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Hepatitis C Genotyping And Viral Titers Among Patients With Beta Thalassemia Major in Al-Najaf Governorate - Iraq

الباحث الأول: AYMEN ABD. ALBAKAA

الباحثين الآخرين: FARIS M. AL-HARIS, ALAA JUMAAH MNAJI NASRAWI, DR. KAMAL ROTHAN AL SAAIDY

المجلة: Advanced Scientific Research

تاريخ النشر: None

مختصر البحث:

Background: Beta thalassemia syndromes are a group of hereditary disorders characterized by a genetic deficiency in the synthesis of beta-globin chains. One option for treatment patients with thalassemia major includes chronic and regular transfusio… Background: Beta thalassemia syndromes are a group of hereditary disorders characterized by a genetic deficiency in the synthesis of beta-globin chains. One option for treatment patients with thalassemia major includes chronic and regular transfusion therapy in order to maintain hemoglobin at an adequate level. But, transfusion-related viral infection produces large problems in these patients and may produces significant morbidity and mortality. These viruses may include hepatitis C virus (HCV), hepatitis B virus (HBV), Cytomegalovirus (CMV),and human immune virus (HIV) are common among thalassemic patients. In hepatitis C virus (HCV), many genotypes and subtypes are present , and they are variable in severity ,viral titers, and geographical distribution. Aim: To study the prevalence of hepatitis C virus infection in patients with Beta thalassemia major in AL- Najaf city, and to determine their base line viral titers, their genotypes and the possible relationship between HCV infection in those patients with other risk factors. Patients and methods: This cross-sectional study was conducted at the thalassemia center in AL-Zahraa Teaching Hospital for Maternity and Children in AL- Najaf city, from 1st September 2018 to the end of October 2019. A total of 356 patients pre-diagnosed with B-thalassemia major who’s registered in thalassemia center were surveyed with ELISA test to detect HCV. we did Quantitative Real Time PCR (RT-qPCR) for Beta thalassemia major patients with positive ELISA samples to confirm HCV infection and to quantitate base line viral titer for those patients. Serum samples which showed HCV RNA, and positive Real-Time PCR technique were examined by Reverse Transcription PCR (RT-PCR) to detect Genotypes &their subtypes. Medical records and some data of Beta thalassemia major (B-TM) patients with positive ELISA test for HCV infection were analyzed to study a possible risk factor. Results: This study revealed that (28) patients (7.86 %) were seropositive for HCV from a total number of (356) thalassemia major patients. From those with ELISA positive , only (16) patients (57.14 %) were PCR positive and (12) patients (42.85 %) were negative PCR assay .So the percent of patients with positive PCR from a total number of included thalassemia major patients was (4.49 % ) . Regarding genotypes: genotyp1A ( 81.25% ), genotype 4 ( 12.5% ) and mixed type 1c & 4 (6.25% ).Viral load range from 11 300 to 3 090 000 IU/ML , (mean = 1 236 982.9),( median = 1002500) A significant difference between HCV infected group and those who are not infected in regard to age, ALT and AST ( P -value was 0.0009 ,0.000 and 0.04 respectively ) . Also there is a significant difference between HCV infected group and those who are not infected in regard to splenectomy and number of transfusions (p- value was 0.041 and 0.000 respectively ).A significant difference in regard to age between infected patients with high viral load and infected patients with low viral load groups (p-value =0.007). Conclusion: The percentage of HCV infection among ß-TM patients in our center was16 (4.49 % ) patients. HCV genotype 1a is the commonest genotype in ß-TM patients in our center. The percent of HCV infected patients with genotype 1a with high base line viral load more than infected patients with low viral load.

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The role of Albumin infusion before exchange transfusion in term neonates with hyperbilirubinemia

الباحث الأول: FARIS ALHARIS

الباحثين الآخرين: AYMEN A. ALBAKAA, ALAA JUMAAH NASRAWI, ALI M. SHUAIB

المجلة: Advanced Scientific Research

تاريخ النشر: None

مختصر البحث:

Background: Bilirubin is toxic substance to the central nervous system of neonates, so when neonates suffer from sever hyperbilirubinemia they need to be treated with phototherapy and even exchange transfusion. Objectives: is to detect the effects o…

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Is Garlic Necklace Effective in the Treatment of Neonatal Jaundice

الباحث الأول: Alaa Jumaah Manji Nasrawi

الباحثين الآخرين: Shamim Riyadh Mohammed Hussien

المجلة: Mashhad University of Medical Sciences

تاريخ النشر: None

مختصر البحث:

Background: Hyperbilirubinemia is a prevalent clinical problem which affects 60% of term and 80% of preterm neonates. Garlic is the most well-known remedy used in Iraq for the treatment of jaundice. To test the effectiveness of garlic necklace in th…

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Serum ferritin and liver function test response to oral versus subcutaneous iron chelating agent

الباحث الأول: Aymen Abd. Albakaa

الباحثين الآخرين: Faris M. Al- Haris Alaa Jumaah Mnaji Nasrawi Jassim Mohammed Al Musawi Talib Abdul Jalil Al Madany

المجلة: European Journal of Molecular & Clinical Medicine (EJMCM)

تاريخ النشر: None

مختصر البحث:

Abstract Thalassemias are group of inherited autosomal recessive blood disorder. The genetic defect, which could be either mutation or deletion, results in complete absence or reduction synthesis of one of the globin chain that make up hemoglobin.… Abstract Thalassemias are group of inherited autosomal recessive blood disorder. The genetic defect, which could be either mutation or deletion, results in complete absence or reduction synthesis of one of the globin chain that make up hemoglobin. This cause reduction of haemoglobin molecules production ,resulting in decreased of oxygen carrying capacity of the circulation thus causing anemia, the characteristic presenting symptom of the thalassemia. Good chelation therapy and regular blood transfusion protocol have increased the life expectancy. Objectives : is to compare serum ferritin level and liver function test in a group of patients with beta thalassemia major in response to subcutaneous and oral chelating agent . Patients and Methods: Prospective analytic study design done on group of 60 patients with beta thalassemia major diagnosed by hemoglobin electrophoresis registered in thalassemia center in AL – Zahra Teaching Hospital for Maternity and Children in AL- Najaf AL- Ashraf , during a period from 1st of February 2019 to 1st of February 2020, aged 2.5 to 17.9 years with serum ferritin levels above 1000 ng/ml and liver transaminases below 5 folds the normal upper limit . The patients divided into 2 groups, 30 patients were on Deferasirox {Exjade} therapy and 30 patients were on Deferoxamine {Desferal} therapy . Base line S. Ferritin value as well as LFT (S. GOT , S. GPT , ALP and TSB) value, were taken as base line level and then every (8-12) weeks and were used to assess the changes that occurred in response to subcutaneous and oral chelating agent . Results : Our study show significant decline in SF (P value <0.05) in both groups after 1 year of treatment with oral or subcutaneous chelating agent. Patients on Exjade show more rate of decrement of serum ferritin (11%) compared to patients taken Desferal who a rate of decrement (6%). Patients on Exjade and Desferal therapy show increment in liver enzymes after 1 year of treatment with statistically significant results, p-value < 0.05 . Conclusions We found superiority in oral iron chelating agents (Exjade) to subcutaneous iron chelating agents (Desferal). Serum ferritin level is suitable for long term monitoring as an indicator of efficacy than liver biopsy .

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The role of interleukin-23 overexpression in preterm labour

الباحث الأول: ALAA MOHAMMED SADIQ

الباحثين الآخرين: LUMA S. ZEINY, SHAMIM RIADH MOHAMMED AL AASAM, ALAA JUMAAH MNAJI NASRAWI, NOOR ALI LAFTA.

المجلة: Advanced Scientific Research

تاريخ النشر: None

مختصر البحث:

Background: Cytokines may have a role in preterm labour pathophysiology. Many studies revealed the association of cytokines with preterm labour and explained partially the mechanism of preterm uterine contractions. Interleukin-23 (IL-23) is a novel …

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Urinary Tract Infection in Children with Idiopathic Nephrotic Syndrome

الباحث الأول: Faris M Alhares

الباحثين الآخرين: Aymen A Albakaa, Alaa Jumaah Nasrawi and Naim Salim

المجلة: scholars Literature

تاريخ النشر: None

مختصر البحث:

Abstract Nephrotic syndrome is a common childhood kidney disorder featured by increase protein excretion urine with low serum albumin with generalized edema and hyperlipidemia. It’s mainly a disease of childhood 15 times more than an adult. The oc… Abstract Nephrotic syndrome is a common childhood kidney disorder featured by increase protein excretion urine with low serum albumin with generalized edema and hyperlipidemia. It’s mainly a disease of childhood 15 times more than an adult. The occurrence of Urinary tract infection (UTI) in these patients is increasing, this may be to immunoglobulin loss in urine, defective T cell function, immune-suppressive agents, and relative malnutrition. Aim of the Study: It is to evaluate the occurrence of UTI, its etiological agents, antibiotics sensitivity type, and the effect of UTI on relapse and response to therapy in children with nephrotic syndrome in An Najaf Governorate. Methods: A prospective cross-sectional study of all patients with idiopathic nephrotic syndrome from January 2018 to January 2019 visiting nephrology unit in Al Sader teaching hospital and Al Zahraa teaching hospital. The urine sample was taken by a clean catch method of midstream urine and by urine bag methods for those under 3 years old. The specimens were cultured immediately then examined under the microscope. Results: A 101 patients were studied. The mean age and (S.D) for males was 6.3±2.35years and females with 6.5±1.9years. The age range was 1.5 year to 10 years. There were 44 patients (43.6%) had UTI, 29 patients (65.9%) of them were males and 15 patients (34.1%) females. UTI caused by E. coli. in (25) patients ( 58%) ,Streptococcus (8) patients(16.26%), Staphylococcus aurous (5) patients (11.36%), Proteus (3) patients(6.97%), Pseudomonas (2) patients (4.65%), Klebsiella species (1) patients (2.32%). The E.coli show very good antibiotic sensitivity to cefatriaxion, cefataxime and ciprofloxacin. Each of Proteus, Klebsiella, Pseudomonas spp. show a good sensitivity to cefatriaxion, ciprofloxacin and aminoglycoside while each of Streptococcus SPP and Staphylococcus aureus show good response to ciprofloxacin and moderate sensitivity to the augmentine (combination of amoxicillin and clavulanic acid) and to Septrin (co-trimoxazole) (combinations of Sulfamethoxazole and trimethoprim) and there was high in vitro resistance of these bacteria to ampicillin and nalidixic acid. Conclusion: There is a high occurrence of urinary tract infection in idiopathic nephrotic syndrome children of An Najaf Al Ashraf city and its necessity to diagnose the disease early depending on clinical suspicion and doing the GUE and cultures monthly to avoid delay in diagnosis of infections and their sequels.

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The significance of Helicobacter pylori Infection as a cause of recurrent abdominal pain in children

الباحث الأول: Ahmed Abdul Hadi Mohsen

الباحثين الآخرين: Alaa Jumaah Manji, Jasim Mohammed Hashim, Rawasee Malik Obeid

المجلة: Allied Academies

تاريخ النشر: None

مختصر البحث:

Background: Recurrent abdominal pain (RAP) is a frequent gastrointestinal complaint in pediatrics. The roles of Helicobacter pylori (H. pylori) as a cause for these complaints remain controversial. Helicobacter pylori infection is a worldwide infe… Background: Recurrent abdominal pain (RAP) is a frequent gastrointestinal complaint in pediatrics. The roles of Helicobacter pylori (H. pylori) as a cause for these complaints remain controversial. Helicobacter pylori infection is a worldwide infection that is commonly acquired during childhood. Aim of study: To detect the association between recurrent abdominal pain and Helicobacter pylori infection in children between (3-13) years. Patients and methods A hospital base case control study conducted in Alzahraa teaching hospital for maternity and children between first of November 2014 to 28th of February 2015.Thirty three children ranging between (3- 13) years old with mean age ± SD (7.94 ± 2.51) years complaining from recurrent abdominal pain were studied. Patients were classified into three groups according to the age: group A (3patients) whom their age (3-5) years, constituent of group B (25 patients) whom their age ranged (5-10) years, and group C (5 patients) whom their age ranged (10-13) years. Control group consist of 35 healthy children with mean age ± SD (6.03 ± 3.79) years. Complete blood count, blood film, screen for celiac disease, general stool examination, urinalysis, erythrocyte sedimentation rate, ultrasound of abdomen, and screen for Helicobacter pylori in blood and stool were done to all patients. Screening for Helicobacter pylori screen in the blood and stool was done for control group. Results: The present study demonstrated that, out of 33 samples of RAP there were 11 positive (33.33%) and 22 were negative for H. pylori (66.67%). while regarding control group, current study demonstrated that out of 35 cases there were 4 cases positive for H. pylori infection, with a statistically significant difference between patients and control group regarding to H. pylori infection (P=0.029). Moreover, current study demonstrated no a significant difference between the percentage of H. pylori infection when compared among different age groups (p=1.000). We found strongly significant correlation (p<0.001) between H. pylori infection and family history of recurrent abdominal pain. Conclusion: We conclude that H. pylori represent an important cause of abdominal pain in children and must be included in RAP work-up.

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Oral Glucose Tolerance Test in Blood Transfusion Dependent Thalassemic Patients

الباحث الأول: Dr. Qassim Mohamed Hashim

الباحثين الآخرين: Dr. Alaa Jumaah Manji

المجلة: International Journal of Science and Research (IJSR)

تاريخ النشر: None

مختصر البحث:

ackground Beta thalassemia major is a common clinical problem we are facing it in our country, present transfusion protocols have increased the life expectancy of patient with beta thalassemia major, but iron overload is a major clinical complicatio… ackground Beta thalassemia major is a common clinical problem we are facing it in our country, present transfusion protocols have increased the life expectancy of patient with beta thalassemia major, but iron overload is a major clinical complication of the treatment. Aim of the Study This study is to determine the prevalence of diabetes mellitus and association of some factors with impaired glucose tolerance test in transfusion dependent beta thalassemia major. Patients and Methods A case control study was done on a randomized group of patient with beta thalassemia major diagnosed by hemoglobin electrophoresis registered in thalassemia center in ALZahraa Teaching Hospital for Maternity and Children in AL- Najaf AL- Ashraf, during a period from 15 of January 2016 to 1st of May 2016. According to inclusion and exclusion criteria, a total number of 50 thalassemic patients included in this study all of them on blood transfusion as part of their treatment. And 50 patient control are healthy children chosen from visits to schools, with same age. Consent was obtained from the patients first-degree relatives (mother or father) these patients were also informed that the results of the study would be provided to them as free useful laboratory tests. The patients were diagnosed with beta thalassemia major as recorded in their files ( by Hemoglobin electrophoresis). The patients name, age, gender, time of first blood transfusion, number of blood transfusion, time of starting of chelation treatment, period of chelation therapy, history of previous splenectomy, hepatitis state, and family history of diabetes mellitus was taken and relevant systemic examination was done. Patient suffering from any acute illness, liver disease and previously diagnosed case of diabetes mellitus, were excluded, we define impaired Oral glucose tolerance according to World Health Organization. Results There was Statistically significant association of Diabetes and glucose intolerance in thalasemic children ( p-value<0.001), and significant association with higher age ( p-value<0.001) and with low Hemoglobin (p-value<0.001 ) with prevalence of Diabetes and glucose intolerance in thalassemic children. Conclusion The study showed increasing incidence of Diabetes mellitus and glucose intolerance in thalassemia children and this probability increases with low Hemoglobin and higher age.

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The Effect of Hypertonic Saline in Treatment of Moderate Bronchiolitis in Children

الباحث الأول: Alaa Jumaah Nasrawi

المجلة: University of Kufa

تاريخ النشر: None

مختصر البحث:

Background: Airway oedema and mucus plugging are the predominant pathological features in infants with acute viral bronchiolitis. Nebulized hypertonic saline (HS) solution may reduce these pathological changes and decrease airway obstruction.Aim: To…

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Percentage of Patient with Celiac Disease among Children with Short Stature

الباحث الأول: Dr. Alaa Jumaah Manji

الباحثين الآخرين: Dr. Qasim Mohammad Hashim Dr. Jasim Mohammad Hashim,Dr. Ahmed Thamer Abed

المجلة: University of Kufa

تاريخ النشر: None

مختصر البحث:

Abstract: Back ground: Clinical features of celiac disease vary considerably. Intestinal symptoms are common in children whose disease is diagnosed within the 1st 2 years of life. As the age at presentation of the disease shifts to later in childho… Abstract: Back ground: Clinical features of celiac disease vary considerably. Intestinal symptoms are common in children whose disease is diagnosed within the 1st 2 years of life. As the age at presentation of the disease shifts to later in childhood, and with the more liberal use of serologic screening tests, extra-intestinal manifestations and associated disorders, without any accompanying digestive symptoms, have increasingly become recognized, including short stature. We aim in this study to determine the percentage of celiac disease among patients with short stature. Objectives of the Study: (1) to show the percentage of patient with celiac disease in short stature children. (2) to show the effect celiac disease on treatment of short stature children. Method: A cross sectional study that carried out at the Endocrine Pediatrics Clinic at A Zahraa Teaching Hospital for a period from 1st of January 2013 to end of October 2013; a total of 167 children and adolescents, aged range from 2 to 18 years were registered with short stature . 91 children of them only have been enrolled in this study according to inclusion criteria. Enzyme immunoassay (Biosystems, Spain) was used to determine IgA tTG using microplate tests. Samples with concentrations >20U/mL were defined as positive. Patients with positive anti-tTG serology were referred to the gastroenterology clinic to continue investigation of celiac disease by endoscopy and biopsy. Data were analyzed by SPSS software from IBM version 20 using chi square and paired T-test. Result: A total of 167 patients were evaluated 91 of them only have been enrolled in our study according to inclusion criteria; 59 (65%) were female and 32 (35%) were male. Median age was 9 years (from 2 - 18 years).The anti-tTG assays were positive in 16.5% of patients (15/91). Out of 15 patient whose diagnosed as anti-tTG positive, 11 (73%) have been diagnosed as celiac disease by endoscopy and biopsy according to modified marsh classification. All children diagnosed to have celiac disease were kept on a gluten-free diet. Patients were followed-up for six months and showed improvement in growth rate. Conclusion: Celiac disease a cause of short stature that should be included in diagnostic investigations of short stature. Recommendation anti-tTG antibody as routine test recommended for all patients with short statures. All patients with idiopathic short statures and anti-tTG test positive with normal IgA level should be subjected to intestinal biopsy to prove the diagnosis of celiac disease.

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Bubble Nasal CPAP in the Management of Respiratory Distress Syndrome (one year experience in low resources unit)

الباحث الأول: Shamil AZ Sharba

الباحثين الآخرين: Raid MR Umran, Alaa Jumaa

المجلة: Babylon University

تاريخ النشر: None

مختصر البحث:

Background: Respiratory Distress Syndrome is a clinical manifestation due to a deficiency or dysfunction of pulmonary surfactant. The use of CPAP for RDS Produces more regular breathing pattern, establishes and maintains functional residual capaci… Background: Respiratory Distress Syndrome is a clinical manifestation due to a deficiency or dysfunction of pulmonary surfactant. The use of CPAP for RDS Produces more regular breathing pattern, establishes and maintains functional residual capacity, decreases upper airway resistance, results in progressive alveolar recruitment, inflates collapsed alveoli and reduces intrapulmonary shunting, decreases upper airway collapsibility and reduces obstructive apneas, promotes the release of and conservation of surfactant on the alveolar surface. Objective: To evaluate the effectiveness of using bubble CPAP in the management of respiratory distress syndrome and to identify the risk factors associated with its failure. Patients and methods: 63 newborns who have been diagnosed as RDS were started on Bubble CPAP with bi-nasal prongs. Bubble CPAP was considered to be successful if the respiratory distress improved and the baby could be successfully weaned off from CPAP. Based on radiological findings, the severity of RDS was graded as mild, moderate and severe. Results: The mean gestational age was 30.67 ± 2.16 weeks and mean birth weight was 1525.34  441.49 grams. The median age of starting CPAP was 2 hours of life. The median duration of CPAP was 36 hours. 42 (66.67%) newborns were survived and weaned successfully from CPAP and 21 (33.33%) failed to weaned successfully from CPAP and turn to mechanical ventilation. extreme low birth weight, lower gestational age, multiple pregnancies, radiological signs of severe RDS, and delay in the application of CPAP, and long duration of CPAP treatment were associated with poor neonatal out come and failure of CPAP ( p value <0.05). Sepsis, apnea and shock are the main immediate complications of RDS patients which may adversely affect the CPAP success. Conclusion 1. One year experience of the medical and nursing staff with the using of BCPAP had risen its effectiveness from (44.42%) in Umran, et al. to (66.66%) in our study within the same center; however, it is still less than that founded by a lot of other researches. 2. Preterm neonate who are; “extreme low birth weight, lower gestational age, multiple pregnancies (twin or triple), whiteout on the chest X-ray, delay in the application of CPAP, prolong duration of CPAP treatment” have increased risk for CPAP failure. 3. Sepsis, apnea and shock are the main immediate complications of RDS patients which may adversely affect the CPAP success.

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علاء جمعة منجي نصراوي

علاء جمعة منجي نصراوي

الملف الشخصي

الاهتمامات البحثية

البحوث المنشورة

Hepatitis C Genotyping And Viral Titers Among Patients With Beta Thalassemia Major in Al-Najaf Governorate - Iraq

The role of Albumin infusion before exchange transfusion in term neonates with hyperbilirubinemia

Is Garlic Necklace Effective in the Treatment of Neonatal Jaundice

Serum ferritin and liver function test response to oral versus subcutaneous iron chelating agent

The role of interleukin-23 overexpression in preterm labour

Urinary Tract Infection in Children with Idiopathic Nephrotic Syndrome

The significance of Helicobacter pylori Infection as a cause of recurrent abdominal pain in children

Oral Glucose Tolerance Test in Blood Transfusion Dependent Thalassemic Patients

The Effect of Hypertonic Saline in Treatment of Moderate Bronchiolitis in Children

Percentage of Patient with Celiac Disease among Children with Short Stature

Bubble Nasal CPAP in the Management of Respiratory Distress Syndrome (one year experience in low resources unit)

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