Table of content

IRAQI JOURNAL OF MEDICAL SCIENCES

المجلة العراقية للعلوم الطبية

ISSN: P16816579,E22244719
Publisher: Al-Nahrain University
Faculty: Medicine
Language: English

This journal is Open Access

About

Iraqi Journal of Medical Sciences
Aims and Scope
Iraqi Journal of Medical Sciences is published by College of Medicine, Al-Nahrain University. It is a quarterly multidisciplinary medical journal since 2000 . High quality papers written in English, dealing with aspects of clinical, academic or investigative medicine or research will be welcomed. Emphasis is placed on matters relating to medicine in Iraq in particular and the Middle East in general, though articles are welcomed from anywhere in the world.
Iraqi Journal of Medical Sciences publishes original articles, case reports, and letters to the editor, editorials, investigative medicine, and review articles. They include forensic medicine, history of medicine, medical ethics, and religious aspects of medicine, and other selected topics.
عنوان المجلة :
College of Medicine
Baghdad, Iraq
Tel and Fax: + 964-1-5224368
P. O. Box 70044, Baghdad, Iraq.
E-mail: iraqijms@colmed-alnahrain.edu.iq , ijms@iraqijms.com , iraqijms2000@gmail.com,

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E-mail: iraqijms@colmed-alnahrain.edu.iq , ijms@iraqijms.com, iraqijms2000@gmail.com, ‏ http://www.colmed-alnahrain.edu.iq, http://www.iraqijms.net

Table of content: 2018 volume:16 issue:3

Article
1. Editorial :THE INTERSTITIUM (THE PRE-LYMPHATIC REGION), IS IT A NEWFOUND 'ORGAN'

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Many of the human anatomists wouldn't expect to discover a new body part, however, researchers claim that they found a network of fluid-filled spaces in connective tissues all over the body that hadn't been seen before and it acts like an "open, fluid-filled highway" that is supported by a lattice of thick collagen "bundles". The researchers stated that tissue fixation during the procedure of histological tissue processing causes collapse of this network of fluid-filled spaces, and these spaces were not seen during light microscopic examination till the new imaging technique were developed to allow examination of living tissues on a microscopic level. Keywords: Interstitium, anatomy, neworgan, cancer Citation: Mubarak HJ. The Interstitium (the pre-lymphatic region), is it a newfound 'organ'. Iraqi JMS. 2018; 16(3): 230-231. doi: 10.22578/IJMS.16.3.1

Keywords

Interstitium --- anatomy --- neworgan --- cancer


Article
2.CORNEAL CHANGES IN A SAMPLE OF PSEUDOEXFOLIATION IRAQI PATIENTS

Authors: Ahmed M. Rasheed --- Diyar J. Kadum
Pages: 232-238
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Background: Pseudoexfoliation syndrome is a common eye disorder that can affect different parts of the eye causing significant morbidity. Objective: To compare corneal endothelial changes between patients with pseudoexfoliation syndrome and normal age matched patients. Methods: Specular microscopy was used to measure central corneal thickness, average size of endothelial cells and coefficient of variation in cell area, endothelial cell density, as well as hexagonality of 238 eyes from 238 patients (120 eyes from patients with pseudo exfoliation syndrome and 118 eyes from normal age-matched patients). Results: Patients with pseudoexfoliation syndrome had lower central corneal thickness (p value 0.049) compared to the control (491.6±28.86 vs 502.5±35.77 µm), lower endothelial cell density (p value 0.02) compared to control (2458.9±430.8 vs 2585.3±378.8 cell/mm2), lower hexagonality (P value 0.006) compared to control (48.25±18.76 vs 55.06±12,44), also a significantly higher coefficient of variation (p value 0.046) compared to control (36.15±7.381 vs 33.4±6.22). Conclusion: Pseudoexfoliation syndrome is associated with a significant change in the corneal endothelium, including reduction of endothelial cell density, increased variation of cells shape (pleomorphism) and increased variation of cells area (polymegathism). There was a significant change of central corneal thickness. Keywords: Corneal endothelium, specular microscopy, pseudoexfoliation syndrome, central corneal thickness Citation: Rasheed AM, Kadum DJ. Corneal changes in a sample of pseudoexfoliation Iraqi patients. Iraqi JMS. 2018; 16(3): 232-238. doi: 10.22578/IJMS.16.3.2


Article
3.DETECTION OF NEW DELHI METALLO-BETA-LACTAMASE-1 (BLANDM-1) IN CARBAPENEM-RESISTANT PSEUDOMONAS AERUGINOSA ISOLATED FROM CLINICAL SAMPLES IN WASIT HOSPITALS

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Background:Pseudomonas aeruginosa (P. aeruginosa) infections are clinical problem, it is a difficult to treat because of high resistant to many antibiotics (Multi-drug resistant) and a high risk of emergence of resistance during therapy. Carbapenems are therapeutic choice against infections caused by Gram-negative bacilli including strains of P. aeruginosa. New Delhi metallo-β-lactamase-1 (blaNDM-1) gene, an acquired class B carbapenemase. Dissemination predominantly involves transfer of the blaNDM-1 gene among promiscuous plasmids and clonal outbreaks. Bacteria with NDM-1 are typically resistant to nearly all antibiotics. Objective:To detect blaNDM-1 in the isolates of P. aeruginosa, which were recovered from various clinical samples from hospitalized patients in Wasit hospitals. Methods: This cross-sectional study involved 200 clinical samples were collected from three major hospitals in Wasit province. Samples were inoculated in Mackonkey and blood agar for primary isolation and then biochemical tests were used to confirm diagnosis of P. aeruginosa. The susceptibility test for 14 types of antibacterial drugs were tested by using disk diffusion method. Chromosomal and plasmid DNA were extracted by using special methods. Results: Out of 36 carbapenems resistant P. aeruginosa (CRPA) isolates, there were 18 isolates (50%) positive for blaNDM-1 gene. Conclusion: Rate of occurrence of blaNDM-1producers is highest among carbapenem-resistant P. aeruginosa isolated from clinical samples in Wasit hospitals. Therefore, its recognizable proof in clinical bacterial diseases will be suspected in any carbapenem resistance P. aeruginosa. Keywords: P. aeruginosa; carbapenems; metallo-β-lactamase; blaNDM-1 Citation: Hussein ZK, Kadhim HS, Hassan JS. Detection of New Delhi metallo-beta-lactamase-1 (blaNDM-1) in carbapenem-resistant pseudomonas aeruginosa isolated from clinical samples in Wasit hospitals. Iraqi JMS. 2018; 16(3): 239-246. doi: 10.22578/IJMS.16.3.3


Article
4.SODIUM VALPROATE EFFECTS ON LIPID PROFILE AND GLUCOSE LEVEL IN NORMAL AND DIABETIC RABBITS

Authors: Mohammed A. Abdul Bari
Pages: 247-257
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Background: Sodium valproate has turn out to be the most commonly prescribed antiepileptic drug (AED) worldwide. It is also prescribed to diabetic mellitus (DM) patient for treatment of neuropathic pain. Changes in lipid levels and lipid metabolism usually accompanied with diabetic disease leading to increases in circulating levels of free fatty acids (FFA), triglycerides and dense low-density lipoprotein together with reduced levels of high-density lipoprotein cholesterol levels. Objective: To investigate the effect of sodium valproate on lipid profile and glucose level and highlight these effects with and without diabetic disease. Methods: Thirty-two healthy, local domestic rabbits of both sexes were used in the present study. Animals were allocated into two main groups, group A and B. According to induction of diabetes both groups received the same food and put in the same environmental condition. blood glucose level and lipid profile has been done for all groups. Results: There was significant difference in the blood glucose level in the normoglycemic rabbits treated with sodium valproate (200 mg/kg) compared to the untreated (negative control group). The effect of valproate was also observed by the significant difference of blood glucose level in alloxan-induced diabetic rabbits treated with sodium valproate (200 mg) compared with the positive control group. Also, we have statistically observed the significant increase in total cholesterol (TC), low density lipoprotein – cholesterol (LDL-C), and triglyceride (TG) levels in normoglycemic rabbits treated with sodium valproate (200 mg/kg) compare to the negative control group, however, there is no significant difference regarding the high-density lipoprotein – cholesterol (HDL-C) level. As for the alloxan-induced diabetic rabbits, there was a statistically significant difference observed indicated an increase in level of TC, LDL-C, and TG and a decrease in HDL-C. Conclusion: The effect of sodium valproate on glucose level and lipid profile in diabetic rabbits could reflect a possible hypoglycemic and dyslipidemic effects which could be dangerous if the patient is on anti- diabetic drugs with or without cardiovascular accident, although it may be dose-dependent and still falls in the hypothesis field but further experimental studies on human are needed to explore this theory. Keywords: Sodium valproate, anticonvulsants, glucose, lipid Citation: Abdul Bari MA. Sodium valproate effects on lipid profile and glucose level in normal and diabetic rabbits. Iraqi JMS. 2018; 16(3): 247-257. doi: 10.22578/IJMS.16.3.4


Article
5.SAFE PRIMARY REPAIR OF COLORECTAL INJURIES WITHOUT DIVERTING COLOSTOMY

Authors: Taqi S. Atiyah
Pages: 258-267
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Background: Colostomy was used for treatment of colorectal injuries since the 2nd World War, and it is a lifesaving procedure. There is a trend towards primary closure of colorectal injuries without colostomy in hemodynamically stable patients. Objective: To evaluate the safety of primary closure of colorectal injuries without colostomy in hemodynamically stable patients. Methods: A cross sectional study was performed at Al-Imamein Al-Kadhimein Medical City for patients with colorectal injuries over the period from July 2011 to July 2017. Management was started with active resuscitation of the patient, explorative laparotomy (securing hemorrhage) and assessment of the colorectal injuries. When the patients were stable hemodynamically without associated injuries to other parts of the body; debridement of the wound edges of the colon and primary repair by suturing in two layers using 2/0 absorbable suture (polyglactin) on a round needle with or without colostomy. But if the patients were in a shock state with multiple associated injuries to other parts of the body, with severely devascularized lacerated colon; proximal colostomy was done as a part of damage control surgery with resection of the devascularized segment and suturing of the distal end of the colon. Results: A total of 231 patients sustained colorectal injuries; 143 (61.90%) males and 88 (38.09%) females. The age of the patients ranged from 6-76 years, mean age was 32.16±76 year. Colostomy was done for 134 (58.01%) patients. Primary repair without colostomy were done for 97 (41.99%) patients. Postoperative follow up of the patients treated with primary repair of colorectal injuries without colostomy were detected collection and leaking repaired segment of colon in 5 (5.15%) patients. Re-exploration of the abdomen and colostomy were done for them. There was no mortality in patients treated without colostomy. The mortality rate was 9 (6.71%) for patients treated by colostomy due to associated multiple traumas to other parts of the body. Conclusion: Primary repair of colorectal injuries without colostomy are safe in a hemodynamically stable patient without associated injuries to other parts of the body. Keywords: Colorectal injury, primary repair, colostomy. Citation: Atiyah TS. Safe primary repair of colorectal injuries without diverting colostomy. Iraqi JMS. 2018; 16(3): 258-267. doi: 10.22578/IJMS.16.3.5


Article
6.NISSL STAIN EXPRESSION IN THE FRONTAL AND PARIETAL CORTICES OF THE NEWBORN MICE AFTER PRENATAL EXPOSURE TO KETAMINE

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Background: Ketamine is an N-methyl-D-aspartate (NMDA) receptor blocking agent, which is used for induction and maintenance of anesthesia. It affects the cerebral cortex and has an impact on learning and memory functions; suggesting that any changes in NMDA receptors function will have an adverse outcome on learning and memory abilities. Objective: To assess the histological changes in the frontal and parietal cortices of mice offspring’s after prenatal exposure to therapeutic doses of ketamine. Methods: Thirty pregnant mice were included in this study. They were divided into two groups named experimental and control groups (15 mice for each group). Those of experimental group were injected intraperitoneally with ketamine in a dose of 50 mg/kg/day on the 5th, 10th, 15th and 20th days of gestational age to showing effect of the ketamine after injection of it in all trimesters of pregnancy, while those of the control group were injected with distal water only with the same volume. The paraffin block sections of frontal and parietal cerebral cortices of newborn mice were stained by nissl stain. Results: In the control group, the mean number of Nissl stained cells in the frontal cortex showed a statistically significant increase compared to that of parietal cortex, while statistical non-significant decrease in the mean number of nissel stained cells of frontal cortex compared to that of parietal cortex. Conclusion: Iatrogenic apoptotic changes were seen in the cerebral cortex of the experimental mice after prenatal exposure to ketamine and it is more considerable in the frontal cortex than the parietal cortex. Keywords: Frontal cortex, parietal cortex, ketamine, nissl stain, development Citation: Najm MS, Mubarak HJ, Jarullah HA. Nissl stain expression in the frontal and parietal cortices of the newborn mice after prenatal exposure to ketamine. Iraqi JMS. 2018; 16(3): 268-278. doi: 10.22578/IJMS.16.3.6


Article
7.ADENOVIRUS INFECTION IN A SAMPLE OF IRAQI KIDNEY TRANSPLANT RECIPIENTS: MOLECULAR AND HEMATOLOGICAL STUDY

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Background: Human Adenovirus (ADV) is one of highly prevalent viruses worldwide, after primary infection, it remains latent and then might reactivate in immunocompromised patients. High ADV viremia seen in renal transplant recipients (RTR) with clinical presentations range from asymptomatic viremia to respiratory and gastrointestinal disease hemorrhagic cystitis, graft dysfunction and severe disseminated disease. Objective: The objectives of this study are to determine the rate of occurrence of ADV viremia by quantitative Real time PCR (QRT-PCR) in RTR and correlate them with urine cytology results, renal function tests and patients' hematological parameters. Methods: Seventy-one renal transplant recipients (RTR) were enrolled in this study. Whole blood samples (3 ml) divided into two parts, one part for complete blood picture and differential count and other part from which plasma separated and subjected to viral DNA extraction and then ADV Taqman QRT-PCR analysis for viral load measurement. Five ml urine specimens were collected for Pap-stained urine cytology. Results: Out of 71 RTR, 15 (21.12%) had positive ADV viremia by QRT-PCR, with a mean viral load 4.0 x107± 1.9 x108 copies/ml, and 80% (12 out of the 15) of positive viremia patients aged more than 40 years (p=0.011). All of RTRs 15/15 (100%) had symptomatic urinary tract infection (UTI) (p=0.039), and 5 out of 9 patients who had lymphopenia had positive viremia (p=0.007). Pap-stained urine cytology smears showed that 39/71 (55.71%) of the RTRs had positive decoy cells (DC), but there was no significant correlation between ADV viremia and the presence of DC (p=0.107). Conclusion: The present study showed the prevalence of ADV viremia in RTRs, with very high viral load, which is associated with lymphopenia and overt clinical features, this suggests that ADV might be an important cause of morbidity in RTRs. Keywords: Adenovirus, renal transplantation, real-time PCR, urine cytology Citation: Ahmed HM, Al-Obaidi AB, Hussein MR, Kadhim HS, Ghazi HF. Adenovirus infection in a sample of iraqi kidney transplant recipients: molecular and hematological study. Iraqi JMS. 2018; 16(3): 279-288. doi: 10.22578/IJMS.16.3.7


Article
8.PRE AND POST EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY (ESWL) URINE CULTURE AS A GUIDE FOR ANTIBIOTICS MANAGEMENT

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Background:The lifetime prevalence of kidney stone disease is estimated at 1-15%. The positive urine cultures can be obtained not only from Struvite stones, but also from calcium oxalate stones and also high levels of endotoxins are found both in infection stones (Struvite and carbonate apatite stones), and in non-infection stones. High concentrations of endotoxins (lipopolysaccharides) are thought to be released in the systemic circulation during stone treatment, inducing a systemic inflammatory response (SIRS) and this leads to urosepsis. Pre-Extracorporeal shock wave lithotripsy (ESWL) prophylactic antibiotics have an important role in reducing post-SWL infections, however, previous studies reported conflicting results. The issue of administering prophylactic antibiotics remains controversial in patients with sterile urine undergoing ESWL. Objective: To evaluate possible risk factors for post ESWL bacteriuria and consequently to identify patients with higher danger for urinary tract infection (UTI) or sepsis. Methods: Urine samples from 50 patients underwent ESWL, were collected by clean catch mid-stream urine collection method in sterile containers. Those patients were attending and admitting to Al-Imamein Al-Kadhimein Medical City during the period from October 2016 to January 2017. All patients had a urine culture performed before and after shock wave lithotripsy. Statistical analysis was performed with Epi-Info 7 and Excel programs. Statistical significance was evaluated using the Fisher's exact test with p <0.05 considered statistically significant. Results: A total of 50 patients who underwent ESWL during; the 2- months study period was enrolled in the study. Thirty-three 33 (66%) out of 50 were men and 17 (34%) out of 50 were women. 10 (20%) of patients had hypertension and 5 (10%) had diabetes mellitus. Fifty urine samples were collected from patients enrolled in this were cultivated on blood and MacConkey agar Pre-and post-ESWL Regarding Pre-ESWL results revealed 14 (28%) were urine culture positive while 23 cases were post-SWL urine culture positive. Conclusion: Antibiotic prophylaxis is not justified without defined risk factors such as positive urine culture before ESWL, an external bladder catheter or nephrostomy tube and a history of infectious stones or recurrent urinary tract infection. Keywords: Extracorporeal shock wave lithotripsy (ESWL), urine culture, renal stone and antibiotics Citation: Al-Anbary LA, Khaleel AA, Hassan JS. Pre and post extracorporeal shock wave lithotripsy (ESWL) urine culture as a guide for antibiotics management. Iraqi JMS. 2018; 16(3): 289-297. doi: 10.22578/IJMS.16.3.8


Article
9.IMMUNOHISTOCHEMICAL EXPRESSIONS OF PAX8 IN OVARIAN SURFACE EPITHELIAL TUMORS

Authors: Samar A. Al-Shami --- Ban J. Qasim --- Ahmed M. Hassan
Pages: 298-307
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Background: PAX8 is a nuclear transcription factor with limited expression in normal and neoplastic tissues, it has the potential to induce tumorigenesis and is expressed in a tissue during neoplastic transformation. PAX8 is a useful marker to distinguish gynecologic cancers from non-gynecologic malignancies. Objective: To assess the immunohistochemichal expression of PAX8 in ovarian surface epithelial tumors. Methods: This study included a total of 100 ovarian tissue paraffin blocks, 70 tissue paraffin blocks of ovarian tumors obtained from patients who underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy and 30 tissue paraffin blocks were the control group included normal ovarian tissue and fallopian tubes tissue. From each paraffin block, 2 sections were taken, one was stained with the routine hematoxylin and eosin stain and the other section was stained immunohistochemically for PAX8. Results: PAX8 showed a high significant difference in its immunohistochemical expression between the control group and the case group with the highest expression in malignant ovarian surface epithelial tumors (P < 0.001). Also, PAX8 showed a highly significance in the expression of PAX8 in relation to histopathological types (P < 0.001) except for the mucinous tumors, which showed statistically non-significance (P = 0.641), also, a highly significant relation with the increment of tumor grade (r = 0.769, P < 0.001). PAX8 showed a non-significant relation with increase of the age (r = 0.147, P= 0.225), with tumor stage (r = 0.433, P = 0.057), with the presence of ascites (P = 0.446). Conclusion: The highly significant differences in the immunohistochemical expression of PAX8 in the ovarian surface epithelial tumors tissues compared to the control groups reflect its important role in ovarian tumorigenesis. Besides PAX8 can be used as an important marker for discriminating ovarian non-mucinous from mucinous tumors. Also, there is a possible role of PAX8 in the development and differentiation of ovarian malignant surface epithelial tumor. Keywords: Ovarian surface epithelial tumors, ovarian carcinoma, transcription factor, paired box antigen, PAX8, immunohistochemistry Citation: Al-Shami SA, Qasim BJ, Hassan AM. Immunohistochemical expressions of PAX8 in ovarian surface epithelial tumors. Iraqi JMS. 2018; 16(3): 298-307. doi: 10.22578/IJMS.16.3.9


Article
10.IMMUNOHISTOCHEMICAL EXPRESSION OF CD133 IN OVARIAN SURFACE EPITHELIAL TUMORS

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Background: The identification of antigenic profile of the cancer stem cells might have relevant clinical implication as they're able to proliferate and self-renew, in turn sustaining tumor growth. CD133 is one of robust surface marker for cancer stem cells in various neoplastic human tissues, including ovaries. It is associated with the clinical outcome of patients. Objective: To assess the immunohistochemichal expression of cancer stem cell marker (CD133) in ovarian surface epithelial tumors. Methods: This study included a total of 100 ovarian tissue paraffin blocks, 70 tissue paraffin blocks included ovarian tumors obtained from patient who underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy, while 30 tissue paraffin blocks assigned as the control group included normal ovarian tissue and fallopian tubes tissue. From each paraffin block, 2 sections were taken, one was stained with hematoxylin and eosin stain and the other section was stained immunohistochemically for CD133. Results: CD133 showed a high significant difference in its immunohistochemical expression between the control group and the case groups with the highest expression seen in malignant ovarian surface epithelial tumors (P < 0.001). CD133 expression was highly significantly associated with histopathological type (P < 0.001). CD133 also showed a significant relation to age (r = 0.254, P= 0.034), tumor grade (r = 0.794, P < 0.001), tumor stage (r = 0.543, P= 0.013) and presence of ascites (P < 0.001). Conclusion: CD133 expression revealed a highly significant differences in the ovarian surface epithelial tumors tissues compared to control group, which reflect its important role in ovarian carcinogenesis. Keywords: Ovarian surface epithelial tumors, ovarian carcinoma, cancer stem cells, cancer stem cell marker, CD133, immunohistochemistry Citation: Al-Shami SA, Qasim BJ, Hassan AM. Immunohistochemical expression of CD133 in ovarian surface epithelial tumors. Iraqi JMS. 2018; 16(3): 308-318. doi: 10.22578/IJMS.16.3.10


Article
11.DETECTION OF RESPIRATORY SYNCYTIAL VIRUS IN INFANTS AND YOUNG CHILDREN WITH CHEST INFECTION: A COMPARISON OF REVERSE TRANSCRIPTION-PCR TECHNIQUE TO CHROMATOGRAPHIC IMMUNOASSAY AND ENZYME LINKED IMMUNOSORBENT ASSAY

Authors: Arwa M. A. Al-Shuwaikh --- Suha H. Ali --- Hala S. Arif
Pages: 319-326
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Background: Human respiratory syncytial virus (hRSV) is a major cause of viral lower respiratory tract infection among infants and young children less than 2 years old. Multiple methods are used for the laboratory diagnosis of hRSV infections, including chromatographic immunoassay, enzyme linked immunosorbent assay (ELISA) and reverse transcription polymerase chain reaction (RT-PCR) technique for detection hRSV-antigens, hRSV-antibodies and hRSV-RNA, respectively. Objective: To compare the efficiency of three diagnostic methods in detection of hRSV in infants and young children with chest infection. Methods: This study included 100 hospitalized infants and young children (39 females and 61 males) aged from (1) month to (24) months, their mean age (6.87 ± 6.03) months, who required hospital admission at the Pediatric Department in Al-Imamein AL-Kadhimein Medical City Hospital, Central Teaching Pediatric Hospital, and Al-Kadhimiya Pediatric Hospital in Baghdad-Iraq. Samples were collected over a three-month winter period from January 2017 to April 2017. Fresh nasal swab specimens were collected and testes for hRSV antigens by using chromatographic immunoassay as a rapid test, in addition, nasopharyngeal/throat swabs specimens were processed for detection of hRSV-RNA by RT-PCR, both for direct detection. Also, ELISA was done to measure anti-hRSV IgM antibodies in serum for indirect detection of RSV infection. Results: hRSV was found to be positive in (27%), (56%) and (44%) of specimens by rapid chromatographic immunoassay, ELISA and RT-PCR technique, respectively. Comparing with RT-PCR, the sensitivity of rapid test was (59.09%) ranged from (44.41) to (72.31) and the specificity was (98.21%) ranged from (90.55) to (99.91) with likelihood ratio equal to (33.09), while the sensitivity of ELISA test was (75.61%) ranged from (60.66) to (86.17) and specificity was (59.62%) ranged from (46.07) to (71.84) with likelihood ratio equals to (1.87). Conclusion: The RT-PCR technique was more sensitive than antigen or antibody detection methods for the diagnosis of hRSV Keywords: hRSV, rapid chromatographic immunoassay, ELISA, RT-PCR Citation: Al-Shuwaikh AMA, Ali SH, Arif HS. Detection of respiratory syncytial virus in infants and young children with chest infection: a comparison of reverse transcription-PCR technique to chromatographic immunoassay and enzyme linked immunosorbent assay. Iraqi JMS. 2018; 16(3): 319-326. doi: 10.22578/IJMS.16.3.11


Article
12.IDENTIFICATION COMMON CAUSE OF NEONATAL SEPSIS BY ANALYTICAL PROFILE INDEX SYSTEM (API)

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Background: Neonatal Sepsis is a bacterial infection of the blood in a neonate and an infant younger than 4 weeks of age. The analytical profile index or API is a classification of bacteria based on experiments, allowing fast identification. This system is developed for quick identification of clinically relevant bacteria. Objective: To identify the pattern of organisms in neonatal sepsis using API system in Baghdad City hospital, Al-Imamein Al-Kadhimein Medical City and Central Pediatrics Teaching Hospital. Methods: In this cross-sectional study, blood samples from 100 neonatal patients were inoculated into a blood culture bottle and incubated at 37 °C under aerobic conditions, subculture was done after 24 h of incubation, the growth was identified by phenotypic characteristics, gram's stain, and API system. Results: Positive blood cultures were detected in 82 (82%), according to API system the most prominent bacterial isolates from blood culture in neonates with early-onset sepsis were non-coagulase Staphylococcus (20.4%) Staphylococcus aureus (18.1 %), Acinetobacter bumanii (13.6%), Pseudomonas aeruginosa (11.36 %), Streptococcus agalactiae (11.3 %), while in late-onset sepsis the most common bacteria were Staphylococcus aureus (21.0%), non-coagulase Staphylococcus (13.1%), Citrobacter freundii and Pseudomonas aeruginosa (10.5 %) respectively. Conclusion: The API 20E may be useful for the identification of the bacterial species rarely described as pathogens in neonatal sepsis will help us to study the clinical burden resulting from the emergence of these species as causes for this neonatal infection. Keywords: Early-onset sepsis, late-onset sepsis, blood culture, API system Citation: Al-Mossawi HSM, Hassan JS, Al-bashier NM, Al-Omrani AAA. Identification common cause of neonatal sepsis by analytical profile index system (API). Iraqi JMS. 2018; 16(3): 327-334. doi: 10.22578/IJMS.16.3.12


Article
13.PATIENTS ATTITUDE TOWARDS PRESENCE OF UNDERGRADUATE MEDICAL STUDENTS DURING CONSULTATION IN 2016

Authors: Berq J. H. Al-Yasseri
Pages: 335-343
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Background: Bedside teaching enables students and trainees to acquire many clinical skills and professional behaviors during process of learning. Objective: To investigate views of patients towards presence of undergraduate medical students during consultation. Methods: This is a cross-sectional study conducted in Al-Imamein Al-Kadhimein Medical City, Baghdad-Iraq; during period of February through July, 2016. It involved patients admitted to internal medicine, surgery, and gynecology and obstetrics departments of hospital during time of data collection. The study relied on performing face to face interviews with participants and a total of 400 individuals were enrolled in it. To be included in the study, patient's age should be 18 years or older. Seriously ill, confused or cognitively impaired individuals were not involved. SPSS program was used for computerized statistical analyses. Categorical variables were compared using Chi-square X² tests, and Continuous variables were compared by Student t - test or analysis of variance (ANOVA) test. P -values less than 0.05 & 0.01 was considered to be statistically significant and highly significant, respectively. Results: Those who allowed presence of students represented 80.3% of participants. Factors associated significantly with patients' decision were age (p=0.034) and hospital department (p=0.009). Among those with positive attitude, 145 (45.2%) thought students' number should not exceed five, while remaining did not care. Answers of patients about their view for allowing students to perform examination revealed that 169 (52.6%) accepted all times, 105 (32.7%) linked acceptance by students' sex, and remainders rejected all times. Conclusion: The overall attitude of our patients towards students' involvement in consultation was positive and comparable to that reported in previous studies. Keywords: Patients' Attitude, Bedside Teaching, Medical Consultation, Iraq Citation: Al-Yasseri BJH. Patients attitude towards presence of undergraduate medical students during consultation in 2016. Iraqi JMS. 2018; 16(3): 335-343. doi: 10.22578/IJMS.16.3.13


Article
14.MOLECULAR DETECTION OF CYTOMEGALOVIRUS IN A SAMPLE OF IRAQI PATIENTS WITH ACUTE LEUKEMIA AND STEM CELL TRANSPLANTATION

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Background: Acute leukemia and hematopoietic stem cell transplantation are risk factors for opportunistic infection and reactivation of many latent infection like cytomegalovirus. Objective: Detection and quantification of cytomegalovirus viremia in patients with acute leukemia after induction chemotherapy and post allogeneic stem cell transplantation patients. Methods: A prospective study enrolled 61 patients with acute leukemia. Forty-eight of them evaluated while induction chemotherapy (group I), while the other 13 within 1-year post bone marrow transplantation (BMT) (group II). In addition, 30 apparently healthy individuals were recruited as (control group), blood samples were collected from all groups. Viral DNA was extracted from 1 ml plasma samples, and then, cytomegalovirus DNA was detected and quantitatively assessed by Taqman quantitative real-time PCR. Results: Twelve (25%) out of 48 patients in group I, 2 (15.4%) out of the 13 patients in group II, and 2 (6.7%) out of 30 in the control group had positive cytomegalovirus viremia. The mean cytomegalovirus viremia was 5.192x102, 2.71x102 and 1.60x102 copies/ml for group I, group II and controls respectively, p=0.056. Conclusion: There is a relatively high prevalence of cytomegalovirus viremia in Iraqi patients with acute leukemia after chemotherapy and post BMT. Real-time PCR assay is helpful for early diagnosis of cytomegalovirus viremia in leukemic patients and used to monitor post BMT patients at risk for cytomegalovirus disease. Keywords: HCMV, acute leukemia, stem cell transplantation, real-time PCR Citation: Al-Toban HA, Al-Marsomy HD, Al-Obaidi AB, Al Tameemi WF, Mohammed MA, Al-Saeed RM, Al-Shemary IK. Molecular detection of cytomegalovirus in a sample of iraqi patients with acute leukemia and stem cell transplantation. Iraqi JMS. 2018; 16(3): 344-352. doi: 10.22578/IJMS.16.3.14

Table of content: volume:16 issue:3