross sectional study. The statistically required number of participants was decided by a professional statistician to be 70 healthy subjects. However, 300 healthy subjects are included in the present research to cover the need for subgrouping (146 male and 154 female) aged 20 - 50 years (31.84 ± 9.28 years). The male and female were classified into three age groups for each one, ten years interval was considered to be suitable for classifying subjects.Subjects with abnormal lung function such as smokers were excluded. A uniform case sheet was assigned for every participant in the study which includes, name, gender, age, weight, height, smoking habits, residence, cultural status, socioeconomic status, present and past medical history, family history of respiratory illnesses. They were asked to perform the forced expiratory maneuver through the standardized spirometer and then through the newly constructed gas mass device.The accuracy (systematic error) and reproducibility (random error) were tested for the constructed gas mass device.A comparison between forced vital capacity (FVC) and adjusted gas mass (AGM) was made on two main groups , the male group and female group, both of them were subdivided to three age groups.The results revealed that there were no significant differences in values of FVC and AGM measured by standard Vitalograph spirometer and gas mass device respectively. Regression lines indicated that there were strong positive correlations between gas mass (GM) and FVC in male and female. Separate data for male and female are processed and the results indicated that FVC values and GM (or AGM) values are significantly higher in male than in female , P?0.05. Regression lines indicated that there was a negative correlation between age and both of FVC and GM, a positive correlation between height and both of FVC and GM and a weak positive correlation between weight and both of FVC and GM. From the present study, it can concluded that gas mass device is simple, portable and easily handled device. It is also reproducible and accurate device for the measurement of GM in normal subjects.

اثر عوامل البيئة الاجتماعية على سلوك سيطرة وزن المراهقين في المدارس الثانوية في مدينة بغداد == Impact of Socio - Environmental Factors Upon Adolescents' Weight Control Behaviors In Secondary Schools At Baghdad City

اسم المؤلف: بثينة بشير صالح
اسم المشرف: اقبال غانم علي معلة
الموضوع العام: الطب
السنة: 2014
الموضوع الدقيق: التمريض
الدرجة: دكتوراه
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: دراسة وصفية(مقطعية) اجريت في جانبي الكرخ والرصافة لمعرفة اثر عوامل البيئة الاجتماعية على سلوك سيطرة وزن المراهقين في المدارس الثانوية في مدينة بغداد للفترة من 20 من شهر نيسان لعام 2013 الى نهاية تشرين الاول لعام 2014.تهدف هذه الدراسة للتعرف على عوامل ال | Overweight and obesity are one of the biggest threats for public health, both in children and adolescents. Fair enough, a lot of attention is paid towards this threat. However, hardly any attention is paid to weight loss behavior in normal weight children and adolescents. Teenagers who consider themselves as too fat who were negative body image a high risk for unnecessary weight loss behavior. A Cross - Sectional Descriptive study was conducted on impact of socio - environmental factors upon adolescents' weight control behaviors in secondary schools at both sides Al - Karkh and Al - Risafa sectors of Baghdad city. The study period started from 20th of April 2013 to the end of October 2014. The study aimed to find out the relationship between weight control, and socio - environmental factors and adolescents' demographic data (age, gender, Body Mass Index, and socio - economic status), and find out the impact of socio - environmental factors upon adolescents' weight control behaviors. A non - probability (purposive sample) of secondary adolescent schools , while 1254 adolescents' students were chosen randomly from that schools. The study instruments consist of four parts. The first part concerned with adolescents' students and their parents? socio - demographic data; the second part is about adolescents' students eating patterns and their meals list at home. The second part is divided into six sections. The 1 section consists of 28 items : the adolescents' students eating patterns and meals list at home, section 2 and 3 contains 16 items : for eating the snacks and fast food, section 4 is composed of 12 items : which are about adolescents' students eating time in schools with peers, section 5 has 12 items : related to the reasons of skipping meals, and section 6 consists of 6 items : about adolescents' lifestyle. The third part is about the physical activities and dieting programs, it consists of 7 items. The fourth part 10 items are related to the adolescents' weight control behaviors. Test - retest determined the reliability of the study instrument which was r = 0.90. A descriptive statistical analysis (frequencies and percentages) and inferential statistical analysis, and (chi - square) were used. The result of the study sample indicated that more than two fourth of the Body Mass Index was almost equal in under or normal weight while the another half were overweight and obese, and the sample's family socio - economic status was in high or low level status. The study indicated most of the adolescents' took breakfast at home, eating snacks, reasons of skipping breakfast meal, and their lifestyle had a highly significant association with their gender and that indicate no differentiate between their gender eat what they want at any time. The results of the study reflected the adolescents' students eating lunch and dinner at home, and reasons of skipping breakfast meal had no significant association with their ages. The adolescents' students favorite to eat snacks and fast food at home and it's had a highly significant association with their Body Mass Index. Also there is a highly significant associated for the study sample socio - environmental factors with their socio - economic status. The results of the study reflect that is a highly significant association between eating habits and their total weight control behavior methods. The study recommended the Ministry of Health need to activate the nutritional program strategies for weight management within school health services, and need to increase establishment other especial centers for managing adolescents from risk for overweight and obesity like as Obesity Research and Therapy Unit in AL - Kindy College of Medicine and Nutrition Research Institute. I suggest a schedule as a guideline for healthy nutritious for weight control and achieve daily physical activity Finally Ministry of Education need to involved teachers in that strategies and training them in relation to these programs.

عزل بكتريا Bacillus cereus من بعض عينات الغذاء == Isolation of Bacillus Cereus From Some Foods Samples

اسم المؤلف: ضحى عبد الله كاظم الظويهري
اسم المشرف: حبيب صاحب نهر
الموضوع العام: الطب
السنة: 2014
الموضوع الدقيق: الاحياء المجهرية
الدرجة: ماجستير
اللغة: الانكليزية
مكان الجامعة: بابل
الصفحات الاولى:
المستخلص: كائن Bacillus cereus موجود في كل مكان وهوممرض منقول بالاغذية والذي يمكن ان يسبب نوعين من امراض الجهاز الهضمي : القيء والاسهال. في هذه الدراسه, تم جمع 140 عينه غذائية شملت (الرز, اغذية الاطفال، الدقيق، منتجات الالبان، اللحوم، الحليب , التوابل) جمعت عشوائيا | Bacillus cereus is a ubiquitous organism and a potential foodborne pathogen that can cause two types of gastrointestinal diseases : emesis and diarrhea. In this study, a total of 140 food samples included (rice, infant food, flour, dairy products, meat, milk powder and spices) were collected randomly from restaurants, food stores and various sale points in the local markets of the Hilla province during the period of November 2014 to April 2015 in attempt to isolate of Bacillus cereus from these samples and detection the prevalence of diarrheal (hbl and nhe) and emetic (ces) enterotoxins genes by using Polymerase Chain Reaction (PCR). All bacterial isolates were identified by cultural, microscopic and biochemical examinations. The results showed that 56 (40%) of samples showed positive growth for Bacillus cereus. The antibiotic sensitivity test of some isolates to 10 antibiotics was studied. It has been found that all B. cereus isolates were resistant to Ampicillin, Ampiclox, Cefotaxime, and Cephalexin, while all isolates were sensitive to Gentamycin, Ciprofloxacine and Chloramphenicol, but most of them showed different rate of sensitivity to one or more of antibiotics such as Neomycin 90% and 80% for both Tetracycline and Erythromycin. Polymerase Chain Reaction technique (PCR) was used to detect the ability of bacterial isolates to encode two types of enterotoxin genes, diarrheal and emetic genes. The results showed that 4(7.14 %) of isolates harboured hblA gene, 16 (28.57%) hblC, 5(8.92 %) hblD, 46(82.14%) nheA, 24(42.85%) nhe B, 26 (46.42%) nheC and 3(5.35%) of the isolates harboured Ces gene. On the other hand, through using PCR it was found that nhe gene was present in most isolates, while hbl gene was variable among the studied isolates. Moreover, the Ces gene was found only in isolates being isolated from rice samples, while it was not found in other types of samples.

تاثير العلاج بعقار الميثوتركسيت على عامل النمو البطاني الوعائي، والعوامل الدموية ومضادات الاكسدة في الصدفية == Effects of Methotrexate Therapy On Vascular Endothelial Growth Factor, Hematological And Antioxidants Parameters In Psoriasis

اسم المؤلف: شكرية حاتم علوان
اسم المشرف: محمد عبيد المحمدي | محمد كاظم الحطاب
الموضوع العام: الطب
السنة: 2014
الموضوع الدقيق: الفسلجة
الدرجة: ماجستير
اللغة: الانكليزية
مكان الجامعة: بابل
الصفحات الاولى:
المستخلص: مبدا الدراسة : الصدفية مرض جلدي شائع ذو علامات جلدية ظاهرة، يتميز بالتهاب مزمن للجلد مع اختلاف في نضوج الخلايا الكيراتينية، التي تزيد من سمك الجلد. عملية تكوين الاوعية الدموية (Angiogenesis) هي المسؤول بالدرجة الاساس عن تطور افة الصدفية، واحد اهم عوامل تكو | Background : Psoriasis is a common skin disease with extra - cutaneous manifestations. It characterized by chronic inflammation of the skin with changes in the maturation of keratinocytes, which manifested by the hyperproliferation of the epidermis. Angiogenesis process is a central regulator of development psoriasis lesion and one of the important angiogenesis factor is vascular endothelial growth factor (VEGF).A major site of oxidative stress occurs in the skin due to reactive oxygen species, which play an important role in inflammatory skin diseases such as psoriasis. Objectives : The aim of this presented study is to evaluating the effect of MTX drug on psoriatic lesions by calculating psoriasis area and severity index (PASI) for three months. In addition, investigate the changes of the level of serum VEGF, antioxidants (GSH and SOD) and lipid profile, which include (TC, TG, HDL, LDL and VLDL). As well as, hematological assessment such as (RBCs, Hb, PCV, RBCs indices, ESR and WBCs) in patients with psoriasis before and after (one and three months) from treatment with oral methotrexate therapy in comparison to their levels in healthy control persons. Materials and Methods : This study was a cohort study in which a total of 80 subjects, half of them(40) with psoriasis (25 male and 15 female) had selected randomly from Marjan Medical City in AL - Hilla city and the other half (40)as healthy controls (21 male and 19 female). These subjects collected during the period from 28th/ October /2014 until 15th/ August/ 2015. Physical examination (body mass index) done to each subject that enrolled in the study. A clinical assessment of psoriasis disease activity in psoriasis patients and methotrexate efficacy was done with the Disease Activity Index (DAI) represented by PASI score. Blood collection was obtained from all psoriatic patients and control to use in determine the level of all biochemical parameter such as VEGF, GSH SOD and lipid profile , as well as hematological investigation which include RBCs, Hb, PCV, RBCs indices, ESR and WBCs. Result : The results of this work showed, The effect of systemic methotrexate therapy on psoriasis lesion by significant reduction of PASI levels after treatment and by a significant mean difference in psoriasis area severity index before and after (one and three months) from treatment in psoriatic lesions (P?0.05). Also, no significant differences (p> 0.05) between the mean of age for psoriatic patients group (male and female) and healthy control group (males and females). The body mass index shows significant increase (P?0.05) in psoriasis patients than control group. The serum of VEGF level was significant increase in patients with psoriasis when compare with control through study periods, and there was significant reduction in the level of VEGF in psoriasis patients as compared its level before and after treatment with MTX for one and three months (P?0.05). While, the level of GSH and SOD significant decrease in patients than control ,during the treatment with MTX ,there was significant difference increase in the level of GSH of patients as compare with baseline level (before treatment) (P?0.05). In addition, the level of SOD of patients appear there was no statically difference before treatment and after treatment with MTX. The results of the present study also show a significant increase (P?0.05) in total cholesterol(TC), triglycerides(TG), low density lipoprotein - cholesterol (LDL) and very low density lipoprotein - cholesterol(VLDL) concentration, while found a significant decrease (P?0.05) in level of HDL in serum of psoriasis group compared with those of the healthy control group. When compare between patients during follow up periods, found there was no significant different of level of TC, TG, LDL and VLDL between psoriasis patients in period before treatment when compared with after one months from treatment with MTX (P>0.05). While there is a significant increase between patients before treatment compare with after three months, and after one month from treatment compare with after three months from treatment with MTX (P? 0.05). The level of HDL in psoriatic patients was significant increase at (P? 0.05) before treatment as comparing with after (one month and three months) from treatment with MTX, but there is no significant difference between patients after one from treatment as compared to with after three month from treatment with methotrexate (P> 0.05). The result of hematological for the results of study showed , there is a significant decrease (P? 0.05) in RBCs counts, Hb, PCV and RBCs indices compared with healthy control. While significant increase in total WBCs counts and ESR in psoriatic patients in all periods of follow up periods as compare with control. When compare the RBCs, Hb, PCV, RBCs indices of patients in all periods before and after (one and three months) from treatment with MTX, found there is no significant difference among them at (P> 0.05). While the result of WBCs count show significant decrease (P?0.05) between patient before treatment and after three months from treatment with MTX , and between after one month from treatment with MTX as compare with after three month from treatment , but there is no significant difference between before treatment compare to after one month from treated with MTX. The results of ESR of psoriasis patient show significant decrease (P? 0.05) between before treatment as compare with after three months from treatment with MTX , and after one month from treatment compare to after three month from treatment.While there is no any significant difference between patient before treatment compare with after one month from treatment with methotrexate (P>0.05). Conclusion : The vascular endothelial growth factor have play important role in the evaluation of psoriasis severity, oral methotrexate therapy have efficacy upon serum levels of vascular endothelial growth factor. Efficacy of oral methotrexate therapy on psoriatic patient’s treatment, have there was faster remission of psoriatic lesions and this reflect the immune - modulatory anti - inflammatory role of The MTX in psoriasis patient.
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