faris mhammed abdalsada Alhares

ABSTRACT 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 β-TM patients in our center was16 (4.49 % ) patients. HCV genotype 1a is the commonest genotype in β-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. (28) (PDF) Hepatitis C Genotyping And Viral Titers Among Patients With Beta Thalassemia Major in Al-Najaf Governorate -Iraq. Available from: https://www.researchgate.net/publication/343063812_Hepatitis_C_Genotyping_And_Viral_Titers_Among_Patients_With_Beta_Thalassemia_Major_in_Al-Najaf_Governorate_-Iraq [accessed Dec 04 2020].

Abstract: 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 of intravenous infusion of human albumin before double volume exchange transfusion in rapid reduction of total serum bilirubin after exchange and in decreasing the risk of second time exchange. Patients and methods: A randomized control trial study done between January and December 2017 on fifty three neonates admitted to neonatal care unit of AL-Zahraa Teaching Hospital at AL-Najaf that fulfill the inclusion criteria and exclusion criteria. So two groups enrolled in the study as control group(n=29) and albumin group (n=24) , the albumin group receive albumin 1g/kg 20% one hour prior to exchange transfusion while in control group exchange transfusion only without albumin used. Results: A significantly lower mean post exchange total serum bilirubin in albumin group than that in control group at 6,12and 24 hours as p-value< 0.001 ,the mean of phototherapy duration significantly decreased in test group in comparison to control group (8.6±0.96hoursvs 17.9±3.8hours) respectively as p-value<0.001, also none of albumin group need second time exchange while three cases in control group underwent second time exchange with no side effects related to albumin use noticed. Conclusion: We conclude that Albumin administration before exchange blood transfusion can effectively reduces total serum bilirubin, period of phototherapy and greatly minimize risk of another exchange transfusion.

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. Keywords: Urinary Tract Infection; Nephrotic Syndrome

Abstract: This prospective study deals with 250 female neonates who were (1-28 days)old , they were admitted to the intensive care unite of neonates in AL-Zahraa teaching hospital in AL-Najaf city through the period from April to October 2008.We used gray scale sonography (Dynamic with stress technique ) as a screening tool for developmental dysplasia of the hip (DDH). The positive result from total number was three (1.2%).Two of them were delivered by normal vaginal delivery and one delivered by caesarian section ,in all the affected neonates the right hip joints were involved.

Abstract A comparative clinical study was done on neonatal patients with jaundice admitted to neonatal unit in Al Zahra Maternity& Pediatric Teaching Hospital in AL Najaf city from the beginning of the April to the end of September 2007 to show the difference between the effect of intensive and traditional phototherapy. (162) patients included in the study half of them put under intensive phototherapy and another half put under traditional phototherapy. We see that all of patients under intensive phototherapy showed the decrement in TSB level more than that in patients under traditional phototherapy with a significant difference only in ABO and Rh incompatibility.

Abstract: This study is a prospective study of (52) cases of bloody diarrhea in children (less than 5 years) admitted to maternity and Children hospital in Najaf Governorate in January to May 2007 with a review to their clinical presentation, investigation (GSE and stool culture) the etiology of bloody diarrhea a many children included in our study shows that the most common cause were Escherichia coli (23%) followed by Entameba histolytica (13.4) then few cases caused by salmonella (1.9 %).