Al-Sadder Teaching Hospital Research Articles

Evaluating the Efficacy of Methocarbamol and Nefopam in Orthopedic Surgical Pain.

Introduction Pain after orthopedic surgeries represents a special concern in patients with fractures. The use of multimodal analgesia significantly reduced the opioid need and reduced the risk of their side effects. Objectives This study compared the effectivenessand safety of methocarbamol and nefopam in the reduction of post-operative pain for patients undergoing orthopedic surgeries. Method This prospective, double-blind, randomized controlled trial took place at Al-Sader Teaching Hospital in Basrah, Iraq, from the first of February 2022 to the end of October 2023. The study aimed to assess the post-operative pain relief efficacy and safety of intramuscular nefopam (20 mg) and intravenous methocarbamol (1 g) in 110 adults (aged 18-65) undergoing elective orthopedic surgeries. Exclusions were made for allergies to the drugs, substance abuse history, and severe hepatic or renal impairment. Participants were randomized into two groups, with pain intensity measured at one hour, six hours, and 12 hours post-operation using the visual analog scale (VAS). Side effects were also evaluated. Statistical analysis was done using SPSS 27, with a significance level set at p<0.05 and a 95% confidence interval (CI). Results In this study, we conducted a rigorous comparison between two groups, methocarbamol and nefopam, to evaluate their efficacy and safety in post-operative pain management. We started by ensuring that the groups were well-matched in terms of age, gender distribution, and body mass index (BMI). The results showed remarkable similarities in mean age, gender distribution, and BMI, supported by robust p-values, affirming the effective matching of the two groups. Moving to pain management, we observed a significant advantage in favor of methocarbamol. At all-time intervals (one hour, six hours, and 12 hours post-operation), methocarbamol consistently demonstrated lower mean VASscores compared to nefopam. These differences were highly statistically significant, underscoring the superior pain relief efficacy of methocarbamol. Exploring side effects, we found no statistically significant disparities in the occurrence of nausea and vomiting between the two groups. However, there was a noticeable trend towardhigher tachycardia incidence in the nefopam group, though it did not reach statistical significance. Conclusion The present study showed a higher efficacy of methocarbamol in post-operative pain reduction in comparison to nefopam. No serious side effects were observed with both drugs.

Antibiotic Resistance of Bacteria isolated in Urinary Tract Infections

Abstract Objectives: This study aimed to examine the relationships between isolated bacterial agents, age, and gender, as well as antibiotic resistance of UTI isolates, in addition to investigate the antibiotic resistance in a section of Iraqi patients with UTI. Methods: Isolates (885) from patients and outpatients with symptomatic urinary tract infections at Al-Sadder teaching hospital in Basra province, southern Iraq, from January to August 2022. Results: The results of patient specimens cultured on appropriate culture media indicate that the number of negative cultures was 528 while the number of positive cultures was 357; females are more susceptible to UTIs than males (170). The age category 60 years had the highest infection rate (31%), followed by 20-29 years (19.3%). The most prevalent etiological agent was Escherichia coli (28.3%), followed by Staphylococcus spp. (19.3%), Candida albicans (14.9%), and Klebsiella pneumonia (14.9%). Conclusion: The results demonstrate that various bacteria exhibit variable degrees of sensitivity to different antibiotics, with the significant finding that the majority of urinary isolates were highly resistant to commonly used antibiotics.

Long-Term Effect of Post-Covid-19 Syndrome on Respiratory Parameters in Iraqi People

Background: The long-term sequelae of COVID-19 are thought to be a novel area of research due to variances in the epidemiology and therapy. Nevertheless, the follow-up time interval (6 or 12 months) was excessively long, and the time point of the follow-up period varied from 3 to 24 months in the prior research. More research is required to understand better COVID-19's effects, including their long-term effects on the lungs and how they may affect pulmonary function. Therefore, this study aims to investigate the long-term impact of post-COVID-19 syndrome on pulmonary function tests. Methods: This research was a case-control study conducted from 13 October 2023 to 13 November 2023 at the Al-Sader Teaching Hospital in Maysan City. There are fifty-eight patients and fifty-eight controls included. This study comprised patients who visited a pulmonary consulting clinic and had COVID-19 symptoms, matched by controls who were chosen at random. The controls had to meet the same criteria as the cases, with the exception that they did not have COVID-19 disease. The most popular kind of breathing or pulmonary function test is spirometry, spirometry was used to measure: FVC, FEV, and FEV1/FVC ratio. Result: Sixty-six post COVID-19 syndrome with ages (34.1 ± 9.8) years and sixty-seven controls were enrolled. The results of FVC and FEV parameters indicate a significant difference (P&lt;0.05) between cases and control groups. However, no significant differences existed between groups for the FEV1/FVC ratio. In the comparison of lung function tests between cases and control across different age groups (18-29, 30-39, 50-65) years, we found that mean FVC is significantly lower for the age group 18-29 years than for 30-39 and 50-65 years, and the mean FEV is significantly lower for the age group 18-29 years than for 30-39. Conclusion: After COVID-19, a significant number of patients continue to have symptoms, with respiratory symptoms accounting for the majority of complaints. Patients with continuing symptoms were younger and presented a significantly lower FVC and FEV.

Incidental Thyroid Carcinoma in Thyroidectomy Specimen with Clinical Correlation in Iraqi Patients

Abstract Background: Incidental thyroid carcinoma is a clinically unsuspected carcinoma that was discovered by histopathological examination of a thyroidectomy specimen removed for benign diseases. Objectives: To evaluate the frequency of incidental thyroid carcinoma in the thyroidectomy specimens and how to avoid its sequel in Iraq. Materials and Methods: A retrospective study of 104 cases of total and subtotal thyroidectomy for benign diseases was collected from Al-Sader teaching hospital during 2019–2022, reviewed by two pathologists for incidental primary malignancy, and analyzed using SPSS version 27. Results: Incidental thyroid malignancy was detected in 10.54% of all cases. It had been found in 13.8% of multinodular goiter (MNG) cases. Eight cases out of eleven (72.7%) of incidental malignancies were detected in total thyroidectomy specimens and the same percentage of them were detected in MNG cases. Ten out of eleven cases (90.9%) of incidental carcinoma were papillary carcinoma type (six cases were micropapillary type and four cases were conventional type of papillary carcinoma) with one case of follicular carcinoma. Conclusion: MNG does not mean the absence of carcinoma in the thyroid gland. Total thyroidectomy is the best surgery to avoid complications of unsuspected carcinoma and the sequel of another surgery.

Antimicrobial susceptibility of bacterial clinical specimens isolated from Al-Sader Teaching Hospital in Basra-Iraq

Antibiotic resistance is a global health concern that requires multiple efforts to establish proper preventive and curative programs. This study aimed to assess the antibiotic susceptibility profiles of commonly isolated bacteria at Al-Sader Teaching Hospital, Basra-Iraq. A total of 234 clinical specimens were collected from urine, skin infections, and blood. The bacterial isolates were initially identified using standard microbiological methods, and the identification of the four most common isolates was confirmed by PCR technique using species-specific primers (malB for Escherichia coli, rpoB for Klebsiella pneumonia, OprL for Pseudomonas aeruginosa, and mecA for methicillin resistant Staphylococcus aureus). The identified bacteria were subjected to disc diffusion and VITEK2 system to test the antibiotic susceptibility. E. coli was the most prevalent in urine (51.25%), followed by S. aureus (15%), while S. aureus (31.25%) and P. aeruginosa (30.20%) were more prevalent in skin infections. S. aureus (31.57%) and E. coli (26.31%) were predominant in the blood samples. The Antibiotic susceptibility pattern of Gram-negative isolates revealed high resistance to Cefoxitin (90%), Aztreonam (87%), Ceftriaxone (87%), Piperacillin/tazobactam (85%), and Amoxicillin/clavulanic acid (85%). S. aureus showed high resistance to Cefoxitin (93%), Oxacillin (89.58), and Methicillin (91%), whereas, the highest sensitivity was recorded for Colistin (100%), Rifampin (93%), Amikacin (87%), and Meropenem (76%). A high level of multidrug-resistance strains was detected among Gram negative bacteria (76%) and S. aureus (56%). The current study provides valuable insights into the distribution of pathogenic bacteria and their antibiotic resistance patterns in different clinical samples, contributing to improved treatment strategies and infection control measures.

Effectiveness of Medicinal Plant Extract against Pathogenic Bacteria in the Prevention and Treatment of Urinary Tract Infections

A urinary tract infection (UTI) is an infectious disease that infects humans in the presence of microorganisms, often not treated with broad-spectrum antibiotics because they contribute to developing resistant microorganisms. Therefore, this study aimed to investigate the antibacterial efficacy of medicinal plants used to treat infection in the urinary tract. One hundred samples were collected from patients with UTIs, ranging in age from 10–60 years. Outpatients and inpatients with UTIs live in Al-Najaf Center and attend treatment at Al-Hakeem Hospital and Al-Sader Teaching Hospital. Ten microliters of urine samples were inoculated on selective media to isolate and identify pathogenic bacteria, presumptive identification was performed using the Viteck-2 system. Eight antibiotics were used for showed antibiotic susceptibility: cefixime (5 μg), streptomycin (25 μg), amoxicillin (30 μg), erythromycin (10 μg), ciprofloxacin (10 μg), azithromycin (15 μg), gentamicin (10 μg), and nitrofurantoin (50 μg). Two species of plants were used to determine antibacterial activity: Castanea crenata and Saussurea costus. Of 100 urine samples, 80 tested positive for bacteriuria. Escherichia coli was the most prevalent bacterium in the urine 50 (62.5%), followed by Klebsiella pneumonia 10 (12.5%), Proteus vulgaris seven (8.75%), Pseudomonas aeruginosa six (7.5), Staphylococcus aureus four (5%), and Streptococcus pyogenes three (3.75%). Some bacteria with Gram staining comprising E. coli, Klebsiella spp., Pseudomonas spp., and Proteus spp. are resistant to many antibiotics. C. crenata and S. costus inhibited the growth of pathogenic bacteria isolated from the urine samples. Testing and determining the antimicrobial activities of medicinal plants will help pharmaceutical companies develop modifiers or precursors for synthesizing new therapeutic alternative drugs to treat infectious diseases caused by pathogens.

Identifying and Isolating of H. pylori in patients who are experiencing Inflammation in their Gastrointestinal tract

Background: Peptic ulcer illness, stomach cancer and chronic gastritis are gastro-duodenal diseases that are mostly caused by Helicobacter pylori, or H. pylori. Objective: To find out how common Helicobacter pylori infection is among patients at Al Sadder Teaching Hospital in Al-Najaf, Iraq, as well as related factors including age, gender, residency, and blood group. Methods: The entirety of 197 patients—79 men and 118 women—of both genders and various age groups—from under 10 to around 60 years old—were reported to have symptoms of gastrointestinal inflammation. Result: The total numbers of participants in the current study were 197 patients, found 156 (79.2%) positive and 41(20.8%) negative results. Females had a greatest percentage of H. pylori (47.2%), while males had the lowest incidence of prevalence (32%). The age group (31-40) had greatest percentage with (14.7%), followed by the age group (41-50) with (13.2%), and then the age group (21-30) with (11.7%) while lowest percentages in age groups &lt; 10 and ˃ 60 years old. The blood group type O, which had the greatest positive rate (27.9%), was followed by the blood groups types A, B, and AB, with 16.8%, 13.7%, and 4.1%, respectively. People who live in rural areas (30.4%) have a elevated frequency of H. pylori infection when compared with persons who reside in urban areas (28.4%). Conclusion: The findings showed that H. pylori was more frequent in women than men, in rural areas, and in patients between the ages of 31 and 40. Additionally, individuals with the O blood group had higher H. pylori frequency.

Assessment of some cytokines levels in a pauci-immune crescentic glomerulonephritis patients

Background: Glomerulonephritis is the common cause of end-stage of renal failure. Rapidly progressive glomerulonephritis (RPGN) is characterized by glomerular injuries and formation of crescents. Moreover, anti-neutrophil cytoplasmic antibodies (ANCA), and pro-inflammatory cytokines play a damaging role in a crescent glomerulonephritis. Objectives: The main goal of the current study was aimed to determine the ANCA autoantibodies, and the serum levels of pro-inflammatory cytokines (IL-6, IL-17, IL-18, INF-γ), as well as the relationship between these cytokines and ANCA test in a pauci-immune crescentic glomerulonephritis patients. Methodology: The study was carried out in AL-Yarmouk teaching hospital and AL-Sader teaching hospital during the period from April 2022 to April 2023. This study was involved 90 patients with a crescentic glomerulonephritis disease, the diagnosis was made by the consultant medical staff. In addition to a 60 samples of healthy individuals as control group was involved to comparison the results. ANCA test was made by Indirect immunofluorescence method for the detection of ANCA autoantibodies in serum, in addition to measure the serum level of cytokines including IL6, IL-17, IL-18, and IFN-γ by using Enzyme Linked Immune Sorbent Assay methods. Results: This study has shown that the majority of patients were male (66.7%). Moreover, the most effected age groups within the age ≥ 61 years in percentage (65.5%) followed by the age group 51-60 years old (28.8%). There were 59 (65.5%) positive cases for ANCA from total patients and all of these cases were MPO-ANCA. The total RPGN patients were showed a highly significant increased mean serum levels of IL-18, IL-17, IL-6, and INF-γ as compared to healthy controls, as well as, the same cytokines were showed significant increased levels in myeloperoxidase (MPO)-ANCA positive serum in crescent glomerulonephritis patients as compared to ANCA –negative serum of patients. These results indicate a functional role of IL-6, IL-17, IL-18, and INF-γ in ANCA-mediated neutrophil activation by the interdependence of IL-6, IL-17, IL-18, and INF-γ priming for ANCA responses. Conclusion: It can be drawn from the present study that, the pro-inflammatory cytokines play an integral role in determining the course of disease and it can be used as major drug targets for therapy, as well as these cytokines have the ability to priming neutrophils thus contribute in the progression of a pauci-immune crescentic glomerulonephritis disease.

Phenotyping and Genotyping Evaluation of E. coli Produces Carbapenemase Isolated from Cancer Patients in Al-Basrah, Iraq.

One of the most important nosocomial organisms that cause urinary tract infections (UTIs) in cancer patients is Escherichia coli. A significant cause of concern in managing UTIs is the development of carbapenem-resistant bacteria. Escherichia coli with carbapenem resistance has become a more serious problem, particularly in Iraq. In this regard, the present study aimed to estimate the prevalence of carbapenem-resistant E. coli in Al-Basrah, Iraq. Conventional tests and the Vitek®2 system were used to identify the isolates and determine the susceptibility of E.coli isolates to antimicrobials. In addition, E.coli isolates were tested by mCIM and eCIM methods. Moreover, the major carbapenemase genes, including blaSPM, blaIMP, blaVIM, and blaKPC were detected by polymerase chain reaction. In total, 120 urine samples were collected from cancer patients who were suspected of having urinary tract infections at Basrah Center of Oncology Al-Sader Teaching Hospital, Basrah, Iraq. Identification of bacterial growth by using biochemical tests revealed different bacterial species. The most frequent bacteria were E. coli (n=22, 53.65%) isolates. The results showed that 13 (59.09%) and 11 (50%) out of 22 E. coli isolates were positive for the production of carbapenemase, based on the eCIM and sCIM, respectively. The majority of E.coli in this study possessed the blaVIM gene (n=13, 59.1%), followed by the blaKPC gene (n=5, 22.73%), blaIMP gene (n=5, 22.73%), and blaSPM gene (n=4, 18.18%). There is a spread of more than one type of carbapenemase among the E. coli isolates collected from UTI cancer patients in Basrah Hospital. The E. coli identified in the current study had a strong capacity to produce carbapenemase enzymes against the four generations of antibiotics, including imipenem and meropenem antibiotics.

Study about the association between toxoplasma and breast cancer in Najaf During 2020

This study was begin from January to December 2020 , to learn where there breast cancer and toxoplasma infection are related By used immunology test results . 2020, to know the association between Toxoplasma infection and breast cancer .by examine immunological test.32 women who had tumors were the subjects of a study conducted at the Al-Sadder Teaching Hospital in Al-Najaf Al-Ashraf , with breast tumor symptom . the mean age of women from 35-45 years ago . X-ray was done at first and sonar to detected the site of tumor and size . Biopsy was taken and sent to the Al- kafeel histopathological laboratory for making block and stain with hemaxlin and eoxin typical Histological change and ductal cancer show with irregular shape of duct mammary gland ,by use H &amp; E method , serological was applied for toxoplasma appear in Five women is positive test for Toxoplasma AB by used special kit . the rest women consider control group . this study was find significant Toxoplasma associated with breast cancer , the case record at first time in Al-Najaf government.

Evaluation of knowledge of medical department nurses regarding standard procedure toward electrocardiogram in Al-Amara City Hospitals, Iraq

Objective: To assess knowledge for medical department nurses regarding the standard procedure toward electrocardiography in Al-Amara city hospitals. Methodology: This descriptive study was conducted from 12th November 2019 to 31th May, 2020. We elected a random sample of 60 staff nurses in the medical division's wards, ICU, and emergency department in Al-Sadder teaching hospital, Al-Zahrawi surgical hospital, and Misan center for cardiac diseases. We used a questionnaire composed of 20 multiple choice questions. Data analysis was carried out utilizing inferential statistics. Results: Majority of the nurses in the study had moderate level of knowledge about standard procedure ECG. Conclusion: The standard procedure of electrocardiogram is very necessary to improve the knowledge and skills to enable the nurses to understand and identify electrocardiogram errors and able to accurately position electrodes.

Nurses' knowledge and attitudes about enteral feeding complications by nasogastric tube in intensive care units

Objectives: To determine the knowledge and attitudes concerning enteral feeding difficulties by nasogastric tube and demographic variables and to evaluate nurses' knowledge and attitudes about these complications. Materials: This cross-sectional study was conducted in the teaching hospitals in Al-Basrah City; Al-Basrah Teaching Hospital, Al-Mawani Teaching Hospital, Al-Faiha Teaching Hospital, and Al-Sadder Teaching Hospital from October 25, 2022, to February 15, 2023. One hundred fifty nurses were enrolled using purposeful (non-probability) technique. A questionnaire was used for data collection. Results: Majority of nurses (63.3%) had little to no understanding about nasogastric tube complications, while just 26.7% and 10% had moderate or good knowledge, respectively. The majority of nurses (74%) had negative attitudes toward nasogastric tube problems, followed by nurses with moderate attitudes (11.3%) and positive attitudes (14.7%). Conclusion: Nurses had inadequate attitudes and knowledge regarding nasogastric tube complications associated with enteral feeding.

Acute limb ischemia associated with COVID-19 in Basra province, Iraq

Objective: To investigate acute limb ischemia (ALI) incidence, characteristics, and clinical outcomes at Basra Tertiary Hospital during the COVID-19 Pandemic. Methodology: This cross-sectional investigation included 53 COVID-19-infected patients with limb ischemia in Al-Sader teaching hospital from April 2020 to May 2022. Each patient's gender, age, smoking status, and medical history like diabetes, hypertension, hypercholesterolemia, and respiratory failure were recorded. Results: Mean age of patients was 63 ± 8 years. Out of 53 patients, 88.7% were males and most (67.9%) were 60 years old or more. 75.5 of patients were smokers, 50.9%, 39.6%, 22.6%, 28.3% had diabetes mellitus, hypertension, hypercholesterolemia and respiratory failure, respectively. There was a significant association between embolectomy, actylase anticoagulant, death and amputation. 84.6% of patients with embolectomy had amputation while 80% who took actylase anticoagulant had no amputation. Conclusion: In covid-19 related ALI, amputation was common in embolectomy patients while it was rare in patients who received actylase. Most of deceased patients had amputations.

Study of midkine protein as prognostic marker for thyroid disease in Al-Najaf City

Objectives: The aim of this study is to detection of various thyroid diseases in the early stages and their impact on the metabolic state of the body through the estimation of the Midkine by using ELISA method. Methadology: The current study was conducted on 45 patients with thyroid disease was attending in endocrine and diabetic center in the Al-Sadder Teaching Hospital and Al-Hakim General Hospital in AL-Najaf Province, and 45 healthy person, the samples collected during the period from September 2021 to 2`January. Results: The result of hormonal markers shows high significant with p-value = &lt;0.001 in the level of T3 was higher in Hypothyroidism compared to Hyperthyroidism and the control group. On the other hand, this result was high significant with p-value = &lt;0.001 in the level of T4 was higher in Hypothyroidism compared to Hyperthyroidism and the control group. In addition, this result was high significant with p-value = &lt;0.001 in the level of TSH was higher in Hyperthyroidism compared to Hypothyroidism and the control group. The results of biochemical marker of Midkine was higher in Hyperthyroidism and Hypothyroidism (499.6 ± 120.2 and 489.1 ± 108.1 respectively) compared to and the control group (372.9 ± 92.5).

Association of Tobacco Smoking with Systemic Co-Morbidities among Patients Seeking for Dental Care Services: Across Section Study

Background: Smoking is a common risk factor for chronic diseases, including cancer, lung diseases and cardiovascular disease. The adverse effects of tobacco smoking on oral health are well documented. This includes common and rare conditions of benign to life-threatening diseases such as bad breath, discoloration of teeth and dental restorations, taste and smell disorders , periodontal disease , oral mucosal lesions such as smoker's melanosis and smoker's palate, potentially malignant lesions and oral cancer . Aim of the Study: To verify associated of the smoking with systemic dissase among patients seeking for dental health care Patients and methods: A cross-sectional study performed at the dental and maxillofacial unit in AL-Sader Teaching hospital, Al-Najaf city the data were collected during a period of four months, starting 1st March to the 1st June 2019. Target population: study participants were selected by systemic random sampling patients attended Al Sader Teaching hospital at maxillofacial unit according to special criteria. Results: A total of 400 participants were enrolled in this study , their age ranged 18 – 65 years, no significant difference had been found regarding the age distribution between smokers and non-smokers sub groups, (P&gt;0.05). No significant association was found between smoking and residence, (P&gt;0.05). A significant association was found between occupation and smoking status , where unemployed were the dominant among smokers, contributed for 52.9%, compared to other occupations, (P = 0.001). Conclusions: Significant associated with observed between oral disease and cigarette smoking among patient seeking oral health care.

Evaluate microbial profile and IL-17 level in transmission transfusion infection patients

Transfusion-transmitted infections (TTIs) an important causes of morbidity and mortality among recipients of blood /blood products since it among the essential vehicles for infectious agents that lead to disability or death. So this study aimed to evaluate the important causative agents and the role of IL-17 in progressive disease . A Case-control study was performed to 100 patients with Transfusion blood attended to AL-Sadder teaching hospital with group of 30 healthy individual as control. Blood sample was collected from all patients and control. IL-17 level were measured by enzyme-linked immunosorbent assay (ELISA). The result shown that Hemodialysis patients 54 (54%) patient from which 40(74%) suffering from TTI, HCV were most common causative agents with 42 % and the male recorded 63%. While 46(46%) patients with thalassemia from which 32(70%) were TTI and HCV a most common pathogen with 19(41 %), the male higher than female with frequency (65%). In conclusion: This result explain that HCV infected more than non-infected HD patients and the serum IL-17 level increased significantly in HD patients with HCV, then patients without HCV infection in comparison with healthy control group.

NGAL as a biomarker in chronic kidney disease

The current study was performed with 65 patients with Chronic kidney disease, their mean age (44.38±14.59) years, who have visited the physician's consultancies and the kidney disease unit at Al-Sadder Teaching hospital in Al-Najaf, Iraq, and 25 persons as a healthy control group their mean age (48.68±16.37) years. The study was conducted from September 2021 to May 2022. In this study, serum NGAL levels were measured in patients and healthy groups. It also assays the relationship between levels of these biomarkers with some hematological and biochemical parameters RBCs, Hb, PCV, Creatinine, Urea, GFR. The results revealed that there was a Significant decrease with mean± SD of RBCs, HGB, as well as PCV, (3.36±0.69 X106/ mm3), (8.99±1.76mg/dl), (28.47±4.2%) respectively of patients with kidney disease as compared with healthy groups (4.55±0.47 x 106mm3), (14.28±1.43 mg/dl), and (40.11±3.84 %) respectively. The results also shows significant difference (p-value&lt;0.05) decreased with mean± SD of eGFR in Kidney failure patients (13.42±13.83 ml/min/1.73 m2) as compared with healthy control group (114.12±12.49 ml/min/1.73 m2).

Physiological study of NGAL and Cystatin C in chronic and acute kidney disease patients

Kidney disease is an important global health concern, affecting ~15% of the global population and typically associated with systemic disorders (e.g., diabetes). Increased incidence of kidney diseases and their progression to critical stages are facing many nations across the globe. The current study was performed with 65 male patients (20 with Acute kidney disease and 45 with chronic kidney disease, their mean age (44.38±14.59) years, who have visited the physician's consultancies and the kidney disease unit at Al-Sadder Teaching hospital in Al-najaf, Iraq, and 25 persons as a healthy control group their mean age (48.68±16.37) years, They were all Males with no prior medical history and no indications or symptoms of renal disease, diabetes, anemia, hypertension, thyroid illness, dyslipidemia, or obesity . The study was conducted from September 2021 to May 2022. Biomarker appropriate for kidney failure monitoring should have narrow biological variability Such as NGAL and Cystatin C Were biomarkers of tubular epithelial cells injury and pathogenesis of KD progression, it was predicted to be reflecting disease activity and kidney function. In this study, serum NGAL and Cystatin C levels were measured in patients and healthy groups.

Role of MCP-1 in the developments of diabetic nephropathy in patients with type 2 diabetes mellitus patients

Several complications may be developed during infection with type 2 diabetes mellitus. One of the most is diabetic nephropathy, leading to end-stage renal disease in more than 30% of diabetes mellitus. Monocyte, which is derived from blood circulation to the tissue the maintains an inflammatory state. Several factors and chemokines regulate the activity of monocytes. One of them is Monocyte chemoattractant protein-1 (MCP-1) which is released by several adipocytes that help attract monocytes during inflammation. Patients and methods: the samples were collected from patients who attended diabetes and endocrinology center in Al-Sader Teaching Hospital in Najaf between January 2019 to April 2019. This study involves 300 subjects. One hundred fifty of them were diagnosed with type 2 diabetes mellitus. According to their albumin/creatinine ratio (ACR), these patients were classified into three groups, including 50 patients with severe nephropathy, 50 patients with moderate nephropathy, and 50 patients with mild nephropathy. The control group involved 150 subjects who appeared healthy and the same age as the patients' group. Result: a significant increase of MCP-1 level was found in patients with mild, moderate and severe diabetic patients compared with healthy control.

Evaluation of Nurses' Knowledge and Practices Concerning Nursing Care Guide in the Intensive Care Unit in Misan Governorate Hospitals

Background: Intensive care nurses must possess good knowledge and high professional skills in everything related to the critical care environment such as tools and equipment for specialized technical devices and nursing care for critically ill patients whose cases require mechanical ventilation through endotracheal intubation.&#x0D; Aim of the study: The study aim was to evaluate knowledge and practices of the nurses regarding nursing care guide at the intensive care units in Al-Sadder teaching hospital and Al Zahrawi surgical hospital.&#x0D; Methodology: Conducted is a descriptive design study in the intensive care units at Al-Shaheed Al-Sadder teaching hospital and Al Zahrawi surgical hospital, started in the 25 \ September \ 2018 to the 30 \ October \ 2019. Select purposive sample comprised of 60 nurses. Instrument of the study is adopted and developed via the researcher. Questionnaire was consisted (30) questions to evaluate the nurses' knowledge and (65) checklist items to evaluate the nurses' practices concerning the nursing care guide. The validity of the instrument obtained by 17 expert's panel, Analysis of data is performed via the application of description statistic (frequencies, percentages, arithmetic mean, and standard deviations), and the inferential statistical (chi-square test) to present association between variables.&#x0D; Results: Outcomes of study is revealed that the majority of nurses have a moderate level of knowledge, and practices about nursing care guide at the intensive care unit, total mean are with regard to knowledge (0.41) and, and in practice (1.84).&#x0D; Conclusion: Study Illustrated that not all intensive care unit nurses were trained adequately on the nursing care guide in the ICU, approved by Iraqi Ministry of Health. That there are non-significant differences between demographical data with their knowledge, while showed that there was high significant differences with practices related to nursing care.&#x0D; Recommendation: Assert to update nurses' knowledge and current skill set in critical care units in hospitals to provide nursing care through adequate and high practices by training continuously, it is preferable to increase the proportion of males to females into the intensive care unit, and as for nurses who have less than five courses must intensify and double the number of training courses for their.&#x0D;