Al-Yarmouk Teaching Hospital Research Articles

Serum Leptin as a Marker for Severity of Endometriosis

Background Endometriosis a disease of theories, and one of the important causes of chronic pelvic pain, dysmenorrhea, dyspareunia, and subfertility. Surgery is the mainstay step for the diagnosis; noninvasive test is the goal in the future. Aim of Study. To test the role of serum leptin in determination of severity of endometriosis. Study Design. A cross-sectional study done in Al-Yarmouk Teaching Hospital from 1st of January 2018 to 1st of January 2019. Methods 60 BMI-matched patients were involved in the study. A study group of 30 patients were operated either by laparoscopy or laparotomy for many reasons diagnosed as endometriosis by histopathology, and 30 normal women as a control group underwent elective surgery. Blood sample was taken from all patients in the theater room when laparoscopy finding went with endometriosis, and classifying according to surgical staging of endometriosis, the level of serum leptin was measured by ELISA using Human LEP (Leptin) ELISA Kit. The recording of finding of laparoscopy after conforming of diagnosis by histopathology was compared with the result of serum leptin. Result The result shows no significant difference between the two groups regarding parity and age; however, the level of serum leptin was significantly high in the endometriosis group than in the control group. The P value was less than 0.05. Also, the result shows no significant differences between serum leptin in both groups according to the symptom but there was a significant difference with surgical staging. The mean of the level of serum leptin in stage 1 was 214.8, while it was 340.3 in stage 4. Conclusion Serum leptin can be used as a marker of severity of endometriosis.

Comparison of Some Physiological Parameters in Female Rheumatoid Arthritis Patients in Pre- and Postmenopausal Stages

Rheumatoid arthritis is an autoimmune disorder that is highly prevalent, leading to gradual cartilage distraction, and therefore is important to diagnose in the early stage. This study aimed to estimate the level of rheumatoid factor (RF) and Anti-citrullinated protein (Anti-ccp) in the serum of female patients. We also investigated several female reproductive hormones in the patients and compared their levels in the premenopausal and postmenopausal phases. The study included 88 female subjects, 50 suffering from signs of rheumatoid arthritis who were attending AL-Yarmouk teaching hospital, Baghdad, Iraq, and 38 without clinical signs of RA as a control group. The ELISA technique was used to estimate all the studied parameters. The results showed a significant elevation in the levels of RF (103.6 ± 227.0 vs. 22.1 ± 111.0 U/ml) and Anti-ccp (158.0 ± 170.0 vs. 0.51 ± 1.69 U/ml) in patient’s serum as compared to the control. The percentage of overweight and obese patients was higher than that of those with normal weight. Also, the current results showed significant differences in the serum concentrations of the reproductive hormones between the premenopausal and postmenopausal phases in the patients group. The level of FSH in postmenopausal female patients was higher than that in premenopausal ones (33.5 ± 17.9 vs. 9.01 ± 9.31 U/ml). Also, the level of luteinizing hormone (LH) in the postmenopausal patients was higher than that in the premenopausal patients (26.4 ± 12.3 vs. 12.7 ± 10.2 U/ml). While the level of prolactin (PRL) in RA postmenopausal female patients was lower than that in the premenopausal patients (8.60 ± 7.07 vs. 14.8 ± 10.6 ng/ml). In addition, the level of Anti-mullerian hormone (AMH) in post-menopausal patients was lower than that in the pre-menopausal ones (0.034 ± 0.023 vs. 0.635 ± 0.683 ng/ml). Finally, the concentration of estradiol (E2) in the post-menopausal female patients was lower than that in the pre-menopausal ones (32.9 ± 18.6 vs. 76.5 ± 43.6 ng/ml).

Chemerin Level as a Marker in Preeclampsia and its Relation to the Disease Severity and Neonatal Outcome

Aim of study: To detect serum chemerin level in patient with preeclampsia and evaluate the association between maternal serum chemerin, disease severity and neonatal outcome. Patients and Method: A case control study included 100 pregnant women with singleton pregnancy, gestational age of 20 weeks or more, normal fetal morphology, and absence of concomitant diseases, who were collected from inpatient during delivery was conducted in the Department of Obstetrics and Gynecology at Al-Yarmouk Teaching Hospital during the period from 1st of June 2018 till end of May 2019. They were divided into three groups (control, mild preeclampsia, and severe preeclampsia). Patients with history of chronic hypertension, diabetes mellitus, cardiovascular disease, neurological disorder, renal impairment, or premature rapture of membrane were excluded from this study. blood sample was taken from all patients and sent for human chemerin assay. After delivery, birthweight of baby, APGAR scores at one and five mints, neonatal intensive care unit and adult intensive care unit admission, and hospitalization time were also noted. Results: There were no statistically significant differences between the study groups in age, BMI level, and parity. Chemerin level was significantly elevated in patients with severe preeclampsia (435.06 ng/ml) and mild preeclampsia (227.49 ng/ml) than that in non-preeclamptic patients (202.6 ng/ml). It was negatively correlated with each of gestational age, birth weight, Apgar score at one and five minutes. While it was positively correlated with admission’s duration. Serum chemerin > 228.5 ng/ml is predictive for diagnosis of preeclampsia and level > 380.9 ng/ml is indicator for severe preeclampsia. Conclusion: Chemerin may play a role in the pathogenesis of preeclampsia as maternal serum chemerin level was significantly higher in patients with preeclampsia

The value of mid-trimester fetal liver length measurement in prediction of gestational diabetes in Iraqi women

Background. Gestational diabetes (GD) is a hyperglycaemic state specific to pregnancy. A well-tolerated, quick and minimally-invasive method for the early detection of GD in pregnancy is lacking. Objective. To evaluate the correlation between the mid-trimester length of the fetal liver and GD. Methods. A prospective study was conducted at the National Endocrine and Diabetic Center, College of Medicine, Al-Mustansiriya University, Iraq and the Obstetric and Gynecological Department at Al-Yarmouk Teaching Hospital, Iraq, from September 2016 to September 2018. One-hundred-and-twenty singleton pregnant women at high risk for gestational diabetes mellitus (GDM) were recruited. An ultrasound scan was performed at 23 weeks’ gestation followed by a 75 g oral glucose tolerance test (OGTT) at 24 weeks. A correlation was assessed between the mid-trimester fetal liver length (FLL) measurement and the OGTT. Results. Mean (SD) FLL values were significantly higher among GDM patients v. healthy pregnant females respectively: 37.2 (3.4) v. 33.1 (2.7); p <0.001. Univariate analysis showed that FLL in GDM group was 1.6 times the non-GDM group (odds ratio (OR) 1.6; 95% confidence interval (CI) 1.31 - 1.96). There was no significant change after adjustment for parity and cumulative risk factors. Based on the above, FLL is an independent predictor for GDM (OR 1.6; 95% CI 1.30 - 1.96; p <0.05). Conclusion. FLL measurement by ultrasound at 23 weeks’ gestation is a feasible alternative to OGGT for the early detection of GDM in high-risk patients

The Clinicopathological Characteristics of Endometrial Carcinoma in Iraqi Women: Cross Sectional Study

Aim of the Study: The current study included a sample of Iraqi women from various centers in Baghdad and Al-Diwaniyah province with an established diagnosis of endometrial carcinoma aiming at highlighting the main clinicopathological features of this malignant tumor. In this study, the authors retrospectively collected information about women affected by endometrial carcinoma during the last 3 years, form January the 1st 2015 to December the 31st 2018. Information was retrieved from clinical reports registered at Al-Yarmouk Teaching Hospital laboratories and Al-Diwaniyah teaching Hospital laboratory and also from some private laboratories in Baghdad and Al-Diwaniyah province, Mid-Euphrates region of Iraq. At the end of the study we were able to collect information about 27 cases of endometrial carcinoma. The information included age of women, size of tumor, myometrial invasion, involvement of ovaries, cervix, and fallopian tubes, lymphovascular invasion and pelvic lymph node involvement. Majority of cases of endometrial carcinoma were initially diagnosed in women postmenopausally and that most of cases were of endometrioid variety, low grade and early stage.

Causes and frequency of cochlear explantation

Background: The cochlear implant (CI) is unique among medical devices in that it serves as a neurosensory prosthesis capable of restoring or providing de novo the sense of hearing to its users. Causes of cochlear device explantation are divided primarily into device failures and medical failures. Study design: Retrospective and prospective analysis. Objective: determine the causes and the frequency of device and medical failure. Patients and Methods: The study involve 17 patients who had cochlear explantation from total implantation 766 patients in the department of otolaryngology in AL-Yarmouk teaching hospital during period from April 2008 to March 2018, and the data was collected from operative notes that is documented in patients files. Results: A total of 766 implants were performed from April 2008 to March 2018, with 17 devices explanted, the implanted devices were 45.8% Cochlear nucleus devices, and 27.5% were MED-EL devices and 26.6%. Where Advance bionics. The overall failure rate was 17 of 766 (2.22%) of which 13 (76.47%)due to medical failures and 4 (23.5%) due to device failures. Patients with cochlear nucleus devices underwent 9 explants (2.56% failure rate) of which 8 (88.9%) was medical failures and 1(11.1%) was device failures. Patients with MED-EL underwent 3 explants (1.42% failure rate), which all of them was due to device failures Patients with advance bionics underwent 5 explants (2.45% failure rate) all of them was medical failure. Medical failures included wound infection with wound breakdown, wound infection with flap necrosis, hematoma, cholesteatoma and biofilm. Device failure include hard failure and soft failure. Over all the average time to explantation was 559days (range, 10-3468 days). Conclusion: Overall, cochlear explantation rate is low. The medical causes was more common and more with cochlear nucleus device type. the device failure rate was more common with MED-EL device type.

DETECTIN OF VASPIN RS2236242 AND CHEMERIN RS17173608 GENE POLYMORPHSIMS IN A SAMPLE OF OBESE IRAQI POLYCYCTIC OVARY SYNDROME WOMEN

This study was performed to detect assess Vaspin rs2236242 and Chemerin rs17173608 gene polymorphisms with its association with susceptibility of obese PCOS in Iraqi women .Blood samples from 100 women with obese PCOS and 75 healthy control women matched in age and BMI were collected from AL-Yarmouk Teaching hospital during February2018-July 2018 were enrolled in case control study. Tetra amplification refractory mutation system‐polymerase chain reaction (T-ARMS-PCR) was performed to detect the adipokine SNPs in patients and healthy women under study. Results demonstrated a significant variations in either genotype distribution and alleles frequencies between the obese PCOS and healthy women regarding vaspin rs2236242 polymorphism. The T allele increased the PCOS risk in comparison with the A allele which was the protective against PCOS, as well clear positive correlation between rs17173608 SNP of chemerin and susceptibility of PCOS was identified also, and The T allele had related with elevated PCOS risk as in comparison to the G allele. Data from this work determined for the first time a significant association between vaspin and chemerin SNPs and susceptibility PCOS risk in Iraqi obese women especially T allele .To confirm our findings new studies with large sample size and different ethnicities must be required.

Pattern of Mechanical Intestinal Obstruction in Al-Yarmouk Teaching Hospital

Background: The effective treatment of patients with intestinal obstruction is essential and requires initial rapid diagnosis and therapeutic intervention . Aim of Study: To determine the causes, the accuracy of preoperative diagnosis, and other epidemiological characteristics of intestinal obstruction in Al-Yarmouk Teaching Hospital in Baghdad, Iraq. Patients and Method: A prospective study was conducted in the Surgical Department of Al-Yarmouk Teaching Hospital for a period of two years (from Jan 1999 to the end of Dec 2000) and included 178 patients admitted and proved to be diagnosed with mechanical intestinal obstruction. Results: Of the 178 patients enrolled in this study; maximum incidence was seen in patients aged between 40-59 years with male predominance (62.4%). Abdominal pain and constipation, were presenting in majority of cases (87.6% and 83.1% respectively). Common causes were hernias, adhesions and bands (35.4% and 28.6% respectively). Small bowel was involved in 69.7% cases and large bowel in 30.3%. Laparotomy was the main option for management (69.1%). The mortality rate was 9.5% and death is associated significantly with aging and volvulus and intussusception as causes of intestinal obstruction. Conclusion: Acute intestinal obstruction still a major cause of morbidity and mortality which was associated with aging, compounda volvulus and intussusception. Hernias and adhesions were the leading causes of intestinal obstruction. Abdominal pain and distension, and constipation were seen in majority of cases. Laparotomy was the most common method of intestinal obstruction management in our institute

Evaluation Efficacy of Clarithromycin and Levofloxacin in the Eradication of Helicobacter Pylori (H.P) Infected Iraqi Patients at Al-Yarmouk Teaching Hospital

Helicobacter pylori (H.P) infection is an increasing concern in modern medicine due to its effect on the pathogenesis and management of peptic ulcer disease and gastritis and its possible link to gastric adeno carcinoma cases. The eradication of HP is a mandatory approach in documented cases of HP infection mainly gastric and duodenal ulcers. The treatment options is variable globally according to microbial susceptibility test and local guidelines. This study focused on two main options in the eradication of HP and found that levofloxacin based therapy is superior to clarithromycin based approach in the rate of eradication , with comparable rate of adverse events.

Evaluation of maternal serum sestrin2 levels in preeclampsia and their relationship with the Disease severity

Background: Preeclampsia (PE) is considered one of the major causes of both maternal and fetal mortality and morbidity. Advances have been made on understanding the pathophysiology of this pregnancy-specific disorder. Sestrin2 (SESN2) is a metabolic regulator protein, whose expression is induced in response to exposure to different adverse effects such as hypoxia, DNA damage, or oxidative stress, thus acting as cytoprotective. Objective: The objective of the study was to investigate the levels of maternal serum SESN2 in preeclamptic and uncomplicated pregnancies and their association with the disease severity. Patients and Methods: This was a case–control study conducted at the Department of Obstetrics and Gynecology at Al-Yarmouk Teaching Hospital in Iraq – Baghdad city from the first of March till the end of November 2019. The study included a total of 92 pregnant women, 27 with a healthy pregnancy, 33 with nonsevere PE, and another 32 having severe PE. From all participants, blood samples were collected for the evaluation of serum SESN2 levels using enzyme-linked immunosorbent assay. Results: The mean readings of SESN2 for normal pregnancies were 5.22 ± 1.71 ng/ml which was significantly lower than that for the nonsevere PE group (8.41 ± 1.42 ng/ml), while SESN2 levels were the highest among those with severe PE (16.92 ± 5.15 ng/ml). A negative correlation was found between each of GA at delivery, birth interval, and birth weight and the SESN2 level (P = 0.001); while mean arterial pressure positively correlated with SESN2 levels (P = 0.001), the cutoff value for the diagnosis of severe PE was 9.95 ng/ml (sensitivity of 93.8% and specificity of 98.8%). Conclusion: Maternal serum SESN2 levels are significantly higher in pregnancies complicated by severe PE than nonsevere PE and control groups. It could be a useful biomarker that can help in diagnosing severe PE.

Assessment of left ventricular longitudinal function in hypertensive patients without left ventricular hypertrophy by mitral annular plane systolic excursion

Background: Hypertension is an important risk factor for many cardiovascular diseases worldwide. Assessment of left ventricular (LV) systolic function has a major diagnostic and prognostic importance in patients with hypertension. The use of mitral annular plane systolic excursion in the assessment of LV systolic dysfunction is helpful especially in cases of poor imaging quality, “since good imaging quality is needed for the modern echocardiographic techniques. Objectives: Detection of early subclinical LV longitudinal systolic dysfunction in hypertensive patients without LV hypertrophy (LVH) with preserved ejection fraction by mitral annular plane systolic excursion. Patients and Methods: A comparative case-control study which took place at Al-Yarmouk Teaching Hospital in Baghdad/Iraq from October 2018 to October 2019. The study population consisted of 60 patients without LVH and 60 healthy subjects considered as controls. Echocardiographic parameters for left ventricular systolic assessments were done for all subjects. Results: Mean peak annular systolic velocity was significantly lower in hypertensive patients without LVH compared to controls (P = 0.034). There was no significant difference between hypertensive patients without LVH and controls regarding mitral annular plane systolic excursion (P = 0.4). There was positive linear correlation between mitral annular plane systolic excursion and peak annular systolic velocity for hypertensive patients without LVH (r = 0.535, P = 0.015). Conclusion: Although there was a significant linear correlation between mitral annular plane systolic excursion and peak systolic velocity and both are considered as a surrogate for LV longitudinal systolic function, mitral annular plane systolic excursion cannot be used for assessment of LV longitudinal systolic function in patients with hypertension without LVH.

Effectiveness of an Education Program on Nurses- Midwives' knowledge toward Postpartum Hemorrhage at Delivery Room of Maternity Hospitals in Baghdad City

Objectives: To find out the effectiveness of education program application on nurses-midwives' knowledge toward prevention and management of postpartum hemorrhage in delivery room and some socio demographic characteristics Methodology: a quasi -experimental "test-retest"design has carried throughout the present study with the application of a pre –test and post- test for nurses-midwives' knowledge toward postpartum hemorrhage. The study was conducted in six hospitals in Baghdad: Fatima Al – Zahra for Maternity and Pediatric, Al -Elwia maternity, Baghdad Teaching, AL-Imamine Al - Kadhimin Teaching, Al-Karckh maternity and Al-Yarmouk Teaching hospital for the period from 27th May 2018 to10th December 2018. The sample was conducted on Non-probability (purposive sample) of (97)nurse-midwife. Who were evaluated by using as questionnaire for the nurses-midwives' knowledge which consisted of two parts; the first part included the socio-demographic characteristics of the nurses and the second part included The knowledge of nurses - midwives towards prevention and management of postpartum hemorrhage consists of 43 questions in the form of multiple choices. Descriptive statistical and inferential analyses were used to analyze the data . 
 Results: The result indicates that nurses - midwives' knowledge and practices about prevention and management of PPH have been greatly improved after their being exposed to the education program. 
 Recommendation: The necessity of making periodical training program must conduct regularly in all obstetric hospitals for all nurses and midwives in the delivery rooms, operating theaters, maternity and maternity and emergency obstetric wards, and it should be mandatory.

THE ROLE OF ACTIVIN A AND FOLLISTATIN IN THE DIFFERENTIATION BETWEEN VIABLE INTRAUTERINE PREGNANCY FROM MISSED MISCARRIAGE AND ECTOPIC PREGNANCY

Objective: The objective of the study was to investigate the role of activin A and follistatin (FS) in the differentiation between viable intrauterine pregnancy from missed miscarriage and ectopic pregnancy (EP).
 Study Design: This was a case–control study.
 Setting: This study was conducted at the Department of Obstetrics and Gynecology at Al-Yarmouk Teaching Hospital, from February 2017 to October 2017.
 Patients and Methods: The study included 90 pregnant women, aged from 21 to 40 years old in their the first trimester attending the outpatient and inpatient clinic with single fetal pregnancy with a gestational age range between 6th and 8th weeks, they were divided into three groups; Group A: Includes 30 cases with uncomplicated pregnancies in their first trimester, Group B: Includes 30 cases diagnosed as missed miscarriages, and Group C: Includes 30 cases diagnosed as EPs.
 Results: There was no significant difference in the maternal age and body mass index between the three groups, β-human chorionic gonadotropin, activin A, FS, and their ratio were significantly higher in the healthy intrauterine pregnancy compared to missed miscarriage and EP. Activin A and activin A/FS ratio had an excellent ability to discriminate EP from healthy intrauterine pregnancy, while FS alone had good ability to discriminate between EP and intrauterine pregnancy. Activin A had fair ability to discriminate missed miscarriage from intra healthy uterine pregnancy, while both FS and activin A/FS ratio had poor ability to differentiate missed miscarriage and intrauterine pregnancy.
 Conclusion: Activin A can be used with high accuracy as a biomarker for EP and missed miscarriage, FS alone, and activin A/FS ratio is a possible biomarker, but it offers lower accuracy compared to activin A alone.

Prevalence and Risk Factors for Transmission and Genotype of HCV in Iraqi Patients

BACKGROUND: Hepatitis C virus (HCV) infection is a serious public health problem in the world, and about 170 million patients are chronically infected with HCV. Worldwide; different epidemiologic patterns of HCV infection have been identified.
 
 AIM OF THE STUDY: By this study, we try to know the prevalence and risk factors for HCV transmission in Iraqi patients and genotype distribution of the disease.
 
 PATIENTS & METHODS: In a cross sectional study of 355898 persons, 232645 males & 123253 females; had been enrolled for the study in Baghdad teaching hospital, Iraqi blood bank, Al-Yarmouk teaching hospital, Al-Nu'man teaching  Hospital and Al-Basrah teaching hospital from February 2017 to February 2019. Positive patients for hepatitis C antibody were further studied for way of transmission and viral load and genotype. History had been taken about the possible risk factor for HCV transmission which included (15) risk factors.
 
 RESULTS: A total of 355898 persons, 232645 males & 123253 females their Mean age at diagnosis was 47.3 (± 15.6) years, Ranged (19–78) years. The mean body mass index (BMI) of the study sample was 22.9 (± 3) kg/m2, studied all screen for hepatitis C antibody 1155 discovered to be positive 650 were males and 505 were females, further study done for viral load in 746 patients and genotype in 633 patients: 356 (48%) with high viral load, 390 (52%)with low viral load and 345 (52.8%) with genotype V and 301 (46.2%) with genotype IV, while genotype II was 2 (0.3%) and III 7 (0.5%), The most common possible ways of transmission of the disease by history in this study was blood transfusion 53%, dental procedure 42%, hemodialysis 36%, caesarean section 34.5%, while injured male during shaving 33%, patient who have surgical operation 24%, Tattooing in 8%, cupping in 6.6%, IV injection in 4% heterosexual seen in 2%, renal transplant in 2%, and only 1% in needle stick injury. while the more frequent genotype is 1 then 4. Hemodialysis and improper use of IV medication had been found to be more significant in HCV male patients .The relation between possible risk factor for transmission of HCV and residence, viral load were not significant.
 
 CONCLUSION: The most common probable risk factors as single risk factor for the male was blood transfusion, and for female was caesarean section. While for two risk factors for male were Blood transfusion and Hemodialysis and for female were Caesarean section & Dental procedure and for both gender were hemodialysis & dental procedure. 
 
 While for three risk factors for both gender were surgery, barbers, and dental procedure. In our study we had found the prevalence of HCV in our Iraqi big sample was relatively low. The most common genotype was genotype I then genotype IV with rarity of genotype III 0 and genotype II.

DENND1A and THADA Gene Polymorphism Among Iraqi Women With Polycystic Ovary Syndrome

Objectives: To study the two gene polymorphism (DENND1A and THADA genes) among Iraqi women with polycystic ovary syndrome (PCOS). Materials and Methods: This case-control study was done at the Gynaecological Department of Al-Yarmouk Teaching Hospital of AI-Mustansiriyah College of Medicine, Baghdad during January-December 2018. Two-hundred women were enrolled in the study, including 100 women with PCOS as the case group and 100 healthy and age-matched women as the control group. Main outcome measures were to analyze DENND1a gene polymorphism rs2479106 and THADA gene polymorphism rs12478601 at genotype and allelic levels. Results: The DENND1A gene polymorphism rs2479106 had three genotypes of AA, AG, and GG. The homozygous mutant genotype (GG) was considerably related to the incidence of PCOS (OR=5.43, 95% CI=1.13-25.97, P=0.034) with 5-time more risk compared with those carrying the wild homozygous genotype (AA). The heterozygous genotype (AG) was more but not statistically different (OR=1.73, 95% CI=0.85-3.54, P=0.131). At the allelic level, G allele was two times more frequent among cases compared to control cases with a highly significant difference. THADA gene polymorphism rs12478601 had three genotypes of CC, CT, and TT. Although TT genotype was repeated more among the case group than controls, the difference was not significant (P=0.346). Likewise, no significant differences were found in the allele distribution of this polymorphism. Conclusions: In general, the DENND1A-rs 2479106 polymorphism was considerably related to the incidence of PCOS among Iraqi women while THADA-rs12478601 polymorphism was not.

Employing Gamma Ray Irradiated Giardia lamblia as Trialed Vaccine in Experimental Animal

This is an experimental trial to prepare a vaccine from gamma-irradiated Giardia lamblia which is evaluated in experimental animals. The study was conducted from December 2015 to April 2016. The field survey of the parasite was conducted from those patients attending the laboratories of the Alawi Children's Hospital in Rusafa and the Al-Yarmouk Teaching Hospital in Karkh, through which 1250 stool samples of different age groups were examined. Five groups of mice were used in the study; the first was injected with normal saline and considered as a negative control group, the second was injected with cystic form of non-irradiated Giardia lamblia and considered as a positive control group, whereas the other three groups were injected with gamma irradiated Giardia lamblia at three different doses 10, 15 and 25 rad respectively. Giardia lamblia was primarily cultivated in liver infusion agar for ten days to obtain the active phase. On the sixth day, the cystic phase was purified and standardized to be used in the infection of mice with or without the exposure of gamma rays. Mice showed high sensitivity to parasitic infestation, in the gamma non-irradiated and the irradiated with gamma 10 rad, and 15 rad irradiated groups which was 100%. The results expressed an excystation process of the depleted phases and the release of the feeder phases. The results of the three irradiated groups consisted of histopathological changes of the small, and the rectum by dissection after two weeks of infection, with intestine amputation lesions, as well as ulceration and inflammation of the inflammatory cells represented in small numbers of neutrophil, lymphocytes, and eosinophils. The presence of ulceration and fall of epithelial cells in the intestinal cavity has been shown, and different forms of the parasite have been observed. Mice which was injected with irradiated G lamblia at high dose (25 rad), not show and sensitivity to the challenge infection and no excystation of thy parasite had been done. After 2 wreaks, a comparison was achieved between all study groups in which no histopathological changes were noticed in the mice irradiated with dose of25 rad. After another two weeks, a challenge dose was given (un-attenuated G lamblia) and mice were dissected after another two weeks, no changes on the level of histopathology of intestinal tissue were noticed the results suggested that mice acquire an immunity against the parasite infection.

Estimation of immunoglobulin ( IgG and IgM) in sera cutaneous leishmaniasis patients (L.donovani and L. infuntum) in Baghdad city

Leishmaniasis are parasitic diseases caused by protozoan flagellates of the genus Leishmania, parasites infecting numerous mammal species, including human. Baghdad city regarded as endemic area for cutaneous leishmanisis,so an expermental study was done in Baghdad city , the sample taken from the patients cutaneous leishmaniasis attending dermatologic clinic in Baghdad Teaching Hospital and Al Yarmouk Teaching Hospital during the period from first of October 2017 to the first of February 2018.Ninety blood samples were collected from infected and suspected people with cutaneous leishmaniasis , which were confirmed by laboratory tests because they were all infected by amastigote form of cutaneous leishmaisis, as well as the data clarified there are a shared rate among people with cutaneous leishmaniasis and visceral leishmaniasis represented by L.donovani was( 10,11.1%) ,while L.infuntum was(40, 44.4%).

Rationales for the Use of Cancer Stem Cells Markers in the Staging of Papillary Thyroid Carcinoma.

Fine needle aspiration biopsy (FNAB) is a standard procedure for the detection of thyroid nodules malignancy, yet 10-25% of the sample diagnosed may go undetermined or suspicious. The utility of cancer stem cell markers (CSCM) as a differential diagnosis molecular marker in nodules of suspicious decision in FNAB was hypothesized. Papillary thyroid carcinoma (PTC) and thyroid fibroadenoma (TFA) samples were selected to test the hypothesis. The samples employed in this study were from patients who had thyroid hyperplasia and a suspicious or undetermined diagnosis by FNAB. The patient underwent a successful thyroidectomy at Al-Yarmouk Teaching Hospital in Baghdad between January 2015 and December 2017. All nodule samples underwent a systematic histopathological examination after resection. Tumors diagnosed as PTC and those diagnosed as fibroadenoma (TFA) were selected for this study. Collectively 39 PTC and 11 TFA nodules were included. Quantitative reverse transcriptase real-time PCR (qRT-PCR) and immunohistochemistry (IHC) were used to determine levels of mRNA and proteins of CSCM ALDH1A1, CD44, ABCG2, and Oct3/4 in both types of tumors were used. This study revealed that the expression levels of CSCM were significantly increased in PTC tissues when compared to benign tissues and the positive correlation was found between the CSCM expression levels and tumor stage, size, and gender. In conclusion, for a more precise diagnosis, we suggest these markers be included in what is currently available to characterize malignancy from what is not in thyroid cancer, as well as for the staging process of PTC.

Effect of Curcumin Supplement on Pulmonary Functions, Total and Differential White Blood Cell Count, Serum Level of Leptin and Body Mass Index in a Sample of Iraqi Patients with Chronic Bronchial Asthma

Asthma is a heterogeneous disease, usually characterized by chronic airway inflammation together with increased oxidative stress that lead to clinical symptoms of asthma. 
 Obesity is a known risk factor of asthma as the obesity is correlated with systemic inflammation and airway restriction. Curcumin, a natural product derived from the rhizomes of Curcuma longa (Turmeric), has a wide range of beneficial properties including anti-inflammatory and weight reducing agent. This study was designed to evaluate the effect of curcumin as supplement therapy on the pulmonary function, total and differential white blood cell count and metabolic status of chronic bronchial asthmatic patients. It is a prospective randomized controlled interventional study carried out on 40 patients visiting Al-Yarmouk teaching hospital and conducted from October 2017 to April 2018. The patients were allocated into group1; include 17 asthmatic patients assigned to receive conventional therapy for asthma alone, and group 2; include 23 asthmatic patients assigned to receive conventional therapy for asthma plus 750 mg curcumin capsule twice daily for two months. Results revealed significant improvement in forced expiratory volume in one second (FEV1) and the ratio of forced expiratory volume in one second to forced vital capacity (FEV1/FVC) in group 2 patients after two months(P<0.01). The total white blood cell count didn’t show any difference after treatment except decrease in neutrophil count after curcumin supplement (p< 0.05). The leptin level and body mass index present with no significant difference in both groups after two months (p >0.05).

Effect of Curcumin Supplement on Pulmonary Functions, Total and Differential White Blood Cell Count, Serum Level of Leptin and Body Mass Index in a Sample of Iraqi Patients with Chronic Bronchial Asthma

Asthma is a heterogeneous disease, usually characterized by chronic airway inflammation together with increased oxidative stress that lead to clinical symptoms of asthma. Obesity is a known risk factor of asthma as the obesity is correlated with systemic inflammation and airway restriction. Curcumin, a natural product derived from the rhizomes of Curcuma longa (Turmeric), has a wide range of beneficial properties including anti-inflammatory and weight reducing agent. This study was designed to evaluate the effect of curcumin as supplement therapy on the pulmonary function, total and differential white blood cell count and metabolic status of chronic bronchial asthmatic patients. It is a prospective randomized controlled interventional study carried out on 40 patients visiting Al-Yarmouk teaching hospital and conducted from October 2017 to April 2018. The patients were allocated into group1; include 17 asthmatic patients assigned to receive conventional therapy for asthma alone, and group 2; include 23 asthmatic patients assigned to receive conventional therapy for asthma plus 750 mg curcumin capsule twice daily for two months. Results revealed significant improvement in forced expiratory volume in one second (FEV1) and the ratio of forced expiratory volume in one second to forced vital capacity (FEV1/FVC) in group 2 patients after two months(P<0.01). The total white blood cell count didn’t show any difference after treatment except decrease in neutrophil count after curcumin supplement (p< 0.05). The leptin level and body mass index present with no significant difference in both groups after two months (p >0.05).