Baghdad Teaching Hospital Research Articles

Novel Insights Into The Role Of Serum Interleukin-39 In Patients With Systemic Lupus Erythematosus

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that has a genetic predisposition and a complex pathogenesis in which the involvement of various cytokines has been shown. In the current study, serum interleukin-39 (IL-39) levels from 99 patients with SLE and 33 healthy control subjects who attended the Baghdad Teaching Hospital Rheumatology Unit were examined. Patients were divided into 3 subgroups according to disease status: inactive (n = 33), active moderate (n = 33), and active severe (n = 33). This topic has not yet been explored, so the significance of IL-39 as a biomarker for SLE was evaluated. Cytokine levels were measured using enzyme-linked immunosorbent assay kits. Full medical histories, body mass index, gender, and clinical disease activity, the latter evaluated using the SLE disease activity index, were documented. Laboratory disease parameters, including anti-dsDNA antibodies, C3 and C4 levels, erythrocyte sedimentation rate, and C-reactive protein titres, were measured. The mean age of patients was 33.92 ± 0.91 years. The IL-39 level was higher in patients (13.70 ± 0.35 ng/l) than in controls (10.67 ± 0.19 ng/l, p < 0.01). The mean of IL-39 levels was highest in patients with active severe SLE (17.42 ± 0.48 ng/l) and then became incrementally lower with reducing disease severity, i.e., active moderate, 13.34 ± 0.23 ng/l; inactive, 10.93 ± 0.24 ng/l. Serum IL-39 showed good validity for the diagnosis of SLE. With a cut-off value ≥ 10.25 ng/l and an area under the curve of 0.79, diagnostic sensitivity, accuracy, and specificity were 79.98%, 51.5%, and 71.97%, respectively. In conclusion, serum IL-39 levels were significantly higher in patients with SLE than in healthy controls and were correlated with disease activity. This interleukin may be useful in predicting disease severity.

Microbial Sampling and Analysis Taken from Fingerprint System Devices Located at Al-Yarmouk Teaching Hospital in Baghdad - Iraq

Biometric devices (BDs) are nowadays common in use for a variety of purposes. This system involves physical contact between the skin and surface of the device, which is likely to be contaminated by microorganisms of multiple users. However, it can be a source of multiple microbiological contaminations. This study was done at AL-Yarmouk Teaching Hospital-Baghdad- Iraq, during the period started from 15th November 2023 till 15th March 2024. It was designed to find out the most common bacteria and fungi that might contaminate the fingerprint devices and performing antimicrobial susceptibility tests. Forty-six sterile swab samples taken from Twenty-three fingerprint system devices distributed in twelve different hospital departments. From each device we took two swabs, one before sterilization other after, and tested sensitivity patterns against 16 antimicrobials. Four Gram positive bacteria scored on fingerprint devices, in Medicine, Surgery, Orthopedics and Obstetrics & Gynecology departments represented by Coagulase-negative Staphylococci (CoNS). Response to sensitivity test for antibiotics, especially Moxifloxacin, Linezolid, Teicoplanin, Vancomycin, Tigecycline and Rifampicin, 100%, as well other antibiotics but in varying degrees, and not any type of fungi were isolated. In conclusion, Gram positive bacteria population was the most common organisms, and highly response in varying degrees to the most Sixteen antibiotics used in sensitivity test, however, should proper maintenance and educational practices must be applied to minimize contamination.

The Level of Serum Selenium in Patients with Cervical Intraepithelial Neoplasia in Medical City/ Baghdad Teaching Hospital

Introduction: Selenium is an essential trace element involved in different physiological functions of the human body. An inverse relationship between serum selenium levels and cervical intraepithelial neoplasia has been reported. cervical intraepithelial neoplasia is regarded as a potentially premalignant transformation of squamous cells of the cervix. Objectives: To evaluate the relationship between the serum level of selenium and cervical intraepithelial neoplasia. Methods: A case-control study was conducted at Baghdad Teaching Hospital and Iraqi National Cancer Research Center in the University of Baghdad during the period from July 2021 to July 2022. A convenient sample of 100 women was enrolled in the current study and included case group which consisted of 50 women who were diagnosed with cervical intraepithelial neoplasia and control group which consisted of 50 women who did not have cervical intraepithelial neoplasia as confirmed through histological examination after punch biopsy by colposcopy. Results: The serum level of the selenium was significantly lower in the case groups compared to the control groups (P-value=0.001). In addition, the proportion of the participant with abnormal levels of selenium was significantly higher in the case group compared to the control group (P-value=0.001). In the case group, there was a significant difference between the cervical intraepithelial neoplasia grade regarding the serum level of selenium, the level of selenium significantly decreased with the progression of the disease (P-value=0.001). Conclusions: Selenium deficiency may significantly increase the incidence of cervical intraepithelial neoplasia. In addition, it significantly impacts the transformation to a higher degree as there was a significant difference between cervical intraepithelial neoplasia I, II, and III regarding the level of serum selenium.

"Efficacy of the Low-Fodmap Diet in Managing Irritable Bowel Syndrome Symptoms: A Prospective Observational Study at Baghdad Teaching Hospital"

"Efficacy of the Low-Fodmap Diet in Managing Irritable Bowel Syndrome Symptoms: A Prospective Observational Study at Baghdad Teaching Hospital"

Lysine (K)-specific methyltransferase 2A (KMT2A) rearrangements among Iraqi de novo acute myeloid leukemia

Abstract: BACKGROUND: The classification of acute myeloid leukemia (AML) has evolved extensively over the last 20 years significantly, impacting the diagnosis and prognosis of the patients. The lysine (K)-specific methyltransferase 2A (KMT2A) gene, which has more than 80 gene fusions, is present in approximately 10% of all leukemias. Most KMT2A rearrangements are associated with adverse prognosis and need heavy chemotherapy protocol upfront. OBJECTIVE: This study aims to study the prevalence of KMT2A gene fusion among Iraqi patients with AML and its association with clinical and hematological parameters and patients’ outcomes. PATIENTS, MATERIALS, AND METHODS: A prospective cohort study conducted between December 2020 and May 2022 enrolled 115 Iraqi adults newly diagnosed with AML at the Hematology Unit of Baghdad Teaching Hospital. The patients were also monitored at this facility during the study period. Genetic rearrangements were detected using the Leukemia Q-Fusion Screening Kit through Real-Time Quantitative Reverse Transcription PCR (RT-qPCR) analysis. RESULTS: KMT2A rearrangements were identified in 23 (20%) patients. The most common was t(10;11) which presented in 15 (13%) patients, followed by t(9;11) in 5 (4.3%) patients and t(11;17) in 3 (2.6%) patients. Patients with KMT2A rearrangements were significantly older and more likely to have splenomegaly. At 1-month posttreatment, they had significantly lower red blood cell counts and hemoglobin levels and higher blast percentages. Only 4.3% achieved complete remission (CR) compared to 76.1% without KMT2A rearrangements, with a significantly higher mortality rate (30.4% vs. 5.4%, P = 0.0001). Regarding the treatment response, no significant differences were observed among the different fusion types of KMT2A rearrangements. CONCLUSION: KMT2A rearrangements are more prevalent among Iraqi AML patients compared to the global trend and are associated with older age, higher rates of splenomegaly, poorer hematological recovery, and worse outcomes, regardless of the KMT2A rearrangement fusion type.

Assessment of risk factors for myocardial infarction and its relationship with some variables

The aim of the study is to assess the risk factors which lead to myocardial infarction and relation to some variables. The filed study was carried out from the 1st of April to the end of Sept. 2005. The Sample of the study consisted of (100) patients in lbn-Albeetar and Baghdad Teaching Hospital. The result of the study indicated the following; 45% of patients with age group (41-50) were more exposed to the disease and there is no significant difference was seen in the level of education, Martial status, weight and height. The result shows that there are significant difference in risk factors like hypertension, cholesterol level in blood and diabetes. When analyzed by T.test at level of P < 0.01 and there are significant difference in smoking habits, hypertension, and diabetes mellitus patient's when analyzed by chi-squire at level of P < 0.01. The researcher recommends taking the Preventive measuments to control the risk factors.

Impact of maternal risk factors on the outcome of pregnancy in Baghdad city

To find out the impact of maternal risk factors on the outcome of pregnancy in Baghdad city. A descriptive purposive study was carried out on 100 postpartum women who had delivered for 1 hr. to 24 hrs. ago . the study sample was selected from three hospitals in Baghdad city ( Baghdad teaching hospital ,Fatima Al-Zahra'a maternity and pediatric teaching hospital and Al-Yarmook teaching hospital),during the period from 25 Jan. to 25 Feb. 2006. The data were collected through the use of questionnaire format reviewing pregnants' records and personal interview and were analyzed by using descriptive and inferential statistical approaches. The finding revealed that maternal pregnancy complications had weak effects on pregnancy outcome , while maternal employment & spouse's consanguinity were predictors for poor pregnancy outcome . The study recommended the necessity of establishing health education programs for pregnant to be self monitoring & early detection of complications that associate the pregnancy . In addition promote the system of follow up care during antenatal ,perinatal,& postnatal.

Epidemiological and Clinical Characteristics of Multiple Sclerosis in the Iraqi Population: A Study of 600 Cases

Background: These are two diseases of the central nervous system which are associated with demyelization of nerves and which has caused neurological disease and disability all over the world. Multiple Sclerosis (MS) and Neuromyelitis Optica (NMO) are chronic diseases exhibiting features of an autoimmune affection mainly affecting the central nervous system. To date, no study or report has looked at the epidemiology and clinical profile of these disorders in Middle Eastern countries, Iraq included, even though there is bibliographic evidence of the existence of these conditions in Western peoples. This project aims at encompassing this gap by carrying out a descriptive epidemiological analysis study of multiple sclerosis (MS)and neuromyelitis optica (NMO) in the Iraqi population. In this case, the research is going to be aimed at the demographic characteristics of patients, their clinical presentation and outcomes of their treatment. Methodology: A post hoc comparative cross-sectional examination of the medical records of 600 patients in Iraq was performed as part of the present investigation. For this study, data was gathered and analyzed. An additional 150 individuals with neuromyelitis optica and 450 patients with multiple sclerosis were recalled from the sample. The information was collected from Baghdad Teaching hospital in Medical City complex. The records of the patients were combed through for the previous 10 years in a row in order to determine the demographic and clinical features of the patients, as well as information on the relapses, treatment, and rehabilitation processes. In order to examine the prevalence and incidence of the two illnesses, the research used comparisons based on frequency and percentage analysis, as well as the t-test and the Chi square statistic. Results Although there were some similarities between NMO and MS, the relapse rate was notably higher in NMO patients (3. 4, compared with 2. 8 in patients with MS), and severe relapses were more frequent in the NMO group (38. ∗%, compared with 29. ∗% in the MS group; p = 0. 041). This means that NMO is much more aggressive than MS. Moreover, the NMO patients experienced more severe and longer lasting relapses than the Ms patients (median relapse duration 4. 1 weeks, p = 0. 008 compared to the 3. 2 weeks of Ms patients; 34. 7% degree of impairment in NMO patients, p = 0. 007 compared to the 21. 8% degree of impairment in Ms patients). The first notitur is that more patients with NMO received immunosuppressants (86. 7% versus 46. 7% of patients with multiple sclerosis who received immunosuppressive drugs; p = 0. 001) Thus, it is necessary to use other approaches with this group of patients. Despite this, the results showed that there was no significant difference between the two groups in relation to the time it took to resume work and/or a normal lifestyle. Thus, out of the sample, 28% showed complete recovery with the remainder 56%. Regarding the recoveries made, majority stated they had full recovery at 92 percent, 8 percent had partial recovery. Conclusion: The current study focuses on this problem in the Iraqi population and also acknowledge that NMO seems to be worse and more progressive than MS. It also puts much stress on the early diagnose of such cases as well as the use of treatment techniques that are both wide and intense especially with those who have other related complications of NMO. Each of the result supports the argument of the need to establish new treatment procedures that are relative to the area with the intention of enhancing the living standards of the patients. These results are a significant addendum to the overall shortage of knowledge of multiple sclerosis and neuromuscular disorder in the regarding of patients who belong to the developing world. In addition, they form a basis for future research that will help in the discovery of methods that can be utilised in enhancing disease treatment in the developing countries.

Attention Deficit Hyperactivity Disorder among Children with Speech Difficulties

Abstract: Speech sound disorders and attention deficit / hyperactivity disorder are developmental disorders that can significantly impact academic success. The comorbidity of these disorders may substantially add to the difficulties experienced by the child and require a combined treatment approach. Objectives: (1) to assess sociodemographic characteristics of children’s with speech difficulties (2) to assess attention deficit hyperactivity disorder and speech difficulties (3) to identify the relationship between attention deficit hyperactivity disorder and speech difficulties. Methodology: A descriptive cross-sectional study design was carried out in Baghdad Teaching Hospital. A non- probability (purposive) study sample of (300) child, who attended Hearing and Speech Center for the period from 12/April/2023 to 25/January/2024. The Questionnaire which is composed of: Socio-demographic characteristics, scales of behavioral problem, attention deficit hyperactivity disorder. Results: The study results reveal that the children experiencing severe attention deficit hyperactivity disorder and that significant relationship have been reported among speech sound disorder with attention deficit hyperactivity disorder at p-values= 0.046, also indicates that there was significant relationship among childhood apraxia and attention deficit hyperactivity disorder at p-values= 0.007. Conclusion: The children experience severe of attention deficit hyperactivity disorder, the significant relationship has been reported among speech sound disorder with attention deficit hyperactivity disorder, also indicates that there was significant relationship among childhood apraxia and attention deficit hyperactivity disorder.Recommendations: An intervention program to be planned accordingly and areas of deficit will be targeted in therapy. Liaison with parents and school teachers is indicated in order to achieve the child’s maximum potential.

Assessment of Behavioral Problems among Children with Speech Difficulties

Abstract: Behavioral problems can present differently for many children with speech difficulties, some common ones outbursts or tantrums, unwillingness to follow directions, being angry or irritable, purposefully annoying others and physical aggression toward others, such as hitting, kicking, or scratching, some children may show one of these behaviors, while other children may have many. Objectives: to assess sociodemographic characteristics, behavioral problems and speech difficulties among children with speech difficulties. Methodology: A descriptive cross-sectional study design was carried out in Baghdad Teaching Hospital. A non- probability (purposive) study sample of (300) child, who attended Hearing and Speech Center. The data were analyzed using descriptive and inferential statistical procedure for data analysis. Results: The study results reveal that (41.7%) of children with age group 6-less than 8 years (73%) of them were males and remaining (27%) were females, second born among (41%) of them while (28.7%) of them were not registered and (36.7%) of children having stuttering; speech sound disorders were prevalent among (39.7%); childhood apraxia of speech prevalent among (19.7%). Conclusion: The children experience mild behavioral problems regarding somatic complaints, thought problems, and rule-breaking behaviors, and experience moderate behavioral problems regarding anxious/depressed problems, withdrawal, social problems, and aggressive behavior, while experiencing severe behavioral problems regarding attention and hyperactivity. Recommendations: the child with speech difficulties to be seen by a speech language pathologist (SLP) to assess the child to obtain a clear idea of the child’s strengths and weaknesses in speech and language.

Gene expression of psID gene in Pseudomonas aeruginosa isolated from clinical causes

One hundred clinical samples were collected from Baghdad hospitals including Teaching Laboratories Hospital, Medical City, Baghdad Teaching Hospital and Ghazi Hariri Hospital including burn infections, wound infections, urinary tract infections, otitis media from May 2022 to September 2022, The samples were identefied by microscopic, phenotypic and culturale on MacConkey agar and by biochemical tests including oxidase, catalase, citrate utilization test, triple sugar-iron test (TSI), gelatinase test, motility test and ornithine decarboxylation test. After diagnosis, we received 19 isolates of Pseudomonas aeruginosa . To detection biofilm genes used PslD gene, we all (19) isolates of Pseudomonas aeruginosa have these genes in percentage 100% with a molecular weight of 295 base pair. The gene expression study was done to evaluate the gene expression of the PslD biofilm gene using three concentrations of cefotaxim antibiotic (2, 4 and 8) μg/ml. Only two concentrations 2 and 8 μg/ml of cefotaxim had gene expression results of psID gene, 19.32 at RNA concentration when treated with 2 μg/ml of cefotaxim, 22.56 at RNA concentration when treated with 8 μg/ml of cefotaxim and undetermined at RNA concentration when treated with 4 μl/ml of cefotaxim.

Nurses' Adherence to Infection Control Practices in Emergency Departments

Background: Follow-Up on Infection Prevention Measures It is an assortment of techniques intended to keep things free of microbes, Patient protection from diseases necessitates several actions. Preventing and controlling infections is one of the most crucial tasks for nurses. Using hand hygiene with personal protection equipment is a crucial step that can help prevent infections or their repercussions. The safety of patients and maintaining sterility and cleanliness in hospitals are the responsibilities of all nurses working there. Objectives: to evaluate the adherence of emergency department nurses to infection control protocols and recommendations. Methodology: This cross-sectional study selected a nonprobability (purposive) sample of 120 nurses working in emergency departments across three hospitals: Baghdad Teaching Hospital (50%), Al-Kindy Teaching Hospital (35.8%), and Sheik Zaydi Hospital 14.2%. The study was conducted from September 20, 2023, to 30 June 2024. collection tool, which consists of two parts: The first part is the demographic characteristics of the nursing staff (age, gender, level of education, years of experience in the emergency department, and participation in training courses related to infection control measures). Second part: Checklists were utilized for observation. The study instrument's reliability was assessed using the Statistical Package for Social Science Program (IBM SPSS) by applying Cronbach's Alpha. Results: The study finding shows that, based on the data, 66.7% of the respondents reported a fair level of practices about infection control measures. Sociodemographic factors such as qualifications notably impact nurses' practices regarding adherence to infection control practices. CONCLUSIONS: The researcher concluded that the nurses' practices were not at the level required (fair) to fit with the critical and special nature of the emergency department. Recommendations: Standard precautions are the basic level of the infection control process. The participants may possess satisfactory knowledge and compliance levels. However, more training programs and more focus on the standard precautions by educational institutes are needed for nurses to improve their knowledge and compliance with infection-control standard precautions.

Prevalence of Hyperparathyroidism among Dialysis Patients in Baghdad Teaching Hospital

Chronic kidney disease is common due to the high prevalence of its main causes. Many pathological changes occur in these patients. Hyperparathyroidism is one of the most common pathologies reported in chronic kidney disease patients. High prevalence rates have been reported worldwide in previous studies, and different factors have been implicated to be associated with Hyperparathyroidism. The aim of this study is to assess the prevalence of hyperparathyroidism among Iraqi patients with chronic kidney disease on hemodialysis therapy and to identify the factors associated with hyperparathyroidism. This was a cross-sectional study with analytic utility performed in in Baghdad Teaching Hospital, Dialysis Center during the period from June 2020 to March 2021. The study included 100 patients (60 males and 40 females). Patients with one or more of the following were excluded: primary hyperparathyroidism. Known parathyroid gland disease, malignancy, bone diseases, Kidney transplantation, or history of parathyroid surgery. Data was collected using a data collection form, and analysis was performed using the statistical package for Social Sciences version 26 (SPSS 26). Appropriate statistical tests were applied accordingly at a level of significance of 0.05. The mean age of the patients was 53.1 ± 14.2 (range: 18 – 80) years, male to female ratio was 1.5 to one. Prevalence of hyperparathyroidism was 33%. No significant association between hyperparathyroidism and each of age, the cause of CKD, or comorbidities. Hyperparathyroidism was more frequent in females (P<0.05). Higher prevalence of Hyperparathyroidism was reported among users of calcium tab supplementation\chelating, vitamin D, and Cinacalcit (P<0.05). Hyperparathyroidism was frequent among Iraqi CKD patients treated by hemodialysis in a rate of 33%. Higher prevalence of Hyperparathyroidism appeared to be associated with female gender, longer duration on hemodialysis, using calcium supplementation/chelating, vitamin D, and Cinacalcit.

The relationship between vitamin D status and disease activity in Iraqi systemic lupus erythematosus patients.

To find the relationship between vitamin D deficiency and the activity of systemic lupus erythematosus in Iraqi patients. The case-control study was conducted at Baghdad Teaching Hospital, Baghdad, Iraq, from July to October 2018, and comprised systemic lupus erythematosus patients regardless of age and gender visiting the Rheumatology outpatient clinic. Serum levels of complement protein 3, complement protein 4, anti-doublestranded deoxyribonucleic acid and 25-hydroxy vitamin D were estimated. Based on disease activity scores, patients were divided into moderate activity group SLE-M and severe activity group SLE-S. Healthy subjects matched for age and gender were also enrolled as the control group. Data was analysed using Graph Pad Prism 5.0. Of the 150 subjects, 62(41.3%) were in SLE-S group, 38(25.3%) in SLE-M and 59(33.3%) in the control group. Among the patients, 97(97%) were females and 3(3%) were males, with a female-to-male ratio of 32:1. The patients' age range was <10-≥50 years, while the control group consisted of 2 (4%) males and 48 (96%) females with an age range of <10-≥50. The mean levels of serum complement protein 3, complement protein 4 and vitamin D levels were significantly lower in the patient groups compared to the controls (p<0.05). Systemic lupus erythematosus patients suffered from either vitamin D deficiency or insufficiency, and low vitamin D levels were found related to disease activity.

Evaluating treatment effect on interferon-alpha in female patients with systemic lupus erythematosus: a case-control study.

To assess the effect of treatment on interferon-alpha titer in the serum of female patients with systemic lupus erythematosus. The case-control study was conducted at the Rheumatology Unit of Baghdad Teaching Hospital from January 2022 to April 2022 and comprised female systemic lupus erythematosus patients and healthy controls matched for age. The treated patients formed group A, while the untreated patients were placed in group B, and the controls were in group C. The disease severity status was confirmed using the systemic lupus erythematosus disease activity index. The serum level of interferon-alpha was determined using the enzyme-linked immunosorbent assay. Data was analysed using SPSS 21. Of the 150 subjects, 5033.3%) were in each of the 3 groups. The mean age of patients was 32.3±9 years while that of the controls was 33.0±11 years. Erythrocyte sedimentation rate, creatinine and aspartate aminotransferase were significantly higher in patient groups compared to the controls (p<0.05), while no-significant difference was noted between the treated and untreated groups (p>0.05). Interferon-alpha level was significantly high in group B compared to group A (p=0.037). The increase was more pronounced in those aged ≤50 years (p<0.05). Interferon-alpha was significantly high in group B patients with a disease duration of <1 year compared to group A (p=0.01). Interferon-alpha showed a significant increase in group B compared to the group A in patients with inactive systemic lupus erythematosus disease activity index and with family history (p<0.05). Treatment had a direct impact on interferon-alpha protein level in the serum of female patients of systemic lupus erythematosus.

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.

Impact of Infliximab Biosimilar (Ixifi®) Trough Levels on Disease Activity and Inflammatory Markers in Iraqi Rheumatoid Arthritis Patients

Background: Rheumatoid arthritis is an autoimmune inflammatory condition that impacts the small and larger joints. Ixifi® is a biosimilar medication derived from infliximab that exclusively targets Tumor Necrosis Factor-α. Serum Ixifi® trough concentration is necessary to manage disease activity in rheumatoid arthritis. Objective: Assess the impact of the Ixifi® trough level on disease activity and inflammatory biomarkers. Methods: A cross-sectional observational study was undertaken at Baghdad Teaching Hospital, involving forty-two patients diagnosed with rheumatoid arthritis according to ACR/EULAR 2010 criteria. After 3 months after initiating therapy with Ixifi®, the serum concentrations of Ixifi®, as well as CDAI, ESR, and CRP biomarkers, were measured. Results: After 3 months of therapy with Ixifi®, the patients in the remission group had a higher concentration of Ixifi® compared to the mild, moderate, and severe disease activity groups. Ixifi® trough level in remission was 5.45 µg/ml, while in mild, moderate, and severe groups, it was 3.575 µg/ml, 2.2 µg/ml, and 0.66 µg/ml, respectively. The CDAI scores were in the severe group (26.0), moderate group (19.0), mild group (7.0), and remission group (2.0). Furthermore, the findings indicate an inverse correlation between the Ixifi® trough level and both ESR and CRP. Conclusions: A drop in Ixifi® levels leads to an increase in disease severity and inflammation, while high concentrations of Ixifi® decrease disease activity, ESR, and CRP.

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.

Synergistic and Cytotoxic Effects of the Combination of Inerolysin and Vaginolysin Toxins on VK2 and HeLa Cells Isolated from an Iraqi Woman Who had an Abortion

Objective: The goal of this study is to purify inerolysin produced by Lactobacillus iners and vaginolysin produced by Gardnerella vaginalis, and to investigate the cytotoxic effects of the combination of these purified toxins on VK2 and HeLa cells. Methods: Out of 592 specimens from Baghdad teaching hospitals, 101 isolates were identified as L. iners and 165 isolates as G. vaginalis. The toxins were purified using ammonium sulfate precipitation, ion exchange chromatography, and gel filtration. The cytotoxic effects of the combined inerolysin and vaginolysin on VK2 and HeLa cells were studied. Results: For inerolysin, the optimal precipitation saturation ratio was 70%, with ion exchange chromatography yielding a specific activity of 14 mg and gel filtration increasing the specific activity to 40 U/mg. For vaginolysin, the optimal precipitation saturation ratio was 50%, with ion exchange chromatography yielding a specific activity of 4 mg and gel filtration increasing the specific activity to 10 U/mg. The combination of toxins showed a viability ratio of 38% for VK2 cells and 31% for HeLa cells at higher toxin concentrations. Conclusion: Inerolysin and vaginolysin cause lysis of vaginal and cervical cells, which may lead to abortion. The killing ratio increases with higher concentrations of the toxins.

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.