محمد عبدالعالي محسن الحكيم

Background: Obesity is a global pandemic, and the Middle East, particularly Iraq, faces a high burden of this condition. Bariatric surgery, such as Laparoscopic Sleeve Gastrectomy (LSG), is the most effective treatment, but it carries a significant risk of micronutrient deficiencies, notably zinc and iron, which are implicated in common post-operative complications, such as hair loss. While this association is well-documented in Western and Asian cohorts, there is a critical lack of localized data from the Iraqi patient population. This pilot study aimed to investigate changes in serum zinc and iron status over a 12-month period in a group of Iraqi patients following bariatric surgery, providing localized evidence to optimize post-operative nutritional protocols. Methods: A total of 15 morbidly obese patients (mean BMI 46.0 ± 4.0 kg/m², mean age 42.0 ± 7.5 years) undergoing bariatric procedures (mini-gastric bypass, RYGB, and SG) at Al-Batool Hospital, Najaf, Iraq, were included. Serum zinc and iron levels were measured preoperatively and at 3-, 6-, and 12-months post-operation. The prevalence of deficiency was determined using established reference values. Results: Both zinc and iron serum levels declined progressively post-surgery. The prevalence of zinc deficiency increased from 13.3% preoperatively to a peak of 33.3% at 6 months. Similarly, iron deficiency rose steadily from 20.0% preoperatively to 46.7% at 12 months. While changes in mean levels and deficiency prevalence were not statistically significant over time (P>0.05), a numerical trend toward higher deficiency rates was observed in female patients and in those with a higher preoperative BMI. Conclusion: Bariatric surgery significantly exacerbates the already high prevalence of zinc and iron deficiencies in Iraqi patients. The progressive increase in deficiency rates, particularly for iron, underscores the critical need for rigorous, lifelong nutritional monitoring and aggressive, targeted supplementation protocols to mitigate the risk of associated complications in this specific patient cohort. Keywords: Bariatric Surgery; Zinc Deficiency; Iron Deficiency; Laparoscopic Sleeve Gastrectomy; Iraq; Micronutrients.

Forkhead box protein A1 (FOXA1) is pioneer factor has a dual role either as growth stimulator or a repressor and the significance role of this protein as a therapeutic biomarker still controversial, so the aim of this study was to identify the precise role of FOXA1 protein expression in treatment of BC patients by immunohistochemical (IHC) staning method. In this study, seventy three tissues samples embedded in wax block were taken from BC patients with (52.71+11.55) years who had surgery between 2014-2020 and thirty eight of normal (non tumoral) breast tissues samples with (54.17+10.84) years as a control group. There was a significant association between positive FOXA1 protein expression and Luminal A and Luminal B of BC (P=0.011). Moreover, FOXA1 positivity was elevated significantly in patients with positive Estrogen receptors (ER) expression (P=0.0001), positive Progesterone receptor (PR) expression (P=0.016). Furthermore, there was no significant correlation between FOXA1 expression in BC patients and Her2 expression (P=0.764). FOXA1 positive expression can be employed as a therapeutic marker to predict hormone responsiveness.

Forkhead box protein A1 (FOXA1) is pioneer factor has a dual role either as growth stimulator or a repressor and the significance role of this protein as a prognostic biomarker still controversial, so the aim of this study was to identify the precise role of FOXA1 protein expression in prediction of BC patients outcome and recurrence of BC by immunohistochemical (IHC) staning method. In this study, seventy three tissues samples embedded in wax block were taken from BC patients with (52.71+11.55) years who had surgery between 2014-2020 and thirty eight of normal (non tumoral) breast tissues samples with (54.17+10.84) years as a control group. Negative FOXA1 expression increased significantly in patients with recurrence BC (P=0.006), BC patients with good prognosis and moderate prognosis have a significant correlation with positive FOXA1 expression (P=0.018). Overall survival (OS) was 82.74% in patients with positive expression of FOXA1 which is longer than OS in BC patients with negative expression of FOXA1 (61.31%), (P=0.001). Disease free survival (DFS) was 81.36% in BC patients with positive expression of FOXA1 which also longer than in BC patients with negative expression of FOXA1 (59.8%) (p=0.0001). FOXA1 was a good prognostic marker for survival of BC patients.

The current study includes the detection of Aeromonas sobria isolates were obtained from total 157 samples involved the clinical samples (diarrhea samples) from patients suffering from diarrheal infections during the period from April 2017 to November 2017. at AL-Central Health Laboratory in Najaf governorate. These isolates were diagnosed by four method as (Culture method, biochemical tests, Vitek@2GN cards system and Polymerase chain reaction (PCR) technique). TheVitek@2GN cards system was the best method for diagnosis, which have led to isolate and diagnosis of 33 isolate. Multidrug resistance (MDR) of bacteria were detected by MIC testing and performed with the automated VITEK@2 GN/AST compact system. A clear variation was observed in their susceptibility to 13 antibiotics disks, these isolates of A.sobria were revealed resistance for some antibiotics such as Penicillin class Methicillin, Amoxicillin, Ampicillin, Penicillin (100%), and (91.6%) for Carbenicillin, and high rates of resistance (100%) to Cephalosporins that represented by Ceftazidime, Cefotaxime, Cefoxitin and Cefepime. The investigation of mobile genetic elements among isolates demonstrated thatA.sobria have been Class I integron genes (class 1 integron represented by integrase intI1, and IMP genes).