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التاثير المايكروبي المضاد لدقائق الفضة النانوية ضد بكتريا الزوائف الزنجارية المعزولة من عينات سريرية == The Antimicrobial Effect of Silver Nano Particles (AgNPs) Against Pseudomonas aeruginosa Isolated from Clinical Samples

اسم المؤلف: سارة عقيل حسن التميمي
اسم المشرف: هدى هادي الحسناوي
الموضوع العام: الطب
السنة: 2017
الموضوع الدقيق: الاحياء المجهرية
الدرجة: دكتوراه
اللغة: الانكليزية
مكان الجامعة: بابل
الصفحات الاولى:
المستخلص: اجريت هذه الدراسة للكشف عن التاثيرالمايكروبي المضاد لدقائق الفضة النانوية ضد بكتريا الزوائف الزنجارية المعزولة من عينات سريرية, تم جمع 100 عينة من مصادر سريرية مختلفة, تضمنت العينات السريرية عينات الحروق , والادرار, والدم, واصابات الاذن, والقشع تم اخذ هذه العينات من المرضى الراقدين في مستشفى الحلة التعليمي خلال الفترة من تشرين الثاني 2016 الى كانون الثاني 2017. زرعت جميع العينات على وسط السترمايد, وسط اكار الدم, وحضنت كل الاطباق هوائيا بدرجة حرارة C°37 لمدة 18ساعة. تم تشخيص بكتريا الزوائف الزنجارية بالاعتماد على الصفات المظهرية والكيموحيوية.كان توزيع العزلات كالاتي : 22(52.4%) من عينات الحروق, 8(19%) من عينات الادرار, 14.3)6%) عينة من المرضى المصابين بالالتهاب الاذن الخارجية, 4(9.5%) من عينات الدم,2(4.7%) من عينات القشع. اظهرت نتائج اختبار الحساسية باستخدام طريقة الانتشار في الوسط ان جميع العزلات(26) كانت مقاومة لكل من الببراسلين (100%), السيفوتاكسيم (100%),بينما نسبة المقاومة لكل من الاميكاسين (88%), سيفترياكسون (65%), جنتامايسن (62%), بينما وجدت نسبة مقاومة قليلة للسفتازديم (15%), وكل العزلات كانت حساسة (100) لكل من الميروبينيم, اوفلوكساسين, نورفلوكساسين والسبروفلوكساسين. تم في هذه الدراسة ايضا الكشف عن تكوين الاغشية الحيوية بواسطة طريقتين : طريقة الطبق الزرعي النسيجي (TCP) وطريقة صبغة الكونكو الحمراء (CRA) فكانت النتائج كالاتي : وجد ان في طريقة الطبق الزرعي النسيجي كانت جميع عزلات الزوائف الزنجارية والبالغ عددها (9) منتجة للاغشية الحيوية, (4) من اصل (9) (44%) من عزلات الزوائف الزنجارية انتجت مستعمرات سوداء بواسطة طريقة صبغة الكونكو الحمراء. وكذالك في هذه الدراسة تم الكشف عن تاثير جزيئات الفضة النانوية ((AgNPs على تكوين الاغشية الحيوية باستخدام تراكيز مختلفة (µg/ml 2.5, µg/ml 5, 10 µg/ml, 20µg/ml),حيث اظهرت النتائج ان اعلى فعالية لجزيئات الفضة النانوية كانت عند التركيز (20) وبنسبة تثبيط (100%), من جهة اخرى تم اختبار التاثير البكتيري المضاد لجزيئات الفضة النانوية ضد مختلف انواع العزلات البكتيرية باستخدام طريق التخافيف في الوسط الصلب وتراكيز مختلفة من جزيئات الفضة النانوية (12.5 µg/ml, 25 µg/ml, 50 µg/ml, (100 µg/ml, 200 µg/ml وكانت العزلات كالتالي : ـ(S. aureus, E. coli, E. cloacae, K. pneumonia, P. aeuroginosa)اظهرت النتائج ان اعلى فعالية لجزيئات الفضة النانوية كانت عند التراكيز(100 µg/ml, 200 µg/ml).ايضا تم تعريض ظاهرة السوارمنك في عزلات الزوائف الزنجارية لتراكيز مختلفة من جزيئات الفضة النانوية (2.5 µg/ml, 5 µg/ml, 10 µg/ml ), ووجد ان اعلى نشاط لجزيئات الفضة النانوية ضد ضاهرة السوارمنك وانتاج البايوسيانين كانت بتركيز ((10 µg/ml, 5 µg/ml .تم زراعة جميع عزلات بكتريا الزوائف الزنجارية (26)عزلة بوجود نترات الفضة (AgNO3) بتراكيز تتراوح (100 µg/ml - 400 µg/ml ) باستخدام طريقة التخافيف في الوسط الصلب مع قدرات مختلفة لانتاج البيوسيانين. اظهرت النتائج ان جميع العزلات 26((100 المنتجة للبايوسيانين كانت مقاومة للسلفر نايتريت (AgNO3) من خلال ظهور نمو في الطبق الحاوي على التراكيز المذكورة نترات الفضة (AgNO3).في هذه الدراسة تم اختبار بكتريا الزوائف الزنجارية لانتاج البكتريوسين باستخدام عزلات بكترية مختلفة تضمنت العزلات (امعائية مذرقية,مكورات العنقودية الذهبية,اشريكية قولونية, كلبسيلة رئوية). كذلك تم العثور على مجموعة واسعة من منطقة تثبيط (24mm - 30mm) في الانواع البكتيرية اعلاه مع قطر (30mm, 28mm, 24mm, 30mm) على التوالي. عزلات (امعائية مذرقية, كلبسيلة رئوية) كانت الاكثر تاثر والتي انتجت قطر تثبيط ((30mm. في هذه الدراسة ايضا تم تقييم علاقة مقاومة الفضة مع انتاج بيوسيانين في بكتريا الزوائف الزنجارية متعددة المقاومة للمضادات الحيوية. في هذه الدراسة تم استخدام تقنية تفاعل البلمرة المتسلسل للتاكد من وجود بعض الجينات. في هذه التقنية، تم فحص جينات bla - IMP)) التي تشفر الى انزيم ميتالو - β - لاكتاميز المسؤول عن مقاومة ايميبينيم وجينات (silS ,silE) التي تشفر لمقاومة الفضة في عزلات بكتريا الزوائف الزنجارية بواسطة استخدام برايمرت خاصة. وقد وجد ان جميع العزلات ال 26 (100%) من بكتريا الزوائف الزنجارية كانت سلبية لهذه الجينات. كما تم استخدام اثنين من البرايمرات المحددة للكشف عن فينازين (بيوسيانين) (phzS, phzM). اظهرت النتائج لل (phzM) ان من اصل 26)) عزلة , 21 (80.8%) اعطت نتيجة ايجابية, , فيما يخص (phzS gene) وجد ان 14(% 53.9) عزلة كانت حامله لهذا الجين . والخاتمة ان جزيئات الفضة النانوية (AgNps) تمتلك تاثير ضد الاغشية الحيوية وايضا لها تاثير بكتيري مضاد ضد بكتريا الزوائف الزنجارية وانواع بكتيرية اخرى, والتي من الممكن استخدامها كعلاج بديل. فيما يخص انتاج البايوسيانين ومقاومة الفضة، ظاهريا كان هناك تاثير البايوسيانين على مقاومة الفضة ولم تكن مقاومة الفضة بسبب نقل وجود جينات (silS, silE). | This study was conducted to detect the antimicrobial effect of silver nanoparticles (AgNPs) against Pseudomonas aeruginosa isolated from clinical samples, total of 100 specimens were collected from different clinical sites included urine, burns, ear, blood , and sputum. The specimens were taken from patients admitted to Al - Hilla Teaching Hospital during a period extended from November 2016 to January 2017. All specimens were cultured on selective medium (cetrimide agar), blood agar, then incubated at 37°C for 18 hr. The isolated of P. aeurginosa were diagnosed depending on morphological and biochemical characteristics.The distribution of P. aeurginosa isolates was as follows : 22(52.4%) isolates from burns, 8(19%) isolates from urine, 6(14.3%) isolates from patients with otitis externa, 4(9.5%) isolates were isolated from blood and 2(4.7%) isolates from sputum. Antibiotic susceptibility test using disc diffusion test revealed that all isolates (26) were resistant (100%) to Piperacillin, Cefotaxime. While the resistance rate for Amikacin (88%), Ceftriaxone (65%), Gentamicin (62%), but low resistance rate was found to Ceftazidime (15%) and all isolates were sensitive (100%) to Meropenem, Ofloxacin, Norfloxacin and Ciprofloxacin. The biofilm formation in P. aeurginosa isolates was investigated by two methods include, tissue culture plates method (TCP) and congo red agar method (CRA). The results showed that all isolates 9 (100%) were found to be biofilm producer when investigated by TCP assay, and 4 out of 9 (44. %) isolates of P. aeurginosa were producing black colonies when detected by CRA method.The effect of AgNps on biofilm formation was tested by using different concentrations of silver nanoparticles (2.5 μg/ml, 5 μg/ml,10 μg/ml, 20μg/ml). The results showed that the highest activity was at a concentration of 20 μg/ml, with an inhibition rate of 100%. On the other hand the antibacterial activity of AgNps was tested against different bacterial species isolates (Staphylococcus aureus, Escherichia coli, Enterobacter cloacae, Klebsiella pneumoniae, Pseudomnas aeurginosa) using agar dilution method with different concentrations of silver nanoparticles (12.5 μg/ml, 25 μg/ml, 50 μg/ml, 100 μg/ml, 200 μg/ml). The results showed that the highest activity was at a concentration of (100 μg/ml and 200μg/ml). On the other hand Swarming motility in P. aeruginosa isolates was detected and subjected to different concentrations of (AgNps) (2.5 µg/ml, 5 µg/ml, 10 µg/ml), it was found that the highest activity of AgNps against swarming motility and pyocyanin production of P. aeurginosa was at a concentration of (5 µg/ml, and 10μg/ml).The relation of silver resistance with pyocyanin production in P. aeruginosa was assessed. Screening test for silver resistance was performed by agar dilution method, all (26 isolates) of P. aeruginosa were cultivated in the presence of AgNo3 at a concentration (100 µg/ml - 200 µg/ml, 400µg/ml) using agar dilution method with differing capacities for pyocyanin production. All isolates of P. aeurginosa 26(100%) that produce pyocyanin were found to be resistant to AgNo3.In this study P. aeruginosa isolates were tested for bacteriocin activity by the agar well diffusion method using different bacterial isolates : E. coli, K. pneumoniae, S. aureus, E. cloacae. Wide range of inhibition zone (24mm - 30mm) was found against above bacterial species with diameter (28mm, 30mm, 24mm, 30mm), respectively. The most affected bacteria were K. pneumoniae and E. cloacae isolates, which produce inhibition zone (30)mm.PCR technique was used in this study for investigation some genes. In this technique, blaIMP gene that encode Metallo - β - lactamase enzyme responsible for imipenem resistance and (silE and silS) genes that encoding silver resistance were investigated in P. aeuroginosa isolates by using specific primers. It was found that all 26 (100%) isolates of P. aeuroginosa were negative for these genes. Also two specific primers were used to detect phenazine (pyocyanin) modifying genes (phzM, phzS). According to phzM gene, it was found that out of 26 P. aeuroginosa isolates, 21 (80.8%) isolates gave positive results at 330 bp, in regard to phzS gene, it was found out of 26 P. aeurginosa isolates, 14 (53.9%) isolates gave positive result at 664 bp.In conclusion AgNps have an antibiofilm, antibacterial activity against P. aeruginosa and different bacterial species that could be used as an alternative therapy. In regard to pyocyanin production and silver resistance, phenotypically there was effect of pyocyanin pigment on silver resistance and the silver resistance was not due to carriage of silE, silS genes.

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

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

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

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

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

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

دراسة جزيئية وبكتريولوجية لبكتريا Porphyromonas gingivalis المعزوله من المرضى المصابين بامراض اللثه == Molecular and Bacteriological Study of Porphyromonas gingivalis Isolated from Patients with Periodontitis

اسم المؤلف: فاطمة مالك عبود
اسم المشرف: محمد صبري عبد الرزاق السعيد | الهام عباس بنيان
الموضوع العام: الطب
السنة: 2015
الموضوع الدقيق: الاحياء المجهرية
الدرجة: دكتوراه
اللغة: الانكليزية
مكان الجامعة: بابل
الصفحات الاولى:
المستخلص: تم جمع 103عينة من الصفيحة الجرثومية العميقة (subgingival dental plaque) من المرضى الذين يعانون من التهاب اللثة المزمن والمتقدم (72, 31) على التوالي لمراجي العيادة الاستشارية لامراض اللثة في كلية طب الاسنان/ جامعة بابل والمركز التخصصي لطب الاسنان في مدينة الحلة. للفترة من كانون الاول 2013 الى حزيران 2014. تم تشخيص وعزل بكتريا P. gingivalis بطرق مختلفة منها استخدام الطرق البكتيرية التقليدية واظهرت النتائج ان 69.5%) 16) منها تم عزلها من التهاب اللثة المزمن وتم عزل 7 (30.5) من التهاب اللثة المتقدم باستخدام التنمية على الوسط الانتقائي الخاص لهذه البكتريا. وكذلك تم استخدام طريقة التشخيص الجزيئي باستعمال المعلم الوراثي المستند على دور جين 16s rRNA حيث اظهر ان12 عزلة من اصل 23 عزلة تم تشخيصها بشكل نهائي انها تعود لبكتريا P. gingivalis. منها حوالي 8 تعود الى التهاب اللثة المزمن و4 تعود الى التهاب اللثة المتقدم. بالاضافة الى ذلك, تم التحري عن قابلية هذه البكتريا للالتصاق(adherence ability) بالخلايا الطلائية المبطنة للفم حيث وجد ان جميع العزلات لها القابلية على الالتصاق بهذه الخلايا وتم ايضا اختبار قابليتها على انتاج انزيم (Gingpain) ووجد ان جميع العزلات منتجة الى هذا الانزيم.في هذه الدراسة تم التحري المظهري عن عملية تكوين الاغشية الحيوية(Biofilm formation) للعزلات المدروسة باستخدام فحص tissue culture plate test (TCP) اذ كانت مكونة للاغشية الحيوية بنسبة 100% وكذلك تم فحص تاثير بعض المواد المستخدمة في طب الاسنان على انتاج biofilm ووجد ان اعلى تثبيط سجل للكلورهكسدين (غسول الفم) والشب (Alum)ويليه تاثير Clove مقارنة باقل تاثير لمادة السعد ((Cyprus rotundus. وكذلك تم الكشف عن حساسية العزلات لبعض المضادات الحيوية ووجد بان كل العزلات كانت حساسة الى Co - amoxiclave وعلى العكس اغلب العزلات تظهر مقاومة عالية لل Amoxicillin بينما سجلت مقاومة قليلة جدا لل Ampicillinو Metronidazole(16.3%, 20.3%, ) على التوالي. واخيرا تم فحص تاثير بعض المواد المستخدمة في طب الاسنان على تثبيط نمو هذه البكتريا وتوضح النتائج ان اعلى تاثير سجل للكلورهكسدين (غسول الفم) والشب (Alum)ويليه تاثير القرنفل(Clove) mm) 25,30,40) على التوالي مقارنة باقل تاثير لمادة السعدC. rotundus (10mm) .في هذه الدراسة ايضا تم التحري عن التغاير الجيني ((TLR - 4 Polymorphisms باستخدام تقنية البلمرة والقطع بالانزيم ((PCR - RFLP. وتبين من النتائج وجود ثلاث انماط جينية في موقع طفرة Thr399Ile : CC وCT وTT ، اذ بلغت نسبة انتشارها ((12.5%,10%,77.5% في مجموعة المرضى على التوالي بينما هناك فقط نمطين في مجموعة السيطرة TT,CCوبنسبة انتشار(36.6% ,63.4%) على التوالي ، فيما بلغت نسبة انتشار الاليلC السائد في المرضى 82.5 % بالمقارنة للسيطرة 63.3% مع وجود اختلاف معنوي. وفي المقابل سجل وجود ثلاث انماط جينية في موقع طفرة Asp299Gly : AA وAG وGG وبنسبة انتشار % 67.5 و12.5% و20% في مجموعة المرضى على التوالي بينما هناك فقط نمطين في مجموعة السيطرة GG, AA وبنسبة انتشار34.4%) 66.6%,) على التوالي. حيث سجلت نسبة انتشار الاليل A السائد (73.75%) في مجموعة المرضى بالمقارنة بمجموعة السيطرة (66.6%) وبفرق معنوي. | In this study, 103 clinical samples were collected from subgingival dental plaque of patients with chronic (CP) and aggressive periodontitis (AP) (72 and 31) respectively, and (n=30) a healthy group admitted to teaching Hospital in college of Dentistry / Babylon University and specialized center of Dentistry in Hilla city, From February 2013 to June 2014). Out of which (n=40) with a chronic periodontitis group from them blood sample were collected for detection of gene polymorphisms in Toll - like receptor - 4 (TLR - 4). These dental plaque samples were subjected to different methods for identification of P. gingivalis mainly traditional bacteriological method. It was found that 23 P. gingivalis isolates were recovered by using selective media where 19 isolates (26.3%) obtained from (CP) and 4 isolates (12.5%) from (AP). Furthermore, molecular detection method was applied by using 16s rRNA gene as a genetic marker for confirmation of detection of P. gingivalis isolates, 12 isolates of P.gingivalis out of 23were detected by molecular method focusing on the role of 16s rRNA gene of P. gingivalis. 8 isolates were isolated from CP, and 4 isolates were isolated from AP subgingival plaques. In addition, these 12 isolates were investigated to detect Adherence of P.gingivalis to oral epithelial cells. The result showed that all isolates have ability to adhere to oral epithelial cells. The study also detected the ability of this bacteria for production of Gingipain, it was found that all isolates were positive for this enzyme at a rate 100%.Furthermore, biofilm formation was tested in the semi quantitative microtiter plate test. The results revealed that all isolates were biofilm former, high and moderate biofilm formation mode were accounted for (50%) while there are no isolates that express non biofilm formation.Regarding to effect of Chlorhexidine (CHX) gluconate (0.12%) on biofilm formation, the results of this study demonstrated (CHX) effectively and reduced the viability of biofilm - forming bacteria from moderate to 25%, weak to 75% and no strong. The study was also evaluating the effect of some plant extracts on biofilm formation. The results showed the highest effect for Alum potassium phosphate followed by Clove, in contrast to lowest effect of C. rotundus. And after screening the effect of Flagyl solution on production of bacterial pigment. The results showed that the metronidazole produced the highest inhibition activity range (30 - 10mm). Furthermore, the susceptibility of isolates to a variety of antibiotics had been investigated and it had been found that all isolates were sensitive to co - amoxiclave and, in contrast, the isolates showed high resistance to other type of beta lactam such as amoxicillin (54.3%). In addition, the result showed that the resistance of p. gingivalis was very low for ampicillin and metronidazole (16.3% and 20.3%), respectively.The screening of antimicrobial activity of (CHX) gluconate (0.12%) was carried out and the results showed that it produced the highest inhibition activity whether against p. gingivalis with inhibition zone range 40 - 15mm. Finally in vitro antibacterial activity of Alum, Clove and Cyperus rotundus plant extracts was studied and the results revealed that all tested isolates were inhibited by aqueous extracts at 50% concentration. The maximum inhibition zone was observed in Alum and Clove extracts respectively (30mm, 25mm), compared to the minimum inhibition by Cyperus rotundus (10mm). The antibacterial actions of 20% concentration of plant extract gave lower inhibition zone than 50% concentration of that extract which represented by (19mm, 16mm, and 10 mm) of the previous three mentioned extracts. This study also aimed to investigate the association of Thr399Ile and Asp299Gly single nucleotide polymorphisms (SNPs) in the (TLR - 4) with the incidence of (CP).The results revealed at the site of SNPThr399Ile, there were three genotypes for this SNP among CP patients; CC, CT and TT with frequency of 77.5%, 10% and 12.5 % respectively, whereas, there were only two genotypes among control group; CC and TT with frequency of 63.4% and 36.6% respectively with no significance differences between patients and control. However, the frequency of allele C (dominant) was higher among CP group (82.5%) than control (63.3) with significant difference. The site of SNP of Asp299Gly also showed three genotypes among CP patients; AA, AG and GG with frequency of 67.5%, 12.5% and 20% respectively, whereas, there were only two genotypes among control group; AA and GG respectively with frequency of 66.6 and 34.4% respectively with no significance differences between patients and control. However, the frequency of allele A (dominant) was higher among CP group 73.75 % than control 66.6%.

دور السايتوكينات المعزولة من انسجة المشيمة المغذية للجنين لدى النساء مع الاجهاض التلقائي == The role of cytokines isolated from feto - placental tissues in women with spontaneous miscarriage

اسم المؤلف: ميسلون عبد الحميد ناصر
الموضوع العام: الطب
السنة: 2015
الموضوع الدقيق: الاحياء المجهرية
الدرجة: دكتوراه
اللغة: الانكليزية
مكان الجامعة: البصرة
الصفحات الاولى:
المستخلص: شملت الدراسة الحالية (172( امراة، تتراوح اعمارهم بين 16 - 41 عاما، من المرضى الذين قدموا الى مستشفى الولادة والاطفال في البصرة بسبب الاسقاط التلقائي غير الكامل في الشهور الثلاثة الاولى من الحمل ، بالاضافة الى النساء مع الحمل الطبيعي في وقت الولادة خلال الفترة من شباط 2012 الى ايار 2014 وتم تقسيمهن الى 3 مجموعات :  المجموعة - ا : وشملت )65) من النساء مع الاجهاض التلقائي المتكرر (RSM) خلال الاشهر الثلاثة الاولى، مع متوسط العمر (25.2 ± 7.28) سنة. المجموعة - ب : وشملت (36) من النساء مع الاسقاط التلقائي غير الكامل في الاشهر الثلاثة الاولى من الحمل ولها على الاقل ثلاثة مرات حمل طبيعي سابق (الاجهاض التلقائي غير المتكرر ( non - RSM بمتوسط من العمر (26.61 ± 6.97) سنة. المجموعة - ج : السيطرة (الحمل الطبيعي) : 71 امراة بمتوسط من العمر (26.17 ± 7.01) سنة. وتم الحصول على الدم الوريدي من المجاميع قيد الدراسة من اجل البحث عن المضاد المناعي م وج الخاص بمقوس قوندي , IgM ) IgG (. والتشخيص المصلي للاصابة بمقوسات قوندي يستخدم على نطاق واسع لفحص النساء الحوامل والمجهضات. كان معدل حدوث داء المقوسات (38.4٪) التي وجدت في 101 مجموعات الاجهاض التلقائي بواسطة فحص (ELISA). اظهرت عينتين (3.08٪) نتائج ايجابية المضاد المناعي (م). بينما كانت 24 (36.92٪) عينة ايجابية للمضاد المناعي (ج) لمقوس قوندي في مجموعات المرضى , بينما لم تسجل اصابة في 71 امراة من مجموعة السيطرة . غالبية النساء المصابة (50٪) في سن (30 - 39) سنة في حالة المضاد المناعي (ج)، في حين ان (10.26٪) في سن (20 - 29) سنة في حالة من المضاد المناعي (م).والنتائج كشفت عن ان اعلى نسبة للاجهاض التلقائي لوحظت في نساء الارياف . وفي الوقت نفسه، تم جمع نسيج الارومة المغذية للجنين خلال عملية الكشط والدم الوريدي للكشف وتقييم السيتوكينات المضادة للالتهابات (IL - 4، IL - 6، IL - 10) والسيتوكينات الموالية للالتهابات (IL - 2،عامل نخر الورم - الفا TNF - α، - γ IFN) وقياس تركيزها باستخدام فحص انزيم مرتبط البلمرة المناعي ، تبين تركيز عال (49.97 ± 8.82، 180.7 ± 15.03، 94.34 ± 7.68) للسيتوكينات في الارومة المغذية للجنين (IL - 4، IL - 6، IL - 10 على التوالي) في حالة مجموعة السيطرة بالمقارنة مع مجموعات المرضى وتم الكشف عن نتيجة عكسية في مصل الدم ، في حين ان التراكيز عالية من السيتوكينات الموالية للالتهابات (IL - 2، TNF - α، IFN - γ) كانت (134.17 ± 24.37، 432.16 ± 51.7، 100.46 ± 9.94 على التوالي) في حالة مجموعة الاجهاض التلقائي المتكررRSM)) بدلا من مجموعة السيطرة ومجموعة الاسقاط التلقائي غير المتكرر RSM - non مع وجود اختلافات معنوية كبير.p<0.001 وقد تبين في الدراسة الحالية وجود علاقة واضحة بين مناعة الامهات نوع TH2 والحمل الطبيعي، في حين يرتبط رد فعل جهاز المناعة نوع TH1 بفقدان الحمل. والتوازن الدقيق بين السيتوكينات الناتجة عن TH1 / TH2 ممكن ان يمنع خمج مقوسات قوندي . الذي يرتبط مع الانتاج الكبير من TH1 للسيتوكينات الموالية للالتهابات.وعلاوة على ذلك نتائج حساب مستويات CD44، اظهر فرقا معنويا عاليا p<0.001 في حال مقارنة بين مجموعة السيطرة والمجموعتين من النساء المجهضات . وهكذا تم تسجيل ارتباط CD44 مع فعالية خلايا TH2 ؛ لذا فمن المرجح انه قد يكون هناك وجود علاقة بين الحمل الطبيعي وكثافة CD44 على سطح الخلية

فاعلية البرنامج التثقيفي على معارف وممارسات العاملين الصحيين تجاه السيطرة على العدوى في مراكز الرعاية الصحية الاولية في مدينة كربلاء المقدسة == Effectiveness of an Education Program on Health Care Workers' Knowledge and Practices toward Infection Control at Primary Health Care Centers in Holy Karbala City

اسم المؤلف: سلمان حسين فارس الكريطي
اسم المشرف: اركان بهلول ناجي
الموضوع العام: الطب
السنة: 2017
الموضوع الدقيق: التمريض
الدرجة: دكتوراه
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: دراسة شبه تجريبية اجريت في مراكز الرعاية الصحية الاولية في مدينة كربلاء المقدسة للفترة من اذار 2102 . لغاية نهاية شهر نيسان 2102 لقد هدفت الدراسة الى تقييم فاعلية البرنامج التثقيفي على معارف وممارسات العاملين الصحيين تجاه السيطرة على العدوى في مراكز الرعاية الصحية الاولية في مدينة كربلاء المقدسة. تم تقييم الاحتياج للبرنامج التثقيفي، واظهرت نتيجة التقييم وجود ضعف في معارف وممارسات العاملين الصحيين تجاه السيطرة على العدوى في مراكز الرعاية الصحية الاولية.) شملت عينة الدراسة ) 22 عاملا صحيا اختيروا بشكل غير عشوائي )عمدي( ، وقد قسمت العينة الى مجموعتين مجموعة الدراسة ) 22 ( عاملا صحيا، والمجموعة الضابطة ) 22 ( عاملا صحيا . تم بناء برنامج تثقيفي حسب احتياج العاملين الصحيين واعدت ثلاث استمارات واحدة للمعلومات الخاصة بالعينة لتحديد صفاتها، واستمارتين لتقييم معارف وممارسات العاملين الصحيين ، استعملت للاختبار القبلي والبعدي. تم تحقيق مصداقية الاداة بعرضها على مجموعة خبراء لمراجعتها وتحديد درجة مصداقيتها، وتم تحديد ثبات اداة القياس من خلال الدراسة التجريبية.تم الاختبار القبلي لافراد المجموعتين ومن ثم تطبيق البرنامج التثقيفي لمجموعة الدراسة فقط للفترة من التاسع عشر لغاية الثالث والعشرين من حزيران 2102 ، تم الاختبار البعدي الاول مباشرة بعد تنفيذ البرنامج، ثم الاختبار البعدي الثاني بعد اربعة اسابيع من الاختبار البعدي الاول.تم تحليل النتائج باستخدام الاحصاء الوصفي والاحصاء الاستدلالي. اظهرت النتائج استفادة العاملين الصحيين بعد تطبيق البرنامج التثقيفي حيث الزيادة في مستوى المعرفة والممارسة للعاملين الصحيين وان البرنامج التثقيفي الخاص بالسيطرة على العدوى كان فعالا في تحسين معارف وممارسات العاملين الصحيين المشاركين فيه وعدم وجود اختلافات هامة بين مستوى تحسين معارف وممارسات العاملين الصحيين نتيجة لتطبيق البرنامج طبقا للعمر، المستوى التعليمي، سنوات الخبرة والمشاركة في الدورات التدريبية في الاختبار البعدي لمجموعتي الدراسة والضابطة باستثناء سنوات الخبرة في مجموعة الدراسة فقد اظهرت النتائج وجود اختلافات هامة بين مستوى تحسين معارف العاملين الصحيين في الاختبار البعدي لمجموعة الدراسة .واوصت الدراسة بتوفير الادلة الارشادية والتاكيد على اهمية التعليم المستمر للعاملين الصحيين باستعمال الممارسات المعتمدة على الادلة لتطبيق الاحتياطات القياسية للسيطرة على العدوى. وان هنالك حاجة لاكثر من برنامج تثقيفي حول السيطرة على العدوى في كل مراكز الرعاية الصحية الاولية ولعينة اكبر لتستفيد من النتائج . | A quasi experimental study was carried out at the primary health care centers in holy Karbala city from March 2016 to the end of April 2017.The study aims to assess the effectiveness of an educational program on the knowledge and practices of healthcare workers in Karbala city. Assessment of needs was done to evaluate the needs for the educational program. The result of the assessment revealed that the healthcare workers had deficit knowledge and practice regarding infection control in primary health care centers. A Non - Probability sample of (52) healthcare workers was selected randomly and divided into two groups : (26) considered as a study group and the other (26) considered as control group. An educational program was constructed, and three formats were developed one for assessing demographic characteristics of sample, the other two for assessing healthcare workers knowledge and practice. Validity of the instrument was determined through content validity by a panel of experts, and reliability of the tool was determined through a pilot study.A pre - test was done for both groups; educational programs were applied only for the study group from June 19th to June 23rd 2016. Then the first post - test was applied after the implementation of the program and the follow up after four weeks from 1st post test.Analysis of data was performed through the application of descriptive and inferential statistics.The findings revealed that the healthcare workers of the study group had benefited from the implementation of the educational program; their knowledge and practice were significantly improved comparing with the control group, the infection control education program was found to be effective in knowledge and practices improvement to the participant HCWsand non - significant association between HCWs knowledge and practice improvement effect result by application of the education program and their age, education, years of experience and training session in post - test I for study and control group. Except for years of experience in study group it shows a significant association with knowledge improvement.The study recommends the availability of written guidelines and focus on the importance of continuing education for HCWs using the evidence - based practices for application of standard precautions of infection control; and more educational programs of infection control are needed in all PHC centers and on a larger sample to benefit from the results.

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

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

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

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

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

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

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

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

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.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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.

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.
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