Children's Teaching Hospital Research Articles

THE ROLE OF NUTRITIONAL STATUS IN THE PERSISTENCE OF MEASLES IMMUNITY AMONG CHILDREN: A MULTIVARIATE ANALYSIS

<p><strong>Background:</strong> The persistence of measles immunity in children is influenced by multiple factors, including nutritional status. This study aimed to assess the role of body mass index (BMI) as a proxy for nutritional status in the persistence of measles immunity, alongside other socio-demographic factors, in a pediatric population. <strong>Methods:</strong> A multivariate logistic regression analysis was conducted on 200 children (2-15 years) attending the University Teaching Children's Hospital in Lusaka, Zambia. Immunity retention was measured through IgG serology. BMI represented nutritional status, and the analysis adjusted for key variables such as HIV status, breastfeeding history, sex, and education level. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated to determine the association between nutritional status and immunity persistence. <strong>Results:</strong> Children categorized as well-nourished had significantly lower odds of waning immunity (OR = 0.37, 95% CI = 0.16–0.83, p = 0.016). However, for children with over or under malnutrition, the association was not statistically significant (OR = 0.23, 95% CI = 0.03–1.62, p = 0.140). Additionally, HIV-positive status was associated with decreased immunity retention (OR = 0.28, 95% CI = 0.14–0.56, p < 0.001). Breastfeeding was positively associated with immunity persistence (OR = 3.34, 95% CI = 1.53–7.29, p = 0.003), while other socio-demographic factors such as sex and education level showed no significant effect. <strong>Conclusion:</strong> Nutritional status, as measured by BMI, plays a significant role in the persistence of measles immunity among children, with over- and under-nourished children being associated with lower immunity retention. These findings suggest that nutritional interventions may be necessary to improve vaccine efficacy, particularly in populations with high rates of malnutrition or obesity. The results also highlight the need for further investigation into the mechanisms linking nutritional status to immune response and the development of targeted public health strategies to optimize measles immunization outcomes in children.</p><p> </p><p><strong> Article visualizations:</strong></p><p><img src="/-counters-/soc/0722/a.php" alt="Hit counter" /></p>

Evaluation of the Level of Electrolytes in Children with Steroid Sensitive or Steroid Resistant Nephrotic Syndrome

Background: Childhood idiopathic nephrotic syndrome is one of the most common conditions pediatric nephrologists encounter globally. Nephrotic syndrome is characterized by proteinuria, hyperlipidemia, and edema. The degree and duration of proteinuria have an impact on serum electrolyte levels. However, local data is limited. Objectives: To assess and compare the degree of electrolyte imbalance and its relationship to kidney function indicators during relapse and remission in children with idiopathic nephrotic syndrome. Methods: In this case-control study, blood samples were collected from 80 Iraqi children with an age range of (2-14) years. They were divided into three groups: Group I (20 individuals with steroid-sensitive nephrotic syndrome (SSNS)), Group II (20 individuals with steroid-resistant nephrotic syndrome (SRSN)), and Group III (40 healthy individuals as the control group). Serum electrolyte levels (Na, Ca, Cl, and K) were measured by an ion-selective electrode (9180 electrolyte analyzer). Blood creatinine and urea were measured by a Cobas c311 autoanalyzer during the relapse and remission phase. The patients were clients of the pediatric nephrology consultation center at the Children's Teaching Hospital / Baghdad Medical City and Al-Batoul Teaching Hospital for Women and Children from 15 February to 20 August 2022. The controls were healthy children whose medical history was reviewed to eliminate a history of kidney disease and underwent a comprehensive physical examination. Controls were recruited from a network of family, friends, relatives, and the National Autism Center/ Child Protection Teaching Hospital affiliated with Medical City/Baghdad. Results: Serum Calcium levels showed a clear decrease in all SSNS and SRSN patients compared to the control group. The levels of Sodium and Chloride were significantly lower than the control group during the relapse phase. The results of the relapse phase of SRNS patients indicated higher serum potassium concentration compared with the control group and the SSNS patient group, with a statistically significant difference). Conclusion: All children with idiopathic nephrotic syndrome had hypocalcemia in the relapse and remission phase. SRNS cases had hyperkalemia, Sodium, and chloride fluctuated between low levels during the relapse phase and normal levels during the remission phase.

Assessment of growth status in children and adolescents with type 1 diabetes mellitus in Baghdad: a case-control study.

To assess growth parameters in adolescents and children with type 1 diabetes mellitus, and the factors influencing their growth. The case-control study was conducted from February to December 2020 at the Endocrine Outpatient Clinic of the Central Child Teaching Hospital of Paediatrics, Baghdad, Iraq, and comprised patients aged 2-16 years who had type 1 diabetes for at least a year. The patients formed group A, while healthy controls matched for age and gender from different schools and kindergartens formed group B. Weight, height and body mass index of all the subjects in both groups were measured and worked out, and the values were compared. Data was analysed using SPSS 25. Of the 192 subjects, 96(50%) were in each of the 2 groups; 50(52.1%) girls and 46(47.9%) boys in group A, and 58(60.4%) girls and 38(39.6%) boys in group B. The overall mean age was 9.66±3.26 years. Group A children had significantly lower mean height, weight and body mass index Z scores compared to group B (p=0.001). The height Z score of group A children was significantly inversely associated with age, duration of disease, and glycated haemoglobin level (p=0.001), while the weight Z score was significantly inversely correlated with age and glycated haemoglobin (p=0.001). The body mass index Z score of group A was significantly inversely associated with age and glycated haemoglobin level (p<0.05). Children with type 1 diabetes mellitus had significantly lower mean height, weight and body mass index Z scores compared to their counterparts in the control group. Pubertal age group, poor glycaemic control, longer disease duration, and using conventional insulin regimen were the factors affecting growth parameters.

Factors affecting parental refusal of lumbar puncture in Iraqi children in COVID-19 era: a cross-sectional study.

To assess the frequency and causes of parental lumbar puncture refusal for their children. The cross-sectional study was conducted at the Central Child Teaching Hospital, Baghdad, Iraq, from October 1, 2021, to April 1, 2022, and comprised children aged at least >1 month at the emergency department who had been advised to undergo lumbar puncture. Data from the mother of the child was collected using an interviewbased questionnaire, exploring. demographic characteristics, the cause of lumbar puncture refusal, as well as knowledge of the advantages and risks of lumbar puncture. Data was analysed using SPSS 26. There were 128 children with a mean age of 3.9±2.1 years (range: 1-120 months). The parents of 18(14%) patients refused the procedure, and the most frequent reason was fear of paralysis 12(67%). Refusal was significantly associated with mother's age, parents' levels of education, and parents' knowledge of the risks of lumbar puncture (p<0.05). Raising public awareness and parents' educational level regarding the necessity and safety of lumbar puncture procedure is vital to decrease the refusal rate and ensure a better health outcome.

Acute renal injury among seriously ill Iraqi children: risk factors, management, and outcome.

To determine the frequency of acute kidney injury in seriously ill young patients, and to find out the risk factors linked to renal impairment. The cross-sectional study was conducted from June 1 to December 1, 2019, at the Central Child Teaching Hospital, Baghdad, Iraq, and comprised patients of either gender aged from >28 days to <18 years who presented to the emergency department with any critical acute illness who had to undergo hospitalisation. Kidney Disease Improving Global Outcomes criterion was used to identify patients having acute kidney injury. Such patients were followed up during their hospitalisation and their follow-up data was collected daily till discharge... Data was analysed using SPSS 25. of the 485 critically ill paediatric patients, 113(23.3%) had acute kidney injury; 57(50.9%) females and 56(49.1%) males. The overall mean age was 18.68±25.8 months (range: 1.5-120 months). There were 46(40.7%) patients with stage 3 disease. The incidence of acute kidney disease was not significantly associated with either age or gender (p>0.05). Diarrhoea and vomiting were the only complaints that had a significant association with acute kidney injury (p=0.001). Sagwa was consumed by 40(8.2%) cases, and 35(87.5%) of them developed acute kidney injury (p=0.001). Ventilator was used in 12(10.6%) cases, Of the total 65(13.4) cases of mortality, 21(18.6%) had acute kidney injury compared to 44(11.8%) of the rest (p=0.014). Acute renal impairment was found to be prevalent in seriously ill paediatric patients and was linked to increased mortality. Sagwa poisoning, diarrhoea and vomiting as presenting complaints had a significant association with acute kidney disease in such patients.

Genetic Basis of Biofilm Formation Genes Ebp and Bph (phos) among Multidrug Resistance Enterococcus faecalis Isolates, Iraq

Abstract Background: Biofilm produced by Enterococcus spp. increase their inherent and acquired antibiotic resistance, posing a significant challenge to infection treatment, particularly in virulent strains. Objective: This study aimed to investigate some genes responsible for biofilm formation (Bph (phos) and EbpB) by polymerase chain reaction (PCR) technique. Materials and Methods: A total of 130 clinical samples were collected during this study, which were obtained from patients who were admitted to Feminine and Children Teaching Hospital in Al-Diwaniyah City during a period extending from (November 2022 to March 2023). All samples were subjected to culturing on different media (blood agar, MacConkey, Bile Esculin agar, and M-El chromogenic ager), after which catalase and oxidase tests were conducted biochemically. After cultivation, the VITEK-2 compact system was used to identify the samples. The isolates were investigated genotypically for harboring biofilm formation genes, including EbpB and Bph (phos), by molecular method (PCR). Results: The VITEK-2 compact system revealed that only 12 isolates were identified as E. faecalis. The most effective antibiotics against E. faecalis were (vancomycin, teicoplanin, linezolide, tigecycline, and ampicillin), and the highest resistance was against erythromycin (100%) and tetracycline (91.6%). Enterococcus faecalis isolates were investigated genotypically for harboring biofilm formation genes that include EbpB and Bph (phos) by molecular methods, PCR. The results showed that EbpB and Bph (phos) genes were positive for all isolates with a percentage of 100%. Conclusions: It was found that the presence of biofilm formation genes in E. faecalis EbpB, and phos (Bph) increase the pathogenicity of this pathogen. These genes showed a high percentage among E. faecalis isolates. Also, all isolates had the potential to form a biofilm, which complicates their treatment with antibiotics, confirming the critical need to develop novel antimicrobial agents that control the infection associated with the development.

Weight in relation to feeding practice among two years old children in Al-Hillah City

Background: Babies and young children require adequate and high-quality nutrition to grow up healthy and reach their full potential. Breast milk is a baby's healthiest option because it contains all the essential nutrients they need, and it has long been known that breastfeeding is good for both mom and baby. Objectives: To determine the relationship between mothers' feeding practices and child weight status under two years old. Materials and Methods: A descriptive correlational study design was carried out at Babylon Teaching Hospital for maternity and children and Al Nour Hospital, which was applied from December 2019 to the end of February 2020 as a period for data collection. The sample consisted of (150) mothers admitted with their infants in pediatric wards. The instrument was adopted and finally constructed after an extensive literature review to be ready for data collection and consumed 15-20 minutes with each participant. Results: The study indicated that (76.7%) of mothers have bad feeding practices regarding child feeding, whereas (23.3%) have good feeding practices. In addition to other significant results, our study demonstrates a considerable positive relationship between the mode of feeding and a child's weight. Conclusions: The vast majority of mothers have bad child-feeding practices. There was a significant correlation between the type of feeding and infant weight and a strong association between the mother’s feeding practice and child weight. Keywords: Weight, Feeding practice, Two Years Old Children, Effects, Relation.

Comparison of the Areas Under the Curve of Vancomycin Continuous vs. Intermittent Infusion in Critically Ill Pediatrics: A Randomized Clinical Trial.

Providing data on the superior efficacy of vancomycin administered based on the area under the curve over 24 hours to the minimum inhibitory concentration of vancomycin (AUC24/MIC) is crucial. However, data on dosing and monitoring of vancomycin pharmacokinetics in the pediatric population are limited. Previous findings have showed that intermittent infusion of vancomycin (IIV) may not achieve the desired levels, continous infusions of vancomycin (CIV) reach the desired serum concentration faster than IIV and are associated with reduced nephrotoxicity. This study aimed to compare the serum concentrations, AUC24, clinical variables, and adverse effects of two vancomycin administration methods in the pediatric population. This study was a double-blind, randomized, controlled clinical trial conducted at a tertiary children's teaching hospital. Inclusion criteria were age between 2 months and 15 years and weight less than 67 kilograms, with exclusion criteria including renal impairment. Participants were divided into CIV and IIV groups following distinct administration protocols. Demographic, clinical, and laboratory data, including vancomycin serum concentrations, were compiled. Assessments included pediatric mortality risk, pediatric sequential organ failure assessment, and regular temperature monitoring. Pharmacokinetic analysis was conducted using Monolix software 2023R1. Primary endpoints were vancomycin serum levels and AUC24 between cohorts on day three, with nephrotoxicity and additional adverse drug responses evaluated. Sixty-eight patients in the pediatric intensive care unit (PICU) were allocated to either CIV (33) or IIV (35) for vancomycin treatment. In the CIV group, 82% of patients achieved an AUC24 ≥ 400 mg.h/L, compared to 23% in the IIV group. Continuous infusions of vancomycin demonstrated a greater AUC24 (587.7 ± 184.4 mg.h/L vs. 361.9 ± 113.2 mg.h/L, P < 0.05) compared to IIV. Two cases of nephrotoxicity were reported, one in each group, with mortality and adverse events being comparable between the two groups. This study demonstrated that continuous vancomycin infusion has a higher success rate in safely achieving therapeutic vancomycin levels in PICU patients compared to intermittent vancomycin infusion.

Molecular study of antibiotic resistance gene among nitrofurantoin-resistant gram-negative bacteria isolates from pregnant women

In pregnancy, urinary tract infection (UTIs) is a significant risk factor for morbidity, and nitrofurantoin is a common UTI therapy. The goal was to identify gram-negative UTI isolates and detect antibiotic resistance genes. The research involved 350 pregnant women hospitalised to Al-Zahraa teaching hospital for children’s health and maternity between September and December 2024. Out of 250 pregnant patients, 200 (57.14%) urine samples were bacterial-free, whereas 150 (42.86%) were positive for gram-negative bacteria. The findings showed that 105 isolates (70%) were Escherichia coli, 33 (22%) were Klebsiella pneumoniae, 8 (5.3%) were Pseudomonas aeruginosa, 3 (2%) were Proteus mirabilis, and 1 (0.7%) were Acinetobacter baumannii. The disc diffusion Kirby-Bauer method determined 150 (100%) gramme negative bacteria’s nitrofurantoin sensitivity. 33 (22%) isolates were antibiotic-resistant, 16 (10.66%) intermediate, and 101 (67.33%) susceptible. PCR analysis showed that all 33 out of 33 (100%) gram negative isolates had Ribe, and AcrAB genes. Additionally, a significant prevalence of nfsA-2 genes was discovered in 32 out of 33 isolates (96.96%) the nfsA-1 gene in 78.78% (26/33) of the isolates. The NfsB gene was detected in 30 out of 33 (90.90%) distinct isolates of nitrofurantoin-resistant gram-negative bacteria. The Nucleic acid and amino acid sequence study of NfsA and Ribe genes in some local isolates of K. pneumoniae reveals variations in sequence when compared to other global strains with the same genes.

Identification of beta-lactamase genes in Nitrofurantoin-resistant gram-negative bacteria isolated from pregnant women using molecular techniques

The predominant infection among pregnant women is urinary tract infection (UTIs), which may lead to various complications. So, this investigation was to detect gram-negative UTIs isolates and beta-lactam resistance genes. The study included 100 (28.57%) inpatient pregnant women and 250 (71.42%) outpatient pregnant women treated at Al-Zahraa teaching hospital for children’s health and maternity, Al-Najaf City, Iraq. Finding showed that The majority of the age group was 31-40 years old which involved 80 (22.85%) growth and 45 (12.85%) no growth. Results also showed the high rate of bacteria among pregnant women in third-trimester was 127 (36.28%). According Kirby-Bauer methods, only 33/150 (22%) of gram-negative isolates were nitrofurantoin-resistant. Results of PCR amplification showed that all 33 out of 33 (100%) gram negative isolates had the ctx-m gene. Additionally, a significant prevalence of AmpC gene was discovered in 32 out of 33 isolates (96.96%). The veb gene, on the other hand, was only detected in P. aeruginosa isolates, with a prevalence of 1 out of 33 (3.03%). The PCR findings revealed the presence of oxa-like 5 genes in 12.12% (4/33) of the isolates. Although oxa-69 was not identified in this study.

Unnecessary blood and blood products transfusion: Single institute study of the expected harmful effect of unneeded transfusion

Background. Blood and blood products such as packed RBCs, whole blood or other types of blood transfusions are some of the most common daily medical procedures performed all over the world. However, the doctor decisions to transfuse blood are not easy in clinical practice. Method. It was used a descriptive prospective study including 136 children who received blood and blood products transfusions in Al-Diwanyah Maternity and Children Teaching Hospital, Iraq, from 15 January to 15 November 2023. Result. The gender distribution among patients was of 56 males (41.17%) and 80 females (58.82%), all of them exposed to unnecessary blood transfusion. There was no significant difference in gender between high and low level of the hemoglobin groups. Presence of underlying chronic disease was higher in the group with Hb level less than 8 compared to the group with Hb level above 8 (55.65% vs.44.11 %), and the difference was significant (p = 0.042). Provisional diagnosis before transfusion was more effective in lower hemoglobin level subjects than in those with higher hemoglobin level (p = 0.019). About 70 % of these unneeded transfusions were performed due to lack of doctor awareness regarding the indications and the time when the blood and blood products transfusions were necessary. Conclusion and recommendations. All the new strategies of the hospital should be focused on avoiding the harmful effect of any procedure like blood transfusions, weighting their balance of benefits and harms. It is no need to perform a blood transfusion as an initial treatment if the affection can be treated by other means, excepting the life saving emergency situations after trauma or life threating hemorrhage. In some patients who are asymptomatic and/or where specific therapy is available, lower threshold levels may be acceptable. Continuous medical educational and increased doctor’s knowledge might help decrease unnecessary transfusions. Prior to surgery, multidisciplinary teams and discussions about transfusion should be engaged between pediatrician and surgeon. Safe blood and blood products as well as the cost of blood transfusion services should be considered before any decision.

Congenital Heart Disease In Preterm Infants

Background: Congenital heart defects and preterm birth are two important causes of neonatal and infant mortality. However, the relationship between them has not yet been fully clarified. Objective: To find the association of congenital heart disease with premature delivery. Patients and Methods: The study is an observational cross sectional study, done in Al-Batool teaching hospital for maternity and children from July 2022 to January 2023. A self-prepared questionnaire was used to gather data. Gestational age was calculated mainly on postnatal gestational assessment by Dubowitz/Ballard method by a pediatrician. Echocardiography was done by Echocardiography specialist doctor to identify the presence and types of congenital heart defects. SPSS version 25 was used for statistical analysis. Results: Total number of births (term and preterm) was 1616, congenital heart diseases were detected in 60(3.71%) of them, most of them were isolated heart defect. In preterm babies, the congenital heart diseases were detected in 8% (p value was &lt;0.001), they were of different types as followings: patent ductus arteriosus (n=10,26%), atrial septal defect (n=8,21%), ventricular septal defect (n=7,18%), transposition of the great arteries (n=4,10%), tetralogy of Fallot (n=2,5%), and complex of congenital heart disease (n=7,18%), while in full term babies, the rate of congenital heart diseases was only 1.9%. Conclusion: The incidence of congenital heart disease was higher in preterm than full term delivered babies, mostly in the group of transposition of the great arteries, ventricular septal defect, complex heart defects, followed by atrial septal defect. Keywords: Preterm, delivery, congenital heart disease.

Congenital Heart Disease In Preterm Infants

Background: Congenital heart defects and preterm birth are two important causes of neonatal and infant mortality. However, the relationship between them has not yet been fully clarified.&#x0D; Objective: To find the association of congenital heart disease with premature delivery.&#x0D; Patients and Methods: The study is an observational cross sectional study, done in Al-Batool teaching hospital for maternity and children from July 2022 to January 2023. A self-prepared questionnaire was used to gather data. Gestational age was calculated mainly on postnatal gestational assessment by Dubowitz/Ballard method by a pediatrician. Echocardiography was done by Echocardiography specialist doctor to identify the presence and types of congenital heart defects. SPSS version 25 was used for statistical analysis.&#x0D; Results: Total number of births (term and preterm) was 1616, congenital heart diseases were detected in 60(3.71%) of them, most of them were isolated heart defect. In preterm babies, the congenital heart diseases were detected in 8% (p value was &lt;0.001), they were of different types as followings: patent ductus arteriosus (n=10,26%), atrial septal defect (n=8,21%), ventricular septal defect (n=7,18%), transposition of the great arteries (n=4,10%), tetralogy of Fallot (n=2,5%), and complex of congenital heart disease (n=7,18%), while in full term babies, the rate of congenital heart diseases was only 1.9%.&#x0D; Conclusion: The incidence of congenital heart disease was higher in preterm than full term delivered babies, mostly in the group of transposition of the great arteries, ventricular septal defect, complex heart defects, followed by atrial septal defect.

Clinical Characteristics and Therapeutic Management of Osteogenesis Imperfecta in Iraqi Children

Background: Osteogenesis imperfecta (OI) is a rare congenital condition that results in bone fragility, recurrent fractures, and various extra-skeletal manifestations. Currently, intravenous bisphosphonate is the mainstay of medical treatment in OI. Objective: To identify the effect of current management strategies on Iraqi children diagnosed with OI. Methods: A retrospective study enrolled OI patients who were registered in Central Child Teaching Hospital, Baghdad, Iraq, from January 2015 to December 2022. We enrolled confirmed OI cases (either clinically and/or radiologically) who received cyclic pamidronate therapy for at least 3 cycles. They neither received other types of bisphosphonates nor underwent surgical intervention. Results: A total of 52 cases of OI had been identified, but only 36 patients were eligible for the current study. The mean age of the patients was 6.64±4.22 years. A statistically significant drop in the annual fracture rate in OI patients who received intravenous pamidronate cycles was seen, along with a significant rise in weight for age Z-score, lumbar spine bone mineral density DEXA Z-score, and alkaline phosphate levels. No significant improvement was documented in height for age Z-score in OI patients. Conclusions: Intravenous pamidronate cycles for Iraqi children with osteogenesis imperfecta work to lower their risk of breaking bones every year and raise their weight, lumbar spine bone mineral density, and alkaline phosphate levels. Pamidronate did not result in an improvement in the height of OI children.

Determination of Some Chemicals Compounds in the water system of the Al-Ramadi teaching hospital for maternity and children

Determination of Some Chemicals Compounds in the water system of the Al-Ramadi teaching hospital for maternity and children

Epidemiological profile of hemophilia A in Karbala-Iraq.

Hemophilia is an X-linked congenital bleeding disorder caused by a deficiency of coagulation factor VIII (FVIII) (in hemophilia A) or factor IX (FIX) (in hemophilia B) and is one of the most important hereditary conditions in Iraq. The current study tried to provide a glimpse into the epidemiological and clinical status, as well as complications and treatment used for patients with hemophilia A in Karbala, Iraq. This retrospective research was carried out by reviewing the medical records of 90 male patients diagnosed with hemophilia A registered at the Hereditary Blood Disease Center in Karbala Teaching Hospital for children in Karbala, Iraq. The data was collected from May 10, 2023, until June 15, 2023, and included age, severity, type of bleeding, therapeutic approach, chronic viral infections including hepatitis B, hepatitis C, and human immunodeficiency virus (HIV). The median age of the patients was 15 years (18.86±14.42). In this study, one-third of patients' presentations started in the first year of life. The most common type was severe hemophilia A (factor VIII activity < 1%). Consequently, more than half of the patients were treated with factor VIII concentrate. Four patients had hepatitis C, while HIV was confirmed in one patient. The epidemiological or clinical parameters of hemophilia A patients in Karbala seem similar to those in other cities in Iraq. By considering this preliminary data, further comprehensive studies for patients with hemophilia and associated complications in other provinces or cities in Iraq are highly suggested to provide a clear perspective about the prevalence and epidemiological burdens.

The Aperta type of neural tube defect: The relevant experience in a local community with the diversity of the presentation.

A series of birth defects known as neural tube defects (NTDs) appear when the neural tube fails to fully or partially close during fetal development. In nations without folic acid supplementation, their incidence ranges from 0.5 to 2 per 1,000 births. The purpose of our study is to estimate the prevalence of NTDs and define the workup for newborn infants with an open neural tube in Al-Qadissiyah, Iraq. This 18-year descriptive retrospective analysis included all babies with NTD diagnoses at the Maternity and Child Teaching Hospital in Al-Qadissiyah Governorate, Iraq. Over the research period, 187 cases of NTDs were evaluated. NTDs presented a male predominance and an incidence rate of 9.4 per 1,000 births, with spina bifida (67.9%), encephalocele (24.02%), and anencephaly (8.02%) being the most prevalent defects. The typical gestational age was 36±5, whereas the typical maternal age was 30±5. It should be noted that 29.9% of women did not take folic acid supplements during the first trimester, while one-third of moms did not benefit from medical supervision during pregnancy. In 65.2% of instances, an antenatal diagnosis was made, and cesarean section was the mode of delivery in 87,8% of cases. Other than that, 64.7% of women lived in low socioeconomic conditions, and 67.9% were from rural areas. The relevance of reinforcing and maximizing folic acid measures throughout the periconceptional phase is emphasized by the fact that NTDs require high intensity and advanced care.

Single nucleotide polymorphism of IL-18 gene and resistin gene in children infection with Entamoeba histolytica

Abstract Background: Human amebiasis is caused by Entamoeba histolytica, which is found in many tropical countries. E. histolytica infections are known to have a wide range of clinical consequences. Most infections are asymptomatic; some cause diarrhea and dysentery, and only a few cause extraintestinal consequences, including liver abscess. Single nucleotide polymorphisms (SNPs) are the most prevalent kind of sequence variation in genomes and are regarded as useful genetic markers for exposing the evolutionary history and common genetic variants that explain the heritable risk for common illnesses and effected in the progression of some infections. Objective: Investigation of gene polymorphism of the parameters (interleukin 18 [IL-18], resistin) most susceptible to parasitic infection. Materials and Methods: Stool samples were collected from patients who were attending the (Kerbala Teaching Hospital for children in the holy city of Kerbala), between February 2021 and January 2022. In total, 3748 samples of feces from children between the ages of 1 and 15 years from both gender were tested using both direct smear and acid-fast stain tests in addition to rapid test techniques. Five milliliters of blood were obtained from 25 patients infected with E. histolytica, as well as 5 mL of blood from 25 healthy youngsters (sample control). Results: The result showed the distribution of genotype of IL-18 SNPs in intestinal parasites patient in contrast to the control group; there is an increase in the level of IL-18 in some SNPs, resistin concentration was statistically significantly different between resistin gene polymorphisms. Conclusion: The IL-18 and resistin polymorphism can be considered one of the genetic factors responsible for the progression of E. histolytica infection.

Isolation and Diagnosis of Escherichia coli bacteria from Patients with Urinary Tract Infections and Bacteriosis and Studying their Sensitivity to Some Antibiotics and Nanobodies

The current study included the collection of 120 clinical samples (diuresis, blood) from patients visiting Baghdad city hospitals (Yarmouk Teaching Hospital, Central Children's Teaching Hospital, and Baghdad Teaching Hospital) for the period from November 2022 to February 2023. 30 discharge samples were collected from healthy people as a control group. The samples were within different ages and genders ranging from 14 years to 52 years. 10% of the E bacteria have been isolated coli of blood and 150% of blood based on phenotypic and culture characteristics and biochemical tests and the diagnosis was confirmed using the phytic device.&#x0D; The results of the sensitivity test of bacterial isolates using the tablet method of diffusion showed that most of the isolates were resistant to the antibiotics used, where the percentage of resistance to Tetracycline (96%), (84%) Nitrofurantoin, (82%) Ceftriaxone, (66%) Meropenem, (52%) Ciprofloaxcine, (70%) Gentamicin, (80%) Amikacin, (46%) Imipenem, Nalidixic acid (40%).&#x0D; The antimicrobial activity of gold and titanium nanoparticles was evaluated against 15 bacterial isolates (5 isolated from diuretic samples, 5 exit samples, 5 blood samples) using the diffusion method by gratigran. The results showed that the nanoparticles had a clear inhibitory effect against the studied isolates where the average inhibition diameters ranged between 17-22 mm and the MIC value (Minimal inhibitory concentration) was between 64-126.

Thyroid Function in patients with nephrotic syndrome

Nephrotic syndrome is a common pediatric kidney disease characterized by leakage of protein from the blood to the urine through damaged glomeruli. It is classically defined as nephrotic range proteinuria, hypoalbuminemia and edema. In children with nephrotic syndrome, it is probable to determine a hypothyroid state because of significant loss of thyroxine (T4) and triiodothyronine (T3) in the presence of proteinuria. This study aimed to evaluate the thyroid function in children with nephrotic syndrome and its correlation with the state of patients ( relapse or remission ). Methods: A comparative study was carried out on total of 60 patients with nephrotic syndrome (divided into two equal groups of 30 with remission and 30 with relapse ) in the age group from 1-18 years who admitted to department of nephrology in Babylon teaching hospital for Maternity and children from November 2020 to May 2021, serum albumin, serum cholesterol, thyroid stimulating hormone (TSH) and thyroxine( T4 )were done to all patients and the result compared. Result: The mean age of patients was (5.74 ± 3.77) years; most patients (N=42, 70.0%) were male. Hypothyroidism represents (N=19, 31.7%) of patients with nephrotic syndrome, while patients with normal thyroid function (euthyroid) represented (N=41, 68.3%). Significant differences existed between the means of TSH and T4 according to the patient's state (remission or relapse). There was a significant association between the state of patients and thyroid function tests. Among patients with relapse (N=19, 63.3%) presented with hypothyroidism and (N=11, 36.7%) of patients presented with normal thyroid function (euthyroid state), while among those with remission, all patients (N=30, 100%) presented with normal thyroid function (euthyroid state). In conclusion, hypothyroidism is more common in nephrotic syndrome patients during relapse, so it's important to assess thyroid function during relapse. Keywords: Thyroid, nephrotic syndrome, Nephrotic syndrome