ذكرى عبد جبر الكيشوان

This study mainly aims to evaluate whether Thr399Ile polymorphism in TLR-4genes is related to DFU in a sample of Iraqi patients with type 2 diabetes mellitus (T2DM). The case- control study included 120 patients with the type 2 diabetes, 60 participants with the type 2 diabetes and foot ulcer group I, 60 participants with the type2 diabetes group II and 60 controls group III.TLR-4(Thr399Ile) genotyping was done by Polymerase chain reaction (PCR) followed by restriction analysis. There was no statistical difference in the distribution of TLR-4 (Thr399Ile) genotypes between the 3 study groups, the genotypes in group I included CT 6 (10.0%) and TT 0.(0 %) was compared with wild type CC 54 .(90.0 %) while CT 10(16.7 %) and TT 0.(0 %) was compared with CC 50 .(83.3%) in group II and in group III CT 7(11.7%) and TT 0.(0 %) was compared with CC 53 .(88.3%).The distribution of genotypes between group I and group III was (OR= 1.2, 95% CI: 0.4-3.8, p= 0.8) while when comparing group I and group II (OR=1.8, CI=0.6-5.3, p=0.3). On the other hands, the comparison between group II and group III was (OR= 0.7, 95% CI: 0.2-1.9, p = 0.4)

Background: Coronary heart disease is the leading cause of adult mortality and morbidity throughout the world. Well known risk factors independently or combined are involved in both atherosclerosis and myocardial infarction. Recent data have shown that viral and bacterial infections may also contribute to acute thromboembolic events, hence a case control study was carried out. Aims: To investigate the possible association between periodontal health and patients with Acute Myocardial Infarction (AMI). Material and Methods: 50 patients, and 50 control were included in the study. Data on hypertension, diabetes, and smoking status were recorded. Clinical examination of AMI patients was carried out during the hospital stay. Clinical Attachment Loss performed for all subjects. Results: There were no significant variations between the groups regarding the age, gender and BMI, while more incidence of risk factors in patients. There were significant worsening of grades of periodontitis with increasing age. Higher incidence of periodontitis in patients with AMI were distinguished. Those with unhealthy periodontium shows 11.5 times higher chance to have AMI. Most of the subjects in control group (92%) had healthy periodontium, whilst advanced periodontitis was limited to the patients only (50%). The bulk of the subjects (63%) were either overweight or obese, meanwhile, only 3.3% of the subjects were underweight. No statistically significant relationship of obesity with occurrence of AMI. No significant differences between the groups existed in the relation of BMI and grades of periodontitis. Conclusion: Overall result of this case control study showed an association between periodontitis and acute myocardial infarction.

Background: BRCA1 immunohistochemistry (IHC) provides a rapid initial screen to detect BRCA1 dysfunction in ovarian cancer that resulting from genetic alterations.Aim: To assess the expression of BRCA1 protein by IHC analysis among a group of Iraqi ovarian cancer patients to evaluate the patterns of expression and its correlation with the clinicopathological parameters in attempting to evaluate a significance role of BRCA1 gene implication in ovarian cancer.Methods: Forty three paraffin embedded samples of ovarian cancer cases were analyzed for BRCA1dysfunction by IHC analysis. The semi-quantitative approach using modified histochemical score (H-score) was achieved to assess the patterns of BRCA1 gene expression. Results: Complete loss of BRCA1 nuclear expression was detected in 30.2% of the cases while, reduced expression occurred in 46.5% of cases, giving rise to 76.7% of all cases detected with altered BRCA1 nuclear expression. Altered BRCA1 expression was found to be higher in agegroup ≤ 45 years (78.3%) in comparison with those of ages >45 years. Altered BRCA1 expression was significantly correlated with the high grade and with the unilateral tumor site when compared with the low grade and bilateral tumor site (P≤0.05), and was insignificantly correlated with the high stage ovarian tumors, 11.6% of cases were detected by cytoplasmic BRCA1 expression and no association was found between cytoplasmic expression and tumor grade, stage and tumor site. Conclusion: Altered BRCA1 expression may play a significant role in the progression of ovarian cancer. Recommendation: BRCA1 IHC is a clinically useful approach to detect the BRCA1 dysfunction and the H-score assessment reflects good estimation for BRCA1expression patterns.

Aim of Study: The aim is to do molecular characterization of Staphylococcus aureus isolated from hospital staff and environment, in order to determine the gene(s) that is (are) responsible for antibiotics resistance especially mecA and SCCmec. Methodology: This study that aimed to detect methicillin resistant Staphylococcus aureus in isolates from AlSader Teaching Hospital and al-Hakeem General Hospital in Annajaf during the period from November 2015 to April 2016. From a total of 250 clinical samples that were collected to isolate Staphylococcus aureus from the hospital staff (nurses, doctors, workers, medical student ---etc.), and also from different parts of hospital environments. A total of 50 Staphylococcus aureus isolate were detected and confirmed by different morphological and biochemical confirmatory test. Results: These 50 isolates then studied by VITEC2 and also by cefoxitin disc susceptibility test .It was able to detect only 41 isolates that had cefoxitin resistance which represented 82% of the total Staphylococcus isolates which are regarded as Methicillin Resistant Staphylococcus aureus phenotypically. Polymerase chain reaction test was done to find out the genes that are responsible for methicillin resistance in these isolates, using three types of primers one was for Sa442 gene which was designed to confirm that the isolates were Staphylococcus aureus and two other genes to confirm that the isolates were methicillin resistant which were mecA and SCCmec with the different subtypes of the last gene, and it was found that from the 41 isolates which were phenotypically confirimed to be methicillin resistant only 32 were found to harbor these genes which represented only 78% of the phenotypically confirmed MRSA; It was found also that the subtype SCCmec type IV was the most dominant gene among SCCmec types in these isolates as it was detected in 23 out of 32 isolates (71.9%), followed by SCCmec type III Which was found in 5(15.6%) of the isolates. Conclusions: Polymerase chain reaction is the golden slandered for identification of methicillin resistant Staphylococcus aureus MRSA. The SCC mec type IV was the most dominant among SCCmec genotypes of MRSA strains that were isolated from hospitals in the present study. Recommandation: Vancomycin resistant staphylococcus aureas (VRSA) should be taken in consideration when we are working with hospital cross infection. Further studies on large scale should be performed in order to study MRSA in the whole country. Antibiotic prescribing policy should be put under observation and guidenece inside and outside hospitals.

Myocardial infarction (MI) is a disorder that could be a reason for morbidity & mortality. Effective & early identification is crucial for management. One analytical technique for the diagnosis of MI is evaluating plasma troponin (Tn) values. Bearing in mind the problems of blood aspiration from patients, a noninvasive practice like measuring of saliva Tn can be used as an alternative way. The present works aims to inspect variations in plasma & salivary Troponin I (TnI) measurements in AMI patients. Methods: The study involved 100 patients diagnosed as AMI by physicians. After obtaining their agreement, both salivary & plasma TnI levels was assessed by saliva & blood sampling consequently by means of; VIDUS® techniques and kits. Results: The mean age of patients was 56.5years and 79% of patients were male. There was week positive correlation between blood and serum troponin levels (r=0.1, P<0.05). The mean troponin level in serum was 8.07ng/L and troponin level in salvia was 0.16 ng/L showing a steady increase in saliva and blood during the process of AMI. There was no significant correlation of both serum & salivary TnI with increasing age or with gender differences. Conclusion: There was week positive significant correlation between S TnI & Sal TnI concentrations showing a steady increase in saliva and blood during the process of AMI.

One of important microvascular complication of patients with T2DM is neuropathy, commonly diabetic peripheral neuropathy (DPN). MTHFE/C677T polymorphisms affect MTHFR enzyme activity with subsequent elevation in the toxic homocysteine concentrations that result in vasculopathy and nerve ischemia. This case control study was planned to estimate the association between the MTHFR/C677T polymorphism and the occurrence of peripheral neuropathy in type 2 diabetic (T2DM) patients in a group of Iraqi people Eighty three Iraqi subjects were included in this study, 36 had diabetic peripheral neuropathy, 25 without peripheral neuropathy and 22 were healthy control. Genomic DNA was isolated from fresh whole blood and genotyped using the polymerase chain reaction–based restriction fragment length polymorphism assay for the MTHFR gene C677T mutation. The distribution of MTHFR/ C677T mutated genotypes between DPN and healthy groups was statistically differed with increased risk of occurrence of DPN (OR= 3.1, 95% CI: 1.02-9.4, p=0.05), while this risk was highly increased by seven folds when comparing DPN group with those without DPN& 2 (OR= 6.7, CI=2.1-20.8, p=0.0008).MTHFR/C677T polymorphism is highly associated with development of peripheral neuropathy in T2DM Iraqi population

This research was performed to evaluate type 2 diabetes mellitus duration as a risk factor for development of peripheral neuropathy (DPN).Initially 157 patients with T2DM who fit the general inclusion criteria were collected, but only 61 of them enrolled in this study due to the application of restricted inclusion criteria and according to the results of the nerve conduction study (NCS) those 61 patients divided into two groups, group 1: 36 patients, had diabetic peripheral neuropathy (DPN), and group 2:25 patients without DPN. For all these patients a lot of investigations were performed to exclude any other cause of neuropathy( lipid profile, renal, thyroid functions, fasting blood sugar and glycated hemoglobin).Significant statistical differences in the duration of T2DM between study groups was observed, p value was 0.04.The more duration of T2DM the high risk for diabetic peripheral neuropathy.

Breast cancer represents the most common cancer in women worldwide, constituting 23% of female cancers. In Iraq, It is considered as the first cause of death in women, accounting approximately one-third female cancers. The incidence increased dramatically, especially after Gulf War 1 and 2, probably due to exposure to environmental hazards as depleted uranium. Other factors such as life style may play a role breast cancer. The present study was designed to investigate the genetic alteration in two tumor suppressor genes(p53 and PTEN) and their possible role in breast cancer progression. The current study included 132 sample of Paraffin-embedded breast cancer tissues which were analyzed for PTEN and p53 expression by immunohistochemistry. We also studied the correlation between PTEN and p53 expression in relation to clinicopathological parameters. The loss expression of PTEN protein was found in 76 (63.8%) of 119 breast cancer tumors, while, The overexpression of P53 protein was found in 65.2% (86 out of 132).The loss expression of PTEN was correlated with high grade and stage, lymph node involvement, large tumor sizes and age of patient less than 50 years compare with low grade, lymph node negative, small tumor sizes and age patient more than 50 years. The p53 expression was significantly correlated grade, stage and lymph node status as well as age group less than 50 years.The loss function of p53 and PTEN geneswas found in more of half breast cancer cases and the expression of PTEN protein decreased in p53-deficient cells compared with that in p53 normally expressed cells. The loss function of p53 and inactivation of PTEN genes are well with high grade and stage as well as lymph node positive. The genetic alteration of p53 and PTEN genes play important role in progression of breast cancer

PTEN tumor suppressor gene is located on chromosome 10q23, consisting of 9 exons, that encodes a 403 amino acids dual-specificity phosphatase with lipids and protein phosphatase activities. PTEN plays a major role in control multiple cellular functions such as cell metabolism, cell cycle progression and cell survival. The PTEN gene is frequently mutated or inactivated in high proportion of human cancer including breast cancer. The aim of this study was to find the correlation between the decrease of PTEN expression with clinicopathological parameters in breast cancer patients. The current study included 85 sample of Paraffin-embedded breast cancer tissues were analyzed for PTEN expression by immunohistochemistry. We also demonstrated correlation PTEN expression and clinicopathological factors. The loss expression of PTEN protein was found in 50 (58.8%) of 85 breast cancer tumors, while PTEN protein expression was normal in 35 (41.2%) of 85 tumors. The loss expression of PTEN was correlation with lymph node involvement and age patient, and there was no significant correlation with stage, grade, tumor sizes and histological types. Conclusion : These results demonstrated the loss of PTEN expression was found in more than half of breast cancer cases and the reduced expression of PTEN protein was correlated with lymph node metastases and may play a role in progression of breast carcinoma , and hence , worse prognosis in the patients with breast cancer. Beside, the detection of the loss of PTEN expression may serve as a useful biologic marker for progression in invasive breast cancer.

This study aimed to evaluate whether (1237 T/C) polymorphism is related with diabetic foot ulcer in type-2 diabetes mellitus of Iraqi patients in Najaf city. Diabetic foot ulcer (DFU) is one of the most prevalent and serious diabetic complications. DFU accounts for about 15% of the diabetic population. It is commonly associated with the increased diabetic morbidities and mortalities. The type 2 diabetes is recognized by aberrations of glucose, lipid and protein metabolism. It is increasingly appreciated that wound healing defect seen in diabetic patients is attributed to the altered protein and lipid metabolism. This study involved (180) subjects, between them, 60 were patients as group one suffering from type 2 diabetes and 60 were patient suffering from type 2 diabetes and foot ulcer as group two. In addition, 60 healthy group three as control subjects. Polymerase chain analysis was used for detection of TLR-9 genotypes followed by restriction analysis. We observed no significance differences in the distribution of the genotypes and alleles of (1237 T/C) polymorphism among the study groups.