Iraqi Patients Research Articles

Iraqi patients suffering from valvular heart diseases' serum iron levels

Valve heart disease (VHD), caused by a heart valve becoming too narrow (valvular stenosis) or not closing adequately (valvular insufficiency), is one of the heart illnesses that causes the most morbidity and mortality. The study included ninety participants, who were divided into three groups: Thirty people in excellent health, thirty patients with aortic valve disease (atrioventricular valve group: 14 men, 16 females), and thirty patients with mitral valve disease (mitral valve group: 13 males, 17 females). group C, the control group, consisted of 16 men and 14 women. Serum UIBC decreased significantly (P < 0.001) while serum ferritin, transferrin saturation, and iron increased significantly (P < 0.001) when the patient groups were compared to group C. Conversely, there were no statistically significant changes (P>0.05) seen in the concentrations of transferrin and TIBC in the serum between the two patient groups and the control group. Moreover, no appreciable variations were noted in the concentrations of iron, TIBC, UIBC, transferrin, transferrin saturation, or ferritin between the AV and MV groups.

Association of hsCRP and Serum Kalirin Levels with the Development and Severity of Premature Coronary Artery Disease in Iraqi Patients

Background: Coronary artery disease (CAD) is a major contributor to morbidity and mortality worldwide. Early-onset CAD, also known as PCAD, is a severe form of CAD associated with high mortality and a poor prognosis. Early diagnosis is crucial to reducing complications. While hsCRP is an established biomarker for CAD, kalirin is a potential novel biomarker due to its role in promoting smooth muscle proliferation and endothelial dysfunction. Objective: To evaluate the relationship between serum kalirin and hsCRP levels with the presence and severity of PCAD and to compare the diagnostic value of both biomarkers. Method: The study recruited 92 participants into two groups: the PCAD group (46) included patients with confirmed CAD by angiographic findings and the second group was the non-CAD group (46) with negative findings by coronary angiography. The levels of serum kalirin and hsCRP were measured for both groups using enzyme-linked immunosorbent assay (ELISA) kits. Results: Serum levels of kalirin and hsCRP were strongly associated with the presence of PCAD (p<0.001), and both biomarkers were associated with disease severity (p=0.002, <0.001, respectively). ROC analysis showed that hsCRP possesses a slight advantage (AUC=0.796) over kalirin (ROC=0.717) as a diagnostic marker for PCAD. Conclusions: Serum kalirin and hsCRP levels are associated with PCAD and with the severity of the disease, both markers possess moderate diagnostic capabilities for PCAD with a slight advantage for hsCRP.

Assessment of Left Arterial Function by using 2-Dimensional Speckle Tracking in Obese versus Non-Obese Diabetic Patients

Both obesity and diabetes are major problems for the public's health. Both are known to contribute to the development of atrial cardiomyopathy. However, the consequences of obesity on the function of the left atrium(LA) in diabetic individuals have not been determined as of yet. The aim of this study is to compare the peak atrial longitudinal strain (PALS) measured by two-dimensional (2D) speckle tracking in obese versus non-obese diabetic Iraqi patients. For a study that was designed to be cross-sectional, the data collection period lasted for a total of ten months. In this study, the participants had to have diabetes mellitus type 2. A comparison was made between patients who were obese and patients who were not obese using 2-D speckle tracking to measure the peak left atrial longitudinal strain. Several additional factors, such as age, gender, body mass index, conventional echocardiographic parameters, and volume-derived LA function, were investigated during this study. A total of 59 patients participated in this study. The ratio of males to females was exactly 1:1.5, and the average age was (54 ± 9.4) years old. Coexistent systemic arterial hypertension was observed in 25 % of the study population. Patients with type 2 diabetes mellitus and obesity had ad higher E/e` ratio and lower PALS than patients with type 2 diabetes mellitus without obesity, whereas all other parameters were statistically non-significant (EF, E/A, S prime, LA volume index). It was found that the peak longitudinal strain of the LA, which was measured using 2-D speckle tracking, was lower in the obese diabetic individuals. This was in contrast to diabetic people, who did not have obesity issues. An evaluation of the global strain in the left atrium can help in the early detection of remodeling and dysfunction in the left atrium if it is compared to the size of the left atrium and the filling pressures of the left ventricle, both of which are respectively determined by the E/e' ratio and the left atrial volume.

Screening for Janus kinase-2 exon 12 mutations among Janus kinase-2 V617F-negative polycythemia vera suspected Iraqi patients

Abstract: BACKGROUND: Diagnosis of myeloproliferative neoplasms including polycythemia vera (PV) has been greatly improved following the identification of driver mutations at exon 12 and exon 14 of the Janus Kinase 2 (JAK2) gene. There are limited academic studies that report the frequency of the JAK2 exon 12 gene with limited number of patients. OBJECTIVES: The aim of this study was to evaluate the frequency of JAK2 exon 12 mutations among JAK2V617F-negative PV-suspected Iraqi patients. PATIENTS’, MATERIALS AND METHODS: This is a retrospective study conducted at the National Center of Hematology/Mustansiriyah University from December 2019 to January 2022; patients with suspicion of PV were enrolled in this study. Screening for JAK2 exon 14 (JAK2V617F) mutations was done for all 323 patients. Out of them, there were 102 patients with JAK2V617F-negative who retrospectively screened for JAK2 exon 12 mutations by direct sequencing (Sanger sequencing). RESULTS: Initial evaluation for the total 323 patients suspected with PV revealed that 84 cases were mutated for the JAK2V617F gene, and 239 were unmutated. The frequency of JAK2 exon 12 was about 1% among JAK2V17F-negative patients. The median age for all patients was 35 years. Among the total cases, 21 cases (20.59%) showed splenomegaly at the time of clinical onset sequencing of these cases revealed only one case mutated with JAK2 exon 12 (E543-D544del). CONCLUSION: The current study showed that the frequency of JAK2 exon 12 mutations in JAK2V617F-negative cases was very low. Despite PV patients with JAK2 exon 12 mutations represent a small proportion of total PV cases, JAK2 exon 12 mutations should be routinely screened in JAK2V617F-negative cases.

Investigation and assessment of oxidant – antioxidant status of some enzymes and vitamins in Iraqi patients with chronic myeloid leukemia

Abstract Aim. To investigate and assess the concentrations of glutathione peroxidase, superoxide dismutase, catalase, vitamin A and vitamin C in Iraqi patients infected by chronic myeloid leukemia (CML). Material and methods. Forty-eight Iraqi patients of ages ranged between (15-75) years took part in the current study. Enzymatic antioxidants (Gpx, SOD and CAT) and antioxidant vitamins (A and C) were estimated spectrophotometrically in blood sera of all patients according to age and sex variables, and then all clinical parameters were compared with healthy individuals (control groups). Results. Evaluation of oxidant-antioxidant status. Glutathione peroxidase (GPx), superoxide dismutase (SOD) and catalase (CAT) enzymes concentrations recorded high significant decreasing (***p <0.0001) in blood serum of CML patients according to age and sex factors. Moreover, vitamins A and C showed a high significant decreasing (***p <0.0001) in their concentrations as measured in blood serum of CML patients with diverse ages and sexes. The GPx, SOD, CAT, Vitamin A and Vitamin C in the current study, are considered excellent biochemical markers for following the acuity of CML disease depending on age and sex variables. Conclusion. The clinical significance of oxidative stress represented by lack of enzymes and vitamins in the current study was proven. Statistically significant differences were recorded and observed between patients and control groups depending on age and sex factors.

Correlation between Serum Levels of Factor I, CD59, Interferon-gamma, and Interleukin-6 with the Response to Rituximab in Iraqi Patients with Rheumatoid Arthritis

Background: Rituximab is a chimeric IgG1 kappa immunoglobulin that has been genetically modified to incorporate human constant region sequences together with murine light- and heavy-chain variable region sequences. People use it to treat rheumatoid arthritis and certain malignancies. Objective: The study aimed to assess the potential association between the serum levels of Factor I, CD59, interleukins (IL)-6, and interferon-gamma (IFN)-γ and the response to Rituximab treatment in Iraqi rheumatoid arthritis patients. Methods: A cross-sectional study was conducted at the rheumatology center at Baghdad Teaching Hospital. Ninety adult patients who have been diagnosed with rheumatoid arthritis and are receiving Rituximab intravenous infusions were included. The enrolled patients were divided into a responder group (45 patients) and a non-responder group (45 patients). The response to Rituximab was assessed according to the 28-joint Disease Activity Score (DAS28). Results: The serum levels of Factor I and CD59 were significantly higher in the non-responders group in comparison to the responders group. In addition, the serum IL-6 and IFN-γ levels were significantly elevated in the non-responders group in comparison to the responders group. The estimated marker serum levels showed a strong, significant correlation with the 6-month change in DAS28. Conclusions: In Rituximab nonresponder RA patients, serum levels of Factor I, CD59, Factor H, IL-6, and IFN-γ are higher, and they have good potential to be used in the assessment of the response to Rituximab therapy.

Neutrophil/Lymphocyte and Platelet/lymphocyte Ratios as Predictors of Patient Response to Bevacizumab in Iraqi Patients with Metastatic Colorectal Cancer

Background: Global clinical trials have shown that bevacizumab, along with chemotherapy, is beneficial for people with metastatic colorectal cancer (mCRC). Nevertheless, there isn't a useful biomarker to predict its effectiveness. Objectives: The study's goal was to analyze and evaluate the practical pretreatment biomarker in people with metastatic colorectal cancer (mCRC) to predict bevacizumab efficacy. Methods: This study, which is retrospective, includes 157 patients diagnosed with mCRC who received bevacizumab in association with chemotherapy from three centers in Iraq. The study looked at how clinical data and biomarkers relate to disease control (DC), overall survival (OS), and progression-free survival (PFS). It also looked at how well they could predict these outcomes. The cutoff values of neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) were examined with ROC analysis. Results: For all patients, the median follow-up duration was 12 months. The PLR, NLR and median alkaline phosphatase (ALP) values were considerably lower in disease-control (DC) patients than in non-DC patients. The carcinoembryonic antigen (CEA) baseline level significantly correlated with shorter OS, while the ALP baseline level did not significantly correlate with shorter PFS. Among the clinical data, only multiple organ metastases showed a strong correlation with a shorter PFS and OS. Conclusions: A low pretreatment N/L ratio and P/L ratio might be good predictors of bevacizumab efficacy for metastatic colorectal cancer patients, and it could be clinically useful for choosing responders.

The Association between the Response to Rituximab with Sociodemographic Data and Disease Characteristics Among a Sample of Iraqi Patients with Rheumatoid Arthritis

Background: Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease. Rituximab (RTX), a monoclonal antibody with anti-CD20 action, is now used as a treatment. Even with proper RTX use, some patients showed variations in response. Objective: To assess the association of different sociodemographic data and disease characteristics with RTX responsiveness in RA patients. Methods: A cross-sectional study was conducted in the Specialized Center of Rheumatology at Baghdad Teaching Hospital in Baghdad, Iraq. The study included 90 RA patients who received a 1000mg RTX intravenous infusion for at least six months. The collected sociodemographic data included age, gender, smoking status, body mass index (BMI), disease characteristics such as co-morbidities, and the use of previous biological agents. The activity of RA was assessed by the 28-joint Disease Activity Score (DAS28) and Clinical Disease Activity Index (CDAI). Results: Upon measuring the DAS28, the enrolled patients were divided into RTX responders (50 patients) and RTX non-responders (40 patients). Patients with a family history of RA were significantly higher in the RTX responders (21% versus 2% in the non-responders group). The responders had a significantly longer RA duration (p=0.030).The mean of CDAI and DAS28 were significantly higher in patients with no family history of RA than in those with a family history of RA. Conclusions: Disease duration, family history, and the use of previous biological agents could be considered as possible predictors of response to RTX, thereby saving time and treatment costs.

Surgical decision-making: key factors influencing the shift from laparoscopic to open cholecystectomy

Background: Recognizing the preoperatively and intraoperatively factors can aid surgeons in making timely decisions to shift from laparoscopic cholecystectomy (LC) to open cholecystectomy (OC). This study aims to identify the main factors leading to LC conversion to OC among Iraqi patients. Methods: One-year prospective research was performed using cross-sectional design between 1st April, 2023, and 3oth March, 2024, at Alkalis General Public Hospital and Al Hayat Private Hospital, Diyala, Iraq. Pre and intraoperative data were collected from the planned LC surgeries including demographics, medical history, laboratory and Ultrasound findings. Descriptive and bivariate analysis was carried out to compare variables between patients undergoing LC and those requiring conversion to OC. Results: Out of 172 LC patients (mean age 48.28±12.62), 52.9% were female, 55.8% obese, 50.6% aged 49+, 23.3% diabetic, and 19.8% had emergency cholecystectomy; 15 (8.7%) required conversion to open surgery. The conversion group was mainly men (66.7% vs. 46.5%, P = 0.001) and older (73.3% vs. 48.4% aged 49+, P = 0.003). Obesity (60.0% vs. 55.4%, P = 0.005) and diabetes (53.3% vs. 20.4%, P < 0.001) were more common. Public hospital referrals were higher (86.7% vs. 52.2%, P < 0.001). Elevated total bilirubin, direct bilirubin, and alkaline phosphatase levels were significant predictors of conversion to OC. Adhesions in Calot's triangle (20.0% vs. 13.4%, P = 0.021) were more common in the conversion group, along with unclear anatomy, thick gallbladder wall, bleeding, stone and bile spillage, and cystic duct injury. Conclusion: In conclusion, out of 172 LC patients, 15 (8.7%) required conversion to open surgery, predominantly older men with higher obesity, diabetes, and elevated bilirubin and alkaline phosphatase levels, and more adhesions in Calot's triangle.

Molecular Detection of adhesion gene in Uropathogenic Escherichia coli Isolated from Children in Iraqi patients

Molecular Detection of adhesion gene in Uropathogenic Escherichia coli Isolated from Children in Iraqi patients

An Immunological and Molecular Study of Regulatory T-cell Activity in Iraqi Patients with Psoriasis Treated by Topical and Biological Therapy

An Immunological and Molecular Study of Regulatory T-cell Activity in Iraqi Patients with Psoriasis Treated by Topical and Biological Therapy

Diagnosis Study of Peptic Ulcer in Iraqi Patients Students

Background: Even in the absence of a Helicobacter pylori infection, psychological stress and a need for fast food can cause peptic ulcer. Research on the relationship between sociodemographic traits and peptic ulcers has revealed a number of risk factors, including a packed family, poor income, unemployment, marital tension, and physical and mental strain. The aim of the current study is to determine the clinical picture of gastric ulcer based on medical history and social status in a sample of Iraqi patients. Methods: Students studying science and medicine who had signs of peptic ulcer disease were the subjects of a cross-sectional investigation. The sample was collected during the period of one year, November 2021 to February 2022. Initially, the procedure was elucidated to the patients, and informed consent was obtained from all enrolled individuals. Peptic ulcer disease was diagnosed by routine examinations, Helicobacter pylori diagnosis by stool antigen test, and gastroduodenoscopy of the patients, in addition to taking the medical history and information about the social status. Results: The study included 45 patients with peptic ulcer, 15 (33.33%) males and 30 (66.66%) females, aged 19-26 years. The control group was 25 healthy individuals, and their symptoms were either acute abdominal pain proven to be caused by peptic ulcer in the patients or hematemesis in 13 (28.88%) patients. Conclusion: Peptic ulcers can be visualised and bleeding can occur, so there should be awareness of pain management and prompt treatment. There should be good and effective analgesia, reassurance, and empathy with patients, and advice on protection against gastric and intestinal ulcers when needed.

Critical Roles of IL-40 and IL-41 in the Determination of the Severity of Hydatid Cyst Infection in Iraqi Patients

Background: Hydatid cystic disease is a serious public health concern worldwide, and the link between the intermediate host (human) and parasite is important to the disease's etiology and severity. Objective: Determine the levels of IL-40 and IL-41 in the serum of Iraqi patients infected with hydatid disease, as well as their function in disease severity. Methods: The quantified ELISA was used to assess the levels of IL-40 and IL-41 in serum from 35 persons in Baghdad, Iraq, who had been diagnosed with hydatid cysts and were undergoing surgery to remove them. In addition, control samples from forty healthy individuals were taken for comparison purposes. Results: The patients' ages ranged from 8 to 63. Females had higher infection rates than males. Rural areas have a higher rate of infection than urban areas. The lungs and liver were the most severely injured. The majority of lung infections resulted in coughs and chest discomfort, whereas liver damage resulted in stomach pain as well as substantial changes in hematological parameters (white blood cells, hemoglobin, and erythrocyte sedimentation rate), liver enzyme, and C-reactive protein in patients compared to controls. Patients had lower IL-40 levels than the control group, but significantly higher IL-41 levels (p<0.05) than healthy controls. Conclusions: Patients with hydatid cysts showed higher serum levels of IL-41 and lower levels of IL-40, which may correlate with disease severity and act as biomarkers for chronic hydatid cyst infection.

Evaluation of lipid profile, liver function enzymes, and trace elements in Iraqi diabetic nephropathy patients.

Diabetic nephropathy, a common complication of type 2 diabetes (T2DM), is associated with abnormal lipid profiles, liver dysfunction, and kidney impairment. However, research on its association with trace elements in Iraqi patients is limited. The objective of the present study is to evaluate the association between lipid profile, liver function, and trace elements in diabetic nephropathy (DN) patients. In this study, 120 individuals were selected. Sixty of these individuals were labeled as the DN patient group, and 60 individuals were labeled as the healthy control group. A flame atomic absorption spectrophotometer (FAAS) was utilized to assess the levels of zinc (Zn), copper (Cu), and magnesium (Mg), whereas a flameless atomic absorption (FAA) was used to assess manganese (Mn). A colorimetric method was used based on the protocols included in the leaflets by Spinreact kits to determine the levels of lipid profiles and liver function enzymes in the serum. The mean value of high-density lipoprotein (HDL) decreased significantly in the DN patient group compared to the control group (p < 0.001) while cholesterol and low-density lipoprotein (LDL) decreased insignificantly. Conversely, the mean value of triglycerides (TGs) increased significantly in patient group ((p < 0.001) while very low-density lipoprotein (VLDL) increased insignificantly. On the other hand, the mean values of aspartate aminotransferase (AST), alanine transferase (ALT), alkaline phosphatase (ALP), and γ- glutamyl transferase (GGT) were significantly greater in DN patients compared to the healthy controls. Conversely, the mean values of total protein (TP) and albumin (Alb) were significantly lower in the DN patient group. In terms of trace elements, the mean values of Zn, Mg, and Mn were significantly lower in each of the patient groups compared to the healthy group. Conversely, a significant elevation in the means of Cu and Fe was observed in patients compared to the healthy group. Additionally, the findings revealed no association between BMI and lipid profile, liver enzymes, or trace elements. However, an association with age was limited to TGs, ALP, and GGT. The study's results show that the DN patients have abnormalities in their serum trace element levels. This means that these elements could be valuable indicators for monitoring and assessing the progression of DN. Understanding the correlation between lipid profile, liver function, and trace elements could offer valuable insights for managing and preventing diabetic nephropathy. More extensive studies, including an additional group of DM patients without nephropathy complications, are required, and could be used in practice due to the progression of the disease.

The potential role of dyslipidemia in COVID-19 severity among Iraqi patients.

The correlation between dyslipidemia and the severity of coronavirus disease 2019 has been widely categorized. Dyslipidemia is one of the most dominant disorders among these patients. Systemic inflammation accompanied by cytokine storm hemostasis modifications and severe vasculitis have all been reported to occur among COVID-19 patients, and these may contribute to some severe complications. The aim of this study is to assess the possible relationship between dyslipidemia and the severity of coronavirus disease 2019. This work encompassed 200patients with coronavirus disease 2019 (100dyslipidemic and 100normolipidemic) who were hospitalized at Baghdad Teaching Hospital/ Medical City-Baghdad, Iraq, from October 2021 to October 2022; their ages ranged between 40 and 55. Eligible individuals had a positive nasal swab polymerase chain reaction for severe acute respiratory syndrome coronavirus 2infection. Every participant's anthropometric and clinical features were measured. The study includes the measurements of glycemic, lipid profile, renal function test, D-dimer, C-reactive protein, serum ferritin, and interleukin-6 in dyslipidemic and normolipidemic groups. Considerable increase (p= 0.001) in glycemic and lipid levels in the dyslipidemic group compared to normolipidemic. Moreover, dyslipidemic patients have higher lipid indices (ratios) than the normolipidemic group. Significant increases (p= 0.001) in serum urea and creatinine levels were found among the dyslipidemic group compared to normolipidemic. There was a non-considerable decrease (p= 0.062) in serum total protein in the dyslipidemic group concerning the normolipidemic. In contrast, a considerable decrease (p= 0.045) in serum albumin was detected in the dyslipidemic group compared to normolipidemic. D-dimer, serum C-reactive protein, ferritin, and interleukin-6 were significantly increased (p= 0.001) in the dyslipidemic group compared to normolipidemic. Dyslipidemia potentially raises the severity of coronavirus disease 2019. There was a significant disturbance in renal function tests among coronavirus disease 2019patients. The study found a significant and statistical difference in kidney functions between dyslipidemic and normolipidemic groups. The patients, especially the dyslipidemic ones, have experienced protein abnormalities and a significant inflammation rate reflected by higher C-reactive protein and interleukin-6, which is due to the severity of coronavirus disease 2019. It is possible to conduct more research with a larger sample size. The majority of people who have dyslipidemia need to be enlightened.

Cytogenetic Analysis Associated with Hashimoto's Thyroiditis in Samples of Iraqi Patients: an in vitro study

Background: One of the most prevalent autoimmune diseases is Hashimoto's thyroiditis (HT), which is characterized by autoantibodies specific to the thyroid but whose precise cause is still unknown. Objectives: By comparing a sample of Iraqi patients with healthy controls using the comet assay, chromosomal abnormalities, micronucleus production, and mitotic index, the current study aims to clarify the cytogenetic impact of Hashimoto's thyroiditis. Methods: The study included ten Iraqi patients with HT (six males and four females), ages 20 to 75 years old, compared with ten healthy control groups (six males and four females). Results: The results showed that only cells in metaphase /1000 were being assessed, and the patient group (9.82 ± 0.0153) was more affected than the healthy control group (5.94 ± 0.170). The micronucleus formation result compared to the proportion of healthy controls was (0.004±0.0018 Mn/cell), while the frequency of Mn formation in HT was higher (0.0068±0.00132 Mn/cell). Three parameters were employed in the comet assay to indicate DNA damage in HT patients and healthy controls: tail length (9.2±6.016 and 25.5±10.607 px), tail moment (2.047±2.687 and 11.32±15.058), and DNA damage in the tail (20.892±11.225 and 35.153±44.429%). Conclusion: The percentage of mitotic index, micronucleus formation, and DNA damage detected by the comet assay in HT patients was higher than in healthy control.

Identification of the IL-13 gene rs20541 single nucleotide polymorphism and its association with renal cell carcinoma in Iraqi patients

Identification of the IL-13 gene rs20541 single nucleotide polymorphism and its association with renal cell carcinoma in Iraqi patients

Detection of HBV DNA by direct PCR protocol and Nested PCR protocol and comparing them in chronic patients and healthy carriers of Hepatitis B virus.

Hepatitis B virus is a major public health problem, and the outcome of infection depends on the effectiveness of the virus's interaction with the host, and in particular on the strength of the natural and conditioned response of humoral and cellular immunity. This study was conducted to assess the clinical status, genetic immunity and viral (viral) traits of Iraqi patients with chronic hepatitis B virus and healthy carriers of hepatitis B surface antigen, as well as to show the relationship between the immune status and the chronic condition of the disease. The study included (60) patients with chronic hepatitis B virus type (B) and (60) healthy hepatitis B surface antigen carriers who attended the Teaching Hospital for Gastrointestinal and Liver Diseases in Nasiriya City Al-Hussein Teaching Hospital, Thalassemia Center and the Central Blood Bank in Nasiriya Citysouthern of Iraq. for the period from the first period. From February 2022 until the end of February 2022, the average age of patients infected with chronic hepatitis B virus was 64.5 years, and the average age of healthy carriers of hepatitis B surface antigen was 35. 1 year, and the ratio of males to females was (12.2:) for chronic patients and (13.6:) for carriers of the disease. As for the deoxyribonucleic acid, it was (100%) in chronic patients and healthy carriers using the Nested type polymerase chain reaction, and at a rate of (30.0%) and (46.7%) in chronic patients and healthy carriers, respectively using the polymerase chain reaction technique. direct with a significant difference between the two interactions. The current results confirm that a nested PCR protocol to detect HBV DNA is a more sensitive way of detecting HBV in Iraq CHB patients and carriers. Recent advanced techniques such as nucleic acid assays, quantitative assays for viral load and RT-PCR for Iraqi viral hepatitis laboratories are recommended.

The Correlation of Oxidative Stress Markers and Biochemical Cardiac Enzymes in Iraqi Patients Diagnosed with Acute Myocardial Infraction

A myocardial infarction (MI), is the irreversible death (necrosis) of heart muscle commonly known as a heart attack. Acute myocardial infarction (AMI) occurs when blood flow decreases or stops to the coronary artery of the heart, causing damage to the heart muscle. MI is associated with an intelligible imbalance in oxidative stress. After myocardial injury, many cardiac biomarkers become detectable in venous circulation such as cardiac enzymes. The study's main goals were to evaluate the clinical significant change in cardiac enzymes and investigate the positive and negative correlation with some serum oxidative stress markers total oxidative state (TOS), free amine and total antioxidant capacity (TAC) in patient and control groups. This study contained 120 subjects who were divided evenly into patients and control groups for the period between July and September 2022. The serum levels of oxidative stress markers were measured manually using spectrophotometer (model, Cecil, CE10N / England). The activity of cardiac enzymes and lipid profile were also determined by using Spectrophotometric kits supplied from Biolabo, France. The study showed that TOS had a significantly positive correlation with CK (r = 0.269*, p= 0.038) and ALT (r = 0.259*, p= 0.046), also for free amine, TnI (r = 0.287*, p= 0.026). Moreover, cardiac Troponin had highly positive correlation with oxidants and enzymes of the cardiomyocyte.

Estimation of interleukin-6 level and atherogenic indices as predictors of severity of rheumatoid arthritis in Iraqi patients

Background &amp; Objective: Rheumatoid Arthritis (RA) is an inflammatory illness that causes joint degeneration and inflammation of the synovial membrane, leading to significant disability over time. Interleukin-6 (IL-6) is a widely distributed pro-inflammatory cytokine that has a variety of roles in several pathophysiologic systems, most notably in the RA development. The purpose of this study was to assess the blood levels of IL-6 and the severity and activity of RA in patients, and to assess the association of atherogenic indices with IL-6 as a predictor of severity in RA disease. Methodology: This study was a case control observational study involving 300 participants diagnosed with RA by the rheumatologists in accordance with American College of Rheumatologists (ACR)/ European League Against Rheumatism (EULAR) 2010 criteria. Serum levels of IL-6, CRP, RF and ACPA were measured by using ELISA technique. While, lipid profile was determined with spectrophotometry. Receiver operating curve (ROC) was used to study the opportunity of using atherogenic indices and IL-6 as diagnostic tools for RA. Results: The results indicated a higher IL-6 level in RA patients in comparison to the control group, e.g., 28.55 (18.76-41.07) pg/mLvs 10.19 (6.11-12.50) pg/ml. High atherogenic index of plasma (AIP) risk &gt; 0.24 in RA patients parameters (GDF-15, IL-6), the lipid profile parameters and atherogenic indices (TC, TG, VLDL-C, LDL-C, CRI-I, CRI-II, AIP, and AC) were compared with moderate atherogenic risk (AIP &lt; 0.24) in RA patients. While a significant decrease was recorded in the HDL-C and BMI levels, it had significantly high atherogenic risk (AIP &gt; 0.24) compared with moderate atherogenic risk (AIP &lt; 0.24) in RA patients. The ROC results analysis showed that the top 5 highly sensitive predictors for RA, e.g., CRI-I, AC, AIP, CRI-II followed by IL-6, have a relatively good sensitivity and specificities for predictors for RA. Conclusion: Increase in interleukin-6 may indicate the activity and severity of the disease. This biomarker could be helpful for early disease detection. The results showed a higher IL-6 in RA patients as well as increased dyslipidemia and atherogenicity in RA patients. Elevation of serum IL-6 and atherogenic indices are the best predictors for RA patients with a higher risk of atherosclerosis than other biomarkers. There is an important correlation between atherogenic indices parameters and the immunological biomarkers IL-6 indicating a significant role of the inflammation in the incidence of atherogenic indices in RA. Abbreviations: AUC- Area Under Curve; ACPA - Anti Cyclic Citrullinated Peptide Antibodies; CRP- C-Reactive Protein; ESR- Erythrocyte Sedimentation Rate; RF- Rheumatoid Factor; BMI- Body Mass Index; GDF-15 -Growth Differentiation Factor-15; DAS28-CRP- Disease Activity Score-28-C-Reactive Protein; TC- Total Cholesterol; TG- Triglyceride; HDL-C -High Density Lipoprotein Cholesterol; LDL-C -Low Density Lipoprotein Cholesterol; VLDL-C-Very Low Density Lipoprotein Cholesterol; AC-Atherogenic Coefficient; AIP-Atherogenic Index of Plasma; CR-I, CR-II- Castelli’s Risk Indexes. Keywords: Rheumatoid Arthritis, Interleukin-6, Atherogenic Indices. Citation: Abdulridha GAO, Hussein MA, Majeed SR. Estimation of interleukin-6 level and atherogenic indices as predictors of severity of rheumatoid arthritis in Iraqi patients. Anaesth. pain intensive care 2024;28(4):700−705; DOI: 10.35975/apic.v28i4.2400. Received: February 26, 2024; Reviewed: April 16, 2024; Accepted: July 09, 2024