Background: Primary hypothyroidism can be defined as an increase in serum thyroid-stimulating hormone (TSH) level, and the concentration of free T3, free T4, T3, and T4 is low. Hypothyroidism is a prevalent disease mostly affecting middle-aged women. One of the most important determinants of glucose homeostasis is thyroid hormones. Hypothyroid patients have a higher prevalence of insulin resistance and tendency to Type 2 diabetes mellitus than the normal individual. Objective: To investigate the correlation between TSH and hemoglobin A1c (HbA1C) in patients with primary hypothyroidism; so, to study the effects of hypothyroidism on glucose metabolism. Subjects and Methods: Ninety-five Iraqi primary hypothyroidism patients and 40 healthy persons taken as control were selected from Specialized Centre for Endocrinology and Diabetes during the period from June 2017 to January 2018. The patients were diagnosed previously as cases of primary hypothyroidism, and they were on treatment and still on treatment. All patients were sent to investigate TSH, T4, T3, and HbA1c. The patients were subdivided into three main groups: first is uncontrolled nondiabetic primary hypothyroid group (36 patients), second is controlled nondiabetic primary hypothyroid group (43) and third is the diabetic primary hypothyroid group (16 patients). Results: A significant difference (P < 0.05) between HbA1C% in both controlled and uncontrolled hypothyroid groups against the control group, but there is no significant difference (P = 0.08) between the controlled and uncontrolled hypothyroid groups. The TSH relation with HbA1c was found to be significantly positive in the uncontrolled hypothyroid and diabetic, hypothyroid groups (r = 0.401 and 0.58, respectively). Conclusions: Significant increment was found in the level of HbA1c in hypothyroid patients, whether it is controlled or uncontrolled and a positive relationship was observed between TSH and HbA1c% in the uncontrolled and diabetic hypothyroid groups. Diabetes augments the effects of hypothyroidism on HbA1c.
{"title":"Glycemic status in patients with primary hypothyroidism and its relation to disease severity","authors":"Atheer A. Ali, Khalid Allehibi, Nihad Al-Juboori","doi":"10.4103/mj.mj_5_20","DOIUrl":"https://doi.org/10.4103/mj.mj_5_20","url":null,"abstract":"Background: Primary hypothyroidism can be defined as an increase in serum thyroid-stimulating hormone (TSH) level, and the concentration of free T3, free T4, T3, and T4 is low. Hypothyroidism is a prevalent disease mostly affecting middle-aged women. One of the most important determinants of glucose homeostasis is thyroid hormones. Hypothyroid patients have a higher prevalence of insulin resistance and tendency to Type 2 diabetes mellitus than the normal individual. Objective: To investigate the correlation between TSH and hemoglobin A1c (HbA1C) in patients with primary hypothyroidism; so, to study the effects of hypothyroidism on glucose metabolism. Subjects and Methods: Ninety-five Iraqi primary hypothyroidism patients and 40 healthy persons taken as control were selected from Specialized Centre for Endocrinology and Diabetes during the period from June 2017 to January 2018. The patients were diagnosed previously as cases of primary hypothyroidism, and they were on treatment and still on treatment. All patients were sent to investigate TSH, T4, T3, and HbA1c. The patients were subdivided into three main groups: first is uncontrolled nondiabetic primary hypothyroid group (36 patients), second is controlled nondiabetic primary hypothyroid group (43) and third is the diabetic primary hypothyroid group (16 patients). Results: A significant difference (P < 0.05) between HbA1C% in both controlled and uncontrolled hypothyroid groups against the control group, but there is no significant difference (P = 0.08) between the controlled and uncontrolled hypothyroid groups. The TSH relation with HbA1c was found to be significantly positive in the uncontrolled hypothyroid and diabetic, hypothyroid groups (r = 0.401 and 0.58, respectively). Conclusions: Significant increment was found in the level of HbA1c in hypothyroid patients, whether it is controlled or uncontrolled and a positive relationship was observed between TSH and HbA1c% in the uncontrolled and diabetic hypothyroid groups. Diabetes augments the effects of hypothyroidism on HbA1c.","PeriodicalId":33069,"journal":{"name":"mjl@ lmstnSry@ lTby@","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45163739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Cytotoxic drugs often suppress the bone marrow's ability to produce white blood cells which lead to the induction of neutropenia and the risk of febrile neutropenia. Chemotherapy-induced neutropenia (CIN) is major dose-limiting toxicity of systemic chemotherapy and it is associated with significant morbidity and mortality. Objective: Evaluating frequency and severity of CIN after initial and subsequent chemotherapy cycles among non-Hodgkin lymphoma (NHL) children undergoing similar chemotherapy regimens. Patients and Methods: A prospective study performed in the Oncology Department of Child Central Teaching Hospital/Baghdad, between August 1, 2012, and January 31, 2014, which included (59) patients <15 years, with newly diagnosed NHL who received similar chemotherapy regimens of NHL. All patients were evaluated for the incidence of neutropenia after the initial or subsequent course of chemotherapy to compare between CIN after first and subsequent chemotherapy cycles of similar regimens, that is,: COPADM1 versus COPADM2 and COPADM3, “COPADM” regimen includes the following drugs (C: Cyclophosphamide, O: Oncovine, P: Prednisone, AD: Adriamycine, and M: Methotrexate), each chemotherapy cycle was received every 21-day interval. Results: Of a total 59 patients with NHL,55.9% of them were male and 44.1% were female, who received initial (COPADM1) and subsequent (COPADM 2 and COPADM 3) chemotherapy cycles of NHL, there is a significant increment in the risk of CIN after initial cycle “COPADM1” in comparison to other subsequent cycles of COPADM2 and COPADM3, “P = 0.01.” The patient characteristics (age group and gender) had no significant effect on the risk of CIN, there is a higher percent of severe neutropenia and hospitalization with parenteral antibiotic use after the first COPADM cycle in comparison with subsequent cycles but statistically not significant (P = 0.6 and 0.1, respectively). Conclusion: Frequency of CIN after the first chemotherapy cycle had significantly higher than subsequent cycles, with lesser extent to neutropenic severity and neutropenia-related hospitalization.
{"title":"Chemotherapy-induced neutropenia after initial and subsequent chemotherapy cycle of non-hodgkin lymphoma","authors":"Entisar Al-Shammary, D. Mohammed","doi":"10.4103/mj.mj_4_20","DOIUrl":"https://doi.org/10.4103/mj.mj_4_20","url":null,"abstract":"Background: Cytotoxic drugs often suppress the bone marrow's ability to produce white blood cells which lead to the induction of neutropenia and the risk of febrile neutropenia. Chemotherapy-induced neutropenia (CIN) is major dose-limiting toxicity of systemic chemotherapy and it is associated with significant morbidity and mortality. Objective: Evaluating frequency and severity of CIN after initial and subsequent chemotherapy cycles among non-Hodgkin lymphoma (NHL) children undergoing similar chemotherapy regimens. Patients and Methods: A prospective study performed in the Oncology Department of Child Central Teaching Hospital/Baghdad, between August 1, 2012, and January 31, 2014, which included (59) patients <15 years, with newly diagnosed NHL who received similar chemotherapy regimens of NHL. All patients were evaluated for the incidence of neutropenia after the initial or subsequent course of chemotherapy to compare between CIN after first and subsequent chemotherapy cycles of similar regimens, that is,: COPADM1 versus COPADM2 and COPADM3, “COPADM” regimen includes the following drugs (C: Cyclophosphamide, O: Oncovine, P: Prednisone, AD: Adriamycine, and M: Methotrexate), each chemotherapy cycle was received every 21-day interval. Results: Of a total 59 patients with NHL,55.9% of them were male and 44.1% were female, who received initial (COPADM1) and subsequent (COPADM 2 and COPADM 3) chemotherapy cycles of NHL, there is a significant increment in the risk of CIN after initial cycle “COPADM1” in comparison to other subsequent cycles of COPADM2 and COPADM3, “P = 0.01.” The patient characteristics (age group and gender) had no significant effect on the risk of CIN, there is a higher percent of severe neutropenia and hospitalization with parenteral antibiotic use after the first COPADM cycle in comparison with subsequent cycles but statistically not significant (P = 0.6 and 0.1, respectively). Conclusion: Frequency of CIN after the first chemotherapy cycle had significantly higher than subsequent cycles, with lesser extent to neutropenic severity and neutropenia-related hospitalization.","PeriodicalId":33069,"journal":{"name":"mjl@ lmstnSry@ lTby@","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48319451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: The study was aimed to identify the risk factors for obstetrical brachial plexus palsy (OBPP). Patients and Methods: A retrospective case–control study was designed. A comparison was performed between cases of brachial plexus paralysis (n = 32), with controls without brachial plexus paralysis (n = 30) randomly selected from physical rehabilitation medicine examination. Statistical analysis was performed using the SPSS Package. Results: Independent risk factors for brachial plexus paralysis were macrosomia (birth weight 4000 g; odds ratio [OR] = 12.353; 95% confidence interval [CI] 2.510–60.802, P < 10−3), labor dystocia and instrumental vaginal delivery (forceps delivery and vacuum extraction; OR = 8.8; 95% CI 2.743–28.234, P < 10−3), and prolonged pregnancy (OR = 1.28; 95% CI 1.066–1.538, P = 0.011); however, vaginal breech delivery (breech presentation or extraction; OR = 3.231; 95% CI 0.598–17.456, P = 0.258), parity (OR = 2.545; 95% CI 0.677–9.565, P = 0.206), shoulder dystocia (OR = 1.957; 95% CI 0.571–6.702, P = 0.367), and after cesarean section (OR = 1.103; 95% CI 0.987–1.234, P = 0.238) do not represent any risk factor. Conclusions: In our population (n = 62), macrosomia, labor dystocia, instrumental vaginal delivery, and prolonged pregnancy were the significant risk factors for neonatal brachial plexus paralysis, while shoulder dystocia, breech deliveries, parity, and cesarean section were not. Despite our small sample, we found three significant risk factors associated with OBPP.
{"title":"Risk factors for obstetrical brachial plexus palsy","authors":"H. Belabbassi, Amina Imouloudene, H. Kaced","doi":"10.4103/mj.mj_2_20","DOIUrl":"https://doi.org/10.4103/mj.mj_2_20","url":null,"abstract":"Objective: The study was aimed to identify the risk factors for obstetrical brachial plexus palsy (OBPP). Patients and Methods: A retrospective case–control study was designed. A comparison was performed between cases of brachial plexus paralysis (n = 32), with controls without brachial plexus paralysis (n = 30) randomly selected from physical rehabilitation medicine examination. Statistical analysis was performed using the SPSS Package. Results: Independent risk factors for brachial plexus paralysis were macrosomia (birth weight 4000 g; odds ratio [OR] = 12.353; 95% confidence interval [CI] 2.510–60.802, P < 10−3), labor dystocia and instrumental vaginal delivery (forceps delivery and vacuum extraction; OR = 8.8; 95% CI 2.743–28.234, P < 10−3), and prolonged pregnancy (OR = 1.28; 95% CI 1.066–1.538, P = 0.011); however, vaginal breech delivery (breech presentation or extraction; OR = 3.231; 95% CI 0.598–17.456, P = 0.258), parity (OR = 2.545; 95% CI 0.677–9.565, P = 0.206), shoulder dystocia (OR = 1.957; 95% CI 0.571–6.702, P = 0.367), and after cesarean section (OR = 1.103; 95% CI 0.987–1.234, P = 0.238) do not represent any risk factor. Conclusions: In our population (n = 62), macrosomia, labor dystocia, instrumental vaginal delivery, and prolonged pregnancy were the significant risk factors for neonatal brachial plexus paralysis, while shoulder dystocia, breech deliveries, parity, and cesarean section were not. Despite our small sample, we found three significant risk factors associated with OBPP.","PeriodicalId":33069,"journal":{"name":"mjl@ lmstnSry@ lTby@","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47429529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: In the medicolegal daily practice, electrocution is a traumatic cause of death owing to wide use of electricity and electrical devices in different activities of modern life at home and workplaces. Electrical current passage through tissues elaborates different types of energy (the electrical, thermal, and mechanical energies) which can cause skin lesions, multiorgan damage, and even death. The severity and extent of tissue injuries depend on the current type (alternating current [AC] or direct current), its strength (amperage), voltage (low or high), frequency, tissue resistance, duration of exposure, and its pathway through the body. Microscopic examination of tissue samples from the heart may show nonspecific findings to electrocution, but sometimes none is detected by conventional hematoxylin and eosin stains (H and E). Therefore, immunohistochemical studies could help the forensic pathologists in their diagnosis, especially cases with less typical findings or obscure circumstances. Heart-type fatty acid-binding protein 3 (H-FABP3) is a small cytoplasmic protein of (15 kDa), composes of 133 amino acids, involves in active fatty acid metabolism, and transports fatty acids from the cell membrane to mitochondria for oxidation. Due to its cytoplasmic location and small molecular weight, it released from cardiac myocytes into the circulation following an ischemic episode. Objective: This study was conducted to evaluate the effect of electric current on the expression of H-FABP3 in human heart tissue autopsy samples. Methods: Human heart tissue samples were collected during the period from January 1 2016 to June 30, 2016, through autopsy of 30 medicolegal cases of electrocution as well as 30 cases of fatal head injuries which were used as control. They were examined by conventional histopathological H and E stain and immunohistochemical technique so that H-FABP3 was detected using FABP3 polyclonal antibody and demonstrated by ready to use biotin-free, one-step horseradish peroxidase polymer anti-mouse, rat, and rabbit immunoglobulin G with 3,3'-diaminobenzidine to achieve the aim of this study. Results: This study shows that electric shock was the fifth cause of traumatic death, being responsible for death of only 4.5% of cases referred to the medicolegal directorate in Baghdad during the period of study. It is almost accidental death in Iraqi society with higher incidence to be due to contact with low-voltage household AC sources with young males at the age of (15–20 years old) are being more vulnerable to fatal electrical injury than females during their early productive life (with male:female ratio = 6:1). Heart tissue ischemia is a major cause of death following electrocution, especially when victim being in contact with household low-voltage AC in the presence of transthoracic pathway to the ground and low body resistance due to skin wet which can cause death within a minute in association with mild if any electrical skin burns.
{"title":"Detecting heart tissue injury in electrocution human cases using heart-type fatty acid-binding protein 3","authors":"Ameen Kathum, N. Al-Khateeb","doi":"10.4103/MJ.MJ_2_19","DOIUrl":"https://doi.org/10.4103/MJ.MJ_2_19","url":null,"abstract":"Introduction: In the medicolegal daily practice, electrocution is a traumatic cause of death owing to wide use of electricity and electrical devices in different activities of modern life at home and workplaces. Electrical current passage through tissues elaborates different types of energy (the electrical, thermal, and mechanical energies) which can cause skin lesions, multiorgan damage, and even death. The severity and extent of tissue injuries depend on the current type (alternating current [AC] or direct current), its strength (amperage), voltage (low or high), frequency, tissue resistance, duration of exposure, and its pathway through the body. Microscopic examination of tissue samples from the heart may show nonspecific findings to electrocution, but sometimes none is detected by conventional hematoxylin and eosin stains (H and E). Therefore, immunohistochemical studies could help the forensic pathologists in their diagnosis, especially cases with less typical findings or obscure circumstances. Heart-type fatty acid-binding protein 3 (H-FABP3) is a small cytoplasmic protein of (15 kDa), composes of 133 amino acids, involves in active fatty acid metabolism, and transports fatty acids from the cell membrane to mitochondria for oxidation. Due to its cytoplasmic location and small molecular weight, it released from cardiac myocytes into the circulation following an ischemic episode. Objective: This study was conducted to evaluate the effect of electric current on the expression of H-FABP3 in human heart tissue autopsy samples. Methods: Human heart tissue samples were collected during the period from January 1 2016 to June 30, 2016, through autopsy of 30 medicolegal cases of electrocution as well as 30 cases of fatal head injuries which were used as control. They were examined by conventional histopathological H and E stain and immunohistochemical technique so that H-FABP3 was detected using FABP3 polyclonal antibody and demonstrated by ready to use biotin-free, one-step horseradish peroxidase polymer anti-mouse, rat, and rabbit immunoglobulin G with 3,3'-diaminobenzidine to achieve the aim of this study. Results: This study shows that electric shock was the fifth cause of traumatic death, being responsible for death of only 4.5% of cases referred to the medicolegal directorate in Baghdad during the period of study. It is almost accidental death in Iraqi society with higher incidence to be due to contact with low-voltage household AC sources with young males at the age of (15–20 years old) are being more vulnerable to fatal electrical injury than females during their early productive life (with male:female ratio = 6:1). Heart tissue ischemia is a major cause of death following electrocution, especially when victim being in contact with household low-voltage AC in the presence of transthoracic pathway to the ground and low body resistance due to skin wet which can cause death within a minute in association with mild if any electrical skin burns. ","PeriodicalId":33069,"journal":{"name":"mjl@ lmstnSry@ lTby@","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46427295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Diagnosis of sinus venosus atrial septal defects (ASDs) poses clinical difficulties than that of ostium secundum ASDs which may delay its diagnosis and treatment. Surgical repair of sinus venosus ASDs is more intricate in correlation with the repair of ostium secundum ASDs and conveys the risk of stenosis of the superior vena cava (SVC) or the rerouted pulmonary veins (PVs) and sinus node dysfunction (SND). Objectives: To compare diagnostic modalities and surgical outcome of sinus venosus ASDs to that of ostium secundum ASDs. Patients and Methods: Out of the total 72 patients in the age range of 1 year–46 years, 36 patients underwent surgical repair of sinus venosus ASDs and 36 patients underwent surgical repair of ostium secundum ASDs. Their data were collected and retrospectively studied from June 1, 2009, to October 1, 2016, at Ibn-Alnafees Teaching Hospital for cardiothoracic surgery in Baghdad, Iraq. We divided the patients into two groups: Group A including 36 patients who had sinus venosus ASDs and Group B including 36 patients who had ostium secundum ASDs. A comparison was made between the two groups according to preoperative variables, diagnostic modalities, intraoperative variables, and postoperative morbidity and mortality. Results: Transthoracic echocardiography (TTE) was the mainstay for the diagnosis of ASD secundum, while ASD venosus type needed more modalities for diagnosis. No operative death, postoperative bleeding, acute renal failure, SND, SVC stenosis, and PV stenosis were observed in any patient in the two groups. Residual shunt was not observed in any case in the two groups. Conclusion: TTE, transesophageal echocardiography, cardiac magnetic resonance imaging, or diagnostic catheterization may be needed for the diagnosis of sinus venosus ASD. Surgery is the mainstay of sinus venosus ASDs with low morbidity and no mortality, similar to ostium secundum ASDs.
{"title":"Sinus venosus versus ostium secundum atrial septal defects: Their diagnosis and surgical outcome","authors":"H. Mohsin, Firas Kareem","doi":"10.4103/MJ.MJ_7_19","DOIUrl":"https://doi.org/10.4103/MJ.MJ_7_19","url":null,"abstract":"Background: Diagnosis of sinus venosus atrial septal defects (ASDs) poses clinical difficulties than that of ostium secundum ASDs which may delay its diagnosis and treatment. Surgical repair of sinus venosus ASDs is more intricate in correlation with the repair of ostium secundum ASDs and conveys the risk of stenosis of the superior vena cava (SVC) or the rerouted pulmonary veins (PVs) and sinus node dysfunction (SND). Objectives: To compare diagnostic modalities and surgical outcome of sinus venosus ASDs to that of ostium secundum ASDs. Patients and Methods: Out of the total 72 patients in the age range of 1 year–46 years, 36 patients underwent surgical repair of sinus venosus ASDs and 36 patients underwent surgical repair of ostium secundum ASDs. Their data were collected and retrospectively studied from June 1, 2009, to October 1, 2016, at Ibn-Alnafees Teaching Hospital for cardiothoracic surgery in Baghdad, Iraq. We divided the patients into two groups: Group A including 36 patients who had sinus venosus ASDs and Group B including 36 patients who had ostium secundum ASDs. A comparison was made between the two groups according to preoperative variables, diagnostic modalities, intraoperative variables, and postoperative morbidity and mortality. Results: Transthoracic echocardiography (TTE) was the mainstay for the diagnosis of ASD secundum, while ASD venosus type needed more modalities for diagnosis. No operative death, postoperative bleeding, acute renal failure, SND, SVC stenosis, and PV stenosis were observed in any patient in the two groups. Residual shunt was not observed in any case in the two groups. Conclusion: TTE, transesophageal echocardiography, cardiac magnetic resonance imaging, or diagnostic catheterization may be needed for the diagnosis of sinus venosus ASD. Surgery is the mainstay of sinus venosus ASDs with low morbidity and no mortality, similar to ostium secundum ASDs.","PeriodicalId":33069,"journal":{"name":"mjl@ lmstnSry@ lTby@","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47158652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hypoxia is defined as decreased levels of oxygen in the cells, which are caused by vascular and pulmonary diseases. The catalysts of hypoxia in the physiological role are important in all living cells, whereas its metabolic dysfunction is related to many diseases. Hypoxia-inducible factors (HIFs) activity should be controlled by providing HIF modules. Forkhead box protein M1 (FOXM1) plays a crucial role in the maintenance and differentiation of airways epithelial cell lining, especially during embryonic life, where it is essential in the formation and proliferation of pulmonary vessels. FOXM1 is overexpressed in the pulmonary artery smooth muscle in response to hypoxia through the elements that are present in the promoters of FOXM1; therefore, it was used to diagnose patients with pulmonary artery hypertension.
{"title":"Hypoxia-inducible factors-α as a regulator for forkhead box protein M1 in pulmonary artery hypertension","authors":"I. Raoof, A. Daoud","doi":"10.4103/MJ.MJ_12_19","DOIUrl":"https://doi.org/10.4103/MJ.MJ_12_19","url":null,"abstract":"Hypoxia is defined as decreased levels of oxygen in the cells, which are caused by vascular and pulmonary diseases. The catalysts of hypoxia in the physiological role are important in all living cells, whereas its metabolic dysfunction is related to many diseases. Hypoxia-inducible factors (HIFs) activity should be controlled by providing HIF modules. Forkhead box protein M1 (FOXM1) plays a crucial role in the maintenance and differentiation of airways epithelial cell lining, especially during embryonic life, where it is essential in the formation and proliferation of pulmonary vessels. FOXM1 is overexpressed in the pulmonary artery smooth muscle in response to hypoxia through the elements that are present in the promoters of FOXM1; therefore, it was used to diagnose patients with pulmonary artery hypertension.","PeriodicalId":33069,"journal":{"name":"mjl@ lmstnSry@ lTby@","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48731292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Intra uterine insemination is an assisted reproductive technique using husband or donor sperms, at the time of ovulation in natural or stimulated cycle, to be placed in the uterine cavity or in the cervical canal. It is a common procedure used for the treatment of infertility. Objectives: To identify factors that can predict successful outcome in intrauterine insemination and the socio-demographic characteristics of couples visiting intra uterine insemination department in Al–Yarmouk Infertility Center through five-year records review. Patients & Methods: A descriptive study (review of records) was conducted on all available records of infertile couples (259 couples), undergone intra uterine insemination treatment for their infertility problems in Al-Yarmouk Infertility Center, from 2007 through 2011. The necessary data were collected from only124 couples with complete information. Results: The overall pregnancy rate was 27.4% (34 cases) in whom 4.8% were delivered successfully; the miscarriage rate was 4%, and no ectopic pregnancy or multiple pregnancies were encountered. Four significant variables were identified for successful outcome: duration of infertility ( 50% normal progressive motility 37.3 vs. 18.5%). Conclusions: Intrauterine insemination provides better results in couples with secondary infertility, shorter duration of infertility, increasing number of trials, and in those with 50% normal sperm motility or more.
{"title":"The intra-uterine insemination in Al-Yarmouk infertility center: A five-year records review","authors":"W. Al-Ani, Hiba Khalil, M. Sabri","doi":"10.26903/mmj.v16i3.108","DOIUrl":"https://doi.org/10.26903/mmj.v16i3.108","url":null,"abstract":"Background: Intra uterine insemination is an assisted reproductive technique using husband or donor sperms, at the time of ovulation in natural or stimulated cycle, to be placed in the uterine cavity or in the cervical canal. It is a common procedure used for the treatment of infertility. Objectives: To identify factors that can predict successful outcome in intrauterine insemination and the socio-demographic characteristics of couples visiting intra uterine insemination department in Al–Yarmouk Infertility Center through five-year records review. Patients & Methods: A descriptive study (review of records) was conducted on all available records of infertile couples (259 couples), undergone intra uterine insemination treatment for their infertility problems in Al-Yarmouk Infertility Center, from 2007 through 2011. The necessary data were collected from only124 couples with complete information. Results: The overall pregnancy rate was 27.4% (34 cases) in whom 4.8% were delivered successfully; the miscarriage rate was 4%, and no ectopic pregnancy or multiple pregnancies were encountered. Four significant variables were identified for successful outcome: duration of infertility ( 50% normal progressive motility 37.3 vs. 18.5%). Conclusions: Intrauterine insemination provides better results in couples with secondary infertility, shorter duration of infertility, increasing number of trials, and in those with 50% normal sperm motility or more.","PeriodicalId":33069,"journal":{"name":"mjl@ lmstnSry@ lTby@","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46854555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Menopause is the perpetual cessation of menstruation due to defeat of ovarian follicular activity. Menopause in women leads to various physiological changes in the body. Objective: To study the metabolic and hormonal changes in postmenopausal women. Patients and Methods: Forty five postmenopausal women were participated in the study and compared them with 45 premenopausal women who had a regular menstruation. They were attending the Medical City Hospital/ Obstetrics and Gynecology Department during the period from July 2016 until the end of December 2016. Anthropometric and physiological parameters were taken. Biochemical and hormonal parameters were measured for all individuals. Results: In this study, there was a significant increase in serum apolipoprotein E levels, total cholesterol, triacylglycerol, low density lipoprotein cholesterol, urea, and thyroid stimulating hormone in postmenopausal group as compared to premenopausal group, (P ≤0.05). Serum total tri- and tetra-iodothyronine levels were decrease in postmenopausal group as compared to premenopausal group, but it was not significant. There was a significant increase in apolipoprotein E in postmenopausal women who had family history for dyslipidemia, (P =0.001). There was a significant positive correlation between apolipoprotein E and thyroid stimulating hormone. While there was a significant negative correlations among apolipoprotein E with high density lipoprotein cholesterol and estradiol, (P ≤ 0.01). Conclusions: The physiological basis and the complex interaction between thyroid hormones and apolipoprotein E and their relation with estradiol hormone among postmenopausal women trigger the lipids control mechanism.
{"title":"Metabolic and hormonal changes associated with menopause","authors":"H. Ahmed","doi":"10.26903/MMJ.V16I3.114","DOIUrl":"https://doi.org/10.26903/MMJ.V16I3.114","url":null,"abstract":"Background: Menopause is the perpetual cessation of menstruation due to defeat of ovarian follicular activity. Menopause in women leads to various physiological changes in the body. Objective: To study the metabolic and hormonal changes in postmenopausal women. Patients and Methods: Forty five postmenopausal women were participated in the study and compared them with 45 premenopausal women who had a regular menstruation. They were attending the Medical City Hospital/ Obstetrics and Gynecology Department during the period from July 2016 until the end of December 2016. Anthropometric and physiological parameters were taken. Biochemical and hormonal parameters were measured for all individuals. Results: In this study, there was a significant increase in serum apolipoprotein E levels, total cholesterol, triacylglycerol, low density lipoprotein cholesterol, urea, and thyroid stimulating hormone in postmenopausal group as compared to premenopausal group, (P ≤0.05). Serum total tri- and tetra-iodothyronine levels were decrease in postmenopausal group as compared to premenopausal group, but it was not significant. There was a significant increase in apolipoprotein E in postmenopausal women who had family history for dyslipidemia, (P =0.001). There was a significant positive correlation between apolipoprotein E and thyroid stimulating hormone. While there was a significant negative correlations among apolipoprotein E with high density lipoprotein cholesterol and estradiol, (P ≤ 0.01). Conclusions: The physiological basis and the complex interaction between thyroid hormones and apolipoprotein E and their relation with estradiol hormone among postmenopausal women trigger the lipids control mechanism.","PeriodicalId":33069,"journal":{"name":"mjl@ lmstnSry@ lTby@","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49112844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Rheumatoid arthritis (RA) is a chronic, systemic inflammatory disorder that principally attacks synovial joints. Aims: To evaluate the status of serum fucose and protein bound fucose, anti-CCP, TNF-α and RF in serum of RA patients. Subjects and methods: The study has included 30 patients with early RA (with disease duration 1 year) diagnosed according to the 2010 EULAR criteria (25 females, 5 males) with age range (30-60) and 28 healthy control individuals (22 females,6 males) with age range (30-55), who were age and sex matching with patients. Results: Levels of total serum fucose and protein bound fucose significantly decrease in RA patients than healthy control, while anti-CCP, TNF-α, RF, CRP and ESR significantly increase in RA patients than healthy control. Levels of total serum fucose, protein bound fucose & ACCP were not significant between three stages of activity in late & early RA patients. The level TNF-α & RF were significant only in very active cases in late RA, while not significantly in all cases of early RA. Positive correlation was found between ACCP & ESR in RA patients & early RA patients. Positive correlation found between TSF & PBF, negative correlation found between TNF-α & ESR in late RA patients. Positive correlation found between ACCP & ESR, CRP & ESR in early RA patients. Conclusions: This study illustrate that total serum fucose and protein bound fucose aid to diagnosis RA patient. Also Anti-CCP is a good & specific marker for diagnosis of RA,it is a good prognostic and as index test of severity
{"title":"The role of serum fucose, protein bound fucose and other biomarkers in patients with rheumatoid arthritis","authors":"A. Joda","doi":"10.26903/MMJ.V16I3.111","DOIUrl":"https://doi.org/10.26903/MMJ.V16I3.111","url":null,"abstract":"Background: Rheumatoid arthritis (RA) is a chronic, systemic inflammatory disorder that principally attacks synovial joints. Aims: To evaluate the status of serum fucose and protein bound fucose, anti-CCP, TNF-α and RF in serum of RA patients. Subjects and methods: The study has included 30 patients with early RA (with disease duration 1 year) diagnosed according to the 2010 EULAR criteria (25 females, 5 males) with age range (30-60) and 28 healthy control individuals (22 females,6 males) with age range (30-55), who were age and sex matching with patients. Results: Levels of total serum fucose and protein bound fucose significantly decrease in RA patients than healthy control, while anti-CCP, TNF-α, RF, CRP and ESR significantly increase in RA patients than healthy control. Levels of total serum fucose, protein bound fucose & ACCP were not significant between three stages of activity in late & early RA patients. The level TNF-α & RF were significant only in very active cases in late RA, while not significantly in all cases of early RA. Positive correlation was found between ACCP & ESR in RA patients & early RA patients. Positive correlation found between TSF & PBF, negative correlation found between TNF-α & ESR in late RA patients. Positive correlation found between ACCP & ESR, CRP & ESR in early RA patients. Conclusions: This study illustrate that total serum fucose and protein bound fucose aid to diagnosis RA patient. Also Anti-CCP is a good & specific marker for diagnosis of RA,it is a good prognostic and as index test of severity","PeriodicalId":33069,"journal":{"name":"mjl@ lmstnSry@ lTby@","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48608644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ibrahim Ekhlayef Mughir Al Doghan, H. Jasim, H. Hussein
Background: Empyema Gallbladder is a sequel of severe acute cholecystitis. Previously, laparoscopic cholecystectomy was relatively contraindicated because of fatal complications. Objectives: To determine the safety of laparoscopic surgery in treatment of empyema gallbladder. Methods: A retrospective study conducted on 92 patients from Nov. 2007 to May 2017, with gallbladder empyema who underwent laparoscopic cholecystectomy at Al-Yarmouk teaching hospital in Baghdad, Iraq. The operation was done by using four ports. Results: A retrospective study of 92 case of empyema gallbladder, laparoscopic cholecystectomy was performed for 92 cases proved to have empyema gallbladder. A successful laparoscopic cholecystectomy done to 75 cases (81.52%) (Group I), a conversion to open cholecystectomy was done to17 (18.47%) (Group II) patients due to various reasons, the most common as a gangrenous wall of gallbladder 6 (6.5%) patients, bleeding from cystic artery 5 (5.4%) patients, severe obscured anatomy of Calot’s triangle duo to adhesions 3 (3.2%) patients. Duodenal injury 2 (2.1%) patients and common bile duct injury 1 (1.08%) patient. Maximum operative time was 80 minutes for all cases. Postoperative complications occurred in 22(29.3%) patients of Group I, and 9(52.9%) patients of Group II. Group I (75 patients) in whom successively laparoscopic cholecystectomy (LC) was done, and Group II (17 patients) where conversion to open cholecystectomy. About 53(70.6%) of Group I patients discharged from hospital within 1-3days, and about 9 (52.9%) of Group II patients discharged from hospital within 7days. Conclusions: Gallbladder Empyema is a serious sequel of acute cholecystitis, where the laparoscopic cholecystectomy can be done to treat it safely.
{"title":"The safety of laparoscopic surgery in treatment of empyema gall bladder","authors":"Ibrahim Ekhlayef Mughir Al Doghan, H. Jasim, H. Hussein","doi":"10.26903/mmj.v16i3.116","DOIUrl":"https://doi.org/10.26903/mmj.v16i3.116","url":null,"abstract":"Background: Empyema Gallbladder is a sequel of severe acute cholecystitis. Previously, laparoscopic cholecystectomy was relatively contraindicated because of fatal complications. Objectives: To determine the safety of laparoscopic surgery in treatment of empyema gallbladder. Methods: A retrospective study conducted on 92 patients from Nov. 2007 to May 2017, with gallbladder empyema who underwent laparoscopic cholecystectomy at Al-Yarmouk teaching hospital in Baghdad, Iraq. The operation was done by using four ports. Results: A retrospective study of 92 case of empyema gallbladder, laparoscopic cholecystectomy was performed for 92 cases proved to have empyema gallbladder. A successful laparoscopic cholecystectomy done to 75 cases (81.52%) (Group I), a conversion to open cholecystectomy was done to17 (18.47%) (Group II) patients due to various reasons, the most common as a gangrenous wall of gallbladder 6 (6.5%) patients, bleeding from cystic artery 5 (5.4%) patients, severe obscured anatomy of Calot’s triangle duo to adhesions 3 (3.2%) patients. Duodenal injury 2 (2.1%) patients and common bile duct injury 1 (1.08%) patient. Maximum operative time was 80 minutes for all cases. Postoperative complications occurred in 22(29.3%) patients of Group I, and 9(52.9%) patients of Group II. Group I (75 patients) in whom successively laparoscopic cholecystectomy (LC) was done, and Group II (17 patients) where conversion to open cholecystectomy. About 53(70.6%) of Group I patients discharged from hospital within 1-3days, and about 9 (52.9%) of Group II patients discharged from hospital within 7days. Conclusions: Gallbladder Empyema is a serious sequel of acute cholecystitis, where the laparoscopic cholecystectomy can be done to treat it safely.","PeriodicalId":33069,"journal":{"name":"mjl@ lmstnSry@ lTby@","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45367112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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