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Evaluation of the Involvement of the Tempromandibular Joint in Patients with Osteoarthritis and the Accuracy of Ultrasonography as Compared to Computed tomography for Detection of Osteoarthritic Changes.

Author name: احمد عادل عثمان

Supervisor name: هاجر ابراهيم عبد الله

General topic: Dentistry

Specific topic: Oral and Maxillofacial Surgery

Degree: Master

University: Mustansiriyah University

Language: English

University location: Baghdad

First pages:

Abstract: خلفية البحث : اضطرابات المفصل الفكي الصدغي تشير الى مصطلح مركب يحتوي على عدة حالات تتضمن المفصل الصدغي ,التركيبات المحيطة او كلاهما , تظهر على شكل الم في منطقة المفصل والعضلات المرتبطة,وتحدد بالقدرة على الحركة الطبيعية مثل المضغ, الكلام والبلع. مرض التهاب | Tempromandibular joint disorders is a collective term embracing a number of conditions affecting the TMJ, the surrounding structures or both,manifested by pain in the area of joint and associated muscles, and limitation in the ability to make normal movement like mastication,speech and swallowing. Osteoarthritis is a group of mechanical abnormalities involving degradation of joints, including articular cartilage and subchondral bone. Symptoms may include joint pain, tenderness, stiffness, locking, and sometimes an effusion. A variety of causes—hereditary, developmental, metabolic, and mechanical deficits may initiate processes leading to loss of cartilage. 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 undergo atrophy, and ligaments may become more lax.Objective of the study : • To determine the extent of tempromandibular joint involvement in patients with osteoarthritis.• To evaluate the correlation between clinical and radiographical findings. • To evaluate the accuracy of sonography in detection of osteoarthritic changes compared to Computed tomography.Materials and method : A comparative study had been done using thirty six symptomatic patients(24 female and 12 male) above 40 years diagnosed as osteoarthritis by specialist rheumatologist in Alkarkh general hospital, with clinical finding related to osteoarthritis like pain,tenderness,crepitation, clicking and limited mouth opening. these patients were exposed to computed tomography(CT) scan (Philips - Brilliance 64) in Al - Karkh general hospital and then the results were compared with sonographic findings (Philips 12.5 MHz transducer) to see the disc displacement, effusion, erosion, flattening, osteolytic and osteophytic lesions in the condylar head.The period of the study started from (october - 2013 to june - 2014).Results : The result of the study showed that the mean age of osteoarthritic patients was (49.69) years, and female percentage (66.7%) and male(33.3%). Chief complaine showed more predilection in the left side (28%) and bilateral showed(56%).Clinically : limitation in mouth opening (50%),crepitation(36.11%), clicking (27.7%), and tenderness (20.8%). Radiographically Computed tomography(CT) scan showed disc displacement (50%), joint effusion (37.5%), flattening(36.11%), osteophyte(18,05%), and erosion(11.1%). There was significant correlation between clicking and joint effusion in computed tomography(CT),while tenderness showed significant correlation with osteophyte and joint effusion in sonography. Other correlations were non significant correlation between clinical and radiological changes. Association between computed tomography(CT) and sonography showed fair agreement in osteophyte detection,fair agreement in joint effusion,moderate agreement in detection of joint erosion,moderate agreement in reduction of space and anterior disc displacement and also moderate agreement in condylar head flattening. Conclusions : Osteoarthritis in tempromandibular joint may be unilateral or bilateral. About 50% of Patients with osteoarthritis have limitation in mouth opening. Clinical findings play a major role in diagnosis of osteoarthritis. The tempromandibular joint changes in osteoarthritis were the results of degenerative processes, in contrast to rheumatoid arthritis were the changes as a result of the disease. Sonography was more likely to be sensitive rather than specific in detection of osteoarthritic changes

حدوث وشدة الالم بعد استخدام ثلاثة انظمة مختلفة لتحضير قنوات الجذور == Incidence And Severity of Pain Following The Usage of Three Different Root Canal Instrumentation Systems

Author name: احمد حمد عبيد

Supervisor name: جمال عزيز مهدي

General topic: Dentistry

Specific topic: Dental Treatment

Degree: Master

University: Mustansiriyah University

Language: English

University location: Baghdad

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Abstract: Postoperative pain after endodontic procedures is an undesirable occurrence for both patients and clinicians. Certain factors may predispose to the development of postoperative pain. Knowledge of the causes and mechanisms behind interappointment pain in endodontics is of utmost importance for the clinician to properly prevent or manage this undesirable condition. The causative factors of interappointment pain encompass mechanical, chemical, and microbial injuries to the pulp or periradicular tissues, which are induced or exacerbated during root canal treatment. Ninety patients were recruited and included in this study out of one hundred and twenty patients, those patients requiring endodontic treatment on their permanent upper or lower molar teeth with asymptomatic irreversible pulpitis preoperatively, access opening and instrumentation was performed at the same visit.Patients ranged in age from 19 to 50 years old, and all were in good health, as determined from a written health history and oral interview.The patients were assigned randomly into three groups of 30 patients each : ? First group (n=30) : Teeth were instrumented using Universal ProTaper System (Full Rotary technique).? Second group (n=30) : Teeth were instrumented using ProTaper Next System (Full Rotary technique).? Third group (n=30) : Teeth were instrumented using WaveOne System (Reciprocating technique).Pain assessment carried out at day 1, 2, 3 & 7 using Verbal Rating Scale (4 - Point Scale). Patients recorded the incidence and severity of pain experienced.Patients were called at 24, 48 and 72 hours to obtain their reports for the first three days. Seven days after treatment their records were reviewed and percussion test was performed. Result showed that all groups induced Post - operative Pain, the difference is some systems cause more Post - Operative pain than other do : group 3 (WaveOne group) showed higher incidence and severity of PostoperativePain, followed by group 1 (Universal ProTaper group) that has shown less incidence and severity of Post - operative Pain than group 3 (WaveOne group), last group which it was group 2 (ProTaper Next group) has shown the lowest incidence and severity of Post - operative Pain. The data obtained were analyzed statistically using Chi Square test, total score for Verbal Rating Scale at day 1, 2, 3, and 7 showed that there was a highly significant differences between ProTaper Next group and other twogroups (P ? 0.001), and non - significant differences between ProTaper group and WaveOne group (P ? 0.05).

مستخلصات الشاي تاثيرها الذاتي او الاضافي على حياة خلايا السرطان : دراسة داخل وخارج الانبوب == Herbal Tea : Its Own Or Additive Effect On The Survival Of Cancer Cell Line : An In Vitro And Ex Vivo Study

Author name: هدى غسان حميد

Supervisor name: مروان صالح النمر | ناهي يوسف ياسين

General topic: Medicine

Specific topic: Medicines and Toxins

Degree: Master

University: Mustansiriyah University - Faculty Of Medicine - Pharmacology Department

Language: English

University location: Baghdad

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Abstract: اجريت هذه الدراسة في فرع الفارماكولوجي في كلية الطب في الجامعة المستنصرية بالتعاون مع مركز ابحاث السرطان والوراثة\الجامعةالمستنصرية خلال الفترة من شهر كانون الثاني - شهراب لسنة 2014. الدراسة اقرت من قبل مجلس كلية الطب. صممت هذه الدراسة لتوضيح فعالية نبات ا | This study was conducted in the Department of Pharmacology at College of Medicine with incorporation of the Iraqi Center for Cancer and Medical Genetic Research at Al - Mustansiriya University, Baghdad, Iraq during 2014. This study was designed to elucidate the anti - cancer effect of Camellia sinensis by using four types of tea (black, green, white and oolong). Two experimental cancer models applied in this study; cancer cell lines (In vitro) and mice - bearing tumor (ex vivo). Several methodological and extracted aqueous and organic solvents were used to extract the tea. Microwave assisted extraction using distilled water as a solvent is applied in this study as the yield of bioactive substances are higher than other methods and organic solvents. The antioxidant activity was evaluated through the quantification of total flavonoids, total polyphenolic compound (bioflavanoids), total flavonols, reducing power, and proanthocyanidines. The scavenging property against reactive nitrogen species also was studied. The result showed that the different tea types contain approximately the same quantity of phenolic compounds; the only significant difference was in the proanthocyanidins level, which is a class of flavanols, found in high quantity in green tea compared with other tea extracts. Moreover, a significant scavenging property of peroxynitrite radical observed with all tea extracts. The extracts of black, green and oolong tea prevented or halted nitric oxide generation whereas the white extract tea promoted its generation, that is, a nitric oxide donor. The in vitro cytotoxic activity of Camellia sinensis in form of black, green, white and oolong tea was evaluated against four different types of cell lines. These are the AMN3 mammary cell carcinoma, Rhabdomyosarcoma, HeLa cells and Rat embryo fibroblast cells). The results showed greater effect of green and black tea over white tea and oolong tea against mammary cell carcinoma while the results of rhabdomyosarcoma cell line, which is an aggressive cancer cell, revealed a significant inhibitory effect of the growth of these cells by white and oolong tea extracts. All four types show almost equal percent of growth inhibition on HeLa cell line with the white tea been the most significant. A significant inhibitory effect of all tea extracts against the growth of rat embryo fibroblast cells indicated that the cytotoxic effect of the Camellia sinensis extended to normal cells and not specific to cancer cell. In addition, the antitumor effect of tea extracts was investigated (ex vivo) on BALB - c mice bearing - tumor. The volume, shape and color of the tumor masses were examined, in addition to measurement of the tissue malondialdehyde level as a biomarker of the lipid peroxidation, total tumor protein measurement and a histopathological study were done. The white tea showed antitumor effect by attenuating all the biomarkers of tumorogenesis. Herbal tea extracts induced DNA damage in term of separation the double strands molecule of calf thymus double stands DNA and human genomic DNA which may partly explained anti - cancer effect. We concluded that white tea extract is a promising nutrient that ameliorates the histopathological changes in mice bearing mammary tumor via generation reactive oxygen species by the evidence of activation lipid peroxidation process. Camellia sinensis plant can induce non harmful effect on DNA

تاثير كل من عقار الروزوفاستاتين وعقار الاتورفاستاتين على مؤشرات نسب السكر المصاحبة للسمنة المحدثة في الفئران == Effects Of Atorvastatin Versus Rosuvastatin On Glycaemic Indices In Diet Induced Obese Mice

Author name: نورس لطيف وهاب

Supervisor name: علي اسماعيل عبد الله محمد | حيدر مطير القريشي

General topic: Medicine

Specific topic: Medicines and Toxins

Degree: Master

University: Mustansiriyah University - Faculty Of Medicine - Pharmacology Department

Language: English

University location: Baghdad

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Abstract: Numerous interventional cardiovascular disease outcome studies have resulted in statins being an essential factor of cardiovascular primary and secondary prevention strategies.In recent years there was ahigh concern that statin use is associated with diabetes new onset which is strong, independent risk factor for cardiovascular (CV) and cerebrovascular outcomes ,several studies resulted in conflicting results regarding different statin types & dose effect on glycemic control. Atorvastatin which is the most widely used statin worldwide and rosuvastatin the most efficacious ;they have different structural characteristics that have been speculated to have influence on diabetes onset.Aim of the study : The present study aims at investigating the effect of different doses of atorvastatin and rosuvastatin on glycaemic indices and metabolic disorders on mice model of diet induced obesity. Materials and method : The animals were divided into two groups : one served as control that received normal regular chow & the other group received high fat diet for the whole 12 weeks of experiment.After eight weeks of HFD feeding ;group (2) farther subdivided into five groups(12 mice in each) ; the first group received HFD only ,the second group received single daily dose / po of 20mg /kg rosuvastatin ,the third group received single daily dose / po of 40mg /kg rosuvastatin ,the fourth group received single daily dose / po of 20mg /kg atorvastatin ,and the fifth group received single daily dose / po of 40mg /kg atorvastatin for the last four weeks of experiment.Body weight ,food intake, lipid profile ,glycaemic indices were taken at baseline ,before treatment and after treatment.At the end of experiment ,animals were sacrificed , plasma & tissue sample were collected for biochemical analysis and histological observations.Results : Results of the present study shows that high fat diet feeding resulted in obesity development and metabolic abnormality like; hyperglycemia ,hyperinsulinemia ,insulin resistance , dyslipidemia and moderate to severe hepatic steatohepetitis compared to control group. and treatment resulted in significant improvement in lipid profile ,reduction in food intake ,body weight ,also associated with improvement in insulin sensitivity , hepatic steatohepetitis and reduction in insulin secretion.twenty mg/kg dose of atorvastatin showed better influence on glycaemic indices and comparable influence on hepatic picture over fourty mg/kg does while twenty mg/kg dose of rosuvastatin resulted in deterioration of glycaemic indices and no apparent improvement in hepatic steatosis. Unlike group that received 40 mg /kg rosuvastatin which showed significant improvement in all related metabolic disorders. Conclusion : Feeding mice with high calories diet for 2 month result in induction of obesity and disturbance of metabolic parameters. Treatment with rosuvastatin or atorvastatin has good impact on bodyweight , metabolic derangements &hepatic steatosis in obese mice. Both drugs seems to improve lipid profile in dose dependent manner, however their effects on glycaemic indices has different attitude. It is seems that rosuvastatin, especially at high dose, has better impact on glycaemic indices than atorvastatin and this might attributed to the difference in their pharmacokinetic properties

التقييم الفسلجي للاعتلال العصبي الذاتي لمرضى داء السكري

Author name: نسرين قادر كامل

Supervisor name: محمد شريف عبد الله | موسى محمود مربط

General topic: Medicine

Specific topic: Physiology

Degree: Master

University: Mustansiriyah University

Language: English

University location: Baghdad

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Abstract: (Diabetes Mellitus) D.M : - is the most common endocrine disease, characterized by abnormalities of glucose, protein and lipid metabolism. Diabetic neuropathy is one of the long term chronic complications, which contributes to increase the morbidity & mortality rate in diabetes. One of the earliest manifestations of diabetic autonomic neuropathy is denervation of the cardiovascular system, assessment of cardiovascular reflexes affords a satisfactory evaluation. Along duration time.A battery of bedside clinical tests was used to assess the autonomic function of the heart. This is the response of blood pressure to sustained handgrip and standing - up. The R - R interval change and Q - T interval change in the E, C G in response to standing - up, deep breathing and valsalva maneuver. Number of the patients was 40 diabetic subject and 22 age and sex matched healthy controls. Insulin dependent diabetes Mellitus (IDDM) was 25(62.50%) of cases, non insulin dependent Diabetes Mellitus (NIDDM) was 15(37.5%) of cases, autonomic neuropathy was detected in 23 patients (57.5%), Orthostatic hypertension in 19 cases (47.5 %), abnormal blood pressure response to sustained hand grip in 20 (50%), abnormal valsalva ratio in 10 (25%), abnormal heart rate response to deep breathing in 11 cases (27.2%).Among the 13 patients with cardiac diabetic autonomic neuropathy, had a Q - Tc interval of > 440 ms ( p < 0.05 ). Compared to the remaining 4 patients had normal Q - Tc interval of 399.5 ± 37.49ms.Cardiovascular tests for cardiac autonomic neuropathy showed increase prevalence with increase in the duration of Diabetes Mellitus above 15 years.This study showed that diabetics had significantly impaired cardio - autonomic reflexes compared to non diabetics. Also, other group of diabetics who have apparently normal cardio - autonomic reflexes were found to have significantly different values compared to the control group, (heart rate variations with deep breathing and valsalva maneuver had a negative correlation with age)

تاثير استخدام عقار الميتفورمين منفردا او مع عقار السيتاكلبتين على مستويات الاومنتين - 1 لدى مرضى داء السكري من النوع الثاني == Effects Of Metformin Alone Or In Combination With Sitagliptin On Serum Omentin - 1 Levels In Patients With Type - 2 Diabetes Mellitus

Author name: ميقات طالب حمادة

Supervisor name: حيدر مطير خليل القريشي | عبد الكريم يحيى السامرائي

General topic: Medicine

Specific topic: Medicines and Toxins

Degree: Master

University: Mustansiriyah University - Faculty Of Medicine - Pharmacology Department

Language: English

University location: Baghdad

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Abstract: الخلفية : داء السكري يشير الى مجموعة من امراض الايض مع ارتفاع مستوى سكر الدم. يمثل النوع الثاني من داء السكري ما نسبته 90 - 95% من جميع حالات السكري. يمثل النقص في الانسولين ومقاومة الانسولين وغيرها من الاضطرابات الهرمونية المشاكل الاساسية لمرضى السكري من ال | Background : Diabetes mellitus (DM) describes chronic metabolic disorders with hyperglycemia. Type II DM (T2DM) represents for approximately 90 - 95% of all diabetic types. A combination of insulin deficiency, insulin resistance and other hormonal irregularities are key problems with T2DM. Adipose tissue can be classified into two types : the brown and white adipose tissues. The white type is considered an important secretory organ which produces many bioactive molecules, collectively termed adipokines. Recently, a new adipokine named omentin - 1, has been identified and it was found that individuals with impairment in glucose homeostasis and newly diagnosed T2DM showed a lower serum omentin - 1 level. However, the effects of antidiabetes drugs on serum omentin - 1 level had not been studied extensively.Objective : The current study was design to measure serum omentin - 1 in T2DM as comparing with control subjects, also to study the effect of three months therapy with metformin and/or sitagliptin (when added to ongoing metformin therapy) on serum omentin - 1 levels in addition to other parameters.Method : This study was carried out on thirty healthy control subjects, and sixty three T2DM patients. The patients enrolled in the current study were divided into two groups. First group : included thirty one of newly diagnosed T2DM patients, started treatment with metformin. Second group : included thirty two patients with T2DM, already on ongoing metformin therapy and started treatment with sitagliptin. All patients received their treatment for three months duration, and blood samples were collected from them at the beginning of the study and after three months of starting treatment to measure the possible change in the studied parameters which include : fasting blood glucose (FBG), postprandial blood glucose (PBG), Glycosylated haemoglobin (HbA1c), serum level of insulin, insulin resistance (IR), serum omentin - 1 levels, lipid profile, body mass index (BMI) as well as blood pressure. Results : The results showed that baseline level of serum omentin - 1 in the newly diagnosed T2DM was significantly lower than matched control subjects. The level of omentin - 1 was significantly reduced after three months duration of treatment in sitagliptin group with no significant change in metformin group. FBG, HbA1c and PBG were decreased significantly after three months in metformin group, while in sitagliptin group, only HbA1c and PBG were decreased significantly after three months. In both groups, and after three months duration of treatment, there were no significant changes in serum level of insulin, IR, TG, VLDL - C, HDL - C, BMI, and blood pressure.Conclusion : In newly diagnosed patients with T2DM, serum omentin - 1 was reduced compared to age and BMI matched healthy subjects. Three months treatment with sitagliptin resulted in a significant reduction in omentin - 1 levels compared with baseline values. However, three months treatment with metformin had no significant effect on serum omentin - 1 level compared with pre - treatment value

تاثير استخدام عقار الكلورال هيدريت منفردا او استعماله مجتمعا مع عقار الديازيبام كمهدئ عند قياس الاداء السمعي الدماغي عند الاطفال == Chloral Hydrate Alone Or In Combination With Diazepam As A Sedative For Auditory Brainstem Response Testing In A Pediatric

Author name: مريم محمد حميد مصطفى

Supervisor name: حيدر مطير خليل القريشي | حيدر وهاب السرحان

General topic: Medicine

Specific topic: Medicines and Toxins

Degree: Master

University: Mustansiriyah University - Faculty Of Medicine - Pharmacology Department

Language: English

University location: Baghdad

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Abstract: اجريت الدراسة الحالية لبحث تاثير استخدام الكلورال هيدريت منفردا او استعماله مع الديازيبام كمهدئ عند قياس الاداء السمعي الدماغي عند الاطفال من اجل تقييم ما اذا كان اضافة الديازيبام له تاثير ايجابي او سلبي.اعتمدت الدراسة الحاليه على160 متطوعا من الاطفال ال | Background : children usually need sedation for diagnostic and therapeutic interventions. It is well known that pediatrics age groups are at higher risk for sedation - related complications than adults. Auditory brainstem response testing is one of the important diagnostic procedure that usually need sedation in order to preformed in children. Chloral hydrate is a hypnotic agent used since 1832 with low incidence of adverse events; whoever, despite the world wide use it is being abandoned due to bitter test, long time of sedation onset, vomiting and mild sedation. Rectally diazepam, on the other hand, produces higher and fast concentration in CSF with greater rate of success but probably with higher adverse events. Aim of the study : were to compare the sedative effect of chloral hydrate with chloral hydrate diazepam combination as well as their related adverse effects in children underwentg auditory brainstem response testing. Methods : in this randomized clinical study, 160 child underwent sedation for auditory brainstem response test participated. They were divided equally and randomly into 4 groups. Group A : Received 20 mg/Kg oral chloral hydrate as sedative, Group B : Received 20 mg/Kg oral chloral hydrate plus 0.5 mg/Kg diazepam rectally, Group C : Received 40 mg/Kg oral chloral hydrate as sedative, and Group D : Received 40 mg/Kg oral chloral hydrate plus 0.5 mg/Kg diazepam rectally. At the beginning, blood pressure, respiratory rates, peripheral oxygen saturation recorded, and then re - recorded immediately after drug administration and at (3, 5, 10, 20, …. min). Ramsay sedation scale used for assessment of the sedation level which measured every 10 min. Results : This study shown the beneficial use of chloral hydrate in combination with diazepam as sedation in ABR test (in groups D) by increased in the sedated number (p<0.05), decreased in the requirement of chloral hydrate re - dose, increased in the number of children whom completed ABR test (p<0.05) without significant differences on side effects or vital signs compared with the others three groups. 4.3. Conclusion : From this study we concluded that : • Used of oral chloral hydrate in dose (20mg/kg) alone not sufficient as sedative in paediatrics for ABR test.• Used of oral chloral hydrate dose (20mg/kg) in combination with rectal diazepam (0.5 mg/kg) better than used it alone as sedative in paediatrics for ABR test.• Used of oral chloral hydrate dose (40mg/kg) in combination with rectal diazepam (0.5 mg/kg) was the best sedative in paediatrics for ABR test. • Used of Chloral hydrate diazepam combination in ABR test of paediatrics increased the number of the sedated children, decreased the requirement of chloral hydrate re - dose, and increased the number of completed ABR test, with less complication

تاثيرات استخدام عقار الفيراباميل وعقار السايكلوسبورين في حالة اعتلال عضلة القلب الناتج من استخدام عقار الدوكسوروبسين : في الفئران المختبرية == Effects Of Verapamil,Labetalol And Cyclosporine Use In The Condition Of Cardiotoxicity Resulted From Doxorubicin Use : Animal Model Study

Author name: محـمد عبد العزيز محـمد

Supervisor name: حيدر مطير خليل القريشي | خالد جمعة 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: Doxorubicin is a member of anthracycline antibiotic that widely used in the treatment of different types of cancer such as hematological malignances, solid tumors, and different organ tumors, doxorubicin is very efficient in the treatment of cancer. But the use of doxorubicin is limited by the side effect of doxorubicin on the same organ, the most important organ that affected by doxorubicin is the heart, the toxicity of doxorubicin in the heart, the use of doxorubicin due to the cardiotoxicity that induced by doxorubicin will lead to cardiomyopathy and in the final result of these cardiotoxicity lead to congestive heart failure that occurred secondary to the cardiotoxicity may appear after long period of termination of treatment by doxorubicin.ObjectivesThe aim of the present study its investigate the possible modulation effect of drugs (verapamil, cyclosporine, labetalol) on the cardiotoxicity that induced by doxorubicin drug. Animals and methods forty Dwale - Spargue male rats where enrolled in this study, the animals divided into groups, (5) rats in each group and assigned as I,II,III,IV,V,VI,VII,VIII.Group I : received physiological saline (5ml/kg), orally, daily for ten days and served as the control.Group II : received a single dose of doxorubicin (15mg/kg), intraperitoneal and was sacrificed after 48 hours which served as doxorubicin group.Group III : received verapamil (5mg/kg), orally daily for ten days and on day eight, one hour after drug administration, a single dose of doxorubicin (15mg/kg), intraperitoneal were given.Group IV : received cyclosporine (0.5mg/kg), orally daily for ten days, and on day eight, one hour after drug administration, a single dose of doxorubicin (15mg/kg, intraperitoneal) was given.Group V : received cyclosporine (1mg/kg), orally daily for ten days ,and on day eight ,one hour after drug administration a single dose of doxorubicin (15mg/kg),intraperitoneal was given. Group VI : received both of verapamil (5mg/kg,orally) and cyclosporine (0.5mg/kg,orally) one hour apart, daily for ten days ,and on day eight, one hour after drug administration ,a single dose of doxorubicin (15mg/kg), intraperitoneal was given.Group VII : received labetalol (0.5mg/kg), orally daily for ten days, and on day eight, one hour after drug administration, a single dose of doxorubicin (15mg/kg, intraperitoneal) was given. Group VIII : received labetalol (1mg/kg, orally),daily for ten days ,and on day eight ,one hour after drug administration ,a single dose of doxorubicin (15mg/kg), intraperitoneal was given.Serum MDA, LDH, Troponin I, and interleukine - 17. Were measured and histopathological changes also viewed?ResultsThe results in this study showed an increase in the cardiac biomarkers in the doxorubicin group compared to the control group, the cardiac biomarkers that measured are LDH, MDA, Troponin I, interleukine - 17. Also the results showed histopathalogical changes in cardiac tissue in doxorubicin group as compared to the control group, also the results showed the pre - treatment with verapamil, cyclosporine low dose, cyclosporine high dose, combination of verapamil and cyclosporine low dose, labetalol low dose, labetalol high dose showed decreasing in the cardiac biomarkers MDA, LDH, Troponin I, interleukine - 17 to a significant amount compared to the doxorubicin group, also showed histopathlogical improvement in cardiac tissue. Conclusions Doxorubicin drug used as antineoplastic agent will produce a toxic effect on the cardiac tissue, this toxic effect will limit the use of doxorubicin, cyclosporine, labetalol and verapamil produced differential effects and protection from Doxorubicin induced cardio toxicity via amelioration of cardiac biomarkers and histopathological changes

عزل وتحديد هوية فيروس الحصبة في علاقته ببعض الجوانب المناعية من الاشخاص النازحين الملقحين في محافظة بابل == Isolation And Identification Of Measles Virus In Relation To Some Immunological Aspects From The Vaccinated Displaced Individuals In Babylon Governorate

Author name: ليث احمد عمران كيف الكيف

Supervisor name: محمد عبد كاظم حسن السعدي | يونس عبد الرضا كحيوش الخفاجي

General topic: Medicine

Specific topic: Microbiology

Degree: Master

University: Mustansiriyah University

Language: English

University location: Baghdad

First pages:

Abstract: اجريت الدراسة لتقييم مناعة المجتمع لكلا النازحين والمقيمين الملقحين بلقاح فيروس الحصبة ضد خمج الحصبة في محافظة بابل. لذا تضمنت هذه الدراسة معايرة الحالة المناعية في امصال النازحين والمقيمين محافظة بابل مع عزل وتشخيص فيروس الحصبة من الحالات المشتبه بها. ت | The study was conducted to evaluate the herd immunity for both the displaced and residents vaccinated with measles virus vaccine against measles infection in Babylon governorate. Therefore this study includes the evaluation of the immune status in sera of Babylon governorate displaced and residents with specific aspect for isolation and identification of measles virus from suspected cases. The immune response was evaluated by means of ELISA test (enzyme linked immunosorbet assay) for titration of IgM and IgG immunoglobulin level, in addition to evaluation of perforin level in the sera of 90 measles vaccinated individuals included in this study (50 displaced and 40 residents) from different areas in Babylon governorate, that were collected during the period extent from January up to April of 2016. Data about individuals were fixed according to information of formula including age, sex, geographical location, place displace of displaced and the vaccination date. Successful virus isolation from suspected cases on two types of cells culture included Vero cells line and chicken embryo fibroblast was carried. The titer of the isolated virus on Vero cell line reached (105.8 TCID50 / 0.1ml),which was higher than the titer of the virus isolated on CEF which reach (105.4 TCID50 / 0.1ml) after the third passage of the virus. The isolated virus was confirmed by indirect immunofluorescence technique.The age of subjects included in this study ranged from <1 year up to 24 years old. The results revealed that 15 (30%) have positive IgM index in sera of displaced, whereas residents sera sample shown only 6 (15%) positivity. Howover, all 90 (100%) subjects of both groups showed positive IgG index. The results of the present study showed that there were no significant difference of perforin level in sera of refugees and residents at p<0.05.Assaying of immune response against measles virus by measuring IgM immunoglobulin in sera of vaccinated displaced and resident with measles vaccine reflected a highly significant difference between two groups which reached 0.43 mIU/ml in sera of displaced in comparison with residents sera which reached 0.34 mIU/ml. The result showed also high significant differences in IgM between females and males. The females sera IgM levels of displaced and residents were higher than its level in males sera which reached 0.47 mIU/ml and 0.35 mIU/ml, respectively, in comparison with male sera level which reached 0.40 mIU/ml and 0.32 mIU/ml, respectively. According to age group, the highest IgM value was recorded in displaced and residents sera in age group 10 - 14years (0.50 mIU/ml) and 5 - 9years (0.36 mIU/ml) respec - tively. Whereas the lowest IgM serum value was detected in age group <1 year (0.34 mIU/ml) and 15 - 19years (0.31 mIU/ml) for displaced and residents subjects. According to geographical location, the highest IgM level was detected in sera of displaced from Tal Afar city (0.44 mIU/ml) followed by displaced from Ramadi (0.41 mIU/ml) and the lowest IgM value was detected in sera of displaced from Mosul city (0.33 mIU/ml). Whereas the highest IgM value in sera of residents in the subjects of Al - Mahaweel city (0.37 mIU/ml) followed by subjects of Hilla and Al - Qasem city (0.29 mIU/ml and 0.28 mIU/ml) respectively. For IgG serum immunoglobulin the results revealed that there was no difference in significant levels in both group population. But according to age groups significant difference between displaced and residents was detected at p <0.05 in which the 1 - 4 years old showed the highest IgG serum level in both group (1.98 mIU/ml and 2.18 mIU/ml) respectively. While the lowest IgG sera value was recorded in displaced age group of < 1 year old (0.60 mIU/ml) compared with residents age group of 20 - 24 years old (1.65 mIU/ml).It could be concluded that the results showed that the displaced do not have any effect on the residents of the province of Babylon for measles as a result of the good immunization by Babil Health directorate following to the Ministry of Health.

تاثير استخدام عقار الميتفورمين منفردا او استعماله مجتمعا مع عقار كلكلزايد على مستوى الاومنتين - 1 - في مرضى داء السكري من النوع الثاني == Effects Of Metformin Alone Or In Combination With Gliclazide On Serum Omentin - 1 Levels In Patients With Type 2 Diabetes Mellitus

Author name: سمر محمد غني سليمان

Supervisor name: علي اسماعيل عبد الله محمد | حيدر فاضل الربيعي

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: اجريت الدراسة الحالية لبحث التاثير العلاجي لاستخدام عقار الميتفورمين منفردا او استعماله مجتمعا مع عقار كلكلزايد على مستوى الاومنتين - 1 - باالاضافة الى المؤشرات الحيوية الاخرى في مرضى داء السكري من النوع الثاني من اجل تقييم ما اذا كان الجمع بين العقارين ( | Background : Omentin is a newly identified adipokine, which is highly expressed in visceral adipose tissue, in which omentin - 1 is the main isoform in human circulation, associated with cardio - metabolic disturbances. So considering the impact of anti - diabetic drug on omentin - 1 levels may provide adjuvant strategy to protect diabetic patients against clinical hazards.Aim of the study : The present study aimed to investigate the influence of treatment with metformin alone or in combination with gliclazide on the level of serum omentin - 1, in addition to the other biomarkers adopted in the study in order to evaluate whether the combined therapy (metformin plus gliclazide) ameliorate or adversely effects on some cardiac protector markers of metformin among recently diagnosed patients with type 2 diabetes mellitus.Methods : A total number of 100 recently diagnosed patients with type 2 diabetes mellitus were enrolled in the present study from December 2014 until June 2015. Sixty eight patients completed the 12 weeks course of treatment; divided into two equal groups based on treatment regimen in which group1 treated with metformin and group2 treated with metformin plus gliclazide. Thirty two patients did not complete the course of the treatment for unknown reasons and considered as default. In addition to 31 healthy volunteers were randomly chosen and considered as Control Group. In which all the participants in the study underwent detection of blood pressure, pulse rate, weight, height & BMI in addition to the estimation of the levels of others biochemical analysis as glycemic indices, lipid profile & serum omentin - 1at the beginning of the study & after 12 weeks of treatment regimen.Results : The results of this study shown the beneficial amelioration of metformin on some markers that affect CVS represented as significant reduction in BMI (p<0.05), modest improvement in lipid profile with modest elevation in HDL level & lowering blood pressure, significant reduction in the levels of blood glucose & HbA1C (p<0.05), improves insulin sensitivity, reduced insulin resistance, and elevation of serum omentin - 1 level among newly diagnosed type 2 diabetic patients (group1). Furthermore, the results of current study are revealed that adding of gliclazide to metformin in treatment of type 2 diabetic patients might influence the documented beneficial effects of metformin on cardiovascular system at least by adversely changing the levels of serum omentin - 1 among group 2. Conclusions : Adding of gliclazide to metformin in treatment of patients with type 2 DM might extend the therapeutic action of metformin in regarding much better controlling of glycemic indices, insulin sensitivity and lipid profile. But, at the same time, it might attenuate some of beneficial effects of metformin on cardiovascular system at least by adversely influence on body weight and serum omentin - 1 levels.

تاثير استخدام عقار النكلوزمايد بالمقارنة مع عقار المتفورمين على وزن الجسم ومؤشرات السكر في السمنة المحدثة عند الفئران == Effects Of Use Of Niclosamide Drug In Comparison With Metformin Drug On Body Weight And Glycemic Indices In High Fat Diet Induced Obese Mice

Author name: خالد دهان صليبي

Supervisor name: علي اسماعيل عبد الله محمد | خالد جمعة 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: في ستينيات القرن الماضي كان هناك نوع من العلاجات تستخدم للسيطرة على وزن الجسم او لتخفيفه , تلك المواد تعمل على تثبيط عضيات المايتوكوندريا من انتاج الطاقة وتحويل مجرى تفاعلات الاكسدة نحو انتاج الحرارة بدلا عن الطاقة وبذلك تحفز من زيادة اكسدة الشحوم ومادة ا | Background : Obesity is a state of excessive accumulation of fat tissue in the body , increasing energy expenditure is good way to manage obesity and the related complications. Mitochondrial uncouplers increase energy expenditure , they used before for weight controlling programs because these compounds uncouple mitochondria from generating ATP , moreover stimulate lipid and glucose oxidation preventing lipid accumulation in excess caloric intake conditions specially. Niclosamide an old drug introduced in 1960s as anthelmintic and had FDA approval for the treatment of most of tapeworm infections. It is well known mitochondrial uncoupler.Aim of the study : The present study aimed to investigate the influence of trial of the use of niclosamide in comparison to effect of metformin and their combination on body weight , glycemic indices and lipid profile in high fat diet induced obese mice.Materials and methods : The animals firstly divided to two groups one fed with normal regular mouse chow (30 mice) and the 2nd fed with high fat diet (60%kcal) for 2.5 months(100 mice) 10 mice from each group sacrificed at beginning of study represent baseline values and another 10 mice from each group sacrificed after 2.5 months to assess effect of high fat diet on study parameters. The group that fed with high fat diet further subdivided to 4 groups after 2.5 month of high fat diet feeding each 20 mice , 10 mice from each group sacrificed before treatment represent pretreatment values. Before treatment there are 5 groups assigned as group 1 fed normal regular mouse chow till the end of study , group 2 fed high fat diet without treatment till the end of study , group 3 fed with high fat diet till the end of study and treated with niclosamide for one month (150mg/kg) after obesity induction by high fat diet , group 4 fed with high fat diet till the end and treated by metformin (300mg/kg) for one month and finally group 5 fed with high fat diet till the end of study and treated by combination of niclosamide and metformin (150mg/kg , 300mg/kg respectively). blood samples taken from tail vein to evaluate the study parameters at baseline and after obesity induction by high fat diet (after 2.5 months) and after treatment ,then animals were sacrificed and livers were taken for histopathological observations.Results : The results of this study shown that the animals fed with high fat diet show metabolic disturbances manifested by significant increase (P < 0.05) in body weight , fasting insulin & fasting plasma glucose. Lipid profile show significant changes (P < 0.05)(cholesterol , triglycerides ,low density lipoproteins increased while high density lipoproteins decreased ) as compared to control group. High fat diet group also show impaired glucose tolerance , impaired insulin sensitivity and obvious liver structural changes manifested by sever steatosis.Treatment with niclosamide show improvement in all metabolic disturbances induced by obesity ; body Weight , fasting insulin and fasting plasma glucose reduced significantly (P < 0.05). Lipid profile parameters improved ; cholesterol , triglycerides , low density lipoproteins reduced significantly (P < 0.05) by one month treatment with niclosamide and high density lipoproteins increased significantly (P < 0.05) as compared to their baseline values before treatment, Glucose and insulin tolerance improved. It is nice to mention the influence of niclosamide in this study was comparable to metformin in all evaluated parameters.Combination of both drugs show favorable improvement in metabolic disturbances induced by obesity rather than each drug when used alone specially on liver histopathological changes.Combination of both drugs show significant reduction (P < 0.05) in body weight ,fasting plasma glucose and fasting plasma insulin. Lipid profile parameters improved significantly (P < 0.05) , glucose and insulin tolerance improved.Liver histopathological changes ameliorated to higher extent and become the closet to normal liver tissue morphology.Conclusions : The result suggest niclosamide have good antidiabetic action and can ameliorate the metabolic changes induced by obesity significantly. Its action is comparable to that of well known antidiabetic drug metformin. Niclosamide has favorable effect on body weight and can reduce body weight. Its combination with metformin show better improvement in metabolic disturbances induced by obesity and it has very good hepatoprotective effect against liver histopathological changes induced by high fat diet.

دراسة مستوى الهيبسيدين ومستقبلات الترانسفرين في عينات من المرضى العراقيين المصابين بحالات فقر دم نقص الحديد واضطرابات زيادة الحديد في الدم == Study Of Hepcidin Level And Transferrin Level In Samples Of Iraqi Patients With Iron Overload And Iron Deficiency Disorders

Author name: داليا نايف جاسم

Supervisor name: علاء الدين مظفر زبير القاسم

General topic: Medicine

Specific topic: Diseases - Blood

Degree: Master

University: Mustansiriyah University

Language: English

University location: Baghdad

First pages:

Abstract: The circulating peptide hepcidin is secreted mainly by the liver as an 84 - amino acid precursor that is subsequently processed and secreted as a 25 - amino acid peptide form. It is considered the "master regulator" of iron metabolism.Transferrin receptor is a carrier protein for transferrin. It is needed for the import of iron into the cell and is regulated in response to intracellular iron concentration. It imports iron by internalizing the transferrin - iron complex through receptor - mediated endocytosis. This study addresses the physiological role of hepcidin in vivo and investigates the role of hepcidin as an erythroid regulator, contributing to the modulation of iron absorption by the intestine and iron release by the macrophages in the situation of anemia with normal or increased iron stores. Measuring the transferrin receptor level and it's relation to hepcidin is another part of the data involved in this study.Methods : This study included 64 Iraqi patients, 34 of them have iron deficiency anemia and the other 30 are iron overload patients. They attended the National Center of Hematology and Thalassemia center in Al - Karama Teaching Hospital during the period from October 2014 until April 2015 together with 30 healthy controls. Information regarding age, sex and clinical presentation were recorded. ELISA technique used to measure hepcidin and transferrin receptors level in patients and healthy control groups.Results : ? Mean serum hepcidin level in iron deficiency anemia patients was (205.3ng/ml) while in iron overload patients was (6.7ng/ml).? Mean serum level of transferrin receptors in iron deficiency anemia was (11006.3ng/ml) and in iron overload was (604.5ng/ml).Conclusion : ? The mean level of serum hepcidin in thirty iron deficiency anemia patients is high. Its elevation represented an acute phase response. While in thirty patients with iron overload, hepcidin mean level was low mainly due to stress erythropoiesis.? The current study result addresses the usefulness of soluble transferrin receptor for assessing high iron status in population and how soluble transferrin receptor is useful in the evaluation of anemic patients.

تقييم نظام المعلومات الصحي في العراق == Assessment Of The National Health Information System In Iraq

Author name: ثائر عيسى مراد

Supervisor name: مازن غازي جاسم الربيعي | امجد داود نيازي

General topic: Medicine

Specific topic: Community Medicine

Degree: Master

University: Mustansiriyah University

Language: English

University location: Baghdad

First pages:

Abstract: تعتبر الاحصائيات الصحية الرصينة ضرورة لاتخاذ القرارات السليمة في كل مستويات النظام الصحي. ولكن في الحقيقة ان نظم المعلومات الصحية في معظم البلدان تعتبر غير كافية لتوفير المعلومات اللا زمة لدعم الادارة الصحية ولهذا فان معظم النظم الحالية تعتبر كعائق اداري | Sound health statistics are essential for health decision - making at all levels of the health system. Unfortunately, health information systems in most countries are inadequate in providing the needed management support and the current systems are therefore widely seen as management obstacles rather than as tools, the current study is an attempt to assess the health information system in Iraq with recognizing the strengths, weaknesses and gaps in addition to assessment of the structure and performance of this system; it also attempts to assess the behavioral, technical and organizational determinants affecting the health information system performance. A cross - sectional study was conducted for the assessment process and the levels of the assessment included the ministry of health (national level), the health directorates (provincial level), the districts related to the health directorates reaching to the health centers level, as well as the hospitals related to the health directorates, in addition to the ministry of planning and the ministry of interior. In addition to ministry of health (central level) a total of six governorates were selected by simple random sampling including the capital Baghdad with a seven districts were selected from those governorates also by simple random sampling and a total of twenty six health centers were selected from those districts, as well a total of seven hospitals were included in the study from all governorate and they were selected according to convenience. The interview has been done by using the health metrics network assessment tool version 4, in addition to a complementary assessment tools which are the PRISM package tools that were used at the district and primary health center levels. Based on the data collected and according to the health metric network assessment tool findings the overall health information system has laid in the adequate state (65.96%) with most of its comprising components function poorly. Data dissemination and use and data management categories were the weakest with a score of 50% and 53.3% respectively, while for the resources category it was found to be adequate 63.3%, and for that of HIS indicators, data sources and information product categories they were 73.3%, 66% and 69.6% respectively. For that of the PRISM tools and the findings obtained by them from the collected data the results revealed that a low data quality in term of accuracy with 29.03% at the facility level and 55.35% at the district level, while the completeness rate was excellent with a score 96.38% at the facility level and 98.23% at the district level, for that of the timeliness it was 70.43% timeliness at the district level. The information use for a given feedback at the facility was 50% and at the district was 82.12% and for observed meeting records it was 50% for the facility and 41.6% for the district level. For that of the functionality a 34.61and 67.30% of the facilities reported having a reminder mechanism for data completeness process and meeting a deadline for submitting monthly reports respectively, Data analysis was better at the district 85.71% than at the facility 81.7%, Data display were present in all of the facilities and districts. For the technical determinant the results showed 57%, 85.7%, 71.4% and 100% of the district respondents felt that the form is complex and difficult to follow, data software is a user - friendly, information technology is easy to manage and a comprehensive picture of the health system performance is captured by the system respectively,85.7% believed that the information system collecting information from some vertical programs and one district reported of no collection at all, in addition to that 100% reported the absence of a software that integrates data from different information systems and the available information technology doesn't provide full access procedure to district and senior managers. Regarding the behavioral determinants the results revealed that overall mean confidence for the information system tasks is 69.41% while for that of the task competence the overall mean competence level is 37.1%. Knowledge of checking data quality, knowledge of health information system rationale and problem solving showed results of 35.32% 37.68% and 2.98% respectively, and that of motivation level was 43.4%. Organizational determinants results revealed that the management functions at facility and district levels were almost absent, while for the perceived promotion of a culture of information it showed a total score of 63.96% and rewarding for a good performance was 56.83%. The activities for promotion of a culture of information are a 25% at the facility level and 28.75% at the district level. And that of supervision quality at the facility were (72.80%). Availability of resources revealed that 100% of the facilities have two or more computers and calculators respectively while only 57.7% have an internet access. Access to the electricity and water supply is very high, No facility reported of running out in registers in the last 12 months. Finally, the current study shows the importance for the need of further attention to be drawn to HIS, in addition to that, increasing the awareness and well coordinated efforts that need to be done to overcome weaknesses and to provide a well functioning HIS enabling for evidence based decision making and action provision in the health system.

تاثيرات السيتاكولين ,الجنسنك واستخدامهما معا على الذاكرة العملية والاداء الحركي النفسي == Effects Of Citicoline, Ginseng, And Their Combination On Psychomotor Performance And Working Memory

Author name: تيسير لطيف علي

Supervisor name: حيدر القريشي

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: اساس الدراسة : اجريت الدراسة الحالية لتقييم التاثير العلاجي لعقار السيتاكولين والجنسنك واستخدامهما معا على الذاكرة القصيرة المدى والاداء الحسي الحركي, وذلك من خلال دراسة الاثار المركزية والطرفية للعقارين على مقاييس الاداء الحسي الحركي , الذاكرة العمليه , | Citicoline is one of components that present in the human brain, which act to protect the neurons and enhance memory and other cognitive functions due to its choline in their structure which play an important role in the biological membrane biosynthesis. On other hand Ginseng is an herbal plant is known for its therapeutic medical importance, it's used for different purposes in medical fields, that is effective against many diseases, act as a tonic and provide energy with significant reduction in mental and physical fatigue.Aims of the study To evaluate the central effects of Panax Ginseng and/or citicoline on normal healthy volunteers.Material and Method The subjects are randomly divided into four groups for assessment of central effects of Panax Ginseng and /or citicoline compared with placebo. The evaluation of the central effects was done by using the Leeds psychomotor battery tester for evaluating the psychomotor performance, workshop test was used to evaluate working memory function.The enrolled volunteers were randomly divided into the following groups : First group regarded as control group that treated with 500 mg/day of starch capsule as a single dose, second group, received Panax Ginseng capsule 500 mg /day, a third group received citicoline capsule 500 mg/day and the fourth group received Panax Ginseng capsule 500 mg/day plus citicoline capsule 500 mg/day as a single dose. All participants are followed for two consecutive weeks from starting treatments.ResultsIn the present study the placebo didn't have any central effect and MDA serum levels were not significantly change. Panax Ginseng has statistically significant effect on the most parameters of the psychomotor performance, working memory performance, as well as reduction of MDA serum levels. On the other hand, citicoline has statistically a significant effects on most parameters of the psychomotor and working memory function with statistically significant reduction of MDA serum levels.The combination of Panax Ginseng and citicoline have a highly statistically significant effect on all psychomotor performance, working memory performance and statistically significant reduction in the oxidative stress marker (MDA). ConclusionResults of the present study showed that combined effects of citicoline plus Panax Ginseng on central function produced more statistically significant effects on psychomotor performances, CFFF and working memory function than either Panax Ginseng or citicoline when they used alone, in addition to the combined effects of citicoline plus Panax Ginseng have a more significant effect on the oxidative stress,during mental stress.

تقييم وحدات الرعاية المركزة لحديثي الولادة في ردهات الولادة لمستشفيات بغداد == Evaluation Of Neonatal Intensive Care Units At Maternity Wards In Baghdad Hospitals

Author name: بشرى احمد عبد اللطيف

Supervisor name: جمال محمود الخضيري

General topic: Medicine

Specific topic: Community Medicine

Degree: Master

University: Mustansiriyah University

Language: English

University location: Baghdad

First pages:

Abstract: تتباين انظمة الرعاية لحديثي الولادة المطبقة ولكنها كلها تعتمد على وحدات الخدج الموجودة في مختلف بلدان العالم النامية والمتقدمة.انجزت هذه الدراسة المقطعية التقويمية في وحدات حديثي الولادة لردهات الولادة في مستشفيات بغداد (الكرخ والرصافة) مستثنين وحدات ال | Neonatal health care is provided via a variety of neonatal care units that are available globally both in different developing and developed countries.A cross - sectional evaluation study was conducted in all accessible fifteen neonatal intensive care units in Baghdad (Kharkh and Rosafa) maternity wards, excluding paediatric hospitals, during the period from November 2013 till the end of March 2014.The study aims : 1. Health care evaluation in neonatal intensive care units of maternity wards in Baghdad hospitals in terms of input (human and non - human resources) and outcome.2. Identifying causes of admissions and causes of deaths occurring in neonatal intensive care units The study consisted of two parts : A structure evaluation is using a check list to assess availability of human and non - human resources, covering infrastructure, manpower, equipment, and supplies; and an outcome evaluation study using hospital registration records review for causes of admission and causes of death in neonatal intensive care units during the year 2013.It was found that the mean number of specialist doctors in neonatal intensive care units was 2.1 and with standard deviation ±1.3, and college nurse was 2.2, with standard deviation of ±4.004, pharmacist was 0.4 with standard deviation of± 0.516 and for supplementary staff 1.5 with standard deviation of± 0.516.More than half 54% of nurses had no training in neonatal care.Concerning the availability of general equipment it was adequate except for computers 40%.Air conditioning, lighting and windows in addition to safe water supply was good 100% but ventilation was poor 67%, hand washing area was not always present 60% and free elbow operated water tubes were available in 6.7%. Availability of neonatal intensive care units special area was adequate for storage area 85.7% gowning area78.6%, while all the remaining areas were poorly available (resting room, examining room, mother room, boiling and autoclave room, area for mixing intravenous fluid and medication).Neonatal intensive care units were narrow and area/incubator ranging from 2.28m2 to 4.36m2/ incubator. Number of incubators was 246 with patient/ incubator ratio 53.6 : 1 and 27% of Neonatal intensive care units had no regular maintenance for incubators. Large Neonatal intensive care units >25 incubators were overcrowded, having below standards area/incubator, incubators covers only two third of neonatal care. Still up to one third of Neonatal intensive care units are getting their oxygen supply by cylinders, not pipes. Most equipment for individual use were poorly available. Most of Neonatal intensive care units emergency (cupboard) drugs and supplies were sufficiently available round the clock. Total admissions to Neonatal intensive care units were 13195 neonates. Male neonate's admissions 60% were higher than females 40%. Main causes of admission were Respiratory distress syndrome 43%, prematurity and low birth weight 19.4%, and Transient tachypnea 17.4%; birth asphyxia 4%, and hypoglycemia 3.8%, Congenital anomalies 3.7%, Neonatal jaundice 3%, while meconium aspiration and septicemia were the lowest1%. From all these admissions 74% were discharged well, (6%) were referred, while those discharged against medical advice were (4%) and the rest (16%) died. The main causes of death in Neonatal intensive care units were Respiratory distress syndrome 34%, prematurity and low birth weight 31% congenital anomalies 12%, birth asphyxia 8%, septicemia 4%, meconium aspiration 1% and 10% due to other unclassified causes. From this evaluation study, it can be concluded that there were Neonatal intensive care units with under staffing, undertraining and poor designing. Respiratory distress syndrome and prematurity were the main neonatal health problems.

تقييم استخدام الروزوفاستاتين والتلميسرتان في حالة تسمم عضلة القلب الحاد المحدث من استخدام الدوكسوروبيسيبن في الجرذان المختبرية == Evaluation The Usage Of Rosuvastatin And Telmisartan In Doxorubicin Induced Acute Cardiotoxicity In Rats

Author name: ايهاب اياد احمد

Supervisor name: علي اسماعيل عبد الله محمد | خالد جمعة 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: اجريت الدراسة الحالية لتقييم التاثيرالعلاجي لاستخدام الروزوفاستاتين والتلمسارتان في التقليل من سمية القلب المحدثة من عقار الدوكسوروبسين في الجرذان المختبريةباستخدام الطرق الكيميائية الحيوية والنسيجية ومقارنة تاثير الاستخدام المزدوج بفعالية استخدام كل م | Background : Doxorubicin, an anthracycline antibiotic is a powerful antineoplastic drug, but its therapeutic usefulness is limited by its cardiotoxicity. Aim of the study : The present study investigated the influence of pretreatment with rosuvastatin and telmisartan alone or in combination in different doses on doxorubicin induced acute cardiotoxicity in rats using biochemical and histological approaches. Materials and methods : The animals were divided into eight groups of 5 animals each. The first group received no drug(s) po but a single dose of distilled water (7.5 ml/kg, ip) on day eight, which serves as the control group. The second group received no drug(s) po but a single dose of doxorubicin (15 mg/kg, ip) on day eight, and serves as doxorubicin only received group. The third and sixth group received rosuvastatin (2 , 10) mg/kg/day respectively for nine successive days, and on day eight, one hour after drug administration, a single dose of doxorubicin (15 mg/kg, ip) was given. The fourth and seventh group received telmisartan (2 , 4) mg/kg/day respectively for nine successive days, and on day eight, one hour after drug administration, a single dose of doxorubicin (15 mg/kg, ip) was given. The fifth and eighth group received both drugs, where the fifth group received both of rosuvastatin (2 mg/kg, po) and telmisartan (2 mg/kg, po), 1 hour apart, daily for nine successive days, and on day eight, one hour after drug administration, a single dose of doxorubicin (15 mg/kg, ip) was given. While the eighth group received both of rosuvastatin (10 mg/kg, po) and telmisartan (4 mg/kg, po), 1 hour apart, daily for nine successive days, and on day eight, one hour after drug administration, a single dose of doxorubicin (15 mg/kg, ip) was given.At day ten of the study, blood samples were taken for biochemical analysis, then animals were sacrificed and hearts were taken for histopathological observations. Results : Rats treated with doxorubicin showed cardiotoxicity as evidenced by significant elevation of serum cardiac troponin (CTn - I) level, lactate dehydrogenase (LDH) activity, serum malondialdehyde (MDA) level, and interluekine 17 (IL - 17) level associated with important histopathological alterations while pre - treatment with rosuvastatin and telmisartan elicited a significant decrease in the activities of all markers measured in comparison with doxorubicin treated group with pronounced resolution of Dox induced cardiac histological changes to a milder picture.Conclusion : These results suggest pretreatment with rosuvastatin and telmisartan alone or in combination provide a significant protective effect against acute - doxorubicin induced cardiotoxicity in rats represented by biochemical markers and histological approaches.

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

Author name: اميل فاروق الشاوي

Supervisor name: رياض خضير لفتة | صالح الحسناوي

General topic: Medicine

Specific topic: Community Medicine

Degree: Doctorate

University: Mustansiriyah University

Language: English

University location: Baghdad

First pages:

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

التغيرات الكيما حيوية في مصل الدم لتراكيز الهيبسيدين والانترلوكين - 6 نسبة لحالة الحديد قبل وبعد العلاج الكيميائي عند المرضى البالغين المصابين بسرطان الدم النيقاني الحاد == Biochemical Changes In Hepcidin And IL - 6 Concentrations Relative To Iron Status In Patients With Acute Myeloid Leukemia Before And After Treatment

Author name: هبة عمار محمد

Supervisor name: ختام عبد الوهاب علي | علاء فاضل علوان

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: هدف الدراسة : لتعيين العلاقة بين هرمون الهبيسيدين (hepcidin) (الهرمون المنظم لتوازن الحديد في الجسم والانترلوكين - 6 ( (interlukin - 6و علاقتها ببعض المتغيرات الكيميائية الحياتية عند المرضى المصابين بابيضاض الدم النيقاني الحاد ((AML قبل وبعد اكمال الجرعة الك | Acute myeloid leukemia (AML) is a clonal, malignant disease of hematopoietic tissues characterized by the accumulation of abnormal blast cells, especially in bone marrow, and impaired production of normal blood cells. The statistics show that this disease in men is more prevalent than women and this type of leukemia is increasing with age. Objectives : To assess biochemical changes related to iron status in acute myeloid leukemia pre and post course of chemotherapy and evaluate a relationship between serum hepcidin and IL - 6 in patients with acute myeloid leukemia pre and post chemotherapy and compare their levels to controls and their contribution on the pathogenesis of AML.Patients, Materials and Methods : The present study conducted at the National Center of Hematology and Baghdad Teaching Hospital in the Medical City from February 2014 to June 2014.The study included Fifty - eight (58) patients (30 male and 28 female) diagnosed with acute myeloid leukemia the age of patients range (15 - 65 years). Forty three (43)patients continued the study (24 male and 19 female) divided into two groups : Group (1) Patients with AML before starting chemotherapy. Group (2) the patients after 4 weeks of chemotherapy. Patient's treatment was done according to international protocol used in acute myeloid leukemia and called (3+7) where Doxorubicin was given from the first day to third day and Cyatrabine (Ara - C) was given from the first day to seventh day.Evaluationwas done on day (28) from starting chemotherapy to assess response of patients through bone marrow aspiration.All patients were subjected to complete history and physical examination. Diagnosis of AML patients was established by complete blood count and blood film, bone morrow aspiration and biopsy, hepcidin, interlukine - 6, C - reactive protein, ferritin, iron, total iron binding capacity, alkaline phosphstase, direct bilirubin were done for all patients.Forty - three (43) healthy subjects (24 male and 19 female) were enrolled in the study mainly from medical staff and their families. They were age and sex matched to patients group and considered as controls as ( Group 3).Results : • Serum hipcidin levels were significantly higher in(AML)patients (Group 2) compared to newly diagnosed(Group 1) and to healthy subjects ( P<0.0001).• Serum (IL - 6) levels were higher but not significant in(Group 1) compared to (Group 2) and significantly with healthy controls(P<0.214 and P<0.0001 respectively).• A significant increase in mean of serum ferritin levels were observed in (Group 2) compared to newly diagnosed patients (Group 1)(P<0.002) and the levels were significantly higher in newly diagnosed group compared to healthy controls (P<0.015).• Patients with (AML) during remission show significant decrease in levels of iron compared to newly diagnosed group(P<0.0001),while levels in healthy controls was higher values than both (Group 2) and (Group 1) (P<0.0001).• Total iron binding capacity (TIBC ) levels showed a significant decrease in (Group 2) after treatment compared to (Group 1) before treatment(P<0.0001) but the levels were significantly higher in healthy controls compared to (Group 1) and (Group 2) (P<0.0001).• Mean serum ALP levels showed highly increase in (Group 2) patients when compared to patients before treatment (Group 1)( P<0.0001), but the difference is not significantly higher between the newly diagnosis and controls (P<0.687).• A significant increase in mean serum direct bilirubin levels were observed in (Group 2) patients when compared to (Group 1) and healthy controls(P<0.0001).• Regarded to CRP levels in AML patients before and after treatment, the CRP levels increased in AML patients after treatment than newly diagnosed AML patients.Conclusions : Hepcidin and Interlukin - 6 may be used asprognostic for acute myeloid leukemia and also can play an important role in pathogenesis of AML.

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

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.

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.