Centers In Baghdad Research Articles

A Study of the Clinical Characteristics of Patients with Low Back Pain at a Single Center in Baghdad

Background: Low back pain is a prevalent and consequential problem in contemporary culture. In the early phases of their careers, many athletes who train particularly hard have considerable low back difficulties Aims of study is to enhance understanding and guide best management practices for those with or at risk of low back pain and to identify diverse aspects of clinical and epidemiological factors in Iraqis for low back pain. Patients and methods: A cohort of 440 individuals diagnosed with Low back pain (LBP) from the rheumatology department at Baghdad Teaching Hospital-Medical City in Baghdad province were involved in the current cross-sectional investigation. The sample consisted of 180 men and 260 women, with an average age of 45.7±14.8 years. The research was carried out from 12/October/2023 to 12 /March/2024. Results: All individuals in this study had LBP. The means age was 45 for the group of patients under consideration. 7 ± 14. 8 years. LBP had the highest incidence in the middle-aged (40-59 years 23%) and the lowest was recorded for the aged above 70 years (7. 5%). Females accounted for 59. 1% of the participants. Most of them; a percentage equivalent to 75. 5% were married. Approximately a third or 30% were employed while, 70.9% of the respondents were jobless. 6 % were overweight people and 77 % were non smokers in the study group. The mean age at the first complaint, visit and diagnosis of the disease were 43. 0 ± 14. 0 years (range: 11–75), 43. 3 ± 14. 2 years (range: McGregor observed that 11% to 78% of patients had some degree of in Continuation of Disturbances: Symptoms, defective vision, and 43. 5 ± 14. 2 years (range: 14–78),respectively. Intervertebral disc prolapse was the most frequent diagnosis among the patients with LBP (49. 8%), while infections were the least frequent (0. 2%). In the following aspects of the Oswestry Low Back Pain Disability Scores, majority participated as follows; 44. 3% with fairly severe pain intensity, 42% who require some help with personal care but mostly manage with it, 39. 5% who lift heavy weights but manage light to medium weights, 34. 1% who are prevented from walking more than 100 yards by their pain, 37. 5 The Analyzed Oswestry Low Back Pain Disability Score mean was 22. 22 ± 7. 26. Conclusion: LPB has a higher frequency among the female population

The psychological impact of COVID-19 pandemic on Iraqi health workers.

To explore the psychological impact of coronavirus disease-2019 on frontline healthcare workers in Iraq. The cross-sectional study was conducted from November 2020 to September 2021 after approval from the ethics review committee of the College of Medicine, Mustansiriyah University, Baghdad, Iraq, and comprised doctors and nurses from 4 teaching hospitals and 8 primary healthcare centres in Baghdad. Psychological sequels, like anxiety, depression, fear and insomnia, were assessed along with exposure to coronavirus disease-2019. The study questionnaire was based on the Patient Health Questionnaire Anxiety and Depression Scale. Data was analysed using SPSS 26. Of the 400 participants, 288(72%) were doctors and 112(28%) were nurses. Overall, 215(53.7%) subjects had had a coronavirus disease-2019 infection, 192(48%) reported having anxiety, 148(37%) fear, 100(25%) depressive symptoms, and 51(12.8%) complained of insomnia. Doctors were more likely to have anxiety than nurses (p<0.05), but the difference in terms of depression was not significant (p>0.05). The mental health of the frontline healthcare workers was found to have been affected by the coronavirus disease-2019 pandemic, with anxiety and fear being the main symptoms.

Measuring The Level of The Hormone Progesterone on The Day of Transfer of Fresh and Frozen Embryos and Its Impact on Pregnancy Outcomes

Objective: Prediction of the effect of the hormone progesterone on pregnancy results that measured on the day of transfer of fresh and frozen embryos. Method: This research at reproductive centres in Baghdad from May 2022 to April 2023 examined how serum progesterone levels affect embryo transfers in ICSI procedures in 100 fresh or frozen cycle women. The study examined clinical data and endometrial preparation techniques to determine if progesterone levels affect pregnancy rates. Data were analysed using SPSS to determine how pre-transfer hormonal levels affected implantation and pregnancy outcomes. Participants were selected according on inclusion and exclusion criteria. The study shows that progesterone is essential for IVF embryo transfers. Results: Compared to frozen cycles in females, fresh cycles had greater mean age and progesterone levels but lower COC number and 2PN levels, with no changes in BMI, MII, or injectable MII. Frozen cycles produced more good-grade embryos, whereas fresh cycles produced more fair-grade embryos. There were no differences in the number of "C" embryos. Fresh cycle groups had greater pregnancy rates (59.1%) than frozen cycle groups (38.9%), but progesterone levels did not change between cycle types. Conclusion: The study found that fresh cycles include older participants, greater progesterone but lower COC and 2PN levels, and higher pregnancy rates than frozen cycles. BMI, MII levels, embryo count, poor grade "C" embryos, and progesterone levels associated to pregnancy outcomes did not differ across groups.

Using the Weibull Distribution to Analyze the Reliability of Water Turbidity Removal and the Amount of Chlorine Remaining in the Water After Treatment

All water treatment centers in Iraq operate according to the standards specified in the legal regulations. Therefore, periodic evaluations must be conducted to study and analyze the quality of the outputs of these centers. The research used the two-parameter Weibull distribution to evaluate the reliability of turbidity removal and residual chlorine in the water at the Rashidiya water center in Baghdad, Iraq. The distribution parameters were estimated using the Maximum Likelihood method with the Matlab 2022 program, and the chi-square test for Goodness of Fit was used at a significant level of 0.05. The study found that the mean (and median = 9 NTU) of turbidity values were 9.47 NTU, which is within the permissible limit, and the mean (and median = 0.03 mg/L) of chlorine values were 0.0295 mg/L, much less than the permissible limit. The study also found that the average efficiency of turbidity removal was 72.179%, which is relatively acceptable, but needs improvement. The analysis showed that the value of reliability for the removal of turbidity was 0.99 ,and for the remaining amount of chlorine was 0.99, indicating that the Rashidiya water center was reliable during the study period. The study recommended several recommendations, the most important of which is the evaluation of all water treatment standards in the Rashidiya water center in particular and in all water treatment centers in Baghdad in general. Maintain continuous turbidity and chlorine levels monitoring to ensure compliance with permissible limits. Make efforts to improve the turbidity removal efficiency. Fostering collaboration between water treatment centers, researchers and regulatory agencies. Develop public awareness campaigns to educate the public on the importance of clean and safe water.

Proportion and Potential Risk Factors of Poor Glycemic Control among Patients with Type 2 Diabetes Mellitus: Experience of a Tertiary Center in Baghdad, Iraq, 2020

Background: Diabetes Mellitus is the most prevalent metabolic disorder worldwide. Effective diabetes self-management and keeping the Glycosylated hemoglobin level within the normal range could decrease the burden on the health system by reducing hospital admissions and diabetic complications, lowering the financial strain on the health system. Objective: To recognize the potential risk factors of poor glycemic control in patients having type 2 Diabetes Mellitus in Baghdad, Iraq. Patients and Methods: This cross-sectional study was conducted in the Diabetes and Endocrine Center at Al-Kindy Teaching Hospital, Baghdad, Iraq, from June to November 2020. The total number of the study's participants was 234. Based on the cutoff point of glycosylated hemoglobin of 7, the patients with glycosylated hemoglobin of ≥7 were considered uncontrolled, and those with glycosylated hemoglobin of &lt;7 were considered controlled. Results: The proportion of cases with uncontrolled diabetes was 68.4% (160). The remaining 74 patients had controlled diabetes. Age, sex, marital status, and employment status were not significantly associated with the control status (P&gt;0.05). The binary analysis showed a significant association observed between the control status and level of education (P=0.001), income (P=0.001), presence of comorbidities (P=0.028), positive family history (P=0.03), dyslipidemia (P=0.001), cholesterol level (P=0.002), high triglyceride level (P=0.001), and low-density lipoprotein-cholesterol level (P=0.025). The smoking status, body mass index, and high-density lipoprotein-cholesterol level were not significantly associated with the control status (P&gt;0.05). The disease characteristics, including the disease duration, fasting blood glucose, type of medication, self-monitoring, healthy diet, physical activity, and medication adherence, were significant factors (P&lt;0.001). The multivariate regression method showed that dyslipidemia, FBS≥130, physical inactivity, and poor medication adherence were significant predictors for uncontrolled DM (P-value = 0.03, 0.001, 0.03, and 0.043, respectively). Conclusion: The most important potentially modifiable risk factors for poor diabetes control were dyslipidemia, physical inactivity, and poor adherence to the management protocol. Enhancing the education of patients and their healthcare providers on these factors is crucial to improving the patients’ control status.

Knowledge, Practices, and Barriers of Communication Skills among a Group of Primary Health-care Physicians in Baghdad 2023

Abstract Background: Communication skills are essential for health professionals to achieve a positive relationship with patients, improving their health and quality of life. Communication is the foundation for obtaining medical history and conveying a diagnosis and treatment plan. Objectives: To assess the knowledge, practice of communication skills among primary care physicians, to find out any barriers related to the communication skills, and the association between the studied variables with knowledge and practice of communication skills. Methodology: A cross-sectional study with analytic component conducted in 40 Primary Health Care Centers in Baghdad, with data collection during a period of 4 months from March 1, 2023 to June 30, 2023. Data had been collected in a questionnaire by direct interview with the participants done by the researcher and including three parts: (participants’ sociodemographic characteristics, knowledge, practice toward communication skills, and the barriers to successful communication). Results: The total number of the participants was 126. The level of knowledge of the participants about physician-patient communication skills was fair in 74 (58.7%) of them, poor in 35 (27.8%). The highest prevalence of poor level of knowledge was seen in participants with specialties other than family medicine and in those with more than 20 years of experience. Level of practice of the participants toward physician-patient communication skills was good in 63 (50%) of them and 63 (50%) had moderate level of practice. The highest prevalence of moderate level of practice was seen in elderly age participants. The most common barrier as mentioned by the participants was time limitation. Conclusion: The majority of primary health-care physicians in this study have fair levels of knowledge, with moderate to good level of practice about communication skills. Family physicians and those who had experience between 10 and 19 years had better knowledge about communication skills. Time limitations are perceived as the biggest hindrance to communication followed by the presentation with multiple complains.

Application of PCR and ELISA for Investigation the Helicobacter pylori in Stool Specimens of Infected Patients

Background: Infection with Helicobacter pylori is a global health issue, and non-invasive and accurate testing is a promising diagnostic method. Because H. pylori antibodies collapse quite gradually even after effective treatment. So, the tests for identifying the antibody of H. pylori are missing specificity and sensitivity. Instead, the tests of stool antigen for H. pylori are described as an alternative method because they have more reliability and simplicity. Aim: The study was aimed to assess the performance of enzyme-linked immunosorbent assays (ELISA), for the detection of H. pylori antigen in stool and compare it to molecular tests by using two housekeeping genes. Methods: Stool samples were collected from patients (85) who attended the Gastroenterology and Hepatology Teaching Center in Baghdad, Iraq, and underwent esophagogastroduodenoscopy (EGD) for biopsy in a period extended from November 2020 to July 2021. PCR and ELISA were used to Investigate H. pylori in stool specimens of infected patients. Results: The result revealed that 74/85 (87.88%) of specimens were positive by ELISA, whereas 49/85 (57.6%) were positive for the 16 SrRNA gene related to Helicobacter genus and 35/85 (41.1%) were positive for amiA gene related to H. pylori species, and that means the ELISA test is more accurate than PCR analysis for detection of H. pylori bacteria in stool specimen. Conclusion: Detection H. pylori Ag using the ELISA test was superior to the molecular test. Therefore, the ELISA test might replace other methods and could be used for the detection of active H. pylori infection before the inauguration of treatment between dyspeptic patients.

Isolation, Identification and Antimicrobial Susceptibility of some Bacterial Species Isolated from Dental Plaque

Dental plaque is a sticky bacterial film that develops on teeth producing plaque as a result. If it ‘is not removed with regular dental cleanings and daily brushing, it can initiate oral health issues such as gum diseases and dental caries. This study aimed to determine the prevailing bacterial species found in some patients’ dental plaque cases and dental caries and to analyze the antimicrobial susceptibility of the obtained bacteria. A total of 60samples of dental plaque were taken from patients who attended the health centres in Baghdad with different ages using cotton swabs. All gained swabs were transported to the microbiology laboratory and cultured on culture media. According to standard laboratory diagnosis protocols, primary diagnosis was performed. VITE 2Compact Automated-System (GP (and (GN (diagnosis cards used according to manufacturer company constructions (BioMérieux)to confirm the diagnosis. Antibiotic susceptibility test was done by using antibiotic disks according to Kirby-Bauer method. Out of 60samples, forty-two (70%) samples showed growth on culture media, while 18(30%) showed no growth, most of the isolates, 29(69.0%) were Gram-positive bacteria represented by Streptococcus mutans, Staphylococcus aureus, and only 13(30.9%) of isolates were Gram-negative includes Klebsiella pneumonia and Escherichia coli.According to the antibiotic susceptibility test results, Gram-positive bacteria showed high resistance against amoxicillin, Cefotaxim and erythromycin with percentages of 86.2%-and 89.6%respectively. Gram-negative bacteria showed high resistance against amoxicillin and erythromycin with percentages of 76.9%and 69.2%against Cefotaxim

Deep Learning Models and Fusion Classification Technique for Accurate Diagnosis of Retinopathy of Prematurity in Preterm Newborn

اعتلال الشبكية الخداجي (ROP) هو السبب الأكثر شيوعًا لعمى الأطفال الذي لا رجعة فيه، ويعتمد تشخيصه وعلاجه على الدرجات الذاتية بناءً على سمات الأوعية الدموية في شبكية العين. ومع ذلك، فإن هذه الطريقة شاقة وعرضة للخطأ، لذا فإن الأساليب الآلية مرغوبة لمزيد من الدقة والإنتاجية. تهدف هذه الدراسة إلى تطوير نهج قائم على التعلم العميق للتشخيص الدقيق لمرض اعتلال الشبكية الخداجي الزائد عند الأطفال الخدج باستخدام نماذج التعلم التحويلية وتقنية تصنيف الاندماج. زودنا مركز الأمل للعيون في العيادة الخاصة في بغداد، العراق، بـ 2776 صورة لقاعدة فحص مرضى اعتلال الشبكية الخداجي بين عامي 2015 و2020، واستخدمنا هذه الصور لتدريب ثلاثة نماذج للشبكات العصبية التلافيفية العميقة (ResNet50 وDensenet161 وEfficientNetB5). تم استخدام نهج مصنف الاندماج لدمج النماذج الثلاثة من أجل تشخيص شامل ودقيق. تتميز النماذج الثلاثة بمعدلات دقة نسبية تبلغ 69.78٪ و80.57٪ و81.29٪ في تصنيفاتها الخاصة. ومع ذلك، زادت الدقة الإجمالية إلى 90.28 في المائة عند استخدام مصنف الاندماج. هذا يدل على أن الطريقة المقترحة مفيدة لتحديد اعتلال الشبكية الخداجي عند الخدج. تشير نتائج الدراسة إلى أن الطريقة المقترحة لديها القدرة على تعزيز الدقة والسرعة التي يتم بها تشخيص اعتلال الشبكية الخداجي بشكل كبير، مما قد يؤدي بدوره إلى الكشف المبكر عن المرض وعلاجه وتقليل احتمالية الإصابة بعمى الأطفال.

Investigating the mental health landscape of elderly people attending primary healthcare centers in Baghdad, Iraq

Investigating the mental health landscape of elderly people attending primary healthcare centers in Baghdad, Iraq

Prevalence of Impacted Third Molars Among Iraqi Patients Attending Al-Maghrib Specialized Dental Health Center in Relation to Age and Gender Using Panoramic Radiographs

Introduction: The most commonly impacted tooth is third molar. Aim: To investigate the prevalence of pattern of third molar impaction among patients attending Al-Maghrib specialized dental health center in Baghdad city. Materials and Methods: A cross-sectional analysis was conducted on digital orthopantomogram (OPGs) of high quality belonged to 519 patients referred to Al-Maghrib specialized dental health center in Baghdad city/Iraq between January2023 to June 2023. Data include age, gender and angulation type. Results: The age range was 20-70 years old. The prevalence of impacted third molar was 92%. The percentage of impacted lower third molar (51%) was higher than that of upper third molar (49%). Middle-aged patients (20-30, 31-40 years) recorded higher percentages of impaction than other age groups (31.7% and 32% respectively). Male gender revealed higher percentage (58%) of impaction than female gender (42%). Vertical and then mesioangular inclinations are the most prevalent types of lower third molar angulations (45% and 30% respectively). Conclusion: Higher prevalence of impaction in third molars was recorded in the current study that was more prevalent in the middle-aged patients with male predilection. The impaction was more common in the mandible than the maxilla. The most prevalent lower third molar angulation is vertical followed by mesioangular.

Finding the Best Route for Connecting Citizens with Service Centers in Baghdad Based on NN Technology

A geographic information system (GIS) is a very effective management and analysis tool. Geographic locations rely on data. The use of artificial neural networks (ANNs) for the interpretation of natural resource data has been shown to be beneficial. Back-propagation neural networks are one of the most widespread and prevalent designs. The combination of geographic information systems with artificial neural networks provides a method for decreasing the cost of landscape change studies by shortening the time required to evaluate data. Numerous designs and kinds of ANNs have been created; the majority of them are PC-based service domains. Using the ArcGIS Network Analyst add-on, you can locate service regions around any network site. A network service area is a region that comprises all accessible roadways (that is, routes that are within defined impedance) (that is, streets that are within specified impedance). In contrast to the Google Maps application, the 5-minute service area for a site on a network comprises all streets that can be accessed within five minutes.

Evaluation of Health Care Services at Primary Health Care Center in Baghdad City

Objective: To evaluate services that provided in "chief health care centers in the capital of Iraqi then to comparability of these centers about services and comparative to such excellence". Materials: ", using the evaluation approach, descriptive design these studied made to Evaluate of excellence provided care services to the clients at health care centers in Baghdad. a sample was probabilities appearing in different stage of (15) was selected of health care centers. study sample was consisting from (5) typical centers, (5) municipal centers, and (5) countryside centers. created questionnaire shaped was collected from (33) objects. The first part consisted from (8) portions of point that embrace incorporeal (8) objects, consistency (4) objects, reply (4) items, prominence and self-assurance (4) objects and understanding (5) items. through pilot study Rationality and reliability of the survey are determined. Data are gathering throughout using survey and the conference technique. descriptive statistical applicate on data analysis approach of meltable statistical methods are showed in result paper below Outcomes: all-out of PHC centers services shoes increase and excellence and no variance between these HC centers in different sectors built on such value in the most department of health care. Conclusion: Depending on the study outcomes, primary health care services offered in health centers were of an acceptable quality

Prevalence and risk factors of antenatal depression among pregnant women attending primary healthcare centers in Baghdad, Iraq: A cross-sectional study

Prevalence and risk factors of antenatal depression among pregnant women attending primary healthcare centers in Baghdad, Iraq: A cross-sectional study

Demographic and Clinical Characteristics of Kidney Donors at First Check: A Single-Center Experience.

Kidney transplant is the best treatment for patients with end-stage kidney disease. In many regions of the world, including the Middle East, most kidney transplants are from living donors. In contrast to recipients, data for living donors remain scarce. Here, we describe living donor baseline characteristics at first hospital check at a single center in Baghdad, Iraq. We collected and analyzed demographic, laboratory, imaging, and histocompatibility data from donor records at the Nephrology and Renal Transplantation Center, Medical City-Baghdad, Baghdad, Iraq, from July 2022 to September 2022. We included 124 kidney donors (56.4% male) who donated their kidneys 1 to 3 years previous to our study, with a mean age of 34.84 ± 10.04 years and mean body mass index (weight in kilograms divided by height in meters squared) of 27.11 ± 2.12. Most donors donated their kidneys to a firstdegree relative (69.2%); blood group O was the most prevalent (47.5%). More than half of the donors were unemployed. Histocompatibility testing showed that 40% of the donors had >3 human leukocyte antigen mismatches with their recipients, and 30% of the recipients were high-risk sensitized patients with a calculated panel reactive antibody >50%. Regarding the virus status, 68.5% of the donors tested positive for cytomegalovirus immunoglobulin G, 8% of the transplants were high-risk cytomegalovirus status, and 43.5% tested positive for Epstein-Barr virus immunoglobulin G. Renal imaging showed that 75.8% of donors had a single artery and 24.1% had a double artery (26.6% double left, 40% double right, and 33.3% both). For living transplant procedures at a single center in Iraq, most were from related donors. Most donors are unemployed, which mandates future health and social support. High immunological and viral risks must not be ignored in a single center with living related donors.

An overview of neuro-ophthalmic disorders at Jenna Ophthalmic Center, Baghdad, Iraq (2021-2022).

Neuro-ophthalmic disorders are often documented individually for each illness, with little data available on their overall incidence and pattern. The overall incidence of neuro-ophthalmic illnesses in Iraq is still not recorded. This study aimed to evaluate the clinical, demographic, and etiological features of patients seeking consultation at an Iraqi neuro-ophthalmology clinic. A prospective cross-sectional observational research was conducted at the Janna Ophthalmic Center in Baghdad, Iraq. The center serves a diverse patient population from various governorates. All newly diagnosed patients with neuro-ophthalmic disorders who visited the neuro-ophthalmological clinic, regardless of gender or age group, were included. The neuro-ophthalmologist established a diagnosis for each case by reviewing the patient's medical history, doing physical examinations, administering specific tests, and, in certain cases, using neuroimaging methods. The duration of the study was extended from March 2021 to November 2022. Among the 6440 patients evaluated, 613 cases were confirmed at the neuro-ophthalmology clinic. Ischemic optic neuropathy (NAION, AION, and PION) was the most prevalent diagnosis, accounting for 17.61% of newly reported cases in the field of neuro-ophthalmology. This was followed by sixth nerve palsy. Diabetes mellitus affected 42.7% of the cases, followed by hypertension, which affected 39.3% of the participants. The incidence of neuro-ophthalmic diseases tended to be high. Ischemic optic neuropathy and sixth nerve palsy, traumatic/compressive optic neuropathy, and papilledema were the most common neuro-ophthalmic disorders reported.

Prevalence and perception of herbal use among diabetic patients attending primary health center in Baghdad

Prevalence and perception of herbal use among diabetic patients attending primary health center in Baghdad

Prevalence and Factors Associated with Sarcopenia among a Sample Aged 60 Years and Older in Iraq

Abstract Background: Aging is an unavoidable process characterized by a progressive decline in body organs and skeletal muscle. Sarcopenia is defined as low muscle mass and function; it is diagnosed according to the working group of sarcopenia definition; also, it can predict the adverse disability outcome and subsequent functional deterioration. Objectives: This study aims to estimating the prevalence of sarcopenia in old Iraqi adults and determines some sociodemographic factors that may be related. Methods: A descriptive cross-sectional study was conducted on 500 elderly aged ≥60 years in a community-dwelling and senior citizen center in Baghdad. The data were obtained from a questionnaire (sociodemographic and behavioral data) in addition to anthropometry measurements. The cut-off point score was derived from the European Working Group on Sarcopenia in Older People 2. Results: Sarcopenia was present in 15%, 21.5% in males and 8.2% in females. It was positively associated with aging, significantly associated with males, marital state, retirement, nonsmoker, alcoholic, fall history, normal body mass index, and elderly. While it was negatively related to educational level and physical activity. Conclusions: Sarcopenia prevalence was presented with a considerable prevalence among old adults, as well as had a great association with all behavioral and lifestyle variants studied.

Biochemical Assessment of Insulin and Dopamine 2 Receptors in Patients with Type 2 Diabetes

Dopamine (DA) plays a key role in the body's regulation of insulin production. This study aimed to estimate insulin and dopamine 2 receptors in type 2 diabetic patients. The study included 180 subjects aged (20-65) years during the period from November 2022 to March 2023. They were divided into two groups: 120 patients with type 2 Diabetes mellitus (60 males and 60 females), and 60 healthy individuals (30 males and 30 females) as a control group. The biochemical tests (insulin and dopamine 2) were measured by the Human Insulin ELISA kit and Human Dopamine 2 receptor ELISA kit in Bioassay Technology Laboratory. The HbA1c, urea, and creatinine were measured by the kit from Roche/ Hetachi Diagnostics Ltd Company. The fasting blood glucose and HbA1c were measured to diagnose all patients with T2DM and controls to confirm the subjects with T2DM. The samples were obtained from the AL Kinday Hospital and Endocrine Center in Baghdad, Iraq. The results of this study explained that the patients and controls were comparable in age, gender, and smoking status with no significant differences (P&gt; 0.05). while results reported that there was a greater significant difference (p&lt;0.01) in levels of the mean for fasting blood sugar (FBS), glycated hemoglobin (HbA1c), and a significant difference (p&lt;0.05) in urea and creatinine levels between the type 2 diabetic patients and the controls there was a significant difference detected in values of insulin and dopamine 2(p&lt;0/05) between the patient and control groups. It can be concluded from our study that those who had type 2 diabetes mellitus had higher levels of dopamine and insulin when compared with the control group.

Nitric Oxide and Hypochlorite Assessment and Screening of some β-Lactamase Encoding Genes among Gram Negative Bacteria in Patients with Acute Leukemia

Objective: The serologic levels of both nitric oxide (NO) and hypochlorite (ClO-) were assessed in this study for Iraqi acute leukemic patients infected with Gram negative bacteria (GNB). Alongside, the phylogenetic analysis for both blaSHV and blaTEM genes of GNB was performed. Methods: The clinical samples were recovered from acute leukemic patients at hematology center in Baghdad from January 2021 to December 2021. The identification of bacterial isolates and susceptibility test were performed using Vitek 2 Compact System. Serum levels of NO and ClO- were assayed by Enzyme Linked Immunosorbent assay and colorimetric method, respectively. Gene screening was done utilizing polymerase chain reaction. DNA sequencing, GenBank accession numbers submission, and phylogenetic analysis were also conducted. Results: From 260 patients with acute leukemia, 485 clinical samples were collected from different sites. Of this total, 70 (15%) isolates of GNB were obtained, distributing as Klebsiella pneumoniae 23 (33%), Escherichia coli 21 (30%), Pseudomonas aeruginosa 18 (26%), and Acinetobacter baumannii 8 (11%). These isolates were mainly collected from urine 39 (55.71%), followed by blood 23 (32.85%), and the least from swabs 8 (11.42%). The infections of GNB were higher among acute myeloblastic leukemia (AML) patients 40 (57.14%) than these with acute lymphoblastic leukemia (ALL) 30 (42.85%). The levels of NO were higher among groups of patients than control groups. Additionally, ClO-levels were observed to be slightly increased in patients above these of controls. Most isolates of K. pneumoniae and E. coli showed high resistance rates for penicillins (ampicillin and ticarcillin), cephalosporins (ceftazidime, cefotaxime, ceftriaxone, and cefepime), followed by gentamicin and ciprofloxacin. Cefoxitin, aztreonam, imipenem and meropenem were nearly more effective against GNB isolates. On the other hand, about half isolates P. aeruginosa and all A. baumannii were resistant to the tested antibiotics. Extended Spectrum β- Lactamases (ESBLs) were released in 49 (70%) of the tested isolates of GNB. The multidrug resistant (MDR) pattern was noticed among 58 (82.85%) of GNB. Interestingly, ESBLs producing MDR isolates were determined in 34 (58.62%) of the studied GNB. Genotypic screening revealed that blaSHV and blaTEM genes were characterized in 20 (28.57%) and 32 (45.71%) of GNB isolates, respectively, while all GNB were negative for blaCTX-M. DNA sequencing of blaSHV amplicons revealed the occurrence of one point mutation (111T&gt;A) in six isolates of K. pneumoniae with a missense effect (p.31Q&gt;L) on the encoded protein. Forty-five GenBank accession numbers were recorded in NCBI to represent the studied variants of ESBLs. Phylogenetic analysis of both blaSHV and blaTEM displayed the possible epidemiologic routes of the tested GNB by detecting the origin host, source of collection, and geographic spread as compared with the reference sequences. Conclusion: high serum levels of both NO and ClO- indicated the potential role of these microbicidal agents to predict the serious infections of GNB in acute leukemia population. Phylogenetic analysis represented an important tool, possibly aiding in early control and prevention of pathogenic GNB.