Show: 25 50 75 100 Results

Search results: 50 out of 1,021

العلامات البيولوجية لسايتوم النواة الصغيرة الشدقي في عينة من المرضى العراقيين المصابين بداء الذئبة الحمامية المجموعية == Buccal Micronucleus Cytome Assay in Patients with Systemic Lupus Erythematosus

Author name: احمد خالد محمد
Supervisor name: زياد شفيق الراوي | فائق ايشو كوريال
General topic: Medicine
Specific topic: Diseases - Joints
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: داء الذئبة الحمامية المجموعية هو مرض مجموعي منيع للذات مع تداخل عوامل وراثية وبيئية في عملية امراض الداء. عدة دراسات اكدت وجود تضرر في الدنا عند مرضى داء الذئبة الحمامية المجموعية.الهدف : لتقييم المورفولوجيا الخلوية والنووية لعينة من مرضى داء الذئبة الحمامية المجموعية من خلال المقايسة العددية للنواة الصغيرة الشدقية ولتقييم اثر خصائص المرضى على التغيرات النووية ان وجدت.المرضى والطرائق : شملت الدراسة 58 مريضا عراقيا مصابا بداء الذئبة الحمامية المجموعية و58 شخصا سويا كمجموعة ضبط متوافقة من حيث العمر والجنس.تم اخذ التاريخ المرضي الكامل واجراء الفحص السريري التام لكل افراد المجموعتين. ووثقت خصائص المرضى (العمر، والجنس، ومعيار كتلة الجسم، ومدة المرض، ومعامل مجموعة تقدير الذئبة للجزر البريطانية (بيلاج) لعام 2004، والتاريخ العائلي للامراض المنيعة للذات، والادوية المستعملة). تكون بروتوكول المقايسة العددية للنواة الصغيرة الشدقية من : جمع الخلايا من كلا الشدقين بواسطة ملوق خشبي وتحضير مباشر للشرائح مع تثبيت الخلايا بواسطة الكحول المطلق بواقع شريحتين لكل شخص. احتسبت 1000 خلية لكل شخص لتقدير تكرار النوى الصغيرة لديه. تم تلوين الخلايا بواسطة طريقة الفولغين - الثينوين المختصة بالدنا. تم التحري في الخلايا المفحوصة عن التشوهات النووية (النوى الصغيرة، والبراعم النووية، وازدواجية النواة، والخلايا القاعدية والمتخصصة، والكروماتين المكثف، والخلايا ممزقة النواة، والخلايا المتغلظة والخلايا حالة النواة).النتائج : اظهر مرضى الذئبة الحمامية المجموعية ارتفاعا واضحا في تكرار الخلايا ذات النوى الصغيرة (القيمة الاحتمالية اقل من 0.0001)، والبراعم النووية (القيمة الاحتمالية اقل من 0.0001)، وازدواج النواة (القيمة الاحتمالية اقل من 0.0001)، والخلايا القاعدية (القيمة الاحتمالية اقل من 0.0001)، والكروماتين المكثف (القيمة الاحتمالية اقل من 0.0001)، والخلايا ممزقة النواة (القيمة الاحتمالية اقل من 0.0001)، والخلايا المتغلظة (القيمة الاحتمالية=0.012)، والخلايا حالة النواة (القيمة الاحتمالية اقل من 0.0001) اكثر مما لدى مجموعة الضبط. لم يكن هناك تاثير معتد به للعمر او معياركتلة الجسم او مدة المرض او معامل مجموعة تقدير الذئبة للجزر البريطانية 2004 او الادوية المستعملة على عدد النوى الصغيرة ضمن مجموعات المرضى. كما اظهر البحث ان فحص المقايسة العددية للنواة الصغيرة الشدقية حساس ومعتد به في التحري عن داء الذئبة الحمامية المجموعية (القيمة الاحتمالية اقل من 0.01).الاستنتاج : مرضى الذئبة الحمامية المجموعية لديهم ارتفاع ذو اعتداد عال في الوسمات الحيوية لضرر الدنا وعيوب الحرائك الخلوية والكوامن التكاثرية والموت الخلوي بالمقارنة مع مجموعة الضبط. لا يوجد تاثير لخصائص المرضى على التشوهات النووية. فحص المقايسة العددية للنواة الصغيرة الشدقية هو طريقة حساسة وغير باضعة وبسيطة جدا يمكن استعمالها في التحري عن داء الذئبة الحمامية المجموعية | Systemic lupus erythematous (SLE) is a systemic autoimmune disease with both genetic and environmental factors implicated in disease pathogenesis. Several studies have addressed the presence of deoxynuclic acid (DNA) damage in SLE patients.ObjectivesTo assess cellular and nuclear morphology in a sample of SLE patients by buccal micronucleus cytome assay and to evaluate effect of patients' disease characteristics on nuclear abnormalities if present.Patients and methodsFifty eight Iraqi SLE patients and 58 healthy controls matched in age and sex were included in this study. Full history was taken and complete physical examination was done for individuals in both groups. Patients' baseline characteristics [Age, sex, body mass index (BMI), disease duration, British Isles Lupus Assessment Group (BILAG) 2004 score, family history of autoimmune diseases, and medications used] were recorded. The buccal micronucleus cytome assay protocol consisted of : cell collection from both cheeks with a wooden spatula; direct slide preparation and fixation with absolute alcohol. Two slides were prepared for every subject and 1000 cells were evaluated per subject to determine the micronucleus (MN) frequencies. Slides were stained with the DNA - specific Feulgen - thionin method. Cells were screened for nuclear abnormalities : micronuclei, nuclear buds, binucleation, basal and differentiated cells, condensed chromatin, karyorrhectic cells, pyknotic cells, and karyolytic cells.ResultsPatients with SLE showed significantly higher frequencies of micronuclei (p<0.0001), nuclear buds (p<0.0001), binucleated cells (p<0.0001), basal cells (p<0.0001), cells with condensed chromatin (p<0.0001), karyorrhectic cells (p<0.0001), pyknotic (p<0.012) and karyolytic cells (p<0.0001) than the control group. Patient's age, BMI, SLE disease duration, BILAG2004 score, and drugs used had no significant effect on micronucleus groups (p>0.05). Buccal micronucleus cytome was significant and sensitive method for SLE screening (p<0.01).ConclusionsSLE patients had a highly significant increase in the biomarkers of DNA damage, cytokinetic defects, proliferative potential, and cell death compared to controls. No significant effect of patients' baseline characteristics on nuclear abnormality. Buccal micronucleus cytome was a sensitive, non - invasive, and very simple method that can be used for SLE screening.

تقييم وظيفة اليدين لدى عينة من المرضى العراقيين المصابين بالتهاب المفاصل الروماتويدي == Assessment of Hand Function in a Sample of Iraqi Patients with Rheumatoid Arthritis

Author name: محمد صاحب حسن
Supervisor name: خضير زغير معيوف البدري
General topic: Medicine
Specific topic: Diseases - Joints
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: التهاب المفاصل الروماتويدي هو احد الامراض المنيعة للذات المجموعية المزمنة التي تؤثر على الغشاء الزليلي للمفاصل وكذلك الاجهزة والاعضاء الاخرى. يؤثر هذا المرض عادة على مفاصل اليدين والقدمين الصغيرة ويؤدي الى ضرر للمفاصل متعذر العكس مع التشوه والاعتلال الوظيفي.وظيفة اليدين تشكل ميدانا هاما من الحالة الصحية لمرضى التهاب المفاصل الروماتويدي واحد المحددات الرئيسة لنوعية حياتهم. لذلك فان تقييم وظيفة اليد هو جزء اساسي في متابعة مرضى التهاب المفاصل الروماتويدي وقياس استجابتهم للعلاج.وقد وضعت العديد من المقاييس لتقييم وظيفة اليد. هذه المقاييس هي اما استبيانات تقرير ذاتي، او اختبارات قائمة على الاداء، او مزيج من الاثنين معا. لكل مقياس منها نقاط قوة ونقاط ضعف. احد المقاييس المقبولة على نطاق واسع، والمذكور في كتاب منهجي شائع، يشمل اختبارات سريرية بسيطة لتقييم وظيفة اليد : قبضة المفتاح، مسكة الكرة، مسكة القلم، قوة القرص، وقوة القبضة.الاهدافتهدف هذه الدراسة الى تحديد العوامل التي تؤثر على وظيفة اليدين في عينة من المرضى العراقيين المصابين بالتهاب المفاصل الروماتويدي، وتقييم ترابط اختبارات وظيفة اليد السريرية مع بعضها البعض في نفس العينة.المرضى والطرائقتم اجراء دراسة مقطعية على 116 مريضا عراقيا مصابا بالتهاب المفاصل الروماتويدي، تم اختيار المرضى عشوائيا، جميعهم استوفوا معايير الكلية الامريكية لامراض المفاصل لتصنيف التهاب المفاصل الروماتويدي لعام 1987 المعدلة، ومعايير الكلية الامريكية لامراض المفاصل / الرابطة لاوروبية ضد الروماتيزم لتصنيف التهاب المفاصل الروماتويدي لعام 2010. تم استبعاد المرضى الذين يعانون من امراض وحالات اخرى التي قد تؤثر على وظيفة اليد.تم تقييم المرضى وجمع المعلومات التالية : العمر، سيادة اليد، محيط الساعدين، مدة المرض، مدة التيبس الصباحي، العلاج الحالي، تشوهات اليدين، درجة فعالية المرض (DAS28)، العامل الروماتويدي (RF)، ومرحلة ستاينبروكر (Steinbrocker) لتقدم المرض اعتمادا على التصوير الشعاعي. تم احتساب درجة تشوه اليدين لجمع كل تشوهات اليدين في قيمة واحدة.تم تقييم وظيفة اليدين من خلال ثلاثة اختبارات شخصانية (قبضة المفتاح، مسكة القلم ومسكة الكرة) واختبارين موضوعيين (قوة القرص وقوة القبضة، مقاستان باجهزة قياس متخصصة).اجري التحليل الاحصائي باستخدام برامج الكمبيوتر المتخصصة.النتائجاظهرت الدراسة ان لاختبارات وضائف اليد الموضوعية (معدل قوة القبضة ومعدل قوة القرص) ترابطا عكسيا معتدا معتدل القوة مع درجة تشوه اليدين (r= - 0.459 , p<0.001 او افضل) ودرجة فعالية المرض (DAS28) (, p<0.001 r= - 0.572او افضل) ، وترابطا عكسيا معتدا ضعيفا مع مدة المرض (, p<0.001 r= - 0.248او افضل) ومدة التيبس الصباحي (, p<0.001 r= - 0.312او افضل) ومرحلة ستاينبروكر لتقدم المرض شعاعيا (p<0.001 r= - 0.36 ,او افضل)، وترابطا طرديا معتدا ضعيفا مع محيط الساعدين (p<0.001 r= - 0.312 ,او افضل).كما اظهرت الدراسة ان اختبارات وضائف اليد الموضوعية تتحسن كلما طالت فترة تعاطي العقار البيولوجي اتانرسبت (Etanercept) في المرضى الذين يستخدمون هذا العلاج، الا ان هذا الترابط لم يكن معتدا به احصائيا عند احتساب جميع المرضى في عينة الدراسة.واظهرت الدراسة ان لمتوسط رتبة الاعاقة في اختبارات وضائف اليد الشخصانية ترابطا طرديا معتدا ضعيفا مع درجة تشوه اليدين (p=0.002 او اقل،r=0.283 او اكثر)، ودرجة فعالية المرض (DAS28) (p=0.013 او اقل،r=0.296 او اكثر)، ومدة التيبس الصباحي (p=0.015 او اقل،r=0.226 او اكثر)، ومدة العلاج بعقار الاتانرسبت (Etanercept) (p=0.046 او اقل،r=0.186 او اكثر).لم يكن لاختبارات وضائف اليد الشخصانية ترابط معتد به مع عمر المريض، مدة المرض، ومرحلة ستاينبروكر لتقدم المرض شعاعيا. كما لم يكن هناك فرق معتد به في اختبارات وضائف اليد الموضوعية والشخصانية بين اليد السائدة وغير السائدة، وبين المرضى ذوي نتيجة ايجابية للعامل الروماتويدي وذوي النتيجة السلبية.و اظهر البحث ان لجميع اختبارات وضائف اليد ترابطا معتدا به مع بعضها البعض (p<0.001 ،r=0.334 او افضل) وخصوصا ترابط قوة القبضة مع قوة القرص اذ كان الاقوى (p<0.001 ، r=0.788 ). | Rheumatoid arthritis (RA) is a chronic systemic autoimmune inflammatory disease affecting the synovium of joints as well as other organs. It commonly affects the small joints of the hands and feet, and results in irreversible joint damage, deformity, and functional impairment. Hand function is an important domain of the health status of RA patients and a key determinant of their quality of life. Assessment of hand function, therefore, is an essential part in the follow - up of RA patients and in gauging their response to treatment.Numerous measures were developed to evaluate the hand function. These measures are either self - report questionnaires, performance - based tests, or combinations of both. Each measure has its own strengths and weaknesses. One widely accepted measure, suggested by a popular textbook, includes simple clinical tests to assess hand function : Key grip, ball grasp, pen grasp, pinch grip and grip strength.ObjectivesThis study aims to determine the factors affecting the hand function in a sample of Iraqi patients with rheumatoid arthritis, and to evaluate the correlation between the clinical tests of hand function in the same sample.Patients and methodsA cross - sectional study was conducted on 116 randomly selected Iraqi patients with rheumatoid arthritis fulfilling the 1987 Revised ACR Criteria for Classification of Rheumatoid Arthritis and the 2010 ACR / EULAR criteria for rheumatoid arthritis. Patients with other conditions that can affect the hand function were excluded.Patients were evaluated for age, hand dominance, forearm circumference, duration of illness, duration of morning stiffness, current treatment, fixed hand deformities, DAS28, RF seropositivity and Steinbrocker’s radiographic progression stage. A novel score was used to combine all hand deformities into one value.Hand function was assessed by three subjective tests (key grip, pen grasp and ball grasp) and two objective tests (pinch strength and grip strength, measured by specialized dynamometers).Statistical analysis was conducted using SPSS 20 and Excel 2013 computer software.ResultsObjective hand function tests (mean grip strength and mean pinch strength) had a significant moderate negative correlation with the score of hand deformities (p<0.001, r= - 0.459 or better) and DAS28 (p<0.001, r= - 0.572 or better), and a significant weak negative correlation with disease duration (p<0.001, r= - 0.248 or better), duration of morning stiffness (p<0.001, r= - 0.312 or better) and Steinbrocker’s radiographic progression stage (p<0.001, r= - 0.36 or better), and a significant weak positive correlation with forearm circumference (p<0.001, r=0.344 or better).Objective hand function parameters seemed to improve with the duration of Etanercept therapy among patients using Etanercept, although this correlation was not statistically significant for the whole study sample.The mean ranks of impairment of subjective hand function tests showed a significant weak positive correlation with the score of hand deformities (p=0.002 or less, r=0.283 or more), DAS28 (p=0.013 or less, r=0.296 or more), duration of morning stiffness (p=0.015 or less, r=0.226 or more) and duration of Etanercept therapy (p=0.046 or less, r=0.186 or more). The mean ranks of impairment of subjective hand function tests showed mostly no significant correlation with age, disease duration and Steinbrocker’s radiographic progression stage. There was no significant difference in both objective and subjective hand function parameters between the dominant and non - dominant hand and between RF positive and RF negative patients.All five hand function tests showed a significant correlation with each other (p<0.001, r= - 0.334 or better) with the strongest correlation being between pinch strength and grip strength (p<0.001, r=0.788).

علاقة مستوى فيتامين د وهورمون النحافه مع مرض فصال الركبه الاولي في مجموعه من النساء العراقيات == ASSOCIATION OF VITAMIN )D( AND SERUM LEPTIN LEVELS WITH KNEE OSTEOARTHRITIS IN A SAMPLE OF IRAQI FEMALES

Author name: زهراء عبد الله
Supervisor name: سامي سلمان شهاب
General topic: Medicine
Specific topic: Diseases - Joints
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine - Internal Medicine Department
Language: English
University location: Baghdad
First pages:
Abstract: Osteoarthritis (OA) is a biomechanical process whereby joints respond pathologically mechanical stress, resulting in cartilage degradation and changes in subchondral bone. It has many risk factors as known female gender, obesity, and aging. Vitamin D may exert its effect on OA through bone; its deficiency could impair the ability of bone to respond optimally to insults. Leptin is a peptide hormone secreted by adipocytes and plays an important role in regulation of body weight, its level more in obese subjects and female gender regardless of obesity, so it may play a metabolic link between obesity and osteoarthritis. So both vitamin deficiency and increase leptin level may be risk factors for osteoarthritis Objective : To examine the cross - sectional association of vitamin D and serum leptin levels in a sample of Iraqi female with knee osteoarthritis.Method : A total of 180 women divided into 2 groups 90 subjects the first group for vitamin D levels and 90 subjects the second group for serum leptin levels and each group further classified into patients and equal number of their matched healthy controls in age and sex.In each group osteoarthritis was diagnosed according to ACR criteria for osteoarthritis and their body mass index (BMI) classified according to WHO classification of BMI into 3 groups : normal weight, overweight, obese Radiological grading done according to kellegren and Laurence radiological classification for osteoarthritis. Both vitamin D and leptin levels were assessed using ELIZA method.The first group (vitamin D and osteoarthritis) mean vitamin D levels in cases (45cases) were (0.309_+0.641) compared to (0.2614_+0.386) in controls. So vitamin D deficiency is prevalent among cases and controls and its level was inversely associated with body mass index, the deficiency was more severe among female in obese and overweight than normal weight.Associations of vitamin D levels with radiological grading, cases with grade ||| and |\/ are more deficiency than grade ||.The second group (serum leptin level and osteoarthritis), leptin was significantly higher in cases compared to controls, the mean serum leptin was (52.41_+28.26) and (40.39_+ 25.67) respectively. Its level directly correlated with body mass index, higher levels in obese and overweight than normal weight subjects, the difference was significant among both cases and controls.Association of leptin levels with radiological grading, the mean serum leptin was higher in cases with grade ||| , |\/ than grade ||.Conclusion : Vitamin D deficiency was prevalent among middle age Iraqi women, so it is difficult to establish a clear association between vitamin D deficiency and osteoarthritis in this study, and the deficiency was more in women with higher body mass index.Serum leptin level was higher in osteoarthritis women than their matched controls, and its level directly associated with increased in body mass index

تقييم كثافة العظام لدى مرضى المصابين بالانسداد الرئوي المزمن

Author name: سجا محمد كاظم
Supervisor name: محمد وهيب سلمان العبيدي
General topic: Medicine
Specific topic: Diseases - Thoracic
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:

نوعية الحياة لمرضى الفشل الكلوي المرحلة النهائية الذين يخضعون لغسل الكلى، بغداد، العراق 2017 == Quality of Life of End Stage Renal Disease Patients Undergoing Hemodialysis, Baghdad, Iraq, 2017

Author name: هند وليد خضر
Supervisor name: عدنان عبد العظيم | فارس حسن اللامي
General topic: Medicine
Specific topic: Family Medicine
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: Background : The quality of life is an important predictor of outcome in end stage renal disease patients. The quality of life needs to be regularly assessed. Our study describes quality of life, as well as demographic and clinical variables associated with quality of life in chronic haemodialysis patients in Baghdad, Iraq, 2017.Method : This was a descriptive cross sectional study conducted from March to May, 2017 at dialysis unit in Baghdad and Al - Karama teaching hospitals. The study participants were all patients available during data collecting period included. The participants were directly interviewed according to a special questionnaire designed for the purpose of the study; it contains items exploring socio - demographic data, clinical data. Data regarding assessment of effect of kidney disease on quality of life were collected by kidney disease quality of life - short form 1.3 versions .The maximum score of the total quality of life was 100 points. The score had been categorized as excellent > 80 score, good (61 - 80) score, moderate (40 - 60) score, and the poor score (< 40).Results The total number of participants was 248 patients. The mean of quality of life was 47.63±16.22. The total score was excellent in12 participants (4.8%), good in 47 (19%), moderate in 99 (39.9%), and poor in 90 participants (36.3%). The highest mean of quality of life domains was found for social support subscale, the low scores was reported for work status, role limitation due to physical problem, role limitation due to emotional problem, general health, and sexual function.Conclusions : The study had shown that the quality of life of hemodialysis patients was highly impaired and it clearly defines how the disease state adversely affects the physical and mental status of the patient. Regular and systematic monitoring for dialysis patients’quality of life must be considered as an effective tool of quality control in dialysis care

اضطرابات الغدة الدرقية في مرضى الذئبة الحمامي المجموعي

Author name: هند عدنان محمد
Supervisor name: خضير زغير معيوف البدري
General topic: Medicine
Specific topic: Diseases - Joints
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: Thyroid hormone abnormalities had been shown to be more frequent in patients with systemic lupus erythematosus (SLE), hence, performance of thyroid function tests in patients with SLE, as a part of the biochemical and immunological profiles, may help in early detection of associated thyroid disorders.Aim of the Study : To assess the thyroid hormone abnormalities in a group of systemic lupus erythematosus Iraqi patients.Patients and Methods : A case - control study was conducted at Baghdad Teaching hospital, Department of Rheumatology during the period from September 2016 to July 2017. Including 58 SLE patients and 60 controls who met the inclusion criteria. After ethical approval, data were collected using a preconstructed data collection sheet, questionnaire included demographic and clinical data of the patients and controls. Thyroid function tests, complete blood count, ESR, anti - double - strand DNA and complement C3 and C4 test were performed. Statistical analysis was done using the statistical package for social sciences (SPSS) v.24.Results : The mean age of the studied groups was 28.26 ± 7.1 years and 29.18 ± 6.3 years in SLE and control groups, respectively. No statistically significant differences between both groups had been found in age, BMI, or other demographic variables (P>0.05). Abnormal thyroid function was significantly more frequent in SLE patients (25.9%) than controls (5%), (P< 0.05). Primary hypothyroidism and Subclinical hypothyroidism were the more frequent disorder in SLE patients; 6/15 nd 5/15, respectively, each of subclinical hyperthyroidism and primary hyperthyroidism was reported in 2/15 SLE patients. Prednisolone and Hydroxychloroquine were the more frequently used medications among the SLE patients and were insignificantly associated with abnormal thyroid function in SLE patients, (P>0.05). High ESR was reported,, Leucopenia , high Anti dsDNA , low C3 and low C4 and Lymphopenia were reported in SLE patients. While all of SLE patients were ANA +ve and none of them had thrombocytopenia.Conclusions : Thyroid dysfunction was more frequent in SLE Iraqi patients compared to healthy population and the primary hypothyroidism and subclinical hypothyroidism were the more frequent types.

الكشف عن العلامات السطحية باستخدام تقنية التدفق الخلوي عند المرضى العراقيين المصابين بالداء الزلاقي == DETECTION OF SURFACE MARKERS BY FLOW CYTOMETRY IN IRAQI PATIENTS WITH COELIAC DISEASE

Author name: كرار علي محمد حسن الساكني
Supervisor name: هيفاء سلمان الحديثي | باسم احمد عسكر
General topic: Medicine
Specific topic: Microbiology
Degree: Master
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: الداء الزلاقي هو مرض مزمن، يحدد مناعيا من شكل الاعتلال المعوي الذي يؤثر في الامعاء الدقيقة عند الاطفال والبالغين ذوالميول الوراثي . وتظهر بشكل سريع عند ابتلاع الاطعمة التي تحتوي على الغلوتين. ويشار ايضا الى انه ذرب الاضطرابات الهضمية والحساسية من الغلوتين في الامعاء او غير ذرب الاستوائية. يمكن تعريف الغلوتين بانه كتلة البروتين المطاط الذي يبقى عندما يتم غسل عجين القمح لازالة النشا. مكونات البروتين الرئيسية في الغلوتين (غليادين وغلوتينين) وهي بروتينات التخزين في الحنطة. استجابة الخلايا المناعية للغليادين تشمل زيادة التعبير من المستقبلات السطحية. بعض من هذه المستقبلات تشمل HLA - DR ، جزيء التصاق ما بين الخلايا ، CD3 ( في خلايا Tالناضجة ) ، CD25 وCD69 ( في خلايا T المنشطة والخلايا القاتلة الطبيعية ) .هدف هذه الدراسة هو التحقيق في القيمة السريرية لستخدام علامات CD في تشخيص الداء الزلاقي . اشتملت هذه الدراسة على 40 مريضا (21 من الذكور و19 من الاناث) مصابين بالداء الزلاقي حضروا مستشفى الجهاز الهضمي والكبد التعليمي في مدينة الطب ، وخلال الفترة ما بين فبراير 2013 الى حزيران 2013. كذلك تالفت مجموعة السيطرة من 40 شخصا اصحاء الذين لم يشكو من اي مشكلة في الجهاز الهضمي. وتم اخذ عينات من الدم الوريدي لكل شخص ( الدماء الجديدة لاجراء اختبار الكشف عن العلامات السطحية باستخدام تقنية التدفق الخلوي والامصال لاجراء اختبار tTG الاضداد الذاتية باستخدام تقنية الاليزا ) . هذه الدراسة بينت ان اعمار المرضى المصابين بالداء الزلاقي في هذه الدراسة قد تراوحت ما بين سنتين الى ستة وخمسين سنة وبمتوسط عمر (15.6 ± 13.1) سنة. انخفاض مستوى الدم من خلاياT اللمفاوية الموجبة لعلامة CD3 بشكل ملحوظ في الحالات ( المرض الزلاقي ) التي تراوحت بين (7.6 - 62.3) بمتوسط (36.8 ± 16.7) مقارنة مع مجموعة السيطرة التي تراوحت بين (4.4 - 62.1) بمتوسط (41.9 ± 16.9). في حين ان مستوى الدم من خلايا T اللمفاوية الموجبة لعلامة CD6بزيادة كبيرة في مجموعة الحالات التي تراوحت بين(1.8 - 25.6) بمتوسط (10.5 ± 5.1) بالمقارنة مع مجموعة السيطرة التي تراوحت بين(1 - 9.4) بمتوسط (3.6 ± 2.2) . كما اثبتت الدراسة الحالية ان هناك فروقات ذات دلالة احصائية في مستويات المصل الذي يحتوي اضداد ذاتية tTG - A (p < 0.001) والمصل الذي يحتوي اضداد ذاتية tTG - G (p < 0.007) بين الحالات والسيطرة. اخيرا استنتجنا ان علامة CD69 هي اداة دقيقة لتشخيص اولي للداء الزلاقي . كذلك هناك ارتباط كبيربين كل من المصل الذي يحتوي اضداد ذاتية tTG - A والمصل الذي يحتوي اضداد ذاتية tTG - G مع خلايا Tاللمفاوية الموجبة لعلامة CD69 في المرضى الذين يعانون من الداء الزلاقي | Coeliac disease is a chronic, immunologically determined form of enteropathy affecting the small intestine in genetically predisposed children and adults. It is precipitated by the ingestion of gluten - containing foods. It is also referred to as coeliac sprue, gluten - sensitive enteropathy, or non tropical sprue. Gluten can be defined as the rubbery protein mass that remains when wheat dough is washed to remove starch. The major protein components of gluten—gliadin and glutenin—are storage proteins in wheat. The response of immune cells to gliadins includes the increased expression of surface receptors. Some of these receptors include HLA - DR, intercellular adhesion molecule, CD3 (in mature T - cells), CD25 and CD69 (in activated T - cells and natural killer cells). This study conducted to investigate the clinical value of using CD markers in diagnosis of coeliac disease. A total of 40 patients (21 males & 19 females) with coeliac disease attending the Gastroenterology and Hepatology Teaching Hospital in the Baghdad Medical City, during the period between February 2013 - June 2013.The control group consisted of 40 apparently healthy individuals who were not complaining of any gastro - intestinal problem. Venous blood samples were taken from each subject (fresh blood tested for detection of surface markers by flow cytometry and sera tested for Anti - tissue transglutaminase auto - antibodies by Enzyme Link Immune Sorbent Assay).This study shows that the age of coeliac disease patients in this study was ranged between (2 - 56) years with the mean age of (15.6 ± 13.1) years. Blood level of CD3 positive T - lymphocytes was not significantly decreased in cases group that ranged between (7.6 - 62.3) with mean (36.8 ± 16.7) when compared with controls group that ranged between (4.4 - 62.1) with mean (41.9 ± 16.9), While the blood level of CD69 positive T - lymphocytes was significantly increased in cases group that ranged between (1.8 - 25.6) with mean (10.5 ± 5.1) when compared with controls group that ranged between (1 - 9.4) with mean (3.6 ± 2.2). Also the current study has been demonstrated that there were a statistical significant difference in the serum levels of tissue transglutaminase - A auto - antibodies (p < 0.001) and tissue transglutaminase - G auto - antibodies (p < 0.007) between cases and controls. Finally this study concluded that CD69 marker is an accurate tool for the diagnosis of coeliac disease. There were significant correlations between each of Serum tTG - A auto - antibodies and Serum tTG - G auto - antibodies with CD69 positive T - lymphocytes in coeliac disease patients.

تقييم مؤشرات النمو لدى الاطفال المصابين بداء السكري من النوع الاول المراجعين لمستشفى حماية الاطفال التعليم / مدينة الطب بغداد / العراق 2017 == Evaluation of growth parametersamong children with Type 1 Diabetes Mellitus attending Diabetic clinic at Children Welfare Teaching Hospital / Medical City Baghdad - Iraq, 2017

Author name: زينة ستار هادي
Supervisor name: ايمان عدنان القصير
General topic: Medicine
Specific topic: Family Medicine
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: Background : Type 1 diabetes mellitus (T1DM) is a chronic autoimmune disease characterized by lack of insulin production, it is the most common type of diabetes in childhood. T1DM was listed among the causes of growth retardation in children. Glycemic control is an important factor in growth of children with T1DM.Objectives : To assess growth parameters (height, weight and body mass index [BMI] )in children with T1DM, and to study the impact of age at diagnosis, duration of disease, and glycemic control on growth indices.Patients and methods : A cross sectional study was conducted at diabetic clinic in Children Welfare Teaching hospital - Medical City - Baghdad, for the period from the 1st of February to the end of May 2017. A total of 100 children with T1DM between (2 - 14) years of both gender was included in the study, the information were obtained directly during interview including : relevant demographic data, disease information (age at diagnosis, duration of disease and type of presentation). Also each patient had two measurements for weight in kilogram and height in centimeter first one was measured by researcher at the time of interview and the second one obtained from their case file around the time of diagnosis.Results : A total of 100 children with T1DM included in this study showed that male to female ratio were equal. Peak age of children at diagnosis was less than 5 years. Most of patients presented with classical signs and symptom (64%). Of the total diabetic children in this study, (5%), (2%), and (5%) were stunted, wasted and underweight, respectively. Duration of T1DM was a significant determinant of growth indices (height and weight). Conclusions and Recommendations : Retarded growth indices (height and weight) were the highest growth problems among diabetic children. Duration of diabetes was an important determinant of growth parameters. We recommend for paying attention to anthropometric measurements in management of T1DM and participation of PHCC in the management plan.

الحالة السريرية والمرضية النسيجية لمرضى سرطان الرئة في العراق وقت عرض الحالة == Clinical And Pathological Profile Of Iraqi Lung Cancer Patients At Time Of Presentation (An Observation Study)

Author name: هالة ساطع طه
Supervisor name: منور عبد الاله النقاش
General topic: Medicine
Specific topic: Therapeutic Radiology
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: الخلفية العلمية : في جميع انحاء العالم يمثل سرطان الرئة 13% (1.6 مليون) من مجموع حالات السرطان و18% (1.4 مليون) من الوفيات الناجمة عن السرطان على اساس تقديرات عام 2008 وسرطان الرئة في العراق سبب شائع في للوفاة في كلا الجنسين اهداف الدراسة : التقييم السريري والتصويري للحالة المرضية وايجاد علاقة بين الانواع الفرعية النسيجية المرضية وغيرها من معلومات المريض .طريقة البحث : تعتبر هذه الدراسة من نوع دراسة المراقبة (دراسة مقطعية) تتكون من 60 مريض يعانون من مرض سرطان الرئة متوسطة اعمارهم 60 عام 38 ذكور و22 اناث (نسبة الذكور الى الاناث 1.7 : 1) تم جمع حالات المرضى من العيادة الاستشارية في مستشفى الاورام التعليمي في مدينة الطب من شهر كانون الثاني الى شهر نيسان 2016 تم تقييم جميع الحالات واجراء الفحص السريري والتشخيصي والنسيجي.النتيجة . تم دراسة (60) مريضا اثبتت اصابتهم بسرطان الرئة سن الحد الادنى للمرضى هو 32 سنة والحد الاقصى 81 سنة بمتوسط عمر 60 عام 38 من الذكور و22 اناث معظم المرضى لديهم صعوبة التنفس في وقت العرض (21%)، ونفث الدم (20%). تليها السعال (16 %). اما المكان التشريحي الاكثر اصابة بسرطان الرئة الفص العلوي الايمن 14 (23%). ثم الفص العلوي الايسر 9 (15%). يعد الغسل القصبي اختبار الخلايا 22 (36%) اكثر وسيلة مستخدمة لتشخيص المرض يليها فحص الخلايا المسحوبة بواسطة الابرة الناعمة 9 (15 %)، طموح السائل الجنبي 8(13.3%) الخزعة الاستئصالية 7 (11.7%)، الخزعة الجراحية 5 (8.3%)، علم خلايا البلغم 4(6.7%)، الخزعة الماخوذة بمساعدة الجهازالطبقي المقطعي 2 (3.3%) النتيجة التشريحيةالمرضية الرئيسية هي سرطان الخلية الحرشفية (41.7%) ثم الغدية (36.7%) بعدها سرطان الرئة صغير الخلية ، ورم الظهارة المتوسطة (8.3%) اخيرا يمثل سرطان الخلايا القشرية هو الشائع في الذكور 20(52.6%) ولكنه في الاناث 5 (22.7%) ومع ذلك السرطانات الغدية هي الاكثر شيوعا في الاناث 12 (54.5%) من الذكور 10 (26.3%) هنالك علاقة طردية بين نسبة حدوث سرطان الرئة من نوع الخلايا الصغيرة مع التدخين حيث ان جميع المرضى هم مدخنين بينما في الخلايا الحرشفية فان (47.8%) هم مدخنين (P=0.003) اغلب المرضى لديهم ورم خبيث منتشر وقت تشخيص الحالة (56%) و(33.3%) لديهم استسقاء رئويالاستنتاجات : 1 - اكثر عارض مرضي يعاني منه مرضى السرطان في العراق هو ضيق التنفس ثم النفث الدموي.2 - الفص العلوي الايمن هو الاكثر اصابة بالمرض 3 - الغسل القصبي وفحص الخلايا هو اكثر طرق التشخيص شيوعا 4 - سرطان الخلايا الحرشفية هو النوع النسيجي المرضي السائد في الذكور بينما سرطان الرئة من نوع الغدي هو السائد في الاناث 5 - هناك علاقة ذات دلالة احصائية بين سرطان الخلايا الحرشفية والتدخين (P=0.003) واغلب المرضى يعانو من مراحل متقدمة في وقت عرض الحالة | Background; Carcinoma of the lung is currently the leading cause world wide of death . The disease has become an epidemic as incidence rates and lung cancer deaths have risen dramatically over the last century, Throughout the world, lung cancer accounts for 13% (1.6 million) of the total cases of cancer and 18% (1.4 million) of the cancer - related deaths based on 2008 estimates. Among males, lung cancer is the most commonly diagnosed cancer and leading cause of cancer death. Among females worldwide, it is the fourth most commonly diagnosed cancer and the second leading cause of cancer death.Aim of study : 1 - Identify the most common stages of lung cancer at time of presentation2 - Estimate the anatomical distribution of lung cancer according to histopathological subtypes3 - Find the acorrelation between histopathological subtypesAnd other parameters of patient profilePatients &Methods : Methods;An observation study ( A cross sectional study) of 60 patients with lung cancer with mean age of 60 years old.38 male;22 female (male : female 1.7 : 1). cases were collected from consultant clinic at the Oncology Teaching Center in Medical City. The data were collected from 1st January to 30th of April/2016. All patients were evaluated from history ,physical examination ,sent for investigations &review of histopathology samples.Results : A total of 60 lung cancer patients were studied,mean age of patients 60 yrs old , male : female ratio 1.7 : 1 ,most patients are smoker, Sequamous cell carcinoma is commonest type (41.9% ) of all patients, and its male predominant (33.3%) .Most patient diagnosed by bronchial wash and cytology (36%) ,Right upper zone is commonest site of malignancy (23.3%) ,most patients presented in advance stage and metastasis (56%).Conclusions*Lung cancer is commonest cause of cancer related death.*Proper stage of disease is recommended as mediastinscopy found 15% of occult lymph node metastasis in radiologically normal nodes.*Most patients have metastasis at time of presentation so we can use new radiological modalitiy to diagnosed occult metastasis.*use molecular biology to proper diagnose the histopathologiac subtypes and identify the response to treatment and give a prognosis idea*Active surveillance of primary small lung lesion

دراسة جزيئية للطفرتين NPM1 - A وFLT3 - ITD مع التعبير النسخي للمورث الجزيئي FLT3 في نموذج من المرضى العراقيين البالغين المصابين بابيضاض الدم النقياني الحاد وعلاقتهما مع المؤشرات السريرية والمختبرية == Molecular Study of NPM1 - A, FLT3 - ITD Mutations and FLT3 Transcript Expression in a Sample of Iraqi Adult Acute Myeloid Leukemia Patients : Their Correlations with Clinicopathological Parameters

Author name: شيماء محمد عبد اللطيف
Supervisor name: ختام رزاق كاظم الخفاجي | علي محمد جواد
General topic: Medicine
Specific topic: Diseases - Blood
Degree: Doctorate
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: Acute myeloid leukemia is a hematological malignancy of myeloid progenitor cells characterized by anomalous proliferation, inhibition of differentiation and extension of leukemic cells blocked at the early stage of hematopoiesis. It has a great variability in the pathogenesis, clinical features, and treatment outcomes. Detection of molecular markers has become a smart tool to further division of patients in acute myeloid leukemia subgroups.Nucleophosmin1 mutations are found in approximately 30% of adult acute myeloid leukemia patients and are associated with a good outcome when detected in absence of duplications in the Fms - like tyrosine kinase 3 gene. Over 50 molecular Nucleophosmin1 mutation variants have been recognized; the most common one is Nucleophosmin1 - A mutation.The Fms - like tyrosine kinase 3 receptor is expressed on the surface of hematopoietic stem cells and plays a vital role in normal hematopoiesis. Numerous studies have revealed that high levels of Fms - like tyrosine kinase 3 were expressed in patients with acute myeloid leukemia. Fms - like tyrosine kinase 3 - Internal tandem duplication mutations are found in around 20 - 25% of patients with acute myeloid leukemia and are associated with increased transcript level of Fms - like tyrosine kinase 3 and with a poor scenario in adult acute myeloid leukemia patients.Aim of the Study1. Detect the frequency of Nucleophosmin1 - A; Fms - like tyrosine kinase 3 - Internal tandem duplication along with assessment of Fms - like tyrosine kinase 3 transcript expression in a sample of newly diagnosed Iraqi adult acute myeloid leukemia patients.2. Study the relationship of Nucleophosmin1 - A, Fms - like tyrosine kinase 3 - Internal tandem duplication mutations and Fms - like tyrosine kinase 3VItranscript expression with various clinicopathological parameters and French - American - British subtypes of the disease as well as the correlation among the three markers.Materials and MethodsThis is a cross - sectional study, conducted during the period extending between April 2015 and September 2016. The bone marrow aspirate samples of 53 adult acute myeloid leukemia patients were collected at the time of diagnosis and prior to treatment at the Hematology Ward of Baghdad Teaching Hospital in Medical City compared with 53 control individuals. All the control bone marrows obtained from patients with anemia and idiopathic thrombocytopenic purpura and were negative for infiltrative lesions. The related clinical and laboratory data for each patient were registered at the time of diagnosis.The study was conducted at Main Laboratory of Baghdad Teaching Hospital/ Medical City, Clinical and Communicable Diseases Research Center/College of Medicine/ University of Baghdad and Postgraduate Laboratory of Pathology and FoThe RNA was extracted and was reverse transcribed into cDNA. Real time polymerase chain reaction technique was applied on bone marrow aspirate samples of acute myeloid leukemia and control groups to detect the frequency of Nucleophosmin1 - A mutation, Fms - like tyrosine kinase 3 expression using a TaqMan probe and SYBR green assays respectively and detection of Fms - like tyrosine kinase 3 - Internal tandem duplication mutation using gel electrophoresis post polymerase chain reaction procedure

تقييم مصل الابلين في المرضى الذين يعانون من المتلازمة التاجية الحادة == Evaluation of Serum Apelin in Patients with Acute Coronary Syndrome

Author name: بشار جواد حسين
Supervisor name: زينا حسن عبد القهار
General topic: Medicine
Specific topic: Clinical Biochemistry
Degree: Master
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: يشير مصطلح المتلازمة التاجية الحادة الى اية مجموعة من الاعراض السريرية المتوافقة مع اقفار عضل القلب الحاد والتي تتضمن الذبحة اللامستقرة واحتشاء عضلة القلب غير المرتبط بمقطع ST ((NSTEMI وكذلك احتشاء عضلة القلب الناجم عن ارتفاع مقطع ST (STEMI).بالاضافة الى تقييم النتائج السريرية ونتائج مخطط كهربائية القلب, فقد تم تقييم العديد من الواصمات الكيميائية الحيوية لدى المرضى الذين يعانون من الام الصدر من اجل تشخيص اقفار عضل القلب; فيما لايزال باقي الواصمات تحت البحث.ان الابلين (apelin) هو احد الببتيدات المستحدثة داخلية المنشا التي تمتاز بخصائص تؤثر في التقلص العضلي وفي توسيع الاوعية. ظهر من خلال الفحص الكيميائي الهستولوجي المناعي بان الابلين يصنع في خلايا العضلات الملساء وفي خلايا الارومة الليفية (الفايبروبلاست) للشرايين التاجية. وعلى نحو مماثل, وجد مؤخرا بان مستوى الابلين في مصل الدم كان مماثلا لمستواه في الفحص الكيميائي النسيجي داخل الاوعية الدموية وانسجة القلب.الاهداف : لتقييم مستويات مصل الابلين فيما يتعلق بالانواع الفرعيه من المتلازمة التاجية الحادة.المرضى والمواد وطرائق العمل : اجريت هذه الدراسة خلال الفترة من شهر ايلول 2014 الى شهر اذار 2015. اشتملت الدراسة على 59 مريضا يعانون من المتلازمة التاجية الحادة وكالتالي (30 منهم يعانون من الذبحة اللامستقرة و15 من احتشاء عضلة القلب غير المرتبط بمقطع ST ((NSTEMI اضافة الى 14 ممن يعانون من احتشاء عضلة القلب الناجم عن ارتفاع مقطع ST (STEMI). اشتملت الدراسة ايضا على (28) شخصا سليما ظاهريا حيث تم استخدامهم كمجموعة ضابطة. تم الحصول على عينات الدم لقياس كل من (الابلين والتروبونين وانزيم كرياتنين كاينيز CK - MB وكذلك صورة الشحوم) لكافة الاشخاص المشتركين في البحث.النـتائـــجاظهرت نتائج قياس الابلين في مصل الدم انخفاضا احصائيا لدى كافة مرضى المتلازمة التاجية الحادة (1846,1±320,9 ng/ml) بالمقارنة مع المجموعة الضابطة (2719,4±272,5) (p<0.05). فيما يتعلق بالمجاميع الثانوية من المرضى, كان مستوى الابلين في المصل الاقل لدى مرضى احتشاء عضلة القلب غير المرتبط بمقطع ST ((NSTEMI (1729±480) و(1816±289) لدى مرضى احتشاء عضلة القلب الناجم عن ارتفاع مقطع ST (STEMI) و(1916±224,4) لدى مرضى الذبحة اللا مستقرة عند مقارنتهم مع المجموعة الضابطة.كان مستويات الكوليستيرول والبروتين الشحمي خفيض الكثافة LDL لدى المرضى اكثر من مجموعة الضبط ولكنها لم تكن فروقات معنوية. بينما وجدت فروقات ذات دلالة معنوية في نتائج كل من ثلاثي الغليسريد والبروتين الشحمي عالي الكثافة HDL والبروتينات الشحمية وضيعة الكثافة VLDL بين المرضى والمجموعة الضابطة على التوالي.سجلت نسبة توزيع عوامل الاختطار في مرضى المتلازمة التاجية الحادة اعلى مستوياتها بالنسبة للسمنة (< 80%), وارتفاع ضغط الدم (~ 70%) بينما تم تسجيل النسب الاقل بالنسبة للتدخين وتضخم البطين الايسر ونقص تروية القلب وكذلك شذوذ شحوم الدم (Dyslipidemia). | The term acute coronary syndrome (ACS) refers to a group of clinical symptoms compatible with acute myocardial ischemia including unstable angina (UA), Non - ST - segment elevation myocardial infarction (NSTEMI) & ST - segment elevation myocardial infarction (STEMI).In addition to clinical and electrocardiogram (ECG) findings, several Biochemical markers are considered in patients with chest pain to diagnose myocardial ischemia.Apelin is a novel endogenous peptide with inotropic and vasodilatory properties, immunohistochemically it was hown to be synthesized in smooth muscle cells and fibroblast cells of coronary arteries. it was recently reported that serum measurements of apelin were similar to its immunohistochemical data in vessels and heart tissues.Objectives : To evaluate serum levels of apelin in relation to the subtypes of ACS..Patients, Material & Methods : The present study was conducted during the period from September 2014 until March 2015. Fifty - nine patients with ACS are included as 30 unstable angina (UA), 15 non ST elevation myocardial infarction (NSTEMI), & 14 ST elevation myocardial infarction (STEMI) patients. The study included also (28) apparently healthy persons served as control. Blood samples were obtained for measurements of (apelin, Troponin, CK - MB, & Lipid Profile) for all participants.Results : Serum apelin levels were significantly decreased in total patients with ACS (1846.1±320.9 ng/ml) compared to control (2719.4±272.5) (p< 0.05). Regarding patients' subgroups; serum apelin was lowest in STEMI (1729.0±480.0), NSTEMI (1816.0±289.0), & UA (1916.0±224.4) when compared with control.Total cholesterol and LDL levels were higher in patients compared to control although the difference was not significant. While there were significant differences in TG, HDL and VLDL between ACS patients and control group.The percentage of risk factors' distribution in ACS recorded the highest for obesity (>80%), hypertension (~80%), and DM (~70%); while lesser percentages were recorded for smoking, left ventricular hypertrophy, ischemic heart disease, and dyslipidemia.Conclusion : Data obtained revealed a reduction in serum apelin levels in all patients groups especially STEMI. Since apelin acts as an indicator for the efficiency of heart function and coronary circulation, it could be used as a indicator for assessment of severity of ischemia in ACS patients.

التاثيرات الصحية لداء الفقار المقسط على جودة الحياة والاداء الوظيفي للمرضى العراقيين == Health - Related Quality of Life and Work Outcome in Iraqi Patients with Ankylosing Spondylitis

Author name: نورا صباح مهدي
Supervisor name: نزار عبد اللطيف جاسم
General topic: Medicine
Specific topic: Diseases - Joints
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: Background : Ankylosing Spondylitis (AS) is a chronic inflammatory rheumatic disease, mainly affecting the axial skeleton, and less frequently the peripheral joints, entheses as well as other extra - articular organs such as the eyes, heart and lungs. AS has a considerable effect on the individual’s healthrelated quality of life. Work disabled patients with AS experience a significantly reduced quality of life.Objective : To evaluate health - related quality of life and factors influencing it in patients with Ankylosing Spondylitis, as well as, to assess work outcome and its correlation with quality of life in AS patients.Patients and Methods : A case - control study was conducted at the Rheumatology Unit in Baghdad Teaching Hospital during the period from August 2017 to March 2018. A total of 168 patients (151 male : 17 female) with Ankylosing Spondylitis were enrolled in the study, all of them fulfilled the modified New York criteria for Ankylosing Spondylitis, and Assessment of Spondyloarthritis International Society (ASAS) classification criteria for axial spondyloarthropathy, and compared with 169 healthy controls (149 male : 20 female) matched for age and sex. Socio - demographic and clinical data of the patients and controls were collected. Health - related quality of life and work outcome were evaluated by the medical outcome survey short form - 36 (SF - 36) and work productivity and activity impairment - specific health problem (WPAI - SHP) scores respectively.Results : the mean age of the studied groups was 37.4 ± 9.4 years and 36.9 ± 9.5 years in Ankylosing Spondylitis and control groups, respectively. The median disease duration in AS patients was 11.3 ± 7.6. The quality of life in Ankylosing Spondylitis patients on all the scales of the short form 36 (SF - 36), was significantly worse than in the control group. Mental health quality of life was mostly affected than physical health overall. Role - physical was the most affected subscale of the short form - 36 (SF - 36). Male gender, smoking,fatigue, bath Ankylosing Spondylitis functional index (BASFI), treatment with biologics (anti - tumor necrosis factor) were significantly associated with the components of physical & mental health - related quality of life. Of 168 patients, 126 were employed (75%). Patients with Ankylosing Spondylitis reported work absenteeism loss, work productivity loss, overall work impairment, and daily activity impairment of 9.19%, 48.17%, 36.19%, 50.82% respectively. Work productivity and activity impairment - specific health problem (WPAI - SHP) summary scores were significantly correlated with all scores of quality of life (short form - 36).Conclusions : Ankylosing Spondylitis has negative impact on patients’ healthrelated quality of life, affecting both physical & mental health. Male gender, smoking, fatigue, poor functional status, treatment with biologics were the most associated factors with better or worse quality of life in patients with Ankylosing Spondylitis. AS has a significant effect on working conditions, quality of life has a direct relationship with a patient’s ability to work.

تقييم نوعية الحياة لدى المرضى العراقيين المصابين بمرض بهجت وعلاقتها مع فاعلية المرض == Quality of life assessment in Iraqi patients with Behçet’s disease and its relationship with disease activity

Author name: میس عجیل جبار
Supervisor name: فائق ايشو كوريال
General topic: Medicine
Specific topic: Diseases - Joints
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: Behçet’s disease is a multisystem inflammatory disorder characterized by recurrent exacerbations affecting mucocutaneous tissues, eyes, blood vessels, and several other tissues. Among them, vascular and nervous system involvement are the most common causes of mortality in Behçet’s disease. The previous studies have shown that Quality of Life in patients with Behçet disease was negatively affected by the disease.Aim of the study : To evaluate Quality of Life in patients with Behçet’s disease compared with healthy controls, To assess the correlation of Quality of Life with organ involvements of Behçet’s disease and To assess the effect of demographic and clinical features of Behçet’s disease on Quality of Life. Patients and Methods : A case - control study was conducted at the Rheumatology Unit of Baghdad Teaching Hospital in Medical City from July 2017 to January 2018 . A total of seventy - one consecutive patients (45 male : 26 female) were classified as Behçet’s disease by fulfilling the International Study Group criteria 1990 for Behçet’s disease and compared with seventy - one healthy controls (45 male : 26 female) matched for age and gender. After acquiring their consent, findings were gathered using a preconstructed data collection sheet for patients and controls that evaluate Age, gender, smoking status, disease duration, age at disease onset, Behçet’s disease organ involvements were reported. Disease activity was assessed using Behçet's disease current activity form and health - related quality - of - life was evaluated using The Short Form - 36 (SF - 36) .Results : All the components of Short Form - 36 (SF - 36) , it’s summary scores and Total Short Form - 36 (Total SF - 36) score was significantly lower ( p - value <0.001 ) in patients compared to control . Patients with eye involvement had significantly higher Physical functioning (p - value = 0.023), role - physical ( p - value <0.001), and bodily pain (p - value <0.010) subscores when compared to those without eye involvement. Patients with skin involvement did not show a significant impairment in all SF - 36 subscales when compared to those without skin involvement. Behçet's disease Patients with articular involvement, Physical functioning (p - value = 0.027), bodily pain (p - value <0.001), and general health (p - value = 0.018) subscores are significantly impaired when compared to those without articular involvement .Behçet’s disease patients with myalgia, Physical functioning (p - value = 0.001), bodily pain (p - value = 0.018), and vitality (p - value = 0.038) subscores are significantly impaired when compared to those without myalgia. patients with Central nervous system involvement, physical functioning (p - value = 0.006), rolephysical (p - value <0.001), bodily pain (p - value = 0.001) , general health (p - value = 0.001) and vitality (p - value = 0.042) subscores are significantly impaired when compared to those without Central nervous system involvement. There are certain demographic and treatment modalities had a significant positive impact on Total SF - 36 score : Male gender (p - value = 0.020) , use of cyclosporine (p - value = 0.043 ), use of infliximab (p - value = 0.001), and use of adalimumab (p - value = 0.001) . While others had a significant negative impact on Total SF - 36 score : Disease duration (pvalue = 0.019) , Behçet’s Disease Current Activity Form (BDCAF) (p - value = 0.043 ), and use of Mycophenolate mofetil (p - value = 0.043 ).

تقييم نسبة خلايا الدم المتعادلة الى الخلايا اللمفاوية وعرض توزيع الصفائح الدموية كعلامات التهابية في عينة من المرضى العراقيين المصابين بمتلازمة الالم الليفي العضلي == Evaluation of blood neutrophil - lymphocyte ratio and platelet distribution width as inflammatory markers in a sample of Iraqi patients with fibromyalgia

Author name: فادية علي شعلان
Supervisor name: زياد شفيق الراوي
General topic: Medicine
Specific topic: Diseases - Joints
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: Fibromyalgia syndrome is a diminished quality of life related to generalized body pain with physical and psychological symptoms that occurs in the absence of a clear pathologic cause. Neutrophil to lymphocyte ratio is a simple parameter to assess easily the inflammatory status of a subjects. Platelet distribution width is a regular parameter in blood routine examination which reflects variation of platelet size distribution. Mean platelet volume is a part of the complete blood count test and correlates with the platelets function and activation.Objective : To evaluate Neutrophil to lymphocyte ratio, Platelet distribution width and Mean platelet volume in patients with Fibromyalgia as an inflammatory markers.Patients and Methods : This case - controlled study was conducted at Baghdad Teaching Hospital, Unit of Rheumatology, from July 2017 till November 2017. A total of 100 Iraqi patients with Fibromyalgia diagnosed according to 2012 Canadian Guidelines in addition to 50 healthy subjects worked as a control group were recruited. Data were collected using a paper clinical research form through interview and questionnaires. It consisted of two parts : the first part for the demographic data and full history, the second part laboratory data when the samples collected and sent for laboratories to obtain Platelet distribution width and Mean platelet volume while Neutrophil/lymphocyte ratio was calculated manually.Results : The neutrophil to lymphocyte ratio was significantly higher among patients with fibromyalgia (2.18) compared to healthy controls (1.92) (p =0.033). The Mean platelet volume was significantly higher in patients with fibromyalgia (8.3) compared to healthy controls (8) (p =0.045). In contrast, the Platelet distribution width was significantly lower among patients with fibromyalgia (16.7) compared to healthy controls (17) (p=0.01). No statistically significant differences had been found in demographic variables. None of the tested parameters qualified as an acceptable test for predicting a diagnosis of fibromyalgia, since the Receiver operating characteristic area associated with any of them did not reach the minimum value of (0.65).Conclusions : The Neutrophil to lymphocyte ratio is significantly higher in fibromyalgia patients compared to the healthy controls. The Mean platelet volume is significantly higher in the patients compared to the controls. The Platelet distribution width was significantly lower among the patients compared to the healthy controls. None of these tested parameters qualified as an acceptable test for predicting a diagnosis of Fibromyalgia.

العلاقة بين الخصائص السريرية وبروز القرص القطني وانتقامة المثبت بفحص الرنين المغناطيسي == The Relationship between Clinical Features and Magnetic Resonance Imaging Proven Lumbar Disc Bulging and Herniation

Author name: ابان ناظم علي
Supervisor name: خضير زغير معيوف البدري
General topic: Medicine
Specific topic: Diseases - Joints
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: Lumbar disc herniation is one of the commonest causes of low backpain. The Magnetic resonance imaging is a gold standard noninvasiveinvestigation for viewing lumbar anatomy and physiology in great details.Obesity is strongly linked to biomechanical changes that damage thespine and contribute to a range of spinal diseases including intervertebraldisc herniation.Aim of the studyTo evaluate the effects of body mass index and waist to hip ratio on thepresence, extent and severity of lumbar disc bulging and herniation as wellas to determine the relationship between clinical features and magneticresonance imaging proven lumbar disc bulging and herniation.Patients and methodsA cross - sectional study was conducted at Baghdad Teaching Hospital,Rheumatology Unit during the period from October 2017 to May 2018. Atotal of 100 patients with lumbar disc bulging and herniation proven by MRIwere included in this study. The patients were examined neurologically andtheir body mass index was calculated as well as the waist to hip ratio.ResultsThe magnetic resonance imaging findings demonstrated that (72%) ofthe studied group had disc bulge, (13%) had disc protrusion and (15%) haddisc extrusion with no cases of disc sequestration. Multiple discinvolvements were seen in (73%) of those patients. The correlation betweenbody mass index and the total disc bulge/extrusion score was statisticallysignificant. There was a significant association between neurological deficitand body mass index as well as between straight leg raising test, femoralVIstretch test, neurological deficit and the waist to hip ratio. On the other hand,there was no significant association between clinical features and nerve root compression for patients with both normal body mass index as well as overweight and obese ones, although the frequency of patients with positive clinical findings was higher in patients with nerve root compression but the difference did not reach the significant level (P - value >0.05). The sensitivity of straight leg raising test, femoral stretch test and crossed straight leg raising test were (39.6%), (25.3%) and (6.6%) respectively.ConclusionsThere is an increase in the likelihood of having lumbar disc herniation and its global severity in overweight and obese patients. The clinical findings were more severe in overweight and obese patients especially in patients with central obesity. There was no significant association between the clinical features and the nerve root compression in patients with both normal body mass index as well as overweight and obese ones. The type of disc displacement associated poorly with clinical signs and symptoms as well as with the obesity.

العوامل المرتبطة مع سرطان الثدي وتاثيراتها في عينة من المرضى لمستشفى الامل الوطني لعلاج السرطان في بغداد == Factors associated with Breast Cancer Impact in a sample of Al - Amal National hospital for Cancer management in Baghdad

Author name: اسامة مدحت لفتة
Supervisor name: احمد سمير النعيمي
General topic: Medicine
Specific topic: Community Medicine
Degree: Master
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: Breast cancer (BC) known to be the most common cause of cancer - related death among females with excess of more than a million inflicted with this disease every year. In Iraq, breast cancer is the most common type of malignancy among the Iraqi population in general. The disease affects physical and mental health among breast cancer survivors. The true impact of a successful medical intervention could be understood by the degree to which the treatment has a positive influence on patient’s immediate and /or future well - being. Assessment of quality of life among breast cancer is vital to identify area of concerns to the patient and health professional, and to suggest means to improve disease outcome and reduce patient’s suffering. The current study aimed at measuring the impact of Breast Cancer on different aspects of health related quality of life. In addition, to studying the association between the impact of breast Cancer and sociodemographic characteristics or treatment modalities.A cross - sectional study was conducted on a total of 250 randomly selected females with an established diagnosis of breast cancer attending Al - Amal National hospital for Cancer management in Baghdad. Data collection took place during the period from January to April, 2016, each participant was asked to fill The questionnaire composed of three parts : The first one covered sociodemographic characteristics including : age, gender, educational attainment, marital status, living arrangement, finical status, BMI and blood pressure. The second part contained the ABCIS (Arabic Breast Cancer Impact Scale) with 14 questionnaire items. The third part of the questionnaire gathered data about disease associated factors like duration, treatment modalities. The answers that reflect the impact of the disease on specific life domains were anchored to a 5 points Likert - scale type rating scale. It ranges from large extent to no impact. Higher rating reflects higher negative impact. In addition, the importance of each domain rated on 4 points likert - scale ranges from very important to not important. Higher rating reflects greater importance.Breast cancer had negative impact on patients quality of life. The psychological domain was the most affected among the three domains of quality of life, while theviisocial domain was the least affected. The retest part of the study supported a high reliability for the tested instrument among Iraqi Breast Cancer patients. A quarter of study subjects described the quality of their life as poor. This group of females is at risk for bad prognosis and deterioration of their conditions later on.The study failed to detect an association between type of treatment (whether radio or chemo - therapy) and negative impact of breast cancer on quality of life. Most cancer patients in Iraq fail to cope with the new events and changes in their body image and daily activities that resulted from their disease, neither in their social or occupational life. This might be related to the lack of the psychological therapy and rehabilitation program, which should be provided in all stages of management.

الكشف المبكر للخلل الوظيفي لعمل البطين الايسر الانقباضي في المرضى المصابين بارتجاع الصمام الابهر المزمن غير ذوي الاعراض باستخدام صدى القلب ثنائي الابعاد ذي التتبع النقطي == Early Detection of Left Ventricular Systolic Dysfunction In Asymptomatic Patients with Chronic Aortic Regurgitation by Two Dimensional Speckle Tracking Echocardiography

Author name: ثامر عماد احمد
Supervisor name: امال نوري المراياتي
General topic: Medicine
Specific topic: Echocardiography
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: Chronic aortic regurgitation (AR) is a left ventricular (LV) volume overload lesion with a long latency period prior to symptom development. Prior to symptoms, patients may exhibit normal exercise tolerance associated with LV remodeling and a preserved ejection fraction (EF).Conventional echocardiography has many limitations in prediction of early LV systolic dysfunction. Therefore; early detection of subclinical LV systolic dysfunction is crucial and could influence patients' prognosis by aiding the clinician to candidate patients for better management.Recently, 2 - D speckle tracking echocardiography have been shown to be useful noninvasive tools for detecting subtle LV contractile changes in the prior to reduced LVEF in patients with chronic AR .Aim of the Study : To detect early LV systolic dysfunction in asymptomatic patient with chronic aortic regurgitation by two dimensional speckle tracking echocardiography comparing that to conventional echocardiographic systolic parameters (EF by Simpson’s method and MAPSE ) and tissue Doppler echocardiographic systolic parameter ( s) .Patients and Methods : Sixty one asymptomatic patients with chronic aortic regurgitation, with no ischemic heart diseases ( by Angiography ) or conductive heart diseases, no diabetes mellitus, no hypertension, and no other valvular heart diseases (group 1) and fifty age and sex - matched healthy subjects (group 2) were enrolled into the study. Group (1) was further classified into 3 sub - groups according to 4 chosen parameters from the published guidelines of ASE into : Mild AR, Moderate AR, and Severe AR.All patients and controls underwent echocardiographic examination including conventional echocardiography, tissue Doppler study and 2 - D Speckle Tracking Echocardiography.Results : As compared to other systolic parameters ,global longitudinal strain measured by 2 - D speckle tracking echocardiography was the most useful tool to detect subtle LV systolic dysfunction with sensitivity and specificity of 75.4% and 99% respectively and AUC of 0.928 for a cut off value of > ( - 19.62).Moreover, GLS has highest sensitivity and specificity in detection of subtle LV systolic dysfunction in moderate AR .In moderate AR ,a cut off value of > ( - 19.62) has sensitivity and specificity of 91.3% and 95.5% respectively, with PPV and NPV of 87.5% and 96.9% respectively, AUC of 0.981 and a P value of <0.0001. In all types of AR, GLS had higher NPV than PPV which makes it a powerful screening tool for early detection of subtle LV systolic dysfunction.Conclusion : Global Longitudinal strain measured by 2 - D speckle tracking echocardiography is an excellent tool for early detection of subtle LV systolic dysfunction in asymptomatic patients with chronic AR.

تقييم خدمات الفحص الطوعي الاسترشادي لمرض نقص المناعة المكتسب (الايدز) في بغداد ،2014 == Assessment of HIV/AIDS Voluntary Counseling and Testing Services in Baghdad 2014

Author name: نزار عبد المهدي ناهي
Supervisor name: صالح جاسم علوان
General topic: Medicine
Specific topic: Applied Epidemiology
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: تعتبر خدمات الفحص الطوعي الاسترشادي ((VCT حجر الزاوية للوصول مبكرا الى الوقاية والرعاية لخدمات الدعم في مجال فيروس نقص المناعة البشرية / الايدز. وبالرغم من كون ان هذه الخدمة قد تم العمل بها في بعض المواقع منذ عام 2004، فاننا لا نملك اي دراسة لتقييم طريقة تنفيذ هذه المراكز او تقييم ادائها في العراق.الاهداف : تقييم مراكز الفحص الطوعي الاسترشادي في محافظة بغداد وفقا للمعايير الوطنية والدولية.الاساليب : تم استخدام دراسة مقطعية لما مجموعه (23) في بغداد بواسطة استبيان وقائمة من المؤشرات المعدلة لرصد وتقييم خدمات الفحص الطوعي الاسترشادي الخاصة بمنظمة الصحة العالمية ((WHO الايدز ومنظمة البرنامج الاممي لمرض نقص المناعة المكتسب ((UNAIDS.النتائج : بينت نتائج الدراسة بان الخطة الاستراتيجية الوطنية للبرنامج الوطني لمكافحة الايدز لا تزال قيد الاعداد، وليس هناك خطة واضحة لاجراء الدورات التدريبية لمقدمي خدمة الفحص الطوعي الاسترشادي، توفر جميع المواقع التي شملتها الدراسة اختبار فيروس نقص المناعة البشرية، بينما تقدم مشورة ما قبل الفحص في (73.9٪) من المراكز ، في حين ان (17.3٪) فقط من هذه المواقع يقدمون مشورة ما بعد الفحص لعملائها.قد تبين ايضا ضعف خدمات الاحالة من والى الخدمات الصحية الساندة الاخرى. الغالبية (62.5٪) من مقدمي خدمة المشورة هم فنيي المختبرات، ان (57٪) من المواقع تعطى النتائج لعملائها في مدة تزيد عن يوم واحد. فيما يتعلق بالتدريب فان (43٪) من مقدمي خدمة المشورة لم يتم تدريبهم لتقديم هذه الخدمة وان كل مقدمي الخدمة لم يتلقون اي تدريب تعزيزي خلال العام الماضي. يستخدم الاختبار السريع ((Raped test في (43٪) من المواقع التي شملتها الدراسة. في حين تستخدم المواقع المتبقية طريقة ال (ELIZA). لم تتوفر غرفة المشورة وخصوصية العميل في (82.6٪) من المواقع في حين ان المواد التعليمية والواقي الذكري متوفرة في (21.7٪) من المراكز. بينت الدراسة ايضا ان عدد المستفيدين من خدمة الفحص الطوعي الاسترشادي في المراكز التي تم مسحها هو(354) مستفيد في الاشهر الثلاثة التي سبقت الدراسة وان غالبية المستفيدين هم من الذكور وبنسبة (84٪) من العدد الكلي .الخلاصة : بينت الدراسة بان خدمات الفحص الطوعي الاسترشادي لمرض نقص المناعة المكتسب البشري في بغداد هي اقل من المعايير الوطنية والدولية الموصى بها.التوصيات : تم التوصية بتعزيز بناء القدرات والتدريب لجميع مقدمي خدمات المشورة والفحص لفيروس نقص المناعة البشرية ، تشجيع استخدام الاختبار السريع في جميع المواقع المسؤلة عن تقديم هذه الخدمة، تعزيز العمل بنظام الاحالة، انشاء نظام للرصد والتقييم، ضمان توافر غرف المشورة في جميع المراكز المعنية، وتعبئة المجتمع المحلي للاستفادة من هذا النوع من الخدمات. | Background : Voluntary Counseling and Testing of HIV (VCT) is a cornerstone for early access to prevention, care, and support services in the area of HIV/AIDS. Although VCT has been available at some sites across the Iraq since 2004, there has been no study conducted to evaluate its implementation and performance in Iraq.Objectives : To assess implementation of VCT services in Baghdad governorate according to the national and international standard.Methods : A cross sectional study to (23) VCT sites in Baghdad utilized indicators from the United Nations program on HIV/AIDS (UNAIDS) and the World Health Organization (WHO).Results : The national strategic plan for the National AIDS Program (NAP) is still under preparation, there was no clear Plan for conducting counselors training courses, all surveyed sites were providing HIV testing, 73.9% were providing pre - test counseling, and 17.3% were providing post test counseling. Weak linkage with other health services. 57% of the sites gave the results to their clients in more than one day. 43% of the counselors were not trained and no refresh training has been received by any counselor during the last year. Counseling room and client privacy was not available in 82.6% of the sites while Provision of VCT educational materials and condoms were only conducted in 21.7%. The study show low service utilization by local community with male client represents 84% of all clients.Conclusion The quality of VCT services in Baghdad is below the recommended national and international standards. Recommendations : Capacity - building of counselors according to the international training guideline, using rapid test in all VCT sites, enhancing referrals, establishing a monitoring and evaluation (M&E) system and ensuring availability of counseling rooms and community mobilization to utilize this kind of services.

ارتفاع ضغط الدم الرئوي في مرضى السل الرئوي النشط == Pulmonary Hypertension in Active Pulmonary Tuberculosis Patients

Author name: مروة بسام عيدان
Supervisor name: عدنان الجبوري
General topic: Medicine
Specific topic: Diseases - Thoracic
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: الخلفية : السل الرئوي هو واحد من اكثر الامراض المعدية شيوعا التي تواجهها في الممارسة السريرية، واكثر من ذلك في البلدان النامية. وقد تم الابلاغ عن عدد قليل جدا من الدراسات بشان ارتفاع ضغط الدم الرئوي في السل الرئوي النشط اهداف الدراسة : لتقييم حدوث ارتفاع ضغط الدم الرئوي في مرضى السل الرئوي النشط في غياب امراض الرئة الاخرى او امراض القلب الاولية .المواد والطرق : خلال الفترة من 1 ديسمبر 2016 الى 30 مايو 2017 اجريت دراسة مستعرضة على 50 مريضا بالسل الرئوي النشط. لجميع المرضى، تاريخ مفصل، الفحص السريري الدقيق، تخطيط القلب , الاشعة السينية للصدر، واختبارات الدم الروتينية. جميع المرضى الذين تم تقييمهم عن طريق دوبلرصدى القلب خلال الصدر بما في ذلك تقدير الضغط الانقباضي الشريان الرئوي وثلاثي الشرف الحلقي خطة الحلقة الانقباضي النتائج : . وجد انه من 50 مريض بالسل الرئوي النشط، كان 4 (8٪) ضغط الشريان الانقباضي الشريان الرئوي ≥40 ملم زئبق، اثنان منهم كان تمدد البطين الايمن <16ملموكان هناك ارتباط كبير بين مرضى السل وارتفاع متوسط العمر، (ع = 0.01 )وارتفاع معدل تعديل ضيق مجلس البحث الطبي (ع <0.0001)، والام في الصدر (ع = 0.01)، وانخفاض تركيز الاوكسجين الدم (ع = 0.001) وتسارع دقات القلب الجيبي (ع = 0.01) وانصباب التامور (ع = 0.01). لا توجد فروق ذات دلالة احصائية بين مرضى السل مع وبدون ارتفاع ضغط الرئوي فيما يتعلق بتاريخ البتدخين واستنتاجات اشعة الصدر فيما يتعلق بالمشاركة من جانب واحد وثنائية الجانب وافة تجويفية.الاستنتاج : ارتفاع ضغط الدم الرئوي بين مرضى السل الرئوي النشط في غياب امراض الرئة الاخرى او امراض القلب الاولية ليس بالامرالغير شائع. | Background : Pulmonary tuberculosis is one of the commonest infectious diseases which are encountered in clinical practice, more so in developing countries. Very few studies have been reported regarding the pulmonary hypertension in active pulmonary tuberculosis. Aims of study : To assess the incidence of pulmonary hypertension in active pulmonary tuberculosis patients in the absence of other lung disease or primary cardiac disease. Materials and Methods : During the period from 1st of December 2016 to 30th of May 2017, a cross - sectional study was done on 50 patients with active pulmonary tuberculosis. For all patients, detailed history, careful clinical examination, electrocardiography (ECG), chest x ray (CXR), and routine blood tests were done. All patients evaluated by transthoracic Doppler echocardiography including estimation of pulmonary artery systolic pressure (PASP) and tricuspid annular plane systolic excursion (TAPSE). Results : Among 50 active pulmonary tuberculosis (PTB) patients, 4 had pulmonary artery systolic pressure (PASP) ≥40 mm Hg, 2 of them had right ventricular dilation and TAPSE <16mm. The incidence of pulmonary hypertension (PHT) among active pulmonary tuberculosis (PTB) patients was 8%.There was a significant association between PTB patients with PHT and higher mean age (p=0.01), higher Modified Medical Research Council dyspnea scale (p<0.0001), chest pain (p=0.01), lower oxygen saturation (SpO2) (p=0.001), sinus tachycardia (p=0.01) and Pericardial effusion (p=0.01). No significant differences between PTB patients with and without PHT regarding smoking history and CXR finding of pulmonary tuberculosis lesion regarding unilateral and bilateral involvement and cavitary lesion. Conclusion : Pulmonary hypertension among active pulmonary tuberculosis patients in the absence of other lung disease or primary cardiac disease is not uncommon in this study.

الارتباط بين الموجات فوق الصوتية للوريد البابي الكبدي والنتائج التنظيرية في دوالي المرئ == Correlation between portal vein Doppler ultrasound and endoscopic findings in esophageal varices

Author name: اسراء مزاحم ذاكر
Supervisor name: ليث احمد خلف
General topic: Medicine
Specific topic: Diagnostic Radiology
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: خلفية عن الموضوع : دوالي المريء ، وهو احد المضاعفات الرئيسية لتليف الكبد ، يمكن ان يؤدي الى تهيدد للحياة نتيجة نزيف الجهاز الهضمي.الهدف من البحث : تقييم الاداة التشخيصية للكشف عن دوبلر الوريد البابي (سرعة ، قطر ، مؤشر الازدحام ، وحجم الطحال) للتنبؤ بدوالي المريء.الطرائق : تم تضمين 51 مريضا بالغا يعانون من تليف الكبد في الدراسة. خضع جميع الاشخاص الى الموجات فوق الصوتية في البطن وتنظير المريء. تضمنت مؤشرات الوريد البابي التي تمت دراستها مؤشر الاحتقان الكبدي ، وقطر الوريد البابي ، سرعة الوريد البابي وحجم الطحال. تم حساب حساسيتها ونوعيتها والقيم التنبؤية باستخدام التنظير المريء كمعيار ذهبيالنتائج : كانت الارتباط بين سرعة الوريد البابي ومؤشر الاحتقان الكبدي مع وجود دوالي المريء ذات دلالة احصائية (قيمة p <0.05). كان سرعة الوريد البابي اعلى حساسية 92.7 ٪ للكشف عن وجود دوالي المريء. وكان مؤشر الاحتقان الكبدي اعلى خصوصية من 99 ٪ واعلى قيمة تنبؤية ايجابية من 99 ٪. كانت القيمة التنبؤية السلبية اعلى سرعة الوريد البابي بنسبة 66.7 ٪.استنتاج : يمكن ان يكون دوبلر بالموجات فوق الصوتية بديلا سهلا ، رخيصا وامنا . حيث لا يتوفر تنظير المريء . مؤشرات دوالي الوريد البوابي مفيدة للكشف عن دوالي المريء وافضل مؤشرات الدوبلر سرعة الوريد البابي ومؤشر الاحتقان الكبدي ، في حين ان قطر الوريد البابي قد يكون لها قيمة محدودة للتنبؤ بدوالي المريء | Background : Esophageal varices, a major complication of liver cirrhosis, can lead to life threatening gastrointestinal bleeding.Objective : Evaluate the diagnostic utility of portal vein Doppler findings (velocity, diameter, congestion index ) and spleen size to predict esophageal varices.Methods : A cross sectional study of 51 adult patients with cirrhosis were included in the study. All of them underwent an abdominal ultrasound and esophageal endoscopy. The portal vein indices that were studied included hepatic congestion index, portal vein diameter portal vein velocity and splenic size. Their sensitivity, specificity and predictive values were calculated using esophageal endoscopy as a gold standard. Results : Association of PVV and HCI with presence of EV was statistically significant (p - value <0.05). PVV had the highest sensitivity 92.7% for detecting the presence of EV. HCI had the highest specificity of 99% and the highest positive predictive value of 99%. Negative predictive value was highest for PVV at 66.7%.Conclusion : Doppler Ultrasound can be an easy, cheap and safe alternative, where esophageal endoscopy is not available, available, for triaging patients for referral for esophageal endoscopy. Portal vein Doppler indices are useful for detecting esophageal varices, the best Doppler indices PVV and HCI, while PVD may have a limited value for predicting esophageal varices.

دراسة تجريبية لانزيمات البروتييز للزائفة الزنجارية المعزولة من المرضى العراقيين المصابين بتقرح القرنية ودورها في علاج تقرح القرنية المتسبب عن المكورات العنقودية == Experimental Study of Pseudomonas aeruginosa Proteases Isolated from Corneal Ulcer of Iraqi Patients and Their Role in the Treatment of Staphylococcus aureus Keratitis

Author name: عائدة حسين ابراهيم
Supervisor name: جاسم محمد كرحوت | منيرة جلوب اسماعيل
General topic: Medicine
Specific topic: Microbiology
Degree: Doctorate
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: One - hundred and twenty samples ( corneal scraping) were collected from patients diagnosed to have microbial keratitis (corneal ulcer) who attended Ibn Al - Haitham Teaching Eye Hospital from the period between May 2013 and November 2013, Pseudomonas aeruginosa was reported 26 (21.6%) from the total cases. All bacterial isolates were diagnosed by conventional and biochemical tests, and confirmed by Vitek 2 Compact System.The role of proteases enzymes ( Elastase ( LasB), LasA, Alkaline protease and Protease IV ) of Pseudomonas aeruginosa in the corneal ulcer was studied by using genetic and molecular biological method by real time PCR, and the results indicated that three bacterial isolates of Pseudomonas aeruginosa possessed elastase gene (LasB) (11.5%), and only one bacterial isolate of Pseudomonas aeruginosa harbored LasA protease gene ( 3.8%). All bacterial isolates of Pseudomonas aeruginosa were harbored alkaline protease gene (100%), and twenty bacterial isolates were harbored protease IV (76.9%).The results of real - time PCR analysis indicated that four bacterial isolates of Pseudomonas aeruginosa (15.3%) were harbored more than one gene of different proteases enzymes ( elastase, alkaline protease, and protease IV).On the other hand our results showed that one bacterial isolates (3.8%) harbored both LasA protease and alkaline protease genes, and twenty bacterial isolates of Pseudomonas aerugenosa (76.9%) were harbored alkaline protease and protease IV genes.The LasA protease was extracted from Pseudomonas aeruginosa isolate by cooling centrifuge and precipitated supernatant by ammonium sulfate at saturation (80%). The resulted extracted crude enzyme concentration was 60 μg/ml. Then the crude enzyme was partially purified by dialysis and gel filtration chromatography by using Sephadex G - 100. The concentration of partial purified enzyme reached 40μg/ml.IIISummaryThe results of the experimental treatment of bacterial keratitis ( in vivo) of infected eyes rabbits caused by Methicillin Sensitive Staphylococcus aureus showed that the efficacy of LasA protease was effective was as Lysostaphin in eradicating Methicillin Sensitive Staphylococcus aureus from the infected corneas after approximately 15 h after giving the drug at dose 100 μl ( concentration 1μg / ml ) . While Vancomycin gave us very little potency in eradicating S. aureusfrom corneas in comparison with potency of LasA protease and Lysostaphin duringthis time but showed good potency very late approximately after 3 days of applicationof treatment.The results of the experimental treatment in vitro (in the test tube ) that is caused by Methicillin Sensitive Staphylococcus aureus showed that the efficacy of LasA protease was similar to that of Lysostaphin drug in the killing of Methicillin Sensitive Staphylococcus aureus in the bacterial broth.

تضمين مؤشر ديوك لفحص اجهاد القلب على سعة انتشار اصابة الشرايين التاجية من خلال الفحص القسطاري == The Implication of Duke Treadmill Score (DTS) on The Extent of Coronary artery Lesions by angiography

Author name: طارق مطشر الثويني
Supervisor name: حسن يوسف النجار | حسن علي الفرحان
General topic: Medicine
Specific topic: Diseases - Heart
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: خلفية : يعتبر فحص اجهاد القلب من الوسائل المفيدة في تشخيص امراض الشرايين التاجية للقلب للمرضى اللذين يعانون من الذبحة الصدرية اضافة الى حساب اختطارهم المستقبلي. ان مؤشر ديوك لفحص اجهاد القلب يعد من المؤشرات التي تعطي فكرة جيدة عن تشخيص الذبحة الصدرية اضافة الى تصنيف المرضى حسب نسبة الخطورة والمضاعفات المستقبلية. وتعتمد هذه العلامة على احتساب مدة الفحص ,الام الذبحة اثناء الفحص والتغيرات الحاصلة على تخطيط القلب الكهربائي.الاهداف : لتحديد فائدة مؤشر ديوك في تشخيص امراض الشرايين التاجية للقلب اضافة الى تطبيقها على سعة انتشار الاصابة للمرضى اللذين يعانون من الذبحة الصدرية.طريقة العمل : تم انتخاب عينة من المرضى المحالين الى المركز العراقي لامراض القلب في مجمع مدينة بغداد الطبية /بغداد - العراق للفترة من شهر مايس 2013 الى نهاية شهر نيسان 2014 واللذين يعانون من الام الصدر للاشتباه باصابتهم بالذبحة الصدرية .تمت اجراء المعاينة الاولية للمرضى من ثم اجراء فحص اجهاد القلب حسب بروتوكول بروس القياسي لفحص اجهاد القلب ثم فحص قسطرة الشرايين التاجية التشخيصية وحسب ضوابط الكلية الامريكية لامراض القلب والجمعية الامريكية للقلب.تم تقسيم مؤشر ديوك الى : مؤشر عالي الخطورة اقل من - 11 ومؤشر متوسط الخطورة ويتراوح من اقل من - 11 الى +5 اما المؤشر الاعلى من +5 يعتبر قليل الخطورة.بالنسبة لاصابة الشرايين التاجية تم اعتبار نسبة التضييق ≥70% في الشرايين التاجية,ونسبة تضيق≥50% في الجذع الايسر الرئيسي ذات اهمية. في حين تم اعتبار الاصابة ذات الاهمية في الجذع الايسر الرئيسي او ثلاثة من الشرايين الاخرى الرئيسية اصابة واسعة. النتائج : اظهرت نتائج البحث التالي : معظم المرضى في مجموعة المؤشر العالي (38 مريض من مجموع اربعين ) اي نسبة 95% كانوا مصابين بنسبة ذات اهمية في الشرايين التاجية, و13 مريض كانوا مصابين اصابة واسعة. على العكس من المرضى في مجموعة المؤشر غير العالي كانت النتائج كالتالي : اكثر من نصف المرضى (23 مريض ) لم يتم العثور على اصابة في الشرايين التاجية , 17 مريض كانوا يعانون من اصابة ذات اهمية , ومريض واحد فقط كان يعاني من اصابة واسعة | Background : Exercise testing is a useful tool in the diagnosis of patients with coronary artery disease and predicting their future risk of cardiac events. The Duke treadmill score (DTS) is a composite index that was designed to provide diagnostic and prognostic estimates based on results from the exercise test, including ST - segment deviation, chest pain, and exercise duration.Aim of the study : To assess the diagnostic and the prognostic value of the Duke treadmill score (DTS) in the evaluation and the risk stratification of patients with coronary artery disease.Patients and methods : A cross sectional study was used to assess patients who were referred to The Iraqi Centre for Heart diseases for the evaluation of chest pain by Exercise test followed by coronary angiography for risk stratification according to the ACC/AHA guidelines, during the period from May 2013_ April 2014. A standard Bruce treadmill protocol was used as the exercise technique with calculation of the Duke treadmill score( DTS) as the following : DTS= exercise time (minute) ̶ 5 ×(maximum ST deviation) ̶ 4× ( treadmill angina index), angina index = 0 if no anginal pain, 1 for nonlimiting anginal pain, 2 if angina was why the test terminated.A (DTS) of ≤ - 11 was defined as high risk , a DTS of > - 11 to + 5 was defined as intermediate risk , while a score of > +5 was defined as low risk. A significant coronary artery lesion was defined as follows : ≥ 50% left main stem stenosis or, ≥70% stenosis in other epicardial vessels. The presence of a significant lesion in the left main stem or three epicardial vessels was labeled as extensive coronary artery disease, while non extensive coronary artery disease indicates a significant lesion in one or two epicardial vessels . Results : There were 80 patients included in the study (40 patients were with high risk DTS, the other 40 were with non high risk DTS). The mean age 55.6 ±9.6 years. 61 patients were males (76.0%) and 19 were females (24.0%). There was no significant difference in age groups and means between males and females(p>0.05) . The main risk factors for coronary artery diseases among study participants were hypertension (65%), diabetes mellitus (34.0%) and smoking (43.0%). Participants who had one risk factor represented 40%, those who had two risk factors represented 26.0%, those who had no risk factors represented 18.0%, and those who had three risk factors represented 16.0%. Almost all patients in the high risk group,( 38 patients of the 40) (95%) had a significant coronary artery disease ,whereas thirteen patients of them (32.0%) had extensive coronary artery disease. Conversely more than half of the patients in the non high risk group(23 of total 40 patients) (58%) had no lesions by angiography, and only 17 patients (42%) had a significant coronary artery disease with only one patient of them had an extensive coronary artery disease (P˂0.001) . It had been significantly found that high risk DTS group had more ST - depression than those of non high risk group, the mean ST - depression value was 2.4 ± 0.5 mm for the high risk group patients vs. 1.4 ± 0.5, for the non high risk group patients ,(p<0.001).Conclusion : The composite DTS provides diagnostic and prognostic information for the evaluation of symptomatic patients for clinically suspected ischemic heart disease

تاثير الفيتامينات B1,B6 and B12) على الاعتلال العصبي المحيطي : دراسة نسيجية، نسيجية كيميائية وكيميا نسيجية مناعية == The effect of vitamins B1, B6 and B12 on peripheral neuropathy , Histological , Histochemical and Immunohistological studies

Author name: صالح مهدي علي
Supervisor name: معن حمد الخالصي
General topic: Medicine
Specific topic: Anatomy and Histology and Embryos
Degree: Doctorate
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: Peripheral neuropathy is a nerve injury process by disease or so on leading to damage of peripheral nervous system . Diabetes mellitus and compression are most common causes of peripheral neuropathy. Vitamins (B1,B6 and B12) commonly used for treatment of peripheral neuropathy. The objective of this study is to compare the effect of vitamins (B1,B6 and B12) on nerve regeneration and recovery after induced sciatic nerve crush injury in experimental animal model.Seventy five male Swiss albino rats were divided randomly into five groups and each group consisted of 15 animals. Group A( which considered as control positive(with crush injury) received normal saline intramuscularly for 45days. Group B received vitamin B1 , group C received vitamin B6 , group D received vitamin B12 and group E which considered as control negative(no crush injury and no treatment) . All animals were injected vitamins intramuscularly for 45days. Tail flick test time was reduced in rats treated with vitamin B12 after crush injury to the Sciatic nerve. Mid thigh circumference (MTC) was significantly increase in B12 treated group after crush injury to the Sciatic nerve. Data analysis was performed by SPSS 20 software using descriptive statistics.IVHistological examination of rats sciatic nerves stain by H&E on day 15 showing degenerative nerve fibers with Schwann cell infiltration in all groups but it is less prominent in group D. On day 45 histological examination of rats gastrocnemius muscles exhibited separation of bundles muscle fibers by connective tissue, variation of fibers in size and shape with atrophy of muscle bundles in all groups .While these were less prominent in rats treated with B12.Van Giesons staining of rat sciatic nerves on day 45 after crush injury. In all groups experimental and control (B,C,D,A) showing degenerative nerve fibers in different areas but less in group D and better organized sciatic nerve fibers in group D.Finally, Immunohistochemical study of (anti S100 protein) of rat sciatic nerves on day 45showed strong activity for those rats treated with vitamin B12 while rats treated with vitamin B1 and B6 exhibited moderate and weak activities respectively .In conclusion vitamin B12 promote peripheral nerve regeneration more than vitamin B1and vitamin B6.

التقييم الجزيئي لعوامل الخطورة الوراثية لامراض القلب والاوعية الدموية لعينة من المرضى العراقيين المصابين بنقص التروية القلبية الحاد == Molecular Assessment of Cardiovascular Genetic Risk Factors among a Sample of Iraqi Patients with Ischemic Heart Diseases

Author name: وسام جاسم محمد
Supervisor name: بسام موسى صادق الموسوي
General topic: Medicine
Specific topic: Diseases - Genetics
Degree: Master
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: Ischemic heart disease (IHD) is a major cause of morbidity and mortality worldwide; its incidence is increasing in developing countries. It is estimated that 17.5 million individuals die from CVD each year, accounting for 31% of all deaths worldwide; more than 75% of these deaths occur in low to middle income population. Understanding the pathogenesis of IHD has been modified over the years and many new genetic risk factors have been recognized. Attention is now focused towards understanding the genetic basis of IHD. Enormous effort has been invested in understanding the genes and specific DNA sequence variations responsible for this heritability and genetic polymorphisms might be risk factors that predispose to IHD.Aim of Study : To analyze the genetic risk factors among Iraqi patients with acute IHD and to determine the frequency of each type of mutation / polymorphism.Patients, Materials & Methods : This is a cross sectional study that recruited 56 patients admitted to the Cardiac Care Unit (CCU) of Ibn Al - Nafees Teaching Hospital with a clinical diagnosis of acute ischemic heart disease (myocardial infarction and unstable angina) during a two - month period between December 8th, 2015 and February 8th, 2016. All cases <50 years with acute MI or angina were included, while those >50 years and those with documented hyperlipidemia were excluded.Demographic and clinical data of the enrolled patients were reported. Two - three ml of peripheral blood samples were aspirated from all recruited patients and collected in K2EDTA tube to be store at - 20oC for further DNA analysis. Molecular analysis to detect 12 commonIIImutations/ polymorphisms, namely : FV G1691A (Leiden), FV H1299R (R2), Prothrombin C20210A, Factor Xlll V34L, β - Fibrinogen - 455 G - A, PAI - 1 4G/5G, GPllla L33P (HPA - 1), MTHFR C677T, MTHFR A1298C, ACE l/D, Apo B R3500Q, and Apo E2/E3/E4 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 were detected using streptavidin - alkaline phosphatase and color substrates according to the manufacturers’ instructions.Results : The age range of patients was 18 - 50 years, with a mean ±SD of 40±7 years. The vast majority of enrolled cases were males (54/56 (96.4%). The traditional risk factors were frequently encountered in the current study (hypertension 21.4%, diabetes 26.8%, smoking 75%, family history of IHD 48.2%, and previous attack of ischemia 23.2%). Serum troponin was positive in 72.2% of cases. The study found that the genotype frequencies of 12 genetic mutations / polymorphisms were as follows :  MTHFR A1298C and C677T were the highest reported mutations among the study group (62.5%) and (50%) respectively, followed by β - fibrinogen gene mutation detected in (46.5%), and PAI - 1 4G/5G polymorphism which was detected in (75%) of patients, while PAI - 1 4G/4G was detected in (16.1%) of patients. Homozygous ACE D/D polymorphism was present in 35.7% in our cases and heterozygous HPA - 1(a/b) polymorphisms was present in 28.6%. The E4 allele of Apo E gene was present in 7.1% of the studied cases.IV Heterozygous factor XIII (FXIII) V34L variant was detected in 21.4% patients, while homozygous state was detected in 3.6% patients, i.e. 25% of selected cases had Leu allele,  Heterozygous FV R2 was detected in 12.5%, and factor V Leiden mutation was detected in 1.8%, while no abnormal homozygous alleles were detected.  Prothrombin G20210A mutation were detected in 1(1.8%) patient. Neither heterozygous nor homozygous states for the mutant Apo B allele were detected in this study. The study showed no statistically significant difference between age group I (<40 years) and age group II (40 - 50 years), but the study showed higher frequency for some genes like PAI - 1(4G) and Apo E4 alleles in group I than group II (100% versus 85.3%) and (13.6% versus 2.9%) respectively, while HPA - 1 (a/b) polymorphism was higher frequent in group II than group I (35.3% versus18.2%).Subgroup analysis of the studied traditional risk factors (hypertension, diabetes mellitus, smoking, family history of ischemic heart disease) showed that β - Fibrinogen mutation had higher frequency in smoker patients than nonsmokers (50% versus 35.71%), the D allele of ACE gene was more frequent in hypertensive than in non - hypertensive patients (91.7% versus 79.5%), and higher frequency of HPA - 1b allele in diabetic than non - diabetic patients 46.7% versus 22%).Genetic risk score (0 - 16) was established according to the number of risky alleles detected in each case; the results showed that all patients had at least 2 genetic risk factors and none had more than 8; the study also showed that patients with 4 or more risky genes represented 82.14% of the studied patients, and that the risk of IHD increases in those who carry 4 or more genetic risk factors when associated with at least one traditional risk factor.

تصنيف المرضى العراقيين المصابين بالاورام العصبيه الغديه وتقدير مدى استجابتهم لعقارالساندوستاتين (الاوكتيريوتايد) == NEUROENDOCRINE TUMORS CLASSIFICATION AND RESPONSE TO LONG ACTING SOMATOSTATIN ANALOGUE; AN IRAQI EXPERIENCE

Author name: مروة خالد عبد الفتاح
Supervisor name: منور عبد الاله النقاش
General topic: Medicine
Specific topic: Therapeutic Radiology
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: The lack of studies regarding the incidence of neuroendocrine tumors (NETs) is related to the rarity of these tumors (25/1,000,000). Chromogranin A is a useful tumor marker for NETs diagnosis & follow - up. Octereotide LAR is an established treatment for NETs by both providing symptomatic relief & inhibiting tumor growth. However, studies regarding incidence of NETs & their response to SAS - LAR are still insufficient.Aim of studyTo shade the light on the incidence of NETs, the clinico - pathologic characteristics of Iraqi patients with NETs & their response to long acting Octereotide.Patients & methodsThis is a cross - sectional observational study that was conducted in Oncology teaching hospital/medical city complex using patients’ follow - up sheets. Data recruitment included all NET patients diagnosed after October 2013 to April 2016.ResultsIn our registry, 38 patients were recorded; most patients (60.5%) were over the age of 50 years with male to female ratio (1.2 : 1). We found the gastroenteropancreatic tract being the most common primary organ followed by pelvis . With respect to the GI tract we found that pancreas (26.3 %) was the commonest primary organ. Metastatic disease at presentation was found in (44.7%) of patients with the Liver (15.8%)was the most common metastatic site.Notably, most of our patients presented with G3 disease (44.7%) & (13.2%) with G1 . Serial CgA tests were performed in (17/28) patients used SAS - LAR, with a change in mean value from (225.3 U/L) pre - using the agent to (17.5 U/L) two months after use & to (8.7 U/L) four months after use(p=0.001) while the change in mean of CgA level was from (205.9 U/L) to (200.9 U/L) in 10 patients who did not use octereotide.(p=0.2). After a period of 2 years ,the median time of remission following SAS - LAR administration was 3 months compared to 7 months in patients received other modalities of treatment. In our study, a statistically significant difference was demonstrated between the two groups of patients.(p=0.003).Conclusion Plasma CgA is the most reliable marker for NETs, reflecting the clinical evolution of the disease. Aids in diagnosis & response assessment to different therapies.Octreotide LAR provides symptomatic response & contributes to disease stabilization & tumor regression in both functional & non functional NETs.1 - INTRODUCTION Neuroendocrine tumors are thought to arise from cells throughout the diffuse neuroendocrine system that is composed of peptide - and amine - producing cells that may secrete different hormones depending on the site of origin. NETs are composed of monotonous sheets of small round blue cells with uniform nuclei and cytoplasm(1). They compromise a broad family of tumors, the most common of which are carcinoid tumors (most commonly arise in the lungs & bronchi, small intestine, appendix rectum, or thymus)& pancreatic NETOther neuroendocrine tumors arise from parathyroid, adrenal, pituitary gland, & in calcitonin - producing cells of the thyroid (causing medullary thyroid carcinoma)( 2).Most NETs seem to be sporadic; risk factors for sporadic NET are poorly understood. Risk factors for the development of midgut carcinoid tumors include age, male sex, and increased body mass index, and menopausal hormone therapy (1).NET may also arise in the context of inherited genetic syndromes, include multiple endocrine neoplasia (MEN) types 1& 2 (2).The incidence of gastrointestinal (GI) NETs is 6.2 per 100,000 populations and has been steadily increasing. The increasing incidence of NETs reportedIn many studies is likely multifactorial and includes increased awareness and improved endoscopic methods of detection.As these tumors are indolent and patients survive a long time, the prevalence is quite high, making them the second most prevalent GI tract tumor, second only to colon cancer. Some are clinically silent and have been detected only at autopsy (incidence 8%). Further ,patients with GI NETs have a higher risk of other noncarcinoid primary tumors. The overall 5 - year survival rate of all patients with GI NETs is 28.5%.(1) Of all NETs ∼25% are located in the respiratory tract. Typical carcinoids (TCs) comprise ∼1% - 2% and atypical carcinoids (ACs) only 0.1% - 0.2% of pulmonary neoplasms. According to the surveillance, epidemiology and end results program (SEER) database from 2003, the combined incidence has been 1.57/100 000 inhabitants . The prevalence of thymic NET is ∼3% of the total number of NETs at all sites. In the last SEER database, a reported incidence of thymic NETs is 0.02/100 000 population per year . They constitute ∼5% of all thymic tumors. Both bronchial and thymic NETs may be part of multiple endocrine neoplasia type 1 syndrome (MEN - 1, 5% - 15%). The median age at diagnosis for bronchial NETs is 64 years and for thymic NETs 59 years.(3) The incidence of G1NET increased from 2.0 to 3.0; there was a large increase in G2NET from 0.01 in 1990 to 0.2 in 2010, and of the G3 - LCNET from 0.01 to 1.8, respectively. In G3 - SCNET incidence in men decreased from 21.3 to 10.1, whereas in women it increased from 4.5 to 7.7.(4).

تاثير عمر الام على نتائج الحمل == Effect of maternal age on pregnancy outcome

Author name: حلا نعمان محمدعلي
Supervisor name: جواد كاظم الديوان
General topic: Medicine
Specific topic: Family Medicine
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: خلفية البحث : في العقود القليلة الماضية ،كان هناك تاخير في الحمل الاول ، ومعدل عمر النساء في وقت الولادة تزايدت. يرافق المراهقات الحوامل والحوامل المتقدمات بالعمرمضاعفات اثناء الحمل والولادة. هدف الدراسة : لدراسه تاثير عمر الام على صحه الام والوليد .المنهجية : دراسة مقطعية اجريت في مستشفى بغداد التعليمي للفترة من بداية شهراذار وحتى بداية شهر حزيران من سنة 2016 ،العينة متكونة من( 500امراة) اختيرت بطريقة العينات العشوائية المنتظمة من ملفات المرضى في قسم الاحصاء .تمت جمع المعلومات من قبل الباحثة من فايلات المرضى اللذين دخلوا او رقدوا في ردهات قسم النسائية لسنة 2015 ، ثم تم تصنيفهم حسب العمر الى ستة فئات عمرية المجموعة(<20 )، المجموعة (20 - 24 ) ،المجموعة (25 - 29) ،المجموعة (30 - 34 ) المجموعة(35 - 39)،المجموعة (40≤) .النتائج : اظهرت الدراسة بان هناك فروق ذات دلالة احصائية بين المجاميع العمرية المختلفة ،بالنسبة لوجود ارتفاع ضغط الدم اثناء الحمل ،داء السكري الولادة المبكرة ،وزن الوليد ،التشوهات الولادية ، وفاة الجنين داخل الرحم ،وطريقة الولادة. ولايوجد فروق ذات دلالة احصائية بالنسبة لوجود الاسقاط ،ولادة جنين ميت ،فقر الدم ،والحمل المتعدد. الاستنتاج : اثبتت الدراسة ان مضاعفات الحمل والولادة والمشاكل المتعلقة بالجنين عند الولادة تكون نسبتها اعلى عندالمراهقات الحوامل والنساء المتقدمات بالعمر . | Background : In the last few decades, there has been a delay in first - time pregnancies, and the average age of women at the time of delivery has increased in many countries. Teenage and advanced maternal ages are associated with adverse pregnancy outcomes.Objective : To demonstrate the effect of maternal age on pregnancy outcomes in different age groups mothers.Subjects and methods : Across sectional study was conducted in Baghdad Teaching Hospital, data was collected in obstetric \gynecology department from 1st of March until 1st of June 2016 .Total of 500 women were included in the study using the systemic random sampling, every 10th case was selected, then divided into six age groups, a list of information was taken from hospital record at statistic department.Results : The results showed that there was statistically significant association among different age group, regarding presence of pregnancy induced hypertension, diabetes mellitus, preterm delivery, birth weight, congenital anomalies, IUD, mode of delivery (p value<0.05). Interestingly there was no statistically significant association regarding presence of fetal loss (miscarriage, stillbirth), anemia, and multiple pregnancies (p value> 0.05).Conclusion : Maternal and neonatal complications are higher during the teenage years and advanced maternal age.Keywords : Maternal age, outcome of pregnancy

دور فحص المرونة وسرعة الموجات المقصوصة في التفريق بين الاورام الحميدة والخبيثة في الثدي == USE OF SHEAR WAVE ELASTOGRAPHY TO DIFFERENTIATE BETWEEN BENIGN AND MALIGNANT BREAST MASS

Author name: اوان حكمت محمد
Supervisor name: ليث احمد خلف
General topic: Medicine
Specific topic: Diagnostic Radiology
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine - Department Of Diagnostic Scans
Language: English
University location: Baghdad
First pages:
Abstract: Shear wave elastography is a new method of obtaining elastography images based on the combination of a radiation force induced in a tissue by an ultrasonic beam and an ultrafast imaging sequence capable of catching in real time the propagation of the resulting shear waves.Aim of studyTo assess the performance of shear wave elastography in differentiating between the malignant and benign breast tumors. Patients and Methods A cross sectional study carried out in Breast Clinic at Oncology Teaching Hospital - Baghdad Medical city for period from 1st of November, 2015 to end of June, 2016 convenient sample of 80 women with suspected breast tumor. After full history and examination, enrolled women were examined with ultrasound by the researcher with help of Radiologist.ResultsA highly significant association was observed between women with BIRADS V and high shear wave elastography ratio (p<0.001). Women with BIRADS V had significantly malignant fine needle aspiration findings of breast (p<0.001) and women with high shear wave elastography ratio were significantly had malignant FNA findings (p<0.001). The cutoff shear wave elastography ratio of 3.75 had good validity results (87% sensitivity, 82.4 % specificity).Conclusions Shear wave elastography is non - invasive reliable diagnostic method facilitating characterization of breast tumor.

العلاقة بين متلازمة الالم الليفي العضلي والبهاق : دراسة مقدمة الى كلية الطب - جامعة بغداد - قسم الامراض الباطنية == Relationship Between Fibromyalgia Syndrome and Vitiligo

Author name: علا سفير خضير
Supervisor name: عمار فيصل حميد
General topic: Medicine
Specific topic: Diseases - Joints
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: Background : Fibromyalgia syndrome (FMS) is a common, chronic, and highly disabling syndrome characterized with chronic widespread pain, fatigue, sleep disturbances, cognitive dysfunction and mood disorders. Vitiligo is an acquired pigment disorder which causes disfigurement to skin and negative effect on quality of life (QOL) for patients. There is no previous study on relationship between FMS and vitiligo.Objective : To assess relationship between FMS and vitiligo in a sample of Iraqi patients and to evaluate the predictors of this relationship if present.Patients and methods : A case controlled study involved 100 Iraqi patients with vitiligo and 200 healthy individuals matched for age and sex as a control group. The 2012 Canadian Guidelines criteria were used for the diagnosis of FMS and applied to all Vitiligo patients and controls included in the study. Baseline characteristics of patients with vitiligo and controls were recorded in form of : age, sex, employment condition, and marital status. Body mass index (BMI) was measured for both groups. Patients with vitiligo were fully assessed for : type, duration, severity of disease and medications used.Results : Prevalence of FMS in a sample of Iraqi patients with vitiligo was12% compared to 7% in controls (p=0.15, OR=1.81,95% CI=0.8 - 4.08). FMS symptoms in vitiligo patients were : fatigue 46%, diffuse body pain 34%, sleep disturbance 33%, cognitive dysfunction in 30%, mood disorders 23%, and visceral symptoms : central nervous system (CNS) 52%, skin 35%, gastrointestinal tract (GIT) 32%, cardiovascular system - respiratory system (CVS - RS) 16%, genitourinary tract(GUT) 8%, and ear nose throat (ENT) 7%).There was significant association between the FMS in vitiligo patients and : females with vitiligo 22.2% compared to none among males with vitiligo 0% (P

مشاهدات فحص الرنين المغناطيسي وتحديد دقتها بالاعتماد على ناظور الركبة في تشخيص اصابات الرباط الصليبي الامامي لمفصل الركبة == MRI FINDINGS VERSUS ARTHROSCOPY IN ANTERIOR CRUCIATE LIGAMENT TEAR INJURIES OF THE KNEE JOINT

Author name: لميس عبد الحسين عزيز
Supervisor name: ليث احمد خلف
General topic: Medicine
Specific topic: Diagnostic Radiology
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: فحص الرنين المغناطيسي لمفصل الركبه هومن الفحوص اليومية والمتكررة في قسم الاشعه .ان مفصل الركبة من المفاصل الكبيرة في الجسم ومع ذلك فان ثباته واستقراره يعتمد على مجموعه من الاربطه والعضلات لاسناده وخاصة الاربطه الصليبيه وتعد اصابات الرباط الصليبي الامامي اكثرها شيوعا خاصة في الحوادث الرياضية والتدريب العسكري وحوادث السيارات والدراجات النارية ومنها ما يترتب عليها من تعويضات مادية وقضائية.في الاونه الاخيرةان لفحص الرنين المغناطيسي دور متزايد في تشخيص امراض واصابات الجهاز العضلي الهيكلي نظرا لقدرته علي ابراز تباين الانسجة وتميزها عن بعضها وكونه خالي من مضار الاشعاع المؤين لذا فانه يشجعنا دراسة امكانيات استخدهمه في اصابات الرباط الصليبي الامامي. الهدف من الدراسة : لتحديد دقة فحص الرنين المغناطيسي في تشخيص اصابات الرباط الصليبي الامامي لمفصل الركبه بالاعتماد على ناظورالركبه التشخيصي والعلاجي .حيث ان اصابات اربطة الركبه تعتبر من الاصابات الشائعه التي توءثر على حياة ومماراسات المريض اليومية .لقد تم عمل هذه الدراسة خلال سنة 2014 - 2015 على 65 شخص متعرضين لاصابات في الركبه مع احتمال وجود تمزق في الرباط الصليبي الامامي تم فحصهم سريريا من قبل طبيب استشاري متخصص في امراض العضام والكسور بعد ذلك تم فحص الركبه باستخدام جهاز الرنين المغناطيسي في معهد الاشعة ثم تم التاءكد من نتيجة فحص الرنين باستخدام ناظورالركبه الذي يعتبر تشخيصا نهائيا وهو طريقة جراحية تتيح للطبيب المعالج مشاهدة ومعالجة الرباط الصليبي بشكل مباشر وباقل نسبة خطا ممكنه. الا ان الناظوريعد طريقة جراحية لها مخاطرها وغير سهلة للمرض مقارنة بالرنين المغناطيسي .وتم التوصل للاستنتاج التالي : لقد اظهرت الدراسة دقة عاليه لفحص الرنين المغناطيسي في تشخيص اصابات الرباط الصليبي الامامي (90.7 % ) وحساسية (91%) مما يمكن استخدامه كفحص اولي وبدقه عالية في اصابات اربطة الركبة ممه يغني عن دور التدخل الجراحي التشخيصي لناظور الركبة | Aim of the study : The study was done to analyze the validity of our MRI interpretation in the diagnosis of anterior cruciate ligament (ACL) tear injuries which is a common problem in many peoples impending their daily activities. Material and method : All patients presented to orthopedic consultation clinic with history of knee trauma and suspected anterior cruciate ligament tear injuries during 2014 - 2015 underwent knee joint MRI examination that followed by diagnostic and therapeutic arthroscopic knee surgery. The clinical diagnosis was confirmed during this procedure. From 65 patients MRI diagnose 58 patients as anterior cruciate ligament tears .The accuracy, sensitivity & specificity of MRI were calculated in correlation to arthroscopic finding. Results : our study showed high MRI accuracy (90.7%) , high sensitivity(91%) and specificity(100%) versus arthroscopy. Conclusion : Magnetic resonance imaging is an accurate non ionizing, multiplaner, non - invasive modality, it can be used as first line investigation in patient with soft tissue trauma to the knee & ligamentous injuries confidently that can replace diagnostic arthroscopy

طراز الامراض التنفسية في مستشفى الحسين التعليمي في مدينة السماوة == The Pattern of Respiratory Diseases in Al - Hussain Teaching Hospital in Samawa City

Author name: مثنى فيصل الظالمي
Supervisor name: عدنان الجبوري
General topic: Medicine
Specific topic: Diseases - Thoracic
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: Background : Respiratory diseases are responsible for a major burden of morbidity and untimely death, with conditions such as asthma, pneumonia, tuberculosis, and chronic obstructive pulmonary disease the most important in world health terms..Objective : to estimate the pattern and to determine the incidence of respiratory diseases among patients admitted to medical wards.Patients and Methods : A retrospective study carried out at AL Hussain Teaching hospital in Samawa city )ALMuthana governoret) during a period from October 2013 to July 2014. 951 patient of both genders were enrolled in this study.Results : The mean age of the studied patients was 49.4 ± 18.1 (range : 15 - 99) years; the higher proportion of patients 244/951 (25.7%) aged > 60 years and the least proportion of patients 75/951 (7.9%) aged < 20 year females were the dominant gender among the studied group; 510/951 (53.6%) and the remaining 441/951 patients (46.4%) were males, with a female to male ratio of 1.16 : 1, Smoker patients were 263/951 represented 27.7% of the studied group, Asthma was the more frequent respiratory disease among the studied group (33.3%) followed by Pneumonia in (22.4%),andChronic obstructive pulmonary disease in (22.1%) . The higher mortality rate was reported among the patients with lung cancer (33.3%), followed by ILD (12.5%) .Conclusion : female was the dominant gender among studied group. Asthma was the more prevalent respiratory disease followed by Pneumonia, .the longer duration of admission was reported in patients with lung abscess.The higher mortality rate was reported in patient with Lung cancer followed by Interstitial Lung Disease and Chronic Obstructive Pulmonary Disease.

تقييم الوضيفة الانقباضية للبطين الايسر باستخدام السرعة الانقباضيه للصمام الاكليلي الحلقي لتصوير دوبلر النسيجي في مرضى احتشاء عضله القلب الحاد لاول مره == Evaluation of LV systolic function by using tissue Doppler Pulsed - Wave systolic Mitral annular Velocities(Sm) imaging after first acute myocardial infarction

Author name: عباس عبد لفتة عباس
Supervisor name: علي ال ياسين
General topic: Medicine
Specific topic: Diseases - Heart
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: على الرغم من الاستخدام الشائع لطريقه سمسون في تقيم الوظيفة الانقباضيه للبطين الايسر في مرضى احتشاء العضله القلبيه الحاد لاول مره الا ان لهذه الطريقة محددات عده في تقيم وظيفة وتحديد اماكن الاحتشاء اضافه الى استغراق وقت اكثر في الفحص بينما تقيم الوضيفة الانقباضيه للبطين الايسر هولاء المرضى باستخدام تصوير دوبلر النسيجي لقياس السرعة الانقباضيه للصمام الاكليلي الحلقي يكون اسهل مما قد تحصل عليه بواسطه طريقة سمسون.منهاج البحث : - الدراسه من نوع الحاله - الضابطه اجريت على 60 مريض لديهم احتشاء عضله القلب الحاد لاول مره و30 شخص سليم من (شهر تموز 2013 - شهر تموز 2014) تم قياس السرعه الانقباضيه للصمام الحلقي الاكليلي mS كعامل متغير باستحدام تصوير دوبلر النسيجي لتقيم الوظيفه الانقباضيه للبطين الايسر واجري الفحص خلال فتره اليوم الاول الى اليوم الثالث بعد الدخول المرضى لوحده العنايه المركزيه للقلب في مستشفى بغداد التعليمي بالنسبه للمرضى بينما الاشخاص السليمين تم فحصهم بوحده فحص الايكو(الطابق الثامن) من المستشفى ذاتها.النتائج : - شكل الذكور 65% من المرضى الذين شملتهم الدراسه مع متوسط العمر(45.7 ± 4.1) . اظهرت الدراسه ان نسبه مرضى احتشاء عضلة القلب الحاد الامامي(41.75%) من كل المرضى ,بينما( 28.3%) من المرضى يعانون من احتشاء عضلة القلب الحاد السفلي و(18.3%) من المرضى يعانون من احتشاء عضلة القلب للجدار الوحشي بينما (11.7%) كانوا يعانون من احتشاء عضله القلب للجدار بين البطينين.واظهرت الدراسة ان وظيفة القلب الانقباضيه للبطين الايسر قد اختلت في (60.6%) من مرضى احتشاء عضله القلب الامامي و(24.2%) من مرضى احتشاء عضله القلب السفلي و(9.1%)من مرضى احتشاء عضله الجدار الوحشي للقلب و6.1% من مرضى احتشاء الجدار الفاصل بين البطينين للقلب.كما لوحظ انخفاظا واضح في السرعه الانقباضيه العليا للصمام الاكليلي الحلقي خصوصا عند موضع الاحتشاء مقارنه بالاشخاص السليمين وتكون فروق معنويه احصائيا p value) (<0.05 الاستنتاجات : - ذروه سرعه الصمام الحلقي الاكليلي كما قيمت بواسطه تصوير دوبلر النسيجي انخفضت وتعكس انخفاضا موضعيا وكليا في الوظيفة الانقباضيه للبطين الايسر في مرضى احتشاء عضلة القلب الحاد لاول مره .الوظيفة الانقباضيه للبطين الايسر كانت اكثر اختلالا في مرضى احتشاء عضله القلب الامامي والسفلي.الكلمات الدليليهاحتشاء عضلة القلب الحاد ,الوظيفة الانقباضيه للبطين الايسر ,تصوير دوبلر النسيجي. | Background : - Acute myocardial infarction (MI) may be associated with regional or global left ventricular dysfunction. Although the Simpson’s method is widely used for the global assessment of left ventricular Ejection Fraction (EF) in acute MI, it has limitations of regional LV assessment and time consuming nature while evaluation of left ventricle systolic function (globally and regionally) can be get by measuring mitral annular systolic velocity (Sm) using tissue Doppler imaging (TDI). Aim : - Evaluation of left ventricular systolic function using tissue Doppler Pulsed - Wave systolic Mitral annular Velocities(Sm) imaging and its relation to ejection fraction by Simpson’s method in first acute MI. . Patients and Method : A case control study, from July 2013 - July 2014 was carried out. Total of 60 patients having acute myocardial infarction and 30 normal healthy subjects underwent measuring of Sm at (anterior, inferior, lateral and septal mitral annular sites) by TDI echocardiographic examination and ejection fraction by Simpson’s method as parameters of assessment of left ventricular systolic function (LVSF) on day 1 - 3 after admission with treatment, in CCU of Baghdad hospital (patients) while normal persons evaluated in out clinic of same hospital. . . Results : Total study sample was 90 persons, 30 normal subjects and 60 patients having acute myocardial infarction (MI). The sample was divided into 4 groups, i.e. anterior MI, inferior MI, septal MI, and lateral MI. The patients were 39 men, 21 women and mean age was 53.03 ± 4.64 years SD. There was a marked reduction in peak systolic (Sm) velocity at mitral annulus, especially at the infarction sites (p < 0.001). There was significant positive linear correlation mean Sm and ejection fraction among patients with MI (r =0.787, P = <0.001). Conclusion : Tissue Doppler Imaging is a reliable, and easily reproducible modality of echocardiography. The reduced peak systolic velocity seems to be an expression of regionally reduced systolic functions. While the reduced mean systolic velocity from 4 mitral annulus sites are expressions of globally reduced systolic functions and were correlated well with the ejection fraction. The Left ventricular systolic function was more impaired in anterior and inferior myocardial infarction. Key words : - Acute myocardial infarction, left ventricular systolic function, tissue Doppler imaging.

العلاقة مابين بعض العلامات الحيوية القلبية الحديثة مع درجة التكلس والتصلب في الشرايين التاجية المقاسة : متابعة علاجية بالستاتين == Association of Some Novel Biochemical Markers with Coronary Artery Calcium Score and Stenosis : Follow Up treatment with Statin

Author name: نور نصير نافع
Supervisor name: باسل عويد محمد صالح | صباح موسى فاضل
General topic: Medicine
Specific topic: Clinical Biochemistry
Degree: Doctorate
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: يعد مفراس شرايين القلب القسطاري من احدث الطرق لتشخيص امراض الشرايين التاجية من خلال التصوير المقطعي (CCTA ) للاوعية الدمويه التاجية، والذي يعد من احدث الطرق التي تطورت بشكل ملحوظ خلال العقد الماضي من خلال تلوين الشرايين التاجية بدون تدخل جراحي لتشخيص المرض وبدقة عالية تتناسب درجة مقياس التصلب (Ca - Score) مع شدة التصلب الشرايين التاجية ويحدد درجة تطور المرض فى المراحل الاولى، ويعد الفتيون اي (Fetuin - A) من احدى العوامل السلبية الحادة المتفاعلة الذي لايزال غير معروف من الناحية الوظيفية الفسلجية، وهنالك العديد من الدلائل والدراسات التي توضح دوره المهم في عملية تكلس الاوعية الدموية الاوستيونكتين (Osteonectin) هو بروتين سكري لاصق ويعتبر عامل نضير صماوي تم تشخيصه حديثا من خلال انعكاس دوره في الحالة المرضية للانسجة الدهنية ، مثل اعادة تجدد الاوعية الدموية. ويعد الفسفاتين (Visfatin) نوع من انواع الاديبوسايتوكينات المتعدد الاوجه والذي يلعب دورا مهما في العمليات الايضية من خلال الجزء الخارجي من تركيبه وكذلك دوره في مختلف الاثار الضارة على الاوعية الدموية من خلال الالتهاب والانتشار . وقد برز حديثا دور البنتراكسين 3 (Pentraxin 3) كعلامة جديدة يعتقد انها اكثر تحديدا في التهاب الاوعية الدموية من البروتينات الاخرى في عائلة البنتراكسين مثل ارتفاع البروتين سي الحاد التفاعلي (hs - CRP).الهدفلدراسة العلاقة مابين العلامات الحيوية القلبية الحديثة الفتيون اي والاوستيونكتين والفسفاتين والبنتراكسين 3 والبروتين سي الحاد التفاعلي(hs - CRP)(Pentraxin 3)(Visfatin)(Osteonectin)(Fetuin - A) في المرضى الذين يشتبه باصابتهم بامراض شرايين القلب التاجية الذين لديهم درجه خفيفة الى متوسطة من تكلس الشرايين التاجية ، ثم مقارنة النتائج مع المرضى للذين يشتبه باصابتهم بامراض شرايين القلب التاجية الذين لايعانون من وجود تصلب في الشرايين التاجية وايضا لدراسة دور هذه العلامات الحيوية الحديثة مع درجة التكلس (Ca - Score) ودرجة السمنة (BMI) ومستويات الدهون في الدم المتمثلة بقياس (Cholesterol,HDL,TG) ثم دراسة تاثير علاج الدهون الـ (Statin, atorvastatin 10 - 40 mg ) على مستوى كل من (العلامات الحيويه القلبية الحديثة ومستوى الدهون ) في المرضى المصابين بامراض تصلب شرايين القلب التاجية الذين يعانون من درجة تكلس خفيفة الى متوسطة ( Ca - Score =1 - 399 Agtaston score) .المواضيع اجريت هذه الدراسة في فرع الكيمياء الحياتية في كلية الطب - جامعة بغداد في المختبرات التخصصية لمستشفى ابن البيطار التخصصي لامراض القلب والشرايين خلال الفترة الممتدة من شباط 2013 الى كانون الاول 2013 من خلال تضمين 200 مريض مصاب بامراض تصلب شرايين القلب التاجية ثم ادراج 65 من المرضى المصابين بامراض تصلب شرايين القلب التاجية الذين لايعانون من وجود تصلب في الشرايين التاجية ولا يستخدمون علاج لدهون (Statin, atorvastatin 10 - 40 mg ) تم تشخيص شدة التكلس بالشرايين التاجية من خلال قياس درجة التكلس من خلال جهاز فليبس للانظمة الطبية 64 بريليناس . ثم تقسيم المرضى الى 65 مريضا وعلى ثلاثة اقسام بحسب درجة التكلس لديهم والى ثلاثة مجاميع : المجموعة الاولى تضمنت 20 مريض لديهم درجة تكلس تساوي صفر وتتراوح اعمارهم مابين (31 - 65) سنة، والمجموعة الثانية ذو درجة تكلس خفيفة الى متوسطة ( Ca - Score1 - 399) تتضمن (25) مريض وتتراوح اعمارهم مابين (47 - 74)سنة، والمجموعة الثالثة ذو درجة تصلب شديدة ( Ca - Score ≥400) وتراوح اعمارهم مابين (49 - 75) سنة. تم متابع تاثير علاج الدهون (Statin, atorvastatin 10 - 40 mg ) على مستوى العلامات الحيوية القلبية الحديثة ومستوى الدهون لدى(20) مريض من اصل (25) من المجموعة الثانية تحت اشراف الطبيب الاختصاص في امراض القلب (د.صباح موسى فاضل).النتائجكشفت نتائج هذه الدراسة انخفاض كبيرذو دلالة احصائية في مستويات تركيز كل من : (الاستيونكتين والفسفاتين) مقرون بارتفاع ملحوظ ذو دلادلة احصائية في مستوى تركيز فيتيون اي فضلا عن الارتفاع غير الملحوظ احصائيا في مستوى كل من (البنتراكسين والبروتين سي الحاد التفاعلي) في المرضى المصابين بامراض تصلب الشرايين التاجية المجموعة الثانية والثالثة ذو درجة تكلس الخفيفة الى شديدة مقارنة بالمرضى المصابين بامراض شرايين القلب التاجية الذين لايعانون من وجود تصلب في الشرايين التاجية.وقد اظهرت هذه الدراسة وجود ارتباط سلبي ذو دلالة احصائية لدى المرضى المصابين بامراض شرايين القلب التاجية الذين لايعانون من وجود تصلب في الشرايين التاجية بين الفسفاتين والبنتراكسين3 بينما لوحظ وجود ارتباط سلبي ذولالة احصائية بين الفسفاتين والاوستيونكتين في المرضى بامراض تصلب الشرايين التاجية المجموعة الثانية ذو درجة تكلس الخفيفة الى المتوسطة ولوحظ ايضا وجود ارتباط سلبي ذو دلالة احصائية مابين البنتراكسين والمقياس درجة السمنة من جهة في المرضى المصابين بامراض شرايين القلب التاجية الذين لايعانون من وجود تصلب في الشرايين التاجية مع وجود ارتباط ايجابي ذولالة احصائية مابين البنتراكسين 3 والبروتين سي الحاد التفاعلي لدى المرضى المصابين بامراض شرايين القلب التاجية الذين لايعانون من وجود تصلب في الشرايين التاجية مقارنة بالمرضى المصابين بامراض تصلب الشرايين التاجية المجموعة الثانية والثالثة ذو درجة تكلس خفيفة الى شديدة .وكذلك اظهرت هذه الدراسة ايضا وجود ارتباط سلبي ذو دلالة احصائية مابين الاوستيونكتين والكلوكوز لدى المرضى المصابين بامراض تصلب الشرايين التاجية للمجموعة الثالثة ذو درجة تكلس شديدة بينما وجد ارتباط سلبي ذو دلالة احصائية مابين الفتيون اي ومقياس درجة السمنة من جهة ومابين الفتيون اي ومستوى الكلوكوز من جهة اخرى لدى المرضى المصابين بامراض تصلب الشرايين التاجية ذو درجة تكلس خفيفة الى شديدة فضلا عن وجود ارتباط ايجابي ذو دلالة احصائية مابين البروتين سي الحاد التفاعلي ونسبة مستوى الكلكوز التراكمي بالدم مقارنتا بوجود ارتباط ايجابي ذو دلالة احصائية مع الكلسترول المفيد في الدم في المرضى المصابين بامراض شرايين القلب التاجية الذين لايعانون من وجود تصلب في الشرايين التاجية بينما لوحظ وجود ارتفاع ملحوظ في كل من ( قيمة نسبة مستوى الكلكوز التراكمي ومستوى الدهون الثلاثية) ومستوى كل من ( (non - HDL ,AIفي المرضى المصابين بامراض تصلب الشرايين التاجية المجموعة الثانية ذو درجة تكلس خفيفة الى شديدةو المجموعة الثالثة ذو درجة تكلس شديدة مقارنة بالمرضى المصابين بامراض شرايين القلب التاجية الذين لايعانون من وجود تصلب في الشرايين التاجية. وقد ظهرت هذه الدراسة دور علاج الدهون في انخفاض مستوى كل من الفتيون اي والبنتراكسين3 وزيادة مستوى الدهون المفيد للمرضى المصابين بامراض تصلب الشرايين التاجية المجموعة الثانية ذو درجة تكلس خفيفة الى المتوسطة بعد متابعتهم لمدة تتراوح مابين (6 - 8) شهور. ولوحظ وجود علاقة طردية مابين هذه العلامات القلبية الحيوية الحديثة مع( درجة التصلب وعدد الاوعية القلبية التي حدث فيها التصلب )مع وجود ارتباط مابين درجة التكلس المقاسة من خلال جهاز المفراس مع نسبة التصلب .الاستنتاجنظرا لكون درجة تكلس الشريان التاجي ذو علامة بديلة متزامنة مع امراض تصلب الشرايين التاجية لوحظ تزامن حدوثها مع ارتفاع مستوى الفتيون اي مقارنتا بانخفاض مستوى كل من الاوستيونكتين والفسفاتين مما جعلني اقترح دور هذه العلامات الحيووية القلبية الحديثة في تطور الناحية المرضية المسببة لتصلب الشرايين التاجية على الرغم من ارتفاع مستوى كل من البنتراكسين 3 والحاسة البروتين سي التفاعلي والتي تعكس الدور المهم للالتهاب كعامل اولي وسيط لتقدم المرض. ثم لوحظ دور علاج الدهون بخفض مستوى كل من الفتيون اي وتابنتراكسين 3من خلال (Pleotropic effect ) خلال فترة متابعة (20) من اصل( 25) من المرضى المصابين بامراض تصلب الشرايين القلبية التاجية ذو درجة تكلس خفيفة الى متوسطة لمدة (6 - 8) اشهر. | Coronary Computed Tomography Angiography (CCTA) is a rapidly growing, noninvasive imaging modality that developed quickly over the last decade, and its role for evaluation of Coronary Artery Disease (CAD ) becomes of great promise with high diagnostic accuracy. The presence and extent of Coronary Artery Calcification (CAC) correlates with the overall magnitude of coronary atherosclerotic plaque burden and with the development of subsequent coronary events. Human Fetuin A, is negative acute - phase reactant, its major physiologic functions are not fully understood. Several lines of evidence have suggested that it may play an important role in blood vessel calcification. Osteonectin is an adhesive glycoprotein; it is a newly identified autocrine/paracrine factor that could affect key functions in adipose tissue physiology and pathology through its implication in pathological condition of adipose tissue such as vascular remodelling. Visfatin is an multifaceted adipocytokine, It’s circulating levels are enhanced in different metabolic disease; extracellular part can exert various deleterious effects on vascular cells, including inflammation and proliferation. The Pentraxin - 3 (PTX3) has emerged as a novel marker thought to be more specific to vascular inflammation than other proteins in the PTX3 family such as high sensitive C - reactive protein (hs - CRP). Objective To study the relationship between novel cardiac biomarkers; Fetuin - A, osteonectin , visfatin, PTX3 and hs - CRP in patients with suspected CAD who have mild to severe degree of coronary artery calcification, Ca - Sore (1 - ≥400 ASU),then compare the results to patients with suspected CAD without calcification (Ca - Sore =zero ASU)and to explain the important role of these novel biomarkers in development of CAC , also to the study association of Coronary calcium score and novel biomarkers with obesity markers(BMI), and parameters of dyslipedemia(LDL - cholesterol,HDL - cholesterol).Finally, to demonstrat the effect of statin therapy (Atorvastatin 10 - 40 mg) on both novel biomarker and parameters of hyperlipidemia in patients with mild - to moderate degree of calcification with Ca - Score (1 - 399 )ASU.Subjects This study was conducted at the Department of physiol Biochemistry, College of Medicine, University of Baghdad and at the Cardiologic Clinics of Ibn - Al - Bitar Hospital, Baghdad, Iraq, during the period from February 2013 to November 2013. A total of 200 subjects with suspected Coronary Artery Disease (CAD) were encountered, 65 of them not on statin derivatives treatment were included in this study. These patients were investigated firstly for coronary artery calcium by using Multi - Slice Computed Tomography Scanner (Brilliance 64, Philips Medical Systems). The included 65 patients were classified according to their obtained values of coronary artery Ca score into three groups : Group I (GI) included 20 subjects who have coronary artery Ca score=0.0 Agatston Score unit (ASU), aged range (31 - 65 year) and considered as control group, Group II (GII) involved 25 patients with coronary artery Ca score of more than 1 - 399 ASU, aged range (47 - 74 year) and Group III (GIII) included 20 patients who have coronary artery Ca score of more than 400 ASU, aged range (49 - 75 year).Twenty patients of GII were followed after putting them on atorovastatin therapy (10 - 40 mg/day) for 6 - 8 months under supervision of the Consultant Cardiologist. Investigations included serum measurements of Fetuin A, Osteonectin, Visfatin, PTX3 and hs - CRP by using enzyme immunosorbent assay (ELISA) technique. HbA1c, fasting serum glucose and lipid profile parameters were also measured by using spectrophotometric methods. All investigations were performed in patients of the three groups (GI, GII and GIII) and also in patients post statin treatment. Results The results of this study revealed significant reduction in serum levels of visfatin (P=0.005) and osteonectin (P=0.0001) with significant increased of fetuin A in GIII compared with GI. In GII, serum level of osteonectin was significantly decreased, while Fetuin A significantly increased in comparison with those of GI(for both, P=0.0001). There was no significant differences between GII and GIII in the these three parameters.With regard to the changes in serum concentrations of pentraxin III and hs - CRP, the results found that both of these biochemical markers did not differ significantly among the three groups (GI, GII, and GIII).This study also showed that there was significant negative correlation between visfatin and pentraxin III in G I (r= - 0.495, P=0.027), while in GII, significant negative correlation was observed between visfatin and osteonectin (r= - 0.546, P=0.005). Pentraxin III also showed significant negative correlation with BMI in GI (r= - 0.528, P=0.017), significant positive correlation with BMI in GII (r=0.406, P=0.044) and significant positive correlation with with hs - CRP (r=0.482, P=0.031) in G I. In GIII, pentraxin III showed significant negative correlation with ostonectin (r= - 0.489, P=0.029). There is significant negative correlation of osteonectin with glucose in GIII (r=0.566, P=0.009) , In GII and GIII, Fetuin A showed significant negative correlation with BMI values (r= - 0.424, P=0.035)and with serum glucose (r= - .444, P=0.049) . Respectively in G I, hs - CRP concentration was found to be significantly positively correlated with HbA1c (r= - 0.509, P=0.022).The mean value of HbA1c was found to be significantly increased in GIII compared with GI (P=0.03). The serum level of TG was significantly increased in GIII and GII in comparison to G I (p= 0.019).The mean value of serum HDL - C levels of GIII was significantly decreased in comparison with that of GI (P=0.044). The serum level of VLDL is significantly decreased in both GI and GII compared to G III (P=0. 019.The mean value of non - HDL was significantly higher in GIII than in GII and that of GI (P=0. 0289), The mean values of atherogenic index of GIII and GII were significantly higher than in GI along with significant differences between that of GI and that of GII and III(P =0.0008).The present study showed the effect of complete course of statin treatment on the serum levels of novel cardiac biomarkers, the most effected one was serum PTX3 with significant decrease of its serum levels after treatment compared to that before treatment of the same patients group (P=0.0001) combined with significant decrease in serum level of Fetuin A (p=0.027) after complete course of statin treatment. In addition, there was significant increased of serum of HDL in patients after complete course of treatment compared to their concentration before starting treatment (P= 0.0001). Significant correlations were also observed between the novel studied biochemical markers and the degree and number of the major coronary arteries stenosis as well as between Ca score and stenosis.

تقييم كفاءة بطانة الاوعية الدموية باستخدام الفحوصات == ASSESSMENT OF ENDOTHELIAL FUNCTION BY NON INVASIVE INVESTIGATIONS IN CORONARY ARTERY DISEASE

Author name: صبا فوزي صالح
Supervisor name: نجيب حسن محمد | عباس ناجي مسلم
General topic: Medicine
Specific topic: Physiology
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: Arterial endothelial dysfunction is one of the key early events in atherogenesis, even preceding the structural atherosclerotic changes that might developed in systemic arteries. However, endothelial function can be assessed through flow mediated dilatation of brachial artery using an ultrasound - based method (Doppler) before and after the shear stress test which causes endothelium - dependent dilatation induced by endothelial Nitric Oxide release.Thus, flow mediated dilatation of brachial artery; the noninvasive endothelial function testing has provided valuable insights into an early atherogenesis and constitutes a helpful test in the detection of coronary atherosclerosis when compared with that of invasive testing of coronary endothelial function. On the other hand, an impairment of flow mediated dilatation in Brachial artery is related to the presence and / or extent and severity of Coronary Artery Disease. While, arterial stiffness index (SI) is widely used as a very sensitive indicator of endothelial dysfunction , arterial intima media thickness which reflects the structural vascular damage is established as a marker of atherosclerosis and has been associated with both incident and prevalent cardiovascular disease. This study was designed to : (1) Assess the role of flow mediated dilatation of brachial artery as a marker of systemic endothelial function,(2)Correlate between flow mediated dilatation of brachial artery with the presence, extent and severity of Coronary Artery Disease (CAD),(3)Find out the association between stiffness index (functional vascular damage) and intima media thickness (structural vascular damage) with the severity and extent of CAD,(4)Evaluate the effect of body mass index, waist to hip ratio and lipid profile on vascular endothelium.Sixty nine (69) patients with chest pain of either sex (46males, 23 females), in addition to 31 control subjects (15males, 16 females) with negative coronary CT angiography findings, all with an age range of (40 - 65years) were involved in this study. In addition to Demographic data and physical measurements, each subject was submitted to medical history, clinical examination, estimation of lipid profile, shear stress test, high - resolution external vascular Doppler ultrasound for brachial and carotid arteries (FMD%, stiffness index, intima media thickness), in addition to the computed tomography angiography (CT) scanning for the coronaries. The shear stress test involves occlusion of brachial artery in the upper arm for 5 minutes using a pressure cuff inducing reactive hyperemia after the cuff is released. However, this study was carried out in the Radiology Department at Al - Yarmook Teaching Hospital, Baghdad from October 2013 till March 2015.According to the coronary CT angiographic findings, patients were classified into three groups : single coronary lesion (SCL), multiple coronary lesion (MCL) and control groups. The results revealed that the FMD% in patients groups (SCL, MCL) is significantly lower than that of control group( P≤0.001, P≤0.01) respectively and it is inversely correlated with percentage of coronary artery stenosis in SCL group (P≤0.01, r=0.433) and with that of SI of both brachial and carotid arteries in both SCL, MCL groups, while a significant difference in SI is noticed between the MCL group and that of control regarding the carotid artery (P≤0.05). A positive statistical correlation is observed between the SI of brachial and carotidarteries among the studied groups, whereas a significant positive statistical correlation is found between the SI of carotid, brachial arteries with the percentage of coronary artery stenosis in SCL group (P≤0.05). Arterial IMT are significantly higher in MCL when compared with SCL (P≤0.0s) which is again significantly higher than control (P≤0.001). A positive correlation is observed between the arterial IMT with the percentage of coronary artery stenosis in SCL group(P≤0.05). Left anterior descending artery showed higher frequency of involvement by atheromatous stenosis (47%) when compared with that of Left main artery with a fequency of (13.72%). However, in MCL group, there was a higher frequency among males (88%) in respect to females (12%).In conclusion, the data of this study revealed that FMD is a useful, non invasive test for the assessment of vascular endothelial dysfunction. Arterial SI which reflects functional vascular damage is a good indicator of coronary artery disease. In addition, arterial intima media thickness can be used as a screening tool for coronary artery disease as it is sensitive indicator of structural vascular damage.

حدوث الاصابة بهشاشة العظام في مرضى الانسداد الرئوي المزمن في مستشفى بغداد وعلاقته بمختلف العوامل الخطره == Occurance of Osteoporosis in COPD Patients in Baghdad Teaching Hospital and Its Relation to Varios Risk Factors

Author name: عباس مصطفى حسن
Supervisor name: عدنان محمد الجبوري
General topic: Medicine
Specific topic: Diseases - Thoracic
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: Background : Chronic obstructive pulmonary disease (COPD) is a syndrome of progressive airflow limitation caused by the abnormal inflammatory reaction of the airway and lung parenchyma. Osteoporosis is one of the major extrapulmonary manifestations of COPD. The, prevalence of osteoporosis in COPD patients in Iraqi population is unknown.Objectives : To study the incidence of osteoporosis among COPD patients and its relations to various risk factors.Materials and Methods : The study was done in Baghdad Teaching hospital.All the diagnosed cases of 70 COPD patients according to the GOLD guidelines were included in this study. The present study was a cross sectional study during a period of August 2014 - Octoper 2015 . A brief history of the patients was taken, especially regarding duration of illness, number of exacerbations in the past 3 years, smoking in pack years, and history of steroid use (both systemic and inhaled steroids) after which cumulative dose of steroids was calculated. Spirometry was done in all these patients to stage the severity of COPD according to GOLD criteria. DEXA scan of the lumbar spine was done using bone densitometer to determine osteoporosis. (WHO) criterion for definition of osteoporosis was applied and patients with T - score of below −2.5 standarddeviation (SD) were diagnosed to have osteoporosis, −1 SD to −2.5 SD were diagnosed to have osteopenia and more than −1 SD as normal.Results : A total of 70 COPD patients were included in this study, Among these, 36 patients (51.4%) had osteoporosis and 23 patients (32.8%) had osteopenia.Majority (94.4%) of the patients who had osteoporosis had stage III and stage IV COPD disease. It was observed that as the severity grade of COPD increased , the risk of osteoporosis also increased. The bone mineral density (BMD) showed a significant difference among different stages of COPD. It was also observed that patients with lower body mass index (BMI) had higher prevalence of osteoporosis (91.7%) as compared to overweight patients. On univariate analysis, it was observed that risk factors for osteoporosis were female sex, higher number of exacerbations, BMI, and severity of COPD. After using multivariate analysis, stage IV COPD , number of acute exacerbations >3 in the previous 3 years , and steroid cumulative dose >1000 mg were observed to be significant risk factors for osteoporosis in COPD patients.

ازدياد تعبيرالمعلمة الجزيئية miR - 21 التي تتوسط هبوط منتظم لجين PTEN في سرطان الثدي ومصاحبتها مع عوامل التنبؤ المعروفة == MicroRNA - 21 overexpression mediated phosphatase with homology to tensin (PTEN) downregulated in breast cancer in association with clinicopathological status

Author name: شروق محمد عباس التميمي
Supervisor name: سالم رشيد حمودي العبيدي | علي حسين الخفاجي
General topic: Medicine
Specific topic: Tissue Diseases
Degree: Doctorate
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: الخلفية : - سرطان الثدي هو الاكثر شيوعا في النساء في كل انحاء العالم . الموروث ( PTEN) هو الموروث المثبط للسرطان ,وهو منظم عكسي(اي مثبط)لاهم طريق لحدوث نمو وتكاثر الخلايا .المعلمة الجزيئية مثل ( miR - 21) هي الجزيئة الاولى التي تم اكتشافها التي تساعد على نمو وتكاثر الخلايا النامية وتمنع موت الخلايا ,اي تطيل من عمر الخلايا النامية. اذا حدث تغير في جزيئة ( miR - 21) وازداد عملها عن الحالة الطبيعية تؤدي الى حدوث نمو مستمر بدون موت الخلايا النامية مما يودي الى حدوث الخلايا السرطانية بالاضافة الى تاثيره على الموروث المثبط لنمو السرطان وهو (PTEN )الذي يعتبر موروث مستهدف له, بحيث يستطيع منع عمل هذا الموروث لذلك يؤدي الى حدوث سرطان الثدي .الهدف من الدراسة : - قياس تعبير المعلمة الجزيئية ( miR - 21) والموروث ((PTEN لمعرفة (زياده او نقصان) على اعتبارهم متغيرات حقيقية عن النسيج الطبيعي وعوامل التنبؤ لسرطان الثدي . المواد وطرائق العمل : - هذه الدراسة هي دراسة تجريبية من الشهر الاول سنة 2013 الى الشهر الاول سنه 2015.تم اخذ خمسين زوجا من العينات, وهذه العينات تؤخذ من سرطان الثدي ومن النسيج الطبيعي للثدي من النساء اللواتي تم استئصال ثديهن بسبب السرطان وهذه العينات تم اخذها في صالة العمليات وكانت العينات طازجة. تم استخلاص شريط ال RNA ثم بعد ذلك تم فحص جزيئة ال (miR - 21) وموروث(PTEN) . وتم تطبيق الواسم المناعي النسيجي الكيمياوي ((IHC لهرمون الاستروجين والبروجستين معher - 2 في العينات التي تم وضعها في بلوكات الشمع وبعد ذلك تم اختيار الحالات الموجبة ل(her - 2)وفحص تضاعف الموروث ( HER - 2) بواسطه تهجين موضعي ذي لونين .النتائج : - معظم الحالات كانت جزيئة ال( miR - 21) مرتفعة في النسيج السرطاني عن ماهو في النسيج الطبيعي وكانت احسن قيمة له (2.940 ) كدليل على ان الجزيئة تغيرت عن قيمته الطبيعية ,وكانت احسن قيمة له (4.156) في حالات انتشار السرطان في العقد اللمفاوية ,وقيمة (6.340 ) كدليل على المراحل المتقدمة من سرطان الثدي .بينما الموروث ( PTEN) كان في جميع الحالات منخفض عن النسيج الطبيعي واحسن قيمة له (0.210) كدليل لتغير تعبيرالموروث عن النسيج الطبيعي , وكانت القيمة) 0.175) دليل انتشاره الى الغدد اللمفاوية, وقيمة (0.098) تمثل المراحل المتقدمة من سرطان الثدي . هنالك علاقه عكسية بين جزيئة ال( miR - 21) والموروث ( PTEN) ولايوجد اي علاقة احصائية بين هذه المتغيرات وبين بقية عوامل التنبؤ الاخرى المعروفة في سرطان الثدي . الاستنتاجات : - التغير في التعبير كل من جزيئة ال ( miR - 21) والموروث (PTEN ) في جميع حالات سرطان الثدي وهنالك علاقة احصائية مع انتشار المرض الى العقد اللمفاوية ومع المراحل المتقدمة من سرطان الثدي . هنالك علاقة احصائية عكسية بين ازدياد التعبير للجزيئة (miR - 21) وانخفاض التعبيرللموروث (PTEN) في عينات سرطان الثدي . | Background : - Breast cancer is the most common cancer in women in worldwide. The phosphatase and tensin homolog gene is a tumor suppressor gene, and a key negatively regulator of cell signaling pathways that regulate growth and survival signaling pathways . More recently, microRNAs are small non protein coding RNAs involved in gene regulation. MicroRNA - 21 was one of the first oncogenic microRNAs and as an anti - apoptotic factor, to be characterized, being up - regulated in numerous tumors including breast cancer. The phosphatase and tensin homolog gene is one of microRNA - 21target genes Aim of the study : - To assess the validity of microRNA - 21 and phosphatase and tensin homolog (PTEN) gene expression as a diagnostic tool for gene alteration .Patients and Methods : - A prospective study , from January 2013 to January 2015. Fifty - pairs of fresh tissues from both breast cancer of invasive ductal carcinoma "NOS" and apparently normal adjacent tissues (from modify radical mastectomy) were by patients were recruited at the Surgical Department /Al - Diawania Teaching Hospital in Al - Diawania city . Total RNA extraction and real - time quantitative polymerize chain reaction technique were used for assessment of microRNA - 21 and phosphatase and tensin homolog gene expression. Tissue sample present in the paraffin embedded blocks belonging to tumor and normal adjacent tissue were used for Immunohistochemistry staining for (estrogen receptor, progesterone receptor and human epidermal growth factor receptor - 2) and dual color - chromogenic insitu hybridization technique for positive human epidermal growth factor receptor - 2 by Immunohistochemistry.Results : - Majority of cases 48(96%) ,were up regulated of microRNA - 21, indicating cancer tissue fold change of microRNA - 21 was significantly higher than that of normal adjacent breast tissue, and the best cutoff value for microRNA - 21 fold change in breast cancer tissues was (2.940)for diagnosis of gene alteration , (≥ 4.156) for positive lymph node involvement and (≥6.340) for higher stage (III,VI).All patients 50(100%) exhibit phosphatase and tensin homolog gene expression down regulation, indicating fold change of cancer tissue for phosphatase and tensin homolog gene expression was significantly lower than that of normal adjacent tissue and the best cutoff value for gene expressional alteration in breast cancer tissues was (0.210) for diagnosis of gene alteration, (≤ 0.175) for positive lymph node involvement and ( ≤ 0.098) for higher stage (III,VI) .Up - regulation of microRNA - A21 and down regulation of phosphatase and tensin homolog gene expression show no significantly correlate with other patients criteria like (age , grade ,size of tumor ,( estrogen receptor, progesterone receptor and human epidermal growth factor receptor - 2) by Immunohistochemical technique and human epidermal growth factor receptor - 2 gene amplification by dual color - chromogenic insitu hybridization technique . Identified significant negative correlation of up - regulation microRNA - 21 and down regulation of phosphatase and tensin homolog gene expression in breast cancer tissues.Conclusion : - gene expression of both microRNA - 21 and phosphatase and tensin homolog was significantly alterated in breast cancer tissues . It has been associated with positive lymph node involvement and higher tumor stage (III,VI)

تقييم وظائف البطين الايسر والبطين الايمن باستخدام معامل كفائة عضلة القلب في مرضى انسداد الشعب الهوائية المزمن == Assessment of left and right ventricular functions by myocardia performance index in patients with chronic pulmonary disease

Author name: ازهر عباس ناصر
Supervisor name: باسل نجيب سعيد الدليمي
General topic: Medicine
Specific topic: Echocardiography
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: انسداد الشعب الهوائية المزمن هو كيان شائع في الممارسة السريرية. ان حدوث تضخم البطين الايمن للقلب وعجر القلب اليمن هو شائع في مثل هؤلاء المرضى. ومع ذلك يحدث بعض الاضطراب في وظيفة البطين الايسر بين هؤلاء المرضى.الارتباط بين انسداد الشعب الهوائية المزمن وعجز القلب قد تم وصفه سابقا. غير ان الارتباط بين مرض انسداد الشعب الهوائية المزمن والخلل الوظيفي للبطين الايسر بدون وجود اعراض هو اقل فهما.تاثيرات مرض انسداد الشعب الهوائية المزمن على وظائف البطين الايمن الانقباضية والانبساطية وعلى وظائف البطين الايسر الانبساطية ,قد تم اثباته. في حين ان معامل كفاءة عضلة البطين الايسر للقلب ، الذي يتضمن زمن قذف البطين وزمن الانبساط وزمن الانقباض ,هو مؤشر وظيفة البطين الشاملة، لم يتم تقييمه في مرض انسداد الشعب الهوائية المزمن.المرضى الذين لديهم ضغط مفرط في البطين الايمن غالبا ما لديهم فشل في وظيفة البطين الايسر الانبساطية.الهدف من الدراسة : تهدف هذه الدراسة الى تقييم الوظيفة الشاملة للبطين الايسر والبطين الايمن للقلب في المرضى الذين يعانون من مرض انسداد الشعب الهوائية المزمن مع او دون ارتفاع ضغط الدم الرئوي باستخدام معامل كفاءة عضلة البطين لمعرفة العلاقة بين نتائج ايكو القلب وشدة مرض انسداد الشعب الهوائية ، اذا كان هناك اي منها.المرضى وطريقة العمل : 60 مريضا يعانون من مرض انسداد الشعب الهوائية المزمن وغير مصابين بامراض القلب [30 مريضا لديهم مرض انسداد الشعب الهوائية المزمن بدون ارتفاع ضغط الدم الرئوي (المجموعة 2), و30 مريض لديهم مرض انسداد الشعب الهوائية المزمن مع ارتفاع ضغط الدم الرئوي (المجموعة 3)] و30 شخص سليم ومطابق للعمر والجنس تم ادراجهم في هذه الدراسة. خضع جميع المرضى للتقييم السريري، فحص وظائف الرئة، تخطيط القلب وفحص ايكوالقلب القياسي والدوبلر النسيجي. مختلف قياسات الايكو الخاصة بوظيفة البطين الايسر والبطين الايمن تم مقارنتها مع مؤشرات وظائف الرئتين وضغط الشرياني الرئوي. تم قياس معامل كفاءة عضلة البطين الايمن ومعامل كفاءة عضلة البطين الايسر للقلب باستخدام الدوبلر النسيجي النبضي.النتائج : 60 مريض قد تم ادراجهم في الدراسة. كان اعمارهم بين 56 - 68 سنة. كان متوسط العمر 61.47 عاما والانحراف المعياري ± 7.47 سنوات.كان هناك 83% ذكور و17% اناث في الدراسة. 19 مريض (63.3 %)من الذين لديهم مرض انسداد الشعب الهوائية المزمن مع ارتفاع ضغط الشريان الرئوي و15 مريض (50 %) من الذين لديهم مرض انسداد الشعب الهوائية المزمن دون ارتفاع ضغط الشريان الرئوي كان مرض انسداد الشعب الهوائية المزمن شديد بينما 11مريض (36.7 %) من الذين لديهم مرض انسداد الشعب الهوائية المزمن مع ارتفاع ضغط الشريان الرئوي و15 (50 %) من الذين لديهم مرض انسداد الشعب الهوائية المزمن دون ارتفاع ضغط الشريان كان مرض انسداد الشعب الهوائية معتدل. كان الانسداد القصبي شديد في المجموعة 1) حجم الزفير القسري49,973±5,303%) والمجموعة 2 (حجم الزفير القسري 44.58 ± 7.45% ) وليس هناك ضعف في فعالية التهوية في مجموعة الاشخاص السليمين.معامل كفاءة عضلة البطين الايمن كان اعلى في المجموعة 2 (0.57 ± 0.11) والمجموعة 3 (0.96 ± 0.05) من المجوعة 1 (0.42 ± 0.043001) (. P <), وكان اعلى في المجموعة 3 من المجموعة 2 (P <.001).معامل كفاءة عضلة البطين الايسركان اعلى في المجموعة 3 (0.7 ± 0.083) من المجموعة 1 (0.5 ± 0.034) والمجموعة 2 (0.56 ± 0.037) (P< .001).للمرضى المصابين بمرض انسداد الشعب الهوائية المزمن ، كان معامل كفاءة عضلة البطين الايسرمرتبط بعلاقة طردية مع العمر ,معدل نبضات القلب, ضغط الشرياني الرئوي الانقباضي ومعامل كفاءة عضلة البطين الايمن ويرتبط بشكل سلبي مع السيوح الانقباضي للمستوى الحلقي للصمام الثلاثي وحجم الزفير القسري في الثانية 1. في تحليل الانحدار الخطي المتعدد , (R=0.674) معامل كفاءة عضلة البطين الايسر ترتبط بصورة مستقلة بحجم الزفير القسري في ثانية واحدة(Beta =1.133, P = 0.007), ضغط الشرياني الرئوي الانقباضي(Beta= - 0.758, P=0.128) ومعامل كفاءة عضلة البطين الايمن (Beta=1.436, P=0.009). مؤشرات وظيفة البطين الايسر الانبساطية (A, E/A, and deceleration time of E) كانت ضعيفة في المجموعة 3 والمجموعة 2 بالمقارنة مع المجموعة1. نسبة السرعة الانبساطية المبكرة لحلقة الصمام الاكليلي الى السرعة الانبساطية المتاخرة(Em/Am) كانت اقل بكثير في مرضى انسداد الشعب الهوائية المزمن الذين لديهم ارتفاع ضغط الشريان الرئوي(0.77±0.066)،وكان وقت الاسترخاء للبطين الايسر اطول بكثير في المجموعة 3(105.43±4.21ms) والمجموعة 2(102.27±4.45ms) بالمقارنة مع مجموعةالسليمين(71.2±5.51ms).وظيفة البطين الايمن الانبساطية, نسبة السرعة الانبساطية المبكرة الى السرعة الانبساطية المتاخرة (E/A)اعلى في الاشخاص السليمين بالمقارنة مع مجموعات المرضى. وقد كان نسبة سرعات التدفق للصمام الثلاثي(نسبة السرعة الانبساطية المبكرة الى السرعة الانبساطية المتاخرة) اقل قيمة بكثير في مرضى انسداد الشعب الهوائية المزمن الذين لديهم ارتفاع ضغط الشريان الرئوي(0.84 ± 0.04) وكان وقت الاسترخاء اطول بكثير في المجموعة 3 (98.87 ± 8.41ms) والمجموعة2 (77.5 ± 4.57ms) بالمقارنة مع الاشخاص السليمين (75.37±5.2) . كان قطر البطين الايسر الانبساطي اقل بكثير في المجموعة 3 (40 ± 2.665) من المجموعة 1(46.2 ± 2.295) والمجموعة2 (44.2 ± 3.367). سرعة حلقة الصمام التاجي (s') كانت الاقل في المجموعة 3 . (9.64 ± 0.92) ولكن المؤشرات التقليدية للوظيفة الانقباضية وسمك الحاجزبين البطينين في الانبساط لا تختلف بين المجموعات.كانت اقطار البطين الايمن الانقباظية والانبساطية اعلى وكان التقصير الكسري للبطين الايمن اقل في المجموعة 3 من المجموعتين الاخريين. كانت حركة حلقة الصمام الثلاثي الانقباظية اقل بكثير في المجموعة 3 (16.07 ± 3.54) بالمقارنة مع المجموعة 1 (21.7 ± 2.71)والمجموعة2 (20.83 ± 2.69) ,ولكن الاختلافات بين المجموعة 1 و2 غير هامة احصائيا.الخاتمة : كانت كلا وظيفتي البطين الايسر الانقباظية والانبساطية عاجزة في مرض انسداد الشعب الهوائية المزمن خاصة في المرضى الذين لديهم ارتفاع ضغط الشريان الرئوي . هذا العجز يرتبط بصورة مستقلة بضغط الشريان الرئوي الانقباضي,معامل كفاءة عضلة البطين الايمن وحجم الزفير القسري في الثانية1.الوظيفة الانبساطية للبطين الايسر والبطين الايمن والوظيفة الشاملة للبطين الايسر والبطين الايمن تتاثر في مرضى انسداد الشعب الهوائية المزمن وخاصة مع تطور المرض. مرضى انسداد الشعب الهوائية المزمن والذين لديهم ارتفاع ضغط الدم الرئوي اكثر عرضة لعجز القلب الايسر والايمن الانبساطي والشامل من المرض الذين لديهم ضغط شريان رئوي طبيعي. دوبلر انسجة القلب هو اداة افضل في تقييم وظائف البطين الايسروالبطين الايمن | Development of right ventricular hypertrophy and eventual right side heart failure is common in patients with Chronic obstructive pulmonary disease (COPD). However, some disturbance in left ventricular (LV) function has been observed among such patients.The co - existence between chronic obstructive pulmonary disease (COPD) and heart failure has been previously described. However, the co - existence between COPD and subclinical LV dysfunction, without the presence of heart failure symptoms, is less well understood.The aim of the study : The aim of this study was to evaluate global function of the LV and RV in patients with chronic obstructive pulmonary disease (COPD) with or without pulmonary hypertension(PH) by using myocardial performance index (MPI) and find out the correlation between echocardiographic findings and severity of COPD.Patients and methods : Sixty patients with COPD without additional cardiac diseases [30 patients with COPD without PH (group 2), and 30 patients with COPD with PH (group 3)] and 30 age and sex - matched healthy subjects (group 1) were enrolled into the study. All patients underwent clinical evaluation, spirometry, electrocardiography and standard and tissue Doppler echocardiography. Various echocardiographic parameters of LV and RV functions were compared with indices of pulmonary function test and pulmonary arterial pressure. RV myocardial performance index (RVMPI) and LVMPI were obtained by pulsed wave Doppler tissue.Results : RVMPI was higher in both group 2 (0.57 ± 0.11) and group 3 (0.96 ± 0.05) than group 1 (0.42 ± 0.043) (P< .001), and was higher for group 3 than in group 2 (P< .001). LVMPI was higher for group 3 (0.7 ± 0.083) than in both group 1 (0.5 ± 0.034) and group 2 (0.56 ± 0.037) (P <.001). For patients with COPD, LVMPI was positively correlated with age, heart rate, pulmonary arterial systolic pressure and RVMPI and negatively correlated with tricuspid annular plane systolic excursion and forced expiratory volume in 1 second. In multiple linear regression analysis (R=0.674), LVMPI was independently associated with forced expiratory volume in 1 second (FEV1) (Beta =1.133, P = 0.007), pulmonary arterial systolic pressure (Beta= - 0.758, P=0.128), and RVMPI (Beta =1.436, p=0.009).LV diastolic function parameters (A, E/A, and deceleration time of E) were impaired for groups 2 and 3 compared with group 1. Mitral early diastolic and late diastolic annular velocities ratio (Em/Am), were significantly lowest in COPD patients with PH(0.77±0.066), and the isovolumetric relaxation time (IVRT) was significantly longer in group 3(105.43±4.21ms) and group 2(102.27±4.45ms) in relation to control group(71.2±5.51ms).RV diastolic function, E/A ratio was higher in the control subjects compared with the patient groups. The tricuspid inflow velocities ratio (E/A) was significantly lowest value in COPD patients with PH (0.84 ± 0.04) and the isovolumetric relaxation time (IVRT) was significantly longer in group 3(98.87 ± 8.41ms) and group 2(77.5 ± 4.57ms) in relation to control group (75.37±5.2). LV end - diastolic diameter was significantly lower for group 3 (40 ± 2.665) than group 1(46.2 ± 2.295) and group 2(44.2 ± 3.367). LV mitral valve annular velocity (S') was lowest in goup3 (9.64 ± 0.92). However, conventional systolic function parameters and IVSd were not different among the groups. Systolic and diastolic RV diameters were higher and RV fractional shortening was lower for group 3 than the other two groups. TAPSE was significantly lower for group 3(16.07 ± 3.54) compared with group 1(21.7 ± 2.71) and group2 (20.83 ± 2.69), but differences between groups 1 and 2 was not statistically significant. Conclusion : Both LV systolic and diastolic functions are impaired in COPD, especially in patients with PH. This impairment is independently associated with pulmonary arterial systolic pressure, RVMPI, and FEV1. Left and right ventricular diastolic function and LV and RV global function are affected in COPD patients especially with progression of the disease. COPD patients with pulmonary hypertension are more liable to LV and RV diastolic and global dysfunction than normal pulmonary pressure COPD patients. Doppler tissue echocardiography is a better tool in the assessment of LV, RV function.

الخصائص الوبائية لحالات الحصبة المسجلة في محافظة النجف الاشرف للفترة من 2007 الى 2014 == Epidemiological Characteristic of Reported Measles Cases in AL - Najaf province /Iraq 2007 - 2014

Author name: عبد الامير حسين حسن الموسوي
Supervisor name: احمد سمير النعيمي
General topic: Medicine
Specific topic: Applied Epidemiology
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: Measles is worldwide, and still epidemic and highly infectious and threatened the life of all populations, but is preventable by full immunization.The importance of this study in AL - Najef government because of previous outbreak. And also a mixing of social due to internal displace populations and religious events during the year.Objective study : to describe the epidemiological characteristics of all reported measles cases in the public health of Najaf government during 2007 - 2014.Method of study : cross sectional for all suspected measles cases that are reported retrospectively in the public health section of directorate of health in AL - Najaf province during 2007 - 2014, and the data collected from the notification and investigation form of measles then entered and analyzed by using EPI - Info and SPSS 21. The result showed 582 of suspected cases, 359 0f them were confirmed, 56% female, the peak age group <5 years.The seasonal distribution of the cases appears in JAN - MAY. There was highly obvious association between the numbers of doses of vaccination with the confirmed cases,The Odd Ratio for having a confirmed case for those with a single dose of vaccination is 0.18 compared to those unvaccinated. and the risk of having confirmed measles for those with unvaccinated increased 5.6 time compared to those with protected a single dose, during the outbreak period (2007 - 2009).We recommend promoting the active surveillance and good collection of notification form and keeping for study in future, improving complete MVC with a good cold - chain and periodic campaigns before winter

تحليل نتائج وخز الرئة القطعي لاربعين مريض في مستشفى بغداد التعليمي == Analysis of Tru - Cut Biopsy Findings In Forty Patients with PERIPHERAL Lung Lesions in Baghdad Teaching Hospital

Author name: احسان سلمان
Supervisor name: مصطفى نعمة عبد علي
General topic: Medicine
Specific topic: Diseases - Thoracic
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: وخزة الرئة التحت الجلدية هي من اكثر الطرق شيوعا في الوقت الحالي معها العديد من الطرق المستخدمة في امراض الجهاز التنفسي .واحده من اهم الطرق هي طريقة الوخز القطعي بمساعدة المفراس الحلزوني .اهداف دراسة البحثلاجل تحليل النتائج من جراء عملية الوخز القطعي في مستشفى بغداد التعليمي لسنة 2015 - 2016.الطرق والمرضىاجريت دراسة مرجعه عن هذه الطريقة ووجدت كثير من النتائج ما يخص الديموغرافية والدلائل الاشعاعية والتشخيص والمضاعفات الناتجة من المرضى الذين اجروا هذه العملية الوخز القطعي تحت السيطرة للمفراس الحلزوني .النتائجاربعون مريض كانوا تحت الدراسة الخاصة للبحث ثلاثون مريض كانوراجال وعشر مرضى نساء .اعمار المرضى تتراوح ما بين 18 - 80 ومعدل العمر للمرضى هو 14.1 سنه . ±58.6 21 مريض من الرجال حاليا مدخنين و6 غير مدخنين و3 مدخنين سابقين بينما من النساء كانوا 3 مدخنين حاليا و5 غير مدخنين و2 مدخنين سابقات .اكثر الاعراض شيوعا بين المرضى في البحث هي ضيق التنفس والسعال ونفث الدم وقلة وزن الجسم.اكثر الدراسات الهستوبايولوجي للمرضى الذين اجروا هذه العملية كانت مسرطنه بنسبة 70% ,شامل بنسبة 12.5%, حميد بنسبة 7.5 % , ذات الرئة بنسبة 7.5%, تحليل غير كافي بنسبة 2.5%.من اكثر المضاعفات شيوعا بين المرضى كانت الاسترواح الصدري ونفث الدم.الاستنتاجعملية الوخز القطعي مع مساعدة المفراس الحلزوني يعتبر من اكثر العمليات الكفؤة في الكشف عن الاوليات والاسباب التي تخص امراض الرئة المحيطية. | Percutaneous lung biopsy is now a common procedure in pulmonary medicine, and several different techniques are in use. The most important one is the use of a tru - cut biopsy under computed tomography (CT) guidance.Aim of Study : To analyze the outcome of tru - cut biopsy in patients with peripheral pulmonary lesions in Baghdad teaching hospital 2016.Patients and Methods : A cross sectional study was done to find out the demographic profiles, indications, radiological findings, diagnosis and complications of the patients who were underwent tru - cut biopsy under CT guided. Forty patients underwent tru - cut biopsy under CT guided in Baghdad teaching hospital( 2015 - 2016).Results : Forty patients were included in our study.Thirty patients (75%) were males, 10 patients (25%) were females. The patients age range from 18 to 80 years, the mean age of the patients was 58.6±14.1 years. In males, 21 patients were current smokers, 6 patients were non smokers and 3 patients ex smokers. In females, 3 patients were current smokers, 5 patients were non smokers and 2 patients were ex smokers. Most common clinical presentation of the patients was chest pain (30%), dyspnea (17.5%), cough (15%), hemoptysis (7.5%), and weight loss (12.5%). The commonest histopathological result of the lesions was malignancy (70%), inconclusive (12.5%), benign (7.5%), organizing pneumonia (7.5%) and inadequate sample (2.5%). The most common complication was pneumothorax (10%) and haemoptysis (5%).Conclusion : Tru - cut biopsy under CT guided is extremely useful in finding specific etiologies of peripheral lung lesions

تاثير التجميد بالتزجيج وطرق الاذابة المختلفة على حيوية وسلامة الحامض النووي للنطف == The Effect Of Laser Thawing After Vitrification On Sperm Motility And DNA Integrity

Author name: شذى صادق المراياتي
Supervisor name: غسان ثابت سعيد
General topic: Medicine
Specific topic: Physiology
Degree: Doctorate
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: ان التجميد بطريقة التزجيج تعتبر من طرق تجميد النطف البشرية وتعتمد على التجميد السريع للماء الى الحالة الزجاجية من خلال زيادة اللزوجة بدون تكوين بلورات داخلية (داخل الخلية). ان التجميد من الممكن ان يؤدي الى تاثيرات ضارة على تركيب ووظيفة النطف البشرية وان الاضرار الناتجة من التجميد من الممكن ان تؤثر على تركيب وسلامة الغشاء البلازمي. وان هذه الاضرار لا تقتصر على اضرار التجميد فقط بل تشمل ايضا على الاضرار الناتجة من عملية الاذابة بسبب اذابة او تبلور الثلج الناتج من التجميد. ان هذه العمليات ( التجميد والاذابة) من الممكن ان تؤثر سلامة الاحماض النووية وكذلك من الممكن ان تؤدي الى تغييرات في نواة النطف البشرية . ان التجميد قد يؤدي الى اجهاد تاكسدي للنطف البشرية كنتيجة الى انحلال الدهون التاكسدي وتقليل الية الدفاعية بواسطة الانزيمات المضادة للاكسدة. خلال عملية التجميد الخلايا والانسجة تخضع الى تغييرات كيميائية وفيزيائية . ان تاثير الليزر ومن خلال التحفيز الضوئي من الممكن ان يقاوم الاضرار الناتجة من التجميد للنطف البشرية وهذا من الممكن ان يؤدي الى تحسين نوعية النطف المجمدة وزيادة قابيلتها على الخصوبة. الهدف : دراسة تاثير الليزر كطريقة لاذابة النطف البشرية المجمدة وتاثيرها على سلامة الاحماض النووية والحركة مقابل الاذابة بدرجة حرارة الغرفة او عن طريق الحمام المائي. الموضوع والطرق : دراسة اجريت على 70 نموذج من النطف البشرية. كل نموذج قسم الى قسمين , قسم قد تم تحضيره بتقنية السباحة الى فوق والقسم الثاني بدون تحضير , وكل قسم قد قسم الى ثلاثة, جمدت, وتم اذابة كل جزء من النماذج بالليزر اوبدرجة حرارة الغرفة او بالحمام المائي بدرجة 37 درجة مئوية . تم دراسة سلامة الاحماض النووية وحركة النطف قبل وبعد التجميد , وكذلك قبل وبعد التحضير بتقنية السباحة الى فوق بطريقة الاكردين اونج (AOT) الحصول بالاعتماد على قياس المذنب (comet).النتائج : اظهرت النتائج ان الاذابة عن طريق الليزر لها تاثير معنوي (P<0.05 ) في تقليل تحطيم الاحماض النووية مع زيادة في الحركة الفعالة للنطف عند المقارنة مع الاذابة بدرجة حرارة الغرفة او بالحمام المائي.الاستنتاج : استنتجت هذه الدراسة ان تجميد الحيامن له اثار مؤذية تؤثر على سلامة الاحماض االنووية وحركة النطف البشرية. ان الاذابة بالليزر تحافظ على سلامة الاحماض النووية والحركة النشطة للنطف وان تقنية السباحة الى فوق كذلك تؤدي الى تنشيط النطف وتقليل تحطم الاحماض النووية. | Vitrification is a method of sperm freezing based on the rapid cooling of water to a glassy state through extreme elevation of viscosity without intracellular ice crystallization. Cryopreservation may lead to deleterious changes of sperm structure and function. Cryoinjury is not limited to the freezing process but may also occur during the thawing process as the ice melts or recrystallizes. It have been reported that cryopreservation/thawing significantly lead to alterations of sperm DNA integrity and could alter the quality of the spermatozoon’s nucleus. Cryopreservation induces oxidative stress in the spermatozoa due to increasing rate of lipid peroxidation and suppression of the antioxidant enzyme defense mechanism. These effects of cryopreservation lead to spermatozoa damage including nucleic acids. Subjects and methods : This prospective study carried on 70 cryopreserved semen samples. Each sample wasdivided into two parts, one part is unprepared and other part was prepared by swim - up technique and each part is divided into 3 parts, freezed and thawed by three methods of thawing by laser irradiation till melting for one part, and by room temperature and water bath at 37°C for the other two parts. The semen parameters were assessed by microscopical examination and the DNA integrity assessed by acridine orange test and comet assay before vitrification and after the three methods of thawing as well as before and after preparation. Result : The results of cryopreserved semen samples showed that laser irradiation thawing has a significant increase in sperm motility as well as a significant decreased DNA fragmentation (P < 0.05) versus room temperature and water bath thawing in addition sperm preparation by swim up method also lead to improve sperm motility and DNA integrity (P < 0.05).Conclusions : Vitrification has a deleterious effect on sperm DNA integrity and motility. Laser irradiation thawing methods of post freezing sperm improves post - thaw motility and DNA integrity. Sperm preparation by swim up technique for sperm preparation increasing motility and decrease DNA damage after thawing . The results of the acridine orange test and comet assay gave relatively similar predictive values for DNA fragmentation.

تواتر التدرن الكامن في المرضى المرشحين للعلاج البيولوجي في مستشفى بغداد التعليمي == The frequency of Latent tuberculosis infection in patients who are candidates for biological therapy in Baghdad Teaching hospital

Author name: امل خالد علي
Supervisor name: مصطفى نعمة عبد علي
General topic: Medicine
Specific topic: Respiratory System
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: Introduction : Tuberculosis remains one of the biggest global human killers accounting for 9.4 million new cases of active tuberculosis and 3 million tuberculosis - related deaths with an incidence of 140/100,000 inhabitants. More than 90% (up to 8 million) of total TB Tuberculosis cases occurring in developing countries and more than half of all deaths (2 million) occurring in Asia.Aim of the study : To assess the burden of latent TB in patients candidate for biological therapy.Patients and method : A descriptive cross sectional study conducted at Baghdad teaching hospital during the period from the 1st of April 2017 to the end of March 2018. A consecutive sampling included 150 respondents candidate for biological therapy were included in this study Results : The mean age of patients was 38.9±11.4 years. TST was positive in 23.3% of studied patients. Significant association between positive TST findings and middle age group (p=0.05). A significant association was observed between positive TST results and gender (p=0.001). Also significant association between prolonged duration of the disease, and positive TST.Conclusions : The TST were positive in about only one quarter of patients with chronic immunomediated diseases who are candidates for biological therapy, and significant associations were found between age group , and TST results.

دراسة الكشف المبكر لمرض الانسداد الرئوي المزمن في الذكور الخالين من الاعراض المدخنين والمدخنين السابقين == Early Detection of Chronic Obstructive Pulmonary Disease in Asymptomatic Male Current Smokers and Ex - smokers By Spirometry

Author name: حسام محمد علي صالح
Supervisor name: عبد الله جنجر الفرطوسي
General topic: Medicine
Specific topic: Diseases - Thoracic
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: Background : Chronic obstructive pulmonary disease is responsible for permanent morbidity, premature mortality and great burden to the healthcare system. The most commonly encountered risk factor is tobacco smoking. Without screening, patients usually overlook early symptoms of cough wheezes but commonly seek medical advice when they become dyspnic on mild to moderate exertion. By that time, half of their ventilatory reserves are lost. Spirometry remains the gold standard for diagnosing chronic obstructive pulmonary disease and monitoring its progression.Aim of study : Early detection of chronic obstructive pulmonary disease in asymptomatic male current smokers and ex - smokers by spirometry.Patients and methods : Consecutive asymptomatic male current smokers (n=100) and ex - smokers (n=100) were participated in screening. All Participants have no history of chronic obstructive pulmonary disease, asthma, chronic respiratory illness or active pulmonary symptoms. Also all of them not on bronchodilators, inhaled corticosteroids, Montelukast, or theophylline.Results : A total of 100 asymptomatic male current smokers and 100 asymptomatic male ex - smokers were screened by spirometry according to the American Thoracic Society and European Respiratory Society guidelines. Overall, airway obstruction was seen in 49 (49%) current smokers, mild obstruction was seen in 22 (22%) and moderate obstruction in 27 (27%) subjects, while in ex - smokers airway obstruction was seen in 52 (52%), mild obstruction was seen in 13 (13%) and moderate obstruction was seen in 39 (39%) subjects.Conclusions and recommendations : Early diagnosis of chronic obstructive pulmonary disease by spirometry will encourage smoking cessation and enable earlier interventions to help prevent exacerbations and hopefully preserve lung function, quality of life and decrease mortality

تاثير تدخين الشيشة الاركيله مقارنة بتدخين السكائر على اختبار وظائف الرئة بين الذكور في مدينة الناصرية == The Effect of Water Pipe (Negril) Smoking on Pulmonary Function Test in compare to cigarate smoking among Males in Al Nasiriya City

Author name: مهند عادل جايان
Supervisor name: قاسم محمد سلطان
General topic: Medicine
Specific topic: Diseases - Thoracic
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: Background : Shisha (wp) smoking is becoming a more prevalent form of tobacc consumption, and is growing worldwide, particularly among the young generation in the Middle East especially among urban youth, college students, and young professionals. However there is limited data about the effects of water - pipe smoking. Publicly considered as aharmless entertainment. Many studies have shown that water pipe smoking associated with development of varying degrees of reduction in the lung function.Objectives : The aim of this study is to assess the effect of water pipe smoking on pulmonary functions with regard to the duration and amount of smoking among different groups of male smokers : water pipe smokers, cigarette smokers, and compare it with a control (nonsmokers) group. Methods : This is a comparative crosssectional study which conducted on 300 male subjects, subdivided into two groups of smokers : 100 water pipe smokers, 100 cigarette smokers and 100 nonsmokers as a control group, all participants were apparently healthy and matched for gender, they were selected from random cafes in al nassirryha city. Data were collected through structured questionnaire and pulmonary function test was performed by portable Spiro lab III spirometer after gaining the participant consent. Results : There was significant differences between the mean ages of the study groups (p value<0.05).water pipe smokers (35.44±10.79) cigarette smokers (46.09±10.54), and nonsmokers (35.55±11.07). The present study revealed that there was a significant reduction in the parameters of the pulmonary function test ( FEV1 ), (FVC )(FEV1/FVC),(PEF),(FEF25 - 75%)and(MVV)for the two groups of smokers as compared to the control group ( P < 0.01 ) .Lung function impairments were very severe in water pipe smokers as compare with cigarette smokers( P < 0.05 ). There were significant inverse correlations between all PFT values and duration and total amount of WP smoking and number of WP smoked per week(P < 0.01) .Conclusion : The results from this study showed that there was a profound effect of WP smoking on PFT values, which were more severe to the effects of cigarette smoking.Keyword : water pipe smoker ,pulmonary function test, nassiryha - Iraq.

مشاهدات الرنين المغناطيسي لدى المرضى المصابين بفرط هرمون الحليب في الدم == MRI FINDINGS OF PITUITARY GLAND IN HYPERPROLACTINEMIC PATIENTS

Author name: رنا علاء الدين حسين
General topic: Medicine
Specific topic: Diagnostic Radiology
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine - Department Of Diagnostic Scans
Language: English
University location: Baghdad
First pages:
Abstract: تحليل مشاهدات الرينن المغناطيسي للغدة النخامية لدى المرضى المصابين بفرط هرمون الحليب (البرولاكتين)في الدم وايجاد توجيها ت عمل للحدود الدنيا لنسبة هرمون الحليب في الدم والتي على ضوئها تكون صورة الرنين المغناطيسي للغدة النخامية مطلوبة 0اساليب الدراسة قمنا بدراسة وصفية استطلاعية شملت ستون مريضا يعانون من فرط البرولاكتين وقمنا باخذ صورة الرنين المغناطيسي للغدة النخامية لهم للفترة من الاول من كانون الثاني ولغاية الثلاثون من شهر اب للعام 2015.النتائجتم فحص ستون مريضا, منهم ثمانية وعشرون اي مايعادل نسبة (46.7%) كان تصويرالرنين المغناطيسي طبيعيا للغدة النخامية, وخمسة عشراي مايعادل نسبة (25%)مر يض لديهم ورم غدة نخامية مايكروي و3منهم ورم غدة نخامية ماكروي. بالاضافة الى تسعة منهم كان لديهم تضخم الغدة النخامية بدون وجود لاي ورم.وقد وجدنا ان قطع القيمة الامثل المصاحب لورم الغدة النخامية (ميكروي /ماكروي )لهرمون الحليب هو (102.5)نانو غرام / ملليتر بمستوى حساسية (77.8%) ومستوى نوعية (95.2%).الاستنتاجاتكان هناك صلة ذات اهمية احصائية بين المرضى الذين يعانون من فرط هرمون الحليب وصورة الرنين المغناطيسي .هذا يدعو الى اجراء صورة الرنين المغناطيسي لجميع الحالات المصابة بفرط برولاكتين الدم عندما تكون نسبة الهورمون مساوية او اكثر من (102.5.نانوغم/مل)بعد استثناء اي سبب ثانوي ممكن يؤدي الى ارتفاع هرمون الحليب. | To analysis the MRI findings of pituitary gland in patients with hyperprolactinemia and establish guidelines for a minimal serum prolactin level for which pituitary MRI imaging is indicated .Methods : A descriptive study was conducted at of a AL - Shaheed Ghazi Hospital and Radiology Institute from 1st of January 30 of August 2015. Sixty patients with hyperprolactinemia underwent magnetic resonance imaging of brain for pituitary gland .Results : The result were based on the analysis of pituitary MRI findings for 60 patients , almost half of the sample were diagnosed as normal 28 (46.7%) ,18 (30%) as pituitary adenoma with macro adenoma being the smallest part 3(5% only).Pituitary hyperplasia account 9(15%) and empty sella 5(8.3%).there was significant statistically association between serum PRL and pituitary adenoma .The optimum cut - off value for serum PRL for any positive pituitary findings (adenoma , hyperplasia and empty sella) was 55.1ng/mL. While the optimum cut - off value of serum PRL for pituitary adenoma (micro/macro) was 102.5 ng/mL.Conclusion : MRI of the pituitary gland was significantly associated with serum PRL levels in patients with hyperprolactinemia .The optimum cut - off value of serum prolactin to predict pituitary adenoma (micro/macro) was 102.5 ng/mL. Therefore pituitary imaging should be obtained for all patients with serum PRL ( equal or higher than this value)after exclusion of any secondary causes of hyperprolactinemia.

تاثيرات عقاري المتفورمين والاناستروزول على شكل ووظيفة المبيض في بمتلازمة تكيس المبايض في الجرذان : دراسة شكلية قياسية، نسيجية، وكيميانسيجية == The Effects of Metformin and Anastrozole on the Morphology and Function of the Ovary in Polycystic Ovarian Syndrome Rat Model, Morphometrical, Histological, and Immunoistochemical Study

Author name: علي محسن عبد الامير
Supervisor name: معن حمد الخالصي
General topic: Medicine
Specific topic: Anatomy and Histology and Embryos
Degree: Doctorate
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:

الخصائص الوبائيه للحروق في مستشفى بغداد للحروق, بغداد, العراق 2015 == Epidemiological Characteristics of BurnInjuries in Baghdad Burn Hospital,Baghdad, Iraq, 2015

Author name: رنا خالد الناصر
Supervisor name: فارس حسن اللامي
General topic: Medicine
Specific topic: Applied Epidemiology
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: Background : Burns are a global public health problem, accounting for an estimated 265,000 deaths annually, in 2013 fire and heat resulted in 35 million injuries. This resulted in about 2.9 million hospitalizations and 238,000 deaths. This makes it the 4th leading cause of injuries after motor vehicle collisions, falls, and violence. About 90% of burns occur in the developing world. This has been attributed partly to overcrowding and an unsafe cooking situation. Iraq burn injuries are the second cause for visiting emergency room after gun fire according to World Health Organization (WHO) Injury Surveillance Pilot Project, Iraq, 2008.Objectives : To describe epidemiological and clinical characteristics, estimate the case fatality rate and identify the main determinants of death among burn cases in Baghdad Burn hospital, Baghdad, Iraq during 2015.Patients and Methods : A cross sectional study was conducted in Baghdad Burn Hospital. The study population was all the burn cases that were admitted to these hospitals during 2015. The files of the patients were obtained from the statistics department in the hospital. All burn patients with different types and degrees of burn injuries who were admitted to this hospital during 2015 were included in the study. Patients with minor superficial burns treated in the emergency department as out patients and cases that admitted for surgical treatment of old scars were excluded.Data was collected using a form included demographic data, etiology, burn type, anatomical location and percentage of body surface area burned, operating procedures and outcome were recorded.Results : This study involved 676 patients, 32.90% of them were females. 26.62% patients were below 10 years of age. Two thirds had less than 20% of body surface area burns (66.42%) and only 9.46% had more than 50% body surface area burns.Flame burns were the commonest (71.59%) followed by scalds (23.37%) and electrical 2.52%. Scalds were common in children. About 76.33% of patients improved 8.28% left on their responsibility and 2.07% shifted to other hospitals. Case fatality rate was 13.30%, Mortality was 44.4% with sepsis as the leading cause, multiple organ failure, and shock were other causes of mortality.Conclusions : Burns injury is a major public health concern and is associated with high mortality. Flame, scald and electrical burns are commonly a result of domestic and occupation accidents and are preventable. Strict follow up to the infection control guideline can minimize the high case fatality rate.

Epidemiological Characteristic of Multi - Drug Resistant Tuberculosis in Iraq July/2011 - July/2015

Author name: قيس قاسم ابراهيم
General topic: Medicine
Specific topic: Applied Epidemiology
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: Background : Multi - Drug Resistant Tuberculosis (MDR - TB) is global and national public health problem that threatens the success of TB control programs.The aim of this study : To describe the epidemiologic characteristics of MDR - TB cases registered in Na0onal Tuberculosis Control Program (NTP) of Iraq during the period July 2011 - July 2015.Methods : A Cross - sectional, record based study was conducted at the Chest and Respiratory Diseases Specialized Center for all electronic records and patients’ forms available from July /2011 to July/2015. A form for collec0ng data was prepared by the researcher according to (MDR) patients Files which is provided by the NTP. Chi - square testing was used to measure the level of sta0s0cal significance set at p<0.05 and a confidence level of 95%.Results : A total of 319 cases, males were (72.6%); the mean age was 40.03±12.24 years, one third of the cases (31.7%) were from Baghdad. cases from urban area (57.8%); Cat - 2 Failure form (88.0%) of the MDR group; pulmonary were (98.3%) of the site of the disease; (17%) with Diabetes Mellitus; duration in days spend by the patient in the first line treatment, direct smear conversion negative and culture conversion nega0ve were (502±133.56), (117±77), (145±91) respec0vely; default was(28.5%) of the ceases; favorable outcome was sta0s0cally significant among middle age groups(30 - 49years) (χ2=8.548, df =2, P = 0.014).Recommendations : Increase attention for better managements of the patients in the first line treatment; give good education messages to patient of MDR - TB and Increase the number of labs capable for early diagnosis is the suitable strategy to control MDR - TB disease.

تاثير عقار الكولجسين بالاضافه الى الاسيتامينوفين مع الاسيتامينوفين وحده على مستوى الالم التصلب والوظيفة البدنية لمرضى فصال الركبه الاولى : دراسة مقارنة == Effects of Colchicine Plus Acetaminophen and Acetaminophen Alone on Pain, Stiffness and Physical Function in Patients with Primary Osteoarthritis of the Knees : A Comparative Study

Author name: كوثر رفيع حربي
Supervisor name: سامي سلمان شهاب
General topic: Medicine
Specific topic: Diseases - Joints
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: Osteoarthritis (OA) is a chronic degenerative disorder of multifactorial etiology characterized by loss of articular cartilage. Basic calcium phosphate (BCP) and calcium pyrophosphate dihydrate (CPPD) crystals are commonly found in osteoarthritic joints. These crystals have been found in the synovial fluid of 60% of patients with knee OA. Inflammation in OA is frequently secondary to the presence of these crystals, and leads to the production of interleukin - 1 (IL - 1), an important mediator of cartilage breakdown in OA. Previous studies referred to a slow acting disease/structure - modifying effects of colchicine in knee OA. Aim of the studyTo examine the effect of combined colchicine plus acetaminophen compared with acetaminophen alone on pain, stiffness, and physical function in patients with knee osteoarthritis after a 1month treatment course, and after 1 month of stopping the treatment.Patients and methods A randomized, double blind study included 150 patients were diagnosed to have knee OA according to the American College of Rheumatology (ACR) criteria for classification of (KOA).Patients were randomly assigned to receive acetaminophen 500mg containing capsule twice daily in the 1stgroup (70 patients),and colchicine 0.5mg plus acetaminophen 500mg in one capsule twice daily in the 2ndgroup (80 patients). The efficacy outcome measure was the change in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) including the pain, stiffness and physical function subscales.Results Both acetaminophen and acetaminophen plus colchicine groups showed significant reduction in the pain, stiffness , physical function and total WOMAC score in the 2nd visit (after 1 month of treatment regimen) (P<0.001).At the third visit one month after cessation of treatment these scores increased again to approximate the baseline value in group 1, while slightly increased in group2, the differences in these scores between the baseline and 3rd visit values were statistically insignificant, (P˃0.05) in group 1 while it still highly significant in group 2, (P<0.001).ConclusionBoth modes of treatment acetaminophen alone or acetaminophen plus colchicine are effective in symptomatic improvement in patients with primary osteoarthritis of the knee in term of pain, stiffness, physical function and total WOMAC score. But the better beneficial symptomatic effect and longer period of action was obtained when colchicine added to acetaminophen than acetaminophen alone.

انتشار اكتناف العين لدى عينة من المرضى العراقيين البالغين المصابين بمتلازمه فرط مرونه المفاصل الحميد == Prevalence of Ocular Involvement in a Sample of Iraqi Adult Patients With Benign Joint Hypermobility Syndrome

Author name: ايناس عدنان مجيد
Supervisor name: محمد هادي العصامي | نجاح كاظم القريشي
General topic: Medicine
Specific topic: Diseases - Joints
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: خلفية البحث : تعرف متلازمه فرط مرونه المفاصل الحميد بانها اضطراب النسيج الضام الوراثي الذي يتميز بالام عضليه هيكليه ونطاق المرونه المفرطه في المفاصل , الكثير من مظاهر العين موجوده عند مرضى متلازمه فرط مرونه المفاصل الحميد بعضها مشهورة الترابط مع المرض والاخرى مخبر عنها في تقارير حاله .الهدف : تقييم انتشار وخصائص اكتناف العين لدى عينة من المرضى العراقيين المصابين بمتلازمه فرط مرونه المفاصل الحميد .المرضى والطرائق : شملت الدراسة ( 300) فرد في الدراسه المقطعيه , )100( مريض بمتلازمه فرط المرونه و)200 (من الافراد الاصحاء وهم مطابقين في العمر والجنس للمجموعه التي اخذت كمجموعه تحكم .خضع كل المرضى للفحوصات العينيه والتي تضمنت تقييم حده البصر مع مخطط سنيل , فحص القطعه الاماميه والخلفيه للعين مع مصباح سلت , فحص شيرمر , صبغه الفلورسين القرنيه وتقدير ضغط داخل العين مع مقياس توتر العين بالنفث الهوائي . تم استبعاد المرضى اللذين لديهم رضح سابق في العين اوالمرضى المصابين بفرط ضغط الدم وداء السكري او تراكب مع امراض الانسجة الضامة الاخرى او التهاب المفصل الالتهابي . جمعت بيانات المرضى الديموغرافية والسريرية بما في ذلك العمر والجنس ومعيار كتلة الجسم ,مده الاعراض , بيانات مرتبطه بمظاهر المرض الريئسيه وميزات اخرى مرتبطه بمتلازمه فرط مرونه المفاصل الحميد . تم قياس تقدير مرونه المفاصل بالنسبه الى طريقه درجه بايتون لكل المشتركين في الدراسه .النتائج : من مجموع 100 مريضا مصابا بمتلازمه فرط مرونه المفاصل الحميد ممن التحقوا في هذه الدراسه . تم تحديد انتشار الاخطاء الانكسارية في (%78 (, وحسر)قصر البصر(في (49%) ثم لابوريه (20%) وطول البصرفي (9%) منهم.وجدت المظاهر العينيه الاخرى المحدده جفاف العين في (15%) , بينما التهاب الجفن الامامي والخلفي في (%5) و(4%)من المرضى على التوالي .شخصت متلازمه الصباغ التشتتي في (3 %) واخر المظاهر العينيه المحدده ساد في (2%) من مرضى متلازمه فرط مرونه المفاصل الحميد .ان كل النتائج السابقه ذات دلاله احصائيه ماعدا ساد حيث لم تصل الى حد الدلاله الاحصائيه .لايوجد رابط معتد بين العمر , الجنس , نوع المفصل الاكثر شيوعا ودرجه المفصل في حرز بايتون مع زياده خطر المظاهر العينيه . الاستنتاجات : مظاهر العين في عينة المرضى العراقيين المصابين بمتلازمه فرط مرونه المفاصل الحميد شائعه نسبيا. ان اكتشافات العين المتعلقة بمتلازمه فرط مرونه المفاصل الحميد الاكثر شيوعا هي حسر البصر ثم لابوريه ثم طول البصر .لقد كان جفاف العين , التهاب الجفن الامامي والخلفي ومتلازمه الاصباغ التشتتي وساد قليله الحدوث في متلازمه فرط مرونه المفاصل الحميد . | Background : Benign joint hypermobility syndrome (BJHS) is a hereditary connective tissue disorder, characterized by musculoskeletal pain and an excessive range of motion in joints . Many ocular manifestations of BJHS have been described, some being well - known associations and others reported for the first time in case reports .Objectives : The aim of this study was to evaluate the prevalence andcharacteristics of ocular involvement in a sample of Iraqi patients with BJHS. Patients and methods : A total of 300 individuals were included in this cross sectional study, 100 patients had benign hypermobility syndrome and another 200 healthy individuals matched in age and sex were taken as a control group.All patients undergone for opthalmological examination involved visual acuity assessment with Snellen chart, examination of anterior and posterior eye segments with the slit lamp, Schirmer test and corneal fluorescein staining and assessment of intraocular pressure with air puff tonometer.Patients had history of previous eye trauma, hypertension, diabetes mellitus, and overlap with other connective tissue diseases or inflammatory arthritis were excluded. Demographics and clinical data were collected including age, sex, BMI duration of symptom, data related to main disease manifestations and other related features to BJHS. The assessment of joint mobility was measured according to Beighton score method for all the participants in the study.Results : A total of 100 patients with (BJHS) enrolled in this study. Prevalence of refractive errors detected in 78% patients, myopia was detected in (49%), followed by astigmatism (20%) and hypermetropia (9% ) .The other identified ocular manifestation was dry eye (15%), While anterior & posterior blepharitis (5% and 4%) respectively. Pigment dispersion syndrome diagnosed in (3%) of patients and The last identified ocular manifestation was cataract which detected in about (2%) of BJHS patients.All previous findings were statistically significant except cataract not reach to statistically significant level. There were no significant correlation between age group, gender, type of common joint involved or degree of beighton score with increase risk of ocular manifestations .Conclusions : Ocular manifestations in a sample of Iraqi patients with BJHS were relatively common. The most common BJHS - related ocular findings were Myopia followed by, Astigmatism and hypermetropia. Dry eye symptoms, anterior and posterior blepharitis, pigment dispersion syndrome and cataract are rare in patients with BJHS.

الخصائص الوبائية لفتحات جدار القلب الخلقية للاطفال دون الخامسة الوافدين الى مستشفى ابن النفيس التعليمي، بغداد 2015 == Epidemiological characteristics of Under Five Children with Ventricular Septal Defects Attending Ibn - Nafees Teaching Hospital, Baghdad 2015

Author name: عمار حسن عبد القهار
Supervisor name: بتول علي غالب ياسين | علاء عبد الحسين الانباري
General topic: Medicine
Specific topic: Community Medicine
Degree: Master
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: Globally at least eight of every 1,000 infants born each year have a heart defect, and as Ventricular Septal Defect (VSD) is the commonest among Congenital Heart Defect (CHD), this study aimed to assess the impact of VSD among CHD and its association with certain factors, and to assess the anthropometrical measures among children with CHD as well as assess nutritional state of their mothers. A hospital based cross sectional study on 349 under five children with CHD attending Ibn Al - Nafees Teaching Hospital were subjected to questionnaires prepared by the researcher. The nutritional status of under five children was assessed through an anthropometric measures (height and weight) and compared with z - score of CDC 2000, meanwhile 296 Mother’s Body Mass Index (BMI) was assessed to point out an association with CHD and VSD.It was found that 54.7% of CHD were VSD, 29.2% were ASD and the combination of VSD and ASD was on the top of congenital heart malformation 61.4%.CHD had increase relation with Father’s and Mother’s education and indirect relation with Mother’s age, also was higher (84.2%) among 20 - 39 years Mother and appear more often in children under one year 64.2%. The studied factors had no obvious influence on VSD rather than other CHD.Nutritional status of the study sample showed that wasted children was almost three times over normal distribution which exhibit acuteness with no evidence on disease chronicity, as shown the study sample showed close frequency distribution regarding stunting and underweight. Mother’s BMI exhibit a problem as 37.2% were overweight and 26.4% were obese.Interfamily marriage express 58.5% positivity and only 8.3% report positive family history. Anemia reported in 33% of Mothers and 30.4% address febrile illness during first trimester.This study observed no significant associations between VSD and other congenital heart defects in term of socio - demographic characteristic; residency, mother’s age, child’s age, Father’s and Mother’s education and consanguinity. Also no associations were found regarding family history, febrile illness, passive smoking, certain medication received, anemia and DM.

تاثير الارتجاع العضوي المزمن للصمام الاكليلي على وظيفة البطيي الايمن الانبساطية باستخدام دوبلر صدى القلب في عدة مراكز للقلب في بغداد == Impact of chronic organic mitral regurgitation on Right Ventricular Diastolic Function using Doppler echocardiographic study in Multi Cardiac Center in Baghdad

Author name: عطاء خليل طه
Supervisor name: غازي فرحان حاجي
General topic: Medicine
Specific topic: Echocardiography
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: Background : To date, little is known regarding the effect of left ventricular volume overload on right ventricular diastolic function. We hypothesized that patients with chronic organic mitral regurgitation and preserved left ventricular systolic function might have subclinical right ventricular dysfunction, and related to pulmonary artery systolic pressure.Objective : To study the effect of left ventricular volume overload on right ventricular diastolic function by Doppler echocardiography in patients with chronic organic compensated mitral regurgitation.Patients and methods : A cross - sectional study held in multi cardiac center in Baghdad. From April 2015 to June 2016. Patients categorized in to two groups; Thirty - one were without pulmonary hypertension (group I, mean age 32±7.1 years) and thirty of patients were with pulmonary hypertension (group II, mean age 36.1±5.7years). All of them compared with sixty - one healthy individuals serving as a control group (group III, mean age 32.1±6.6 years). Transthoracic echocardiography (multiple views) M - mode, Two - dimensional and Doppler were done for all groups of study.Results : Conventional and tissue Doppler echocardiographic assessment of right ventricular diastolic function revealed impairment in up to 44.3% of patients, (19.4% in group I vs 70% in group II, P<0.001). Patients had lower right ventricular E - wave velocity, lower E/A ratio, and prolonged right ventricular isovolumic relaxation time compared to control. Tissue Doppler analysis showed lower E', and lower E'/A' ratio. All changes were statistically significant at P < 0.001). Patients with pulmonary hypertension were older with higher E/E' ratio in comparison to the other two groups (5.79±1.75 in group II vs 3.91±0.41, 4.08±0.93 in group III and I, respectively, P <0.001).
1 ... 3 4 5 6 7 ... 21