Artículos aceptados de próxima publicación, año 2019.

Evaluation of Prevalence of Changes in Thyroid Functional Tests in Mole Hydatiforme Farahnaz Farzaneh and Reza Keikha

Abstract: Introduction Mole hydatiforme is the most common type of gestational trophoblast disease (GTD) and the aim of this study, is evaluation the frequency of changes in thyroid function tests in mole hydatidiform patients. Materials and Methods In this retrospective study, 63 patients with mole hydatidiform who reffering to gynecology ward of Ali ibn Abitaleb Hospital in Zahedan from April 20 16 to March 20 17, were studied. Information such as age, gravidity and laboratory findings including thyroid function tests (TFT) and the presence or absence of clinical symptoms were recorded in the information forms and analyzed by SPSS software. Results In this study, 63 patients with mole hydatidiform were studied. The mean age of the patients was 26.6 ± 7.7 years. The most common clinical manifestation of hyperthyroidism in patients with mole hydatiforme was tachycardia (39.7%). There was no relationship between age and gravidity with the hyperthyroid symptoms and thyroid function tests. Conclusion Overall, the results of this study showed that 67% of patients with mole hydatidiform had reduced TSH and more than 50% of cases had increased free T3 and T4. There was no relationship between maternal age and gravidity with changes in thyroid functional test.

Keywords Mole hydatiforme; Thyroid function test; Gestational trophoblastic disease (GTD)

Prevalence of Celiac in Infertile Women Due to Unexplained Infertility Farahnaz Farzaneh and manigheh Khalili

Abstract Introduction: Celiac disease is an immune response to a gluten-based diet that affects the small intestines of people with a genetic predisposition to disease. Celiac has intra intestinal and extra intestinal manifestations. In recent years, celiac and infertility have been considered. The present study examines the effect of celiac disease and its treatment on the menstrual cycle, pregnancy and menopause. In this study, we compared the prevalence of celiac disease in fertile women with infertile women in Zahedan. Materials and Methods: In this case control study, 150 patients with unexplained infertility from February 2016 to2017 referred to Infertility Clinic of Ali ibn Abitaleb Hospital in Zahedan (Iran), were included in the study. Total IgA and IgA TTG were evaluated. If TTG is positive, for confirmation of diagnosis, biopsy is performed from the distal part of the duodenum. In control group, 150 fertile women with two or more children with the same characteristics were studied. Results: Three patients with unexplained infertility (2%) were positive for TTG. Two of them (1/3%) were positive to celiac disease in small intestinal biopsy. None of the women in the control group had TTG positive (p=0.49). Discussion and Conclusion: It seems that some infertile patients with unexplained infertility suffer from celiac disease, but with a (p=0. 49), it seems that celiac screening as a cause of infertility with unexplained cause needs more studies with larger sample size in Iran.

Keywords: Celiac disease; Infertility; Unexplained infertility

Association of the ATP-binding Cassette Transporter A1 Gene Polymorphism with Lipid Profile and Type 2 Diabetes Mellitus. Abbas Sabbar Dakhil.

Abstract: Diabetes remains unique among the main non-communicable ailments (NCDs) recognized by the World Health Organization (WHO), apart from the circulatory diseases, tumours, and long-lasting respiratory ailments. The current study aimed to determine the correlation between ABCA1 gene polymorphism and lipid profile in type 2 diabetes mellitus patients. Serum samples from 100 type 2 diabetes mellitus patients (46 males and 54 females) and 50 standard subjects (26 males and 24 females) were collected from Najaf province/Iraq. Fasting blood sugar (FBS), and lipid profiles (total cholesterol (TC), triglycerides (TG), HDL, LDL and VLDL) were measured. Polymerase chain reaction (PCR) with the Taq 1 enzyme was used for the amplification of the ABCA1 gene, which contains 525bp of the ABCA1 gene in the locus V825I. The present study revealed a positive correlation between FBS and body mass index (BMI) (r = 0.2390, p = 0.0463), TG (r = 0. 1836, p = .01743), and VLDL (r = 0.1836, p = 0.1839). The frequencies of the GG genotype and the G allele were higher in the normal groups compared to the patients (58% vs. 56% and 70% vs. 67%, respectively); conversely, the frequencies of the AA genotype (18% vs. 22%) and the A allele (30% vs. 33%) were higher in the patients compared to the normal groups. The data also showed a significant relationship between ABCA1 gene polymorphism and both TG and VLDL (P=0.007 for each). There is relationship between the ABCA1 gene and HDL level. Additionally, the G allele could be a defensive factor against diabetes mellitus in Iraqi people.

Keywords: ABCA1 gene; lipid profile; type 2 diabetes mellitus; HDL

Central serous chorioretinopathy risk factors in the mid-Euphrates region, Iraq. Zainab Adel Hashim.

ABSTRACT Central serous chorioretinopathy (CSC) is an ophthalmic disorder that often affects young male patients under psychological stress and is clinically characterized by blurring of vision, metamorphopsia, a visual abnormality in which normally straight lines appears curved, and micropsia, a visual abnormality in which objects appear smaller than normal. The annual incidence of the condition is not well recognized in our country. The objective of this cross-sectional study was to highlight the incidence rate of CSC in our community and to make an insight on possible associated risk factors. This cross-sectional study included 92 patients with visual impairment that has been proved due to central serous chorioretinopathy (CRC). The sample included 68 males and 24 females. The sample of CRC was all the available patients visiting ophthalmology unit at Al-Diwaniyah teaching hospital and at the ophthalmology unit at Medical Committee Institution, both these health centers lie at Al-Diwaniyah province, mid-Euphrates region, Iraq. A rough estimation of the annual incidence of CRC in this mid-Euphrates region of Iraq was 3.5 per 100,000. Mean age of patients was 43.02 ± 4.71 years, and the disease was 2.83 times more common in males. The main possible risk factors are psychosocial stress and steroid therapy. CRC is common in our community, and the main possible risk factors are psychosocial stress, and steroid use and these associations need to be validated in a large longitudinal study or at least a case-control study.

Keywords: Central serous chorioretinopathy, metamorphopsia, micropsia

Detection of Some Virulence Factors Genes in Staphylococcus Aureus Isolated from Different Clinical Cases. Dheaa Ghanim Al-Naaily, Rana Masheel Salim, Aqeel Meer Al-Zamily.

ABSTRACT Staphylococcus aureus is one of the most important pathogenic type to humans, and the most common species responsible for a wide range of diseases such as furuncles, various abscesses, wounds abscesses resulting from surgical operations, dermatitis, soft tissue inflammation, arthritis, bones inflammation, bronchial pneumonia, inflammation of internal parts of the heart and injuries caused by toxins such as toxic shock syndrome and staphylococcus aureus syndrome and food poisoning. The current study aimed by finding the genes responsible for the virulence factors in S.aureus isolates by using the Single and Multiplex PCR mechanism (technology). A total of 60 specimens (urine, burn swabs, wound swabs) from different clinical cases were collected from patients (in different age groups) who admitted to several health centers in Al-Diwaniyah Teaching Hospital, Iraq, during a period extending from October 2016 to January 2017. Some virulence factors were investigated for 30 isolate only of MRSA using Single and Multiplex PCR for detection virulence factor genes which both coa gene encoding production of coagulase, clfA gene encoding for clumping factor, spa gene encoding for protein A, fnbA gene encoding for fibronectin binding proteins, luks gene encoding production of Panton Valentine Leukocidin(PVL). Results of current study showed that all isolates 30 (100%) were possess coa,clfA,spa and fnbA genes, 13 (43.3%) were possess luks gene.

Keyword: Virulence Factors; Staphylococcus Aureus; spa gene; clfA gene

Prevalence of Streptococcus pyogenes bacteria among children with Tonsillitis Abbas Atyia Hammoudi.

ABSTRACT Streptococcus pyogenes is the most common cause of bacterial tonsillopharyngitis with a sore throat in children; it can also cause weakening sicknesses such as rheumatic heart disease and other suppurative sequelae; peritonsillar abscess and lymphadenitis. The present study was con¬ducted to determine the occurrence of Streptococcus pyogenes organism and their antibiotics susceptibility usually used to treat tonsillitis in children. From the period 2015 – 2016, 210 swabs were collected from children complaining of acute tonsillitis who presented to the outpatient department of Al-Karama teaching hospital, Baghdad, Iraq. The results revealed that forty-one isolates (19.5%) cases were positive culture for S. pyogenes. The residual results; other organisms, mixed culture and negatively cultured were excluded from the study. The incidence of Streptococcus pyogenes tonsillitis was most prevalent in the age group 5-7 years 25 (23.8%) and the lowest in the age group 14 -16 years 1 (10%). The isolates showed the frequency resistance percentage to: azithromycin 26 (63.4 %), erythromycin 24(58.5%), clarithromycin 19 (46.3%), 6 (14.6 %)to Amoxicillin + Clavulanic acid (Augmentin) and Clindamycin 5 (12.2 %), while some isolates showed the lowest resistance percentage to Cefotaxime 3 (7.3%). S. pyogenes were frequently sensitive to Clindamycin 36 (87.8 %), Cefotaxime 32 (78 %) and Amoxicillin/clavulanic acid 31 (75.6 %). Streptococcal infections are a considerable problem in medical and health centers. The incidence of Streptococcus pyogenes tonsillitis was the most dominant in the age group 5-7 years and antibiotics Clindamycin, Cefotaxime, and Augmentin are more effective against these bacteria in patients with recurrent tonsillitis. The early diagnosis, appropriate infection control measures, and guidelines are needed to prevent the spread of the infections and the development of complications among patients.

Keywords: Tonsillitis, Streptococcus pyogenes, Antibiotic susceptibility

Non-surgical treatment of ectopic pregnancy Khalidah M. Amin.

ABSTRACT In the past few decades, ectopic pregnancy has been termed by medical practitioners has a global epidemic. With the question lingering on everybody minds how this menace can be tamed. In a bid to reduce the mortality and financial burden brought by this evolving growing health concern, the medic has developed non-surgical alternatives to deal with ectopic pregnancy, i.e., treatment using methotrexate. In a bid to explore this topic further, these study goals were to share the experience of treating mothers who have un-ruptured ectopic pregnancies traditionally. Mothers who were found to have an ectopic pregnancy and fit the medical care were encompassed in the program, a total of 37 women. For instance, those with serum beta HCG in the range of 1000 mIU per liter were treatment expectantly whereas those with a level more than a thousand were given an injection of methotrexate. To monitor the response of experiment, beta HCG levels were monitored for each mother. The results of the current study established that 88.0 % of women who underwent the study, only 12.0 % of them exhibited full resolution while the remaining lot resolved only after a sole dose of methotrexate. From the results of this study, it is evidently clear that a lot of pregnant mothers would be greatly helped if they are enrolled in such therapy at early days.

Keywords: Ectopic pregnancy; Medical management; HCG levels

The Association of Glutaminase (glut) P3 Different Alleles of Trichomonas vaginalis with Infertility in a sample of Iraqi women. Faten Ahmed Hassan, Huda Dhaher Al-Marsomy, Suhad Asaad Mustafa, Sahar H. Abdul- Razzaq.

ABSTRACT Trichomonas vaginalis (T. vaginalis), the etiologic agent of human trichomoniasis, is a flagellated protozoan parasite, has been associated with adverse pregnancy outcomes, HIV transmission, and infertility. A total of one hundred and fifty-seven (157) women at childbearing age (14–49 years),were included in the present study, eighty six (86) symptomatic fertile while the other seventy-one (71) were infertile with or without symptoms attending the Gynecology outpatient Department in Al-Emamayn Al-Kadhimayn Medical City, the High Institute of Infertility Diagnosis and Assisted Reproductive Technologies at AL-Nahrain University in Baghdad, the maternity Teaching hospital, and Dr. Khawer center for infertility and IVF in Erbil province in Iraq . Two vaginal swab specimens were obtained from each of them; one swab was immediately examined by wet mount microscopy, the other swab for molecular study (DNA extraction and p3 nested PCR). One hundred (100) samples positive in one or more tests were identified: 20 (12.7%) infections were detected by wet mount microscopy, while nested PCR was positive in 100 (63.7%) samples. These positive samples were sequenced and phylogenetic tree were done and, there was no association between the variations in glut (p3) gene of T. vaginalis isolated from infected women (fertile and infertile).

Keywords: T. vaginalis; Infertility; Glutaminase (glut) p3 gene variations

The role of folic acid in preventing neural tube defects in Iraqi pregnant women: A cross sectional study Balsam Kahtan Mohammed Department of Anatomy, College of Medicine, University of Al-Qadisyiah, Iraq

ABSTRACT Folate deficiency in pregnant has been linked to neural tube defects in a substantial amount of medical literatures and has become a well-known fact among doctors; however, the knowledge of pregnant ladies about this association is poorly evaluated in our community. Vitamin and mineral deficiency is common among people in developing countries; however, the awareness of those people about such deficits and their associating complications is lacking. This study was conducted to evaluate the knowledge, attitude and practice of a cohort of pregnant ladies in Al-Diwaniyiah province in Mid-Euphrates region in Iraq. The present cross sectional study included 30 pregnant ladies. The study started on November 2018 and ended on January 2019. The study was carried out in Al-Diwaniyah maternity and child teaching hospital in Al-Diwaniyah province in Mid-Euphrates region, Iraq. The knowledge, attitude and practice of women regarding folic acid supplementation during early pregnancy was assessed according to 7 knowledge questions, 5 attitude questions and 5 practice questions. These questions and the demographic data concerning women enrolled in the current study were obtained. The results of current study revealed poor knowledge about the advantage of folic acid in preventing congenital abnormalities was very obvious since most of responses to the 7 questions concerning knowledge domain were within strongly disagreeing, disagree and neutral scores. Majority of response within attitude domain were in the form of disagree and strongly disagree. No correlation was found between any of the domain and the demographic characteristics of the study sample. Current study concluded that in Iraqi community, the knowledge and attitude of women toward the benefit of folic acid during early pregnancy in preventing neural tube defect is poor; however, they practice well with this regard not due to their knowledge but because of the policy adopted by governmental antenatal care clinics and institutes.

Key words: Knowledge, practice and attitude folic acid, neural tube defects