Author name: رؤى محمد كريم

General topic: Medicine

Specific topic: Physiology

Degree: Master

University: University of Baghdad - Faculty Of Medicine

Language: English

University location: Baghdad

First pages:

Abstract: Cervical spondylotic myelopathy (CSM) is considered the most serious consequence of cervical spondylosis and accounts for the majority of non_traumatic paraparesis and/or quadriparesis. The electrical property of the spinal cord and its susceptibility to injuries renders electrophysiology relevant to the management of CSM. SEPs study is an objective assessment of the functional integrity of the neural pathway.With the introduction of MRI, increasing numbers of cases are identified where spondylotic changes and disc herniation reach and compress the cervical spinal cord; however, the significance of these radiological findings with respect to the development of myelopathy is unclear.It is recommended that preoperative sensory - evoked potentials may be considered for patients with CSM in whom clinical factors do not provide clear guidance and would potentially change therapeutic decisions.In this study 22 patients with CSM (11 male and 11 female) and matched with 25 subjects of the control group were enrolled. All subjects were tested with bilateral SNCV of median and sural nerves and with bilateral median and tibial SSEPs tests. Results of SSEPs studies show 19(86.36%) out of 22 patients had abnormal SSEPs study (either tibial or median or both tests abnormal), with 68.2% abnormal tibial and 63.6% abnormal median study. There was no difference between median and tibial SSEPs results in patients (P>0.05) and most of the abnormalities were bilateral and there was no difference between right and left side study of neither median nor tibial SSEPs studies (P>0.05).Median SSEPs showed that abnormality in cortical response N20 and cervical spinal potential N13 compared to control group were highly significant (P<0.0005). Also IPLs were significant regarding (N9 - N13), (N9 - N20), (P14 - N20) and (N13 - N20) with (N13 - N20) was the most significant with 63.6% right and 54.5% left side abnormality. Abnormal cortical response (P37) following tibial stimulation was highly significant compared to control group (P<0.0005) with 14 cases (63.6%) abnormal bilateral tibial SSEPs and 1 patient with unilateral right tibial SSEPs abnormality. Abnormal tibial SSEPs associated with slightly more frequent loss of components than delayed responses. IPL (LP - P37) was highly significant (P<0.0005) with 68.2% right and 63.6% left abnormal results. Patients were classified clinically according to Nurick grading system of cervical myelopathy. Four out of 8 cases with normal median SSEPs of the patients were grade - 1 Nurick, 5 out of 7 cases with normal tibial SSEPs of patients were grade - 1 and 3 out of total 22 patients had normal both median and tibial SSEPs were all grade - 1 and this suggests that normal SSEPs findings mostly correlate with mild and early myelopathy. Six out of 10 cases with abnormal both median and tibial SSEPs were grade - 1 and grade - 2(2 cases grade1 and 4cases grade - 2) and this suggests that abnormal SSEPs findings are useful in prediction the progression of myelopathy in patients with mild clinical neurological deficits in the early stages of the disease.This study concluded that both median and tibial SSEPs montages should be performed to evaluate patients with CSM as the progression of the cervical cord compression may take variable pathways. MRI and SEPs may evaluate different aspects of the disease process; therefore, SEPs study is a useful important objective assessment of the spinal cord function

طيف وتردد طفرات الجين K - ras عند المرضى العراقيين المصابين بسرطان القولون والمستقيم المفرق == Spectrum and Frequency of K - ras Mutations among Iraqi Patients with Sporadic Colorectal Cancer

Author name: شيماء خالد شاكر احمد

Supervisor name: بسام موسى صادق الموسوي

General topic: Medicine

Specific topic: Diseases - Genetics

Degree: Master

University: University of Baghdad - Faculty Of Medicine

Language: English

University location: Baghdad

First pages:

Abstract: Colorectal cancer (CRC) is a serious health problem and is one of the most common cancers in the world. The majority of CRCs are sporadic; several genes have been implicated in colorectal carcinogenesis.Kirsten rat sarcoma viral oncogene homolog (K - ras) is a protooncogene and is one of the important genes responsible for sporadic colorectal carcinogenesis. It is involved in G protein - mediated signal transduction. It has a constitutive guanosine triphosphatase (GTPase) activity, which is lost when the gene is mutated. Analysis of K - ras mutation has important therapeutic impact being one of the most important predictors of resistance to targeted therapy using Epidermal Growth factor receptor (EGFR) tyrosine kinase inhibitors (cetuximab and panitumumab) in addition to its prognostic significance. Aim of study : To determine the frequency and spectrum of K - ras mutations among Iraqi patients with sporadic CRC. Patients, Materials and Methods : This is a retrospective study that included 35 surgically resected cases with sporadic CRC from the Gastroenterology and Hepatology Teaching Hospital / Medical City Complex - Baghdad during the period extending from January 1st, 2014 till December 31st, 2015. Patients’ demographic characteristics as well as tumor characteristics were studied. Samples of DNA were extracted from formalin - fixed paraffin embedded blocks (FFPE) using the QIAamp DNA FFPE Tissue Kit by QIAGEN / Germany. The specified DNA fragment was amplified by a conventional thermocycler (PCR) using specific biotinylated primers followed by hybridization of the amplification products to a test strip containing allele - specific oligonucleotide probes immobilized as an array of parallel lines. The bound biotinylated sequences are detected using streptavidin - alkaline phosphatase and color substrates according to the manufacturers’ instructions.Results : The age of the 35 enrolled cases ranged between (20 - 70) years with a mean (±SD) of 52.7±13.5 years and a median of 55 years; 27(77%) of them were ≥45 years of age and 8(23%) were <45 years of age. Out of the 35 enrolled patients 12 (34%) were males and 23(66%) were females; the male : female ratio was 1 : 2.The most common histological type was the non - mucinous adenocarcinoma constituting 30 (85.7%), with a moderately differentiated grade II histological pattern 29 (82.9%); stage III was the most common tumor stage 13 (37.1%) with predominance of left colonic tumors 20 (57%);15(42.9%) of CRC patients presented with positive regional lymph node involvement.K - ras mutations were detected in 13 (37%) patients; the remaining 22 (63%) show wild - type K - ras. Ten (71.4%) of these mutations were in codon 12 while 4(28.6%) were in codon 13. No mutation was detected in other codons (61,117,146).A total of 14 mutations were detected in the tumors of those 13 patients; 12/13 tumors had single mutations, and only 1/13 had double mutations (in codon 12 and codon 13 simultaneously).The most frequently encountered mutations were the G>T transversions 9 (64.4%). The most frequent mutation constituting 8 (57.2%) was GGT>TGT (GLY>CYS) at codon 12.There were no statistically significant associations of clinicopathological characteristics with K - ras mutation status.Conclusions :  K - ras mutations rate lies within worldwide reports, and lie in the middle between Asian and European figures. Most CRC tumors carry codon 12 K - ras mutations and thus they have a risk of poorer prognosis and response to therapy. Gly12Cys and Gly13Asp predominate over other types of amino acid substitutions, and carry a poorer prognosis. PCR detection of K - ras mutations is preferable to IHC techniques especially so when using anti - EGFR for CRC treatment.

المستويات المصلية للكلكتين - 4 وللمستقبل شبيه التول - 2 في النساء المصابات باورام الثدي == SERUM LEVELS OF GALECTIN - 4 AND TOLL - LIKE RECEPTOR - 2 (TLR - 2) IN WOMEN WITH BREAST TUMOR

Author name: هند حامد عبد العامري

Supervisor name: عائدة رشيد منصور الدرزي

General topic: Medicine

Specific topic: Microbiology

Degree: Master

University: University of Baghdad - Faculty Of Medicine

Language: English

University location: Baghdad

First pages:

Abstract: اشتملت هذه الدراسة على 30 مريضة مصابة بسرطان الثدي, وذات اعمار تتراوح مابين سبعة وعشرين سنة الى ستة وسبعين سنة, وبمتوسط عمر (11.8 50± ) سنة. وقد تم تشخيص هؤلاء المرضى سريريا وشعاعيا من قبل متخصصين, وقد كانوا من بين المرضى الذين حضروا للمركز الوطني للكشف المبكر عن الاورام - مدينة الطب /وزارة الصحة, خلال الفترة من تشرين الاول 2011 حتى شباط 2012.وتضمنت هذه الدراسة مجموعتا ضبط قياسية للمقارنة, المجموعة الاولى - مجموعة السيطرة المرضية لمريضات يعانون من ورم غدي ليفي حميد (الاورام الحميدة) وقد تم تشخيص هؤلاء المرضى ايضا سريريا وشعاعيا من قبل متخصصين, وقد كانوا من بين المرضى الذين حضروا للمركز الوطني للكشف المبكر عن الاورام - مدينة الطب /وزارة الصحة, خلال الفترة من تشرين الاول 2011 حتى شباط 2012., والمجموعة الثانية - مجموعة السيطرة الصحية والتي اشتملت على 20 امراة سليمة ظاهريا. وكشفت الدراسة عن النتائج الاتية : 1. اظهرت النتائج وجود فرق معنوي عالي جدا(P<0.001) في مستوى الكلكتين - 4 بين مرضى سرطان الثدي ومجموعة الضبط الصحية وحتى بين مجموعة السيطرة المرضية (الاورام الحميدة) ومجموعة السيطرة الصحية (P<0.001),ومع ذلك لم يكن هناك فروق ذات دلالة احصائية (P=0.92) بين المرضى ومجموعة السيطرة المرضية (الاورام الحميدة).لذلك لعدم وجود اختلافات ذات دلالة احصائية في القيم الوسيطية للكلكتين - 4 الموجود في المصل بين مرضى سرطان الثدي (الاورام الخبيثة) والمجموعة الضابطة (الاورام الحميدة), لذلك يمكن للمرء التعامل مع حالات اورام الثدي بشكل عام فيما يتعلق بالكلكتين - 4 الموجود في الانسان.2. ايضا هذه الدراسة اظهرت وجود فرق معنوي عالي جدا(P<0.001) في مستوى المستقبل شبيه التول - 2 بين مرضى سرطان الثدي ومجموعة الضبط الصحية وحتى بين مجموعة السيطرة المرضية (الاورام الحميدة) ومجموعة السيطرة الصحية (P<0.001) ومع ذلك لم يكن هناك فروق معنوية ذات دلالة احصائية (P=0.44) بين المرضى ومجموعة السيطرة المرضية (الاورام الحميدة).لذلك لعدم وجود اختلافات معنوية ذات دلالة احصائية في القيم الوسيطية للمستقبل شبيه التول - 2الموجود في المصل بين مرضى سرطان الثدي (الاورام الخبيثة) والمجموعة الضابطة (الاورام الحميدة), لذلك يمكن للمرء التعامل مع حالات اورام الثدي بشكل عام فيما يتعلق بالمستقبل شبيه التول - 2 الموجود في الانسان.3. تمت دراسة القيمة التكهنية للكلكتين - 4 المفحوص لتقييم نفاذية هذا المعامل وقد تم اثبات امتلاكه لاعلى دقة (98.8)مع حساسية 100%بقيم ثبوتية قطعية ( 0.44نانوغرام/مليليتر; ( لذلك ظهور النتائج الموجبة عند هذه القيمة الثبوتية القطعية سوف يساعد للتوصل الى تشخيص مؤكد من قبل الطبيب في العيادة مع نسبة ثقة (95.2% ( في وقت ان التشخيص الاولي للورم يساوي 50%) احتمالية قبل الاختبار ) ومع نسبة ثقة في العيادة (99.4%) في وقت التشخيص الاولي (على اساس تاريخ الحالة والفحص) للورم بنسبة احتمالية عالية (90% احتمالية قبل الاختبار(.4. تمت دراسة القيمة التكهنية للمستقبل شبيه التول - 2 المفحوص لتقييم نفاذية هذا المعامل وقد تم اثبات امتلاكه لاعلى دقة (97.5)مع حساسية 100% بقيم ثبوتية قطعية ( 0.14 نانوغرام/مليليتر; (لذلك ظهور النتائج الموجبة عند هذه القيمة الثبوتية القطعية سوف يساعد للتوصل الى تشخيص مؤكد من قبل الطبيب في العيادة مع نسبة ثقة (90.9% ( في وقت ان التشخيص الاولي للورم يساوي 50%) احتمالية قبل الاختبار) ومع نسبة ثقة في العيادة (98.9%) في وقت التشخيص الاولي (على اساس تاريخ الحالة والفحص ) للورم بنسبة احتمالية عالية (90%احتمالية قبل الاختبار(.5. اوضحت هذه الدراسة ارتفاعا ملحوظا بمتوسط تركيز الكلكتين - 4 (0.895 نانوغرام/مليليتر) بين المرضى الذين قضوا مدة طويلة بالمرض (ثلاثة اشهر فمافوق) بالمقارنة مــــع المرضى حديثي الاصابة بالمرض (اقل من ثلاثة اشهر) بتركيز وسيطي (0.552 نانوغرام/مليليتر(ومع ذلك هذا الاختلاف لم يصل الى مستوى الدلالة الاحصائية (p=0.12 ( لذلك الملاحظة الاحصائية للعلاقة الخطية بين فترة المرض وارتفاع تركيز الكلكتين - 4 تعتبر ضعيفة (r=0.268, p=0.039).6. وقد لوحظ ايضا ارتفاعا ملحوظا بمتوسط تركيز المستقبل شبيه التول - 2(0.619نانوغرام/مليليتر) بين المرضى الذين قضوا مدة طويلة بالمرض (سنة فمافوق) بالمقارنة مع المرضى حديثي الاصابة بالمرض (اقل من ثلاثة اشهر) بتركيز وسيطي (0.343 نانوغرام/مليليتر( ومع ذلك هذا الاختلاف لم يصل الى مستوى الدلالة الاحصائية (p=0.049 ( لذلك الملاحظة الاحصائية للعلاقة الخطية بين فترة المرض وارتفاع تركيز الكلكتين - 4 تعتبر ضعيفة (r=0.16, p=0.22).7. كشفت هذه الدراسة وجودعلاقة ايجابية لكن ضعيفة وعلاقة احصائية خطية غير ملاحظة بين حجم الورم وتركيزالكلكتين - 4 فمقارنة بتصنيف حجم الورم والذي صنف حسب نتائج هذه الدراسة الى فئات, كان التركيز الوسيطي للكلكتين - 4 الموجود بمصل المرضى ذوي الحجم الفئة الرابعة (اعلى حجم) اعلى بوضوح (0.895 نانوغرام/مليليتر) مقارنة مـــــع (0.567 نانوغرام/مليليتر) ذوي الحجم الاول (اقل حجم). (r=0.046, p=0.76).8. اتضح وجود علاقة ايجابية لكن ضعيفة وعلاقة احصائية خطية غير ملاحظة بين حجم الورم وتركيز المستقبل شبيه التول - 2 فمقارنة بتصنيف حجم الورم والذي صنف حسب نتائج هذه الدراسة الى فئات, كان التركيز الوسيطي للمستقبل شبيه التول - 2الموجود بمصل المرضى ذوي الحجم الفئة الرابعة (اعلى حجم) اعلى بوضوح (0. 619 نانو غرام/مليليتر) مقارنة مع (0. 288 نانوغرام / مليليتر) ذوي الحجم الاول (اقل حجم). (r=0.145, p=0.34).9. واخيرا,تبين الدراسة الحالية عدم وجود فروق ذات دلالة احصائية في متوسط تركيز مصل الدم الحاوي كلا من الكلكتين - 4 والمستقبل شبيه التول - 2 للمرضى المصابين بسرطان الاقنية (الموضعي) والاخرون المصابين بالسرطان الارتشاحي (p =0.12, 0.64 على التوالي.( | Thirty patients with breast cancer were enrolled in this study, their ages ranged between (27 - 76) years; with the mean age was 50+ 11.8 years. Also, 30 patients with benign fibroadenoma as case control group their ages ranged between (19 - 52) years; with the mean age was 33.1+ 10.2 years. Those patients were diagnosed clinically, radiologically and cytologically and histopathologically by specialists, and they were among patients who attending the National Center For Early Detection Of Cancer - Medical City Complex / Ministry of Health, during the period from October 2011 to February 2012. Twenty apparently healthy subjects as a control group were included in the present study for comparison. Major findings of current study were the following : - 1. There was a statistical significant difference in the serum level of galectin - 4 between breast cancer patients and healthy control group (p > 0.001) and even between case control and healthy control groups (p>0.001), however , there was no statistical differences between patients and case control groups (p=0.92). Since no statistical significant differences in serum galectin - 4 median values between breast cancer patients (malignant tumors) and case control groups (benign tumors), therefore one can deal with breast tumor cases in general regarding serum galectin - 4.2. Also, The current study has been demonstrated that there was a statistical significant difference in the serum level of Toll like receptor - 2 between breast cancer patients and healthy control group (p > 0.001) and even between case control and healthy control groups (p >0.001), however, there was no statistical differences between patients and case control groups (p =0.44). Since no statistical significant differences in serum Toll like receptor - 2 median values between breast cancer patient (malignant tumors) and case control groups (benign tumors), therefore one can deal with breast tumor cases in general regarding serum Toll like receptor - 2 .3. The predictive value of the tested galectin - 4 to detect the validity of this parameter was studied since it had the highest accuracy (98.8) with sensitivity 100% within the cut off value (0.44ng/ml); therefore, testing positive at this cut - off value will establish a possible diagnosis of tumor with (95.2%) confidence in a clinical setting where the primary diagnosis of tumor had equal odds probability (50% pretest probability), and with (99.4% )confidence in a clinical setting where the primary diagnosis (based on history and examination) of tumor had a high probability (90% pretest probability).4. The predictive value of the tested Toll like receptor - 2 to detected the validity of this parameter was studied since it had the highest accuracy (97.5) with sensitivity 100% within the cut off value (0.14ng/ml); therefore, testing positive at this cut - off value will establish a possible diagnosis of tumor with (90.9%) confidence in a clinical setting where the primary diagnosis of tumor had equal odds probability (50% pretest probability), and with (98.9% )confidence in a clinical setting where the primary diagnosis (based on history and examination ) of tumor had a high probability (90% pretest probability).5. The median concentration of serum galectin - 4 was obviously higher (0.895 ng/ml) among those patients with average to long duration of disease (3months +) in comparison to those with very recent disease (> 3 months) and whose median concentration of galectin - 4 was (0.552 ng/ml). The difference observed failed to reach the level of statistical significance (p value= 0.12); however, there was a statistic significant weak positive linear correlation between disease duration and human galectin - 4 (r=0.268, p=0.039).6. The median concentration of serum Toll like receptor - 2 was obviously higher (0.619 ng/ml) among those patients with average to long duration of disease (1years +) in comparison to those with very recent disease ( > 3 months) and whose median concentration of Toll like receptor - 2 was (0.343 ng/ml). The difference observed failed to reach the level of statistical significance (p value= 0.049); however, there was a statistically non significant weak positive linear correlation between disease duration and serum Toll like receptor - 2 (r=0.16, p=0.22).7. Concerning tumor size categories, the median concentration of serum galectin - 4 was obviously higher (0. 895 ng/ ml) among those patients who were within the fourth (highest) quartile in comparison to those within the first (lowest) quartile (0 .567 ng /ml). There was a weak positive and statistically not significant linear correlation between tumor size and serum galectin - 4 concentration (r=0.046, p=0.76).8. Concerning tumor size categories, The median concentration of serum Toll like receptor - 2 was obviously higher (0.619 ng/ ml) among those patients who were within the fourth (highest) quartile in comparison to those within the first (lowest) quartile (0.288 ng /ml). There was a weak positive and statistically not significant linear correlation between tumor size and Toll like receptor - 2 concentration (r=0.145, p=0.34).9. For both (Galectin - 4 and Toll like receptor - 2) there were no statistical differences in serum median concentration between ductal carcinoma in situ and infiltrative carcinoma (p =0.12, 0.64 respectively)

وظائف الكبد في داء المقوسات == Liver Function Tests in Toxoplasmosis

Author name: مضر نزار داؤد

Supervisor name: ندوة عبد الجبار محمود

General topic: Medicine

Specific topic: Clinical Biochemistry

Degree: Master

University: University of Al Mosul - Faculty Of Medicine

Language: English

University location: Mosul

First pages:

Abstract: تم تصميم هذه الدراسة لغرض التحري عن تاثير داء المقوسات على فحوصات وظائف الكبد عند 60 امراة مصابة بهذا الداء. كانت النسوة المشاركات في هذه الدراسة من مناطق مختلفة من داخل مدينة الموصل ومن المناطق المحيطة بها. وكان تشخيص الداء بواسطة فحصين من فحوصات مصل الدم وهما : فحص تلازن اللاتكس وفحص ارتباط الخميرة للادمصاص المناعي - الغلوبين المناعي صنف - م - . كانت جميع النسوة المصابات بداء المقوسات والمشاركات بهذه الدراسة غير حوامل، غير مدخنات ولايستعملن العلاجات الدوائية وقد شخصن لاول مرة باصابتهن بداء المقوسات. كانت اعمار المشاركات بهذه الدراسة تتراوح بين 16 - 35 سنة مع معدل ± انحراف معياري ( 24.97 ( 5.48 ± سنة.شملت الدراسة قياس الفحوصات الكيماوية الحيوية التالية : فعالية انزيم ناقل الامين الاسبارتيت، انزيم ناقل الامين الالنين، انزيم ناقل كاما كلوتاميل وانزيم لاكتيت نازعة الهيدروجين في مصل الدم، تراكيز ياقوتين الصفراء (الكلي، المباشر وغير المباشر) وكذلك تراكيز البروتين، الزلال والكريين في مصل الدم.تم مقارنة نتائج هذه الفحوصات مع 40 امراة خالية من الاصابة بعد اجراء فحوصات داء المقوسات عليهن،تتراوح اعمارهن بين 17 - 35 سنة مع معدل ± انحراف معياري (85. 23 ± 48. 5 ) سنة.و كانت نتائج المقارنة كالاتي : كان انزيم ناقل الامين الاسبارتيت اعلى عند المصابات بداء المقوسات عند المقارنة بغير المصابات (P=0.001)،وكان انزيم ناقل الامين الالنين اعلى عند المصاباتP< 0.001))، وكان انزيم الفوسفاتيز القاعد اعلى عند المصابات (P= 0.045)،وكان انزيم ناقل كاما كلوتاميل اعلى عند المصابات ( P =0.013). اما بالنسبة لانزيم لاكتيت نازعة الهيدروجين فلم يكن هناك اي زيادة احصائية لهذه الخميرة عند المصابات .(P> 0.05) وبالنسبة لفحوصات ياقوتين الصفراء ( الكلي ، المباشر وغير المباشر )، فلم تظهر اي اختلافات بين المصابات والسليمات من داء المقوسات وكذلك الحال بالنسبة لفحوصات البروتين، الزلال ، الكريين ونسبة الزلال / الكريين حيث لم يظهر اي اختلاف بين المصابات والسليمات .و لغرض التعرف على تاثير عاملي السكن والعمر على نتائج فحوصات الكبد على النساء المصابات تم تقسيم المصابات الى مجموعتين ، المجموعة الاولى من داخل مدينة الموصل والمجموعة الثانية من المناطق الريفية المحيطة بالموصل ولم نجد اي تاثير لهذا العامل P>0.05)). كذلك بالنسبة لعامل العمر، قسمت المصابات الى مجموعتين ، الاولى 25 سنة واقل والثانية اكثر من 25 سنة ولم نجد اي تاثير لهذا العامل (P > 0.05) باستثناء خميرة الفوسفاتيز القاعدي الذي كان اعلى عند النساء الاصغر سنا ( P = 0.009 ) .و مما سبق فقد يكون لداء المقوسات تاثير بسيط على وظائف الكبد من خلال زيادة فعالية قسم من الانزيمات في مصل الدم، لكن هذه الزيادة لاتكفي لحدوث علامات سريرية لالتهاب الكبد عند المصابات بداء المقوسات . | This study was designed to detect the effect of toxoplasmosis on liver function tests in 60 women diagnosed with toxoplasmosis where these women are of different localities in Mosul city and the surrounding rural areas. All these women were diagnosed serologically to have toxoplasmosis by two tests; latex agglutination test and IgM - enzyme linked immunosorbant agglutination assay (IgM - ELISA). All of the cases of toxoplasmosis patients were not pregnant, not smoking, had no medication and diagnosed for the first time to have toxoplasmosis. Their ages ranged between (16 - 35) with a mean  SD of 24.97  5.48 years.The biochemical parameters measured were serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), gamma glutamyltransferase (γ - GT), lactate dehydrogenase (LDH) activities, total, direct  indirect bilirubin, total protein, albumin, globulin and albumin/globulin ratio (A/G ratio). The results of these patients were compared with 40 matched control apparently healthy women with negative tests of toxoplasmosis. There ages were between 17 - 35 with a mean  SD of 23 .85  5.48 years. Serum AST activity was significantly higher in patients compared with controls (P= 0.001), serum ALT activity was significantly higher in patients (P 0.001), serum ALP activity (P = 0.045), serum γ - GT activity was significantly higher in patients (P = 0.013) while serum LDH activity was not significant although it tends to be higher in patients compared with the controls (P  0.05). Serum total, direct and indirect bilirubin, serum total protein, albumin, globulin concentrations and albumin/globulin ratio (A/G ratio) were all not significant when compared with controls (P  0.05). Further analysis of results to determine the effect of locality and age on the patients showed no significant difference between patients from inside Mosul city and those from rural areas. The results showed also no significant differences in biochemical parameters of patients in those 25 years and younger when compared with those more than 25 years (P 0.05) except serum ALP activity which was significantly higher in younger patients at (P = 0.009). The over all analysis of liver enzymes suggests a probable involvement of the liver in the disease process of toxoplasmosis but this involvement is not sufficient to produce clinical signs and symptoms of hepatitis for patients

نمط اكتساب الوزن خلال الحمل في قطاع الاعظمية / بغداد العراق 2014 == WEIGHT GAIN PATTERN DURING PREGNANCY IN SECTOR AL - AADHAMIA/ BAGHDAD - IRAQ 2014

Author name: وسن اسماعيل ابراهيم

Supervisor name: علياء مكي حسن الصافي

General topic: Medicine

Specific topic: Community Medicine

Degree: Master

University: University of Baghdad - Faculty Of Medicine - Department Of General Surgery

Language: English

University location: Baghdad

First pages:

Abstract: Weight gain has unique significance for pregnant women. Recently a new clinical guideline by united state institute of medicine (2009) addressing healthy weight during pregnancy according to prepregnancy body mass index. It has been introduced in some countries, like Iraq in 2013.This study objectives are to assess gestational weight gain pattern of pregnant women and its correlation with maternal health, labor and fetal outcomes, and to estimate the rate of low birth weight.A total 408 of recently delivered mothers attending primary health care centers of AL - Aadhamia sector to vaccinate their children during the period from the first of November, 2014 to the end of May, 2015. A convenient sample was collected through interview with the mothers and review their antenatal care files was done by a tailored questionnaire especially designed. The independent variables were gestational weight gain, body mass index and birth weight, the dependent variables were birth weight, maturity of pregnancy, maternal age, gestational diabetes, hypertension, urinary tract infection, anemia and cesarean section.The prevalence of gestational weight gain was 44.6% had high weight gain. The body mass index at first visit for studied sample were mostly overweight 40.9%. The rate of low birth weight was 18.1%.There was non - significant difference between gestational weight gain with body mass index at first visit, maturity of pregnancy and anemia. But there was a significant difference between gestational weight gain with birth weight, urinary tract infection, gestational hypertension and gestational diabetes.VIIThere was a significant association between low gestational weight gain group and anemia, urinary tract infection and preterm labor, normal gestational weight gain group and preterm labor, high gestational weight gain group with gestational hypertension, gestational diabetes and cesarean section.According the study results, we are recommended health education of women at bearing age before pregnancy and weight monitoring during pregnancy, Awareness of health care providers by training and alert the ministry of health to carry out nationwide study to evaluate gestational weight gain during pregnancy.