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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Author name: احمد فاخر حميد
General topic: Medicine
Degree: Master
Language: English
University location: Baghdad
First pages:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

دراسة خمج فيروس الكبد نمط جي HGV في مرضى الثلاسيميا المصابين وغير المصابين بفيروس الكبد سي (HCV) واهميته السريرية

Author name: مريم صبري ابراهيم
Supervisor name: اروى هادي الحمداني | اشنا جمال فائق
General topic: Medicine
Specific topic: Microbiology - Viruses
Degree: Master
Language: English
University location: Baghdad
First pages:
Abstract: المرضى المصابين بفقر دم البحر الابيض المتوسط هم اكثر عرضة للاصابة بالالتهابات الفيروسية المنقولة دمويا. التهاب الكبد الفيروسي نمط جي (HGV)هو فيروس رنوي(RNA) مرتبط بالتهاب الكبد الفيروسي الحاد والمزمن. التهاب الكبد الفيروسي نمط سيHCV) ) والتهاب الكبد الفير | Thalassemia patients are at increased risk of infection with parentally transmitted viral agents. The hepatitis G virus (HGV) is an RNA virus, which is associated with acute or chronic hepatitis. Hepatitis G virus (HGV) and hepatitis C virus (HCV) infections may have a role in complicating the clinical outcome in patients with thalassemia. This study was designed to investigate the prevalence and clinical importance of HGV infection in thalassemia patients with or without hepatitis C virus (HCV) co - infection, furthermore to sequence and analyze phylogentic of HGV clones. One hundred fifty four thalassemia patients (56.5% male, 43.5% female) with a mean age of 22.84±6.06 years were involved in this study that was conducted in the period between Feb. to May, 2014. Anti - HCV antibody was determined by Enzyme Linked Immunosorbent Assay (ELISA) and confirmed by western blot. Then, HCV - RNA was detected in 53.2% of anti - HCV positive thalassemia patients. HGV antibodies were evaluated by ELISA. Also, the HGV viremia was analyzed in patients with thalassemia by reverse transcription polymerase chain reaction (RT - PCR) protocol. Results obtained showed that the anti - E2 - HGV were found in 16 out of 154 (10.4%) thalassemia patients with significant decrease in its prevalence with increasing age, while HGV viremia was diagnosed in 28 out of 154 (18.2%) patients with thalassemia. No association of HGV infection was found with gender, age and frequency of blood transfusion.According to HCV and HGV infection status, thalassemia patients were categorized into four subgroups : subgroup I (HGV infection), subgroup II (HCV infection), subgroup III (co - infection of HCV and HGV), and subgroup IV (thalassemia patients with neither HCV nor HGV infection). Seven point one percent (7.1%) of thalassemia patients were found to be co - infected with HCV and HGV.In all thalassemia subgroups, liver transaminases; alanine transaminase (ALT) and aspartate transaminase (AST), alkaline phosphatase (ALP), and total serum bilirubin (TSB) were determined, in addition to measure serum ferritin levels by VIDAS. HCV infection shows significant increase in ALT level while in HGV is not. Co - infection with HCV and HGV decrease ALT levels when compared with infection with HCV alone, so HGV infection is suggested to have no role in increasing the severity of liver diseases in the thalassemia patients. In HGV infection, there were significant increase in ALP levels and significant decrease in ferritin levels than other subgroups in the study. However, HGV infection shows no significant differences in AST and TSB than other subgroups. The results of genotyping in 12 randomly selected patients showed presence of genotype 2 and genotype 5 with percentage of 91.7% and 8.3% respectively. The diagnosis of prevalence of HGV and HCV in patients with thalassemia in Iraq emphasized the importance of these lymphotropic viral hepatitis infections in pathogenesis and outcome of thalassemia patients.

دور الايبشتاين بار فايرس كعامل محتمل لتقدم سرطان الدم اللمفاوي المزمن == Molecular Characterization Of Metallo ? - Lactamase (MBL) Genes

Author name: لمى عامر ياسر
Supervisor name: عامر رشيد النجار | داود سلمان داود
General topic: Medicine
Specific topic: Microbiology
Degree: Doctorate
Language: English
University location: Baghdad
First pages:
Abstract: Epstein Barr virus (EBV) is ubiquitous virus which infects the majority of the human population and is the causative agent of infectious monocleosis and a variety of B - cell tumors including Hodgkin lymphoma, Burkitt lymphoma, human immunodeficiency virus - associated lymphomas and post - transplant lymphoproliferative disorders , this virus expressed many protein and it is associated with a variety of B - cell tumors. Recently many studies have suggested a causal relationship between EBV and chronic lymphocytic leukemia (CLL). A prospective study of thirty samples of formalin - fixed, paraffin - embedded tissue of bone marrow aspirates samples and blood from newly diagnosis BCLL of 30 patients and our control included : 1) 20 bone marrow of patients who they have hematological disease other than leukemia as control. 2) Blood serum from healthy controls to study the level of IL - 10 and IL - 8. The present study conducted at Baghdad Teaching hospitals and the National Center of Hematology from September 2013 to Jun 2014. In this study we investigated the association between EBV and CLL. The detection of EBV encoded RNAs (EBER1,EBER2) by in situ hybridization and also latent membrane protein - 1 (LMP - 1) and EBV nuclear antigen - 2(EBNA2) by immunohistochemistry and detection for the level of Interleukin n (8 and 10) in the serum of CLL patients by ELISA. In situ hybridization study revealed that all the controls were negative for EBERs and 46.7% patients were found to be EBERs positive. There was a correlation between positive EBERs and tumors stage and also EBERs and IL10 and with LMP - 1 and EBNA - 2. Immuno - histochemical method was used to demonstrate the rate of (LMP - 1 and EBNA - 2) in CLL patients where a positive results of EBNA2 and LMP1were found in (43.3 % and 56.6s %), respectively in CLL patient group. All controls were negative with an exception of two patients were LMP1 positive. Enzyme linked immunosorbent assay test (ELISA) was used to detect the level of IL - 8 and IL - 10 in serum of newly diagnosed of CLL patients. Interleukin 8 was significantly higher in CLL cases group (33.1 pg/ml) compared to control group.On the other hand It was found that high increase in IL - 10 level ,in CLL patients when compared with controls. Conclusion : It can be concluded that there is a significant relationship between EBV and Chronic lymphocytic leukemia, mainly EBERs, also the association of significant increase in IL - 10 and IL - 8 with CLL.

مؤشرات جزيئية حول مقاومة الزوائف الزنجارية المرتبطة بخمج المجاري البولية للمضادات الحيوية == Molecular Markers Of Antibiotics Resistance Of Pseudomonas Aeruginosa Associated With Urinary Tract Infections

Author name: كريم عليوي حمادي سليمان
Supervisor name: عامر رشيد النجار
General topic: Medicine
Specific topic: Microbiology
Degree: Doctorate
Language: English
University location: Baghdad
First pages:
Abstract: الزوائف الزنجارية : وهي بكتريا سالبة لصيغة الكرام والمنتشرة بشكل واسع في البيئة مثل التربة والمياه. وهذه البكتريا تتسبب في كثير من الالتهابات مثل التهاب المجاري البولية والتهاب الحروق وهي بكتريا انتهازية. وتشكل تهديد لحياة المصابين بالمجاري البولية وخاص | Pseudomonas aeruginosa is a Gram |( - ve) bacteria, widely presents in the environment such as soil, water, its incubation period (1 - 3) days, generation time 1 - 2 hrs. This bacteria causes many infections such as (UTI), and burn infections. It is an opportunistic pathogen, life threating for immune compromised patients such as diabetic patients. Pseudomonas aeruginosa is a nosocomial pathogen, and it is ranking the second among Gram ( - ve) hospitals acquiring pathogen. Its antibiotic resistance increased due to acquiring many antibiotics resistance genes. The spread of these genes among bacteria is via plasmids. Plasmid profiling of Ps. aeruginosa isolates by gel electrophoresis is a best technique for detection of plasmid content. Through this study, which was carried out in two main teaching hospitals, the diabetic center and private labs in Baghdad, during the period from January to October 2014. A total of (620) urine specimens were collected during (9) months. Urine specimens from inpatients were (420 / 620, 67.75%) and from out patients were (200 / 620, 32.25%). Urine specimens from Dialysis unit were (280 / 620, 45.1%) and from burn units were (140 / 620, 22.5%). The male represented (n = 334, 52.38%) while female were (n = 286, 46.20%). The positive cultures of urine samples obtained from hospitalized patients were (72 / 420, 17.1%) while for urine samples obtained from out patients (n = 40 / 200, 20%) were positive culture. A total of (112) positive culture out of (620) collected with (18.06%) percentage. A total of (30) bacterial isolates were tested by using disc diffusion method for susceptibility test forward to (15) antibiotics. Ps. aeruginosa isolates showed highest resistance to gentamicin (87.5%) while the lowest resistant toward meropenem, and imipenem with resistance percentage (16.7% and 8.0%) respectively.The occurrence of multi - drug resistance in (30) selected isolates were grouped as follows to (MDR) for those isolates which showed resistance to at least (3) antibiotics which was found to be (5 / 30, 6.6%). While (XDR) referred to those isolates which showed resistance to (4 - 5) antibiotics with (19 / 30, 63.3%). In related to (PDR) which referred to isolates that showed resistance to more than 5 with (6 / 30, 20%). The extracted plasmid DNA were resolved by gel electrophoresis for detection of plasmid content for (20) isolates including (10) isolates from inpatients, and (10) isolates from out patients. The selection of these isolates were grouped according to their antibiotic resistance pattern and the number of plasmids that they carried. The results showed that out of (20) there were (12 / 20, 60%) had no plasmid. While the remaining (8 / 20, 40%) had plasmids with different sizes and numbers. By using PCR technique the most common kinds of genes such as bla CTX - M, bla OXA, which encoded extended spectrum ? - lactamase (ESBLS) and those for metallo ? - lactamase such as bla IMP, were investigated with specific primers. Five isolates were selected depending on the numbers of plasmids which they carried and their resistance to antibiotics.

دراسة مؤشرات مناعية وبايوكيميائية مختارة لمرضى السكري النوع الثاني المصحوب وغير المصحوب باعتلال الكلى ذات الادرار قليل الزلال == Study Of Selected Immunological And Biochemical Markers In Type 2 Diabetes With And Without Microalbuminuric Nephropathy

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

مميزات التحويرات المناعية للريسفراترول المستخلص من قشور العنب الاحمر على التهاب الكبد المحدث باستخدام ديكالاكتوزامين والذيفان المعوي نوع ب للمكورات العنقودية == Immunmodulatory Properties Of Resveratrol Extracted From Skin Of Red Grape On Acute Liver Injury Induced By D - Galactoseamine And Staphylococcus Enterotoxin B

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

دراسة معظم السمات المناعية وتحديد البكتريا الابرز في مرض التهاب السحايا باستعمال تقنية البي سي ار == Study Some Immunological Aspects And Determination Of Most Prominent Bacteria In Meningitis Patients By Using Real Time Pcr

Author name: شيماء عبد الرضا حميد
Supervisor name: زينب فاضل عاشور | دريد قاسم الشريف
General topic: Medicine
Specific topic: Microbiology - Immunology
Degree: Master
Language: English
University location: Baghdad
First pages:
Abstract: Meningitis, which is inflammation of the membranes that surround the brain and spinal cord and can occur at any age, it is caused by infectious microorganisms include (Bacteria, Viruses, Fungi, and Parasites) and non infectious include (Drugs, Carcinoma and Inflammatory disorder), also requires early treatment with aggressive use of potent antimicrobials; otherwise the outcome almost ends fatally.The predominant causes of bacterial meningitis are streptococcus pneumoniae, Haemophilus influenzae type b (Hib) and Neisseria meningitides.This prospective study includes 40 cases of meningitis which have been admitted to the Baghdad Teaching Hospital and Child Welfare Teaching Hospital during the period from May to November/ 2014.The detection of meningitis causative agent were specified by using the standard biochemical and microbiological methods such as : Determination of protein and sugar in Cerebrospinal fluid, Differential and cell count, growth on Culture media and morphological appearance on Gram's stain.Confirmative tests were also done for identification of meningitis causative agent; these tests included Procalcitonin, IL - 6, CRP, D. Dimer. These confirmative tests have been crowned by PCR technique, by employing the detection of the bacterial gene.The DNA of bacteria was extracted from CSF of meningitis patients and detection the type of bacteria gene by using multiplex PCR technique that using primers to amplify each ply, bexA and ctrA gene.Out of 40 samples, 28 (70%) were identified as bacterial meningitis and 12 (30%) as viral meningitis, the result of PCR reaction revealed unmistakably that 20 (71.4%) of 28 were detected the bacteria (S. pneumonia, H. influenzaetype b and N. meningitides) as a causative agent, while there were no detectable infectious agents in the (40) control group included in this study.Viral meningitis patients showed the number of lymphocytes (31.92 cell/ mm3) and neutrophils (1.00 cell/ mm3), while the highest number of lymphocytes and neutrophils in bacterial meningitis caused by S. pneumoniae (77.08 cell/ mm3) , (28.86 cell/ mm3) respectively, so that there was significant difference between cells (lymphocyte and neutrophil) with study group at P value = 0.010, P value = 0.013 respectively. In microbiological examination 22.5% of patients group (40) showed positive result of culture and 7.5% showed positive result of gram stain.In biochemical tests, the detection of Cerebrospinal fluid's protein and glucose level was done. The level of protein concentrations in bacterial meningitis with S. pneumoniae (103.08 mg/l), H. influenzae (65.14 mg/l) and in other bacteria was (124.44 mg/l) which is higher than the protein concentration in viral meningitis (42.25 mg/l), and these results showed highly significant difference at (P=0.010). Results of glucose's level determination showed that there were no significant difference among the studied groups (P =0.2). Results of glucose's level determination showed the presence of non significant difference among the studied groups, (60.92 mg/dl), (43, 57 mg/ dl), (51.00 mg/dl), (41.50 mg/dl) consecutively appeared in bacterial, viral.Interleukin - 6 and Procalcitonin levels were diagnosed by Enzyme Linked Immunosorbent Assay, while the plasma D. Dimer and erum C - Reactive protein was diagnosed by NaycoCard technique.The current results showed the presence of high concentration of IL - 6 among meningitis patients, high concentration of serum IL - 6 appeared in bacterial and viral meningitis (28.68 pg/ml) when compared with control group (2.194 pg/ml) (P =0.001), while CSF IL - 6 show high concentration in bothbacterial and viral meningitis but with no significant difference (579.24 pg/ml) (P =0.0001). The data of this study showed, there was correlation between IL - 6 levels and neutrophil in meningitis patients. Interleukin - 6 had significant correlation with neutrophil (P =0.009). While no significant correlation appeared between IL - 6 and Lymphocyte.Procalcitonin results showed high concentration in bacterial meningitis group compared with viral and control group with a highly significant differences (P =0.0001).The results of CRP shown no significant differences between bacterial and viral group, while the levels of D. Dimer appear significant differences in both groups when compared with control group.Current study indicated that PCR, Procalcitonin and D. Dimer played an important role in diagnosis of meningitis disease.
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