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تقييم وتعريف المكورات المسبحية الطافرة والمتحولة اللثوية في مرضى تسوس الاسنان وامراض النسيج الداعم للاسنان Evaluation and Identification of Streptococcus mutans and Entamoeba gingivalis in Patients with Periodontal Diseases and Dental Caries

اسم المؤلف: مؤيد نعمة مصلح الخفاجي
اسم المشرف: الهام عباس بنيان الساعدي هيام خالص المسعودي
الموضوع العام: الطب
الموضوع الدقيق: الاحياء المجهرية
الدرجة: ماجستير
اللغة: الانكليزية
السنة: 2015
مكان الجامعة: بابل
المستخلص: The present was carried out during the period of November 2014 to April 2015 in Al - Hilla City. This study included 100 samples which were collected from patients at ages ranged between 4 to 75 years old whom were suffering from dental caries and periodontal diseases ; (50) samples were taken from patients infected with dental caries (23 male and 27 female) and (50) samples taken from patients with periodontal diseases (15 male and 35 female), who have submitted to a college of Dentistry in Babylon university and special center of Dentistry. Thirty samples were taken from apparently healthy persons and considered as control.The isolation and identification of S. mutans was performed by Mitis Salivarius Bacitracin agar as a selective medium and biochemical tests as well as API 20 strep, then investigated the virulence factors and show the effect of some antibiotics on bacterial isolates, and the identification of E. gingivalis parasite was by a wet preparation method.The obtained results showed that S. mutans was with a higher existence in patients with dental caries, with lower existence in the patients with periodontal diseases and it was found in healthy persons (30%, 18%, and 0%) respectively. Entamoeba gingivalis was higher in patients with periodontal diseases than patient with dental caries and less in healthy individuals (62%, 24%, and 6%) respectively. The presence of these microorganisms was related to the type of dental disease (p=0. 009), gender (p=0. 009), age (p=0. 008) and risk factors (diabetes, smoking and hypertension) (p=0.037).The effect of some antibiotics on S.mutans was also tested, and the obtained results showed that all isolates were with high resistance to Erythromycin (70.8%) and (66.7%) were resistant to Doxycycline. Some isolates showed low level of resistance to Vancomycin (54.2%), CefatoximeII(33.4%) and Clindamycin (25%), while these isolates were with high susceptibility to Chloramphenicol (100%) and Ofloxacin (83.4%).Finally, some virulence factors of S. mutans were studied and it was seen that the (62.5%) of S. mutans isolates produced α - hemolysis and (8.3%) produced β - hemolysis but (29.2%) of isolates non - hemolysis, but (58.3%) of isolates were made capsule and (100 %) were able to synthesize glucan, (83.3%) of S. mutans isolates were able to produce mutacin and (45.83%) of isolates were found to produce dextranase enzyme, while (84%) were able to biofilm formation .In addition, all isolates in this study were able to adhere to oral epithelial cells.
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دراسة على المايكرومايكروبية الشائعة المعزوله من القناة الهضمية وبعض المعايير المناعية للمرضى الذين يعانون من مرض السكري النوع الثاني A Study on Common Microbiaes isolated from Gastrointestinal and some Immunological Parameter in Patients with Type II Diabeties Mellitus

اسم المؤلف: شذى خزعل كاظم الوائلي
اسم المشرف: هيام خالص المسعودي علي حسين البياتي
الموضوع العام: الطب
الموضوع الدقيق: الاحياء المجهرية
الدرجة: ماجستير
اللغة: الانكليزية
السنة: 2015
مكان الجامعة: بابل
المستخلص: المرضى الذين يعانون من من داء السكري النوع الثاني هم مجموعة غير متجانسة من الاضطرابات التي تتميز بمقاومة الانسولين الواسعة للانسجة ويختلف على نطاق واسع. داء السكري من النوع الثاني هي حتى الان الاكثر شيوعا. تضمنت الدراسة (100) مريض مصاب بالسكري النوع الثاني مشخص من قبل اطباء متخصصين بالسكري و(50) شخص من الناس الاصحاء وفي الفئه العمرية (25 - 65) سنة الوافدين الى مستشفيات في بابل (القاسم ومرجان) خلال الفترة من كانون الثاني 2015 حتى حزيران 2015.واظهرت النتائج ان البكتريا السالبه لصبغة كرام من مجموع العزلات هي السائدة مقارنة مع البكتريا الموجبه لصبغة كرام تشكل 26٪ وشكلت العزلات البكتيرية E.coli الاكثر شيوعا كانت يتبعها Enterobacter spp., K.Pneumoniae, Proteus spp., والبكتريا الاقل شيوعا كانتS.aureus, S.epidermidis, Citrobacter, Micrococcus Kocuria kristinae وStreptococcus spp,في حين ان الطفيليات الاكثر شيوعا كانت E.histolyticaبنسبة 55% وGiardia lambliaبنسبة 45% . تم دراسة عوامل الضراوة للبكتريا الشائعه المعزولة من مرضى السكري من النوع الثاني في هذه الدراسة. وكانت عزلات K.pneumoniae وعزلات Enterobacter وبعض عزلات E.coli تعطي الكبسول بينما بكتيريا Proteus spp. المعزوله في هذه الدراسة لم تمتلك الكبسولة. تم الكشف عن عامل الاستعمار CF - I وIII في العزلات البكتيرية فكانت ايجابيه في البكتريا الاكثر شيوعا وكانت جميع عزلات بكتيريا المكورات العنقودية الذهبية قادرة على انتاج المخثرة التي يعتبر عامل الضراوه لامراضية هذه البكتيريا. وان كل عزلات المكورات العنقودية الذهبية والاشريكية القولونية اظهرت تحللا كاملا (lyses كاملة) β - الانحلالي، في حين ان جميع عزلات المكورات العقدية نمط (lyses غير مكتملة) α - الانحلالي حيث اظهرت خط مخضر حول المستعمرات البكتيرية. وكانت جميع عزلات S.epidermidis وبعض العزلات من Proteus spp. (غير الحالة للدم) γ - الحالة للدم. في هذه الدراسة تم التحري عن sidrophore بين العزلات البكتيرية واظهرت النتائج ان جميع العزلات البكتيرية (E. coli K.Pneumoniae,)، ومعظمها من عزلات E. aerogenes و.Proteus spp كانوا قادرين على صنع sidrophore. وكانت بعض العزلات من. Proteus spp وEnterobacter ايجابية لتفاعل الجيلاتيناز، في حين ان جميع العزلات من Klebseilla واكثر عزلات E.coli سالبة لهذا العامل. واظهرت نتائج اختبار انتاج ال lipase في سالبة الجرام ان معظم العزلات ايجابية لاختبار lipase. وكشفت النتائج ان جميع العزلات كانت موجبه Biofilm وضع تشكيل (50٪)، في حين لا يوجد عزلات سالبه له. وفيما يتعلق بعوامل الضراوة الشائعة للبكتيريا المعزولة من عدم وجود مرض السكري وعوامل الضراوة فكانت نادرة. وكانت نتائج المتغيرات المناعية (C3، C4، Ig A، IL4، وIL6) للمرضى السكري في الدراسة, قد انخفضت مستويات C3، IgA، IL4، وIL6 للمرضى السكري ، في حين مستوى C4 قد ارتفع. من خلال نتائج هذه الدراسة، يمكن ان نستنتج؛ ان انواع البكتيريا التي عزلت من مرض السكري من النوع الثاني هي التالية E.coli تليها K. Pneumoniae, Enterobacter spp., Proteus spp, Micrococcus, Citrobacter S.epidermidis, kocuria kristinae, S.aureus , and Streptococcus spp. والطفيليات هي الاميبا الحاله للنسيج ثم الجيارديا اللامبيليا | In this study include (100) diabetic type (II) patients as diagnosed by Diabetolegist and 50 healthy control with an age range of (25 - 65 years) who attended to the two hospitals in Babylon : (Al - Qasem and Marjan), during the period from January 2015 until June 2015. Shown that grams - negative bacteria constitutes 74% from the total isolates and were considered the predominant aetiological agent of DM compared to gram - positive bacteria which constitutes 26%. The most common bacterial isolates were E.coli followed by Klebsella Pneumoniae, Enterobacter spp, Proteus spp, and less common bacteria were Staphylococcus aureus, Staphylococcus epidermidis, Kocuria kristinae, Citrobacter, Micrococcus and Streptococcus spp, whereas the most common parasites were Entamoeba histolytica 55% and Giardia lamblia 45%.The virulence factors of common bacterial isolated from diabetes Mellitus type II in this study are studied. The capsule was present in all Klebsella pneumoniae isolates, Enterobacter isolates and some isolates of E.coli, whereas the other bacteria such as Proteus mirabilis isolates in this study does not possess the capsule. Colonization factor antigens were detected; The CF - I and III were detected in mostly bacterial isolates which showed positive results with these factors. All isolates of Staphylococcus aureus bacteria were able to produce coagulase which is considered as a virulence factor for pathogenicity of these bacteria. All isolates of Staphylococcus aureus and E. coli expressed β - hemolytic (complete lyses), while all isolates of Streptococcus were α - hemolytic pattern (incomplete lyses) showing a greenish line around the bacterial colonies. All isolates of Staphylococcus epidermidis and some isolates of Proteus spp. were γ - hemolytic (non hemolytic). In the present study the siderophore synthesis was investigated among bacterial isolates and the results showed that all bacterial isolates (E. coli and K. pneumonia), and mostly of isolates of Enterobacter spp. and Proteus spp. were able to synthesis siderophore. Some isolates of Proteus mirabilis and Enterobacter spp. were positive for gelatinase reaction, while all isolates of Klebseilla pneumoniae and mostely E.coli were negative for this factor. The results of lipase production test in G - ve showed that most isolates were positive to lipase production test. The results revealed that all isolates were biofilm former, high and moderate biofilm formation mode were account for (50%) while there is no isolates that express non - biofilm formation. Regarding the virulence factors of common bacterial isolated of non - diabetes Mellitus have rare virulence factors.The results of Immunological parameters (C3, C4, IgA, IL4, and IL6) for DM patients were studied. In this study the levels of C3, IgA, IL4, and IL6 for DM patients were decreased, whereas the level of C4 was increased. In light of the results documented in this study, we can conclude the following; the types of bacteria which isolated from diabetes mellitus type II from the most to least common are E.coli followed by K. Pneumoniae, Enterobacter spp., Proteus spp., S.aureus, S.epidermidis, kocuria kristinae, Citrobacter, Micrococcus, and Streptococcus spp. And parasite : Entamoeba histolytica and Giardia lamblia isolated from diabetes mellitus type II. Most bacterial isolates in this study have the ability to possess more than one virulence factor such as capsule, siderophors, lipase production, hemolysin, extracellular protease, adherence factors, and biofilms to produce infection in diabetes mellitus type II patients. The virulence factors of common bacterial isolated in non - diabetes mellitus have rare virulence factor. The levels of Immunological parameters of C3, IgA, IL4, and IL6 for DM patients were decreased, whereas the level of C4 was increased.
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دراسة جزيئية وبكتريولوجية لبكتريا Porphyromonas gingivalis المعزوله من المرضى المصابين بامراض اللثه Molecular and Bacteriological Study of Porphyromonas gingivalis Isolated from Patients with Periodontitis

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

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

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

دراسة لبعض الخصائص الوبائية والمصلية لاصابات الـBordetella perlussis في محافظة بابل

اسم المؤلف: عمار عباس شعلان
اسم المشرف: محمد عبود القرة غولي يحيى الطفيلي
الموضوع العام: الطب
الموضوع الدقيق: الاحياء المجهرية
الدرجة: ماجستير
اللغة: الانكليزية
السنة: 2005
مكان الجامعة: بابل
المستخلص: تهدف هذه الدراسة الى وصف بعض الخصائص الوبائية للسعال الديكي في محافظة بابل وتقييم الاضداد المتخصصة للـ Bordetella pertussis IgG وIgA باستخدام تقنية الـ ELISA للتشخيص المختبري للسعال الديكي، هذا بالاضافة الى قياس الاستجابة المناعية الخلطية للقاح الثلاثي (DPT). جمعت عينات الدم من : 68 طفل مصاب بالسعال ديكي راقد في المستشفى (36 غير ملقح و32 ملقح) ، 103 من اشخاص اسوياء (49 شخصا ملقحا، 54 شخصا غير ملقح) و20 من العاملين بالخدمة الصحية في محافظة بابل. اضداد Bordetella pertussis IgG وIgA تم قياسها بواسطة تقنية الـ ELISA لكل مجموعات الدراسة. التعداد الكلي والتفريقي للخلايا البيضاء اجري للـ68 مريض و20 من مجموعة السيطرة. اظهرت الدراسة ان اعلى مستوى حدوث للسعال الديكي لوحظ في المرضى اقل من عمر سنة (49% من مجموع الحالات). كانت نسبة الذكور للاناث 1.27 : 1. 71% من المرضى مقيمين في المناطق الريفية مقارنة بـ 29 % في المناطق الحظرية. 36 (53%) من المرضى كانوا غير ملقحين و26 (38%) كانوا ملقحين جزئيا، بينما 6 (9%) تلقوا تلقيحا كاملا (3 جرعات من اللقاح الثلاثي). لوحظت مضاعفات السعال الديكي في 88% من المرضى، والتي كانت بصورة رئيسية الاختناق (88%)، اختلاجات (26%)، ذات الرئة (29%)، والوفاة (4%). كما لوحظ ارتفاع في تعداد الخلايا البيضاء في 64% من المرضى وارتفاع في تعداد الخلايا اللمفاوية في 69% من المرضى. معظم الحالات سجلت خلال الفترة بين شهر نيسان وتموز. كانت الحساسية والتخصص التشخيصي لاضداد الـ Bordetella pertussis IgG في الاطفال غير الملقحين كانت 77% و100% على التوالي، في حين كانت الحساسية والتخصص التشخيصي لاضداد Bordetella pertussis IgG في الاطفال الملقحين 67%، 91% على التوالي. كانت الحساسية والتخصص التشخيصي لاضداد الـ Bordetella pertussis IgA في الاطفال غير الملقحين كانت 33% و100% على التوالي، في حين كانت الحساسية والتخصص التشخيصي لاضداد Bordetella pertussis IgA في الاطفال الملقحين 72%، 86% على التوالي. لوحظت افضل حساسية وتخصص تشخيصي في العيانات التي جمعت بعد اكثر من 21 يوما بعد ظهور اعراض السعال الديكي. تم الحصول على اعلى حساسية وتخصص تشخيصي (92، 82% على التوالي) باستعمال مستوى موجب لـ اضداد Bordetella pertussis IgG او IgA. اظهرت الدراسة ان متوسط مستوى اضداد Bordetella pertussis IgG في الاسوياء الملقحين كانت 56.41 U/ml (المدى 19.77 - 143.89 U/ml)، بينما بلغ متوسط اضداد Bordetella pertussis IgG في الاسوياء غير الملقحين 29.33 U/ml (المدى 1.01 - 56.9 U/ml). كان متوسط مستوى اضداد Bordetella pertussis IgA في الاسوياء الملقحين كانت 9.05 U/ml (المدى 3.6 - 29.74 U/ml)، بينما بلغ متوسط اضداد Bordetella pertussis IgA في الاسوياء غير الملقحين 4.79 U/ml (المدى 3.05 - 7 U/ml). اظهرت الدراسة ان 10.7 % (11/103) من الاسوياء يظهرون مستوى موجب لاضداد Bordetella pertussis IgG او IgA، في حين اظهر 70% (14/20) من العاملين في الخدمة الصحية في هذه الدراسة مستوى موجب لاضداد Bordetella pertussis IgG او IgA | The aims of this study is to describe some of the epidemiological features of pertussis in Babylon Province in Iraq, and to evaluate the specific anti Bordetella pertussis IgG and IgA ELISA technique in the laboratory diagnosis of pertussis, and to determine the humoral immune response to DTP vaccine. Blood samples were obtained from the following groups : 68 (36 unvaccinated and 32 vaccinated)clinically diagnosed hospitalized pertussis patients, 103 normal healthy subject of similar age groups (49 vaccinated and 54 unvaccinated) and 20 healthcare workers in Babylon Province. The anti Bordetella pertussis IgG and IgA antibodies were tested by ELIZA technique in all study groups. The study shows that the highest incidence of pertussis was noticed in patients less than 1 year (49% of the total pertussis patients). The male to female ratio was 1.27 : 1. There were 71% of pertussis cases from rural area compared with 29% from urban area. 36 (53%) of the patients were unvaccinated and 26 (38%) of the patients were partially vaccinated, while only 6 (9%) are fully vaccinated (3 doses of DTP vaccine). Complications were noticed in (88%) of the patients; they are mainly apnea (88%), seizure (26%), pneumonia (29%), and death (4%). Most cases were noticed between March and July. The anti Bordetella pertussis IgG diagnostic sensitivity and specificity in unvaccinated subjects were 77%, 100% respectively; while in vaccinated subjects they were 67%, 91% respectively. The anti Bordetella pertussis IgA diagnostic sensitivity and specificity in unvaccinated subjects were 33%, 100% respectively, while in vaccinated subjects they were 72%, 86% respectively. The best diagnostic sensitivity and specificity was observed in samples collected after > 21 days of the onset of pertussis symptoms. The higher diagnostic sensitivity and specificity were obtained by using anti Bordetella pertussis IgG or IgA positive levels. The study shows that the anti Bordetella pertussis IgG mean level in DPT vaccinated normal subjects was 56.41 U/ml (range 19.77 - 143.89 U/ml), while it was 29.33 U/ml (range 1.01 - 56.9 U/ml) in unvaccinated subjects. The anti Bordetella pertussis IgA mean level in vaccinated normal subjects was 9.05 U/ml (range 3.6 - 29.74 U/ml), while it was 4.79 U/ml (range 3.05 - 7 U/ml) in unvaccinated subjects. There is 10.7% (11/103) of the normal subjects which have a positive anti Bordetella pertussis IgG or IgA levels. In addition, 70% (14/20) of the healthcare workers in this study have a positive anti Bordetella pertussis IgG or IgA levels.
الصفحات الاولى:

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

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

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

اسم المؤلف: ليث احمد عمران كيف الكيف
اسم المشرف: محمد عبد كاظم حسن السعدي يونس عبد الرضا كحيوش الخفاجي
الموضوع العام: الطب
الموضوع الدقيق: الاحياء المجهرية
الدرجة: ماجستير
اللغة: الانكليزية
السنة: 2016
مكان الجامعة: بغداد
المستخلص: 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.
الصفحات الاولى:

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

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

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

اسم المؤلف: هديل محمد فياض
اسم المشرف: علاء فاضل علوان داود سلمان داود
الموضوع العام: الطب
الموضوع الدقيق: الاحياء المجهرية
الدرجة: دكتوراه
اللغة: الانكليزية
السنة: 2015
مكان الجامعة: بغداد
المستخلص: Human herpesvirus 6 (HHV - 6) is largely ubiquitous double stranded DNA viruses within the betaherpesvirinae subfamily and of the genus Roseolovirus.HHV - 6A and HHV - 6B infects very high percentage of population around the world, primarily during childhood through respiratory droplets. HHV - 6 has been found out in many types of cancers : lymphomas, leukemia, cervical cancer, and brain tumors.This cross - sectional case control study was carried out in Baghdad Teaching Hospital and National Center of Hematology - AL - Mustansiriyah University - Baghdad, for the period from 1 September 2013 to 1 April 2015.The aims of the study were to explore the seropositivity rate of HHV - 6 antibodies among Iraqi patients with different hematological malignancies using different laboratory assays, beside, the molecular determination of plasma viral DNA load by quantitative polymerase chain reaction (qPCR).The study included 109 patients with different hematological malignancies; 24 patients with acute lymphoblastic leukemia (ALL), 30 patients with acute myeloid leukemia (AML), 11 patients with Hodgkin lymphoma (HL), 39 patients with non hodgkin lymphoma (NHL) and 5 patients with chronic lymphocytic leukemia(CLL). All patients were newly diagnosed and enrolled before receiving chemotherapy. The age range was between 14 - 80 years. Fifty three (48.6%) and 56 (51.4%) patients were males and females, respectively. The diagnosis of their malignancies was based on either bone marrow aspirate biopsy and lymph node biopsy as well as cytochemical investigations. Additionally, 59 apparently healthy blood donors were enrolled as control group. The age range was between 18 - 59 years, twenty eight (47.4%) and 31 (52.6%) were males and females, respectively.The serum anti - HHV - 6 IgG was detected by indirect immunofluorescent technique (IFAT) as well as by enzyme linked immunosorbant assay (ELISA).While, the serum anti - HHV - 6 IgM was detected by ELISA only. The detection and quantification of plasma viral DNAemia was carried out by quantitative polymerase chain reaction. Serological as well as molecular assays were done in Central Public Health Laboratory in Baghdad. The highest IFAT positivity rate was among patients with CLL (100%), followed by patients with AML (83.3%), and the least positivity rate was among patients with NHL (64.1%) compared to that of healthy control. Generally, the total anti - HHV - 6 IgG by IFAT was insignificantly higher among patients compared to healthy controls (74.3% vs 61.0%, p=0.074). The anti - HHV - 6 IgG positivity rates by ELISA were insignificantly higher in all groups of haematological malignancies except in patients with AML in whom it was significantly higher compared to healthy controls (96.7% vs 72.9%, p= 0.007 ). A part from AML, the highest anti - HHV - 6 IgG by ELISA was among patients with ALL (87.5%) followed by patients with NHL (84.6%), and the least was among patients with CLL (80.0%) compared to healthy control. Generally, the total anti - HHV - 6 IgG positivity rate detected by ELISA was significantly higher compared to IFAT in patients (p= 0.013) as well as in healthy control (p= 0.0005).The results of anti - HHV - 6 IgM positivity rate as detected by ELISA was significantly higher in patients with AML (36.7%, p=0.0004), and patients with HL (27.7%, p= 0.038) compared to healthy controls (6.8%). Whereas, other groups of hematological malignancies showed insignificantly higher positivity rate versus control group. However, the highest positivity rate was among patients with AML (36.7%), and the least positivity rate was among patients with CLL (0%). Generally, the total ELISA anti - HHV - 6 IgM positivity rate was significantly higher in patients versus healthy controls (22.0% vs 6.8%, p= 0.011). The results of PCR showed that 5 out of 109 patients had detectable HHV - 6 DNA in the plasma. The highest detection rate was among patients with HL (27.3%), followed by patients with ALL (4.2%), and then patients with AML (3.3%), while the virus was not detected in other disease categories as well as in healthy controls. The plasma viral load (mean ± SD) among the three Hodgkin lymphoma patients was 1.4± 0.3*102 particle/milliliter.The study concluded that the seropositivity rate of HHV - 6 infection is highly prevalent among Iraqi patients with hematological malignancies compared to healthy population. However, primary or reactivation infection as determined by anti - HHV - 6 IgM in patients as well as healthy individuals is relatively low. Furthermore, the HHV - 6 DNA detection rate as well as plasma viral load among malignant patients before receiving immunosuppressive treatment were low.
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دراسة Toll like receptors(TLR2& ( 4 ومؤشرات حيوية مختارة في المرضى المصابين بسرطان المثانة Study Of Toll Like Receptors (TLR - 2 And 4) And Selected Biomarkers In Bladder Cancer Patients

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

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

اسم المؤلف: مي يحيى عبد الحسين
اسم المشرف: عروبة خالد عباس احمد اسمر منخي
الموضوع العام: الطب
الموضوع الدقيق: الاحياء المجهرية
الدرجة: ماجستير
اللغة: الانكليزية
السنة: 2015
مكان الجامعة: بغداد
المستخلص: يعتبر مرض السل الرئوي tuberculosis الذي تسببه بكترياMycobacterium tuberculosis من الامراض المعدية والشائعة واحد الاسباب الرئيسية لحالات الوفاة في العالم, ولاهميته اجريت هذه الدراسة لتسليط الضوء اكثر حول التشخيص المناعي للمرض وعلاقته بالتشخيص الجزيئي.تضم | Tuberculosis (TB) is caused by Mycobacterium tuberculosis; which consider as one of the most common, infectious diseases and major causes of morbidity and mortality worldwide. A prospective study was conducted to diagnose disease by immunological methods and its association with molecular diagnosis.The study included immunological diagnosis by Quantiferon - TB Gold In Tube Test, estimation the serum levels of IFN - ?, TNF - ? and IL - 10 in TB patients and control by a sandwich ELISA test using commercially available kits, in addition to molecular diagnosis by using Gene Xpert MTB/RIF assay, conventional bacteriological tests such as smear microscopy by Ziehl - Neelsen stain for sputum samples. Furthermore, estimation of ESR and WBCs.Fifty TB patients attending the National Reference Laboratory of Tuberculosis /Baghdad from the period between April to July 2014 were recruited in this study. For the purpose of comparison, 50 control samples (respiratory disease and healthy) matched by age and gender were also included.All TB patients' samples were positive by smear microscopy. The results revealed that there were significance differences between AFB scoring and G - Xpert results (p Forty five samples of TB patients with significance difference (p?0.01) were positively detected by Quantiferon - TB Gold Test.The mean serum level of QFT among TB patient and control (3.54 IU/ml vs. 0.866 IU/ml and 0.556 IU/ml), IL - 10 (53.02 Pg/ml vs. 22.24 pg/ml and 7.51 pg/ml) and TNF - ? (74.34 Pg/ml vs. 49.12 Pg/ml and 27.81 pg/ ml) were significantly higher in TB patients as compared to controls (P?0.05).In conclusion, high levels of IFN - ?, TNF - ? and IL - 10 in TB patients serum indicate an important role of theses cytokines in the pathogenesis of tuberculosis, so they could be considered as a good biomarkers for diagnosis and considered as a target for future therapy. The present study revealed significant difference in the WBCs and ESR values between TB patients and control (P?0.05)
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دور الايبشتاين بار فايرس كعامل محتمل لتقدم سرطان الدم اللمفاوي المزمن Molecular Characterization Of Metallo ? - Lactamase (MBL) Genes

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

اسم المؤلف: كريم عليوي حمادي سليمان
اسم المشرف: عامر رشيد النجار
الموضوع العام: الطب
الموضوع الدقيق: الاحياء المجهرية
الدرجة: دكتوراه
اللغة: الانكليزية
السنة: 2015
مكان الجامعة: بغداد
المستخلص: الزوائف الزنجارية : وهي بكتريا سالبة لصيغة الكرام والمنتشرة بشكل واسع في البيئة مثل التربة والمياه. وهذه البكتريا تتسبب في كثير من الالتهابات مثل التهاب المجاري البولية والتهاب الحروق وهي بكتريا انتهازية. وتشكل تهديد لحياة المصابين بالمجاري البولية وخاص | Pseudomonas aeruginosa is a Gram |( - ve) bacteria, widely presents in the environment such as soil, water, its incubation period (1 - 3) days, generation time 1 - 2 hrs. This bacteria causes many infections such as (UTI), and burn infections. It is an opportunistic pathogen, life threating for immune compromised patients such as diabetic patients. Pseudomonas aeruginosa is a nosocomial pathogen, and it is ranking the second among Gram ( - ve) hospitals acquiring pathogen. Its antibiotic resistance increased due to acquiring many antibiotics resistance genes. The spread of these genes among bacteria is via plasmids. Plasmid profiling of Ps. aeruginosa isolates by gel electrophoresis is a best technique for detection of plasmid content. Through this study, which was carried out in two main teaching hospitals, the diabetic center and private labs in Baghdad, during the period from January to October 2014. A total of (620) urine specimens were collected during (9) months. Urine specimens from inpatients were (420 / 620, 67.75%) and from out patients were (200 / 620, 32.25%). Urine specimens from Dialysis unit were (280 / 620, 45.1%) and from burn units were (140 / 620, 22.5%). The male represented (n = 334, 52.38%) while female were (n = 286, 46.20%). The positive cultures of urine samples obtained from hospitalized patients were (72 / 420, 17.1%) while for urine samples obtained from out patients (n = 40 / 200, 20%) were positive culture. A total of (112) positive culture out of (620) collected with (18.06%) percentage. A total of (30) bacterial isolates were tested by using disc diffusion method for susceptibility test forward to (15) antibiotics. Ps. aeruginosa isolates showed highest resistance to gentamicin (87.5%) while the lowest resistant toward meropenem, and imipenem with resistance percentage (16.7% and 8.0%) respectively.The occurrence of multi - drug resistance in (30) selected isolates were grouped as follows to (MDR) for those isolates which showed resistance to at least (3) antibiotics which was found to be (5 / 30, 6.6%). While (XDR) referred to those isolates which showed resistance to (4 - 5) antibiotics with (19 / 30, 63.3%). In related to (PDR) which referred to isolates that showed resistance to more than 5 with (6 / 30, 20%). The extracted plasmid DNA were resolved by gel electrophoresis for detection of plasmid content for (20) isolates including (10) isolates from inpatients, and (10) isolates from out patients. The selection of these isolates were grouped according to their antibiotic resistance pattern and the number of plasmids that they carried. The results showed that out of (20) there were (12 / 20, 60%) had no plasmid. While the remaining (8 / 20, 40%) had plasmids with different sizes and numbers. By using PCR technique the most common kinds of genes such as bla CTX - M, bla OXA, which encoded extended spectrum ? - lactamase (ESBLS) and those for metallo ? - lactamase such as bla IMP, were investigated with specific primers. Five isolates were selected depending on the numbers of plasmids which they carried and their resistance to antibiotics.
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دراسة مؤشرات مناعية وبايوكيميائية مختارة لمرضى السكري النوع الثاني المصحوب وغير المصحوب باعتلال الكلى ذات الادرار قليل الزلال Study Of Selected Immunological And Biochemical Markers In Type 2 Diabetes With And Without Microalbuminuric Nephropathy

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

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

اسم المؤلف: سنن ثائر عبد الوهاب
اسم المشرف: حيدر صباح كاظم علاء الدين مظفر زبير
الموضوع العام: الطب
الموضوع الدقيق: الاحياء المجهرية
الدرجة: دكتوراه
اللغة: الانكليزية
السنة: 2016
مكان الجامعة: بغداد
المستخلص: التهاب المفاصل الرثوي هو احد امراض المناعة الذاتية الاكثر شيوعا والذي يتميز بالتهاب المفاصل المزمن والذي يؤدي فيما بعد الى تدمير المفاصل.لا يزال مرض التهاب المفاصل الرثوي يعرف على انه سمة من التوسع في الغشاء الزليلي وارتشاح الخلايا الالتهابية اضافة الى | Rheumatoid arthritis (RA) is one of the most common systemic autoimmune diseases characterized by chronic joint inflammation and subsequent joint destruction. It is well known that RA is characterized by the expansion of the synovium and infiltration of the inflammatory cells coupled with destruction of adjacent articular cartilage and bone. This is strongly dependent on CD4 T cell. CD4 Cells stimulate monocytes, macrophages, synovial fibroblasts, and other cells to produce cytokines such as tumor necrosis factor - ? (TNF - ?), interleukin - 1 (IL - 1), IL - 6, IL - 15, IL - 17 and metalloproteinases that produce tissue damage. TNF is a major inflammatory cytokine contributing to the pathogenesis of RA, which provides rational for development of anti - TNF biological agents in the treatment of RA.Wnt pathway (a complex protein network) important in control of the bone formation through the regulation of osteoblast activity, and sclerostin is an important in the regulator of the Wnt pathway by blocking Wnt binding to its receptor and thereby inhibiting bone formation. Blockage of Wnt antagonists such as sclerostin will trigger repair or even healing of bone erosion.Recently have shown that IL - 1Ra has been given therapeutically in several experimental models of arthritis with weak effect in RA. This study planned to evaluate the frequencies of CD4+CD25+ Treg cells in Iraqi patients treated with RA under treatment with biological therapy (Etanercept). The level of serum sclerostin, serum level of IL - 1RA, and investigate the correlation between serum sclerostin and Treg expression. Correlate the level of serum sclerostin and Treg expression with disease activity by (CDAI or DAS28).This study was performed during the period from January 2016 to May 2016.The patients were attending the out patients' Clinic in Medical City/Baghdad Teaching hospital/Rheumatology Unit and the laboratory Enzyme Linked Immunosorbent Assay tests were done in Bio - technology center at the University of Al Nahrain, flow cytometery analysis was performed in the private laboratory (Al Rawabi Laboratory) at Yarmouk/Baghdad. Thirty patients and 30 apparently healthy control individuals were included in this study, Patients under treatment of etanercept.The diagnosis of RA patients has performed under the rheumatologist consultant at the consultation clinic of Baghdad Teaching Hospital of the medical city. Blood samples had taken from RA patients to measure Erythrocyte Sedimentation Rate, Complete Blood Picture, Rheumatoid Factor and High - Density Lipoprotein. Also, analyze the serum levels of Anti - Citrullinated Protein Antibodies and estimate the levels of sclerostin and IL - 1RAin patients and healthy individuals using Enzyme Linked Immunosorbent Assay test kits. CD4+CD25+ Treg cells had achieved by flow cytometery analysis.The results showed the reduction in Treg cells in patients (0.00264 ± 0.002) % under biological therapy than control group (0.026 ± 0.012) % with significant difference (p< 0.05). Also body mass index showed significant difference between patients (32.10 ± 5.81) kg/m2 and control group (28.84 ± 4.67) kg/m2 (p< 0.05). The results showed that sclerostin level higher in healthy (1.072 ± 0.59) ng/ml than patients (0.801 ± 0.28) ng/ml which showed significant difference (p<0.05). Furthermore IL - 1RA serum level was higher in healthy (0.979 ± 0.34) ng/L than patients (0.633 ± 0.35) ng/L with significant difference (p<0.05). Anti - Cyclic Citrullinated Peptide results showed non - significant difference between patients and healthy control. Treg cells is reduction in the patients with RA. Sclerostin and IL - 1RA levels are low in patients treated with etanercept.
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دور بعض المؤشرات الالتهابية المختارة في البول وبروتينات خلية البودوسايت عند مرضى اعتلال الكلية السكري The Role Of Selected Urinary Inflammatory Markers On Podocyte In Type 2 Diabetic Nephropathy

اسم المؤلف: داليا محمود خلف
اسم المشرف: رفيف صبيح الشوك عصام نوري الكروي
الموضوع العام: الطب
الموضوع الدقيق: الاحياء المجهرية
الدرجة: ماجستير
اللغة: الانكليزية
السنة: 2017
مكان الجامعة: بغداد
المستخلص: اعتلال الكلية السكري هو السبب الرئيسي للمرض الكلوي المزمن وويرتبط ذلك مع زيادة وفيات مرضى القلب والاوعية الدموية. التعريف الكلاسيكي لاعتلال الكلية السكري هو زيادة افراز البروتين في البول. وتتميز المرحلة المبكرة للمرض عن طريق زيادة صغيرة في افراز الزلا | Diabetic nephropathy (DN) is the leading cause of chronic renal disease. It is associated with increased cardiovascular mortality. The DN has been classically defined as increased protein excretion in urine. Early stage is characterized by a small increase in urinary albumin excretion (UAE), also called microalbuminuria or incipient DN. More advanced disease is defined by the presence of macroalbuminuria or proteinuria. The latter is classically named overt DN.This study was planned with the aim of evaluate the levels of urinary Monocyte Chemoattractant Protein - 1(MCP - 1), interleukin (IL - 18), Osteopontin and Nephrin at diabetic nephropathy and its correlation with the parameters in Iraqi type 2 diabetic subjects and to explore the impact of albuminuria and duration of the diabetes on fine glomerular architecture using podocyte injury related marker (Nephrin) in urine. This may explore the more specific, and sensitive early biomarkers for nephropathy in diabetic patients and could help the physicians in controlling the occurrence of renal failure.Sixty Iraqi type 2 diabetes mellitus patients attending the National Diabetes Center for Treatment and Research at Al - Mustansiriyah University during the period October 2014 - June 2017 were recruited for this study. For the purpose of comparison, 20 control subjects matched for age, gender and ethnic background were also included. The patients and controls were characterized in family history of diabetes, diabetic nephropathy groups divide by used Albumin to creatinine ratio. The patients were also assessed for duration of disease, fasting serum glucose, and serum creatinine and blood urea.The mean urinary level of MCP - 1 (15.38±15.50 vs. 6.10±7.23pg/ml) and IL - 18 (35.90±16.67 vs. 23.55±12.67pg/ml) and osteopontin (337.15±257.06 vs. 174.11±183.65ng/ml) and nephrin (100.01±88.66 vs. 52.23±19.61ng/ml) were significantly higher in T2DM patients as compared to controls.The mean levels of urinary MCP - 1, uIL - 18 and osteopontin in macroalbuminurea group of patients were significantly higher than those in normoalbumine ( p < 0.008, p< 0.0001 and p< 0.03 respectively), and only of the Nephrin in the normoalbuminurea group of patients showed significant increased level as compared to the controls (52.23±19.61 vs.75.05±37.8 ng/ml) (p<0.022).The duration of disease showed an increase in mean of urinary level for all the markers MCP - 1, IL - 18, osteopontin and nephrin (17.01±18.09 vs. 19.76±21.30 pg/ml, 29.24±15.98 vs. 42.98±17.25pg/ml, 321.1±291.05 vs. 409.05±210.0ng/ml, 99.40±48.40 vs. 79.21±44.23 ng/ml) respectively, in late duration of disease as compared with early duration of disease except in Nephrin showed the early duration of disease higher than the late duration of disease (99.40±48.40 vs. 79.21±44.23), although the differences were not significant.The Receiver operating characteristic (ROC) curve analysis for all markers MCP - 1, IL - 18, Osteopontin and Nephrin levels (MCP - 1 = 0.72, IL - 18 = 0.71, Osteopontin =0.70 and Nephrin =0.72) for early diagnosis and detection of DN revealed that the cut - off value of uMCP - 1 was 6.23 pg/mg with 70% sensitivity and 75% specificity; whereas, the cut - off value of u IL - 18 pg/ml was 23.69 ng/mg with 80% sensitivity and 59% specificity and Nephrin was 49.5 ng/ml with 78% sensitivity and 55% specificity. uOsteopontin was 182 ng /ml with 68% sensitivity and 69% specificity.The linear correlation revealed a significant positive linear correlation between urinary MCP - 1, IL - 18, Nephrin and A : C ratio, also showed a significant negative linear correlation between urinary MCP - 1, IL - 18, osteopontin and GFR.In conclusion the Nephrin may be considered as potential diagnostic and prognostic biomarker a for the early detection and progression of diabetic nephropathy while the uMCP - 1, uIL - 18 and uOsteopontine may be considered as potential prognostic biomarkers for the diabetic nephropathy. The duration of disease also affect investigated biomarkers suggesting the long term effect of hyperglycemia
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تقدير مستويات السايتوكينات (الحركيات الخلوية) المولدة للالتهاب والمضادة للالتهاب لدى مرضى فصال العظام في الركبة قبل وبعد الحقن بالبلازما الغنية بالصفيحات الدموية Estimation Of Pro - Inflammatory And Anti - Inflammatory Cytokines In Patients With Knee Osteoarthrosis Before And After Injection With Platelets - Rich Plasma (Prp)

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

اسم المؤلف: حسن هادي زريج
اسم المشرف: زينب فاضل عاشور وسن عبد الاله باقر
الموضوع العام: الطب
الموضوع الدقيق: الاحياء المجهرية
الدرجة: ماجستير
اللغة: الانكليزية
السنة: 2015
مكان الجامعة: بغداد
المستخلص: Prostate cancer is the most common malignancy and the second leading cause of cancer related death among males worldwide. Prostate cancer developed in prostate , a gland that is located below the bladder and just in front of rectum.Inflammation is a fundamental physiological process that can arise in any tissue in response to traumatic, infectiousor autoimmune injury. Transforming growth factor beta one (TGF - ?I) is a potential regulator of prostate cancer cell growth that signals through a heteromeric complex composed of type I and type II receptors.TGF - ?R II is an important receptor , because TGF - ? bind to receptor II to initiate it's signaling, then receptor II recruits receptor I to initiate signal transduction. Interleukin - 17 (IL - 17) is a pro - inflammatory cytokine produced by T - helper 17 (Th17) cells contributes toboth the processes by playing a dual role in the antitumor immunity. On one hand, IL - 17 encourages an antitumor cytotoxic T cell response leading to tumor regression. On the other hand, by promoting angiogenesis and egress of tumor cells from the primary focus, so IL - 17 promotes tumor growth.This study was carried out to establish the correlation between expression of Transforming growth factor beta one(TGF - ?I), Transforming growth factor beta receptor one (TGF - ?RI) and Transforming growth factor beta receptor two (TGF - ?RII) and prostate cancer progression. Also to establish the role of IL - 17 in prostate cancer development.The study consisted of 16 patients with poorly differentiated malignancy (PDM) ,whose age ranged (48 - 89) years, with mean age of (71.2) years , and 25 patients with moderately differentiated malignancy(MDM) , whose age ranged (31 - 83) years , with mean age of (66.6) years , and 46 patients with benign prostatic hyperplasia (BPH) , whose age ranged (27 - 85) years , with mean age of (64.3) years. Allpatients were diagnosed surgically by consultant physicians in Baghdad hospital for specialist surgeries , Al - Yarmook teaching hospital ,as well as AL - Hilla teaching hospital , and 20 normal tissue sample taken from cadaver, whose age ranged (17 - 28) years , with mean age of (21.8) years , where chosen as a control group. The work was conducted in Iraqi center for cancer and medical genetic researches. The study were performed during the period from March 2014 to December 2014).Immunohistochemistry (IHC) technique was used to detect the level of expression of TGF - ?I , TGF - ?RI , TGF - ?RII and IL - 17 protein in tissues of patients and healthy control groups.The current study revealed that there was significant difference in mean levels of TGF - ?I protein expression between each of poorly and moderately differentiated malignancy compared with healthy control subjects with P - value of 0.001 , but there was no significant difference in mean level of TGF - ?Iprotein expression between benign prostatic hyperplasia and healthy control subjects with P - value of 0.398. Also there was no significant difference between poorly and moderately differentiated malignancy in mean level of TGF - ?I protein expression.TGF - ?R1 protein was expressed in 3 (18.7%) and 14 (56%) of poorly and moderately differentiated malignancy respectively , with weak immunostaining reaction was the most frequent score. There was significant difference in mean level of TGF - ?RI protein expression among all studied groups. TGF - ?RII protein was expressed in 6 (37.5%) and 22 (88%) of poorly and moderately differentiated malignancy respectively ,with weak immunostaining reaction was the most frequent score. There was significant difference in mean level of TGF - ?RII protein expression among all studied groups.IL - 17 immunohistochemical expression was detected in tissues of all studied groups , the results showed that moderate immunostaining reaction was the most frequent score among them. There was significant difference in mean levels of IL - 17 protein expression among all studied groups.We concluded that there was statistically significant association between the loss ofexpression of TGF - ?1 signaling receptors, especially TGF - ?RI, andincreasing grades of malignancy in prostate cancer. These resultssuggest a potential mechanism for prostate cancer cells toescape the growth inhibitory effect of TGF - ? and thus, leadingto a more malignant phenotype.
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دراسة المقاومة المتعددة للمضادات الحيوية لعصيات التدرن لدى مرضى التدرن الرئوي A Study On Drug Resistance Of Mycobacterium Tuberculosis Isolated From Pulmonary Tuberculosis Patients

اسم المؤلف: انمار ليث طالب الحسني
اسم المشرف: عامر رشيد النجار احمد اسمر منخي
الموضوع العام: الطب
الموضوع الدقيق: الاحياء المجهرية
الدرجة: ماجستير
اللغة: الانكليزية
السنة: 2016
مكان الجامعة: بغداد
المستخلص: تعتبر عزلات جراثيم التدرن المقاومه للادوية من المشاكل الرئيسية في معالجة مرضى التدرن حول العالم. , ولاهميته اجريت هذه الدراسة لتسليط الضوء اكثر حول الحساسيه الدوائية بواسطة الطرق المختبرية التقليدية وعلى الوسط الصلب ومقارنته مع الطرق التشخيصية المختبرية ا | Drug resistant tuberculosis remained as major problems in the treatment of tuberculosis patients in the world. A prospective study was conducted to evaluate drug susceptibility testing (DST) by classical methods on solid media as compared with advance and molecular Laboratory diagnostic methods (Bactec MGIT 960 and GeneXpert MTB - RIF ). The study included the estimation of the first line anti - TB drugs, including (Rifampicin,Isonizid,Streptomycin and Etambutol) by solid media (Lowenstein - Jensen medium) and Bactec MGIT 960 system. In addition, the use of rapid molecular diagnostic method by GeneXpert MTB/RIF assay. Seventy five TB patients attending the National Reference Laboratory of Tuberculosis /medical city - Baghdad from December 2015 to June 2016 were included in this study. Patients were classified into two main groups : selected MDR patients, which were referred from different hospitals and health respiratory center in Iraq, represented 46 in order to compare different laboratory methods to detect of DST isolates, while 29 were randomly isolated and identified , the study matched by age and gender were also included. This study revealed that the drug resistance tuberculosis to Rifampicin was 47 (62.7%), Isonizid 41 (54.7%), Streptomycin 42 (56.0%) and Ethambutol 38 (50.7%). Respectively , on the golden stander in which solid media were used.The molecular and advance technique (GeneXpert and Bactec MGIT 960) as applied to estimation of drug resistance tuberculosis, the results of drug susceptibility testing (DST), as showed highly sensitivity and Accuracy, when compared with golden stander( LJ media) especially in detected of primary drugs (Rifampicin and Isoniazid) and showed lower sensitivity and accuracy to detected of the secondary drugs (Streptomycin and Ethambutol). The Multiple drug resistance (MDR - TB) case from selective samples was found to be almost similar to that found in other countries of the middle east and other regions in the world. While in the randomly identified samples, the rate of MDR - TB was lower than the referred (previously treated) cases.The GeneXpert MTB - RIF system is rapid molecular methods that used in many countries to identify of MTB and Rifampicin detected during 2 hours only, that used in this study. The high Rifampicin resistance and other drugs of local isolates could be due to abuse of the drug,defaulter and relapse of retreating cases (previously treated).
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التوصيف الجزيئي لعوامل الضراوة المرتبطة باصابات بكتريا المكورات العنقودية السالبة للتخثير والمعزولة من المصابين بالتهاب المجاري البولية في محافظة بابل Molecular Characterization Of Some Virulence Associated Factors For Coagulase - Negative Staphylococci Isolated From Urinary Tract Infection In Babylon Province

اسم المؤلف: سارة هاشم داخل الحلي
اسم المشرف: محمد صبري عبد الرزاق السعيد جواد كاظم الخفاجي
الموضوع العام: الطب
الموضوع الدقيق: الاحياء المجهرية
الدرجة: ماجستير
اللغة: الانكليزية
السنة: 2016
مكان الجامعة: بابل
المستخلص: يهدف هذا البحث الى دراسة بكتريا المكورات العنقودية السلبية التخثر, وشملت الدراسة جمع120 عينة ادرار من المرضى المصابين بالتهاب المجاري البولية من الاشخاص المراجعين والراقدين في مستشفى بابل للنسائية والاطفال ومستشفى الحلة التعليمي وللفترة من كانون الاول 201 | This work aims to study coagulase - negative Staphylococci, which included 120 urine sample were obtained from patients suffering from urinary tract infection; who attained to Babylon Maternity and Pediatrics Hospital, and Al - Hilla General Teaching Hospital, during the period from December 2015 to March 2016), they were diagnosed as having UTI by the Urologists. The samples were analyzed for any signs of infection and immediately inoculated on blood and MacConkey agar media plates. All plates were incubated aerobically at 37 ?C for 24 - 48 hrs.Results of morphological and biochemical characterization revealed that out of total of 120 urine samples, 110 showed positive culture, among them 37 isolates are belonged to coagulase - negative Staphylococci, other 73 isolates belonged to other bacterial genera.Molecular detection of coagulase gene (coa) was done for all CoNS isolates. The results showed that 28/37 isolates (75.67%) were positive for this marker, distributed as follows : S. epidermidis gave 15 isolates, S. saprophyticus gave 9 isolates and S. haemolyticus gave 4 isolates.Also, molecular investigation of fnb A and B genes are carried out for all CoNS isolates by using specific PCR markers. 13/37 isolates (35%) were positive for fnb A gene, as 6/13 of S. epidermidis, 5/13 of S.saprophyticus and 2/13 of S. haemolyticus have this gene in their genome. On the other hand, only 4/37 isolates gave positive result for fnb B gene; as 2 isolates of both S. saprophyticus and S. epidermidis have this gene in their genome.Moreover, sec gene also was investigated in CoNS isolates. The results showed that all CoNS isolates are free from this gene.Regarding urease enzyme production, S. epidermidis and S.saprophyticus isolates were found to be urease positive, while S.haemolyticus isolates display urease negative.To demonstrate the ability of bacteria to form struvite stone, urine samples obtained from healthy individuals were used. It was found that struvite stone was formed by S. epidermidis and S. saprophyticus isolates.Moreover, susceptibility to 10 antibiotics were tested by using disc diffusion test (DDT). S. epidermidis was showed 100% resistance for each Methicilline, Ceftriaxone, Ceftazidime and Cefoxitin. Also, it show high resistance 94%, 88%, 88%, 76%, and 59% for Impenem, Gentamycin, Pipracillin, Ciprofloxacin and Amikacin respectively. However, S. epidermidis showed low resistance (6%) for Vancomycin. So, all S. saprophyticus isolates showed high resistance (100%) to each Pipracilline, Ceftriaxone, Methicillin, Ceftazidime and Ciprofloxacin. It showed high resistance (92%) for each Vancomycin and Imipenem, and (83%), (75%), (75%) for Cefoxitin, Gentamycin and Amikacin respectively. In addition to that, all S. haemolyticus was showed (100%) resistance for each Ceftriaxone, Pipracillin, Methicilline, Ceftazidime and Cefoxitin. Also, showed high resistance (75%), (63%) and (50%) for Gentamycin, Amikacin and Ciprofloxacin respectively. While it was showed low resistance (13%) to Vancomycin.
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الصورة البكتيرية والنسيجية المرافقة لالتهاب اللوزتين المزمن والادينويد عند الاطفال Bacteriological And Histopathological Profile Associated With Chronic Tonsillitis And Adenoid Hypertrophy In Children

اسم المؤلف: رشا محسن كاظم الحسيني
اسم المشرف: حبيب صاحب نهر صفاء حسين الطريحي
الموضوع العام: الطب
الموضوع الدقيق: الاحياء المجهرية
الدرجة: ماجستير
اللغة: الانكليزية
السنة: 2016
مكان الجامعة: بابل
المستخلص: This study aimed to investigate the bacterial profile of surface and core of infected tonsils and adenoid tissues and histopathological examination of these organs.A total of 122 samples represented by 63 excised tonsils and 59 excised adenoids in addition to 57 blood samples were collected from 70 patients who were referred to Hilla Teaching Hospital (Ear, Nose and Throat unit) in Hilla city within a period of four months from November 2015 to February 2016. Those patients weresuffering from chronic tonsillitis and adenoid hypertrophy. The ages of those patients ranged from 2 to 15 years, 41 (59%) of them were males and 29 (41%) were females.The study included three main parts. The first one was the bacterial diagnosis based on relied diagnostic procedures. Second part was the detection of antistreptolysin O (ASO) by using latex agglutination test, while the third part included histopathological study to detect the pathological lesions that occur during these infections.The results indicated that, the most age group being susceptible for chronic tonsillitis and adenoid hypertrophy was the group of 7 - 10 years, represented 33 patients with a percentage of (47%). Among this group, males were more susceptible with percentage of 20 (29%) compared to female patients13 (19%).The surface of all samples (tonsil and adenoid) revealed positive results for bacterial culture, while in the core of tonsil only 44 samples (70%) were positive for bacterial culture while 19 samples (30%) were negative results (no growth). As in tonsils, the core of adenoid revealed positive results in 32 (54%) samples, while 27 (46%) samples were negative results.The suspected isolates were fully identified by using bacteriological, biochemical and Vitek 2 techniques (for two isolates because of those isolates give variable biochemical test results which confused their diagnosis that lead to using of vitek system technique to diagnosis them, these isolates were rare bacteria that infect tonsil and adenoid). The most common types of bacterial isolates were Staphylococcus aureus which accounted for 75 isolates (23.6%), followed by Streptococcus pyogenes 61isolates (19%), Escherichia coli 57 isolates (18%), Klebsiellae pneumoniae 55 isolates (17.3%), Hemophilus influenza 37 isolates (11.6%), Sphingomonas paucimobilis 14 isolates (4.4%), Staphylococcus epidermides 7 isolates (2.2%), Pseudomonas aeruginosae 6 isolates (2%), Pseudomonas stutzeri 5 isolates (1.6%), and Staphylococcus saprophyticus only one isolate (0.3%).Regarding the bacterial population, there is a difference between tonsils / adenoid surface and tonsil/ adenoid core culture were the most predominant isolate from tonsil surface was Staphylococcus aureus and K. pneumoniae from tonsillar core, while from adenoid surface was Streptococcus pyogenes whereas E. coli from adenoid core.The ASO titer in patients with or without group A streptococcal infections were determined by using latex agglutination test. The results revealed that 8 samples (14%) exhibited positive results, while 49 samples (86%) exhibited negative results out of 57 samples. The results showed statistically no significant differences between patient age groups but showed highly significant differences between males and females.Eight specimens were taking for histopathological examination randomly, four samples were adenoids and four samples were tonsils. The histopathology examination of tonsil and adenoid showed the presence of lymphoid hyperplasia,multiple lymphoid follicles, vascular congestion, fibrosis, germinal centers, infiltration of inflammatory cells, necrosis and apoptosis of tissues
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التشخيص الجزيئي لتجرثم الدم لدى الاطفال حديثي الولادة بواسطة استخدام تفاعلات البلمرة المتسلسل في مدينة الحلة Molecular Detection of Neonatal Sepsis By Using PCR In Hilla City

اسم المؤلف: نور حامد عباس المرزوك
اسم المشرف: الهام عباس بنيان الساعدي ميساء صالح الشكري
الموضوع العام: الطب
الموضوع الدقيق: الاحياء المجهرية
الدرجة: ماجستير
اللغة: الانكليزية
السنة: 2015
مكان الجامعة: بابل
المستخلص: في هذه الدراسة, تم جمع 85 عينة دم من 85 مريض مصابين بتسمم الدم (حسب التشخيص السريري الاولي للطبيب), تتراوح اعمارهم بين 1 - 28 يوم من كلا الجنسين (الذكور 53 والاناث 32) للفترة من تشرين الثاني 2014 الى اذار 2015.توضح نتائج هذه الدراسة ان (52,9%) طفلا حديث | Neonatal sepsis can be defined as any systemic bacterial infection confirmed by a positive blood culture in the first month of life. In this study, (85) blood specimens were collected from (85) patients with suspected septicemia, age ranged between 1to 28 days from both sexes (53 males and 32 females) during the period from November 2014 to March 2015.The results of this study revealed that (52.9%) are presented with late onset sepsis (infected during 7 - 28 days of their life), while the rest (47.1%) of the neonates are presented with early onset sepsis (infected during the first seven days of their life). The collected samples were investigated for bacterial isolation. Bacterial culture was positive in (7.06%) patients versus (92.9%) patients revealed a negative bacterial culture. The most common types of bacteria isolated were three isolates of Klebsiella spp. (50.0%), followed by one isolate Staphylococcus aureus (16.67%), one isolate E. coli (16.67%), and one isolate Enterobacter spp. (16.67%).The virulence factors of some bacterial isolates in this study were studied. The capsule was present in all bacteria isolated in this study (100%) except for Enterobacter spp. which did not possess the capsule.Colonization factor antigens were detected in all isolates. It was found that only Klebsiella spp. and E. coli (100%) have the ability to produce CFAI and CFAIII. Whereas Enterobacter spp. and Staphylococcus aureus (100%) have the ability to produce colonization factor antigen I only. The results also showed that all isolates of Klebsiella spp. and Enterobacter spp. did not produce hemolysin, while all isolates of Staphylococcus aureus and E. coli were able to produce hemolysin.Extracellular protease was also investigated. It was found that (100%) of all bacteria isolated in this study were able to produce extracellular protease.Biofilm formation was investigated in all bacterial species, and the results showed that all isolates of Gram negative bacteria and Gram positive bacteria form a biofilm.The ability of some bacteria to produce bacteriocin was tested and the results showed that E. coli and Klebsiella spp. were able to produce bacteriocin.In - vitro, the susceptibility of bacteria towards some antibiotics included in this study revealed that the amikacin and kanamycin are the most effective antibiotics to different types of pathogenic bacteria. Finally, molecular detection for bacterial sepsis was done by using specific primers (16 sRNA, rpoB and its). It was found that 16 sRNA genes were present in (20%) of samples and rpoB gene present in (18.8%). While its gene used for detection of fungi revealed negative results in all samples.
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