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Influence of Metformin Dose and Treatment Adherence on Glycemic Control, Adiposity, and Cardiovascular Risk Markers in Iraqi Patients with T2DM 二甲双胍剂量和治疗依从性对伊拉克T2DM患者血糖控制、肥胖和心血管风险标志物的影响
Pub Date : 2023-01-13 DOI: 10.32007/jfacmedbagdad.6441939
Z. Abdulrahman, Mohammed Qasim Alatrakji, A. A. Al-Maliky, K. Hussein, S. Hussain
Background: Numerous factors, including metformin doses and treatment adherence, may contribute to significant variations in glycemic control and adiposity markers of type 2 diabetes (T2DM) patients.Objectives : This study aims to determine the influence of metformin dose and treatment adherence on glycemic control and adiposity markers in Iraqi patients with T2DM.Methods: Between October 2021 and March 2022, a case-series study at the Diabetes and Endocrinology Center – Baghdad included 153 T2DM patients with a disease duration of more than one year. Clinical and physical examinations were conducted before enrolment. We measured anthropometric variables to calculate the body mass index (BMI), waist-to-hip ratio (WHR), visceral adiposity index (VAI), and other surrogate indicators. We measured glycated hemoglobin (HbA1c), leptin, C-reactive protein (CRP), total cholesterol, HDL-c, and triglycerides in the serum.Results: Increasing metformin doses did not improve the studied parameters. Adherence to treatment significantly influences fasting glycemia, HbA1c level, and the markers of adiposity. Meanwhile, increasing metformin doses is not associated with changes in insulin resistance and cardiovascular disease risk markers.Conclusion: Beyond metformin dose up-titration, treatment adherence affects glycemic control, visceral adiposity, and CVD risk surrogates. Metformin dose up-titration was not linked to insulin resistance and body fat contents.
背景:许多因素,包括二甲双胍剂量和治疗依从性,可能导致2型糖尿病(T2DM)患者血糖控制和肥胖标志物的显著变化。目的:本研究旨在确定二甲双胍剂量和治疗依从性对伊拉克T2DM患者血糖控制和肥胖指标的影响。方法:在2021年10月至2022年3月期间,巴格达糖尿病和内分泌中心的一项病例系列研究包括153名病程超过一年的T2DM患者。入组前进行临床和体格检查。我们测量了人体测量变量来计算体重指数(BMI)、腰臀比(WHR)、内脏脂肪指数(VAI)和其他替代指标。我们测量了血清中的糖化血红蛋白(HbA1c)、瘦素、c反应蛋白(CRP)、总胆固醇、HDL-c和甘油三酯。结果:增加二甲双胍剂量并没有改善研究参数。坚持治疗会显著影响空腹血糖、糖化血红蛋白水平和肥胖指标。同时,增加二甲双胍剂量与胰岛素抵抗和心血管疾病风险标志物的变化无关。结论:除了二甲双胍剂量增加外,治疗依从性影响血糖控制、内脏脂肪和心血管疾病风险。二甲双胍剂量增加与胰岛素抵抗和体脂含量无关。
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引用次数: 4
Measurement of the serum level of Elabela for the early detection of acute kidney injury in hospitalized Iraqi COVID-19 patients 伊拉克新冠肺炎住院患者血清Elabela水平检测对急性肾损伤的早期检测
Pub Date : 2022-10-17 DOI: 10.32007/jfacmedbagdad.6431928
Maha hassan Gadhi, Eman S. Saleh
Background: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is caused coronavirus disease2019 (COVID-19) affecting people worldwide. The angiotensin converting enzyme2 (ACE2) represents areceptor of SARS-CoV-2 on the infected host cell. Apelin or its receptor agonists suppress the production ofangiotensin-converting enzyme (ACE) and angiotensin II (Ang-II) and is characterized by a protective effectagainst SARS-CoV-2.Objective: The study aims to assess the serum level of Elabela biomarker as an early detector for AcuteKidney Injury (AKI) in patients with COVID-19.Cases and Methods: This is a case-control study which included 45 hospitalized adult patients in multiplecenters (public hospitals) receiving COVID-19 cases in Baghdad. These cases had a positive real-time orreverse transcription polymerase chain reaction (RT-PCR) of nasal/oropharyngeal swabs. Excluded from thestudy were those with a negative PCR and comorbidities and 43 apparently healthy adult subjects as controls.The age range of the cases and controls was (20 to 60) yearsResult: There are no a statistically significant differences between the two groups in terms of age and genderdistribution. Statistically significant differences were found in terms of eGFR, S. Creatinine, D. dimer,NEU×103/µL, LYM×103/µL and ELA biomarker. Significant negative correlations were found betweenElabela with D. dimer and NEU×103/µL, and between eGFR with S. creatinine, D. Dimer, and NUT×103/µL.Conclusion: The Elabela biomarker can be used for the early detection of acute kidney injury in COVID-19patients.
背景:严重急性呼吸综合征冠状病毒2型(SARS-CoV-2)是由2019年(新冠肺炎)冠状病毒疾病引起的,影响着世界各地的人们。血管紧张素转换酶2(ACE2)是感染宿主细胞上严重急性呼吸系统综合征冠状病毒2型的受体。Apelin或其受体激动剂抑制血管紧张素转换酶(ACE)和血管紧张素II(Ang-II)的产生,其特征是对SARS-CoV-2具有保护作用。目的:本研究旨在评估Elabela生物标志物的血清水平,作为COVID-19患者急性肾损伤(AKI)的早期检测手段。病例和方法:这是一项病例对照研究,包括45巴格达多中心(公立医院)接收新冠肺炎病例的住院成年患者。这些病例的鼻/口咽拭子实时或逆转录聚合酶链反应(RT-PCR)呈阳性。本研究排除了PCR阴性和合并症患者以及43名明显健康的成年受试者作为对照。病例和对照组的年龄范围为(20至60)岁。结果:两组在年龄和性别分布方面没有统计学意义的差异。eGFR、肌酸酐、D.二聚体、NEU×103/µL、LYM×103/μL和ELA生物标志物存在统计学显著差异。Elabela与D.二聚体和NEU×103/µL呈显著负相关,eGFR与S.肌酸酐、D.二聚物和NUT×103/μL呈显著正相关。结论:Elabela生物标志物可用于早期检测COVID-19患者的急性肾损伤。
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引用次数: 0
The Role of Acute Phase Reactants (Fibrinogen, Ferritin, Albumin, Calcium) in Pregnant Women with Preterm Delivery 急性期反应物(纤维蛋白原、铁蛋白、白蛋白、钙)在孕妇早产中的作用
Pub Date : 2022-10-17 DOI: 10.32007/jfacmedbagdad.6431943
Wasan Wajdi Ibrahim, Maha Talib Mosa
Background: Preterm labor and related prematurity are predisposing factors that increase perinatal morbidity and mortality. Acute phase reactants are inflammatory markers which are positive and negative reactants explained by the reaction of reactants to the subclinical infection that are commonly associated with preterm labor.Objectives: To assess the role of acute phase reactants in pregnant women with preterm delivery.Patients and method: A case control study conducted in Gynecological Department of Baghdad Teaching Hospital from 1st February 2021 to 30th October 2021, on one hundred pregnant women with gestational age (28weeks - 36weeks+6days) who attended outpatient clinic; fifty pregnant women with established preterm labor as case group and fifty pregnant women with no signs and symptoms of preterm labor as control group. Data was collected using structured questionnaire included demographic features, and biochemical parameters (serum ferritin (ng/ml), albumin (gm/dl), fibrinogen (mg/dl), and calcium (mg/dl) .Results: Mean±SD serum ferritin in control group was (46.2 ± 16.2 ng/ml) while in case group (52.47 ± 11.6ng/ml) with significant difference between both groups (P=0.03), mean±SD serum albumin in control group (3.18 ± 0.31 ng/ml) while in case group (2.92 ± 0.39) with highly significant difference between both groups (P<0.001). Validity test of serum ferritin at cutoff   ≥ 52.7 (ng/ml) in case group was as follows: Sensitivity (94%), specificity (90%), negative predictive value (94%), positive predictive value (90%) and the accuracy was (92%). The validity test of serum albumin at cutoff ≤ 3.06 (gm/dl) to detect the preterm labor as follows: Sensitivity (78%), specificity (86%), negative predictive value (78%), positive predictive value (83%) and the accuracy was (84%). Mean±SD serum fibrinogen in control group was (400.9 ± 38.1) while in case group was (410.7 ± 51.2) with no significant difference between both groups (P=0.1). Mean±SD serum calcium in control group was (8.1 ± 0.7) while in case group was (7.92 ± 0.5) with no significant difference between both groups (P=0.1).Conclusion: serum ferritin and albumin can be used in prediction of preterm labor in 3rd trimester.
背景:早产和相关早产是增加围产期发病率和死亡率的易感因素。急性期反应物是炎症标志物,是阳性和阴性反应物,通过反应物对亚临床感染的反应来解释,亚临床感染通常与早产有关。目的:评估急性期反应物在早产孕妇中的作用。患者和方法:2021年2月1日至2021年10月30日在巴格达教学医院妇科进行的一项病例对照研究,对象为100名参加门诊的孕龄(28周-36周+6天)孕妇;50例已确定早产的孕妇为病例组,50例无早产体征和症状的孕妇为对照组。使用结构化问卷收集数据,包括人口统计学特征和生化参数(血清铁蛋白(ng/ml)、白蛋白(gm/dl)、纤维蛋白原(mg/dl)和钙(mg/dl,对照组血清白蛋白平均值±SD为3.18±0.31ng/ml,病例组为2.92±0.39,两组间差异极显著(P<0.001)。血清白蛋白在临界值≤3.06(gm/dl)时检测早产的有效性检验如下:敏感性(78%)、特异性(86%)、阴性预测值(78%)和阳性预测值(83%),准确率为(84%)。对照组血清纤维蛋白原平均值±标准差为(400.9±38.1),病例组为(410.7±51.2),两组比较无显著性差异(P=0.01);对照组血清钙平均值±标度为(8.1±0.7),病例对照组为(7.92±0.5),两个组比较无显着性差异(P=0.1)妊娠晚期。
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引用次数: 1
D-dimer level and Wells score in women undergone Lymphadenectomy in Gynecological Cancer to Assess Risk of Deep Venous Thrombosis d -二聚体水平和威尔斯评分评价妇科肿瘤行淋巴结切除术妇女深静脉血栓形成的风险
Pub Date : 2022-10-17 DOI: 10.32007/jfacmedbagdad.6431944
Nawfal Azzo, Safa Daud Sulman
Background: One of the most important prognostic indicators in cancer is the lymph node dissection. Lymphadenectomy considered as a risk factor for deep vein thrombosis in patients with gynecological malignancy who underwent surgery. D-dimer was used to detect deep vein thrombosis, thus, it’s important to predict complications of post-operative Lymphadenectomy.Objective: To predict the  risk of deep venous thrombosis by used serum D-dimer and wells score after pelvic lymphadenectomy in gynecological cancer.Patients and method:  A cross sectional study conducted in Obstetrics and Gynecology/ ward in medical city, from 1st, January 2021 to 30th, Dec. 2021. A total number of 45 (22 endometrial, 12 ovarian and 11 cervical cancers). Results: The mean±SD level of pre-operative D-dimer in patients with endometrial cancer was (423.2±123.9) while the mean±SD post-operative level was (987±125.1), the mean±SD level of pre-operative D-dimer in patients with ovarian cancer was (602±320.7) while the post-operative was (901.5± 412), mean±SD level of pre-operative D-dimer in patients with cervical cancer was (339±157) while the postoperative was (1214±327), and the mean±SD level of pre-operative D-dimer in all gynecological cancers was (541±167) while the post-operative was (1016±302). The mean±SD of wells score of those who are likely to developed DVT (n=7) in pre-operative was (2.3±0.02) while for those who are unlikely to develop deep vein thrombosis (n=38) was (2.03±0.4) with statistically significant difference (p=0.04) while highly significant difference found in pre- and post-operatively between the group of deep vein thrombosis (p˂0.001).Conclusion: Highly significant increase of post-operative D-dimer in all gynecological cancer patients.
背景:癌症最重要的预后指标之一是淋巴结清扫。淋巴结切除术被认为是接受手术的妇科恶性肿瘤患者深静脉血栓形成的危险因素。D-二聚体用于检测深静脉血栓形成,因此预测淋巴结切除术后并发症具有重要意义。目的:应用血清D-二聚体和wells评分预测妇科癌症盆腔淋巴结清扫术后深静脉血栓形成的风险。患者和方法:2021年1月1日至2021年12月30日在医疗城妇产科/病房进行的横断面研究。共45例(22例子宫内膜癌、12例卵巢癌和11例宫颈癌)。结果:子宫内膜癌症患者术前D-二聚体的平均±SD水平为(423.2±123.9),术后平均±SD为(987±125.1),子宫颈癌症患者术前D-二聚体的平均±SD水平为(339±157),术后为(1214±327),所有妇科癌症术前D-二聚体平均±SD为(541±167),术前为(1016±302)。术前可能发生DVT的患者(n=7)的井的平均±SD评分为(2.3±0.02),而不太可能发生深静脉血栓的患者(n=38)的井评分为(2.03±0.4),具有统计学意义的差异(p=0.04),而深静脉血栓组在术前和术后发现高度显著的差异(p 0.001)所有妇科癌症患者术后D-二聚体显著增加。
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引用次数: 0
Antibacterial and antibiofilm effect of sumac (Rhus coriaria L) fruits extracts against some multidrug_resistant pathogenic bacteria 漆树果实提取物对某些耐多药病原菌的抗菌和抗菌膜作用
Pub Date : 2022-10-17 DOI: 10.32007/jfacmedbagdad.6431964
Sally Alaamery
Abstract Background: The prevalence of multidrug-resistant bacteria and their contribution to increased morbidity and mortality due to the difficult-to-treat diseases caused by these bacteria, has demonstrated a need to develop and use alternative antimicrobial agents to control multidrug-resistant bacteria. There has been a growing interest in medicinal plants and herbs and their extracts as an alternative approach to discovering new antimicrobial compounds Materials and Methods: The sumac (Rhus coriaria L) plant was selected for this study, and aqueous and alcoholic extracts were prepared from its fruits. They were tested against four multi-antibiotic resistant bacterial isolates that produce biofilms ( Gram-positive and Gram-negative), namely Staphylococcus aureus, Enterococcus faecalis, Acinetobacter baumannii, and Pseudomonas aeruginosa which isolated from Iraqi patients with wounds and burns in Medical City hospitals. Results: The current study proved that the aqueous and alcoholic extract of sumac ( Rhus coriaria L ) fruit is effective as an antibacterial and anti-biofilm against the studied multidrug-resistant bacterial isolates at all tested concentrations with significant differences. The study also showed that the alcoholic extract is more effective as an anti-bacterial and anti-biofilm than the aqueous extract of the sumac. Conclusion: The current study provides valuable results for the use of extracts of medicinal plants and herbs, including sumac extracts, to treat pathogenic bacteria that have become more resistant to antibiotics. These plant extracts also contain natural compounds that can be used without causing any harmful effects on patients. Keywords: Antibacterial activity, Anti-biofilm activity, Multidrug-resistant bacteria, Rhus coriaria L., Sumac,
摘要背景:耐多药细菌的流行及其对由这些细菌引起的难以治疗的疾病导致的发病率和死亡率增加的贡献表明,有必要开发和使用替代抗菌剂来控制耐多药菌。人们对药用植物和草药及其提取物越来越感兴趣,将其作为发现新的抗菌化合物的替代方法材料和方法:本研究选择漆树(Rhus coraria L)植物,并从其果实中制备水性和酒精性提取物。他们对四种产生生物膜(革兰氏阳性和革兰氏阴性)的多重抗生素耐药性菌株进行了测试,即金黄色葡萄球菌、粪肠球菌、鲍曼不动杆菌和铜绿假单胞菌,这些菌株是从医疗城医院的伊拉克创伤和烧伤患者身上分离出来的。结果:目前的研究证明,漆树(Rhus coraria L)果实的水提取物和醇提取物在所有测试浓度下对所研究的多重耐药菌株都具有有效的抗菌和抗生物膜作用,但存在显著差异。研究还表明,醇提取物比漆树水提取物更有效地抗菌和抗生物膜。结论:目前的研究为使用药用植物和草药提取物,包括漆树提取物,治疗对抗生素耐药性更强的致病菌提供了有价值的结果。这些植物提取物还含有天然化合物,可以在不对患者造成任何有害影响的情况下使用。关键词:抗菌活性,抗生物膜活性,多药耐药菌,香菜Rhus coraria L.,Sumac,
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引用次数: 0
Evaluation of the Role of Serum Malondialdehyde in the Pathogenesis of Diabetic Retinopathy 血清丙二醛在糖尿病视网膜病变发病机制中的作用评价
Pub Date : 2022-10-17 DOI: 10.32007/jfacmedbagdad.6431957
زينةمحمد حسن, رنا علي حمدي, ابتهال نوري البصام
Background:  The most typical consequence of diabetes mellitus is diabetic retinopathy. An important part of the etiology of diabetes and diabetic retinopathy is played by oxidative stress. Malondialdehyde is a dialdehyde that is moderately toxic and is frequently used as a marker for oxidative stress as well as lipid peroxidation.                       Objectives: To assess the serum malondialdehyde levels in diabetic patients with and those without retinopathy and to compare these levels to controls .In additions to, investigate the relationship between serum malondialdehyde level and long glycemic control, the glycated hemoglobin (HbA1c).Patients and Methods: This case-control study included (120) individuals from 40 to 70 years of age. They were divided into three groups: Group 1: 40 type 2diabetic patients with retinopathy, Group 2 :40 type 2 diabetic patients without retinopathy, and Group 3 40 controls .The biochemical testes included fasting blood glucose measured by Cobas c 311 systems, glycated hemoglobinHbA1c measured by Cobas c 111 systems, and serum malondialdehyde (MDA) measured by enzyme linked immunosorbent assay (ELISA).Results: A higer mean value of (MDA) was found serum diabetic patients with and without retinopathy as compared to control (p=0.0001). As well as a significantly higher mean value of serum (MDA)  in diabetic patients with retinopathy as compared to those without (p=0.0001).A significant positive correlation was found between serum(MDA)  and HbA1C in diabetic patient with retinopathy group (r=0.931,p=0.0001) .Conclusion: Higher serum levels of malondialdehyde is an indicator of increased lipid peroxidation that may be involved in pathogeneses of retinopathy in uncontrolled type 2 diabetic patients.
背景:糖尿病最典型的后果是糖尿病视网膜病变。氧化应激在糖尿病和糖尿病视网膜病变的病因学中起着重要作用。丙二醛是一种中度毒性的双醛,常被用作氧化应激和脂质过氧化的标志物。目的:评价伴有和未伴有视网膜病变的糖尿病患者血清丙二醛水平,并与对照组进行比较,探讨血清丙二醛水平与长期血糖控制、糖化血红蛋白(HbA1c)的关系。患者和方法:本病例对照研究包括(120)名年龄在40至70岁之间的个体。将患者分为伴有视网膜病变的2型糖尿病患者组(1:40)、无视网膜病变的2型糖尿病患者组(2:40)和对照组(340),分别采用Cobas c311系统测定空腹血糖、Cobas c111系统测定糖化血红蛋白(hba1c)和酶联免疫吸附试验(ELISA)测定血清丙二醛(MDA)。结果:与对照组相比,伴有或不伴有视网膜病变的糖尿病患者血清MDA均值较高(p=0.0001)。此外,糖尿病视网膜病变患者的血清(MDA)均值明显高于无视网膜病变患者(p=0.0001)。糖尿病合并视网膜病变组血清丙二醛(MDA)与糖化血红蛋白(HbA1C)呈显著正相关(r=0.931,p=0.0001)。结论:血清丙二醛水平升高提示脂质过氧化水平升高,可能参与2型糖尿病合并视网膜病变的发病机制。
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引用次数: 0
Prevalence of anemia and its risk factors among supplemented and non-supplemented pregnant women in Sulaimani city Kurdistan-Iraq 伊拉克库尔德斯坦苏莱曼尼市补充和非补充孕妇贫血患病率及其危险因素
Pub Date : 2022-10-17 DOI: 10.32007/jfacmedbagdad.6431945
Aras Qadir Pirot, Sardar M. Weli
Abstract: Background: Anaemia is a serious global public health problem that particularly affects pregnant women. It was estimated that 41.8% of pregnant women worldwide were anaemic. Objectives: The objectives of this study were to find out the prevalence of anemia and its associated risk factors among supplemented and non-supplemented pregnant women in Sulaimani city.   Patient and methods: Sixty hundred and forty one samples were collected randomly from the pregnant and control women. Data concerned to age, education, residence, and obstetrical related factors were collected by face to face interview.  Finally, 5 ml of venous blood were collected from each pregnant woman for complete blood count, serum iron, serum ferritin, folic acid and vitamin B12 determination.  Results: this study found that 74.2% and 34.9 of non-supplemented and supplemented pregnant women were anemic respectively. Factors such as; gestational age, gravidity, history of abortion, birth intervals, age, occupation, level of education, body mass index, family income and blood pressure were significantly associated with the rate of anaemia. There were differences between the rate of anemia among supplemented and non-supplemented pregnant women in all factors, the rates were decreased in the supplemented groups. The normal percentage of serum ferritin was very low; 16.5% and 38.4% among non-supplemented and supplemented anemic pregnant women respectively. Conclusion: the prevalence of anemia was high among non-supplemented compared to supplemented pregnant women. The majority of anemia was mild type. All risk factors that are associated with anemia were decreased in supplemented compared to non-supplemented pregnant women. Most of the anemic cases in our result are iron deficient.
摘要:背景:贫血是一个严重的全球性公共卫生问题,尤其影响孕妇。据估计,全世界41.8%的孕妇贫血。目的:本研究旨在了解苏莱曼尼市补充和未补充孕妇贫血的患病率及其相关危险因素。患者和方法:从孕妇和对照组妇女中随机抽取六亿四千一份样本。通过面对面访谈收集与年龄、教育程度、居住地和产科相关因素有关的数据。最后,从每位孕妇身上采集5毫升静脉血,用于全血计数、血清铁、血清铁蛋白、叶酸和维生素B12的测定。结果:本研究发现,未补充和补充的孕妇贫血率分别为74.2%和34.9%。因素包括:;孕龄、妊娠、流产史、出生间隔、年龄、职业、教育水平、体重指数、家庭收入和血压与贫血率显著相关。补充组和未补充组孕妇贫血发生率在各因素上均存在差异,补充组贫血发生率有所下降。血清铁蛋白的正常百分比很低;未补充和补充贫血孕妇分别为16.5%和38.4%。结论:与补充营养的孕妇相比,未补充营养的妇女贫血的患病率较高。贫血以轻度为主。与未补充的孕妇相比,补充的孕妇与贫血相关的所有危险因素都有所减少。在我们的研究结果中,大多数贫血病例都是缺铁。
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引用次数: 0
Early Outcome of Patient Born with Gastroschisis and Omphalocele 先天性腹裂伴脐膨出患者的早期预后
Pub Date : 2022-10-17 DOI: 10.32007/jfacmedbagdad.6431901
S. Berdawd, Abdulrahman Omar Taha
Background: Gastroschisis and omphalocele are the most common congenital defects of the anterior abdominal wall which need urgent and prompt intervention post-operative time outcomes of gastroschisis and omphalocele differ between different countries, especially between developed and developing countries.Objectives: Is to determine the early outcome of patients born with gastroschisis and omomphalocelePatients and Methods: An analytical study including 30 patients (11 gastroschisis and 19 omphaloceles) were treated in Erbil city during 2015 -2018. Patients with associated bladder and cloacal exstrophies were excluded.Results: Female to male ratio was 1.3:1, and the mean age at presentation was 11.7 hours. The Mean weight was 2.86 kg. the Majority of patients25 (83.3%) were term. In Nineteen cases (63.3%)were delivered vaginally (9 gastroschisis and 10comphalocele), prenatally diagnosis was done in 9(30%). The Mean size of the defect was 3.7cm, and the content was mixed in 7(23.3%). Primary repair has performed in 18(60%), a silo in 8(26.7%), and 4(13.3%) treated none surgically (all were omphalocele). Operations have been done within 24 hours of arrival in 16(61.5%). Associated anomalies have been found in 11(57.9%) patients with omphaloceles and only 2(18.2%) patients with gastroschisis. The mean period of hospital stays was6 days. Mortality among the gastroschisis patients were 8(72%), but only 4(21.1%) for omphalocele patients.Conclusion: Gastrochisis and omphalocele constitute a considerable part of neonatal surgical problems and their management is still challenging. Omphalocele cases were more likely to have associated congenital anomalies and gastroschisis, if the associated anomalies were confined to the gastrointestinal tract. There was a high mortality rate, especially in patients with gastroschisis and ruptured omphalocele due to a lack of intensive care units, facilities, and trained personnel to look after such high-risk patients.
背景:腹裂和脐膨出是最常见的前腹壁先天性缺陷,需要紧急和及时的干预。不同国家,特别是发达国家和发展中国家,腹裂和脐膨出的术后预后存在差异。目的:确定出生时胃裂合并脐膨出患者的早期预后。方法:对2015 -2018年在埃尔比勒市治疗的30例患者(11例胃裂和19例脐膨出)进行分析研究。排除伴有膀胱和肛管外翻的患者。结果:男女比例为1.3:1,平均发病年龄为11.7 h。平均体重2.86 kg。大多数患者25(83.3%)为中期。顺产19例(63.3%),其中腹裂9例,脐膨出10例,产前诊断9例(30%)。缺陷的平均尺寸为3.7cm,含量混合在7个(23.3%)。18例(60%)进行了初步修复,8例(26.7%)进行了修复,4例(13.3%)未进行手术治疗(均为脐膨出)。16例(61.5%)在抵达后24小时内完成手术。11例脐膨出(57.9%)和2例腹裂(18.2%)存在相关异常。平均住院时间为6 d。胃裂患者死亡率为8例(72%),脐膨出患者死亡率仅为4例(21.1%)。结论:胃裂和脐膨出是新生儿外科问题的重要组成部分,其治疗仍具有挑战性。如果相关异常局限于胃肠道,脐膨出病例更有可能伴有先天性异常和胃裂。由于缺乏重症监护病房、设施和训练有素的人员来照顾这些高危患者,因此死亡率很高,特别是胃裂和脐膨出破裂的患者。
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引用次数: 0
Evaluation of Some New Cytokines in Rheumatoid Arthritis 类风湿关节炎中一些新的细胞因子的评价
Pub Date : 2022-10-17 DOI: 10.32007/jfacmedbagdad.6431963
Z. Ahmed
Background: Cytokines have an essential contribution to the inflammatory response and the development of chronic inflammation. Therefore, it has a pivotal role in the pathogenesis of rheumatoid arthritis (RA). Interleukins are closely related to RA, and the exact role of some interleukins in the pathogenesis of RA is not yet known.Objectives: To evaluate the levels of interleukins and their ratio, since the levels of interleukins 35 and 39 in RA patients have not yet been determined in Iraq.Patients and methods: An ELISA (enzyme-linked immunosorbent assay) was used to measure the levels of interleukins in the blood of 56 patients with RA and 44 healthy volunteers who were enrolled in the study from November 2021 to March 2022.Results: The serum levels of IL-39 in the RA patient groups were significantly higher than in the control groups (p = 0.043). In contrast, the level of IL-35 was slightly higher in RA patients but not by significantly different values (p = 0.055). The cytokine ratio, IL-39/IL-35, was the same for the groups, and there were no significant differences when comparing patients to controls (14.30 ± 1.47 vs. 13.18 ± 0.71). In addition, IL-39 concentration levels were significantly higher in RA patients under therapy than in RA patients with a first diagnosis and without therapy.Conclusion: The study concluded the crucial role of pro-inflammatory and anti-inflammatory cytokines in the progression of RA.
背景:细胞因子在炎症反应和慢性炎症的发展中起着重要的作用。因此,它在类风湿关节炎(RA)的发病机制中具有举足轻重的作用。白细胞介素与RA密切相关,一些白细胞介素在RA发病中的确切作用尚不清楚。目的:评估白细胞介素水平及其比率,因为伊拉克RA患者中白细胞介素35和39的水平尚未确定。患者和方法:在2021年11月至2022年3月期间,使用ELISA(酶联免疫吸附测定法)测量56名RA患者和44名健康志愿者血液中的白细胞介素水平。结果:RA患者组血清IL-39水平显著高于对照组(p = 0.043)。相比之下,RA患者IL-35水平略高,但差异无统计学意义(p = 0.055)。各组细胞因子比值IL-39/IL-35相同,与对照组比较差异无统计学意义(14.30±1.47∶13.18±0.71)。此外,接受治疗的RA患者的IL-39浓度水平显著高于首次诊断和未接受治疗的RA患者。结论:本研究表明促炎和抗炎细胞因子在RA的进展中起着至关重要的作用。
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引用次数: 0
The Incidence and the Clinical Significance of the Gray Zone in the Clinical Phases of Chronic Hepatitis B Virus Infection 灰色地带在慢性乙型肝炎病毒感染临床分期中的发生率及其临床意义
Pub Date : 2022-10-17 DOI: 10.32007/jfacmedbagdad.6431950
Rabah H Asreah, Jawad A. Alkagany
Background: five clinical phases were described in patients with chronic (HBV) infection: HBeAg- positive HBV infection, HBeAg- positive CHB, HBeAg negative HBV infection, HBeAg-negative CHB and occult HBV infection. Aim: This study aimed to determine the incidence of the unclassified phase (gray zone) in chronic hepatitis B patients and its significant in the clinical practice.  Patients and methods: The study was conducted retrospectively on 109 patients' who have HBsAg positive for more than 6 months. The data recorded include; HbeAg and anti-HBe Ab, ultrasound of the abdomen, HBV DNA load and alanine aminotransferase (ALT), accordingly; we classify the patients to known clinical phases. Patients who were unfit one of these phases considered to be in the gray zone and subsequently sent for liver fibroscan to determine the fibrosis stage.  Results: The mean age of our patients was 34.25 (±13.9) years with 54.12% being males. The mean viral load was 5,885,490 IU/ml and mean ALT was 56.22 (±89.88) U/L. eight  patients (7.3%) were in the HBeAg+ve HBV infection, 13 patients (11.9%) were in HBeAg+ve CHB . Thirty four patients (31.1%) were in the HBeAg-ve HBV infection and 23 (21.1%) were in HBeAg-ve CHB phase, both were showed a significant statistical relationship with age> 35 years. Thirty one (28.4%) further patients failed to identify with any of the four phases (normal ALT with HBV load > 2000 IU/ml), this group also showed significant relation to age above 35 years and 12 patients (38.8%) had significant fibrosis on fibroscan. Conclusions: A considerable number of patients with chronic HBV infection have persistently normal ALT levels, despite elevated levels of viral load; this is known as the "grey zone" phase. These patients merit close follow up with short-interval measurement of liver enzymes, liver fibroscan and biopsy may be considered.
背景:描述了慢性(HBV)感染患者的五个临床阶段:HBeAg阳性HBV感染、HBeAg阴性CHB、HBeAg阴性CHB和隐匿性HBV感染。目的:本研究旨在确定慢性乙型肝炎患者未分类期(灰色区)的发生率及其在临床实践中的意义。患者与方法:对109例HBsAg阳性6个月以上的患者进行回顾性分析。记录的数据包括:;相应地,HbeAg和抗-HBe-Ab、腹部超声、HBV DNA负荷和丙氨酸氨基转移酶(ALT);我们将患者分为已知的临床阶段。不适合其中一个阶段的患者被认为处于灰色地带,随后进行肝纤维化扫描以确定纤维化阶段。结果:患者平均年龄为34.25(±13.9)岁,其中男性54.12%。平均病毒载量为5885490 IU/ml,平均ALT为56.22(±89.88)U/L。8例(7.3%)为HBeAg+ve HBV感染,13例(11.9%)为HBV感染。34例(31.1%)患者为HBeAg-ve HBV感染,23例(21.1%)患者处于HBeAg-ve-CHB期,两者均与年龄>35岁有显著的统计学关系。另有31名(28.4%)患者未能识别出四个阶段中的任何一个(ALT正常,HBV载量>2000 IU/ml),该组患者也与35岁以上的年龄有显著关系,12名患者(38.8%)在纤维扫描中有显著纤维化。结论:尽管病毒载量升高,但相当多的慢性HBV感染患者的ALT水平持续正常;这被称为“灰色地带”阶段。这些患者值得密切随访,可以考虑短时间测量肝酶、肝纤维扫描和活检。
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