Pub Date : 2024-07-01DOI: 10.32007/jfacmedbagdad.6622178
Hiba S. Kareem, Wifaq M. Al-Wattar
Background: Aspergillus spp. causes a wide range of diseases called Invasive Aspergillosis (IA) which is a fatal illness that affects a variety of immunocompromised people worldwide. Objective: Using the lateral flow test for the detection of Galactomannan antigen in immunocompromised patients suspected to have IA. Patients and Methods: This study was conducted on 72 patients, whose samples (serum, Bronchoalveolar lavage, Blood) were collected from the Hematology-Oncology Unit at Baghdad Teaching Hospital and Pediatric Welfare Hospital, and ICU in Ghazi AL-Hariri Surgical Specialties Hospital, and Bone Marrow Transplantation Center in period between November 2022 to February 2023. Patients’ blood and sputum were sent for fungal culture to confirm the diagnosis in most cases. Results: QuicGM Aspergillus Lateral Flow Assay was conducted on 72 patients, of whom 34 () were positive and 38 (52.7) were negative (P-value of 0.001 and 0.5) respectively. This screening aimed at detecting IA. One week later, the second confirmative result was obtained from 24 patients to determine the response to antifungal drugs or recovery from neutropenia on which 15 readings were negative and nine were positive. Out of 48 single readings, 25 were positive and 23 were negative. All for 72 members of the control group gave negative results. This study is the first in Iraq to use this assay. Conclusion: QuicGM Aspergillus Lateral Flow Assay was found to be reliable, sensitive, and specific, and proved to be a very good guide for the early diagnosis of IA in immunocompromised patients and in monitoring treatment outcomes and follow-up.
{"title":"Evaluation of Two Readings for the QuicGM Aspergillus Lateral Flow Assay in a Group of Immunocompromised Patients in Iraq","authors":"Hiba S. Kareem, Wifaq M. Al-Wattar","doi":"10.32007/jfacmedbagdad.6622178","DOIUrl":"https://doi.org/10.32007/jfacmedbagdad.6622178","url":null,"abstract":"Background: Aspergillus spp. causes a wide range of diseases called Invasive Aspergillosis (IA) which is a fatal illness that affects a variety of immunocompromised people worldwide.\u0000Objective: Using the lateral flow test for the detection of Galactomannan antigen in immunocompromised patients suspected to have IA.\u0000Patients and Methods: This study was conducted on 72 patients, whose samples (serum, Bronchoalveolar lavage, Blood) were collected from the Hematology-Oncology Unit at Baghdad Teaching Hospital and Pediatric Welfare Hospital, and ICU in Ghazi AL-Hariri Surgical Specialties Hospital, and Bone Marrow Transplantation Center in period between November 2022 to February 2023. Patients’ blood and sputum were sent for fungal culture to confirm the diagnosis in most cases.\u0000Results: QuicGM Aspergillus Lateral Flow Assay was conducted on 72 patients, of whom 34 () were positive and 38 (52.7) were negative (P-value of 0.001 and 0.5) respectively. This screening aimed at detecting IA. One week later, the second confirmative result was obtained from 24 patients to determine the response to antifungal drugs or recovery from neutropenia on which 15 readings were negative and nine were positive. Out of 48 single readings, 25 were positive and 23 were negative. All for 72 members of the control group gave negative results. This study is the first in Iraq to use this assay.\u0000Conclusion: QuicGM Aspergillus Lateral Flow Assay was found to be reliable, sensitive, and specific, and proved to be a very good guide for the early diagnosis of IA in immunocompromised patients and in monitoring treatment outcomes and follow-up.","PeriodicalId":516152,"journal":{"name":"Journal of the Faculty of Medicine Baghdad","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141698775","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}
Pub Date : 2024-07-01DOI: 10.32007/jfacmedbagdad.6622275
Fatima O Abd alkareem, Ban J. Mohamad
Background: Bowel cancer is the most prevalent digestive system cancer and is the 4th largest cause of cancer-related death worldwide. In Iraq, colon and rectal cancer (CRC) is the 6th most common malignancy in males and the 5th in females. This cancer is sluggish in growth, which gives a window of opportunity to screen for both precursor lesions and early cancer. The Cluster of Differentiation 47 (CD47) protein is a type of transmembrane glycoproteins found on nearly all human cells, including non-hematopoietic and hematopoietic cells. CD47 promotes CRC growth by triggering angiogenesis and apoptosis of tumor cell. Objectives: To evaluate the immunohistochemical expression of (CD47) in various colorectal samples from Iraqi patients with CRC by immunohistochemistry (IHC) assay. Specimens and methods: A total of 45 paraffin-embedded CRC tissue specimens and clinical data were obtained from the Medical City Teaching Hospital in Baghdad and a number of private laboratories in Baghdad, Iraq. In addition, 30 control colon and rectum tissues with no significant pathology were collected from the Forensic Medicine Department for comparison purposes after taking the official approvals. Results: The results revealed a high expression of CD47 in CRC cases, but with no significant correlation with clinicopathological features. Also, the result of figures in this study revealed negative membranous expression of CD47 (score 0), strong membranous expression of CD47 (score 3), moderately membranous expression of CD47 (score 2), and weak membranous expression of CD47 (score 1) Conclusion: Patients with CRC had high CD47 expression, allowing tumor cells to modulate CD47SIRP inhibitory signaling and prevent immune cell attack.
{"title":"Immunohistochemical Expression and Histopathological Role of CD47 in Colorectal Cancer in Iraqi Patients","authors":"Fatima O Abd alkareem, Ban J. Mohamad","doi":"10.32007/jfacmedbagdad.6622275","DOIUrl":"https://doi.org/10.32007/jfacmedbagdad.6622275","url":null,"abstract":"Background: Bowel cancer is the most prevalent digestive system cancer and is the 4th largest cause of cancer-related death worldwide. In Iraq, colon and rectal cancer (CRC) is the 6th most common malignancy in males and the 5th in females. This cancer is sluggish in growth, which gives a window of opportunity to screen for both precursor lesions and early cancer. The Cluster of Differentiation 47 (CD47) protein is a type of transmembrane glycoproteins found on nearly all human cells, including non-hematopoietic and hematopoietic cells. CD47 promotes CRC growth by triggering angiogenesis and apoptosis of tumor cell.\u0000Objectives: To evaluate the immunohistochemical expression of (CD47) in various colorectal samples from Iraqi patients with CRC by immunohistochemistry (IHC) assay.\u0000Specimens and methods: A total of 45 paraffin-embedded CRC tissue specimens and clinical data were obtained from the Medical City Teaching Hospital in Baghdad and a number of private laboratories in Baghdad, Iraq. In addition, 30 control colon and rectum tissues with no significant pathology were collected from the Forensic Medicine Department for comparison purposes after taking the official approvals.\u0000Results: The results revealed a high expression of CD47 in CRC cases, but with no significant correlation with clinicopathological features. Also, the result of figures in this study revealed negative membranous expression of CD47 (score 0), strong membranous expression of CD47 (score 3), moderately membranous expression of CD47 (score 2), and weak membranous expression of CD47 (score 1)\u0000Conclusion: Patients with CRC had high CD47 expression, allowing tumor cells to modulate CD47SIRP inhibitory signaling and prevent immune cell attack. ","PeriodicalId":516152,"journal":{"name":"Journal of the Faculty of Medicine Baghdad","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141706963","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}
Pub Date : 2024-07-01DOI: 10.32007/jfacmedbagdad.6622240
Rusul W. Kadhum, Shaimaa N. Abd-Alhammid
Background: Dutasteride, is a drug whose mechanism of action is inhibition of the enzyme 5-alpha reductase. It has been approved for use in the treatment of benign prostatic hyperplasia. Dutasteride has low solubility and high permeability, which classifies it as Biopharmaceutics classification system class II, according to the Biopharmaceutics Classification System. It has a water solubility of only 0.038 ng/mL and a slow dissolving rate, resulting in its exclusive availability in the market as a formulation contained within soft gelatin capsules. Objective: The aim of this study involves two parts. First, is the enhancement of dutasteride dissolution rate, by the creation of dutasteride nanosuspension, and second is the enhancement of patient compliance by the transformation of this nanosuspension to oral fast-dissolving film, which is characterized by its fast disintegration, stability, and ease of administration. Methods: The solvent anti/solvent precipitation method was used to formulate dutasteride nanosuspension. In addition, dutasteride nanoparticles oral fast dissolving films were prepared by using the solvent casting method. To compare the in vitro release patterns of pure dutasteride film and selected dutasteride nanoparticles film, the statistical analysis for the dissolution investigation was conducted using the model-independent technique (employing similarity factor f2) utilizing a DD solver. The selected dutasteride nanoparticle film was supposed to be the test material, while the pure dutasteride film was supposed to serve as the reference. Results: dutasteride nanosuspension demonstrated a high enhancement of the dissolution rate. In addition, the prepared dutasteride nanoparticles oral fast-dissolving film exhibited a further increase in the rate of dissolution and fast disintegration, and the administration is easy, all of these properties making it a promising dosage form. Conclusion: Nanosuspension is an excellent approach for enhancing the solubility, dissolution rate, and effectiveness of drugs with limited aqueous solubility such as dutasteride. In addition, the oral fast-dissolving film can be considered a promising dosage form that will increase patient compliance due to its high dissolution rate, fast disintegration, and easy administration.
{"title":"Preparation and Characterization of Dutasteride Nanoparticles as Oral Fast-Dissolving Film","authors":"Rusul W. Kadhum, Shaimaa N. Abd-Alhammid","doi":"10.32007/jfacmedbagdad.6622240","DOIUrl":"https://doi.org/10.32007/jfacmedbagdad.6622240","url":null,"abstract":"Background: Dutasteride, is a drug whose mechanism of action is inhibition of the enzyme 5-alpha reductase. It has been approved for use in the treatment of benign prostatic hyperplasia. Dutasteride has low solubility and high permeability, which classifies it as Biopharmaceutics classification system class II, according to the Biopharmaceutics Classification System. It has a water solubility of only 0.038 ng/mL and a slow dissolving rate, resulting in its exclusive availability in the market as a formulation contained within soft gelatin capsules.\u0000Objective: The aim of this study involves two parts. First, is the enhancement of dutasteride dissolution rate, by the creation of dutasteride nanosuspension, and second is the enhancement of patient compliance by the transformation of this nanosuspension to oral fast-dissolving film, which is characterized by its fast disintegration, stability, and ease of administration. \u0000Methods: The solvent anti/solvent precipitation method was used to formulate dutasteride nanosuspension. In addition, dutasteride nanoparticles oral fast dissolving films were prepared by using the solvent casting method.\u0000To compare the in vitro release patterns of pure dutasteride film and selected dutasteride nanoparticles film, the statistical analysis for the dissolution investigation was conducted using the model-independent technique (employing similarity factor f2) utilizing a DD solver. The selected dutasteride nanoparticle film was supposed to be the test material, while the pure dutasteride film was supposed to serve as the reference.\u0000Results: dutasteride nanosuspension demonstrated a high enhancement of the dissolution rate. In addition, the prepared dutasteride nanoparticles oral fast-dissolving film exhibited a further increase in the rate of dissolution and fast disintegration, and the administration is easy, all of these properties making it a promising dosage form.\u0000Conclusion: Nanosuspension is an excellent approach for enhancing the solubility, dissolution rate, and effectiveness of drugs with limited aqueous solubility such as dutasteride. In addition, the oral fast-dissolving film can be considered a promising dosage form that will increase patient compliance due to its high dissolution rate, fast disintegration, and easy administration.","PeriodicalId":516152,"journal":{"name":"Journal of the Faculty of Medicine Baghdad","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141715278","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}
Pub Date : 2024-07-01DOI: 10.32007/jfacmedbagdad.6622277
Mohammed A. Qusay, Sarmad M.H. Zeiny, Haider J.M. Al-Maraashi
Background: Ulcerative colitis (UC) is an inflammatory bowel disease restricted to the large intestine, characterized by superficial ulceration. It is a progressive and chronic disease requiring long-term treatment. Although its etiology remains unknown, it is suggested that environmental factors influence genetically susceptible individuals, leading to the onset of the disease. (C-X-C) ligand 9 is a chemokine that belongs to the CXC chemokine family, it plays a role in the differentiation of immune cells such as cytotoxic lymphocytes, natural killer T cells, and macrophages. Its interaction with its corresponding receptor CXCR3 which is expressed by a variety of cells such as effector T cells, CD8+ cytotoxic T cells, and macrophage, leads to stimulation of the production of IFN-γ and TNF-α and in turn, stimulates the production of Th1 chemokines which results in promoting the inflammation. Objectives: To assess the significance of serum chemokine (C-X-C) ligand 9 as a potential marker for identifying ulcerative colitis in adults with inflammatory bowel disease. Patients and Methods: This is a case-control study that included 50 patients diagnosed with UC, aged between 18 and 75 years, compared to 50 healthy controls, aged between 18 and 60 years. The study was conducted between November 2022 and March 2023, at the Gastroenterology and Hepatology Teaching Hospital at the Medical City Complex in Baghdad. The serum samples were analyzed using the Enzyme-Linked Immunosorbent Assay (ELISA) technique. Results: The mean ± SD in pg/ml of serum CXCL9 in patient group was 26.9 ± 9.05 and in control group was 6.4 ± 2.37 (p< 0.0001) which indicates a highly significant difference. Conclusion: CXCL 9 may be employed as a biomarker for identifying ulcerative colitis and it can be used as a tool for measuring disease activity, in addition to the possibility of being a potential therapeutic target.
{"title":"Serum CXCL 9 as a Potential Biomarker for Patients with Ulcerative Colitis","authors":"Mohammed A. Qusay, Sarmad M.H. Zeiny, Haider J.M. Al-Maraashi","doi":"10.32007/jfacmedbagdad.6622277","DOIUrl":"https://doi.org/10.32007/jfacmedbagdad.6622277","url":null,"abstract":"Background: Ulcerative colitis (UC) is an inflammatory bowel disease restricted to the large intestine, characterized by superficial ulceration. It is a progressive and chronic disease requiring long-term treatment. Although its etiology remains unknown, it is suggested that environmental factors influence genetically susceptible individuals, leading to the onset of the disease. (C-X-C) ligand 9 is a chemokine that belongs to the CXC chemokine family, it plays a role in the differentiation of immune cells such as cytotoxic lymphocytes, natural killer T cells, and macrophages. Its interaction with its corresponding receptor CXCR3 which is expressed by a variety of cells such as effector T cells, CD8+ cytotoxic T cells, and macrophage, leads to stimulation of the production of IFN-γ and TNF-α and in turn, stimulates the production of Th1 chemokines which results in promoting the inflammation.\u0000Objectives: To assess the significance of serum chemokine (C-X-C) ligand 9 as a potential marker for identifying ulcerative colitis in adults with inflammatory bowel disease.\u0000Patients and Methods: This is a case-control study that included 50 patients diagnosed with UC, aged between 18 and 75 years, compared to 50 healthy controls, aged between 18 and 60 years. The study was conducted between November 2022 and March 2023, at the Gastroenterology and Hepatology Teaching Hospital at the Medical City Complex in Baghdad. The serum samples were analyzed using the Enzyme-Linked Immunosorbent Assay (ELISA) technique.\u0000Results: The mean ± SD in pg/ml of serum CXCL9 in patient group was 26.9 ± 9.05 and in control group was 6.4 ± 2.37 (p< 0.0001) which indicates a highly significant difference.\u0000Conclusion: CXCL 9 may be employed as a biomarker for identifying ulcerative colitis and it can be used as a tool for measuring disease activity, in addition to the possibility of being a potential therapeutic target.\u0000 ","PeriodicalId":516152,"journal":{"name":"Journal of the Faculty of Medicine Baghdad","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141697756","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}
Pub Date : 2024-07-01DOI: 10.32007/jfacmedbagdad.6622220
Qabas F. Sami, Ban S. Diab
Background: Emotional abuse is a widespread form of child abuse. It is suggested that the adverse outcomes from all forms of abuse mostly result from the emotional impacts. Resistin, a polypeptide high in cysteine, can serve as a valuable biochemical indicator of periodontal tissue damage when detected in the saliva. Objective: To assess the relationship of emotional abuse with periodontal status and salivary resistin levels. Patients and Methods: This cross-sectional comparative study included 522 intermediate school students aged 13-15 years in Kirkuk/Iraq. Information on emotional abuse was obtained using Glaser criteria which is a self-administered, structured, questionnaire form. The levels of emotional abuse were categorized into mild (score between 24-26), moderate (score between 27-42), and severe (score between 43-72). Periodontal health was assessed by using the community periodontal index (CPI). Non-stimulated saliva was collected and salivary resistin levels were evaluated using an enzyme-linked immunosorbent assay (ELISA). Results: The most common level of abuse was moderate. The largest percentages of participants with dental calculus were observed in moderate (48.2%) and severe (57.5%) abuse groups and the highest mean number of sextants with gingival bleeding was observed in participants who experienced a moderate level of abuse (0.34). While the level of resistin was higher in the mild abuse group (237.06), all of its relationships with the periodontal condition were non-significant. Conclusion: Emotional abuse affects salivary resistin levels but has no obvious effect on periodontal status. Non-significant correlations were observed between salivary resistin levels and the levels of abuse with periodontal conditions.
{"title":"The Effect of Emotional Abuse on Periodontal Status and Salivary Resisti","authors":"Qabas F. Sami, Ban S. Diab","doi":"10.32007/jfacmedbagdad.6622220","DOIUrl":"https://doi.org/10.32007/jfacmedbagdad.6622220","url":null,"abstract":"Background: Emotional abuse is a widespread form of child abuse. It is suggested that the adverse outcomes from all forms of abuse mostly result from the emotional impacts. Resistin, a polypeptide high in cysteine, can serve as a valuable biochemical indicator of periodontal tissue damage when detected in the saliva.\u0000Objective: To assess the relationship of emotional abuse with periodontal status and salivary resistin levels.\u0000Patients and Methods: This cross-sectional comparative study included 522 intermediate school students aged 13-15 years in Kirkuk/Iraq. Information on emotional abuse was obtained using Glaser criteria which is a self-administered, structured, questionnaire form. The levels of emotional abuse were categorized into mild (score between 24-26), moderate (score between 27-42), and severe (score between 43-72). Periodontal health was assessed by using the community periodontal index (CPI). Non-stimulated saliva was collected and salivary resistin levels were evaluated using an enzyme-linked immunosorbent assay (ELISA).\u0000Results: The most common level of abuse was moderate. The largest percentages of participants with dental calculus were observed in moderate (48.2%) and severe (57.5%) abuse groups and the highest mean number of sextants with gingival bleeding was observed in participants who experienced a moderate level of abuse (0.34). While the level of resistin was higher in the mild abuse group (237.06), all of its relationships with the periodontal condition were non-significant.\u0000Conclusion: Emotional abuse affects salivary resistin levels but has no obvious effect on periodontal status. Non-significant correlations were observed between salivary resistin levels and the levels of abuse with periodontal conditions.","PeriodicalId":516152,"journal":{"name":"Journal of the Faculty of Medicine Baghdad","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141698000","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}
Pub Date : 2024-07-01DOI: 10.32007/jfacmedbagdad.6622257
Huda A. Abdulsada, Ekhlass M. Taha
Background: Acute bronchitis, an inflammation of the lower respiratory tract characterized by an acute cough, is a prevalent clinical illness that leads patients to seek out primary healthcare services. About 5 percent of adults in the United States report having acute bronchitis annually, with 90 percent of those affected seeking medical attention. Objectives: The study aimed to determine Nitric oxide, Procalcitonin (PCT), WBCs, neutrophils, lymphocytes, and Oxidative stress index (OSI) levels in acute bronchitis patients. Methods: The study involved 120 volunteers aged 20–50 years old in Al-Zahra Teaching Hospital, Wasit City. 80 patients with acute bronchitis were conducted between (10 November 2022 to 20 March 2023). 40 people were used as a control group. Blood samples were collected from patients and controls. Complete blood account CBC was calculated using a blood sample with EDTA. Serum was used to calculate NO, PCT, and OSI. Blood counts were performed using the SYSMEX XP-300. Nitric oxide and Procalcitonin levels were measured using an ELISA kit. OSI was calculated using the equation OSI = Total oxidant status /Total antioxidant status x100. Results: The current research presents the results of the Procalcitonin, nitric oxide, oxidative stress index, neutrophils, and lymphocytes. Age, BMI, and WBCs in acute bronchitis did not show any significant variances when compared between the two groups. In contrast, nitric oxide, Procalcitonin, oxidative stress, and Neutrophil levels showed a highly significant change among the acute bronchitis patient group compared to the control group. Conclusion: Procalcitonin and nitric oxide may have a role in the diagnosis of acute bronchitis, in addition to lymphocytes and neutrophils.
{"title":"Nitric Oxide, Procalcitonin and Oxidative Stress Index Levels in Acute Bronchitis Patients","authors":"Huda A. Abdulsada, Ekhlass M. Taha","doi":"10.32007/jfacmedbagdad.6622257","DOIUrl":"https://doi.org/10.32007/jfacmedbagdad.6622257","url":null,"abstract":"Background: Acute bronchitis, an inflammation of the lower respiratory tract characterized by an acute cough, is a prevalent clinical illness that leads patients to seek out primary healthcare services. About 5 percent of adults in the United States report having acute bronchitis annually, with 90 percent of those affected seeking medical attention. \u0000Objectives: The study aimed to determine Nitric oxide, Procalcitonin (PCT), WBCs, neutrophils, lymphocytes, and Oxidative stress index (OSI) levels in acute bronchitis patients. \u0000Methods: The study involved 120 volunteers aged 20–50 years old in Al-Zahra Teaching Hospital, Wasit City. 80 patients with acute bronchitis were conducted between (10 November 2022 to 20 March 2023). 40 people were used as a control group. Blood samples were collected from patients and controls. Complete blood account CBC was calculated using a blood sample with EDTA. Serum was used to calculate NO, PCT, and OSI. Blood counts were performed using the SYSMEX XP-300. Nitric oxide and Procalcitonin levels were measured using an ELISA kit. OSI was calculated using the equation OSI = Total oxidant status /Total antioxidant status x100.\u0000Results: The current research presents the results of the Procalcitonin, nitric oxide, oxidative stress index, neutrophils, and lymphocytes. Age, BMI, and WBCs in acute bronchitis did not show any significant variances when compared between the two groups. In contrast, nitric oxide, Procalcitonin, oxidative stress, and Neutrophil levels showed a highly significant change among the acute bronchitis patient group compared to the control group. \u0000Conclusion: Procalcitonin and nitric oxide may have a role in the diagnosis of acute bronchitis, in addition to lymphocytes and neutrophils.\u0000 \u0000 \u0000 ","PeriodicalId":516152,"journal":{"name":"Journal of the Faculty of Medicine Baghdad","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141693175","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}
Pub Date : 2024-07-01DOI: 10.32007/jfacmedbagdad.6622290
Ali M.J Al-Shakarchi, Sazan A. M. Alatrooshi
العلاقة بين تعبير المعلمات المناعية ل (P53) وعدم استقرار الساتل الميكروي (MSI) مع العوامل السريرية المرضية لسرطان المعدة الغدي باستخدام الكيمياء النسيجية المناعية. الخلاصة الخلفية: يحدث سرطان المعدة الغدي بسبب عدم استقرار الكروموسومات، وطفرات TP53، واختلال الصيغة الصبغية، والانتقالات، والجينات الورمية الأولية، والتغيرات الجينية المثبطة للورم.عدم استقرار الساتل الميكروي(MSI) يسبب فشل إصلاح عدم تطابق الحمض النووي، مما يؤثر على دقة تكرار الحمض النووي. يم الكشف عن أخطاء النسخ المتماثل المبكرة بواسطة مجمع البروتين المتغاير (hMSH2/hMSH6) ، الذي يقوم بتفعيل hMLH1) و(hPMS2 لإعادة تكوين الحمض النووي. يحدث عدم استقرار الساتل الميكروي في حالات سرطان المعدة المتفرق ومتلازمة لينش. الهدف من الدراسة: دراسة العلاقة بين تعبيرالمعلم P53 وتعبير المعلمات المناعية لـعدم استقرار الساتل الميكروي (MSI) مع العوامل السريرية المرضية لسرطان المعدة الغدي باستخدام الكيمياء النسيجية المناعية. المواد والطرق: تم فحص 40 كتلة من نسيج سرطان المعدة الغدي المثبت بالفورمالين والمطمور بالشمع في بغداد، العراق. تناولت الدراسة حالات سرطان المعدة الأولية، مع البيانات السريرية المرضية المتاحة، والأنسجة الجراحية. التعبير المناعي الكيميائي الذي تم تقييمه بواسطة نظام تسجيل النقاط. تم استخدام برنامج SPSS لتحليل البيانات، كما تم استخدام اختبارات Chi-square واختبارات Fisher الدقيقة لتقييم الارتباطات. تم اعتبار مستوى الثقة 95٪ والقيمة الاحتمالية P 0.05 أو أقل مهمًا. النتائج : كان التصبيغ المناعي النسيجي الكيميائي لـ P53 إيجابيًا في 65٪ من الحالات، بينما كانت نتائج MSI إيجابية في 97.5٪ من الحالات. حصل الزوجان المتغايران MLH1/PMS2 على نتائج إيجابية بنسبة 32.5% ونتائج سلبية 67.5%، في حين حصل الزوجان المتغايران MSH2/MSH6 على نتائج إيجابية بنسبة 87.5% ونتائج سلبية 12.5%. ارتبطت صبغة P53 بشكل كبير بانتشار العقدة الليمفاوية ودرجة الورم ، ولكن لم يكن هنالك ارتباط مع العوامل الأخرى. لم يتم العثور على ارتباط كبير بين معلمات MSI والعوامل المدروسة,لم يكن هناك ارتباط كبير بين معلمات MSI غير المتجانسة (MLH1 / PMS2) والمعلمات المرضية السريرية، ولكن كان هناك ارتباط كبير بين علامات MSI الزوجين غير المتجانسة (MSH2 / MSH6) والنقائل فقط . الاستنتاج: : يعد P53 معلما حيويا مهما لتقييم انتشار العقدة الليمفاوية وعدوانيتها في التصنيف النسيجي، مما يشير إلى التشخيص، وتحديد مرضى السرطان الأكثر عرضة لخطر الإصابة بالورم النقيلي. على الرغم من أن MSH2/MSH6 اظهر ارتباطا مهمًا مع النقائل الورمية ، إلا أن معلمات MSI كان لها أقل قيمة إنذارية في دراستنا. هناك حاجة إلى مزيد من البحث لإثبات فعاليتها في علاج سرطان المعدة.
{"title":"The Correlation of P53 and MSI Immune Markers in Gastric Adenocarcinoma","authors":"Ali M.J Al-Shakarchi, Sazan A. M. Alatrooshi","doi":"10.32007/jfacmedbagdad.6622290","DOIUrl":"https://doi.org/10.32007/jfacmedbagdad.6622290","url":null,"abstract":"العلاقة بين تعبير المعلمات المناعية ل (P53) وعدم استقرار الساتل الميكروي (MSI) مع العوامل السريرية المرضية لسرطان المعدة الغدي باستخدام الكيمياء النسيجية المناعية. \u0000الخلاصة \u0000الخلفية: يحدث سرطان المعدة الغدي بسبب عدم استقرار الكروموسومات، وطفرات TP53، واختلال الصيغة الصبغية، والانتقالات، والجينات الورمية الأولية، والتغيرات الجينية المثبطة للورم.عدم استقرار الساتل الميكروي(MSI) يسبب فشل إصلاح عدم تطابق الحمض النووي، مما يؤثر على دقة تكرار الحمض النووي. يم الكشف عن أخطاء النسخ المتماثل المبكرة بواسطة مجمع البروتين المتغاير (hMSH2/hMSH6) ، الذي يقوم بتفعيل hMLH1) و(hPMS2 لإعادة تكوين الحمض النووي. يحدث عدم استقرار الساتل الميكروي في حالات سرطان المعدة المتفرق ومتلازمة لينش. \u0000الهدف من الدراسة: دراسة العلاقة بين تعبيرالمعلم P53 وتعبير المعلمات المناعية لـعدم استقرار الساتل الميكروي (MSI) مع العوامل السريرية المرضية لسرطان المعدة الغدي باستخدام الكيمياء النسيجية المناعية. \u0000المواد والطرق: تم فحص 40 كتلة من نسيج سرطان المعدة الغدي المثبت بالفورمالين والمطمور بالشمع في بغداد، العراق. تناولت الدراسة حالات سرطان المعدة الأولية، مع البيانات السريرية المرضية المتاحة، والأنسجة الجراحية. التعبير المناعي الكيميائي الذي تم تقييمه بواسطة نظام تسجيل النقاط. تم استخدام برنامج SPSS لتحليل البيانات، كما تم استخدام اختبارات Chi-square واختبارات Fisher الدقيقة لتقييم الارتباطات. تم اعتبار مستوى الثقة 95٪ والقيمة الاحتمالية P 0.05 أو أقل مهمًا. \u0000النتائج : كان التصبيغ المناعي النسيجي الكيميائي لـ P53 إيجابيًا في 65٪ من الحالات، بينما كانت نتائج MSI إيجابية في 97.5٪ من الحالات. حصل الزوجان المتغايران MLH1/PMS2 على نتائج إيجابية بنسبة 32.5% ونتائج سلبية 67.5%، في حين حصل الزوجان المتغايران MSH2/MSH6 على نتائج إيجابية بنسبة 87.5% ونتائج سلبية 12.5%. ارتبطت صبغة P53 بشكل كبير بانتشار العقدة الليمفاوية ودرجة الورم ، ولكن لم يكن هنالك ارتباط مع العوامل الأخرى. لم يتم العثور على ارتباط كبير بين معلمات MSI والعوامل المدروسة,لم يكن هناك ارتباط كبير بين معلمات MSI غير المتجانسة (MLH1 / PMS2) والمعلمات المرضية السريرية، ولكن كان هناك ارتباط كبير بين علامات MSI الزوجين غير المتجانسة (MSH2 / MSH6) والنقائل فقط . \u0000الاستنتاج: : يعد P53 معلما حيويا مهما لتقييم انتشار العقدة الليمفاوية وعدوانيتها في التصنيف النسيجي، مما يشير إلى التشخيص، وتحديد مرضى السرطان الأكثر عرضة لخطر الإصابة بالورم النقيلي. على الرغم من أن MSH2/MSH6 اظهر ارتباطا مهمًا مع النقائل الورمية ، إلا أن معلمات MSI كان لها أقل قيمة إنذارية في دراستنا. هناك حاجة إلى مزيد من البحث لإثبات فعاليتها في علاج سرطان المعدة.","PeriodicalId":516152,"journal":{"name":"Journal of the Faculty of Medicine Baghdad","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141694269","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}
Pub Date : 2024-07-01DOI: 10.32007/jfacmedbagdad.6622273
Abbas M. Alsaedy, Zeinab M. Al-Rubaei
Background: Cell adhesion molecules are protein entities that are located on the cell surface. The vascular cell adhesion molecule-1 (VCAM-1) and intercellular adhesion molecule-1 (ICAM-1) expression is related to type 2 diabetes mellitus (T2DM) with dyslipidemia. Objectives: To determine the levels of VCAM-1 and ICAM-1 in T2DM patients with dyslipidemia and to explore the relationship between VCAM-1 and ICAM-1 and the development of dyslipidemia in T2DM patients. Patients and methods: The study included 150 individuals with an age range of (35-55) years. Patients with diabetes for more than 5 years were excluded. Fifty healthy individuals constituted Group 1 (G1), fifty patients with T2DM constituted Group 2 (G2), and fifty T2DM patients with dyslipidemia constituted Group 3 (G3). Whole blood samples were drawn to measure HbA1c based on fluorescence immunoassay technology. The serum was separated to measure fasting blood glucose (FBG), triglycerides (TG), total cholesterol (TC), and high-density lipoproteins (HDL) by manual methods, while VCAM-1, and ICAM-1 were determined using the ELISA test. The study was conducted between November 2022 and April 2023 at the National Center for Diabetes Treatment and Research, Baghdad, Iraq. Results: Significantly higher levels of FSG and HbA1c were detected in G2 and G3 compared to G1, but non-significantly so when G3 was compared to G2. Significant higher levels of TG and TC levels were detected for G3 when compared to G1 and G2, but non-significantly so when G2 was compared to G1. HDL levels were significantly lower in G3 compared to G2 and G1, but non-significantly so when G2 was compared to G1. VCAM-1, and ICAM-1 were significantly higher in G2 compared to G1, and VCAM-1 level was significantly higher in G3 compared to G2. Non-significant differences in ICAM-1 levels were found between G3 and G2. Conclusion: VCAM-1 and ICAM-1 are potentially significant factors in the development of dyslipidemia in diabetes patients. They might serve as biomarkers to accurately predict the progression of cardiovascular disease.
{"title":"Study of Adhesion Molecules in Diabetes Mellitus Type2 Iraqi Patients with Dyslipidemia","authors":"Abbas M. Alsaedy, Zeinab M. Al-Rubaei","doi":"10.32007/jfacmedbagdad.6622273","DOIUrl":"https://doi.org/10.32007/jfacmedbagdad.6622273","url":null,"abstract":"Background: Cell adhesion molecules are protein entities that are located on the cell surface. The vascular cell adhesion molecule-1 (VCAM-1) and intercellular adhesion molecule-1 (ICAM-1) expression is related to type 2 diabetes mellitus (T2DM) with dyslipidemia. \u0000Objectives: To determine the levels of VCAM-1 and ICAM-1 in T2DM patients with dyslipidemia and to explore the relationship between VCAM-1 and ICAM-1 and the development of dyslipidemia in T2DM patients.\u0000Patients and methods: The study included 150 individuals with an age range of (35-55) years. Patients with diabetes for more than 5 years were excluded. Fifty healthy individuals constituted Group 1 (G1), fifty patients with T2DM constituted Group 2 (G2), and fifty T2DM patients with dyslipidemia constituted Group 3 (G3). Whole blood samples were drawn to measure HbA1c based on fluorescence immunoassay technology. The serum was separated to measure fasting blood glucose (FBG), triglycerides (TG), total cholesterol (TC), and high-density lipoproteins (HDL) by manual methods, while VCAM-1, and ICAM-1 were determined using the ELISA test. The study was conducted between November 2022 and April 2023 at the National Center for Diabetes Treatment and Research, Baghdad, Iraq.\u0000Results: Significantly higher levels of FSG and HbA1c were detected in G2 and G3 compared to G1, but non-significantly so when G3 was compared to G2. Significant higher levels of TG and TC levels were detected for G3 when compared to G1 and G2, but non-significantly so when G2 was compared to G1. HDL levels were significantly lower in G3 compared to G2 and G1, but non-significantly so when G2 was compared to G1. VCAM-1, and ICAM-1 were significantly higher in G2 compared to G1, and VCAM-1 level was significantly higher in G3 compared to G2. Non-significant differences in ICAM-1 levels were found between G3 and G2.\u0000Conclusion: VCAM-1 and ICAM-1 are potentially significant factors in the development of dyslipidemia in diabetes patients. They might serve as biomarkers to accurately predict the progression of cardiovascular disease.","PeriodicalId":516152,"journal":{"name":"Journal of the Faculty of Medicine Baghdad","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141697753","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}
Pub Date : 2024-07-01DOI: 10.32007/jfacmedbagdad.6622272
Raed M. Al-Azawee, Zeinab M. Al-Rubaei
Background: In eukaryotic cells, the acidification of intracellular compartments is the responsibility of vacuolar H+ ATPase, a family of proton pumps, sometimes known as V-ATPases. Small GTPases are signaling molecules that regulate important cellular processes as well as subcellular activities making them essential players, particularly in a wide variety of coronavirus infection processes. Objectives: The purpose of this research was to assess the levels of ATPase and GTPase in fibrotic lung disease patients who had received or had not received the COVID-19 vaccination, and then to compare these levels with those of the control group. Methods: A total of 150 individuals participated in this study, divided into three groups. The first group was the control group (N=50). In the second group (N=50) patients with fibrotic lung disease () who did not get the COVID-19 vaccination. Fifty patients who had received the COVID-19 vaccination made up the third group ()(N=50). Enzyme-linked immunosorbent assay was the method that was used to determine the amounts of ATPase and GTPase. The P- P-value of 0.05 or less is considered statistically significant. ROC tests were examined for ATPase and GTPase. Results: The data analysis reported a significant rise in alkaline phosphatase, Alanine aminotransferase, and Aspartate-aminotransferase () among the three groups. Both ATPase and GTPase levels were shown to have significantly increased in Groups 3 and 2 as compared to Group 1 levels. Moreover, a substantial rise was discovered in Group 3 in comparison to Group 2 which was detected. Conclusion: ATPase and GTPase levels are increased in patients with fibrotic lung disease regardless of the COVID-19 vaccination state.
{"title":"Study of ATPase and GTPase levels in Fibrotic Lung Disease with and without COVID-19 Vaccination","authors":"Raed M. Al-Azawee, Zeinab M. Al-Rubaei","doi":"10.32007/jfacmedbagdad.6622272","DOIUrl":"https://doi.org/10.32007/jfacmedbagdad.6622272","url":null,"abstract":"Background: In eukaryotic cells, the acidification of intracellular compartments is the responsibility of vacuolar H+ ATPase, a family of proton pumps, sometimes known as V-ATPases. Small GTPases are signaling molecules that regulate important cellular processes as well as subcellular activities making them essential players, particularly in a wide variety of coronavirus infection processes.\u0000Objectives: The purpose of this research was to assess the levels of ATPase and GTPase in fibrotic lung disease patients who had received or had not received the COVID-19 vaccination, and then to compare these levels with those of the control group.\u0000Methods: A total of 150 individuals participated in this study, divided into three groups. The first group was the control group (N=50). In the second group (N=50) patients with fibrotic lung disease () who did not get the COVID-19 vaccination. Fifty patients who had received the COVID-19 vaccination made up the third group ()(N=50). Enzyme-linked immunosorbent assay was the method that was used to determine the amounts of ATPase and GTPase. The P- P-value of 0.05 or less is considered statistically significant. ROC tests were examined for ATPase and GTPase. \u0000Results: The data analysis reported a significant rise in alkaline phosphatase, Alanine aminotransferase, and Aspartate-aminotransferase () among the three groups. Both ATPase and GTPase levels were shown to have significantly increased in Groups 3 and 2 as compared to Group 1 levels. Moreover, a substantial rise was discovered in Group 3 in comparison to Group 2 which was detected.\u0000Conclusion: ATPase and GTPase levels are increased in patients with fibrotic lung disease regardless of the COVID-19 vaccination state. \u0000 \u0000 \u0000 \u0000 \u0000 \u0000 \u0000 \u0000 ","PeriodicalId":516152,"journal":{"name":"Journal of the Faculty of Medicine Baghdad","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141700141","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}
Pub Date : 2024-07-01DOI: 10.32007/jfacmedbagdad.6622285
Samaa D. Ibrahim, Ali L. Jasim
Background: Chronic obstructive pulmonary disease (COPD) is a progressive airflow limitation that is preventable but not curable. It is associated with persistent symptoms that cause a considerable burden on individual productivity at work, and daily activities, and reduced quality of life, also burdening the healthcare system and society. Objectives: The study aims to measure the burden of COPD on patients in terms of daily activities and work productivity. It also seeks to investigate some inflammatory biomarkers' levels and their correlation with selected outcomes. Patients and Methods: A cross-sectional study on 120 stable COPD patients who were diagnosed and treated according to the GOLD guidelines at Kirkuk General Hospital's chest and Internal Medicine consultation clinics, and in private internist clinics in Kirkuk City, Iraq between January and April 2023. The Work Productivity and Activity Impairment Questionnaire (WPAI-COPD) measured the Burden of COPD. The symptom burden was assessed by the COPD assessment test (CAT). The level of IL-6 monoclonal antibodies was measured via a Roche Cobas 6000 analyzer and TNF-α using the ELISA sandwich technique. All these devices and machines were authorized by the Ministry of Health, Iraq. Results: The mean age was (54.1 ± 8.12) years, 62.5% being males and 37.5% being females; 41.7% were public sector employees, and 39.2% were self-employed. Due to COPD, the overall work loss was (45.9±18.91) days, the mean percentage of absenteeism was (10.9% ± 12.31%), activity impairment was (47.5% ±17.79%) among all patients, presenteeism was (40.8 ± 15.05%,) and COPD-related retirees were 14.2% of the study group. The mean CAT score (19.3±5.63) was high and the most troubling symptom among patients was chest tightness. WPAI-COPD scores were higher in older age and longer disease duration. The levels of biomarkers were above the reference ranges, the mean IL-6 level was (69.4 ± 35.29) pg/ml, and the mean TNF-α was (72.3 ± 22.45) pg/ ml. Conclusions: COPD patients exhibit a disease burden in terms of productivity loss at work and activity impairment that increases with aging and disease duration. COPD patients with low BMI are more prone to a decline in lung functions and to worse symptoms.
{"title":"The Burden of Chronic Obstructive Pulmonary Disease COPD in Stable Patients and its Association with Inflammatory Biomarkers and Body Mass Index","authors":"Samaa D. Ibrahim, Ali L. Jasim","doi":"10.32007/jfacmedbagdad.6622285","DOIUrl":"https://doi.org/10.32007/jfacmedbagdad.6622285","url":null,"abstract":"Background: Chronic obstructive pulmonary disease (COPD) is a progressive airflow limitation that is preventable but not curable. It is associated with persistent symptoms that cause a considerable burden on individual productivity at work, and daily activities, and reduced quality of life, also burdening the healthcare system and society.\u0000Objectives: The study aims to measure the burden of COPD on patients in terms of daily activities and work productivity. It also seeks to investigate some inflammatory biomarkers' levels and their correlation with selected outcomes.\u0000Patients and Methods: A cross-sectional study on 120 stable COPD patients who were diagnosed and treated according to the GOLD guidelines at Kirkuk General Hospital's chest and Internal Medicine consultation clinics, and in private internist clinics in Kirkuk City, Iraq between January and April 2023. The Work Productivity and Activity Impairment Questionnaire (WPAI-COPD) measured the Burden of COPD. The symptom burden was assessed by the COPD assessment test (CAT). The level of IL-6 monoclonal antibodies was measured via a Roche Cobas 6000 analyzer and TNF-α using the ELISA sandwich technique. All these devices and machines were authorized by the Ministry of Health, Iraq.\u0000Results: The mean age was (54.1 ± 8.12) years, 62.5% being males and 37.5% being females; 41.7% were public sector employees, and 39.2% were self-employed. Due to COPD, the overall work loss was (45.9±18.91) days, the mean percentage of absenteeism was (10.9% ± 12.31%), activity impairment was (47.5% ±17.79%) among all patients, presenteeism was (40.8 ± 15.05%,) and COPD-related retirees were 14.2% of the study group. The mean CAT score (19.3±5.63) was high and the most troubling symptom among patients was chest tightness. WPAI-COPD scores were higher in older age and longer disease duration. The levels of biomarkers were above the reference ranges, the mean IL-6 level was (69.4 ± 35.29) pg/ml, and the mean TNF-α was (72.3 ± 22.45) pg/ ml.\u0000Conclusions: COPD patients exhibit a disease burden in terms of productivity loss at work and activity impairment that increases with aging and disease duration. COPD patients with low BMI are more prone to a decline in lung functions and to worse symptoms.","PeriodicalId":516152,"journal":{"name":"Journal of the Faculty of Medicine Baghdad","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141709241","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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