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ظاهرة التنمر ضمن طلاب المدارس الاعدادية في بغداد - الكرخ == BULLYING AMONG STUDENTS IN HIGH SCHOOLS IN BAGHDADKARKH

Author name: حيدر مجيد يحيى
Supervisor name: مشتاق طالب هاشم
General topic: Medicine
Specific topic: Community Medicine
Degree: Master
Language: English
University location: Baghdad
First pages:
Abstract: Background : Bullying is a major public health problem especially among students in high schools.Literature showed that bullying have an effect on mental, social, emotional, general behavior and academic function of students in school.Objective : To explore the prevalence of bullying among students in intermediate and secondary schools in Baghdad.Subjects and methods : A multi - stage stratified random sample of (302) students from intermediate and secondary schools in Baghdad - Karkh was included in the study; collection of data was done from October to December 2014. Using Focus Group Discussion each participant was directly interviewed to complete a questionnaire which contains four elements. First element was contained the sociodemographic information, Second element was formulated to measure the bullying depending on “Factors associated with bullying behavior in middle school students” by Bosworth, Espelage and Simon, and “A comparison of the Gatehouse Bullying Scale and the Peer Relations Questionnaire for students in secondary school” by Bond, Wolfe, Tollit, Buttler and Patton, and “Development of the Multi - dimensional Peer Victimization Scale” by Mynard and Joseph. Third element was for measuring the frequency of symptoms of bullying, the statements were translated from a compendium of the National Center on Birth Defects andDevelopment disabilities, Centers for Disease Control and Prevention. Fourth element was to assess the posttraumatic stress symptoms by using Harvard Trauma Questionnaire - Iraqi version for trauma symptoms (Part IV).Chi - square was used to examine the association between independent variables (socio - demographic variables and traumatic events) with dependent variables (bully, victim and witness). P value < 0.05 was considered statistically significant.Results : The rate of bullies was 24.3%, rate of victims was 38.8%, rate of sexual bullies was 17.1%, and rate of sexual victims was 21.4%. There was no significant statistical association between age and bullying (P=0.3).A significant association was noticed between sex and bullying (P=0.001).Bullying was varied significantly between resident area (P=0.004). A significant association was found between bullies with smoking and failure in school (P=0.001 for each).Conclusion : High prevalence of bullying (bullies, victims, sexual bullies and sexual victims) was found among student. The smoking and substance use was reported among the participants of study.Key words : Bullying, victimization, war, PTSD, Iraq.

تقييم تضييق الصمام التاجي باستخدام طريقة PISA للمرضى العراقيين بواسطة الايكو == Assessment of Mitral Valve stenosis by Simplifying proximal Isovelocity surface area in Iraqi Patients by Trans thoracic Echocardiography

Author name: محمد جاسم حتروش
Supervisor name: غازي فرحان حاجي
General topic: Medicine
Specific topic: Echocardiography
Degree: Higher Diploma
Language: English
University location: Baghdad
First pages:
Abstract: Background : Mitral Stenosis refers to narrowing of the mitral valve orifice, resulting in impairment of filling of the left ventricle in diastole. It is usually caused by rheumatic heart disease. Proximal isovelocity surface area measurement, also known as the “flow convergence” method, can be used in Transthoracic Echocardiography to estimate the area of an orifice through which blood flows.Objectives : To compare simple PISA equation, created by combined fixing the angle to 1000 and the Val to 33 cm/s, with mitral valve area measured by pressure half time and planimetry which was taken as reference method.Patients and Methods : A cross sectional prospective study was conducted in multi teaching centers (Baghdad teaching hospital, Ibin AL Nafees hospital, Ibn AL Bitar hospital and Ghazi AL Harriry teaching hospital) from the June 2015 to the June 2016. 104 patients were enrolled in this study, 41 were excluded from the study (patients with mild mitral stenosis, with aortic regurgitation, mitral regurgitation and those with poor window were excluded from the study). Transthoracic echocardiographic examination include para sternal long axis, apical four chamber and parasternal short axis view were used to analyze parameters were selected by M - mode, 2D, and pulse doppler Results : There were 63 patients enrolled in this study with a mean age of 45.4 ± 7.1years, (23.8%) of them within the age group 30 - 39 years and the remaining (76.2%) were > 40 years. Female patients were the dominant represented 73.0% while male were 7.0% of the studied group (female : male ratio was 3 : 1); (61.9%) were in sinus rhythm and (38.1%) in atrial fibrillation. 58.7% of the patients are with Wilkin's score less than8, the mean mitral valve area according to planimetry method was (1.14 ± 0.32) cm2 and it was (1.12 ± 0.28) cm2 by PISA while the mean mitral valve area by pressure half time method was (1.19 ± 0.30) cm2. The agreement between PISA and planimetry revealed that PISA had good agreement with planimetry in diagnosis of mitral stenosis, (kappa= 0.835, P< 0.001). On the other hand, there was a fair significant agreement between pressure half time and planimetry.Conclusions : PISA method can effectively predict mitral valve area and severity of mitral stenosis by the equation; mitral valve area = 115 _ r2/Vmax, Provided that aliasing velocity is fixed at 33 cm/s, with the advantage of easy calculation over other methods used to evaluate mitral valve area by Trans thoracic Echocardiography.

دراسة الفطريات المسببة التهابات الجروح بين المرضى العراقيين في مدينة بغداد == Mycological study of wound infections among Iraqi patients in Baghdad city

Author name: انعام خليفة جاسم سلمان
Supervisor name: جاسم محمد كرحوت | توفيق وليد توفيق
General topic: Medicine
Specific topic: Microbiology
Degree: Master
Language: English
University location: Baghdad
First pages:
Abstract: Two hundred fifty swabs were collected from patients admitted to Burn Unit , Surgical and Plastic Surgery at Burn Specialist Hospital ,Al - Kindy Teaching Hospital , Al - Wasety Specialized Hospital , Sheik Zaed Emergency Hospital and Baghdad Teaching Hospital and they divided in to 150 swabs from burned patients and 100 swabs from other types of infected wounds ( surgical ,fractures ,car accident , gun shot and other types of trauma) during the period from November 2011 till October 2012 . The handling and diagnoses of these swabs were carried out at Teaching Laboratories ,Central Health Laboratory and Ibn - Albalady Hospital.Three major types of wounds were seen including burn , surgical and different kinds of trauma . All isolates obtained in this study identified depending on the microscopical appearance ,colonial morphology of fungi and by using RapID™ Yeast Plus System and with some other tests ,the confirmation of these results was done by using Vitek 2 Compact System.Burn wounds were having the largest number (60%) of studied wound infections and in positive fungal cultures 92(61.33 % of total burn wound), there was 89 isolates(49.17%)of yeasts out of the total fungal isolates which isolated from all kinds of wounds 181isolates , 14 isolates(7.7%)of mold out of the total fungal isolates , the most common fungal pathogen isolated from burn wound was Candida spp. 49 isolates (27%) followed by Cryptococcus spp. 24 isolates(13.25%)and Aspergillus spp. 9 isolates(4.97%).The incidence of wound infections was high in burn patients, and dry heat 133(88.6) was the most common causes of burn wounds , burn wound was higher in females 122(81.33%) than males 28(18.66%), females were admitted to burn hospital with a history of attempted suicide 30(96.8%) moreSummaryIIthan males 1(3.2%) , and there was a significant difference between them ,the difference was also significant in the prevalence of wound infections among males and females , burn injuries occurred in relation to age represented a higher percentage (60.6%) among ages (20 - 29) years old , while the lowest occurrence (33.3%) in ages less than one year , fungal burn infections represented a (100%) in ages less than one year , while (33.3%) was seen in ages between (1 - 9) years old burned patients .The largest number of burn patients was 39(26%)with TBSA(30 - 39%) , the TBSA>30% was mostly infected with fungal elements(82%) ,and reach 10 fungal isolations(100%) with TBSA more than 70 % TBSA. Mortality rate in positive fungal infections was with TBSA 30 - 39 %(50%) and reach (100%) in 50 - 59 % TBSA . Infections was higher in burned patients 31(33.7%) in the second week post injury and the lower incidence in the fourth week 5(5.4%) ,the number of single isolates was 59(32.6%)and mixed isolates 46(25.4%) .While other wounds showed positive fungal cultures 75 ( 75%) , as 62 (34.25%) isolates of them were yeasts from all kinds of wounds 181isolates , and 14 (7.73%) isolates of them were mold , the most common fungal pathogen isolated from these wound was Candida spp. 40 isolates (22.09%) followed by Cryptococcus spp. 9 isolates(4.97%) and Aspergillus spp. 7 isolates(3.86%).In other wounds the infection rate was higher in males 66(66%) than females 34 ( 34% ) , as there was a significant difference between males and females in relation to age when represent a high percentage seen among age group( 1 - 9) years old ( 20 % ) , while the lowest percentage ( 3 % ) was seen in age group less than 1year , the fungal infections occurred in relation to age represent a high percentage (100%) in patients less than one year and in ageSummaryIIIgroup ( 60 - 69) years old , while the lowest infection rate (33.3%) was seen in ages between (20 - 29) years old in patients suffering from other wounds.A high percentage of patients showed infection in the second week post injury 17 ( 23 % ) and the lowest percentage of infection seen in other wounds 2 patients ( 2.7 % ) was in the fourth and eight weeks after injury ,the number of single isolates was 56(30.9%)and mixed isolates 20(11.0%) .Sensitivity test was done by disc diffusion method ,six antifungal discs were used ( Amphotericin - B , Nystatin , Clotremazole , Ketoconazole , Fluconazole and Flucytosine ) , in this study Amphotericin - B was the most antifungal effective against most fungal isolates while , Fluconazole and Flucytosine were the less effective against these isolates

مقارنة فحص جذع الدماغ السمعي مع الفحوصات السمعية الاخرى عند الاطفال الفاقدين السمع == Comparison Between Auditory Brainstem Response with Other Behavioral Methods in Children with Hearing Loss

Author name: منتهى جبار علي
Supervisor name: وجدان فاضل السعيدي
General topic: Medicine
Specific topic: Medical Physics
Degree: Master
Language: English
University location: Baghdad
First pages:
Abstract: هناك دائما حاجة لقياسات تقيم السمع وتحديدعتبة السمع للمرضى الذي لايتجابون مع الاختبارات(السمعية) السلوكية.الهدف من هذه الدراسة, تقيم دقة جهاز فحص استجابة جذع الدماغ ( ABR) Auditary Brain stem Response في تقدير حالة فقدان السمع بالمقارنة مع الاختبارات السلوكية وهما فحص الساحة السمعية (Free Field ) للصغار بعمر(اقل من سنتين) وفحص تخطيط السمع (Pure Tone Audiogram ),اكثر من سنتين. تم فحص مائة واحدى وعشرون طفلا (242) اذن , من المرضى المصابين بفقدان السمع او تاخر النطق باعمار تتراوح بين 1 - 9سنة, وكانت نسبة الاناث 51 ,والذكور 70 .اجريت مقارنة بين نتائج فحص جذع الدماغ وفحص الساحة السمعية في المجموعة الاولى ,بالاضافة الى نتائج فحص جذع الدماغ مع تخطيط السمع في المجموعة الثانية. كانت النسب المئوية لنتائج فحص فقدان السمع المقاسة بواسطة جذع الدماغ الى فحصي الساحة السمعية وتخطيط السمع هي : - 84 % و100 % على التوالي في حالات فقدان السمع الشديد جدا ((profound. وانخفضت نسبة فحص جذع الدماغ الى 57% مع تخطيط السمع و31 % الى فحص المساحة السمعية من فقدان السمع الشديد severe الى السمع الطبيعي. لايمكن الاعتماد فقط على نتائج فحص جذع الدماغ ضمن الترددات ((2 - 4Hz لتقيم عتبة السمع.ولكن يمكن ان يكون جزء ضروري من الفحوصات السمعية.

الاطفال قليلي الوزن والخدج في بغداد : دراسة في المستشفيات == LOW BIRTH WEIGHT AND PREMATURITY IN BAGHDAD : HOSPITAL BASED STUDY

Author name: انغام محمد علي درويش
Supervisor name: ايمان عدنان القصير
General topic: Medicine
Specific topic: Community Medicine
Degree: Master
Language: English
University location: Baghdad
First pages:
Abstract: Low birth weight (LBW), prematurity, small for gestational age (SGA) and intrauterine growth restriction (IUGR) are terms commonly used to describe poor fetal growth and immaturity in the newborn. They are reliable indicators in monitoring and evaluating the success of maternal and child health programs. The aim of this study was to identify SGA, premature and IUGR among LBW neonates. A total of 314 newborn babies and their mothers were included in this study. They were delivered at Al - Yarmouk teaching hospital during the period from 1st November, 2014 to 1st April, 2015. Data regarding the mothers were collected through direct interview and review of medical records and those concerning the neonates from case records and clinical examination. The studied associated factors were the sociodemographic factors, obstetrical history, and medical history. The studied variables were maternal age, maternal occupation and education, parental consanguinity, antenatal care (ANC) visits, parity, multiple pregnancy, birth spacing and chronic medical diseases. SGA was observed in 40.8% of LBW infants, and premature infants were 58%. IUGR was significantly affecting SGA. The association was nonsignificant between SGA and maternal age, occupation, education, parental consanguinity, parity, multiple pregnancy, birth spacing, ANC visits, source of care, hypertension, diabetes mellitus, genitourinary tract infection, antepartum haemorrhage (APH), anemia and medical diseases (heart, renal and thyroid).Strong and effective ANC services and programs are needed to ensure maternal awareness about intrauterine growth monitoring

شكل موجة الدوبلر النبضي لمخرج البطين الايمن وعلاقتها بشدة ارتفاع ضغط الدم الرئوي == Shape of the right ventricular outflow Doppler envelope and severity of pulmonary hypertension

Author name: محمد خالد عبد الكريم
Supervisor name: باسل نجيب سعيد الدليمي
General topic: Medicine
Specific topic: Echocardiography
Degree: Higher Diploma
Language: English
University location: Baghdad
First pages:
Abstract: Design : cross sectional descriptive study .Setting : Baghdad teaching hospital and Iraqi center of heart diseases.Duration : Beginning of September 2014 to end of August 2015 .Background : Pulmonary arterial hypertension is defined as a group of diseases characterized by a progressive increase in pulmonary vascular load, leading to marked increase in pulmonary artery pressure(PAP) . Although direct pressure measurement with right heart catheterization is the reference method and “gold standard” for quantification of pulmonary artery pressure, The invasive nature of catheterization makes it unsuitable for frequent and repeated use. Alternatively, echocardiography offers the advantages of noninvasiveness and versatility and is commonly used to estimate systolic pulmonary artery pressure . Unfortunately, not all of these echocardiographic variables are always present and at times an adequate jet of tricuspid regurgitation (TR) is not available to provide a very satisfactory estimate of the magnitude of pulmonary hypertension (PH) . The pulsed - wave Doppler of Right ventricular outflow tract (RVOT) velocity curve provides a wealth of physiologic information about RV and pulmonary vascular function. Doppler recordings from the RVOT are available in virtually all patients . Moreover, the shape of the Doppler profile in the Right ventricular outflow contains other physiological insights and it is simple to use in clinical practice .Aim : We devised a study to determine whether visual assessment of the right ventricular outflow Doppler signals can be useful identifying the severity of pulmonary hypertension .Patients and methods : We used a pulsed Doppler technique to examine the flow velocity pattern in the RVOT in 127 patients. Inclusion criteria all patients had a complete echocardiogram including pulsed Doppler spectral signals across the RVOT, discernible tricuspid regurgitation signal, good endocardial border resolution of both right and left ventricular chambers for tracing of the end - systole and end - diastole , as well as M - mode of the lateral tricuspid annulus .In addition, all these patients included for the analysis were in normal sinus rhythm . Exclusion criteria : no atrial or ventricular ectopy or other cardiac arrhythmia was present at the time of the study, none of the patients had a pacer or defibrillator wire in the right ventricle (RV). No previous cardiac surgery .Result : Visual inspection of RVOT spectral Doppler signals from the 127 showed four dynamic patterns , pulmonary artery systolic pressure (PASP)was significantly correlated with these different types of RVOT spectral Doppler signals . Both TR pressure gradient (PG) and PASP increased significantly from groups I to IV with p value ˂ 0.05, mean pulmonary PASP was 32.92 in pattern I, 56.07 in pattern II , 73.65 in pattern III and 113.45 in pattern IV and mean TR PG was 27.57 in pattern I , 47.28 in pattern II, 64.32 in patternIII and 102.27 in pattern IV. Furthermore, Right ventricular outflow velocity time integral (VTI) , acceleration time (ACT) , pulmonary vascular resistance (PVR) showed significant correlation with the four right ventricular outflow Doppler patterns with p value ˂ 0.05.Conclusion : In this study, we show that easily appreciated differences in the shape or morphology of the right ventricular outflow tract Doppler signal provide rapid, powerful hemodynamic insight into the presence and severity of pulmonary hypertension . Keywords Echocardiography , Pulsed wave Doppler , Right ventricular outflow tract , Pulmonary hypertension

تقييم مستوى بعض السايتوكينات الدهنية والبروتين الدهني الواطي الكثافة المؤكسد ومستوى دهون الدم قبل وبعد استعمال الميثوتركسيت في مصل مرضى داء الصدفية : دراسة حالات مرضية - مجموعة ضبط == Evaluation of some serum adipokines, oxidized low density lipoprotein and lipid profile before and after methotrexate treatment of chronic plaque psoriasis (A case - control study)

Author name: حيدر عبد جبار داود العمار
Supervisor name: مناف صالح داود | محمد كاظم الحطاب
General topic: Medicine
Specific topic: Clinical Biochemistry
Degree: Doctorate
Language: English
University location: Baghdad
First pages:
Abstract: يعتبر داء الصدفية من الامراض الالتهابية الشائعة التي تصيب الجلد وهو ذاتي المناعة ويصيب الناس بمعدل (2 - 4)% من مجموع سكان العالم. خلايا T المخترقة لانسجة الجلد، الانترلوكينات، والسايتوكينات مثل visfatin)) ، وهرمونhigh molecular weight adiponectin - ذات اوزان جزيئية كبيرة ، وبروتينات رابطة ريتونولية رباعية (RBP - 4) مع البروتين الشحمي الواطئ الكثافة المؤكسدox - LDL جميعها تؤثر بداء الصدفية. عادة يبدو جلد المريض بداء الصدفية مقشرا ومغلف بلون ابيض فضيا وممكن ان يصيب بقية اجزاء الجسم. يطرا على حياة المريض بداء الصدفية نفس ما يطرا على مرضى السكري من الدرجة الثانية او المرضى النفسيين او مرضى القلب من تغيرات. ويكون المريض بداء الصدفية بدينا مقارنة بعامة الناس. على الرغم من ان معرفتنا بسبب السمنة التي يصاب بها المريض بداء الصدفية الا ان هنالك الكثير من الدراسات التي وضعت بهذا الشان تفترض بان السبب هو افراز السايتوكينات المحفزة للالتهاب بواسطة الانسجة الشحمية ربما هو المسؤل عن تدهور حالة الصدفية. الدراسة الحالية قامت باجراء اختبارات لقياس التغيرات الحاصلة في مستويات انزيم الفيزفاتن ، وهرمون سايتوكين دهني ذات اوزان جزيئية كبيرة HMW - adiponectin، وبروتينات رابطة ريتونولية رباعية (RBP - 4) مع البروتين الشحمي الوطئ الكثافة المؤكسدox - LDL وكذلك اقتران هكذا تغيرات مع مدى نشاط او استفحال المرض. الاهداف : ان هدف الدراسة هو : لمعرفة التغيرات الحاصلة في مستويات انزيم الفيزفاتنvisfatin ، السايتوكين الدهني(الاديبونكتين) ذات اوزان جزيئية كبيرةHMW - adiponectin ، وبروتينات رابطة ريتونولية رباعية (RBP - 4) مع البروتين الشحمي الواطئ الكثافة المؤكسدoxidized - LDL في مصل مرضى داء الصدفية قبل وبعد العلاج بالميثوتراكسيت بالمقارنة بمستوياتها في مجموعة الضبط وكذلك لتقييم تاثير ذلك العلاج على مستويات الدهون الاخرى في المصل وكذلك بقياس تاثيره على مناطق الصدفية وشدة المؤشرPASI score. اجريت مقارنة بين السايتوكينات الدهنية و(ox - LDL) المؤكسد مع مؤشر كتلة الجسم (BMI) ومنطقة الصدفية وشدة المؤشر (PASI) وقيمهم التخمينية في وباء الصدفية. اخيرا لتاسيس دور المعطيات المذكورة اعلاه في عملية نشؤ المرض( داء الصدفية). المواد وطرق البحث : اشتملت الدراسة على ست وثمانون شخص (86) من الحالات المطابقة في الجنس والعمر المطابقة للدراسة الحالية (43 مصابين بالصدفية و43 اشخاص اصحاء) اما الحالات المصاحبة بارتفاع ضغط الدم او داء السكري قد تم استبعادها من هذه الدراسة. متوسط العمر كان (41±14.37) للمرضى، بينما كان (35±18.66) لمجموعة الضبط. تم اجراء هذه الدراسة في استشارية الجلدية في مستشفى مرجان التعليمي في مدينة الحلة، وتم اجراء الاختبارات في مختبرات المستشفى ومختبر قسم الجهاز الهضمي خلال الفترة بين (حزيران 2013) الى (اب 2014). تم سحب عينات المصل الماخوذ من الدم لاستخدامه من اجل ايجاد مستوى واجراء اختبارات لقياس التغيرات الحاصلة في مستويات الفيزفاتنvisfatin ، السايتوكينات الدهنية ذات اوزان جزيئية كبيرةHMW - adiponectin ، وبروتينات رابطة ريتونولية رباعية (RBP - 4) مع البروتين الشحمي الواطئ الكثافة المؤكسدox - LDL ومستوى المحتوى الدهني العام في المصل. تم قياس هذه السايتوكيتات في جميع الحالات بواسطة طريقة الفحص المناعي ELISA. تم تقييم نشاط داء الصدفية وكفاءة الميثوتريكسيت بواسطة مؤشر شدة المرض (PASI) وتاثير الميثوتريكسيت على مستويات السايتوكينات الدهنية المذكورة اعلاه والبروتينات الدهنيه المؤكسدة ذات الكثافة الواطئةox - LDL في المصل. النتائج : اظهرت نتائج هذه الدراسة زيادة واضحة (p<0.05) في الفيزفاتنvisfatin ، الاديبونكتن ذات اوزان جزيئيه كبيرةHMW - adiponectin، ونسبة تركيز البروتين الدهني المؤكسد الواطئ الكثافة (ox - LDL) ، ونقصان واضح (p<0.05) في نسبة تركيز البروتين الريتونولي الرباعي الارتباط (RBP - 4) في مصل مرضى الصدفية عندما تقارن مع مجموعة الضبط. اظهرت الدراسة ارتباطا كبيرا بين (ox - LDL) والفيزفاتن visfatin، وبين الاديبونكتين ذو اوزان جزيئيه كبيرهHMW - adiponectin وكذلك البروتين الرباعي الارتباط الريتونوليRBP - 4. فيما اظهرت نتائج الدراسة انه ليس هنالك علاقة بين الفيزفاتن والاديبونكتن ذو اوزان جزيئية كبيرة والبروتين الدهني الواطئ الكثافة المؤكسد ومؤشر كتلة الجسم (BMI) بينما بينت الدراسة علاقة سلبية واضحة بين البروتين الرباعي الارتباطRBP - 4 مع BMI. من ناحية اخرى اكدت النتائج ارتباطا كبيرا مباشرا بين الفيزفاتنvisfatin والاديبونكتن ( HMW) و(ox - LDL) ومؤشر الشدة (PASI) في هذه الدراسة، بينت نتائج الدراسة ايضا ارتباطا سلبيا واضحا بين (PASI) والبروتين الرباعي الارتباط RBP - 4. بالاضافة الى ذلك يوجد اختلاف واضح في معدلات مستوى الدهون في مصل مرضى الصدفية عند المقارنة مع مجموعة الضبط. اخيرا اوضحت الدراسة ، تاثير الميثوتركسيت على مستوى السايتوكينات و(ox - LDL) ومستوى دهون الدم من خلال الانخفاض الكبير في مستوياتها بعد المعالجة وبواسطة متوسط الاختلاف الكبير في قيم (PASI) قبل وبعد المعالجة لمرض الصدفية. الاستنتاجات : تشير نتائج هذه الدراسة الى ان بعض السايتوكينات الدهنية في مصل الدم ومنها انزيم الفيزفاتنvisfatin ، الاديبونكتين ذات اوزان جزيئية كبيرة HMW - adiponectin، والبروتين ذو رابطة ريتونولية رباعية (RBP - 4) مع البروتين الشحمي الواطئ الكثافة المؤكسدox - LDL)) في مرضى داء الصدفية يمكن ان تكون مؤشرات جيدة للتنبؤ بشدة مرض الصدفية وكيفية متابعة العلاج. عند اجراء مقارنة في مرضى داء الصدفية بين السايتوكينات الدهنيه والبروتين الشحمي الواطئ الكثافة المؤكسدox - LDL مع مناطق الاصابة بالصدفية ومؤشر الشدة (PASI) اظهرت الدراسة ارتباط ايجابي ايجابيا مع فيزفاتن، الاديبونكتن ذات اوزان جزيئية كبيرة و(LDL)ox) المؤكسد،، بينما يرتبط سلبيا مع بروتين الرباعي الارتباط الريتنولي RBP - 4بينما اظهرت الدراسة عدم وجود ارتباط بين هذه السايتوكينات ومؤشر كتلة الجسم (BMI).اظهرت الدراسة علاقة قوية بين شدة المرض ومستوى دهون الدم المختلفة في مرضى الصدفية من خلال قياس مؤشر الشدةPASI)) قبل وبعد اخذ علاج MTXكما بينت نتائج الدراسة تاثيرا واضحا للميثوتريكسيت الفموي على مستوى دهون الدم و(ox - LDL) المؤكسد في مرضى الصدفية، بالاضافة الى تحسن سريع في حجم الصدفية، مما يشير الى الدور المناعي لهذا العلاج في داء الصدفية. | Psoriasis is a common inflammatory autoimmune skin disease that affects 2 - 4%of the world population. T - cells infiltration, interleukins and cytokines including adipocytokines like visfatin, high molecular weight - adiponectin(HMW - adiponectin) and retinol binding protein - 4(RBP - 4), together with oxidized low density lipoprotein(ox - LDL) have been implicated in psoriasis pathogenesis. Many epidemiological evidence speculate that patients with psoriasis may be more obese compared with the general population. Although the definite mechanism underlying the correlation between obesity and psoriasis is uncertain, several studies had hypothesized that, the secretion of pro - inflammatory cytokines by adipose tissue may deteriorate psoriasis. Objectives : The aim of the present study is : To investigate the changes of serum visfatin level, HMW - adiponectin, RBP - 4, and oxidized - LDL in psoriatic patients before and after treatment with oral methotrexate therapy in comparison to their levels in control subjects to evaluate the impact of this drug on their serum levels and on psoriatic lesions by measuring psoriasis area and severity index(PASI). To ascertain the association between these adipocytokines and oxidized - LDL with body mass index(BMI) and psoriasis area and severity index(PASI) and their predictive value in plaque psoriasis . Finally, to establish the role of above mentioned parameters in the pathogenesis of psoriasis. Subjects and Methods : A total of 86 subjects (43 with Psoriasis and 43 healthy controls) were enrolled in this study. Their mean age was (41± 14.37) for patients, and (35.81± 18.66) for the control group. The study conducted in dermatology outpatient clinic in Merjan Teaching Hospital in Hilla City, and investigations were done in laboratory units of the hospital through the period from June 2013 to September 2014. The sera obtained from blood were used to determine the level of serum visfatin, HMW - adiponectin, RBP - 4, oxidized - LDL by enzyme - linked immunosorbent assay(ELISA), while lipid profile levels were estimated by spectrophotometric kits. Assessment of psoriasis disease activity and methotrexate efficacy were done by psoriasis area and severity index (PASI)score and methotrexate effects on serum levels of the above mentioned adipokines and oxidized low density lipoprotein.Exclusion criteria include : any person with hypertension, diabetes mellitus, pregnancy, smoking, alcoholism, and other medical diseases even other types of psoriasis disease.Results : Results of this study showed significant increase (p˂0.05) of serum visfatin, HMW - adiponectin, and oxidized - LDL concentrations, and significant decreases (p˂0.05) of retinol binding protein - 4(RBP - 4) concentration in sera of plaque psoriasis when compared with control group. There was a significant correlation between oxidized - LDL and visfatin, HMW - adiponectin and retinol binding protein - 4(r = 0.81, 0.68, ̵ 0.77)(p value˂0.001) respectively . Regarding the anthropometric parameters, this study shows no correlation between visfatin, HMW - adiponectin, RBP - 4, oxidized - LDL and body mass index(BMI)(r= 0.121, 0.043, - 0.170, - 0.049)respectively(p˃0.05). The findings of the present study confirm a significant association between visfatin, HMW - adiponectin, RBP - 4 and oxidized - LDL and PASI score(r= 0.77, 0.64, ̵ 0.77, 0.72)(p˂0.001) respectively. Additionally, there was a significant mean difference in lipid profile in serum of psoriatic patients when compared to control subjects(p value˂0.001). Finally, the impact of systemic methotrexate on above adipocytokines and oxidized - LDL was determined by significant reduction of their levels after treatment and by a significant mean difference in PASI score before and after treatment in psoriatic lesions size. Conclusions : Results obtained by this study indicate that some adipocytokines including serum visfatin, HMW - adiponectin and RBP - 4 levels, in addition to oxidized - LDL measured in patients with plaque psoriasis were closely associated with disease severity and could be used for prediction and treatment follow up.In patients with plaque psoriasis the PASI score is positively associated with serum visfatin, HMW - adiponectin and oxidized - LDL, while negatively correlated with serum retinol binding protein - 4 level, while the study results revealed no significant correlation between BMI and study parameters. This results may indicate that, these parameters could be independently regulated through the path of psoriasis process.The study findings confirm the association between psoriasis and abnormal lipid profile and also the study showed a significant correlation between lipid profile and PASI score(p˂0.05).The study results showed the good effect of oral methotrexate upon the serum adipocytokines and oxidized - LDL - c levels in psoriatic patients, in addition to better remission of psoriatic lesions, which indicate the immune modulatory role of this drug in psoriasis

فاعلية البرنامج الارشادي على معارف الممرضة - القابلة المتعلق بالثاليل التناسلية في مستشفى الكرخ للولادة في مدينة بغداد == Effectiveness of Instructional Program on Nurse / Midwife Knowledge Concerning Genital Warts in Al - Karkh Maternity Hospital at Baghdad City

Author name: حذام اسماعيل حمود
Supervisor name: سهاد حكمت خيري
General topic: Medicine
Specific topic: Obstetrics and Gynecology
Degree: Master
Language: English
University location: Baghdad
First pages:
Abstract: Background : Genital warts is one of the most common sexual transmitted infection. Education for nurses and midwives can play an important role in controlling and preventing this disease.Objectives : To assess the nurse/ midwife's knowledge concern genital warts, to determine the effectiveness of the outcomes of Instructional program, and to find out the relationship between the nurse/midwife knowledge and educational level and experience years Methodology : A quasi experimental study was conducted on a random sample of (100) nurses and midwives who is working at Al - Karkh Maternity Hospital , data was collected from 2ed February to 10th April 2017. Determined validity through a panel of experts of questionnaire and reliability through the pilot study of (10) of nurses and midwives descriptive and inferential statistic were used to analyze the data. Results : The finding of the study shows the highest percentage of study sample (19%)within age group (20 - 24) years , (47%) were married, half of them are graduated from midwifery secondary school, (42%) have less than one years' experience and work in maternity word, (81%)was heard about genital warts before and one third of them heard from another nurse, most of sample dose not participate in any educational course about genital warts, and half of them are treated with genital warts patients. The result of the study through pretest showed that the knowledge of nurse/ midwife is very weak information about genital warts. After the instructional program and through the posttest found a good progress of information which showed that there is a significant statistical relationship between instructional program knowledge and (educational level , years of experience ).

تقييم التغيرات الفزيولوجيه الحاصله في المسالك التنفسيه الصغيره : دراسه مستنده الى المستشفى == EVALUATION OF THE SMALL AIRWAYS CHANGES IN PREGNANCY (HOSPITAL BASED STUDY) AT BAGHDAD TEACHING HOSPITAL

Author name: سيف عبد الحسين حسن
Supervisor name: محمد وهيب سلمان العبيدي
General topic: Medicine
Specific topic: Diseases - Thoracic
Degree: Higher Diploma
Language: English
University location: Baghdad
First pages:
Abstract: يرتبط الحمل بتغيرات فزيولوجيه في السيطره على عملية التفس,حجم الرئه ,ميكانيكية التنفس وعلى التوازن الموجود بين الحوامض والقواعد داخل الجسمالهدف من الدراسه : 1 - مقارنة فحوصات وظائف الرئه للمسالك التنفسيه الصغيره 25% - 75% بين الحامل خلال فترات الحمل المختلفه وغير الحامل.2 - لتحديد التغيرات الحاصله في فحوصات الرئه بالنسبه للمسالك التنفسيه الصغيره قبل الولاده.3 - لتحديد اذا ما كان هنالك اي تاثير لفترة الحمل على فحوصات الرئه الخاصه بالمسالك التنفسيه الصغيره.طريقة العمل : دراسه مقطعيه مستنده الى المستشفى.اجري هذا البحث في مستشفى بغداد التعليمي بالتنسيق بين استشارية الجهاز التنفسي واستشارية النسائيه وشعبة فحص وظائف الرئه.تم اختيار 120 امراه حامل في مختلف فترات الحمل وباوزان واطوال مختلفه ومقارنتها بنساء غير حوامل(40 امراه).جميع المتطوعين للدراسه لم يعانو من امراض مزمنه ولم يكونو مدخنين. تم اخذ موافقة الجميع قبل الفحص بواسطة جهاز فحص وظائف الرئه الالكتروني.تم ادخال البيانات بواسطة SSPS22.النتائج : لوحظ وجود تغيرات في فحوصات المسالك التنفسيه الصغيره 25%بين الحوامل وغير الحوامل حيث كانت القيمه اقل من 0.05كما لوحظ وجود تغيرات بالنسبه لذروة معدل تدفق الزفيرPEFRكانت القيمه اقل من 0.05 الاستنتاج : ان للحمل تاثير على المسالك التنفسيه الصغيره.التوصيات : استخدام فحص وظائف الرئه وخاصه المسالك التنفسيه الصغيره لغرض متابعة كفاءةالجهاز التنفسي للمراه الحامل | BACKGROUND : Pregnancy is associated with physiological changes in the control of breathing, in lung volumes, in the mechanics of respiration and in acid base balance.OBJECTIVE : to assess the effect of single normal pregnancy on small airways.STUDY SETTING : Baghdad teaching hospital.PATIENTS AND METHODS : This study : cross sectional descriptive analytical study. carried out at Baghdad teaching hospital .Started from JUNE 2016 to JUNE 2017 .140 ladies aged 16 - 44 yrs of different height, weight and different conception from 1 st , 2nd and 3 rd trimesters were included also there was a control group which contains 40 ladies.All of them did spirometry .I focused mainly on the small airways parameters(Forced expiratory flow 25% - 50% - 75%) and peak expiratory flow rate for the study(pregnant) and the control(non - pregnant) groupsRESULTS : FEF25% was the only small airway parameter that is affected between the pregnant and the non - pregnant (P value was less than 0.05) BUT not in different trimesters of same pregnancy. Also there was change in the PEFR between the pregnant and the non - pregnant (P value was less than 0.05), But no change between the different trimesters

فاعلية البرنامج التثقيفي على معارف وممارسات العاملين الصحيين تجاه السيطرة على العدوى في مراكز الرعاية الصحية الاولية في مدينة كربلاء المقدسة == Effectiveness of an Education Program on Health Care Workers' Knowledge and Practices toward Infection Control at Primary Health Care Centers in Holy Karbala City

Author name: سلمان حسين فارس الكريطي
Supervisor name: اركان بهلول ناجي
General topic: Medicine
Specific topic: Nursing
Degree: Doctorate
Language: English
University location: Baghdad
First pages:
Abstract: دراسة شبه تجريبية اجريت في مراكز الرعاية الصحية الاولية في مدينة كربلاء المقدسة للفترة من اذار 2102 . لغاية نهاية شهر نيسان 2102 لقد هدفت الدراسة الى تقييم فاعلية البرنامج التثقيفي على معارف وممارسات العاملين الصحيين تجاه السيطرة على العدوى في مراكز الرعاية الصحية الاولية في مدينة كربلاء المقدسة. تم تقييم الاحتياج للبرنامج التثقيفي، واظهرت نتيجة التقييم وجود ضعف في معارف وممارسات العاملين الصحيين تجاه السيطرة على العدوى في مراكز الرعاية الصحية الاولية.) شملت عينة الدراسة ) 22 عاملا صحيا اختيروا بشكل غير عشوائي )عمدي( ، وقد قسمت العينة الى مجموعتين مجموعة الدراسة ) 22 ( عاملا صحيا، والمجموعة الضابطة ) 22 ( عاملا صحيا . تم بناء برنامج تثقيفي حسب احتياج العاملين الصحيين واعدت ثلاث استمارات واحدة للمعلومات الخاصة بالعينة لتحديد صفاتها، واستمارتين لتقييم معارف وممارسات العاملين الصحيين ، استعملت للاختبار القبلي والبعدي. تم تحقيق مصداقية الاداة بعرضها على مجموعة خبراء لمراجعتها وتحديد درجة مصداقيتها، وتم تحديد ثبات اداة القياس من خلال الدراسة التجريبية.تم الاختبار القبلي لافراد المجموعتين ومن ثم تطبيق البرنامج التثقيفي لمجموعة الدراسة فقط للفترة من التاسع عشر لغاية الثالث والعشرين من حزيران 2102 ، تم الاختبار البعدي الاول مباشرة بعد تنفيذ البرنامج، ثم الاختبار البعدي الثاني بعد اربعة اسابيع من الاختبار البعدي الاول.تم تحليل النتائج باستخدام الاحصاء الوصفي والاحصاء الاستدلالي. اظهرت النتائج استفادة العاملين الصحيين بعد تطبيق البرنامج التثقيفي حيث الزيادة في مستوى المعرفة والممارسة للعاملين الصحيين وان البرنامج التثقيفي الخاص بالسيطرة على العدوى كان فعالا في تحسين معارف وممارسات العاملين الصحيين المشاركين فيه وعدم وجود اختلافات هامة بين مستوى تحسين معارف وممارسات العاملين الصحيين نتيجة لتطبيق البرنامج طبقا للعمر، المستوى التعليمي، سنوات الخبرة والمشاركة في الدورات التدريبية في الاختبار البعدي لمجموعتي الدراسة والضابطة باستثناء سنوات الخبرة في مجموعة الدراسة فقد اظهرت النتائج وجود اختلافات هامة بين مستوى تحسين معارف العاملين الصحيين في الاختبار البعدي لمجموعة الدراسة .واوصت الدراسة بتوفير الادلة الارشادية والتاكيد على اهمية التعليم المستمر للعاملين الصحيين باستعمال الممارسات المعتمدة على الادلة لتطبيق الاحتياطات القياسية للسيطرة على العدوى. وان هنالك حاجة لاكثر من برنامج تثقيفي حول السيطرة على العدوى في كل مراكز الرعاية الصحية الاولية ولعينة اكبر لتستفيد من النتائج . | A quasi experimental study was carried out at the primary health care centers in holy Karbala city from March 2016 to the end of April 2017.The study aims to assess the effectiveness of an educational program on the knowledge and practices of healthcare workers in Karbala city. Assessment of needs was done to evaluate the needs for the educational program. The result of the assessment revealed that the healthcare workers had deficit knowledge and practice regarding infection control in primary health care centers. A Non - Probability sample of (52) healthcare workers was selected randomly and divided into two groups : (26) considered as a study group and the other (26) considered as control group. An educational program was constructed, and three formats were developed one for assessing demographic characteristics of sample, the other two for assessing healthcare workers knowledge and practice. Validity of the instrument was determined through content validity by a panel of experts, and reliability of the tool was determined through a pilot study.A pre - test was done for both groups; educational programs were applied only for the study group from June 19th to June 23rd 2016. Then the first post - test was applied after the implementation of the program and the follow up after four weeks from 1st post test.Analysis of data was performed through the application of descriptive and inferential statistics.The findings revealed that the healthcare workers of the study group had benefited from the implementation of the educational program; their knowledge and practice were significantly improved comparing with the control group, the infection control education program was found to be effective in knowledge and practices improvement to the participant HCWsand non - significant association between HCWs knowledge and practice improvement effect result by application of the education program and their age, education, years of experience and training session in post - test I for study and control group. Except for years of experience in study group it shows a significant association with knowledge improvement.The study recommends the availability of written guidelines and focus on the importance of continuing education for HCWs using the evidence - based practices for application of standard precautions of infection control; and more educational programs of infection control are needed in all PHC centers and on a larger sample to benefit from the results.

البروتين الرابط للرتينول4 ونسبتة للرتينول الحرفي مرضى السكري من النوع الثاني البدناء == Serum retinol binding protein 4 and its ratio to serum retinol in obese type 2 diabetic patients

Author name: انس هاشم صادق الحسيني
Supervisor name: عمر فاروق عبد الرشيد | محمود شاكر خضير
General topic: Medicine
Specific topic: Clinical Biochemistry
Degree: Master
Language: English
University location: Baghdad
First pages:
Abstract: Diabetes mellitus is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both, the chronic hyperglycemia of diabetes is associated with long - term damage, dysfunction and failure of various organs, especially the eyes, kidneys, nerves, heart, and blood vessels that impose a tremendous burden on the individual with diabetes and on the health care system.Objective : To study the relationship between retinol binding protein - 4 (RBP - 4) / retinol ratio with insulin resistance in patients with type 2 diabetes mellitus.Subjects and methods : A case - control study was performed at Chemistry and Biochemistry Department, College of Medicine, Al - Nahrain University, Baghdad, Iraq from March 2012 to June 2012. Forty five patients and thirty four healthy controls were enrolled in this study. The patients and controls were taken with cluster random sampling method. The present study includes measurements of hbA1c levels by ion - exchange HPLC method. Fasting blood glucose, lipid profile, blood urea and serum creatinine levels were determined by enzymatic colorimetric methods. Fasting serum insulin, retinol binding protein - 4 ( RBP - 4), retinol levels were measured by enzyme - linked immune sorbent assay in 45 patients with type 2 diabetes mellitus (mean ± SE,MEAN AGE = 52.14 ± 1.01 years).The results were compared with 34 aged matched apparently healthy control subjects (mean age 48.79 ± 1.17 years) divided according to body mass index (BMI) into two groups : 1. Controls with body mass index (BMI) < 25 kg/m2 : normal control group (n = 9, mean age = 49.22 ± 1.88 years).2. Controls with body mass index (BMI) ≥ 30 kg/m2 : obese control group (n = 25, mean age = 48.38 ± 1.45 years) .Results : The results showed significant elevation in blood glucose, glycated hemoglobin HbA1c, serum triglyceride TG, serum very low density lipoprotein VLDL, atherogenic index of plasma AIP, fasting insulin resistance index, fasting glucose insulin ratio, Homeostatic model assessment of β - cells (β - cells function) HOMA - β and serum retinol binding protein 4 in the diabetic patients as compared with both control subjects.High density lipoprotein HDL, insulin and Homeostatic model assessment of insulin resistance HOMA - IR presented significant increase in T2DM when compared to normal control group but not significant difference when compared to obeseInsulin levels and insulin resistance expressed in HOMA - IR showed significant elevation in T2DM as compared to normal control group but not significant when compared to obese control group.Serum cholesterol, low density lipoprotein showed no significant difference between patients and both control groups.Insulin sensitivity index ISI was significantly decreased in T2DM patients as compared to both control groups.Conclusion : It was concluded that serum retinol / retinol binding protein 4 ratio may be considered as indication

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

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

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

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

التقييم الفسلجي للاعتلال العصبي الذاتي لمرضى داء السكري

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Author name: ثائر عيسى مراد
Supervisor name: مازن غازي جاسم الربيعي | امجد داود نيازي
General topic: Medicine
Specific topic: Community Medicine
Degree: Master
Language: English
University location: Baghdad
First pages:
Abstract: تعتبر الاحصائيات الصحية الرصينة ضرورة لاتخاذ القرارات السليمة في كل مستويات النظام الصحي. ولكن في الحقيقة ان نظم المعلومات الصحية في معظم البلدان تعتبر غير كافية لتوفير المعلومات اللا زمة لدعم الادارة الصحية ولهذا فان معظم النظم الحالية تعتبر كعائق اداري | Sound health statistics are essential for health decision - making at all levels of the health system. Unfortunately, health information systems in most countries are inadequate in providing the needed management support and the current systems are therefore widely seen as management obstacles rather than as tools, the current study is an attempt to assess the health information system in Iraq with recognizing the strengths, weaknesses and gaps in addition to assessment of the structure and performance of this system; it also attempts to assess the behavioral, technical and organizational determinants affecting the health information system performance. A cross - sectional study was conducted for the assessment process and the levels of the assessment included the ministry of health (national level), the health directorates (provincial level), the districts related to the health directorates reaching to the health centers level, as well as the hospitals related to the health directorates, in addition to the ministry of planning and the ministry of interior. In addition to ministry of health (central level) a total of six governorates were selected by simple random sampling including the capital Baghdad with a seven districts were selected from those governorates also by simple random sampling and a total of twenty six health centers were selected from those districts, as well a total of seven hospitals were included in the study from all governorate and they were selected according to convenience. The interview has been done by using the health metrics network assessment tool version 4, in addition to a complementary assessment tools which are the PRISM package tools that were used at the district and primary health center levels. Based on the data collected and according to the health metric network assessment tool findings the overall health information system has laid in the adequate state (65.96%) with most of its comprising components function poorly. Data dissemination and use and data management categories were the weakest with a score of 50% and 53.3% respectively, while for the resources category it was found to be adequate 63.3%, and for that of HIS indicators, data sources and information product categories they were 73.3%, 66% and 69.6% respectively. For that of the PRISM tools and the findings obtained by them from the collected data the results revealed that a low data quality in term of accuracy with 29.03% at the facility level and 55.35% at the district level, while the completeness rate was excellent with a score 96.38% at the facility level and 98.23% at the district level, for that of the timeliness it was 70.43% timeliness at the district level. The information use for a given feedback at the facility was 50% and at the district was 82.12% and for observed meeting records it was 50% for the facility and 41.6% for the district level. For that of the functionality a 34.61and 67.30% of the facilities reported having a reminder mechanism for data completeness process and meeting a deadline for submitting monthly reports respectively, Data analysis was better at the district 85.71% than at the facility 81.7%, Data display were present in all of the facilities and districts. For the technical determinant the results showed 57%, 85.7%, 71.4% and 100% of the district respondents felt that the form is complex and difficult to follow, data software is a user - friendly, information technology is easy to manage and a comprehensive picture of the health system performance is captured by the system respectively,85.7% believed that the information system collecting information from some vertical programs and one district reported of no collection at all, in addition to that 100% reported the absence of a software that integrates data from different information systems and the available information technology doesn&#39;t provide full access procedure to district and senior managers. Regarding the behavioral determinants the results revealed that overall mean confidence for the information system tasks is 69.41% while for that of the task competence the overall mean competence level is 37.1%. Knowledge of checking data quality, knowledge of health information system rationale and problem solving showed results of 35.32% 37.68% and 2.98% respectively, and that of motivation level was 43.4%. Organizational determinants results revealed that the management functions at facility and district levels were almost absent, while for the perceived promotion of a culture of information it showed a total score of 63.96% and rewarding for a good performance was 56.83%. The activities for promotion of a culture of information are a 25% at the facility level and 28.75% at the district level. And that of supervision quality at the facility were (72.80%). Availability of resources revealed that 100% of the facilities have two or more computers and calculators respectively while only 57.7% have an internet access. Access to the electricity and water supply is very high, No facility reported of running out in registers in the last 12 months. Finally, the current study shows the importance for the need of further attention to be drawn to HIS, in addition to that, increasing the awareness and well coordinated efforts that need to be done to overcome weaknesses and to provide a well functioning HIS enabling for evidence based decision making and action provision in the health system.

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

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

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

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

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

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