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دور هرمونات الاديبونكتيندور واللبتين والسايتوكينات لدى بعض المرضى المصابين بعجز القلب المزمن == Role Of Adiponectin Leptin&Other Cytokines In Some Chronic Heart Failure Patients

Author name: نور نصير نافع
Supervisor name: عدنان فاضل النجار | صباح موسى فاضل
General topic: Medicine
Specific topic: Clinical Biochemistry
Degree: Master
University: Mustansiriyah University - Faculty Of Medicine - Department Of Biochemistry
Language: English
University location: Baghdad
Key words:
  • Adiponectin
  • leptin
  • cytokine
  • Chronic Heart Failure
First pages:
Abstract: عجز لقلب المزمن : حالة تقويضية معقدة متمثلة بمرحلة تشخيصية متقدمة مدمرة ونهائية. ان عملية انتقال المرض من مستقر الى دنف القلب(اعتلال عام مع هزال) ليست مفهومة جيدا, وهناك عدد من العمليات المختلفة للحفاظ من عملية الهدر، وهي في معظمها حيث وجدت لتكون في وقت م | Chronic Heart Failure(CHF)is a complex catabolic state that carries a devastating prognosis. The transmission from stable disease to cardiac cachexia is not well understood. A number of different mechanism maintain the wasting process, most of which were found to be activated early in the development of CHF.Many of these pathways are initially activated to protect heart from damage and to compensate for impaired myocardial function. Mediators that have been implicated in this process include pro - inflammatory cytokines like interleukin 1 and 6, tumour necrosis factor - ? and the acute phase protein (C.R - P)these cytokines are activated during the course of CHF and maintaining the wasting process. Little is known about the mechanism leading to cardiac cachexia (C.C).Adiponectin and leptin are a protein hormones derived from adipocytes and they are important regulator of energy metabolism and body weight. Previous studies of CHF and C.C , had great differences between cachectic and non - cachectic patients.OBJECTIVETo study the relationship between Adiponectin, leptin & cytokines in cachectic &non cachectic HF patients & compared the results with coronary artery disease( CAD) patients with preserved left ventricular systolic function( LVSF) &healthy control to elucidate their roles in pathobiochemistary of cachexia, & to study the prognostic power of adiponectin in CHF, also to identify & confirm the role of proinflammatory cytokine(IL - 6& TNF - ?)& systemic inflammation marker (C - R.P)in the progression of CHF to cardiac cachexia.SUBJECTS &METHODE Studies were performed in Cardiology Clinics in Ibn Al - Betar hospital for cardiac surgery. Eighty eight subjects were divided into four groups each contain 22 subjects are enrolled in this study : 1st group : patient with HF(reduce LVSF)with cachexia include 5 females &17 males with age range from 47 - 76 years;2nd group : patients with HF(reduce LVSF)but without cachexia include 6 females& 16 males with age range from 34 - 70 years;3rd group : patients with CAD (preserved LVSF)include 11 males &11 females with age range from35 - 80 years & 4th group : consisted of healthy controls include 11male s& 11 females with age range from 36 - 65 years. The hormonal assay was done by ELISA.RESULTSPatients with CHF with cachexia had significantly higher concentrations of adiponectin than all other groups(p=0.004) ,that are associated with significant decrease in serum level of leptin(p=0.002), significant increase in serum level of IL - 6 when compared to other groups (p=0.0001)& significant increase in number of C - R.P positive compared only to healthy control(p=0.007),but serum level of TNF - ? is significantly decrease when compared to both CAD(p=0.023) &healthy control (p=0.0001)although it was non - significant decrease when comper to patient with CHF without cachexia.In the patient with CHF without cachexia, non - significant increase in serum level of adiponectin (when compared to patient with CAD with preserved LVSF& non - significant decrease compare to healthy control), while serum level of leptin was non - significantly decrease (when compared to patient with CAD with preserved LVSF & non - significant increase when compared to healthy control) associated with non - significant decrease in serum level of TNF - ? in comparison to CAD with preserved LVSF but significant decrease compared healthy control(p=0.011)while serum level of IL - 6 significantly increase in comparison to both CAD with preserved LVSF(p=0.01) &healthy control(p=0.008).In CAD with preserved LVSF non - significant decrease in serum level of adiponectin,while non - significant increase in serum level of both leptin , IL - 6 & TNF - ? when compared to healthy control. In this study there is strong significant positive correlation between adiponectin & TNF - ? in patients with CAD with preserved LVSF(r=0.615,p=0.002); while adiponectin was positively correlated with E.F% in patients with CAD with preserved LVSF(r=0.448,p=0.037).Finally there is significant positive correlation between TNF - ? & IL - 6 in patients with CHF with cachexia(r=0.466,p=0.029).CONCLUSIONCachexia, is a catabolic state of CHF associated with increase in serum adiponectin concentration, this may be consider as preservation of physical response to the changes in body fat but might also suggest that adiponectin plays a role in pathogenesis of cachexia, while cachexia associated with HF is not caused by enhance leptin release but, by increased level of adiponectin which is powerful predictor of cardiac cachexia.Cardiovascular Disease(CVD) is associated with elevated marker of systemic inflammation)C - R.P(that plays important role in disease progression& increase level of proinflamnmatory cytokine)IL - 6(has been reported as important pathogenic factor contributed to cardiac injury during CHF& progression to cardiac cachexia, although ,the level of TNF - ? is lower & has no relation to the degree of cachexia

تقييم نسبة الاديبونيكتين والانترلوكين - 6 واضداد البروتين الستروليني في مصل الدم وتركيب الجسم مع الكثافة الكتلوية للعظم لدى المرضى المصابين بالفصال العظمي العقدي == Evaluation Of Serum Adiponectin , Interleukin - 6 , Anti - Cyclic Citrulinated Peptide And Body Mass Index With Bone Mineral Density In Nodal Osteoarthritis Patients

Author name: مصطفى سالم خلف
Supervisor name: عدنان فاضل النجار | عباس طعمة جودة الخزاعي
General topic: Medicine
Specific topic: Clinical Biochemistry
Degree: Master
University: Mustansiriyah University - Faculty Of Medicine - Department Of Biochemistry
Language: English
University location: Baghdad
First pages:
Abstract: الفصا العظمي العقدي هو واحد من انواع التهاب المفاصل الموضعي. هو مرض المفصل التنكسي او الانحلالي, ويشمل الغضروف المفصلي والعظم تحت الغضروف, وهو يعتبر نوع من انواع امراض المناعة الذاتية. السبب الرئيسي للفصال العظمي العقدي غير معروف لكن هناك اسباب متنوعة مثل | Nodal osteoarthritis (NOA) is one type of the localised osteoarthritis that mostly occurs with postmenopausal women. It is degenerative joint disease, including articular cartilage and subchondral bone, it consider type of autoimmune diseases. The main cause of NOA is unknown but there are variety of causes like hereditary and metabolic, may initiate processes leading to loss of cartilage. The cartilage loss process usually lead to induce the immune system to release many of immune factors like cytokines , these factors lead to generation of immune response and inflammation in the joint. The NOA mostly occurs with postmenopausal women. It affects the smaller joint. Over several years, firm knobbly swellings form on the finger joints. These are caused by osteophytes so lead to bony enlargement and are known as Heberden's nodes when they are at the end joints of fingers (distal interphalangeal joints) or Bouchard's nodes when they are at the mid - finger joints (proximal interphalangeal joints). Once the nodes are fully formed, and not necessarily painful, they do limit the movement of the fingers significantly. NOA leads to the formation of bunions, rendering them red or swollen. Some people notice these physical changes before they experience any pain, but in advance cases, many of Symptoms may include like joint pain, stiffness and sometimes an effusion. When bone surfaces become less well protected by cartilage, bone may be exposed and damaged. As a result of decreased movement secondary to pain, regional muscles may atrophy, and ligaments may become more lax.Many studies have been done about inflammatory and biochemical markers in NOA and they found conflicting results. Objective1 - To evaluate serum adiponectin , interleukin - 6 (IL - 6) , anti cyclic citrullinated peptide (ACCP) and bone mineral density (BMD) in NOA.2 - To asses the CRP , RF and ESR in NOA.3 - To asses effect of age , gender , effect of BMI , smoking habit and duration of disease in NOA.Material and Method This study performed during the period from November 2013 to February 2014. These subjects were selected from patients attending the Rheumatology & Rehabilitation Consultation Unit at Al - Yarmouk Teaching Hospital. Patients and controls with hypertension, diabetes mellitus, malignancy, chronic disease of kidney, liver and any patients taken drugs that might effect the results have been excluded from the study.The laboratory tests were done in Al - Yarmouk teaching hospital laboratories and the laboratory research unit in collage of medicine / department of medical biochemistry. Subjects80 subjects (60 patients & 20 healthy controls) were enrolled in this study : A. First group : Patients with Nodal Osteoarthritis (NOA), No. = 60 (female =49 & male =11), rang of age (40 - 88) years.B. Second group : Healthy control group who had no history or clinical evidence of NOA or any other chronic disease like hypertension, DM and other chronic disease that might effect on the study data, No. 20 (female = 15 & male =5 ), rang of age (48 - 82) years.The patients were diagnosed as NOA according to the 2013 American College of Rheumatology (ACR) criteria, also the patients were diagnosed as normal, osteopenia and osteoporosis according to the 2013 American College of Rheumatology (ACR) criteria by measured of BMD (T - score) Normal : T - score (more than or equal - 1), Osteopenia : T - score ( - 1.1 - - 2.5) and Osteoporosis : T - score (less than - 2.5). The patients BMI were measured and determined as Normal (18 - 24.9 kg/m2), Over weight (24.9 - 29.9 Kg/m2), Obese grade - I (29.9 - 34.9 kg/m2) and Obese grade - II (more than 34.9 kg/m2) according to WHO 2012.MethodsELISA technique was used for the determination of serum adiponectin, IL - 6 and ACCP. Measurement of serum uric acid was done by spectrophotometric instrument. qualitative serological tests were used for determination of the CRP and RF also ESR determination were done in hospital laboratory. The BMI was determined by WHO equation's (2012) (weight/ (length) 2), also the BMD was determined by DXA scan according to ACR limits.Results obtained were subjected to statistical analysis by using SPSS and Excel program.ResultsLevels of serum adiponectin, IL - 6, CRP, ESR and BMI were significantly increased in NOA patients most than healthy controls, also the BMD (T - score) significantly decreased in NOA patients than healthy controls. But the age, gender, serum ACCP and uric acid were not significantly changed in NOA patients compared with healthy controls. Study of age, gende , BMI and duration of disease, found that they did not effect any parameters studied in NOA patients, only serum ACCP level was found to be significantly increased in females than males. Serum adiponectin level and CRP were significantly increased more in osteoporosis than osteopenia and normal. CRP was significantly increased in smoker than non smoker NOA patients.This study showed negative correlation between serum adiponectin and BMD, positive correlation between serum adiponectin and ESR, serum adiponctin and IL - 6 and IL - 6 and ESR in NOA patients. This study illustrated change in the status of the inflammatory markers like adiponectin, IL - 6 and other parameters in NOA disease. It illustrated effect of some of the factors like age, gender, BMI, BMD, smoking habit and duration of disease on development of NOA disease and on the status of the parameters studied. Also this study illustrated some correlation between the parameters in NOA patients.

المرضى المصابين بالمتلازمة الشريانية الحاد Vaspin and Omentin - 1 : تقييم مستويات == Evaluation Of Serum Vaspin And Omentin - 1 Levels In Patients With Acute Coronary Syndrome

Author name: مشتاق عبد هنيدي الطائي
Supervisor name: ولاء احمد الجدة | عباس ناجي الشريفي
General topic: Medicine
Specific topic: Clinical Biochemistry
Degree: Master
University: Mustansiriyah University - Faculty Of Medicine - Department Of Biochemistry
Language: English
University location: Baghdad
First pages:
Abstract: Acute coronary syndrome (ACS) is an insufficient supply of the myocardium with oxygenated blood in which atherosclerosis is an essential cause of myocardial ischemia. Adipokine biomarkers plays an essential role in the atherosclerosis and hence coronary artery disease. Serum Vaspin, Omentin - 1 and troponin I Fast are the biomarkers that believed to be independently associated with acute coronary syndrome.Objective : The study was carried out to evaluate : serum Vaspin,Omentin - 1 and Troponin I Fast in patients with acute coronary syndrome [ST - Elevation Myocardial Infarction(STEMI), Non - ST - segment Elevation Myocardial Infarction (NSTEMI),and Unstable Angina pectoris (UA)], that may help in guiding the diagnosis and treatment.Subjects, Materials and Methods : The study include a total (100) individuals; (75) patients with acute coronary syndrome (ACS) and (25) healthy control.A total number of 75 patients with acute coronary syndrome (ACS) (50 male ,25 female ) as : 25 patients with STEMI (22 male and 3 female) 25 patients NSTEMI(16 male and 9 female ) and 25 patients with unstable angina UA(12 male and13 female)were enrolled in this study all taken from Coronary Care Unit (CCU)at AL - Yarmouk Teaching Hospital.Each patient was clinically examined by the consultant cardiologist and the diagnosis was achieved by electrocardiograph (ECG), and cardiac enzyme levels.Venous blood sample (ten milliliters) was drawn from each patient and control after (10 - 12) hours overnight fasting, using a 10 ml disposable syringe between 9.00 and 11.00 A.M.The sample was divided into two portions one for testing Hb concentration and the other part was centrifuged to obtain serum, to be used for measuring the following variables : serum vaspin, serum omentin - 1 and Troponin I Fast, total cholesterol, triglyceride, High density lipoprotein cholesterol and low - density lipoprotein cholesterol, fasting blood sugar, serum creatinine and uric acid.Body mass index was calculated according to the following equation : BMI=weight/height2, also blood pressure was measured.Results : Serum vaspin and omentin - 1 levels were significantly lower in patients groups in comparison with control group, while serum Troponin I fast, total cholesterol, and low density lipoprotein cholesterol levels were significantly higher in patients with coronary artery disease than controls. Negatively significant correlation was found between serum vaspin and omentin - 1 with (BMI, total cholesterol and troponin I Fast).Conclusion : Serum Vaspin and Omentin - 1 levels were lower in acute coronary syndrome patients in comparison with control group, serum vaspin and omentin - 1 showed significant changes with the development and progression of acute coronary syndrome and would be valuable in the assessment of patients with acute coronary syndrome.Vaspin and Omentin - 1 may be used as a predictor of ACS.

دراسة فرط زيادة الانسولين بالدم والمتلازمة الايضية لدى مرضى داء السكري النوع الثاني == A Study Of Hyperinsulinemia And Metabolic Syndrome In Patients With Type 2 Diabetes

Author name: علي عبد اللطيف حسن
Supervisor name: THABIT NUMMAN WAHID AL | AZZAWE
General topic: Medicine
Specific topic: Clinical Biochemistry
Degree: Master
University: Mustansiriyah University - Faculty Of Medicine - Department Of Biochemistry
Language: English
University location: Baghdad
First pages:
Abstract: مرض السكري من النوع الثاني هو اكثر اشكال مرض السكري شيوعا ويتميز باختلال افراز الانسولين واختلال فعاليته ويكون مصحوبا بمشكله زياده الممانعه للانسولين(وهي الحاله التي يكون فيها كميه الانسولين الطبيعيه تكون غير كافيه لانتاج نفس الفعاليه الايضيه في الخلايا | Type 2 diabetes is the most common form of diabetes and is characterized by disorders of insulin action and insulin secretion, and associated with increase problem of insulin resistant which is the condition in which normal amounts of insulin are inadequate to produce a normal insulin response from fat, muscle and liver cells. Insulin resistance in fat cells results in hydrolysis of stored triglycerides, which elevates free fatty acids in the blood plasma. Insulin resistance in muscle reduces glucose uptake, whereas insulin resistance in liver reduces glucose storage, with both effects serving to elevate blood glucose. High plasma levels of insulin and glucose due to insulin resistance often lead to metabolic syndrome.The combination of hypertension, dyslipidemia, insulin resistance, hyperinsulinemia, glucose intolerance, and obesity, particularly central obesity, has been termed the “metabolic syndrome.” It has been proposed that this syndrome is a powerful determinant of type 2 diabetes and cardiovascular disease.Material and measurements : The study is designed to measure BMI, FBS, TG, HDLc, and c - peptide and insulin level. history of hypertension, age of patients and duration of diabetes are Also taken in to account. These parameters and measures applied for forty five patients with diabetes and thirty normal as control subjects.Results : - There is a positive significant Correlation between insulin level of the diabetic patient and BMI - there is Also a positive significant correlation between insulin level and C - peptide in diabetic patient (r=0.781) (p=0.0001) and in healthy control (r=0.599) (p=0.0001). - There is a positive significant Correlation between C - peptide level of the diabetic patient and BMI - There is a significant negative correlation between HDL with HbA1c, in diabetic patient (r= - 0.423) (p=0.006) and significant correlation of HbA1c with FBS - There is a positive significant Correlation between duration of diabetes and age of the patient(r=0.783) (p=0.0001) - There is a significant negative correlation between C - peptide and duration of diabetes in diabetic patient (r= - 0.310) (p=0.045) - There is a significant correlation between TG with FBS values. - There is a negative significant correlation between TG with HDL values. - 37.8% of diabetic patients had metabolic syndrome and no one of the control subjects had the criteria of (WHO).Conclusion : There were large percentage of diabetic patients with different BMI had metabolic syndrome as compared with the control subjects. There were strong correlations between insulin level (hyperinsulinemia) and risk of metabolic syndrome development and appearance of its complications. The risk of hyperinsulinemia and metabolic syndrome was well correlated with BMI than with HbA1c. Most of over weight and obese patients had high insulin level with different degrees of glycemic control and duration of disease. Large number of patient with metabolic syndrome were hypertensive as compared with diabetic patients with out the syndrome.

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

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

دور البروتينات المولدة للاوعية الدموية (Soluble fms - like tyrosine kinase - 1 & placental Growth Factor) ومستوى مؤشر الاجهاد التاكسدي (Glutathione peroxidase) في حالات الاجهاض المهدد == The Role Of (Soluble Fms - Like Tyrosine Kinase - 1 & Placental Growth Factor) And Oxidative Stress Marker (Glutathione Peroxidase) In Threatened Miscarriage

Author name: سرى عبد الكريم عصمت
Supervisor name: ثابت نعمان وحيد العزاوي | هند عبد الخالق ناصر
General topic: Medicine
Specific topic: Clinical Biochemistry
Degree: Master
University: Mustansiriyah University - Faculty Of Medicine - Department Of Biochemistry
Language: English
University location: Baghdad
First pages:
Abstract: المقدمة : يعرف الاسقاط المهدد بانه حالة يمكن ان تصيب معظم النساء الحوامل في بداية الاشهر الثلاث الاولى من الحمل ,يتميز بحدوث نزيف مهبلي مصاحب بالام في البطن والظهر ويمكن ان ينتهي اما بحدوث اجهاض فعلي وموت الجنين او اكمال اشهر الحمل والانتهاء بالولادة.الهدف | Threatened abortion can defined as failure of pregnancy and vaginal bleeding and this occur before twentieth weeks of pregnancy. Aim of study : To evaluate association between maternal serum levels of angiogenic growth factors (sFlt - 1 & PlGF) with threatened abortion by compare it with control healthy level, to evaluate association between maternal serum level of oxidative stress marker (Glutathione peroxidase) with threatened abortion by compare it with control healthy level. To investigate if maternal serum levels of these parameters can be used as predictive markers for outcome of threatened abortion. Subjects & Method : Eighty six women were included in this study with age range from (20 - 35) years, all women attended to Obstetrics and Gynecology department / Alyarmook hospital during period from December 2015 to March 2016.Subjects were divided into three groups(1)Non pregnant women (in luteal phase) : 16 women serve as control group ( 2) Normal pregnant women with gestational age between (6 - 12) weeks : 20 women serve as patient study group(3) Threatened abortion women with gestational age between (6 - 12) weeks with vaginal bleeding : 50 women serve as patient study group. All threatened abortion women had been followed up for 6 months to determine whether they complete their pregnancies with live birth or subsequent miscarriage. Women with or without history of previous abortion, cigarette smoking were included and excluded women with age below 20 years and above 35 years or with diseases like (Hypertension, Diabetes mellitus, Hyperthyroidism) and women in follicle phase. All serum samples were analyzed for soluble fms - like tyrosine kinase - 1 (sFlt - 1), placental growth factor (PlGF) and Glutathione peroxidase by using (ELISA) technique.Results : There was significant lowering in mean value level of sFlt - 1 in threatened abortion women (8.5 ± 4.4 ng/ml) than normal pregnant women (13.8 ± 3.2 ng/ml)and non - pregnant women (15.3 ± 3.2 ng/ml), P value

دور الهرمون مثبت الكالسيوم (الاوستيوكالسين) والهرمون شبيه الانسولين IGF - 1 في مصل الدم على هشاشة العظام لدى المصابات بداء السكري بعد سن الياس == The Role Of Osteocalcin And Insulin Like Growth Factor 1 (IGF - 1) On Osteoporosis In Diabetic Postmenopausal Women

Author name: حيدر رضا محمد سعيد
Supervisor name: نهلة مجيد الصقال | عبد الكريم يحيى السامرائي
General topic: Medicine
Specific topic: Clinical Biochemistry
Degree: Master
University: Mustansiriyah University - Faculty Of Medicine - Department Of Biochemistry
Language: English
University location: Baghdad
First pages:
Abstract: Osteoporosis is a systemic disease of the skeleton that characterized by low bone mass and alteration in micro - architecture of bone tissue, which leads to an increase in brittleness with the ensuing predisposition of bone fracture. Global statistics show that women are more exposed to this disease than men and in particular at menopause. Like osteoporosis, type 2 diabetes mellitus (T2DM) is also greatly related to aging populations, and causes substantial morbidity and in some cases mortality. Diabetes mellitus could affect skeletal system and bone metabolism through multiple pathways and it has been considered as a major risk factor of osteoporosis.Objective : The aim of the study is to evaluate the usefulness of osteocalcin (OC), insulin - like growth factor I (IGF - 1) and bone mineral density (BMD) in postmenopausal women with type2 diabetes mellitus with or without osteoporosis and to compare the results of them with that of healthy control, in addition on studying role in the pathochemistry of osteoporosis and their validation as biomarkers of osteoporosis.Subjects & Methods : The study was performed during December 2013 to April 2014. Subjects were selected from outpatients attended National Diabetic Center (NDC)/ AL - Mustansiriyhiah University.Eighty - six (86) postmenopausal women aging (50 - 72) were included in this study. Subjects were divided into three group (I) included (25) healthy postmenopausal women without osteoporosis and diabetes mellitus (controls), Group (II) included (30) diabetic postmenopausal women without osteoporosis, Group (III) included (31) diabetic postmenopausal women with osteoporosis.Osteoporosis was diagnosed by measuring bone mineral density (BMD) by Dual energy X - ray absorptiometry (DXA). Also the levels of Fasting blood glucose (FBG), Calcium and phosphorus alkaline phosphatase (ALP) by spectrophotometer were measured in addition to measuring HbA1c level by NycoCard device using boronate assay affinity. While serum osteocalcin was measured using (ELISA) technique and IGF - 1 was measured using immunoradiometric assay. patients with malignant diseases, hyperthyroidism, hyperparathyroidism, osteomalacia, renal and hepatic diseases were excluded in addition to patients with chronic treatment with antiacids, estrogen, adrenal or anabolic steroids, anticonvulsants and anti - coagulants. Meanwhile, we ensured that all patients are not alcohol addiction and not smokers (passive & active).ResultsBone mineral density (BMD) was lower significantly in diabetic type II postmenopausal women with osteoporosis compared to diabetic type II postmenopausal women without osteoporosis and control group (0.68±0.04 g/cm2) , ( 0.87±0.03 g/cm2) , (0.89 ± 0.04 g/cm2), (P<0.001) respectively.The mean serum OC was lower significantly in diabetic type II postmenopausal women with osteoporosis group compared to diabetic type II postmenopausal women without osteoporosis group and control group (22.3±5.92 ng/ml), (27.2±5.96ng/ml), (27.3 ±3.49ng/ml) (P<0.001) respectively. Also the mean serum IGF - 1 was lower significantly in diabetic type II postmenopausal women with osteoporosis group compared to diabetic type II postmenopausal women without osteoporosis group and control group (46.6±8.41ng/ml), (65±8.48ng/ml), (88.2 ± 9.91ng/ml) (P<0.001) respectively.The mean of Fasting Blood Glucose was higher significantly in diabetic type II postmenopausal women with osteoporosis group compared to diabetic type II postmenopausal women without osteoporosis group, and control group (204.4±15.29 mg/dl), (187.2±13.45 mg/dl) , (93 ± 7.79 mg/dl) (P<0.001) respectively.The mean HbA1c was higher significantly in diabetic type II postmenopausal women with osteoporosis group compared to diabetic type II postmenopausal women without osteoporosis group, and control group (8±0.5), (7.5±0.53), (5.2 ± 0.33), (P<0.001) respectively.Also results showed no significant change in levels of calcium, phosphorus and alkaline phosphatase in the serum of diabetic type II postmenopausal women with osteoporosis group, compared to diabetic type II postmenopausal women without osteoporosis group and control group.There was a significant positively correlation between BMD with serum osteocalcin (r=0.43, P<0.001) and a strong positively significant correlation between BMD with serum IGF - 1(r=0.706, P<0.001). Also there was a significant negative correlation between BMD with HbA1c ( r= - 0.339, P=0.001), FBG(r= - 0.457, P<0.005) and Age (r= - 0.466, P<0.001).Also there was a positively significant correlation between serum osteocalcin with IGF - 1 (r= 0.34,p=0.007) and serum osteocalcin with BMD (r=0.43, P<0.001).Simultaneously there was a positively significant correlation between serum IGF - 1 and ostocalcin (r=0.34,p=0.007) and a positively significant correlation between serum IGF - 1 and BMD( (r=0.706, P<0.001). Also there was a negatively significant correlation between serum IGF - 1 with HbA1c (r= - 0.332,p=0.009), FBG(r= - 0.345,p=0.005) and Age (r= - 0.496, P<0.001).Conculsion Assessing the circulating levels of osteocalin and IGF - 1 may provide very useful information to diagnose or predict osteoporosis in Type 2 diabetic postmenopausal women.

تاثير عقار الميتفورمين, الكاناكلفلوزين او اجتماعهما معا على بعض المؤشرات الكيميائيه في الفئران ذوات السمنه المحدثه == Effect Of Metformin, Canagliflozin & Their Combination On Certain Biochemical Parameters In Diet Induced Obese Mice

Author name: اسماء عبد الوهاب احمد
Supervisor name: علي اسماعيل عبد الله محمد | خالد جمعه خليل
General topic: Medicine
Specific topic: Medicines and Toxins
Degree: Master
University: Mustansiriyah University - Faculty Of Medicine - Pharmacology Department
Language: English
University location: Baghdad
First pages:
Abstract: تعرف السمنه ب ترسب الدهون وخاصه في منطقه البطن الذي يرتبط ارتباطا وثيقا بالنظام الغذئي الناجم عن مرض خطير مثل السكري , اضطراب الدهون في الدم وارتفاع ضغط الدم التي توثر على صحه الانسان. ميتفورمين له تاثير ايجابي على التغيرات الايضيه الناتجه عن السمنه. علا | Background : Obesity is defined as the deposition of fat, especially in abdominal regions, which is closely related to serious diet - induced diseases such as type2 diabetes, dyslipidemia, and hypertension that affect human health. metformin has favorable influence on metabolic changes induced by obesity. Furthermore; treatment with metformin has good hepatoprotective effects against fatty changes induced by high fat diet. Moreover, it's interesting to mention that canagliflozin has comparable therapeutic effects to metformin on obesity induced metabolic disturbance but, unfortunately, it has not significant therapeutic impact on obesity induced hepatic steatosis. Interestingly, it has been found in the present study that use of metformin and canagliflozin in combination has superior promising impact on obesity induced metabolic and pathological changes.Aim of the study : The present study investigated the influence of metformin, canagliflozin, & their combination on body weight, food intake, glycemic indices, insulin sensitivity, and lipid profiles in diet - induced obese mice Materials and methods : The animals were divided into two groups.The first group feed with normal chow served as normal group {n=10}. The second group feed with high fat diet serve as high fat diet group {n=40} for two and half months and after the induction of obesity, then further subdivides into four groups. Group I : still feed with normal chow serve as control group{n=10}. Group II : received no drug(s) but only feeding with high fat diet, which serves as high fat diet group{n=10}. Group III : received a single dose of canagliflozin {10 mg/kg/po}, daily for 4 weeks by gavage method serves as canagliflozin group{n=10}. Group IV : received single dose of metformin {300 mg/ kg, po}, daily for 4 weeks by gavage method serves as metformin group{n=10}. Group V : received single dose of both canagliflozin {10mg/ kg, po} and metformin{300mg/kg, po}, daily for 4 weeks by gavage method serves as combination group{n=10}.At the end of the study, blood samples were taken for biochemical analysis, then animals were sacrificed and livers were taken for histopathological examination. Results : Mice feeding with high fat calorie content 60% for two and half months showed a significant increase in body weight, food intake, glycemic indices, homeostasis model assessment - insulin resistance (HOMA - IR), fasting plasma insulin and lipid profiles with important histopathological alterations. While, treatment with metformin - canagliflozin combination elicited a significant decrease in the all study and biochemical parameters with significant histopathological changes characterized by complete improvement on hepatic tissues. In comparison to metformin treatment also showed significant decrease in all study & biochemical parameters with good protective effect against obesity - induced hepatic steotosis. Whereas, canagliflozin also showed a significant decrease in all study and biochemical parameters with no significant improvement on hepatic tissue but the main thing that observed with canagliflozin is a superior effect on body weight with respect to metformin.Conclusion : treatment with metformin - canagliflozin combination provides a significant hepatoprotective effects against fatty changes induced by high fat diet. Moreover, this combination has favorable influence on metabolic changes induced by obesity. Whereas, each drugs alone show good improvement on many parameters including body weight, glycemic indices, insulin sensitivity, and lipid profiles with better improvement of hepatic tissue associated with metformin in contrast to canagliflozin that shows no significant improvement in hepatic tissue but, the excellent reduction in body weight seen in canagliflozin with respect to metformin.

دور ال Inhibin - B,FSH وهرمون التستيستيرون في الذكور المصابين بالعقم == Role Of INHIBIN - B Hormone, Follicular Stimulating Hormone, And Testosterone In Infertile Men

Author name: احمد عبد الرحيم ابراهيم ضاحي
Supervisor name: شذى الخطيب | صباح مهدي حسين
General topic: Medicine
Specific topic: Clinical Biochemistry
Degree: Master
University: Mustansiriyah University - Faculty Of Medicine - Department Of Biochemistry
Language: English
University location: Baghdad
First pages:
Abstract: تقييم مستوى هرمون الانهبين.ب. وهرمون المحفز للجريب والتيستوستيرون واللوتيني وهرمون الحليب والاستراديول في مصل والسائل المنوي للاشخاص العقيمين ومعرفة ايهم فائدة اكثر للتشخيص المبكر للعقم بعد مقارنة النتائج مع الاشخاص الاصحاء.المكانوقد اجريت هذه الدراسة خ

استهلاك الجسم للاوكسجين اثناء عملية التروية القلبية - الرئوية باستخدام ماكنة القلب والرئة الصناعية عند درجات الحرارة الاعتيادية والمنخفضة == Correction Of QT, QTp, And Tpte Intervals To Heart Rate

Author name: همام عبد الرحمن ابراهيم العبيدي
Supervisor name: نبا عبد اللطيف رشيد ناجي | احمد عبودي نعمة المحمودي
General topic: Medicine
Specific topic: Medical Physics
Degree: Master
University: Mustansiriyah University
Language: English
University location: Baghdad
First pages:
Abstract: This study was conducted in pursuit of gaining a better understanding of the importance of hypothermia for cardiac surgery, and for CABG in particular. Most of the cardiac surgeons worldwide are accustomed to the use of mild hypothermia (32 - 35)°C for CABG procedures. Studies showed however that the risks of exposing the patient to mild hypothermia are similar to the risks endured during moderate hypothermia (28 - 32)°C. Objectives This study sought to weigh the benefits of mild hypothermia and moderate hypothermia against that of normothermia (35 - 37)°C concerning their impact on tissue oxygen consumption. Design This study is Prospective, randomized, comparative and purely observational and does not involve any intervention to the patient beyond the standard normal management. Setting At the department of physiology, college of medicine, Al - Mustansiriyah university in cooperation with the Iraqi Center for Heart Diseases and Ibn Al - Bitar Specialized Cardiac Surgery Center, in Baghdad, between December 2014 and April 2015. Patients, materials and methods Seventy patients, (55) males and (15) females, undergoing coronary artery bypass grafting surgery (CABG) were included in this study. Patients were allocated into three groups according to the surgeon's preferences; viz (normothermia, mild hypothermia and moderate hypothermia). Systemic complications associated with hypothermia were investigated via chemical analysis of the blood samples for renal and liver functions. Blood samples were collected two times during CPB from the arterial and venous ports of the oxygenator and were immediately analyzed to determine oxygen consumption and oxygen delivery. Results The decrease in the temperature for the hypothermic groups showed similar values of oxygen delivery (DO2) to that of normothermia (3537)°C at the same period during CPB. There were no noticeable changes between normothermia and mild hypothermia (32 - 35)°C. However, for moderate hypothermia (28 - 32)°C, there was a remarkable decrease in the oxygen consumption (VO2). The biochemical analysis for renal and liver functions in the normothermia and moderate hypothermia groups showed no significant differences between preoperative and postoperative results. However, in the group with mild hypothermia there was a significant change in results. Conclusion Moderate hypothermia rather than mild hypothermia proves to be of more benefit to the tissues when compared to normothermic conditions, as it significantly reduces tissue oxygen consumption. Moreover, even normothermia was found to be superior to mild hypothermia due to the latter's adverse effects on renal and liver functions while it maintains similar results with regards to oxygen consumption.

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

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

نمط اصابات الاعصاب المحيطية بين الجنود العراقيين في الحرب باستعمال فحص تخطيط الاعصاب والعضلات == The Pattern Of Peripheral Nerve Injuries In The War Among Iraqi Soldiers By Using Electromyography

Author name: قيصر عبد الرزاق عطيه
Supervisor name: صفاء حسين علي
General topic: Medicine
Specific topic: Physiology
Degree: Master
University: Mustansiriyah University
Language: English
University location: Baghdad
First pages:

الاختلال الانبساطي الوظيفي للبطين الايسر عند مرضى داء السكري من النوع الثاني == The Left Ventricular Diastolic Dysfunction In Asymptomatic Type 2 Diabetes Mellitus Patients

Author name: الاء سعد عادل
Supervisor name: اسماعيل ابراهيم حسين القرغولي | عباس ناجي مسلم الشريفي
General topic: Medicine
Specific topic: Medicine
Degree: Master
University: Mustansiriyah University
Language: English
University location: Baghdad
First pages:
Abstract: نسبة الاختلال الانبساطي الوظيفي للبطين الايسر عند مرضى داء السكري من النوع الثاني والكشف عنها بواسطة فحص الدوبلر النسيجي هدف الدراسة : للبحث عن نسبة الاختلال الانبساطي الوظيفي للبطين الايسر والذي يعد كعامل خطورة على وظائف القلب والاوعية الدموية عند مرضى | Our study about the left ventricular diastolic dysfunction in asymptomatic type 2 diabetic patients, detected by 2 - D and tissue Doppler echocardiography. Type 2 diabetes mellitus (T2DM) is the most common chronic disease, with several complications, affecting all systems and ages. The trends towards improving the longevity in diabetes are achieved by the glycemic control and prevention of complication. Left ventricular diastolic dysfunction (LVDDX) refers to mechanical abnormalities that impede effective volume filling during diastole. It has been described as an early sign of diabetic cardiomyopathy preceding the systolic damage. It can lead progressively to heart failure and is linked to increased mortality.Objective : The aim of this study is to estimate the percentage of left ventricular diastolic dysfunction in asymptomatic patients with type 2 diabetes mellitus detected by 2 - D and tissue Doppler echocardiography.Setting : This study is conducted by the department of physiology, college of medicine, Al - Mustansirirya university in cooperation with the unit of Echocardiography at Al - Yarmouk Teaching Hospital in Baghdad during the period from November 2013 to July 2014. Patients and methods : A total number of 130 subject were examined, where 38 were excluded and only 92 were included in this study, about 46 healthy subjects (control group) (with mean age of 47.07±7.6 year) and 46 patients with T2DM (with mean age of 49.39±5.7 year).Main outcome measures : The plan of the study consisted of the following steps : 1. History interview2. Physical examination3. Physical measurements including : body mass index (BMI), neck circumference (NC), waist circumference (WC), hip circumference (HC) , mid thigh circumference (MTC) calculation by measuring tape.4. Electrocardiography5. Conventional echocardiography and TDI6. Blood sample for hemoglobin A1C (HbA1c), fasting blood sugar (FBS), lipid profile.Results : Our study showed structural and functional changes in the left ventricle in a sample of diabetic patients. Diastolic dysfunction presents in 69.6% of diabetic patients, 41% were males and 59% were females. The mean age of the diabetic patients was 49±5.7 year. The mean duration of diabetes in asymptomatic normotensive type 2 diabetic patients was 7.6 ± 6.4 year. By TDI the diabetic patients in comparison to control group show lower E` average velocity (8.9±1.9 Vs 10.7±1.6 cm/sec)(P<0.0001), higher E/E` average ratio (7.4±1.7 Vs 6.4±1.3cm/sec) (P<0.04), lower E`/A` ratio (0.8±0.3 Vs 1.02±0.3)(P<0.004). While by conventional echo the diabetic patients show lower E velocity (63.7±13.4 Vs 72±19.9cm/sec) (P<0.01) and lower E/A ratio (0.9±0.3 Vs 1.17±0.4) (P<0.0001). Biochemical analysis show lower HDL (1.1±0.2mmol/l)(P<0.0001) and higher TG/HDL (1.8±1.4)(P=0.025). The study showed that diabetic patients had higher BMI 30.6±5.5 kg/m2 (P=0.052), higher neck circumference (40.4±3.9 cm) (P=0.034) and higher waist circumference (105.7±11.7 cm)(P<0.0001). All other values were not significant. Our study revealed that the highest percentage of LV diastolic dysfunction found in the group of diabetic patient with the highest duration of type 2 DM disease. The study revealed some correlations between some parameters of the study like : the duration of T2DM was positively correlated with A velocity (r= 0.29, p= 0.048), FBS was negatively correlated with A velocity (r= - 0.39, p= 0.008), FBS was negatively correlated with LVEDD (r= - 0.29, p= 0.049), FBS was negatively correlated with neck circumference (r= - 0.48, p= 0.0008), HDL was negatively correlated with IVS thickness (r= - 0.567, p= 0.00003) and mid - thigh circumference was positively correlated with A` average velocity (r= - 0.39, p= 0.008)Conclusion : 1. Type - 2 diabetes Mellitus is associated with a higher percentage of left ventricular diastolic dysfunction which is increased with the increased duration of DM. 2. Tissue Doppler echocardiography is a valuable tool in detecting LV diastolic dysfunction in asymptomatic normotensive diabetic patients with non significant features on conventional echocardiography.3. TDI is more sensitive and specific in detecting LV diastolic dysfunction in asymptomatic type 2 DM than pulsed wave flow Doppler.

دراسة نسيجية لجلد اناث وذكور الفئران بعد اعطاء عقار الكلوكوزامين سلفيت == Histological Study On The Male And Female Mice's Skin After The Administration Of Glucosamine Sulphate

Author name: معن ماجد صالح السامرائي
Supervisor name: عبد الامير حمادي النعيمي
General topic: Medicine
Specific topic: Anatomy and Histology and Embryos
Degree: Master
University: Mustansiriyah University
Language: English
University location: Baghdad
Key words:
  • Skin
  • glucosamine sulphate
  • glycosaminoglycans
First pages:
Abstract: يتكون الجلد وكما هو معروف جيدا من عدة طبقات من الخلايا متجددة باستمرار عبر اعادة بناء نفسها ذاتيا مرة كل ثلاثون يوما من خلال دورة حيلتية متكررة وتقسم هذه الطبقات الى نوعين اساسية البشرة والادمة. يعتبر الكلوكوز امين سكر اميني بسيط ينبعث من عمليات الايض ال | It is well known that the skin is made up of multiple layers of cells that fare constantly going through self shedding and regeneration once every 30 days, or so in repeated cycles. The layers can be broadly divided into two sections : the epidermis and the underlying dermis. Glucosamine is an amino monosaccharide derived from cellular glucose metabolism. Glucosamine is a simple component or "building block" of more complex molecules. Glucosamine was considered to be an effective treatment for many joint diseases especially osteoarthritis. It is believed that glucosamine maintain healthy joint functions and rebuild damaged joint cartilage, tendons, ligaments and other connective tissue. It does this by stimulating the production of glycosaminoglycans (GAG’s) which are the structural components of cartilage and connective tissue else where in the body. On that basis, this study was designed to study the effects of glucosamine sulphate on the skin.Twenty male and twenty females adult mice (weighting between 23.3gm to 27.2gm), were divided into two equal subgroups (control and experimental); the drug was given at noon three hours after starvation it had been grinded and mixed with food and given as a single oral dose of 350mg/kg body weight per day for 35 successive days. Histological examination and statistical analysis of multiple sections of ventral and dorsal skin of male and female mice and of both subgroups were done by using hemotoxyline and eosin stain. Special stains were used to demonstrate the specific components of the skin as follows : for collagen fibers (Van Gieson's staining method), for elastic fibers (modified Taenzer - Unna Orcien staining method), and for ground substance (Alcian blue stain method).The results reveal that there was no particular change in the epidermis between the experimental and control groups. On the contrary there was a marked thickening with high cellular contents of both layers of the dermis (papillary and reticular).The dermis of the treated animals contains more collagen and elastic fibers. The predominant cell of the dermis was the fibroblast which was more obviously seen in the ventral skin of the treated animals. This study confirms practically that glucosamine sulphate induces significant structural changes in the skin of male and female mice. Using glucosamine sulphate clinically for medical conditions rather than arthritic diseases is now the target of most recent researches, its ability to decrease wrinkles in the aged skin and promotion of wound healing with less scar tissue is consider to be a light for dermatologist and plastic doctors, plus its effect to rebuild any aged, injured and diseased tissue in the body.

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

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

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

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

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

Author name: احمد فاخر حميد
General topic: Medicine
Specific topic: Anatomy and Histology and Embryos
Degree: Master
University: Mustansiriyah University
Language: English
University location: Baghdad
First pages:

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

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

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

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

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

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

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

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

دراسة بكتريولوجية على التفاقم الحاد لمرضى الانسداد الرئوي المزمن == Bacteriological Study On Acute Exacerbation Of Chronic Obstructive Pulmonary Disease (COPD) Patients

Author name: هبة اسماعيل علي العزي
Supervisor name: عروبة خالد عباس | عبد الحميد القصير
General topic: Medicine
Specific topic: Microbiology
Degree: Master
University: Mustansiriyah University
Language: English
University location: Baghdad
First pages:
Abstract: لا يزال مرض الانسداد الرئوي المزمن مشكلة رئيسية في مجال الصحة العامة. ويرتبط التفاقم الحاد مع فقدان سريع في وظيفة الرئة وخلل في نوعية الحياة وهي من الاسباب الرئيسية للامراضية والوفيات في مرضى الانسداد الرئوي المزمن. تعتبر العدوى البكتيريا هي من الاسباب | Chronic obstructive pulmonary disease remains a main problem in public health. The acute exacerbations are related with rapid loss in lung function and defect in the quality of life and are the main causes of morbidity and mortality in COPD. This study was carried out to isolate and identify the bacteria that cause acute exacerbation in chronic obstructive pulmonary disease and sensitivity of isolated bacteria for most of the antibiotics currently in use.Eighty sputum specimens from patients were included in this study and their age was range forty and above , during the period from January 2015 to June 2015 from three places Al - Yarmouk Teaching Hospital, Medical City Hospital and Medical Al khademeain Emamaain City.Bacteria were identified in 52 (65%) while the patient is not specified any reasoned in 28 patients (35%) patients. The diagnosis of bacteria through culture and microscopic examinations and biochemical tests necessary for diagnosis and then the diagnosis has been confirmed of isolation by the Vitek method for each bacterium, the percentages were as follows : Streptococcus pneumoniae was the most frequently isolated bacteria, which recovered from 21 (26.25%) patients. Followed by Klebsiella pneumoniae, Escherichia coli, Pseudomonas spp., which isolated from (7.5%, 7.5%, and 5%) of patients respectively, while (3.75%) for each of Acinetobacter baumannii & Staphylococcus aureus. The proportion of Stenotrophomonas maltophilia was (2.5%) while the proportion (1.25%) for each of Enterobacter cloacae, Leclercia adecarboxylata, Moraxella catarrhalis & Raoultella ornithinolytica.Through the search three cases were infected with Mycobacterium tuberculosis diagnosed by direct Acid Fast Stain test and their percentage was (3.75%).Sensitivity of bacterial isolates to antibiotics Carbapenems and Doxycycline and Chloramphenicol were the most effective against tested bacteria in vitro while Erythromycin, Tetracycline, and Amoxicillin were the least sensitive

دراسة مناعية وجزيئية لخمج القرنية بحمة الحلا - 1 (حمة الهربس البسيط - 1) == Immunological And Molecular Study Of Herpes Simplex Virus - 1 Keratitis

Author name: نهاية كاظم سالم
Supervisor name: عبد العظيم ياسين عبود البراك | فائز اسماعيل الشكرجي
General topic: Medicine
Specific topic: Microbiology - Immunology
Degree: Master
University: Mustansiriyah University
Language: English
University location: Baghdad
First pages:
Abstract: يمثل التهاب القرنية (Keratitis) مشكلة كبيرة قد تؤدي الى فقدان البصر احيانا نتيجة لخدش القرنية او فقدان الوضوحية في القرنية بعد اختفاء الالتهاب, ويعتبر فايروس الحلا (الهربس) البسيط - 1Herpes Simplex Virus - 1(HSV - 1))) هو من اهم العوامل المسببة لمرض التهاب ال | Keratitis is a medical term referring to inflammation of the cornea. It is a serious problem, resulting in everlasting loss of vision as a secondary effect to corneal scarring or loss of clarity of the cornea after the inflammation has disappeared. Most common microbes causing viral corneal keratitis is Herpes Simplex Virus - 1 (HSV - 1). HSV - 1 is a double stranded DNA (dsDNA) virus belongs to the Herpesiviridae. It affects the majority of peoples and its infections have been frequently without clinical manifestation. Ocular HSV - 1 infections caused multiple pathologies with possibly the most damaging being herpetic stromal keratitis (HSK). This study aimed to evaluate the abilities of the immunological and molecular indicators to diagnose herpetic keratitis in the infected and contralateral eye of patients, as well as to assess the immune status of both eyes by using tears and corneal scraping. Fifty - two patients with herpetic keratitis involved in this study, they attended the outpatient clinics / Ibn - AL - Haithum Teaching Hospital from March 2014 until December 2014. For the purpose of comparison, thirty, apparently healthy age matched control subjects were also included. Tears were collected from infected eyes of the 52 patients and from 16 out of the 52 patients contralateral eyes as well as from 30 controls. Corneal scraping had been obtained from 16 patient's infected eyes with corneal ulcers (epithelial ulcers) out of the total patients (52) with herpetic keratitis. Indirect immunofluorescence assay technique (IFA) was applied to measure levels of immunoglobulins (sIgA and IgG) in tears specific to HSV - 1. Realtime - polymerase chain reaction RT - PCR test was used to diagnose HSV - 1 in corneal scraping and tears of patients and control subjects. Interlukin - 17 (IL - 17A), tumor necrosis factor - alpha (TNF - ?) and interferon - gamma (IFN - ?) were measured in tear samples from patients and control subjects by the ELISA sandwich method. In tear samples; results of RT - PCR showed that 39/52 (75%) of the total patient's infected eyes were positive, 12/16 contralateral eyes were positive (75%). Corneal scraping and tear samples were taken from 16 patients with corneal ulcer, tear samples 14/16 (87.5%) positive result, while the corneal scraping samples were 16/16 (100%) positive, this indicates clearly that the cornea scraping is more appropriate and sensitive sample to detect HSV - 1 than tear. All controls were RT - PCR negative. IFA results of IgA and IgG in tears of infected and contralateral eyes were found to be more than the concentration in tears of control eyes with a highly significant p - value (0.0001). Comparison between the infected and the contralateral eyes indicates that both patients' eyes expressed a significant humoral immune response against HSV - 1. Although there were high significant differences between both the mean value of tears IL - 17A in infected and contralateral eyes with control, while the comparison between patient both eyes gave non - significant difference. The mean of tears TNF - ? and IFN - ? concentration in infected eyes of patients as compared to control was found to be highly significant (p= 0.0001). In this study we compared between patients infected eye with control to evaluate the performance of different markers in tear as HSV - 1specific sIgA, HSV - 1 specific IgG, IL - 17, TNF - ? and IFN - ? by using statistical test called Receiver Operating Characteristic (ROC) curve, the sensitivity for all studied parameters ranged from 80% - 96%.At the same time the comparisons between patient contralateral eyes and controls also revealed a high sensitivity range for these parameters ranged from 81% - 100%.These findings proved the ability of these markers in confirming diagnosis of HSV - 1 keratitis. In conclusion, the high percentage of RT - PCR results for corneal scraping sample indicate that this sample and by using this technique is more appropriate and sensitive to detect HSV - 1 than tear samples and detect the shedding of virus in both eyes of the same patients. Both patient eyes indicated that they were a good source for HSV - 1 diagnosis. In spite of the high sensitivity of all studied markers and their diagnostic ability, TNF - ? showed a higher sensitivity. To assess the immunological status of Herpetic keratitis patients, the studied markers TNF - ?, IFN - ? and IL - 17 were evaluated and showed a highly significant differences which indicated there was an active inflammatory condition combined with HSV - 1 infection and finally it can be concluded that both humoral and cellular branches of immune responses were involved in this disease.

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

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

دراسة جزيئية ومناعية لدى عينة من مرضى التدرن الرئوي == Molecular And Immunological Study In A Sample Of Pulmonary Tuberculosis Patients

Author name: مي يحيى عبد الحسين
Supervisor name: عروبة خالد عباس | احمد اسمر منخي
General topic: Medicine
Specific topic: Microbiology
Degree: Master
University: Mustansiriyah University
Language: English
University location: Baghdad
First pages:
Abstract: يعتبر مرض السل الرئوي tuberculosis الذي تسببه بكترياMycobacterium tuberculosis من الامراض المعدية والشائعة واحد الاسباب الرئيسية لحالات الوفاة في العالم, ولاهميته اجريت هذه الدراسة لتسليط الضوء اكثر حول التشخيص المناعي للمرض وعلاقته بالتشخيص الجزيئي.تضم | Tuberculosis (TB) is caused by Mycobacterium tuberculosis; which consider as one of the most common, infectious diseases and major causes of morbidity and mortality worldwide. A prospective study was conducted to diagnose disease by immunological methods and its association with molecular diagnosis.The study included immunological diagnosis by Quantiferon - TB Gold In Tube Test, estimation the serum levels of IFN - ?, TNF - ? and IL - 10 in TB patients and control by a sandwich ELISA test using commercially available kits, in addition to molecular diagnosis by using Gene Xpert MTB/RIF assay, conventional bacteriological tests such as smear microscopy by Ziehl - Neelsen stain for sputum samples. Furthermore, estimation of ESR and WBCs.Fifty TB patients attending the National Reference Laboratory of Tuberculosis /Baghdad from the period between April to July 2014 were recruited in this study. For the purpose of comparison, 50 control samples (respiratory disease and healthy) matched by age and gender were also included.All TB patients' samples were positive by smear microscopy. The results revealed that there were significance differences between AFB scoring and G - Xpert results (p Forty five samples of TB patients with significance difference (p?0.01) were positively detected by Quantiferon - TB Gold Test.The mean serum level of QFT among TB patient and control (3.54 IU/ml vs. 0.866 IU/ml and 0.556 IU/ml), IL - 10 (53.02 Pg/ml vs. 22.24 pg/ml and 7.51 pg/ml) and TNF - ? (74.34 Pg/ml vs. 49.12 Pg/ml and 27.81 pg/ ml) were significantly higher in TB patients as compared to controls (P?0.05).In conclusion, high levels of IFN - ?, TNF - ? and IL - 10 in TB patients serum indicate an important role of theses cytokines in the pathogenesis of tuberculosis, so they could be considered as a good biomarkers for diagnosis and considered as a target for future therapy. The present study revealed significant difference in the WBCs and ESR values between TB patients and control (P?0.05)
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