دراسة التعبير الوراثي للجينات P53, KRAS, c - MYC & Her - 2/neu وانواع الرنا المايكريوية miR - 21, 34a, 92 & 98 على عينات ماخوذة من الغسول القصبي والانصباب الجنبي لمرضى مصابين بسرطان الرئة ومرضى مصابين بامراض رئوية مزمنة غير سرطانية == Expression of P53, KRAS, c - MYC, Her - 2/neu genes and microRNAs 21, 34a, 92 & 98 in cancerous and non - cancerous bronchial wash and pleural aspirate
استخدام الصبغة المناعية p16INK4a والتهجين الموقعي وتاثيرها على فحوصات عنق الرحم الصحيحة والملتبسة == The Use of p16INK4a and In Situ Hybridization and Their Impact on the Healthy and Equivocal Pap Smears of the Cervix
التقييم السريري ورصد قياس التاكسج خلال الليل للمرضى المعرضين لخطر توقف التنفس الانسدادي اثناء النوم == Clinical Evaluation and Overnight Oximetry Monitoring of High Risk Patients for Obstructive Sleep Apnea
الاعراض السميه في الجهاز الهضمي نتيجة للعلاج الشعاعي الجذري في منطقة الحوض, الانواع, الشده والتواتر == Acute Gastrointestinal radiation toxicities in pelvic radiation therapy; types, grade and frequency
معرفة , اتجاه وسلوك النساء الحوامل عن فقر الدم خلال الحمل في مستشفي بغداد التعليمي 2016 == Knowledge, Attitudes and Practice of Pregnant Women about Anemia during Pregnancy in Baghdad Teaching Hospital - 2016
تقييم مرضى توسع القصبات من الناحية السريرية والاشعاعية == Bronchiectasis Clinical and Radiological Assessment
المضاعفات الرئوية بعد عمليات البطن الجراحية في الردهات الجراحية لمستشفى بغداد التعليمي == Post - abdominal surgery respiratory complications at surgical wards of Baghdad teaching hospital
تقييم استخدام مضادات التخثر الوقائي لمنع الجلطات الدموية الوريدية في المرضى البالغين الراقدين في مستشفى بغداد التعليمي == Assessment of Prophylactic anticoagulant use for prevention of venous thromboembolism in adult inpatients at Baghdad teaching hospital
انتشار ومتنبات الاكتئاب لدى عينة من المرضى المصابين بداء الذاب الحمامي المجموعي == Prevalence and Predictors of Depression in a Sample of patients with Systemic Lupus Erythematosus
التحليل الجزيئي للجين CYP21A2 في المرضى العراقيين المصابين بتضخم الغدة الكظرية الولادي == Molecular Analysis of CYP21A2 Gene in Iraqi Patients with Congenital Adrenal Hyperplasia
Author name:
رقية غياث ياسين العبيدي
Supervisor name:
بسام موسى صادق الموسوي
Abstract:
Background : Congenital adrenal hyperplasia (CAH) is a group of autosomal - recessive disorders that result from a genetic defect in the pathway of steroidogenesis. The most common type is 21 - hydroxylase enzyme deficiency (21 - OHD), which accounts for 90 - 95% of cases and is categorized into two clinical forms : severe classic early onset (salt wasting and simple virilizing) and milder non - classic late onset forms. The molecular analysis of mutations affecting CYP21A2 gene coding for 21 - OH enzyme was not tried earlier in Iraqi patients.Aim of Study : To analyze the commonly expected mutations affecting CYP21A2 gene causing 21 - hydroxylase and thus congenital adrenal hyperplasia in Iraqi children and to determine the frequency of each type and their clinical impact.Patients, Materials & Methods : Fifty - four children with a clinical diagnosis of CAH were recruited from the Pediatric Endocrine Consultation Clinic / Children Welfare Hospital - Baghdad and the Genetic Consultation Clinic - Teaching Laboratories / Medical City - Baghdad during the period between September 14th, 2014 and March 14th, 2015. The clinical diagnosis of 21 - hydroxylase deficiency was made when the patients presented with ambiguous genitalia in females with or without dehydration, or vomiting and dehydration with normal male phenotype early in life, or pseudo - precocious puberty later in life.Peripheral blood samples were collected from all patients. Two samples were taken from those with ambiguous genitalia; one for chromosomal analysis and sex determination and the other for DNA analysis. For the other cases, a single sample was taken for DNA analysis.The other tests, namely electrolytes and hormonal assessment were sent for to be performed by another laboratory (governmental or private).Two cases with ambiguous genitalia showing male karyotypes were excluded from this study as they do not fit in the criteria of 21OHD.Molecular analysis of CYP21A2 gene was performed by PCR amplification using biotinylated primers and hybridization of amplification products to a test strip containing allele - specific oligonucleotide probes immobilized as an array of parallel lines. The bound biotinylated sequences are detected using streptavidin - alkaline phosphatase and color substrates according to the manufacturers’ instructions.Results : CYP21A2 gene was analyzed by CAH StripAssay® for detection of 11 common point mutations, and 50% of deletions and conversions in all 52 cases. Mutations (point mutations and deletions/conversions) were detected in 36 (69.2%) cases while 16 (30.8%) cases had undetected mutations. The most frequent mutations were : large deletions / conversions in 11 (21.15%), Q318X in 7 (13.46%), I2 Splice in 6 (11.54%), I172N in 5 (9.6%), Del 8bp in 1 (1.9%), V281L in 2 (3.85%), P453S in 1 (1.9%), R483P in 1 (1.9%) and multiple mutations in 2 cases (3.85%). Among those with large deletions/conversions, deletion/conversion (P30L, I2Splice, Del8bp) found in 3 (5.8%) cases, Deletion/conversion (P30L, I2 Splice, Del8bp, I172N) in 2 (3.85%) cases, Deletion/conversion (Cluster E6, V281L, L307 frameshift, Q318X, R356W) in 4 (7.7%) cases, complete gene deletion in 2 (3.85%) cases.Four mutations (namely P30L, R356W, Cluster E6, L307 frameshift) were not detected in any of our cases.Most cases demonstrated good correlations between genotypes and phenotypes. In the salt wasting group, the correlation was found in all cases with homozygous genotype, while among the simple virilizing group, the concordance of genotype/phenotype was found in all cases of group B (5 cases with homozygous I172N) and the single case in group A (homozygous I2 Splice), while it was absent in group null (one case withhomozygous deletion/conversion) and in group C (one case with homozygous V281L).Conclusions : 1. The majority of 21 - hydroxylase deficiency cases were females presented early in life with ambiguous genitalia with/without salt losing crisis, while a smaller number of patients were males with normal genitalia and salt wasting with/without precocious puberty; the patients have a high rate of parental consanguinity.2. There is a diversity of mutations affecting CYP21A2 gene in Iraqi 21 - hydroxylase deficiency patients, with a good percentage of undetected mutations.3. The diagnosis of 21 - OHD in CAH patients will be made more accurate when based on results of molecular testing.4. The data of molecular studies are useful in genetic counseling, in prenatal diagnosis and offering accurate treatment plan during pregnancy and in detection of carriers in families having previously affected child, diminishing the complications for these families
تاثير قطر دوالي الخصيه على نوعية السائل المنوي للمرضى المصابين بدوالي الخصية غير السريري == The Impact of the diameter of spermatic veins on Seminal fluid Analysis of patients with Subclinical Varicocele
علاقه بعض الحالات المرضيه بالاختلافات التشريحيه للقنوات الصفراويه في العراقيين باستخدام الرنين المغناطيسي الراسم للقنوات الصفراء والبنكرياس == Association of Some Pathological Conditions with the Anatomical Variations of the Biliary System in Iraqi People Using Magnetic Resonance Cholangiopancreatography(MRCP)
اثار حبوب منع الحمل الفومية احادية الطور على فعالية عامل التخثر السابع ومستوى ثنائي ال دي - دايمر في النساء الاصحاء والبدينات == The Effect of Regular Monophasic Oral Contraceptive Pills on Factor VII Activity and D - dimer Level in Healthy and Obese Women
Author name:
اسراء سعدي عباس
Supervisor name:
هيثم احمد الربيعي
Abstract:
The combined oral contraceptive pill includes a combination of estrogen and progestin. Clinical and epidemiological studies indicate that the use of these pills is associated with an increased risk of thrombotic disorder including both deep vein thrombosis and pulmonary embolism.The pathogenesis of increased thrombotic risk with pills use is that the estrogen content in the pills has many effects on coagulation system that results in shifting of the hemostatic balance toward a prothrombotic state.Obesity is defined as abnormal or excessive fat accumulation that may impair health. Body mass index is commonly used to classify overweight and obesity. It is an independent risk factor for venous thromboembolism and increases the risk of thrombosis 2 - fold, since obese individuals have higher levels of several procoagulant factors. There may be an additional risk of thrombosis caused by venous stasis that also occurs with obesity. Oral contraceptive use in conjunction with obesity increases the risk of thrombosis about 10 - fold.Aim of the studyTo assess the level of FVII activity, D - dimer level, and other hemostatic changes in healthy non - obese and obese women on contraceptive pills and compare them to that found in normal healthy non - user women.Patient, materials and methodsThis case - control study included 50 females attending the family planning clinic at Baghdad Teaching Hospital of Medical City. TheyIIIwere regularly using monophasic regular dose estrogen containing combined oral contraceptive pills (Microgynon® ED Fe) for at least 3 months. Their ages were between 18 and 45 years. Females on pills were divided into 2 groups : Non - obese group : enrolled 25 females with BMI of < 30 kg/m2 (15/25 females were overweight, and 10/25 were of normal weight) Obese group : composed of 25 females with BMI of ≥ 30 kg/m2Twenty five healthy, non - obese (16/25 were overweight and 9/25 had normal weight), age - matched non - pregnant females neither on pills, nor taking any hormonal therapy and having no history of malignancy or previous thrombosis, were assigned as a control group.Relevant clinical data were collected from all participants. Weight and height were measured (in kilograms and centimeters, respectively), and then the BMI was calculated accordingly for each participant.Platelet counts were measured by a hematology auto - analyzer (Cell - DYN, RUBY ABBOTT Diagnostic, USA). Prothrombin time, activated partial thromboplastin time, and factor VII activity were measured using semi - automated coagulometer (STart4®, DIAGNOSTICA STAGO/France). D - dimer levels were measured by turbidimetric immunoassay using an automated analyzer (ARCHITECT c4000, Abbott Diagnostics, USA).ResultsThere was significant reduction in prothrombin time in the non - obese, obese, and pills users groups compared to that in the control group (P= 0.014, 0.020, and 0.006 respectively), while the activated partial thromboplastin time was insignificantly reduced in all of these groups.Moreover 22% of pills user cases had shortened prothrombin time compared to the lower limit of prothrombin time in the control group (11.8 sec), and 8% of them were found to have shortened activated partial thromboplastin time compared to the lower limit of activated partial thromboplastin time in the control group (24.6 sec).The correlations between the duration of pills use (< 1 year and > 1 year) and prothrombin time and activated partial thromboplastin time showed statistically insignificant differences in both study groups.The factor VII activity in the non - obese, obese, and pills users groups were significantly higher than that of the control group (P= 0.041, 0.001, and 0.004 respectively). It had been observed that 22% of pills user cases had FVII activity above the highest value of activity that was found in the control group (95%). Also there was a significant inverse correlation between the prothrombin time and factor VII activity with P - value of 0.008.The D - dimer levels were found to be significantly higher in the non - obese and obese group compared to that of the control group (P= 0.029 and 0.038, respectively). The mean D - dimer of the pills users group was insignificantly higher than that of the control group, P value = 0.053.The platelet count was insignificantly increased in the non - obese group when compared with that in the control group (P= 0.106), while it was significantly increased in the obese and pills users groups compared with that in the control (P = 0.027, and 0.034, respectively). There were no statistically significant differences in the means of prothrombin time, activated partial thromboplastin time, factor VII activity, D - dimer level, and platelet count between the non - obese and obese groups (P > 0.05).
تهدل الصمام الاكليلي تشخيصه ومدى حدوثه == Mitral Valve Prolapse Diagnosis and Incidence
العدوى المكتسبة في وحدات العناية المركزة في مستشفيات محافظة البصرة ،العراق 2013 == Nosocomial Infection in Intensive Care Units at Basra Hospitals, Iraq, 2013
دراسة مقارنة للجرعة الاشعاعية القلبية بانواع مختلفة من العمليات الجراحية لمرضى سرطان الثدي في مركز بغداد للعلاج الشعاعي == Comparative study of cardiac radiation dose with different types of surgery in breast cancer patients in Baghdad radiotherapy center
مقارنة الجرعة التي تستلمها الرئة من الاشعاع المستخدم في علاج سرطان الثدي حسب اختلاف نوع العملية الجراحية المستخدمة في مرضى مركز بغداد للعلاج الشعاعي : دراسة وصفية == Comparative study of lung radiation dose with different types of surgery in breast cancer patients in Baghdad radiotherapy center descriptive study)
انتشار نوبة الاكئاب العظمى عند النساء العراقيات المصابات بهشاشة العظم في فترة ما بعد انقطاع الطمث == Prevalence of Major Depressive Disorder Among Postmenopausal Iraqi women with Osteoporosis
مدى تاثير العلاج الاشعاعي التلطيفي للدماغ في البقاء على قيد الحياة للمرضى الذين يعانون من ورم منتشر في الدماغ من مختلف انواع السرطانات == Impact of whole cranium Radiotherapy on Survival in Patients With Brain Metastasis of Different Cancers
تقييم الكالسيوم في الدم في مرضى الدرن الرئوي النشط : دراسة مقدمة الى كلية الطب ولجنة الدراسات العليا لجامعة بغداد في جزء الاستيفاء لمتطلبات الحصول على درجة الدبلوم في طب الجهاز التنفسي == Assessment of serum calcium in active pulmonary Tuberculosis patients
حياة مرضى سرطان الثدي العراقيات اللواتي عولجن بالعلاج الاشعاعي الثلاثي الابعاد الخالية من الانتكاسة المرضية في مركز بغداد للعلاج الاشعاعي في دائرة مدينة الطب == Progression Free Survival in Iraqi Breast Cancer patients treated by Adjuvant 3D Conformal Radiotherapy in Baghdad Radiation Oncology Center Medical City Complex
تقييم الهبسدي الفيريتين بروتين سي التفاعلي لدى مرضى فقر الدم للمرحلة النهائية للفشل الكلوي == Assessment of Hepcidin, Ferritin and CRP in Anemic End Stage Renal Disease Patients on Hemodialysis
Author name:
ضلال صيول حسن
Supervisor name:
هيثم احمد الربيعي | رائد احمد الربيعي
Abstract:
Chronic kidney disease (CKD) is defined as kidney damage or glomerular filtration rate (GFR) <60 mL/min/1.73 m2 for 3 months or more.End stage renal disease corresponds to stage 5 chronic kidney disease with glomerular filtration rate <15 ml/min/1.73m2, all these patients require hemodialysis.Anemia of chronic disorders is a common normochromic or mildly hypochromic anemia that occurs in patients with chronic kidney disease.It is characterized by a reduced serum iron and iron binding capaci ty and normal or raised serum ferritin with adequate iron stores. The main cause of anemia is deficient erythropoietin synthesis. Blood loss is also a major contributory factor. Hepcidin plays a key role as mediator of anemia of inflammation.Aim of the study1 - To assess the types of anemia in end stage renal failure.2 - To compare the inflammatory parameters including hepcidin, ferritin, C - reactive protein and erythrocyte sedimentation rate between the two vascular accesses of hemodialysis (double lumen and arteriovenous fistula).Materials and methods This case control study was conducted at Al - Hayat center for hemodialysis in Al - Karama hospital, Baghdad, Iraq over 3 months from 1 November 2013 to 31 January 2014. The study populations consist of 60 [III]patients (44 males and 16 females). All patients were adult with documented end stage chronic kidney disease stage 5 on repeated hemodialysis with different durations of illness (1 month - 10 years).Hemodialysis patients were also divided into two groups depending on the vascular access of hemodialysis (double lumen and arteriovenous fistula).The following data were analyzed for all patients : Age, gender, history of hypertension and diabetes mellitus, causes of renal failure, vascular access, duration and frequency of hemodialysis. Complete blood counts, blood film and reticulocyte percentage by auto analyzer machine. Blood urea, serum albumin, serum creatinine, and transferrin saturation percentage, serum hepcidin, ferritin, C - reactive protein by clinical chemistry analyzer. erythrocyte sedimentation rate Twenty normal healthy individuals (age and sex matched) had been included as a control group in this study. All were subjected to the same investigations of the patients.ResultsThe vascular access of hemodialysis was ʺarteriovenous fistulaʺ in (61.7%) of the patients and "double lumen" in (38.3%) of them. The mean duration of hemodialysis was (18.6 ± 2.5) months (range : 1 month - 10 years), high proportion (28.3%) of the patients were on hemodialysis for a duration of 11 - 15 months.There was a significant decrease of absolute lymphocyte count, red blood cell count, hematocrit, hemoglobin and platelets count in patients than controls, but there were insignificant differences for total white blood cell count, absolute neutrophil count and mean corpuscular volume.Also there was a significant increase of red cell distribution width levels in patients than controls (14.8 ± 1.9 vs. 13.3 ± 1.6 respectively), p<0.05.According to the levels of hemoglobin, anemia was reported in 95% of the 60 end stage renal disease. Anemia of chronic disorders was the most frequent type of anemia (45%) among the patients, iron deficiency anemia was found in only (11.7%) while combined anemia was found in (25%), and others who had not any type of previous types of anemia (13.3%). No significant difference was observed between anemic and non - anemic patients according to the vascular accesses of hemodialysis.The mean serum level of hepcidin for patients was (186.1± 28.4 ng/ml) and for controls was (4.7 ±0.9 ng/ml) with a significant difference between both groups. The mean serum ferritin level of the patients (280.8 ± 53.1 ng/ml) was significantly higher than controls, (83.6 ± 14.5). The mean serum C - reactive protein level was higher in patients than control, (8.6 ± 1.1 vs. 3.0 ± 0.2 mg/l) respectively, furthermore, the mean erythrocyte sedimentation rate level was higher in patients (42.3 ± 4.7 mm/1st hr.) than that of controls (6.2 ± 0.8).There was no significant association between levels of hepcidin, hemoglobin, ferritin, C - reactive protein and erythrocyte sedimentation rate of the patients with the duration of hemodialysis. There was no significant difference in the mean levels of hepcidin, ferritin, C - reactive protein and erythrocyte sedimentation rate of the patients according to the vascular accesses of hemodialysis, while there was a significant difference regarding the hemoglobin level. The mean C - reactive protein of patients with serum ferritin level ≥ 800 ng/ml was (16.5 ± 4.2 mg/L) and for those with serum ferritin level < 800 ng/ml it was (7.6 ± 1.1 mg/L), however, the difference
فعاليه جهاز مفراس القلب الملون في تشخيص امراض الشرايين التاجيه في بغداد / العراق 2013 == ACCURACY OF CORONARYCOMPUTED TOMOGRAPHY ANGIOGRAPHY IN THE DIAGNOSIS OF CORONARY ARTERY DISEASE, BAGHDAD - IRAQ, 2013
تقييم برنامج رصد وفيات الامهات في محافظة واسط, العراق 2012 == Evaluation of Maternal Mortality Surveillance System in Wassit governorate, Iraq, 201211
تحديد وحساب الخلايا البلعميه المعلمة بمادة (CD68) في مشيمية النساء الحوامل طبيعيا والمصابات بارتفاع الضغط الحملي == CD68 - labelled macrophages localization and counting in placentas of normal and pre - eclamptic women
