First pages:

Author name: حذام اسماعيل حمود

Supervisor name: سهاد حكمت خيري

General topic: Medicine

Specific topic: Obstetrics and Gynecology

Degree: Master

University: University of Baghdad - Faculty Of Medicine

Language: English

University location: Baghdad

First pages:

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

Author name: سيف عبد الحسين حسن

Supervisor name: محمد وهيب سلمان العبيدي

General topic: Medicine

Specific topic: Diseases - Thoracic

Degree: Higher Diploma

University: University of Baghdad - Faculty Of Medicine

Language: English

University location: Baghdad

First pages:

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

دراسة لمقارنة مستقبلات للهرمون المحرر لموجهة القند لقناة فالوب بواسطة تقنية المناعة النسيجية الكيميائية في النساء اللائي لديهن حمل خارج الرحم, او عملية استئصال الرحم او ربط القناة == Comparative Study of Gonadotropin - releasing Hormone Receptor in Fallopian Tube by Immunohistochemistry among Women with Ectopic Pregnancy, Hysterectomy and Tubal Ligation

Author name: هالة ناظم كاظم مهدي

Supervisor name: ايمان علي هاشم | سعد عبد الباقي عبد الله

General topic: Medicine

Specific topic: Anatomy and Histology and Embryos

Degree: Master

University: University Of Basrah - Faculty Of Medicine

Language: English

University location: Basrah

First pages:

Abstract: الهدف : اجريت هذة الدراسة للمقارنة في مستوى مستقبلات للهرمون المحرر لموجهة القند بواسطة تقنية المناعة النسيجية الكيميائية في قناة فالوب بين النساء اللاتي اجريت لهن عملية ربط الانابيب عند الولادة او الحمل خارج الرحم او عملية استئصال الرحم خلال الطور الافرازي/ اللوتني من دورة الطمث.المرضى والمواد : شملت الدراسة على ثلاثة مجاميع من النساء المريضات. ضمنت المجموعة الاولى على 39 امراة تتراوح اعمارهن بين 15 - 45 سنة لديهن تاريخ سابق للحمل المنتبذ (خارج الرحم) واجريت لهن عملية طارئة. اما المجموعة الثانية ضمت 40 امراه تتراوح اعمارهن بين 25 - 45 سنة اجريت لهن عملية استئصال الرحم الاختياري نتيجة لاسباب نسائية حميدة مختلفة وشملت الاورام الليفية المتعددة ، والعضال الغدي ،او النزيف المهبلي الذي لم يستجب للمعالجة الطبية. هذا بالاضافة الى شمول 40 امراه في اما المجموعة الثالثة فقد شملت 40 امراة تراوحت اعمارهن بين 26 - 45 سنة اللواتي خضعن الى عمليات قيصرية مع ربط القناة (البوق)الثنائي عند اكتمال الحمل. شملت معايير الاقصاء المريضات اللواتي يعانين من امراض الحوض الالتهابية والانتباذ البطاني الرحمي وكذلك اللواتي يستعملن الهرمون المضاهي لهرمون اللوتنة . اجريت هذه الدراسة خلال الفترة من ايلول 2014 وحزيران 2015 في مستشفى الولادة والطفل في البصرة. تمت ازالة قنوات فالوب من المريضات اللواتي اجريت لهن عملية ازالة جراحية لهذه القنوات في المجاميع الثلاث. وقد تم حفظ قنوات فالوب في 10% فورمالين وارسلت الى مختبر الامراض في مستشفى الصدر التعليمي لغرض الفحص النسيجي المرضي (باستعمال طريقة التلوين بالهيماتوكسلين والايوسين ) ولغرض التقصي المناعي النسيجي الكيميائي.النتائج : تبين في الفحص النسيجي المرضي كان هناك العديد من الزغابات المشيماتية الشاحبة في تجويف قناة فالوب. وهناك ايضا طبقات من الارومات الغازية تمتد بشكل حر داخل التجويف . ودل الراسب البني في السايتوبلازم خلايا قناة فالوب على التلوين بواسطة الاضداد الاولية ، ولايوجد تلوين في العينات السالبة باستعمال الفحص المناعي النسيجي الكيميائي . وهناك اختلاف في توزيع وجود مستقبلات للهرمون المحرر لموجهة القند بين النساء ذوات الحمل المنتبذ (58,9%) واللاتي استئصلت ارحامهن (82%) وفي 10% فقط بين النساء اللاتي اجري لهن ربط قناة فالوب عند الولادة وكان ذلك باستعمال تقنية المناعة النسيجية الكيميائيه لكن ذلك كان قريبا من الاعتداد الاحصائي ( الاحتمال =0,069) . بينما كان التوزيع السلبي لمستقبلات الهرمون المحرر لموجهة القند اعلى في النساء اللاتي اجري لهن ربط القناة (90%) مقارنة مع النساء اللاتي لديهن حمل منتبذ (41,1%) او النساء اللاتي اجري لهن استئصال الرحم (18%). ان مستقبل الهرمون المحرر لموجهة القند المتفاعل مناعيا تم تحديده في عينات قناة فالوب من مريضات الحمل المنتبذ في الغشاء المخاطي للقناة فقط (5 من 39) او في الزغابات المشيماتية فقط (6 من39) او في كليهما (13 من 39) ، وكانت الفروقات غير معتدة احصائيا ( الاحتمال اكبر من 0,85).الخلاصة : لقد تبين مما تقدم بان مستقبل الهرمون المحرر لمواجهة القند يملك دور حيوي في بداية الحمل لللاخصاب وغرس الجنين. | Objective : This is a comparative study to detect gonadotropin - releasing hormone receptor expression by immunohistochemical technique in the human fallopian tubes belong to women with ectopic pregnancy, women subjected to tubal ligation at term pregnancy with history of normal pregnancy and hysterectomized women.Patients and Methods : The study involved 3 groups of patients, the first group was involved 39 females ( their ages ranged from 15 - 45 years) with history of ectopic pregnancy who underwent emergency operation, the second group was included 40 (their ages ranged from 25 - 45 years) women who were operated on for elective hysterectomy due to various benign gynecological reasons, like multiple uterine fibroid, adenomyosis and uterine bleeding not responding to medical treatment. The third group was involved 40 women (their ages ranged from 26 - 45 years) subjected to Cesarean section with bilateral tubal ligation at term pregnancy were also included in the study. The exclusion criteria included patients with pelvic inflammatory disease, endometriosis and luteinizing - hormone - releasing hormone analogue users. The study was carried out during the period from September 2014 till June 2015 at Basra Maternity and Childhood Hospital. Fallopian tubes were removed and collected from all the 3 groups patients. Fallopian tubes were preserved in 10% formalin and were taken to the Pathology Laboratory at Al - Saddar Teaching Hospital for the purpose of conventional histopathology i.e, Hematoxyline eosin staining method and immunohistochemical study for gonadotropin - releasing hormone receptor.Results : Histopathological examination of the tissue of fallopian tube, indicates that there are numerous pale chorionic villi in the lumen of the fallopian tube. A brown precipitate in the cytoplasm of the cells of the fallopian tube indicated positive staining by primary antibody while no staining was detected in negative samples by using immunohistochemical examination. There is a difference in the distribution positive cases of gonadotropin - releasing hormone receptor detection among ectopic pregnant women (58.9%), hysterectomized women (82%) and only (10%) among women with tubal ligation at term pregnancy in the fallopian tube by using immunohistochemical technique but statistically the results is marginally significant (P=0.069). The immunoreactive GnRH receptor was identified in the fallopian tube samples from patients with ectopic pregnancy, in the mucosa of the tube alone (5 out of 39) or in the chorionic villi only (6 out of 39) or both of them the mucosa as well as villi (13 out of 39 ). The differences were statistically insignificant (P>0.85). Conclusion : This study was demonstrating that GnRH which is produced by the human fallopian tube, has a vital role in fertilization, early embryonic development and implantation .

مدى شيوع مرض السمنة والعوامل المرتبطة به بين طلبة جامعة ذي قار وكلية مزايا للعام الدراسي 2016 == Prevalence of Obesity and its associated factors Among Thi - Qar University and Mazaya college Students,2016

Author name: Alaa Jassim Mohammod

Supervisor name: Dheyaa k. Al - Omar

General topic: Medicine

Specific topic: Community Medicine

Degree: Higher Diploma

University: University of Thi-Qar - Faculty Of Medicine

Language: English

University location: Dhi Qar

First pages:

Abstract: خلفية البحث : ان معدل انتشار السمنة يزداد في البلدان النامية ودول العلم الثالث .و السمنة هي احدى عوامل الخطر الرئيسية لعدد من الامراض المزمنة كالسكر وارتفاع ضغط الدم وامراض القلب ، ولذلك تعتبر من مشاكل الصحة العامة الرئيسية .الهدف : دراسة معدل انتشار السمنة والعوامل المرتبطة بها بين طلبة الجامعات في محافظة ذي قار . كذلك دراسة الانماط والعادات الغذائية بينهم.اشخاص وطريقة الدراسة : بدات هذه الدراسة المقطعية في الاول من نيسان وانتهت في العاشر من شهر ايار2016، تم من خلالها دراسة مجموعة تتكون من 841طالب وطالبة (358 و456 على التوالي ) بعمر 18 - 36 سنة (بمعدل7. 21 +2.3 سنة ) اختيروا بشكل عشوائي طلبة جامعة ذي قار الحكومية وكلية مزايا الاهلية . شملت استمارة الاستبيان معلومات عن العمر ،الجنس،عدد افراد الاسرة ،الدخل الشهري للاسرة ،المستوى التعليمي للابوين ،السكن ،عدد ساعات النوم خلال اليوم ، وسيلة المجيئ للكلية ،نوع النشاط الممارس اثناء اوقات الفراغ ،العادات الغذائية وقائمة تحتوي انواع مختلفة من الاطعمة ، تم قياس الوزن ،الطول ،محيط الخصر، ودليل كتلة الجسم لتقييم الحالة التغذوية . تم تحليل البيانات باستعمال الرزمة الاحصائية للعلوم الاجتماعية (اس بي اس اس )النسخة 23 اعتبرت قيمة p اصغر من 0.05 ذات قيمة معنوية احصائيا .النتائج : كان معدل كتلة الجسم للطلبة24.17+4.0 كغم /م 2 وكان اكثر من نصفهم من (59.2) من ذوي الوزن الطبيعي (63.8 %من الطلاب و55.2 %من الطالبات ) ، بينما كان معدل انتشار زيادة الوزن وكذلك السمنة بينهم 28.3 % و8.1 % على التوالي . كان معدل انتشار السمنة متقاربا بين الذكور والاناث ، بينما كان معدل انتشار زيادة الوزن اكثر شيوعا بين الطالبات مقارنة بالطلاب (32 %مقابل 23.1 % على التوالي ).كان معدل انتشار قلة الوزن اكثر شيوعا بين الطلاب مقارنة بالطالبات (5.1 %من الطلاب مقابل 3.7 % من الطالبات ) .اعتمادا على محيط الخصر كان 3 % من الذكور و18 % من الاناث اكثر عرضة لخطر الاصابة بالامراض المصاحبة للسمنة .كان معدل انتشار السمنة ومحيط الخصر اعلى لدى الطلبة الذين تتجاوز اعمارهم السادسة والعشرين وكذلك الطلبة من ذوي الاسر التي لاتتجاوز اعداد افرادها الست اشخاص(p<.05) لكلا المتغيرين . نسبيا ، هناك نسبة عالية نسبيا (42.7 %من الطلاب و35.8 % من الطالبات )يقضون اكثر من ساعتين في اليوم امام شاشات الحاسوب . الطالبات اقل نشاطا وحركة من الطلاب (p<.05) نسبة عالية من الطلاب والطالبات لا يتناولون وجبة الافطار والحليب وكذلك الخضروات والفواكه يوميا .الاستنتاجات : تدعم هذه الدراسة بانه هناك عوامل متعددة مسببة للسمنة . واظهرت ان العمر والاسر المكونة من اقل من ستة اشخاص من عوامل الخطر . | Background : The prevalence of overweight and obesity is increasing in both developed and developing countries. Obesity is a major risk factor for many chronic diseases including diabetes, hypertension and ischemic heart diseases, so it is considered a major Public health problem. Objectives : to study the prevalence of obesity and its associated factors among Thi - Qar university students. Dietary habit and food consumption pattern are also assessed.Subjects and methods : A cross sectional study started from 1st of April 2016 - 10th of May 2016, A total of 841 students (358 were males and 456 were females) between 18 years and 36 years of age (mean 21.7 ± 2.3years) were selected randomly from 24 colleges of both Thi - Qar and Mazaya private college. A questionnaire was distributed to each participant : Age, gender, family member numbers, monthly family income, level of parent educations, residency, time of sleep per night, types of activity during leisure times, dietary habit and different food items were considered, Height, weight and waist circumference were measured and BMI was calculated and used to assess weight status. The data were analyzed by using SPSS. p value less than 0.05 was considered as statistically significant.Results : The mean BMI was 24.17 ± 4.0 kg/m2; more than half (59.2%) of students were of normal weight (63.8% of male students and 55.2% of female students); whereas the prevalence of overweight and that of obesity among them was 28.3% and 8.1% respectively. The prevalence of obesity was nearly similar for both male and female students, while the prevalence of overweight was more common among female’s students than among males (32 %of females vs. 23.1% of males). The prevalence of underweight was more common among male than female students (5.1 % of male vs. 3.7 % of female). Depending on their waist circumference 3% of male and 18 % of female students were at a higher risk of developing abdominal obesity co morbidities. There was a significant higher prevalence of obesity and mean waist circumference within students of more than 26 years old aged and of less than 6 household family number (p < .05 for both variables).A relatively high proportion (42.7 % for males and 35.8 % for females) spend more than two hours on screen time daily. Females were significantly (p< .05) much less physically active than males. A high proportion of students (male and female) didn’t have a daily intake of breakfast, milk vegetable or fruitConclusion : The prevalence of obesity and overweight were more than the obesity reported among university students in previous local studies in Iraq, however it still lower than obesity and overweight reported among the university students of the neighborhood countries. The study supports the multi factorial etiology of obesity; it demonstrates that age, parent’s education and household number are risk factors. The study also shows high prevalence of sedentary behaviors, physical inactivity and unhealthy dietary habit among Thi - Qar university students.Recommendation : the study results mandate the need for public health strategies to prevent overweight and obesity and adopt a healthy dietary habit and life style.Key word : Prevalence, Obesity, Overweight, Cross sectional study, Dietary habit, Life style.Abbreviations : WHO, World Health Organization; BMI, body mass index; SPSS, Statistical Package for Social Sciences.

مدى انتشار الامراض غير الانتقالية بين الناس المسنين في مدينة الناصرية 2015 : دراسة مسحية سكانية == Prevalence and patterns of non - communicable diseases among a geriatric population in Al - Nasiriya city 2015

Author name: رحيم نايف ناصر

Supervisor name: علي عبد سعدون الغزي

General topic: Medicine

Specific topic: Community Medicine

Degree: Higher Diploma

University: University of Thi-Qar - Faculty Of Medicine - Department Of Family And Community Medicine

Language: English

University location: Dhi Qar

First pages:

Abstract: دراسة مدى انتشارالامراض المزمنة غير الانتقالية بين الناس المسنين في مدينة الناصرية وتقييم الوضع الصحي العام لهم وتقييم خدمات الرعاية الصحية المقدمة لهذه الفئة من السكان.المواد والاساليب : دراسة مقطعية وصفية وتحليلية من خلال اجراء المسح السكاني للعوائل في بعض الاحياء السكنية. اجريت هذه الدراسة في منطقة حضرية جغرافيا من مدينة الناصرية التي تبعد عن العاصمة بغداد 360 كم جنوبا. تمت الدراسة خلال فترة امتدت اكثر من سنة (من 1 ايلول 2015 الى نهاية شهر تشرين الاول 2016). تم جمع البيانات من عينة تمثيلية من 423 من الاشخاص الذين تتراوح اعمارهم من 60 سنة فما فوق ومن خلال اخذ عينات متعددة المراحل (عنقودية).النتائج : كان معدل انتشار الامراض المزمنة غير الانتقالية بنسبة 89.8% بين الاشخاص المسنين، وفي مقدمتها الحالات الخمسة التالية : ارتفاع ضغط الدم (67%)، مرض السكري (31,2%)، امراض العظام والعضلات (15,4%)، امراض القلب (11,1%)، اعتام عدسة العين (12,8%) وكان انتشار مرضين او اكثر في ان واحد بمعدل 59%.اما اعراض ومشاكل الشيخوخة الرئيسية فكانت : مشاكل في الرؤيا (77,8%), الشعور بالحزن او الاكتئاب (36,4%)، مشاكل السمع (31,7%)، السقوط (30%), مشاكل في الذاكرة (22,9%)، والاعراض البولية (11,1%).اثبتت هذه الدراسة ان معدل انتشار الامراض المزمنة غير الانتقالية في مدينة الناصرية كان مرتفعا ومثيرا للقلق وخاصة امراض القلب والاوعية الدموية التي تحتاج الى الجهود الفعلية والتركيز في مجال الوقاية وكذلك تحسين وتعزيز نظام الرعاية الصحية خاصة في مجال الرعاية الصحية لكبار السن للحد من الاصابة بالامراض المزمنة ومضاعفاتها والاثر السلبي على الحياة والتطور الاقتصادي | More than one year starting from the 1st September 2015 to the end of October 2016, an observational, analytical - cross - sectional study through a household survey was conducted in Al - Nasiriya city to study the prevalence of non - communicable diseases among a geriatric population, other objectives were to describe the symptomatology (geriatric review of system for elderly), subjective general health status of wellbeing, and the accessibility and satisfaction of patients to health care services provided in this segment of the population. A representative sample of 423 individual aged ≥ 60 years through multistage sampling had been included in the study. Special form of questionnaire was planned to collect information, which tested by three experts in the field of community medicine and family medicine for the validity before its use in the collection of data. The diagnosis of cases (the inclusion and exclusion criteria) was clearly depending on the chronic disease card or any available documentations that support the definite diagnosis (medical reports, investigation, or current treatment). In contrast to self - reporting studies, the direct observation from the researcher as an advantage of a cross - sectional household survey study plays an important role in minimizing the information bias during the stage of data collection. In addition, it was based mainly on the doctors - diagnoses conditions and consistent with the definition of chronic diseases A pilot study was conducted on 18 elderly individuals prior to the proper study in order to test the feasibility of the research, time requirement and the cost. The results were discussed with the supervisor for any change or modification needed. All those 18 cases were included in the proper study. For statistical analysis, Statistical Package for Social Sciences (SPSS)version (23) was used for data analysis including frequencies, percentages, test of significance (Chi - square test, Monte Carlo test, Fisher exact test), correlation and logistic regression analysis. A p - value of <0.05 was considered to be significant. The overall prevalence of at least one chronic NCD was 89.8%. The top five chronic conditions : hypertension (67.8%), diabetes mellitus (31.2%), musculoskeletal diseases (15.4%), heart diseases (11.1%), and cataract (12.8%). The prevalence of multi - morbidity (patient with two or more chronic diseases) was 59%. The main geriatric symptoms were vision related problems (77.8%), feeling sad or depressed (36.4%), hearing problems (31.7%), falls (30%), memory problems (22.9%), and urinary symptoms (11.1%). The main limitations in this study were its performance in an urban area, some cautions must be taken regarding the generalization of the results. Also not all types of chronic disease and geriatric symptoms were discussed in this study, however all the available data in the sample were collected and studied. Nevertheless, further studies are required specially to estimate the prevalence of risk factors, to estimate the cost of care and health, expenditure, quality of health services and geriatric health need. This study will help in establishing the priorities to act on according to the magnitude of the problems and their impact. Also to design the strategies for prevention and control of NCDs. According to the results obtained from this study and the current situation regarding the care of geriatric population in Iraq and specifically in Al - Nasiriya city, the most important and practical recommendation is to activate the geriatric health care at PHCCs or at least in every hospital with a geriatric clinic with well - trained doctors and other heath staff in the field of geriatrics.

الاستدلال عن مستقبلات الاستروجين ، البروجستيرون وعامل النمو البشري لدى مرضى سرطان الثدي في الناصرية2014 - 2015 == Expression of Estrogen, Progesterone and Human epidermal growth factor Receptors in Breast Cancer in Al - Nasiriya 2014 - 2015

Author name: اصيل ضيول حسن

Supervisor name: حميد نعيم موسى

General topic: Medicine

Specific topic: Community Medicine

Degree: Higher Diploma

University: University of Thi-Qar - Faculty Of Medicine - Department Of Family And Community Medicine

Language: English

University location: Dhi Qar

First pages:

Abstract: الخلفية : سرطان الثدي هو الورم الخبيث الاكثر شيوعا ومشكلة الصحة العامة للسيدات في جميع انحاء العالم وفي العراق. سرطان الثدي هو مرض متغير الخواص للغاية، هناك ثلاث علامات تنبؤيه : مستقبلات الاستروجين، مستقبلات بروجسترون ومستقبلات عامل النمو عندها قيمة تنبؤيه مستقلة. يظهر تعبيرERفي 80 - 90% من المرضى بسرطان الثدي، بينما يظهر تعبيرPRفي 70 - 80 % من الحالات. مستقبلات عامل النمو موجود في 15 - 20% من الحالات. لهذاسرطان الثدي يمثل بشكل افضل بتعبير المستقبل المشترك من التمثيل بمستقبل واحد 0علامات الواسم المناعي - الكيميائي النسيجي (IHC) من مستقبلات هرمون الاستروجين (ER)،مستقبلات هرمون البروجسترون (العلاقات العامة) ومستقبلات عامل النمو (HER2) يمكن تصنيف التعبير الهرموني لسرطان الثدي الى 4 انواع فرعية : النوع الاول ثلاثي موجب مستقبلات الهرمونات(هرمون الاستروجين موجب والعلاقات العامة موجب ومستقبلات عامل النمو موجب)؛النوع الثاني (هرمون الاستروجين موجب والعلاقات العامة موجب ومستقبلات عامل النمو سالب)؛ النوع الثالث ثلاثي سالب مستقبلات الهرمونات (هرمون الاستروجين سالب والعلاقات العامة سالب ومستقبلات عامل النمو سالب)والنوع الرابع (هرمون الاستروجين سالب والعلاقات العامة سالب ومستقبلات عامل النمو موجب).الدراسات السابقة اظهرت ادلة على الفرق الجزيئية التي تكون مسؤولة عن الفرق النتيجة0الهدف من الدراسة : هو تقييم حالة الهرمونات وعلاقتهم بدرجة ومرحلة الورم لحظة تشخيص المرض0المرضى وطريقة العمل : كان نوع الدراسة دراسة مقطعية في محافظة ذي قارفي مدينة الناصرية في مستشفى الحبوبي مركز الاورام ،تضمنت 165 حالة من المرضى الذين شخصت اصابتهم بسرطان الثدي خلال فترة (كانون الثاني 2014 - كانون الاول 2015) تم تجميع معلومات كل مريض وتحليلها : عمر المريض ،الجنس، مكان الاقامة ومعلومات متعلقة بالورم مثل درجة الورم ومرحلة الورم، ومنزلة المستقبلات (ER،PR،her2مستقبلات)0النتائج : العمري الوسطي = 49 ± 11.1. وكانت معظم الحالات 75,2% هرمون البروجسترون موجب بينما هرمون الاستروجين موجب في (72.7٪)،ولكن معظمهم كانواHER2سالب(78.2٪). كان معظم المرضى من الدرجة الثانية (64.2 ٪ ) والمرحلة الثانية (50.3 ٪ )؛كان النوع الفرعي الاكثر شيوعا (ER / PR موجب وher2سالب )والتي تمثل 64.8٪ 0بالنسبة لمقارنة التعبير الهرموني للمرض مع درجة ومرحلة الورم لوحظ ان اعلى درجة الورم (الثاني) (76.93٪) وجدت في النوع الرابع (ER / PRسالب،HER2موجب) وكانت هناك علاقة بين التعبير الهرموني ومرحلة المرض0 الاستنتاجات : سرطان الثدي يمتلك خصوصية مستقبلات هرمونية0الكثير من الحالات توجد في المرحلة الثانية والدرجة الثانية لحظة التشخيص0 التعبير الهرموني السلبي متعلق بمرحلة متقدمة من المرض 0ينبغي توجيه الجهود في توحيد اساليب وتطوير اختبارات اكثر وثوقا لتشخيص المرض بمرحلة مبكرة0

Epidemiology of Acute Childhood and Adolescent Poisoning in Al - Nassiryia Poison Center (2013 - 2015)

Author name: Khashaa Abdulkadhum Jaber

Supervisor name: Raid Kareem Dehiol

General topic: Medicine

Specific topic: Community Medicine

Degree: Higher Diploma

University: University of Thi-Qar - Faculty Of Medicine - Department Of Family And Community Medicine

Language: English

University location: Dhi Qar

First pages:

Abstract: Background : Acute childhood and adolescent poisoning remain one of the important emergencies causing a significant burden to the populations with important morbidity and mortality rates. Epidemiological studies are so important to determine the extent of the problem, according to which the preventive strategies are related. Objectives : This study aimed to determine the epidemiological features of poisoning for the patients less than 19 years old in Thi - qar governorate, involving the main types, clinical presentations, management, outcome, and seasonal variation of poisoning. Methods : A descriptive cross sectional study was involved 340 patients recorded in Al - Nasiriyah poison center from (January 2013 to December 2015), data that collected from the case sheets and records of phone cases. These data was analysed by the statistical package of social science (SPSS) for analysis. Results : Toddler age group seen in 45% of cases with predominance of accidental type, while adolescents (14 - 18yrs.) are mostly intentional with female preponderance, two hundred cases (58.8%) of the exposed patients were male, urban populations are more prone to poisoning 236 cases (69.4%), accidental exposure is the commonest (83.2%), oral route is (99.4%), (62.9%) of the causative agents are pharmaceutical, and (50.7%) are asymptomatic. most of them treated conservatively (96.5%) with survival rate of (97.9%), mortality seen in those presented after the first 24 hrs. of exposure. One third of acute poisoning occurred in summer season.Conclusion : Toddler age group commonly prone to acute poisoning, male are more in accidental pattern, majority of patients were from urban population, one third of the poisoning occur at summer, and there is a strong relationship between time of arrival to the hospital and outcome of the patient

انتشار عوامل الخطر على نمط الحياة بين عينة من مرضى ارتفاع ضغط الدم في مستشفى الحسين التعليمي خلال سنة 2016 == Prevalence of Life Style Risk Factors among A sample of Hypertensive Patients Attending Al - Hussain Teaching Hospital during 2016

Author name: نورس عبد الله خضير

Supervisor name: مسلم ناهي سعيد

General topic: Medicine

Specific topic: Community Medicine

Degree: Higher Diploma

University: University of Thi-Qar - Faculty Of Medicine - Department Of Family And Community Medicine

Language: English

University location: Dhi Qar

First pages:

Abstract: خلفية الدراسة : ان مرض ارتفاع ضغط الدم هو من اكثر اسباب الموت المبكر في العالم, وان عدد المصابين بمرض ارتفاع ضغط الدم في تزايد مستمر. ويعتبر ارتفاع ضغط الدم من العوامل الخطرة القابلة للتغيير والمسببة لامراض القلب والاوعية الدموية وكذلك امراض الكلى وغيرها.الهدف من الدراسة : لتقييم انتشار عوامل الخطر على نمط الحياة بين عينة من مرضى ارتفاع ضغط الدم في مستشفى الحسين التعليمي خلال سنة 2016. طرق العمل : تعتبر هذه الدراسة دراسة تحليلية مقطعية لعدد من المرضى المصابين مرض ارتفاع ضغط الدم, يبلغ عددهم 576 مريض ممن يرتادون مستشفى الحسين التعليمي في مدينة الناصرية خلال الفترة من الثاني من كانون الثاني 2016 ولغاية الاخر من ايلول لنفس السنة. ان هذه الدراسة تشمل جميع المرضى الذين تتراوح اعمارهم من 25 سنة فما فوق ومن كلا الجنسين ولديهم تشخيص سابق يثبت اصابتهم بمرض ارتفاع ضغط الدم وتم التشخيص بواسطة الطبيب. اما المرضى الغير مدركين باصابتهم بالمرض فهم غير مشمولين بالدراسة, وكذلك النساء الحوامل المصابين بمرض ارتفاع ضغط الدم خلال الحمل هم ايضا غير مشمولين بهذه الدراسة. لقد تم قياس وتحليل مستوى معرفة وتطبيق طرق تعديل النمط المعيشي لدى المرضى عن طريق استبيان خاص صمم خصيصا لهذه الدراسة. النتائج : اظهر تحليل نتائج البيانات ان عوامل الخطر بين عينة من مرضى ارتفاع ضغط الدم الذين يحضرون مستشفى الحسين التعليمي كانت على النحو الاتي : 40% لاستهلاك الملح ,34% لاستهلاك الدهون, 70% للتدخين, 80% للخمول وعدم ممارسة الرياضة و70% لزيادة الوزن والبدانة. الاستنتاجات والتوصيات : تبين هذه الدراسة ان كل عامل من عوامل الخطر في نمط الحياة بين عينة من مرضى ارتفاع ضغط الدم الذين يحضرون مستشفى الحسين التعليمي كان منتشرا للغاية مما يؤدي الى زيادة انتشار ارتفا ضغط الدم. توصي هذه الدراسة بتحسين كل من المعرفة والممارسة لتعديلات نمط الحياة في علاج المرضى. وكذلك يجب اتخاذ التدابير الصحيحة في تشخيص مرض ارتفاع ضغط الدم او ما قبل ارتفاع ضغط الدم من قبل الطبيب. | Background : Hypertension is the common cause of premature death in the world and the number of population with hypertension is increasing. It is a preventable risk factor for stroke, myocardial infarction, heart failure, peripheral vascular disease, aortic dissection, atrial fibrillation, and chronic kidney disease and dementia.Aim of Study : To measure the prevalence of life style risk factors among a sample of hypertensive patients attending AL - Hussain teaching hospital. Subjects and methods : The study was an analytical cross sectional study for 576 hypertensive patients who had attending Al - Hussain teaching hospital in Nasiriya city during the period from the second of January 2016 to the end of September 2016. The study population included all patients aged 25 years and above of both sex with previous diagnosis of hypertension made by medical staff. While the exclusion criteria included those who do not know that they have hypertension, and pregnant women with gestational hypertension. The patient adherence to the individual item of life style modifications was investigated by a special questionnaire designed for the purpose of this study.Results : analysis of data showed that the prevalence of life style risk factors among a sample of hypertensive patients attending AL - Hussain teaching hospital were as the following : 40% for salt consumption, 34% for fat consumption, 70% for smoking,80% for physical inactivity and 70% for overweight and obesity.Conclusions : This study shows that each life style risk factor among a sample of hypertensive patients attending AL - Hussain teaching hospital was of high prevalence which lead to increase the prevalence of hypertension. These results recommend improving both knowledge and practice of life style modifications of patients care. Also correct measures need to be taken from the point of diagnosis of hypertension or pre - hypertension by the doctors or other members of the health care team.

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

Author name: سلمان حسين فارس الكريطي

Supervisor name: اركان بهلول ناجي

General topic: Medicine

Specific topic: Nursing

Degree: Doctorate

University: University of Baghdad - Faculty Of Nursing

Language: English

University location: Baghdad

First pages:

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

Author name: صفا وهاب عزيز

General topic: Medicine

Specific topic: Clinical Biochemistry

Degree: Master

University: University of Babylon - Faculty Of Medicine

Language: English

University location: Babylon

First pages:

Abstract: مرض عوز نازعة هيدروجين الكلوكوز - 6 - فوسفات يعد من الامراض المرتبطة بالاطفال المصابين باليرقان الولادي , تلف الدماغ وحتى الموت . اجريت هذه الدراسة لمعرفة ضرر الاكسدة في الاطفال المصابين باليرقان الولادي وخصوصا المصابين بمرض عوز نازعة هيدروجين الكلوكوز - 6 - فوسفات . اجريت ايضا هذه الدراسة لغرض تاكيد دور جهد الاكسدة ونظام الانزيمي المضاد للاكسدة في الاطفال المصابين باليرقان الولادي في مستشفى بابل التعليمي للنسائية والاطفال في بابل . خلال هذه الدراسة الممتدة من كانون الثاني 2008 الى الثلاثين من شهر حزيران 2008 , تم اختيار 225 طفلا مصابا بيرقان ولادي (145 ذكور و80 اناث) غير معروف السبب و50 طفلا حديثي الولادة طبيعيين (35 ذكور و15 اناث) . الاطفال المصابين باليرقان الولادي تم تقسيمهم الى اطفال مصابين بنقص انزيم عوز نازعة الهيدروجين الكلوكوز - 6 - فوسفات (المجموعة الاولى) واطفال مصابين بيرقان ولادي لكن ليس لديهم نقص في الانزيم اعلاه (المجموعة الثانية) وتم فحصهم بطريقة الاختزالية وطريقة الفقاعة المتفلورة لمعرفة عدد المصابين بنقص هذا الانزيم . لقد تبين من النتائج المحصلة في هذا البحث ان الاطفال المصابين بنقص الانزيم اعلاه هم 20 طفل (8.9 %) , 15 (75%) منهم كانوا ذكورا و5(25%) كانوا اناثا ونسبة الذكورالى الاناث هي 3 : 1 . كل الاطفال المصابين باليرقان الولادي كانوا بحاجة للعلاج الضوئي اما 14 (70%) من الاطفال المصابين بنقص الانزيم احتاجوا الى عملية تبديل كامل للدم . 2(10%) من الاطفال المصابين بنقص الانزيم كانت لديهم علامات تلف بالدماغ عند وصولهم للمستشفى وقد توفوا قبل اجراء عملية تبديل دم لهم . لا يوجد تاريخ ايجابي لتناول الادوية المحفزة لهذا المرض او تناول الباقلاء . تم دراسة عوامل دموية في الاطفال حديثي الولادة في كل المجاميع وتضمنت Hb and PCV , reticulocyte Count , WBC count . لقد تبين من هذه الدراسة وجود زيادة معنوية في reticulocyte and WBC count . لقد تبين ايضا من هذه الدراسة وجود نقصان معنوي في وزن الاطفال المصابين باليرقان الولادي وخصوصا الذين يعانون من نقص الانزيم اعلاه مقارنة مع الاطفال الطبيعيين (P value < 0.05) . ان نقص الانزيم يمكن ان يؤدي الى زيادة خطر اليرقان الولادي . هذه الدراسة دلت على وجود زيادة معنوية في مستوى مالون داي الديهايد (MDA) في الاطفال المصابين باليرقان الولادي والاطفال المصابين بنقص الانزيم (P value < 0.05) بينما نقصان معنوي في مستوى كلوتاثايون (GSH) وفعالية انزيم الكيتيليز (CAT) عندما قورنت مع الاطفال الطبيعيين (P value < 0.05) . وجد ايضا علاقة موجبة بين TSB وMDA وكذلك بين GSH وHb بينما هناك علاقة سالبة بين TSB مع GSH CAT , وHb وكذلك بين MD وكلا من GSHو CAT . | Glucose - 6 - phosphate dehydrogenase deficiency is the most common enzymopathy associated with neonatal hyperbilirubinemia , kernicterus and even death . This study was conducted to know oxidative damage in neonates with neonatal hyperbilirubinemia and G6PD deficiency . Also this study was conducted to detect the role of oxidative stress and antioxidant enzymatic system in neonatal hemolytic jaundice of Babylon Maternity and Children Teaching Hospital . A prospective study was conducted during the period from 1st of January 2008 to the 30th of June 2008 in Babylon hospital of Maternity and Pediatric . Over the study period , a total of 225 full - term newborn infants with neonatal hyperbilirubinemia (145 males and 80 females) and 50 healthy neonates taken as a control group (35 males and 15 females) were studied . Newborns with hyperbilirubinemia were subdivided into G6PD deficiency (I group) and normal G6PD (II group) , a reduction method test and fluorescent spot test were used to assay the activity of G6PD . In this study , 20 (8.9%) of neonates with hyperbilirubinemia had G6PD deficiency . Fifteen (75%) of the G6PD deficient patients were males and 5 (25%) were females with male : female ratio 3 : 1 . In both normal and G6PD deficient (II and I) , reticulocyte counts and WBC were increased while PCV and Hb were decreased when compared with control group . There was a significant decrease in weight in normal and G6PD deficient groups when compared with control group . G6PD deficiency was led to increase risk of neonatal hyperbilirubinemia with significant number of them which required exchange blood transfusion 14 (70%) . All neonates with hyperbilirubinemia have received phototherapy . Two neonates (10%) with G6PD deficiency were presented with kernicterus signs and both of them died . The present study indicates significant increase in malondialdehyde (MDA) level of neonates with hyperbilirubinemia and G6PD deficiency when compared with the control group . A significant decrease in serum catalase (CAT) activity and glutathione (GSH) in neonates with hyperbilirubinemia and G6PD deficiency was found . There was positive correlation between TSB and MDA , GSH and Hb . There was a negative correlation between TSB with GSH , CAT and Hb and between MDA with GSH and CAT .

دراسة فعالية نبات عين البزون كعلاج طبيعي لمرض سرطان الدم المستحث في ذكور الفئران == Study the Activity of Catharanthus Roseus as Natural Treatment for Induced Leukemia in Male Mice

Author name: محمد عبود عياش

Supervisor name: مفيد جليل عوض | نسرين جلال محمد

General topic: Medicine

Specific topic: Clinical Biochemistry

Degree: Master

University: University of Babylon - Faculty Of Medicine

Language: English

University location: Babylon

First pages:

Abstract: Leukemia is cancer of blood - forming tissues, begin in the bone marrow characterized by highly elevated of abnormal proliferation and circulation of immature clonal hematopoietic cells. It can affect all ages around the world which in turn considered as one of public health problem.Plants considered as an important source for medical drugs manufacturing due to the presence of certain compounds with medicinal biological activity, therefore adopted in the preparation of a lot of medicines and medical drugs because of its' speed therapeutic influence and low of negative side effects which caused by chemically manufactured medications.The present study aimed to evaluate the activity and efficiency of vincristine and other important constituent in Catharanthus Roseus plant in treatment of leukemia through enhance and direct impact on some of the body's vital biological activities by using fresh crude plant as herbal medicine. This study is Cohort study design. It is monitoring, detection, and investigation study that included some of groups that completely under control; this study used in medicine, nursing, psychology and social sciences in addition to the Ecology. This study included (60) Albino male mice divided into four groups (15) mice for each. Group (A) was the control group, group (B) was mice feed orally with of C. Roseus plant, group (C) was leukemia induced mice by subcutaneous injection of (300mg/kg B.W benzene), and group (D) was Induced leukemia mice treated by oral feeding with C. Roseus plant. The experimental work was carried out in Clinical Biochemistry Department / College of Medicine / University of Babylon during the period from (October 2015 to August 2016).High - Performance Liquid Chromatography (HPLC) technique was used for measurement of Vincristine drug (VCR) in plant and vitamin D levels in mices' serum, Enzyme Linked Immunosorbent Assay (ELISA) had was used for the measurement of serum ferritin, UV - Vis Spectrophotometer was used for determination of GSH - Px and GST concentrations, while Graphite Furnace Atomic Absorption Spectrophotometer technique (GFAAS) was used for measurement of trace elements concentration of (Fe, Cu, Zn, Se). There were hematological and histopathology studies carried out by using special required equipment to make sure that leukemia disease was indeed occur.Hematological study included measurement of Hb levels and WBC count, while histopathology study included bone marrow, liver, kidney, spleen smear. Microscopic investigation for Chromosomal Aberration and Micronuclei were also had been done.Results showed that C. Roseus plant contain the concentration of vincristine drug up to 148μg/gm. There was highly significant increase of serum ferritin levels, GST activity, Iron and Copper concentration, and WBCs in leukemic group (C) (P<0.001) when compared with control group (A), while there were highly significant decrease of these parameters in group (B) as compared with the control (A) and (C) groups.Results also showed a highly significant decrease of GSH - Px activity, Vit.D levels, Zinc and Selenium concentration, and Hemoglobin levels in group (C) (P<0.001) when compared with the control group, while there were highly significant increase of these parameters in group (B) as compared with control and (C) groups. The present study found a positive correlation between Vit.D and GSH - Px activity, Ferritin and GST activity, while this study found a negative correlation between Ferritin and GSH - Px activity, serum Iron and Selenium concentration.The present study found positive effect of C.Roseus on abnormal parameters and support the biological system which was clear in group (D) which demonstrated that there were significant inhibitions to decrease or increase of these parameters than those in healthy control.

علاقة مستوى فيتامين د والبوتين الدهني ا مع مقاومة الانسولين والعوامل الايضية الاخرى في داء السكري النوع الثاني في محافظة البصرة == Relationship of vitamin D status and lipoprotein(a) levels with insulin resistance and other metabolic markers in type 2 diabetes mellitus in Basrah

Author name: انوار يونس ابراهيم علي

Supervisor name: عبد القادر عبد الوهاب الشاكر

General topic: Medicine

Specific topic: Clinical Biochemistry

Degree: Master

University: University Of Basrah - Faculty Of Medicine - Department Of Biochemistry

Language: English

University location: Basrah

First pages:

Abstract: Diabetes Mellitus is a chronic metabolic disorder , caused persistent hyperglycemia resulting from defects in insulin production, insulin action or both.There are several evidence suggest that altered vitamin D and calcium homeostasis may play a role in the development of T2DM and IR .Lipoprotein(a) is a LDL - like particle consisting of Apo A moiety linked to one molecule of ApoB100 . Several studies revealed that Lp(a) may differentially affect in diabetic patient either increase or decrease or no change from normal range . It is not clear whether Lp(a) concentration is related to T2DM or associated with IR .Objectives : The present study was designed to measure vitamin D status and Lp(a) levels among patients with T2DM , to investigate association between serum 25(OH) D levels with IR , lipid profile and some metabolic factors and to demonstrate whether Lp(a) levels are linked to T2 DM. Methods and Materials : The present study included 80 patients with T 2 DM (30 male and 50female) with mean age (50.51± 10.70) year . Weigh, height, BMI were assessed for each participant . Fasting blood samples were collected to measure HbA1c% .Then another part of blood separated to get serum to measure [Vitamin D , Insulin , Lp(a) , FBS , Lipid profile , creatinine , calcium , phosphate] .Insulin resistance , Insulin sensitivity , β - cell function was calculated by homeostatic model assessment ( HOMA - IR) , (HOMA - IS) and (HOMA - %β ) respectively .Results : The result of this study revealed that serum vitamin D among diabetic patients with a mean (19.94 ± 9.59) ng/ml . Frequency of vitamin D deficiency [s.25(OH)D > 20 ng/ml ] was (52.5%) , Only (12.5%) of diabetic patients had normal levels of vitamin D [s.25(OH)D≥ 30 ng /ml] . Thirty five percent of patients with vitamin D insufficiency [s.25(OH)D = 20 - 29.9 ng /ml ] .Vitamin D among diabetic patients of the present study showed an inverse relationship with BMI , HOMA - IR, insulin , HbA1c, TG , VLDL - c, age statistically significant independent , But positive significant independent association with HOMA - IS , HDL - c and statistically significant not independent associated with FBS, HOMA - %β). No significant associated with other biochemical parameters . Regarding to the levels of Lipoprotein (a) levels among diabetic patients found with a mean (7.93± 5.34) mg/dl and no significant association with glycemic profile (FBS,HbA1c, insulin , HOMA - IR, HOMA - IS , HOMA - %β ) or lipid profile .Conclusion : The decline in the level of vitamin D among diabetic subject may affect glucose homeostasis . In addition to that hypovitaminosis D could be rising with increase BMI and obesity among diabetic subjects , BMI is positively associated with insulin resistance . Serum 25(OH)D among diabetic subject is negatively with insulin resistance . Therefore vitamin D deficiency may contribute to onset of IR and development of T2DM. Regarding to Lipoprotein (a) levels among the majority of diabetic patients were within normal range (≤ 30 mg/dl) and it was noted that the Lp(a) levels were not related to IR or T2DM . In addition to that there is no interference between levels of vitamin D and p(a) levels with respect to IR .

دراسة مستوى بعض العوامل المؤكسدة والمضادة للتاكسد في مرضى اللوكيميا وسرطان الثدى == Profile study of some oxidant and antioxidant levels in leukemic and breast cancer patients

Author name: نهاية مناحي العبودي

General topic: Medicine

Specific topic: Clinical Biochemistry

Degree: Master

University: University Of Basrah - Faculty Of Medicine

Language: English

University location: Basrah

First pages:

Abstract: This study was carried out to evaluate the oxidant and antioxidant level in cancer patients in Basrah during the period from the first of October 2002 till the end of April of the 2003. A total of 98 patients were investigated, who were admitted to the Basrah General Hospital, Teaching Hospital and Basrah Hospital for Maternity and Pediatric in Basrah City. They were 52 female patients with breast cancer and 46 leukemic patients (24 male and 22 female). In addition 125 sex and age - matched persons without malignancy served as controls. They were 64 persons as control for leukemic patients (32 male and 32 female) and 61 females as control for breast cancer patients. The haematological parameters measured were haemoglobin concentration(Hb), packed cell volume (PCV) value and white blood cell (WBC) count, while the biochemical parameters measured were glutathione (GSH) level, uric acid, malondialdehyde (MDA) and phagocytic activity . The leukemic patients were subclassified into two groups according to their age (30 patients ≤16 years and 16 patients >16 years). The breast cancer patients were subclassified into three groups according to their age (11 females as 25 - 34 years old, 17 females as 35 - 44 years old and 24 females as ≥45 years old). The Hb concentration and PCV value were significantly decreased (P<0.05) in leukemic patients of age group 16 years old ,however, in age group > 16 years old ,the decrease were extremely significant (P<0.001). In breast cancer patients the Hb concentration decreased extremely significantly in all age groups (P<0.001). A highly significant decrease was found in PCV value of age group 35 - 44years old (P<0.01), whereas a significant decrease in 25 - 34 years and  45 years age groups (P<0.05) was observed. The WBC count in leukemic patients showed an increase in WBC count significantly in 16 years old age group (P<0.05) and extremely significant increase in >16 years old age group (P<0.001). In breast cancer the WBC count showed decrease in WBC count significantly in 25 - years old patients (P<0.05), highly significant decrease in 35 - years old patient (P<0.01) and extremely significant decrease in 45 years old patients (P<0.001). There were no significant differenses in Hb concentration, PCV value and WBC count between male and female leukemic patients. The biochemical investigation showed an extremely significant depletion in GSH levels in leukemic and breast cancer patients (P<0.001). The phagocytic activity was extremely significantly decreased in all leukemic patients (P<0.001) and highly significant increase in 25 - 34 years old breast cancer patients (P<0.01), significantly increase in 35 - 44 years old breast cancer patients (P<0.05) and extremely significant increase in  45 years old breast cancer patients (P<0.001). There was no significant difference between male and female leukemic patients in phagocytic activity. The MDA level was highly significantly increased in 16 years old leukemic patients (P<0.01) and extremely significant in >16 years old leukemic patients (P<0.001). In breast cancer the MDA level was highly significant increase in all age groups patients (P<0.01). The investigation of uric acid concentration shows extremely significant increase in all leukemic patients (P<0.001) and highly significance increase in 25 - 34 years old and 35 - 44 years old breast cancer patients (P<0.01). Also shows extremely significant increase in 45 years old breast cancer patients (P<0.001). In conclusion, cancer patients suffer a high degree of ROS formation causing considerable oxidative stress which associated with decrease glutathione level and significant degree of lipid peroxidation.

Author name: اسماعيل حسن جواد الموسوي

Supervisor name: قحطان هادي حسين الجبوري | حسن علوان بيعي

General topic: Medicine

Specific topic: Nursing

Degree: Master

University: University of Babylon - Faculty Of Nursing

Language: English

University location: Babylon

First pages:

دراسة انزيم التيلومريز وجين الكلوتاثيون بيروكسيديز الاول في مرضى السكري النوع الاول == Telomerase Enzyme And Glutathione Peroxidase1 Gene In Type 1 Diabetes Mellitus Patients

Author name: دعاء مهدي هادي الحكاك

Supervisor name: مها فاضل سميسم | علي حسين البياتي

General topic: Medicine

Specific topic: Clinical Biochemistry

Degree: Master

University: University of Babylon - Faculty Of Medicine - Department Of Biochemistry

Language: English

University location: Babylon

First pages:

Abstract: Type 1 diabetes is characterized by an immune - mediated depletion of ? - cells that results in lifelong dependence on exogenous insulin. Accumulating evidence suggests that oxidative cell injury caused by free radicals contributes to the development of type 1 diabetes mellitus (T1DM) complications and decreased efficiency of antioxidant defenses (both enzymatic and nonenzymatic) seems to correlate with the severity of pathological tissue changes in T1DM, So many studies have tended to analyze the genetic material that can be related to the occurrence of the disease. Different combinations of genetic defects of antioxidant enzyme are expected. This could readily provide an explanation of the heterogeneity of T1DM.The aim of this study is to assess the differences of GPX1 genotype in T1DM as compare with controls. And the effect of C/T at nucleotide 1050450codon 198 of GPX1 gene polymorphisms on serum glutathione peroxidase (GPX) and telomerase enzyme (TE) concentration in T1DM patients and controls. This study included (108) persons, their ages between (28 - 42 years) and body mass index in normal and overweight (68) of them were uncontrolled diabetes type 1 (HbA1c ? 6.5 %), (34) of them were male patients (M group), the other (34) were female patients (F group), and the other (40) apparently healthy as control group (20) male (MC group) with (20) female (FC group). The sera sample of all groups were used to measure the concentration of fasting blood glucose by using colorimetric methods and ELISA method for determination (TE), total antioxidant capacity (TAO - C), glutathione (GSH), and glutathione peroxidase1 enzyme, while whole blood samples from study subjects were used to measure HbA1c and extract DNA for the study of polymorphisms in GPx1 gene.The results of the present study showed1 - A significant increase in glucose, HbA1c in both male and female patients compared with controls group. (P < 0.0001) and (p< 0.05) respectively.2 - The study showed significant decrease (p? 0.001) in telomerase enzyme in both M and F as compare with MC and FC groups,3 - There was no significant association between M and F (P=0.106) and between MC and FC (P=0.327) regarding to gender.4 - The result showed that telomerase concentration significantly decrease with age (p - value<0.001) which indicated by negative correlation between telomerase concentration and age.5 - The result showed significant negative correlation between telomerase enzyme concentration and BMI in patients and controls.6 - The result showed significant decrease in TAO - C in patient as compared with control groups (P=<0.001)7 - GPX1 concentration significantly decreased in patient as compared with control groups (p - value <0.001 )8 - Significant increase in Glutathione concentration in patients as compared with controls (p - value <0.05)9 - Data on the genetic patterns were analyzed using polymerase chain reaction technique - RFLP revealed, were defined as : the codon 198 of Gpx1 genotyping have the homozygous wild - type (CC) Pro/Pro, the homozygous mutant (TT) Leu/Leu, and heterozygous (CT) Pro/Leu allele. There was significant difference between genotype distribution and frequency of alleles between the two groups of patients (M and F) versus (MC and FC) (odds ratio = 33, into confidence level of 95% : 1.65 to 656.26) and P value ( 0.0219) for M vs. MC, and (OR = 12.60, into the proportion of 95% confidence level : 1.93 to 82.08) and P value (0.0081) for F vs. FC. Also, the frequency of TT genotypes in GPX1gene in male and female were47% and 61.7% compare to control male(0%) and female(10%).10 - The allele frequency showed significant differences in all sample (p=0.0013), in male (0.14) and in female (0.0020).11 - There was significant difference in telomerase concentration (p= 0.001) and in glutathione peroxidase concentration (p< 0.0005) in patients group depending on different of the GPX1 genotyping.12 - Depending on GPX1 genotype there were significant differences in BMI in normal weight and in overweight between patient and control (p=0.0375) and (p<0.0018), respectively.In Conclusion, the TT genotype of The GPX1gene variants Pro 198 Leu may be risk factor to T1DM patients. TIDM significantly associated with glutathione peroxidase and telomerase level in patients with TT genotypes of GPX1 gene compared to those with CT and CC genotypes, and this may be considered as a risk factor for senescence and mortality in T1DM. patients, also there is significant negative correlation between telomerase enzyme and BMI in patients and controls.

التغيرات الحاصلة في نسب الانسولين والاحماض الصفراء والكوليسترول 7 الفا هيدروكسليز وفوق الاكسيد الفائق في مصل مرضى حصى المراره == Serum Insulin, Bile Acid, Cholesterol 7 - Alpha Hydroxylase And Superoxide Dismutase Changes In Patients With Gallstone

Author name: سماح سجاد كاظم الشمري

Supervisor name: محمد عبيد المحمدي | علي خير الله الشاعلي

General topic: Medicine

Specific topic: Physiology

Degree: Master

University: University of Babylon - Faculty Of Medicine - Department Of Physiology And Medical Physics

Language: English

University location: Babylon

First pages:

Abstract: يعتبر مرض حصى المرارةمن اكثر امراض الجهاز الهضمي شيوعا، ووتشكل عبئا كبيرا على انظمة الرعاية الصحية. معظم الناس (حوالي 80 ?) مع حصى المرارة ليس لديهم اعراض. وتشمل مضاعفات حصى المرارة التهاب المرارة والبنكرياس.الهدف من الدراسة : 1 - للتحقيق في العلاقة بين | A gallstone is a stone formed within the gallbladder out of bile components. Cholelithiasis or Gallstone disease (GD) is one of the most prevalent gastrointestinal diseases, with a substantial burden to health care systems. Most people (about 80%) with gallstones are asymptomatic. Complications of gallstones include inflammation of the gallbladder, pancreas. Objective 1. To investigate the association between serum level bile acid and cholesterol 7 - alpha hydroxylase and the development of gallstone disease. 2. To Evaluate the change serum level insulin changes and its effect on gallstone formation. 3. The determination of serum superoxide dismutase changes in patients with gallstone. Material and Methods In this study, one hundred sixty (160) patients with gallstone aged (20 - 70) years and one hundred sixty (160) age and sex match subject (control group) had involved in this study. The patients were intended to undergo surgical removal of gallbladder in Al - Hilla general teaching hospital during the period from November (2015) to May (2016). Blood samples were obtained from all patients prior to surgical treatment. Serum was obtained by usual methods and analyzed for insulin, insulin resistance Cholesterol 7 - alpha hydroxylase, Superoxide Dismutase, Bile acid (Deoxycholic acid and Chenodeoxycholic acid) and lipid profile {total cholesterol, triglyceride, high density lipoprotein - cholesterol and low density lipoprotein cholesterol}. And qualitative analysis of gallstone (Cholesterol stone, mixed stone, pigment stone), then these parameters compared with those of control groups. In addition, a demographic comparison regarding to the age, sex and body mass index between the patients and control groups was carried. Results The results of this study show higher significant percentage of gall stone in female (81%) than male (19%) in the patient group. There was an insignificant difference between male and female patients, according to age group (P<0.05). There is a higher significant (p>0.05) family history in the patients with gallstone compared with control subjects. Additionally, There is highly significant percent of female using oral contraception in pateints than control group (p > 0.01). Similarly, smoking, parity,Type 2 diabetes mellitus and Body Mass Index are found to be significantly higher inpatient group (p>0.01). This study demonstrate that insulin and insulin resistance are significant higher in sera of patients with gallstone as compared with the control group. (p>0.01) Regarding the cholesterol 7 - alpha hydroxylase, superoxide dismutase and Bile acids are found to be significantlylower in sera of patients with gallstone as compared with the control group, p< 0.01). It has also found that there are a higher significant difference in gallstone patients than control regarding total cholesterol, triglyceride, high density lipoprotein - cholesterol and low density lipoprotein cholesterol levels were significantly higher than that of control group (p>0.01). Meanwhile, all these parameters in the study are variated according to gender. However The qualitative analysis of stone that show cholesterol stone is more common than other types.Conclusions In this study the most studied parameters including of Insulin and insulin resistance, cholesterol 7 - alpha hydroxylase, superoxide dismutase and Bile acids, cholesterol, triglyceride, high density lipoprotein - cholesterol and low density lipoprotein cholesterol are significantly different in gallstone patients compared to control subjects and such differences are demographically affected depending on the age, sex, BMI, parity, contraceptive and smoking.

Effect Of SNP rs198389 of BNP Gene On The Natriuretic Peptides Levels In Cardiovascular Patients

Author name: Alaa Salman Idan Al - Ibrahimi

Supervisor name: Monem M. Al | shok | Moaed E. Al | Gazally

General topic: Medicine

Specific topic: Clinical Biochemistry

Degree: Master

University: University of Babylon - Faculty Of Medicine - Department Of Biochemistry

Language: English

University location: Babylon

First pages:

Abstract: Acute coronary syndrome (ACS) refers to any group of acute signs and symptoms attributed to sever obstruction of the coronary arteries. Acute coronary syndrome usually occurs because of one of three problems : ST elevation myocardial infarction, non - ST elevation myocardial infarction, and unstable angina. These types are named according to the results of the electrocardiogram (ECG). In addition to clinical and electrocardiogram (ECG) findings, several biochemical markers are considered in patients with chest pain to diagnose myocardial ischemia. Heart failure (HF) according to American College of Cardiology (ACC) and American Heart Association (AHA) is a complex clinical syndrome that can be caused by any structural or functional disorder in the heart that fails the capability of the ventricle to fill with or to eject blood. The diagnosis is often performed clinically on the basis of the presence of dyspnea, fatigue, signs of fluid overload, such as pulmonary crepitation, peripheral edema, and distension of jugular vein.B - type natriuretic peptide (BNP) and N - terminal pro - BNP (NT - proBNP) are secreted by human atrial and ventricular myocardium. The rise in BNP and NT - proBNP levels after ACS and HF correlates with infarct size and regional wall motion abnormalities. Echocardiography remains the most frequently used and usually the initial imaging test to evaluate all cardiovascular diseases related to a structural, functional, or hemodynamic abnormality of the heart or great vessels. This study is designed to investigate and assess the serum concentrations of BNP and NT - proBNP in patients with HF and ACS; In addition, almost equal number of males and females are chosen to control the effect of age and gender on the levels of BNP and NT - proBNP. Also, the study aims to evaluate the effect of BNP gene T - 381C (rs198389) polymorphism on the plasma human levels of BNP and NT - proBNP and compare the results that will obtain with healthy control.The present study was involved (70) patients, (35) of them with ACS and the other (35) with HF. The study also includes (22) subjects were taken as control group. The sera obtained from the blood of patients and control subjects were used to measure the concentrations of BNP and NT - proBNP, while whole blood samples from study subjects are used to extract DNA for the study of polymorphism in BNP gene.The results indicate both the ACS and HF groups have significantly higher levels of BNP and NT - proBNP when compared to control group, also HF patients have higher levels of both parameters than ACS patients, in all comparison (p

المستويات والانماط الجينية المتعددة للانترلوكين - 6 في مرضى التهاب المفاصل الرثوي في محافظة بابل/العراق == Interleukin - 6 Gene Polymorphisms And Levels In Rheumatoid Arthritis Patients In Babylon Province / Iraq

Author name: سارة حسين عيدان

Supervisor name: عبد السميع حسن الطائي | صباح جاسم الربيعي

General topic: Medicine

Specific topic: Clinical Biochemistry

Degree: Master

University: University of Babylon - Faculty Of Medicine - Department Of Biochemistry

Language: English

University location: Babylon

First pages:

Abstract: التهاب المفاصل الرثوي هو احد الامراض المناعية الذاتية الالتهابية المزمنة الذي يتميز بالتهاب المفاصل المتماثل المستمر الذي يصيب عادة مفاصل اليدين والقدمين.تهدف هذه الدراسة الى التقصي عن العلاقة المحتملة بين مستويات الانترلوكين - 6 والانماط الجينية المتعددة | Rheumatoid arthritis (RA) is a chronic systemic inflammatory, autoimmune disease characterized by persistent symmetric polyarthritis that commonly affects joints of hands and feet.This study aims to investigate the possible association between interleukin - 6 (IL - 6) levels and ( - 174 G/C) IL - 6 promoter polymorphism in RA in Babylon Province. 60 RA patients and 60 healthy controls matched in age and sex were included in this case control study. Measurement of serum IL - 6 and serum anti cyclic citrullinated peptide (ACCP) antibodies were assayed using commercially available ELISA kit. Measurement of blood rheumatoid factor (RF) was assayed by use slide agglutination test for the qualitative and semiquantitative. Whereas, blood C - reactive protein (CRP) was determined using latex - enhanced nephelometry. Disease severity score of RA patients was determined by use DAS - 28. DNA was isolated from white blood cells (WBCs) and ( - 174 G/C) IL - 6 gene promoter polymorphism was determined by polymerase chain reaction - restriction fragment length polymorphism (PCR - RFLP) technique. the study was found significantly high levels of serum IL - 6 and ACCPA in untreated and in treated RA patients when compared to healthy controls. RF of patients with RA in the present study was found to be positive in 83.32% and negative in 16.67 % in overall RA patients, whereas was negative in 99% of healthy control. CRF of patients with RA in the present study was found to be positive in 78.4% and negative in 21.6 % in overall patients with RA, and was positive in 20% of healthy control. Correlation between DAS - 28 and IL - 6 levels in untreated and in treated RA patients were significant positive correlation. Correlation between IL - 6 and ACCPA in untreated and in treated RA patients were significant positive correlation. Correlation between DAS - 28 and ACCPA in untreated and in treated RA patients were significant positive correlation. The Genotype of ( - 174 G/C) IL - 6 gene promoter polymorphism and its percentage in patient found to be 80% GG,18.3% GC and 1.6% CC, whereas in healthy control 98.3% GG, 1.6% GC and 0% CC. Relation between both of IL - 6 levels and DAS - 28 with genotyping of ( - 174 G/C) IL - 6 gene promoter polymorphism in untreated and treated RA patients were found to be positive significant relation. The high levels of IL - 6, and its positive relation with DAS - 28 may suggest a possible role of IL - 6 in the pathogenesis of RA. Moreover, these biomarkers can be used as markers of disease activity in the diagnosis and treatment of RA. ( - 174G/C) IL - 6 polymorphisms are also associated with the RA risk, and the C allele of IL - 6 promoter polymorphisms has dramatically increased the susceptibility of RA in Babylon population. This finding suggests that the ( - 174 G/C) IL - 6 gene promoter polymorphism may also be used as another genetic marker for the onset and development of RA in Babylon population.

Author name: احمد عبد الرحيم ابراهيم ضاحي

Supervisor name: شذى الخطيب | صباح مهدي حسين

General topic: Medicine

Specific topic: Clinical Biochemistry

Degree: Master

University: Mustansiriyah University - Faculty Of Medicine - Department Of Biochemistry

Language: English

University location: Baghdad

First pages:

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

Author name: همام عبد الرحمن ابراهيم العبيدي

Supervisor name: نبا عبد اللطيف رشيد ناجي | احمد عبودي نعمة المحمودي

General topic: Medicine

Specific topic: Medical Physics

Degree: Master

University: Mustansiriyah University

Language: English

University location: Baghdad

First pages:

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

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

Author name: فراس عبد الودود عبد العزيز

Supervisor name: تقي علي موسى الموسوي الواجدي | بسام طالب فائق الكيلاني

General topic: Medicine

Specific topic: Medical Physics

Degree: Doctorate

University: Mustansiriyah University

Language: English

University location: Baghdad

First pages:

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

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

Author name: قيصر عبد الرزاق عطيه

Supervisor name: صفاء حسين علي

General topic: Medicine

Specific topic: Physiology

Degree: Master

University: Mustansiriyah University

Language: English

University location: Baghdad

First pages:

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

Author name: الاء سعد عادل

Supervisor name: اسماعيل ابراهيم حسين القرغولي | عباس ناجي مسلم الشريفي

General topic: Medicine

Specific topic: Medicine

Degree: Master

University: Mustansiriyah University

Language: English

University location: Baghdad

First pages:

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