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Article
Insulin-Like Growth Factor-1 (IGF-1) Predicte the Diagnosis of Growth Hormone Deficincy in Short Prepubertal Children

Authors: Abdul Kareem Y. Al-Samarraie --- Ali A. Ali --- Maan A. J. Bahrani
Journal: Iraqi Journal of Pharmaceutical Sciences المجلة العراقية للعلوم الصيدلانية ISSN: 16833597 Year: 2011 Volume: 20 Issue: 2 Pages: 54-58
Publisher: Baghdad University جامعة بغداد

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Abstract

To study the serum IGF-1 level for prediction of growth hormone deficiency and its role in the diagnosis of short stature in children and adolescents. A study was conducted on forty four (44) short children with growth hormone deficiency. Children were classified into Group I thirty five (35) prepubertal children and Group II (9) patients who entered puberty. In addition to forty (40) apparently healthy children as control group, also were divided into group I control(29) prepubertal &group II (11) pubertal . IGF-1,GH ,Thyroid function ,serology for celiac disease , Hb level ,bone age were done for all patients. IGF-1 and basal GH level (without provocative test) were done for control . There was a significant low difference between the serum IGF-1 level in the patients of group I in comparison to their serum level in control group I {(90.98±23.69) (121.83±23.69) (p<0.05)} . While there was no such difference between the serum IGF-1 level in the patients of group II in comparison to their serum level in control group II {(184.59±196.52) (285.91±68.89) (p<0.05)}. This study shows that IGF-1 level is low compared to control in short GH deficient children who did not enter puberty, while it is less significant in children and adolescents who entered puberty. So IGF-1 is a suitable parameter to predict GH deficiency in short prepubertal children in whom GH deficiency was found by GH provocative testing. But this test is less reliable in children who entered puberty.

ھو دراسة مستوى ھرمون في المصل في تشخیص قصر IGF-1 للتحقق من نقص ھرمون النمو وبیان دور ھرمون 1 IGF- في تشخيص قصرالقامة عند الأطفال والمراھقین . تم إجراء الدراسة على 44 طفلا قصیر القامة والذین لدیھم نقص في ھرمون النمو.حیث تم تصنیفھاإلى مجموعتین الأولى وتضم 35 طفلا في مرحلة ما قبل البلوغ والمجموعة الثانیة و تضم 9 أطفال دخلو مرحلة البلوغ بالإضافة إلىIGF- 40 من الأطفال الأصحاء قسموا إلى مجموعة أولى لم یبلغوا ( 29 ) ومجموعة ثانیة دخلوا البلوغ( 11 ). وتم قیاس ھرمون 1IGF- ,ھرمون النمو, ھرمونات الغدة الدرقیة, اختبار حساسیة الحنطة , مستوى الھیموغلوبین وعمر العظم لجمیع المرضى.وقیاس 1في مصل مرضى المجموعة الأولى ھو IGF - وھرمون النمو یدون فحص تحفیزي للأطفال الأصحاء. معدل مستوى ھرمون 1(121,83± في مصل المجموعة القیاسیة الأولى ھو ( 23,69 IGF- 90.98±23.96 ) نانوغرام/ ملیلیتر بینما معدل ھرمون 1 )في IGF- في حین ان معدل مستوى ھرمون 1 ( p< نانوغرام /ملیلیتر والتي تظھر أن ھناك فرقا ملحوظا بین المجموعتین ( 0.05في مصل المجموعة القیاسیة IGF- 184,59 ) نانوغرام /ملیلیتر بینما معدل ھرمون 1 ± مصل مرضى المجموعة الثانیة ھو( 196,52من خلال ھذه .( p> 285,91 ) نانوغرام /ملیلیتر والتي تظھر أن ھناك فرق غیر ملحوظ بین المجموعتین( 0.05 ± الثانیة ھو ( 68,89في مصل الأطفال قصار القامة الغیر بالغین منخفض بشكل ملحوظ مقارنة مع المجموعة IGF- الدراسة تبین أن نسبة ھرمون 1القیاسیة الأولى بینما لا یوجد فرق في نسبة الھرمون في مصل الأطفال والمراھقین مقارنة مع المجموعة القیاسیة الثانیة.لذلك فان نسبةھو مقیاس مناسب للتنبؤ بنقص ھرمون النمو في الأطفال قصیري القامة الذین لم یصلوا البلوغ والذین تم الكشف عن IGF- ھرمون 1 IGF- نقص ھرمون النمو لدیھم بالفحص التحفیزي لھرمون النمو. ولكن ھرمون1 یعتبر اقل اعتمادا للأطفال الذین وصلوا البلوغ.


Article
Rickets in Children Below 2 Years

Authors: Safa abd Alilah Faraj --- Haider Nadhim Abd --- Abdul-Kareem Mohammed Ali
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2011 Volume: 10 Issue: 3 Pages: 300-304
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Although breast-feeding is highly appraised and widely practiced in Iraq, human milk supplies all necessary nutrients except a few including vitamin D. Despite abundance of sunshine, vitamin D deficiency rickets is not rare in Iraq.OBJECTIVE:We carried out this study with an objective to determine presence, presentation and predisposing factors of rickets in pediatric patients attending Al-Kadymia Teaching Hospital-Baghdad.METHODS:This study was conducted in Department of pediatrics, AL-Kahdymia Teaching Hospital over one year period from first of October 2008 to first of October 2009. Children from newborns to twenty fourth months of age presenting with signs and symptoms of rickets were included and information regarding signs, symptoms predisposing factors ( crowded housing, isolated housing with deficient sun exposure, abundant sun but lack of awareness, malnutrition and antenatal factors ) and investigations was recorded on a proforma. Diagnosis was based on clinical signs, radiological changes on x-ray of wrist joint and biochemical disturbances in serum levels of alkaline phosphatase, calcium and inorganic phosphorus.RESULTS:Sixty children with rickets reported during the study period. Overall, 40 infants (66.6%) were exclusively on breast feeding. The main clinical presentation was in the form of recurrent lower respiratory tract infection 30 infants (50%), recurrent diarrhea & delayed milestones 20 (33.3%) and seizure 6 patients (10%). Skeletal changes on clinical examination were present in 30 (50%). Radiological signs of rickets were present in 50 (83.3%). Symptoms and signs reverted to normal in all cases after vitamin D supplementation.CONCLUSION:Nutritional rickets is still prevalent in Iraq, presenting with variable signs and symptoms, predisposing the childhood population to different illnesses and skeletal deformities. In the presence of abundant sunshine, lack of awareness of exposure to sun, may be the important predisposing factors for development of nutritional rickets.


Article
Utilization of the hematology autoanalyser as a screening test for iron deficiency anemia and β–thalassemia trait

Authors: Abdulsalam Hatem Mohammed --- Abbas Hashim Abdulsalam
Journal: Iraq Joural of Hematology المجلة العراقية لامراض الدم ISSN: 20728069/25432702 Year: 2011 Volume: 1 Issue: 1 Pages: 27-32
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background: Hypochromic microcytic anemia is the most common encountered type of anemiaand it includes several types, iron deficiency and β-thalassemia trait are the commonestexamples, and since the definite diagnostic tests are not always available, therefore, themaximum utilization of the cell count autoanalysers for screening testing and reducingthe number of patients who needs the use of more specialized techniques can be useful.Objectives: To evaluate the results of hematology autoanalyser in iron deficiency anemia and β–thalassemia trait.Patients & Methods: This is a cohort prospective study in which two hundred newly diagnosedpatients with hypochromic anemia, and proved later to be either iron deficiency anemiaalone or β–thalassemia trait alone are included. These patients were attending theNational Center for Hematology from January 2009 to February 2010.Results: There is a highly significant difference in red cell count, hemoglobin concentration andhematocrit percent (p-value < 0.001, 0.003 and < 0.001 respectively) between irondeficiency anemia and β–thalassemia trait. A highly significant relation is found betweenhemoglobin concentration and other red cell parameters and white blood cells andplatelets count (p-value < 0.001 for all) in both types of anemia. Also a significantdifference is noted between hemoglobin concentration and hematocrit percent to identifyanemia in β–thalassemia trait (p-value 0.0236).Conclusions: Red blood cells count is mostly in the lower normal threshold or below in irondeficiency anemia, and it is in the upper normal threshold or above in β–thalassemiatrait. Β–thalassemia trait usually presents with milder anemia or even with lower normalHemoglobin concentration and hematochirt percent, while in iron deficiency the anemiais always clearly present. Relying on Hb concentration rather than on Hct percent toevaluate the presence of anemia makes its diagnosis more obvious. RDW higher than24.3 % is only associated with iron deficiency anemia.


Article
Congenital adrenal hyperplasia: hospital based study

Author: Munib A. Alzubaidi منيب احمد كاظم الزبيدي
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2011 Volume: 53 Issue: 2 Pages: 126-131
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Congenital adrenal hyperplasia is a family of autosomal recessive disorders of cortisol biosynthesis. Depending on the enzymatic step that is deficient, there may be signs, symptoms, and laboratory findings of mineralocorticoid deficiency or excess; incomplete virilization or premature puberty in affected males; and virilization or sexual infantilism in affected females. The most frequent is 21-hydroxylase enzyme deficiency, accounting for more than 90% of cases.Objectives: to review cases of congenital adrenal hyperplasia registered in children welfare teaching hospital- medical city- Baghdad.Patients and method: This study included all patients who were presented and registered in the endocrine clinic of the children welfare teaching hospital- medical city complex as a case of congenital adrenal hyperplasia from the 1st of January 1990 till the 1st of Jun 2009. Demographic informations together with epidemiological, clinical, diagnostic and therapeutic data of the patients were collected.Results: The total number of patients was 60 patients with mean age (6.321) +/- (3.996) SD and male to female ratio of 2:3. Seventy percent of patients presented within the 1st 6 months of life, 61.9% of them were females. Thirty-one (51.7%) patients were delivered in the hospital including 72% of those who were presented within the 1st month. Forty six (76.7%) patients were presented with ambiguous genitalia with or without other presentations, 8 (13.3%) patients presented with salt losing only and 6(10%) patients presented with pseudo precocious puberty with or without other presentations. Consanguinity between the parents was present in 86.7% of patients, 33.3% of patients had positive family history of similar condition, 36.7% of patients had positive family history of neonatal death due to dehydration or abortion and only 3.3% of patients had history of hormonal therapy during pregnancy. Twenty two (36.7%) patients were reared with false sex, 95.5% of them were females reared as males, 33.3% of them accept to change their names & sex of rearing to definitive sex as females and one male (4.5%) patient reared as female had change his name and sex to male. Seventy percent of patients were diagnosed as 21 hydroxylase deficiency, both salt loser (71.4%) and non salt loser (28.6%), (10%) as 11 hydroxylase deficiency, (18.3%) as 3β hydroxysteroid dehydrogenase deficiency both salt loser (54.5%) and non salt loser (45.5%) and (1.7%) as17 hydroxylase deficiency.Conclusions: The commonest form of congenital adrenal hyperplasia in Iraq is 21 hydroxylase deficiencies. There was delay in the diagnosis in spite of hospital delivery, and this may lead to psycho-social problems for the patients and their families regarding changing the sex of rearing. Many patients having genital anomalies did not operate upon yet.


Article
PREVALENCE AND MOLECULAR CHARACTERIZATION OF G6PD DEFICIENT VARIANTS IN SULYMANIA PROVINCE –IRAQ
نسبة الانتشار و الاسس الوراثية لعوز نازعة الهيدروجين الكلوكوز 6 فسفات في سليمانية - العراق

Authors: JALADET MS. JUBRAEL جلادت جبرائيل --- SANA D. JALAL سنا جلال --- NASIR AS. AL-ALLAWI نصير علاوي --- ALI I. MOHAMMED علي محمد --- et al.
Journal: Duhok Medical Journal مجلة دهوك الطبية ISSN: ISSN: 20717334 (online)/ ISSN: 20717326 (Print) Year: 2011 Volume: 5 Issue: 2 Pages: 69-75
Publisher: University of Dohuk جامعة دهوك

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Abstract

Background and objectives Glucose-6-Phosphate Dehydrogenase deficiency is the most common inherited hematological disorder among Iraqis. Studies have addressed its prevalence in several parts of the country, but neither the prevalence nor the molecular variants have been studied in the Sulymania province-northeastern Iraq. This study aimed at addressing the latter issue.Methods A total of 838 random healthy male individuals from Sulymania province were screened for glucose-6-phosphate dehydrogenase deficiency using a fluorescent spot test. If deficient, the results were confirmed by quantitative enzyme assay. Deficient individuals with adequate samples had their DNA extracted and analyzed for four deficient molecular variants using a Polymerase Chain Reaction-Restriction fragment polymorphism method. These variants were the Mediterranean (563 C - ts respectively.Results -6-phosphate dehydrogenase deficient. Forty of these individuals had adequate samples to analyze for the four deficienthad the Chatham variants. No cases of A- or Cosenza variants were identified, leaving 6 cases uncharacterized.Conclusions -6-phosphate dehydrogenase deficiency in Sulymania, an area of northeast Iraq that has not been previously studied.Furthermore, it was found that Mediterranean and Chatham variants constitute the bulk of glucose 6 phosphate dehydrogenase deficient variants in this province.

خلفية واهداف البحث: ان عوز انزيم نازعة الهيدروجين الكلوكوز 6 فسفات ه و من اكثر امراض الدم الوراثية انتشارا في العراقيين. أن العديد من الدراسات قد عنت بتحديد نسبة انتشاره في عدد من مناطق العراق، و لكن لم يسبق ان تم دراسة نسبة الأنتشار أو الضروب الوراثية في محافظة السليمانية- شمال شرق العراق. ان الدراسة الحالية هدفها ان تعالج هذه المسألة.طرق البحث: تم التحري عن عوز نازعة الهيدروجين الكلوكوز 6 فوسفات في 838 من الاشخاص الأصحاء عشوائيا ومن محافظة السليمانية بأستعمال طريقة القطرة المتوهجة. و قد تم تأكيد النتائج لحالات العوز بواسطة حساب كمية الأنزيم. و قد تم عزل الدنا في العينات التي كانت كمية النماذج فيها كافية و من ثم التحري عن اربع من الضروب الواثية لهذا العوز وبطريقة تضاعف الدنا التسلسلي- طريقة تقييد الطول متعدد الأشكال. و شملت هذه الضروب البحر السلبي بالتتابع. A المتوسط ، جاتم ، كوسينزا والنتائج: وجد أن 50 شخصا ( 6%) كان لديه عوز نازعة الهيدروجين الكلوكوز 6 فسفات. و قد كان لدى اربعين منهم 75 %) لديهم ضرب البحر ) نماذج كافية للتحري عن الضروب الوراثية الأربعة. و باجراء هذه الفحوص وجدنا ان 30 السلبي ، بينما بقيت 6 حالات مجهولة A 10 %) لديهم ضرب جاتم. و لم نجد أي حال ة كوسينزا و ) المتوسط و 4 الضرب.الاستنتاجات: وجدنا أن نسبة أنتشار العوز في السليمانية هي 6%، و هي منطقة لم تكن مدروسة سابقا". كما وجد أن ضربي البحر المتوسط و جاتم تشكل أغلبية الحالات في هذه المحافظة.

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