bluuebunny/crossref_metadata_2025 huggingface dataset:
Ceruloplasmin Activity and Ferritin in Patients with Chronic Liver Disease
Authors: Habeeb Mohammed Hussein , Ewadh Mufeed Jalil , Mousa Mazen Jaafer
Published: May 2024

Background:

Ceruloplasmin (CP) is a copper-containing glycoprotein found in the globulin portion of human blood serum 2. CP, a glycoprotein secreted by hepatocytes, carries more than 90% of copper in the bloodstream of healthy people. CP is an effective antioxidant that prevents lipid peroxidation by removing oxygen. CP inhibits lipid peroxidation initiation. CP has function also known as an extracellular superoxide dismutase species (SOD) that neutralizes radicals of superoxide anions.

Aims:

The aim of this study is to understand the status of CP in chronic liver disease (CLD) patients, which could yield important information regarding the overall oxidative stress and iron storage. Out of the total 86 samples, 50 samples were patients who have been diagnosed with CLD, especially chronic hepatitis B virus (HBV) and hepatitis C virus (HCV), collected from the Center of Internal Medicine and Cardiology in Marjan Teaching Hospital in Hillah city, Babylon Province, Iraq and other samples were healthy controls.

Materials and Methods:

The CP oxidase activity test was processed by PPD buffer oxidation. Ferritin concentration was tested by enzyme-linked immunosorbent assay.

Results:

There were no significant differences in levels of ferritin between HBV and HCV patient groups, but there are slight increases in the mean of CP activity in the HCV patients. A positive significant correlation was observed between CP activity and ferritin.

Conclusion:

1. CP activity increases in CLD patient and in HCV more than HBV. 2. CP activity is affected by viral load so it increases in positive viral load patients compared with negative viral load patients. 3. There was a positive correlation between CP activity and ferritin. 4. Serum ferritin is not affected by CLD.
Study the Effect of a Fixed Orthodontic Appliance on the Oral Microbial Cavity
Authors: Al-nafaee Asaad Kareem , Al-warid Rasha Jasim , Abeas Kasem Ahmed
Published: May 2024

Background:

Orthodontics is that branch of dentistry specialty dealing with diagnosis, prevention, and correction of malocclusion aiming to enhance oral health, dental function, and esthetics. The presence of a fixed orthodontic appliance within the oral cavity can alter the microbial balance and so the composition of dental plaque. However, the presence of a fixed appliance alters the physiological characteristics of the oral cavity, causing impaired hygiene, a raise in dental plaque collection, and a delay in the spontaneous physiological processes of tooth cleaning that result in pathogenic bacteria colonization, which causes gingival inflammation, periodontal support degradation, and enamel surface alterations.

Objective:

The study’s objectives were isolated, identification, and molecular detection of microbes associated with orthodontic appliance patients.

Materials and Methods:

A total of 88 study samples (68 case; 20 control), 29 males and 59 females, aged 14–35 years, underwent fixed orthodontics during the initial stage of treatment. The samples were cultured on enrichment media and selective media, including mitis-salivarius agar, Mitis-Salivarius Bacitracin agar, Lactobacillus MRS agar, Eosin Methylene Blue agar, and Mannitol agar. They cultured in aerobic and anaerobic (10% CO2) conditions.

Results:

The positive samples were then purified and identified using morphological and biochemical tests. Among the microbial species gram-positive bacteria accounted for 82.3%, gram-negative bacteria 16.2%, and fungi 1.5%. Our results show that on one hand, gram-positive bacteria, Streptococcus mutans make higher percentage (48.5%) compared to other types. On the other hand, the Escherichia coli with 11.7% is the highest percentage of gram-negative bacteria.

Conclusion:

Bacteria colonization of orthodontic patients was found to be remarkably high compared to that of controls. Finally, the most common bacteria are S. mutans identify using PCR utilizing Sm.479.F/R primer combination.
Expression of Circulatory Interleukin-6 Concentration Associated with Pseudomonas aeruginosa Persistence in Recurrent Urinary Tract Infections
Authors: Al-lateef Bareq A. , Al-shukri Maysaa S.M. , Judi Mohammad Ridha
Published: May 2024

Background:

The main superfamily cytokine member is interleukin-6 (IL-6). IL-6, promptly produced in response to infections and tissue injuries, contributes to host defense through the stimulation of acute phase responses, hematopoiesis, and immune reactions.

Objectives:

To investigate the role of IL-6 as a biomarker in recurrent urinary tract infections (RUTIs). The real-time polymerase chain reactions were performed by using specific primers with reference gene GAPDH and the target genes IL-6.

Materials and Methods:

A case–control study was done in Babylon city hospital from February 2021 to March 2022. A total of 110 patients with RUTIs with different age and sex, and healthy individuals as control group were enrolled in this study. Midstream urine was taken for culturing and identification of Pseudomonas aeruginosa. Blood samples were obtained from all the patients and the secreted IL-6 levels were detected by enzyme linked immunosorbent assay (ELISA). RNA was extracted for gene expression.

Results:

The expression of IL-6 was increased more than % 30-fold in UTIs compared with control group. Also, the results found that serum concentrations of IL-6 detected by ELISA assay showed significant differences at P < 0.001 for the patients compared with control group.

Conclusions:

Interleukin-6 gene expression shows up regulation in RUTI caused by P. aeruginosa.
Students’ Perspective Regarding Current Pathology Training in Theory Classes in MBBS Course and Insights to Improve Teaching–Learning Strategies
Authors: Deshmukh Abhay Vilas , Yadav Vandna , Gupta Anupama , Gangane Nitin M.
Published: May 2024

Background:

As the subject pathology in second MBBS represents a transition phase between theoretical knowledge regarding etiopathogenesis of a disease and communication with patients in clinics, the main goal of a medical teacher is to provide a framework for the description of disease course and to understand the clinical signs/symptoms for management aspects as well.

Objectives:

The aim of this article is to find out students’ perception of importance of pathology subject in MBBS curriculum as well as to assess subject understanding, teaching methodology, and assessment criteria.

Settings and Design:

This is a cross-sectional descriptive e-platform-based feedback analysis.

Materials and Methods:

Ninety-eight students of 2nd MBBS (2018 batch) who were about to appear in university examination in the year 2020 were enrolled. The feedback from students was obtained.

Results:

About 75.8% of students were satisfied with number of lectures for the chapters taught during their tenure. About 91% (n = 81) opined that combination of two or more methods is better while teaching for better understanding; 73.6% (n = 67) felt that pathology lectures were interactive enough. About 80.2% (n = 73) opined that adequate diagrams, flow charts, tables, and clinical applications were included in the lectures, and 79.1% (n = 72) of the students opined that they could implement the knowledge gained in first year whereas 82.5% was same regarding implementation in clinical posting. About 71.34% (n = 65) suggested that weightage of internal examination marks should be increased and 50% passing cut off in university examination should be reduced.

Conclusion:

The study has emphasized the importance of pathology as a subject for understanding clinical subjects and underlines the need of a few changes in teaching-learning process and assessment criteria as per student's perception. As NMC has implemented its competency-based curriculum from 2019 batch onwards, it requires a fundamental change of the roles and commitments of not only educators but also planners and policymakers.
Is There an Association between the Familial Form of Generalized Joint Hypermobility and Developmental Dysplasia of the Hip in Children?
Authors: Doski Jagar Omar , Ali Farman Ola
Published: May 2024

Background and Objectives:

This study aimed to examine the association between the familial generalized joint hypermobility (GJH) and developmental dysplasia of the hip (DDH) in children.

Materials and Methods:

All infants and children included in this case (with DDH)–control study were examined for features of GJH by the revised Beighton's Test Scale (BTS), provided that they had no teratogenic or pathological causes of DDH or GJH.

Results:

Two hundred and eight participants were included in this study: 101 (48.6%) cases and 107 (51.4%) controls; age mean 16.57 [standard deviation (SD) 18.1] months; 61.1% (127) females and 38.9% (81) males. The odds ratio was 2.1 (95% confidence interval 1.197–3.679). The cases had a higher value of BTS score (mean = 4.7, SD = 3.015) when compared with the controls (mean = 3.42, SD = 3.448). The difference was statistically significant, but the correlation coefficient (r) between the study groups and BTS scores was weak (r = 0.194, P = 0.005). The correlation gained slight improvement by justification of the age to obtain homogeneity between the groups (r = 0.276, P < 0.001), but deteriorated and lost its significance when the sex was controlled as a confounder (r = 0.121, P = 0.082). There was a gradual increase in the mean BTS score from grade 1 to grade 4 of DDH but without a statistically significant value (r = 0,132, P = 0.128).

Conclusion:

The familial GJH has a weak positive correlation with DDH but cannot be considered as a possible risk factor for it.
Preparation of Modified Selective Medium for Isolation of Enterococcus faecalis in Pure Culture from Heavy Sources (Rapid Diagnosis)
Authors: AL-Khafaji Jawad Kadhim Tarrad
Published: May 2024

Subject:

This research focuses on the preparation of a new modified selective medium for the primary isolation of Enterococcus faecalis in pure culture from heavy and clinical sources.

Materials and Methods:

The modified selective medium was prepared and named as Enterococcus Jawad (EJ)–Medium. The new medium was prepared by adding 0.4 g of sodium azide, 2 mL of 0.1% crystal violet (CV), and 60 g of sodium chloride in a liter of Brain-Heart Infusion Agar (BHIA), and the pH of the medium was adjusted to 8.6. The primary isolation of E. faecalis from heavy bacterial sources and clinical infections was performed by culturing all collected samples on EJ-medium and comparing them with other approved selective media, such as Azide-BHIA, CV-blood agar, and Enterococcus selective agar (ESA), to estimate the ability of these media in isolating E. faecalis (during primary isolation) in pure culture.

Results:

The results showed that the EJ-medium had a high rate of isolation, 100%, of E. faecalis in pure culture from heavy sources (human feces and sewage water) and from clinical sources (urine, bedsore, and blood) when compared with other culture media that were already used for isolation of this organism. The Azide-BHIA and CV-blood agar showed no high purity in an initial isolation of the organism.

Conclusions:

From these results, we concluded that the EJ-medium is highly efficient in the primary isolation of E. faecalis in pure culture by one step from different environmental and clinical sources; thus, it does not need to be diagnosed by classical methods that are expensive and consume a long time. Since Azide-BHIA, CV-blood agar, and ESA were not exactly selective media for the isolation of E. faecalis in pure cultures from heavy sources, their use was limited in clinical cases.
Congenital atresia of posterior nares: Diagnosis and treatment at Hilla, Iraq
Authors: Aljubory Saad Abdul-Raheem Hussein
Published: May 2024

Background:

Atresia of posterior nares (choana) is a congenital condition in which the posterior nares fail to develop either bilaterally or unilaterally.

Objectives:

The aim of this article is to show different methods of diagnosis and surgical procedures used for management in our department.

Materials and Methods:

In this study, 21 patients were included. It is a retrospective study form. The confirmation of the diagnosis is by failure of 6–8-F tube catheter to pass; CT scan of posterior choana shows the type and thickening of atretic plate (cartilage or bone), and endoscopic examination confirms it.

Results:

Female patients were 15, whereas male patients were 6. Age range was from 1 day to 25 years. All of the patients were within the pediatric age group except one adult patient. Unilateral cases were found in 14 patients, while 7 patients had bilateral atresia. Bilateral atresia was presented within early day life (1–3 days). They were five females and two males. The unilateral cases diagnose at a later life period (4–25 years). There were 4 males and 10 females. Proved by CT scan, mixed bony and membranous atresia were in 18 patients, bony atresia was in 3 patients, and there was no pure membranous atresia. Thirteen of the unilateral cases involved right side, while only one case had left-side atresia (7.6%). Three cases of bilateral atresia had other congenital anomalies (14%). Ten patients were treated by nonendoscopic (transnasal) surgical approach (five of them had bilateral and unilateral atresia, respectively). Endoscopic trans-septal approach was done in two patients, both had bilateral atresia. Nine patients were treated by transnasal endoscopic method. Stent was used in 13 patients postoperatively for 4–6 weeks. Two patients required revision surgery for restenosis.

Conclusion:

Endoscopic transnasal approach is the proper way in the surgical treatment of atresia because it is more accurate, under surgeon vision, less invasive with less morbidity in spite of longer time to perform.
Strengthening Response to COVID-19 Pandemic in Nations with Declining Trend
Authors: Shrivastava Saurabh RamBihariLal , Shrivastava Prateek Saurabh
Published: May 2024

The trends of the ongoing coronavirus disease-2019 (COVID-19) pandemic continues to rise in different parts of the world and no nation can rest assured that they have won the battle against the novel viral infection. The epidemiological trends from some of the affected nations have reported a decline in the number of cases, but we cannot let down our guard. Many sections of the community and other stakeholders are concerned about the emergence of second wave of the infection, but as a Program Manager, our priority has to strengthen our outbreak readiness and emergency response. Further, the health care delivery system has to be reformed in such a way that the needs of the community are given utmost priority and we work together as a team for the containment of the infection. In conclusion, the fight against the COVID-19 pandemic is far from being over and we have to continue our good work and take appropriate measures to further intensify our response to safeguard the health and well-being of the vulnerable population groups and be ready for the most difficult times.
Complications of mini-percutaneous nephrolithotomy and standard percutaneous nephrolithotomy: A comparative study
Authors: Sharif Rawaz Azad Hamad , Jawad Nihad Rifaat
Published: May 2024

Background:

Percutaneous nephrolithotomy (PCNL) is a major surgical procedure and the preferred treatment of choice for renal calculi (medium and large) size.

Objectives:

The study aims to determine complications between mini-PCNL and standard-PCNL, which is a comparative study to show which one has fewer complications and is safer for a patient with better outcomes.

Materials and Methods:

In a 1-year prospective study, clinical data from 44 patients who underwent PCNL (standard and mini) type between February 2021 and March 2022 for renal stones in Erbil city. Inclusion criteria included patients with renal stones (stag-horn, partial stag-horn, and non-stag-horn) and who are performing PCNL procedures. The exclusion criteria included patients who have a contraindication for doing PCNL.

Results:

Forty-four patients participated in the study, 17 underwent mini-PCNL, and 27 underwent standard PCNL. The mean hospital stay among the standard PCNL group (2.5 days) was significantly (P = 0.005) higher than that of the mini-PCNL group (1.7 days). Postoperative fever, infection, and sepsis (25%), bleeding (15.9%), hematuria (65.9%), and retained stone (20.5%). However, the differences in these rates were not significant between the groups. The rate of extravasation in the standard PCNL group (25.9%) was significantly (P = 0.032) higher than that of the mini-PCNL group (0%). Around two-thirds (64.7%) of the mini-PCNL group had no pain, compared with only 11.1% of the standard PCNL group (P = 0.001).

Conclusion:

The effectiveness of mini-PCNL is still under observation. Mini-PCNL postoperatively with less pain and limitation of blood loss, and less hospitalization for patients, with excellent results for stone free in comparison with standard PCNL.
Preparation of Poly (Lactic-co-Glycolic Acid)-Loaded Pentoxyfilline by Nanoparticipation Technique
Authors: Raheem Saad Saleem , Hasan Huda Falah
Published: May 2024

Background:

Nanomaterial concerned to an incidental, natural, or synthesized material containing particles utilized for curing several diseases and keeping for human with animals health; it is either in an unbound condition or as a combination in which one or more external measurements in the size range of 1–100 nm.

Objectives:

The study intended to assess the possible mitigating outcome of the reference pentoxifylline by progressed a new manner of poly (lactic-co-glycolic acid) (PLGA) nanoparticles loading with pentoxifylline on induced thin layer endometrial in female rats.

Materials and Methods:

PLGA nanoparticle was made by employing two procedures included nanoprecipitation technique and double emulsion solvent evaporation method. The experiment firstly was achieved numerous of diagnostic tests to the knowledge of PLGA nanoparticle characteristics that involved ultraviolet (UV) spectrophotometer test.

Results:

UV spectrophotometer test shown for Pentoxyfilline absorbance (0.300124), at wave length (2979) and PLGA- loaded Pentoxyfilline absorbance (3.07877), at wave length 1565), while other tests (scanning electron microscope, cumulative %; encapsulation drug efficiency loading, and zeta) of PLGA-nanoparticle appeared (28.35 nm-35.45 nm, (8.48, 93.3 at maximum wavelength 275 nm, (−13.44 mV), with mobility (−1.05 [μ/s]/[V/cm]) respectively. Conclusion: Regarding the characterization of PLGA displayed in this study, it can be concluded that DMSO related organic phase alone gives the shape, particle size with a small diameter, negatively charged in addition to suitable LD, EE with suitable stabilizer. Also, PLGA-Pentoxyfilline regimen treatment with different doses had the ability in recovery of female rats that exposed experimentally induced thin layer endometrium in the uterine horn by ethanol.
Smell and Taste Disturbances among COVID-19 Patients
Authors: Swain Santosh Kumar , Lenka Smarita
Published: May 2024

Background:

Coronavirus disease 2019 (COVID-19) infection is caused by a novel coronal virus called severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). The common symptoms of the COVID-19 patients include cough, fever, dyspnea, and myalgia. However, the disturbances of the smell and taste are the important clinical presentations of the COVID-19 patients.

Objectives:

The objective of this study is to assess the olfactory dysfunction among COVID-19 patients.

Materials and Methods:

This is a retrospective study, which included COVID-19 patients between March 2020 and August 2020. There were 192 COVID-19 patients evaluated to find out loss of smell and taste. The diagnosis was done from nasopharyngeal swab with laboratory confirmed reverse transcription polymerase chain reaction positive for COVID-19. All the participating patients were undergoing proper otorhinolaryngological examinations, including anterior rhinoscopy, cold spatula tests, and diagnostic nasal endoscopy for proper evaluation of the nose, nasopharynx, and paranasal sinuses.

Results:

There were 112 patients (58.33%) olfactory dysfunction and 86 patients had taste disturbances out of the 192 COVID-19 patients. The mean age of the 112 patients was 52.42 years. Out of the 112 patients, 74 (66.07%) were male and 38 (33.92%) were female. Out of the 112 patients, 32 were presented with pneumonia during their hospitalization. Olfactory dysfunction began 5.4 (4–12) days. The mean duration of the anosmia was 9.2 (4–22) days and 96% of the cases recovered within 26 days.

Conclusion:

Smell and taste disturbances are the important clinical markers for SARS-CoV-2 infection. Testing the smell and taste in this COVID-19 pandemic may be helpful for the early identification of the COVID-19 patients and initiate early treatment or quarantine.
Plasma Level of Programmed Death Receptor Ligand-1 and CD25 in Chronic Myeloid Leukemia Patients and their Correlations with Response to First-Line Therapy
Authors: Jaleil Noor Abdul Razaq , Abed Wisam Majeed
Published: May 2024

Background:

Chronic myeloid leukemia (CML) is a clonal myeloproliferative neoplasm that is characterized by the presence of the Philadelphia (Ph) chromosome, which results from a reciprocal translocation between the breakpoint cluster region (BCR) of chromosome 22 and the Abelson homolog 1 (ABL1) region of chromosome 9. Programmed death-ligand 1 (PD-L1; also known as B7 homolog 1 and CD274) is an immune checkpoint protein, and its engagement with programmed cell death protein-1 (PD-1) receptor on T cells activates co-inhibitory signaling to suppress the function of cytotoxic T lymphocytes (CTLs). Interleukin-2 receptor (IL-2R, CD25) expression is a soluble form of the a-chain of IL-2R (sIL-2R). The IL-2/IL-2 receptor α (IL-2RA) signaling pathway is essential for the regulation of immune responses.

Objective:

To assess the plasma level of PDL-1 and CD25 in patients with CML and their correlations with response to the first line of therapy, tyrosine kinase inhibitor (imatinib).

Materials and Methods:

This case-control study was conducted on 66 patients with CML in the chronic phase (CP) from May 2019 to October 2019. The patients were sequentially selected and subdivided into three subgroups: 20 new diagnoses before starting treatment, 30 imatinib therapy responders, and 16 imatinib resistant for each group. Plasma samples were tested for the levels of PD-L1 and CD25 by the enzyme-linked immunosorbent assay technique.

Results:

Programmed cell death ligands were significantly increased in the plasma of patients with CML compared with the control group, and there was a significant increase in the plasma PD-L1 of patients with a new diagnosis compared with imatinib responders and patients who were resistant. There was no significant difference in PD-L1 level between the responder and resistant groups. Soluble CD25 was significantly increased in the plasma of patients with CML compared with the control group, and there was a significant increase in the plasma CD25 of patients with a new diagnosis compared with imatinib responders and patients who were resistant. There was no significant difference in CD25 level between responder and resistant groups.

Conclusion:

Plasma PD-L1 and CD25 levels were significantly higher in adult patients with CML compared with healthy subjects, and these levels were significantly higher in patients with CML who are newly diagnosed compared with imatinib therapy responders and resistant counterparts. There is no significant difference between responders and resistant groups in regard to PD-L1 and CD25.
Coronary Artery Disease among Patients Younger than 35 Years of Age
Authors: Amen Shwan Othman , Rasool Banan Qasim , Sadraddin Vahel Lutfallah , Awlla Ali Jalal
Published: May 2024

Background:

Coronary artery disease (CAD) and its major manifestation of acute myocardial infarction (MI) are considered as the most common causes of morbidity and mortality worldwide. MI in very young group of age is a significant issue to focus on, however there is a scarcity of data on premature coronary heart diseases-acute MI (AMI) in this group of age. This may underestimate the important difference that exists between young and old groups of age.

Objective:

The main aim of this study is to evaluate the most common risk factors, including hyperlipidemia, smoking, diabetes mellitus (DM), hypertension, and positive family history of AMI with their angiographic profile, among Iraqi patients of <35 years old.

Materials and Methods:

This study was enrolled in Surgical Specialty Hospital-Cardiac Center, Erbil, Iraq among 100 consecutive patients (77 males and 23 females) between November 2016 and December 2017 of those whose age was ≤35 years.

Results:

The mean age was 31.6 ± 2.91 years with an age range of 24–35 years. The incidence of AMI was significantly higher in male patients than females. The most common risk factors were hyperlipidemia (51%), smoking (49%), family history of premature CAD (44%), hypertension (25%), and DM (22%). The most common symptom and presentation of CAD was chest pain and anterior wall myocardial infarction, 67% and 64% respectively. About 56% of all the included patients who underwent Coronary Angiography, had obstructive CAD and among this group 89.2% had single vessel disease, 5.35% had three vessel disease, 3.57% had double vessel disease and 1.78% had abnormal characteristic of coronary artery (Muscle Bridge). The most common involved artery was the left anterior descending (LAD) (36%), followed by the right coronary artery (9%). Based on the electrocardiogram findings, 42% of the patients presented with ST-segment elevation myocardial infarction.

Conclusion:

CAD in patients younger than 35 years occurred more in the male gender. Hyperlipidemia was the most common risk factor among all the patients' and AWMI owing to the LAD artery was the most common presentation.
Free Radicals Have an Important Role in Cancer Initiation and Development
Authors: Al-Oubaidy Shaimaa A. , Mekkey Asmaa Mohammed
Published: May 2024

The present review deal with the role of free radicals in cancer initiation and development because of the importance of free radicals in signal cascade transition of the cells in addition to defense properties against inflammation, the negative function of free radicals when the cells unable to equilibrate the excessive production of free radical which lead to a harmful effect in cell components such as lipid peroxidation, protein structure alteration, and DNA mutation and structural modification of nucleic acid. This review deal with free radicals generation, function, and its role in different cancer stage starting with initiation, survival, development, proliferation, invasion, and angiogenesis, can be concluded the role of oxidative stress in our healthy life and use it as one of the cancer therapy strategies in the future.
Investigation of the Effect of Food Types on Melatonin Hormone Level in Human Body
Authors: Hamza Isam Shaker , Ayyash Mohammed Abbood , Mahmoud Tariq Yassin , Jarallah Aziz Latif
Published: May 2024

Background:

Melatonin, a neurohormone produced by the pineal gland, has recently been reported in foods, mainly of plant origin. Melatonin provides a number of benefits for human health. It has many important health benefits because it is a potent antioxidant and anti-inflammatory hormone.

Objectives:

The aim of this work is to investigate the relationship between malnutrition and food deprivation on melatonin levels in normal individuals in comparison with people suffering from gastrointestinal diseases. This study will focus on the nutritional factors apart from the intake of tryptophan that affects melatonin levels in humans.

Materials and Methods:

This study reported interests regarding the optimization, validation, and application of analytical liquid extraction and high-performance liquid chromatography (SYKAM) coupled to a fluorescence detector for the determination of melatonin in rice grains and blood samples.

Results:

In the present study, the results showed that there were significant differences between the three study groups, where the lowest values for melatonin hormone concentration were found in Group C as 2.033 ± 0.69 pg/mL which includes people suffering from famine, whereas the results of Group B showed clear differences of concentration than that in Group (C) as 3.520 ± 0.62 pg/mL which includes patients who were in hospital suffering from diseases and disorders of the digestive system, but at the same time their values were less than that of the healthy control Group A as 6.457 ± 0.59 pg/mL.

Conclusion:

Based on the present study, it can be concluded that melatonin hormone levels are highly deficient in people who are suffering from poverty, deprivation, and starvation compared to people with problems and disorders of the digestive system.
An Unusual Presentation of Dengue Myocarditis
Authors: Gupta Samiksha , Jesrani Gautam , Rajesh Rayidi , Garg Aman , Gupta Monica
Published: May 2024

Dengue fever (DF) is a common mosquito-borne viral illness, with various cardiovascular implications, including electrocardiographic abnormalities, due to profound myocardial involvement (myocarditis) by the dengue virus. Here, we are describing an untraditional presentation of DF, in which a young male encountered with cardiac rhythm abnormalities without fever, thrombocytopenia, or capillary leakage. The patient had symptomatic hypotension, and his electrocardiogram (ECG) demonstrated alternative patterns of ventricular bigeminy and trigeminy. Serum electrolytes, total leukocyte counts, and renal function tests were normal, but cardiac biomarkers were elevated in this patient. Two-dimensional echocardiography demonstrated global left ventricular wall hypokinesia with an ejection fraction of 53%, but the coronary angiography indicated no vascular thrombus or occlusion. Subsequent evaluation found that the dengue IgM antibody by enzyme-linked immunosorbent assay was positive in this patient. He was managed conservatively for this and had a splendid recovery in the form of normal ECG at the time of discharge and echocardiography on follow-up. The case delineates a rare and challenging presentation of cardiac involvement in DF.
Prevalence of Uncomplicated Recurrent Urinary Tract Infection among Adult Females in Babylon Governorate
Authors: Al-Musawi Lubna Raheem , Al-Husseini Rafid F.
Published: May 2024

Background:

Urinary tract infections (UTIs) are among the most frequent infections in clinical practice. They are classified into uncomplicated UTIs and complicated UTIs. The majority of UTI cases are caused by a single bacterial agent. Diagnosis of UTIs is generally established based on urinalysis and urine culture and treated with appropriate antibiotics.

Objectives:

The aim of this study was to determine the prevalence and characteristics of uncomplicated recurrent UTI among adult females.

Materials and Methods:

This study is a cross-sectional study conducted in the outpatient clinics of Al-Hilla Teaching Hospital and Babil Hospital for Maternity and Childhood during the period from February till June 2020. Data were collected using a specially designed questionnaire, and a total of 300 participants were included.

Results:

The overall prevalence of uncomplicated UTI was found to be 36%. The mean age of patients was 28.94 ± 7.42 years. Ninety percent of the patients were married. The proportion of recurrent UTI among married women was significantly higher than that among nonmarried women (P = 0.001), and recurrent UTI was significantly higher among women with family history of UTI (P < 0.001).

Conclusions:

This study concludes that the prevalence of uncomplicated UTI among adult females in Babylon governorate is 36%, with the majority of cases within the age group of 20–29 years. Recurrent UTI was found to be linked to marital status and positive family history.
The Effect of Serum Albumin Level on the Frailty Score in Elderly Patients Attending Primary Health Care Centres in Babel
Authors: Al_Badri Ali Mousa Essa , Al-Bayati Hayder F. , Obeid Ammar Waheeb
Published: May 2024

Background:

Frailty can be described as a clinical state of practical reserve decline related to ageing. Slowness, fragile, fatigue, and low performance are incorporated and affect the fulfilment of effective tasks negatively. Both under and overweight could lead to a frailty dilemma. It is well known that serum albumin is the most considerable serum protein and is used as an indication of nutritional status. Many studies revealed that hypoalbuminemia was related to higher frailty scores. The universal prevalence of frailty among the elderly population varies between 4% and 59.1%

Objective:

Assessment of the effect of serum albumin on frailty score among patients who are attending primary health care centres.

Materials and Methods:

A cross-sectional study was conducted in a primary health care centre in Babil governorate/Iraq. A convenient sample of 71 old patients attending the primary health care centre. Selected patients of either sex were included and any old patients 60 yrs. old and above (male or female) were included, whereas, anyone below 60 yrs. old were excluded. The Socio-demographic characteristics of the patients (name, age, gender, residence, marital status, occupation, and level of education), and anthropometric measurements (weight, height, body mass index) were analyzed in this study. Frailty score was measured by using (rockwood_cfs) for each patient. P_value of ≤0.05 was considered significant.

Results:

Sociodemographic characteristics showed that frailty score was higher among the age group between 60 to 69 years with a mean age of 67.10 ± 6.75 yrs (P = 0.000). Male gender, urban residence, married, housewife group and primary education showed the highest proportion among the study group patients. Overweight and obesity comprised 33.8% and 50.7% respectively. Our study demonstrated that weight was significantly associated with frailty score (P = 0.031). physical activity was not statistically significant in association with the frailty score. Serum albumin levels of the study group patients was a statistically significant association with frailty scores, where the highest proportion of high frailty scores was among those with low serum albumin levels (P = 0.047).
Prevalence of OXA genes responsible for carbapenem-resistance among Acinetobacter baumannii isolated from clinical samples in Iraq
Authors: Alzaidi Jawad R
Published: May 2024

Background:

Acinetobacter, measured as an opportunistic pathogen has lately occurred as a vital nosocomial pathogen in the world, frequently relating patients with reduced host defenses. Patients in dangerous cases obtain infections while they are staying in care wards, so the incidence of these infections varies significantly in different individuals and clinical settings.

Objectives:

This work aims to examine the prevalence of carbapenem-resistance genes among isolates of Acinetobacter baumannii gathered from three hospitals in Iraq.

Materials and Methods:

A total of 30 isolates of A. baumannii were gathered from different clinical samples from February to July 2022. DNA of all specimens was extracted. Gradient polymerase chain reaction was applied to discover the genes of bla-OXA carbapenemases.

Results:

The results exhibited a variation of carbapenemase genes in all isolates that had been examined. Although all isolates had at least three genes of carbapenemase that have been tested, the most commonly identified genes in class D β-lactamases were bla OXA-51 and bla OXA-23 which was established in all isolates of A. baumannii 30 (100%) tested. It was also found that nine (30%) of tested isolates had borne the gene of bla OXA-58. No isolate exhibited amplification for the gene of bla OXA-40.

Conclusion:

The maximum occurrence and prevalence of the genes of OXA β-lactamase in A. baumannii bacteria in Iraqi hospitals were bla OXA-23 and bla OXA-51.
The significance of heat shock protein 27 in breast cancer: A signature to predict the outcome
Authors: Singh Manish , Patil Bharat Umakant , Ghongade Pravinkumar , Gupta Anupama
Published: May 2024

Introduction:

Heat shock protein (HSP) 27, if overexpressed in breast cancers, affects the disease outcome and sensitivity of tumors to chemotherapy and radiotherapy. There are limited studies on actual patients in India, so the present study was designed to contribute our experiences to the literature regarding HSP 27 expression and its significance in breast carcinoma.

Materials and Methods:

Thirty diagnosed cases of invasive duct carcinoma are evaluated for histopathology grade, stage, and expression of immune markers, namely, ER, PR, HER2, VEGF, and HSP 27, followed up to 2 years after primary management, especially if treated with Herceptin. The staining was evaluated, and data were analyzed using the χ2 and Fisher’s exact tests.

Results:

HSP 27 is expressed strongly in most ER- and PR-positive cases, but there is no correlation with Her2 and VEGF. The findings suggest more advanced disease, adverse outcomes, and lymph node metastasis. Moreover, these findings are directly related to strong HSP 27 expressions and shorter overall survival in the group of ER/PR-positive breast carcinoma cases, but this relation can be relied upon up to stage II disease. After that, in advance cases, HSP 27 loses its significance slowly and could not establish any link between HSP 27 and Herceptin resistance because of a short follow-up.

Conclusion:

HSP 27 proved a promising prognostic marker in ER/PR-positive breast carcinoma cases.
Significance of Cystatin C for Early Diagnosis of Contrast-Induced Nephropathy in Iraqi Patients Undergoing Coronary Angiography
Authors: Abood Zahraa Malik , Rasheed Manal Kamal , Omran Haider Hamza
Published: May 2024

Background:

Contrast-induced nephropathy (CIN) has been traditionally defined as an increase in serum creatinine (sCr) after contrast media (CM) exposure. It is generally a transient and reversible form of acute renal failure.

Objectives:

The objective was to compare changes in serum creatinine and serum cystatin C (sCys C) in patients undergoing CM administration during coronary angiography (CAG) and/or intervention, and whether these changes are a reliable index for early identification of CIN.

Materials and Methods:

In this prospective study, 50 patients were included, 9 of them were omitted, and remaining 41 patients undergoing CAG and/or intervention. sCr, serum urea, sCys C, and estimated glomerular filtration rate (eGFR) were evaluated at baseline as well as 24 h after exposure to CM.

Results:

Forty one patients, six of them develop CIN (CIN group) and the remainder 35 not develop CIN (non-CIN group). Clinical parameters showed no significant association between CIN group and non-CIN group except in diabetes mellitus. As comparing patients before and after catheterization, the CIN group showed increase in sCr and serum urea, while remain nearly the same for sCys C, and obvious decrease for eGFR1 and eGFR2, in addition there is significant association for sCr, eGFR1, and eGFR2. In the non-CIN group, only the serum urea showed significant difference.

Conclusion:

The concentration change of sCr is significantly superior to cystatin C as an early biomarker in the CIN detection. An absolute increase of the concentration of sCr is highly sensitive and specific for the CIN in comparing to cystatin C.
Awareness and attitude on use of nanotechnology among dental and medical professionals in Iraq
Authors: Almuthaffer Azad M. R.
Published: May 2024

Objective:

Several products such as technological devices, pharmaceutical products, have been developed with nanotechnology applications, in medicine fields. This study aimed to assess dental and medical staff perceptions of nanotechnology in Iraq.

Materials and Methods:

This study was based on an online questionnaires distributed to (736) dental and medical staff in Iraq from different region and different place of work, and the method of selecting the sample was stratified random sampling. The study period was two months (June and July 2020).

Result:

the largest percentage was for the dental staff 76.5% did hear about nanotechnology, and about 23.5% did not, while among medical staff 54.9% answer yes, and about 45.1% answer they did not hear about nanomedicine. Regarding the uses or applications of nanomedicinee, largest percentage of the responses was may be 64.7% for the dental staff and 67.1% for medical staff.

Conclusion:

There is an inadequate knowledge of the dental and medical staff about nanotechnology and its applications the in Iraq in field of dentistry and medicine, and it is not effectively used in the dentistry and medical field.
Plasma Sclerostin Level in Multiple Myeloma
Authors: Baiee Noor Hasan , Al-Rubaie Haithem Ahmed
Published: May 2024

Background:

Multiple myeloma (MM) is a heterogenous plasma cell malignancy with various complications. Sclerostin is a Wingless-type (Wnt) inhibitor specifically expressed by osteocytes; it acts as a negative regulator of bone formation.

Objectives:

To assess plasma sclerostin level in MM patients and find its correlations with clinical and laboratory data, including osteolytic bone disease and international staging system (ISS).

Materials and Methods:

This cross-sectional study included 80 individuals: 40 newly diagnosed MM patients and 40 healthy adults. Patients were divided according to the presence of bone disease and ISS stage and were investigated for complete blood count, blood film and bone marrow (BM). Plasma levels of β2-microglobulin and sclerostin were measured using competitive and sandwich enzyme immunoassay techniques, respectively.

Results:

Sclerostin level was significantly increased in MM patients than control group (P < 0.001) and was significantly higher in those with osteolytic bone disease and/or pathological fractures than those without bone lytic lesions (P < 0.001). Patients with ISS stage III showed significantly higher sclerostin level than stages I and II (P = 0.003). High sclerostin levels were positively correlated with blood urea, serum creatinine, uric acid, and β2-microglobulin (P-values 0.034, <0.001, <0.018 and <0.001, respectively) and negatively with glomerular filtration rate (P = 0.001). No significant correlation was found with age, gender, hematological and other biochemical parameters.

Conclusions:

In newly diagnosed MM patients, the plasma sclerostin was significantly correlated with renal impairment. High levels of plasma sclerostin were also found in advanced disease stage and with the presence of significant bone disease.
Effectiveness of intraoperative, intracameral mydriasis compared to preoperative topical mydriatics, in patients undergoing manual small-incision cataract surgery under peribulbar anesthesia: Randomized single-blind controlled study
Authors: Katti Venkatram , Nagendra Abhigna , Kulkarni Alka , Jivangi Vivekanand , Kanakpur Savita
Published: May 2024

Background:

Numerous options which include single-drop instillation, ocular inserts, depot preparation of mydriatic, and intracameral irrigation of mydriatic-cycloplegic drugs have also been used which have yielded comparable results. Out of these, only intracameral irrigation with mydriatics can preclude the need for preoperative preparation.

Objective:

The objective of this study is to assess the effectiveness of intraoperative, intracameral mydriasis as compared to preoperative topical mydriatics, in patients undergoing manual small-incision cataract surgery (MSICS) under peribulbar anesthesia.

Methods:

This was a randomized single-blind controlled study. One hundred and forty-eight patients who underwent MSICS under peribulbar anesthesia were randomized into two groups. Participants were blinded for the type of treatment. In the topical group (n = 74), we achieved mydriasis by application of topical dilating drops preoperatively, whereas in the intracameral group (n = 74), we achieved mydriasis intraoperatively with an intracameral solution. Pupil sizes were measured, at six different intervals during surgery. Visual acuity was recorded on postoperative day 1 in both groups.

Results:

Mean pupil diameter just before administration of peribulbar anesthesia was 8.35 mm in the topical group and 2.8 mm in the intracameral group (P < 0.005). Pupil diameter increased to 7.61 mm 30 s after injecting the intracameral mydriatic solution. Mean pupil diameter progressively reduced in further steps of surgery in both groups. Mean pupil diameter measured 7.18 mm (topical group) and 6.84 mm (intracameral group), respectively, just before the removal of the speculum which was statistically significant (P = 0.034).

Conclusion:

Intraoperative, intracameral mydriatics is an effective method of achieving adequate pupillary dilation during MSICS without the use of preoperative topical mydriatics with satisfactory postoperative visual outcome.
Effect of postextubation high-flow oxygen on oxygen saturation during transit from operation theater to postoperative ward – A randomized, prospective comparative study
Authors: Pakhare Vandana , Nanda Ananya , Varsha K. S. , Malipeddi Vamshidhar , Kulkarni Dilip Kumar , Gopinath Ramchandran
Published: May 2024

Background and Aims:

Postoperative pulmonary complications (PPCs) increase morbidity and mortality. The risk of developing PPC starts immediately after extubation. Transport time is the most influential time for the development of hypoxia. In early postoperative period, there is a decrement in PaO2by 7–18 mmHg from baseline and may lead to severe hypoxia. This can be attributed to diffusion hypoxia, residual effect of anesthetics, pain, and impaired hemodynamics. To prevent this hypoxia, oxygen is almost invariably given with low-flow devices immediately after extubation. We conducted this trial to know the effect of postextubation high-flow oxygen on peripheral oxygen saturation during transit from operation theater to postanesthesia care unit compared to conventional oxygen therapy. Our primary outcome was to estimate and compare the incidence of desaturation in both the groups, whereas the secondary outcome was to compare time to desaturation.

Methodology:

A total of 156 patients were randomly allocated to receive either high-flow or conventional oxygen for 5 min immediately after extubation. Patients were shifted to postoperative ward without oxygen supplementation. Transport time, incidence of desaturation, and time required for desaturation were noted.

Results:

In the high-flow oxygen group, 15.6% of patients had desaturation compared to 26.9% in the conventional group. The average time for desaturation was 3.2 ± 1.7 min in the high-flow oxygen group compared to the conventional group in whom it was 2.6 ± 1.7 min, although this difference was not statistically significant.

Conclusion:

The incidence of desaturation was less, whereas the time taken for desaturation was longer with the use of high flow compared to conventional oxygen therapy following extubation.
Acute presentation of atherosclerotic total distal abdominal aorta occlusion
Authors: Gaba Saurabh , Gupta Monica , Dutta Khushbu , Jesrani Gautam
Published: May 2024

We are presenting the case of a 49-year-old man, a heavy smoker, who had weakness and wasting of the lower limbs along with neuropathic pain for several months for which no medical care was sought. Presentation to the emergency was prompted by a sudden development of pain in the buttocks and cyanosis of the lower limbs. Investigations revealed total atherosclerotic occlusion of the infrarenal abdominal aorta with collateral circulation that was responsible for the delayed presentation. Anticoagulation with heparin was initiated but the patient refused to undergo any invasive procedure. This case highlights that atherosclerotic disease of the aortoiliac region or distal abdominal aorta can present with long-standing symptoms apparently of a neurologic disorder with muscle weakness and wasting rather than an occlusive vascular disease. The symptoms of lower limb claudication and pain may be ignored until a catastrophic complete occlusion supervenes manifesting as acute ischemia as in our case.