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Article
The Pattern of Drug Resistance in Iraqi Pulmonary Tuberculosis Patients Referred to the Specialized Center for Chest and Respiratory Disease

Authors: Arwa Tahrir Ramadhan --- Ahmed Asmer Mankhi
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2014 Volume: 13 Issue: 2 Pages: 181-186
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Tuberculosis control in the world today must face the challenge posed by the global spread of Mycobacterium tuberculosis strains that are resistant to standard anti-TB drugs. OBJECTIVE:This study was done to identify the drug resistance to the first line antituberculosis drugs in Iraqi Patients.METHODS:This prospective study conducted in National Center for Tuberculosis and Chest Diseases in Baghdad from January 2012 to August 2012.For study the demographic characters and drug sensitivity test (DST) in a total number of 155 case of sputum smear positive pulmonary tuberculosis (97 old and58 New) For each patient 3 consecutive sputum samples were taken for direct smear microscopy and cultured to test drug resistance for First Line anti-TB drugs (INH, Rifampicin ,Ethambutol and pyrazinamide). RESULTS:In this study we found ethambutol resistant in 20(34.5%)of samples in the new group and in 49(50.5%) of samples in old group. On the other hand,our study showed that resistance to rifampicin in the new group was 58.6% while in the old group was 75.3%. In regard to the INH drug resistance it seen in 72.4% of samples in new group and in 83.5% of samples in old group.This study showed that reistance to streptomycin present in 44.8% of new group samples and in 55.7% of old group samples .The pattern of drug resistance according to patient group show high frequency of polyresistance 82 cases in both patient group(new and old) and low frequency in other group of resistance 14 cases,and MDR type of resistance in total of 17 cases .CONCLUSION:The study showed 11%(17/155) of patients with pulmonary tuberculosis in this sample of patients had multidrug resistance MDR tuberculosis . .


Article
Evaluation of TLR-2 sera levels in a sample of Iraqi pulmonary TB patients

Authors: Lara Ghali A. Ali --- Nawal Mohammed Utba --- Ahmed Asmer Mankhi
Journal: Iraqi Journal of Science المجلة العراقية للعلوم ISSN: 00672904/23121637 Year: 2018 Volume: 59 Issue: 4B Pages: 1973-1980
Publisher: Baghdad University جامعة بغداد

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Abstract

The non-specific response of immunity has developed as the initial barrier for human protection from invading pathogens, which comprises certain pathogen recognition receptors (PRR) for instance toll-like receptors (TLRs). Toll like receptor 2 (TLR 2) is capable of recognizing pathogen associated molecular patterns (PAMP) coded by Mycobacterium tuberculosis. To evaluate TLR 2 level in sera of pulmonary tuberculosis (TB) patients. About 120 subjects, involving 80 patients with pulmonary TB including 40 multiple drug resistance (MDR), 20 recently diagnosed pulmonary TB (RD) and 20 recurrent TB patients named as old cases (OC), in addition to 40 apparently healthy individuals were studied as control group. Sera from 68 TB patients and 20 healthy controls were obtained for measuring TLR 2 levels by enzyme linked immunosorbent assay (ELISA). The present result revealed that serum levels of TLR 2 showed there is no significant differences between each patient's group and control except OC group given that, has decreased significantly (p<0.05). The mean ±SD of TLR 2 level in MDR, RD, OC and controls were 4.0± 2.4, 3.4±1.4, 2.2±0.9 and 4.1± 3.0 ng/ml, respectively. The results exhibited that during treatment of tuberculosis, patients with pulmonary tuberculosis showed elevated TLR 2 concentration, which looks probably in charge of regulating inflammation and infection. Consequently, this study proposes that killing of MTB could occur in the time of disease management because of effective treatment, in addition to activation and releasing of different immune system mediators via TLR 2.

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Article
Biochemical Study on Pleural Effusion Fluid in Tuberculous and non-Tuberculous in Iraqi Patients
دراسة كيميائية حياتية لسائل غشاء الجنب الالتهابي التدرني و غير التدرني في المرضى العراقيين

Authors: Lara Gale A. Ali لارا غالي عبد علي --- Dhuha Saad Salih ، ضحى سعد صالح --- Ahmed Asmer Mankhi احمد اسمر منخي
Journal: Iraqi Journal of Science المجلة العراقية للعلوم ISSN: 00672904/23121637 Year: 2014 Volume: 55 Issue: 2Supplement Pages: 649-654
Publisher: Baghdad University جامعة بغداد

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Abstract

Seventy exudative lymphocytic pleural fluid specimens of patients with suspected tuberculous pleural effusion submitted to the National Reference Laboratory of tuberculosis/Baghdad from October 2012 to February 2013. These effusions were due to tuberculosis pleuritis (n=12) and non-tuberculosis pleuritis (n=58). The following parameters were analyzed: protein concentration, glucose concentration, lactate dehydrogenase (LDH) concentration and adenosine deaminase activity (ADA). As a result, the protein concentration was higher in TPE patients (8.80 ± 0.89 g/dl) than it's concentration in non-TPE patients (7.61 ± 0.54 g/dl), as well as LDH concentration was (3366.58 ± 284.28 U/L) in TPE patients and (3024.12 ± 116.84 U/L) in non-TPE patients and ADA activity was higher in the TPE patients (226.05 ± 16.90 U/L) than (153.06 ± 9.37 U/L) in non-TPE too. Whereas glucose was the unique parameter that it's concentration is lower in TPE patients than it's concentration in non-TPE patients (27.23 ± 4.81 mg/dl) and (199.80 ± 18.51 mg/dl) respectively. As a conclusion, the combination of the two parameters, protein level > 5 g/dl and glucose level < 60 mg /dl may be diagnostic for tuberculous pleural effusion. The higher level of ADA, greater the chance of the patient having TB while lower the level lesser the chance of the patient having TB. LDH measurement is a sensitive, but rather non-specific inflammatory marker.

شملت الدراسة جمع 70 عينة من سائل الجنب من المرضى الوافدين إلى المختبر المرجعي للتدرن/ بغداد للفترة 1/10/2012 -1/2/2013 و كان عدد المصابين بسائل غشاء الجنب الالتهابي التدرني (12) و عدد المصابين بسائل غشاء الجنب الالتهابي غير التدرني (58). و تم قياس المؤشرات الكيميائية الاتية: تركيز البروتين, تركيز الكلوكوز, انزيم LDH و انزيمADA . وجد تركيز البروتين في مرضى التدرن اعلى (8.80± 0.89 غم/ ديسي لتر) من تركيزه في مرضى غير التدرن (7.61± 0.54 غم/ ديسي لتر) و كذلك تركيز انزيم LDH حيث كان (3366.58 ± 284.28 وحدة / لتر) في مرضى التدرن و (3024.12± 116.84 وحدة / لتر) في مرضى غير التدرن. و انطبق هذا ايضا على انزيم ADA الذي كان تركيزه (226.05 ± 16.90 وحدة/ لتر) في مرضى التدرن و (153.06± 9.37 وحدة/ لتر) في مرضى غير التدرن. اما سكر الكلوكوز فقد كان المؤشر الوحيد بتركيز اقل في مرضى التدرن من تركيزه في مرضى غير التدرن (27.23 ± 4.81 ملغم/ ديسي لتر) و (199.80± 18.51 ملغم/ ديسي لتر) على التوالي. نستنتج, أن دمج المؤشرين, تركيز بروتين > 5 غم/ ديسي لتر و تركيز سكر الكلوكوز < 60 ملغم/ ديسي لتر قد يعد تشخيص لسائل الجنب التدرني و كلما زاد تركيز انزيم ADA يزيد من احتمالية حدوث التدرن في المرضى و العكس صحيح. اما انزيم LDH فبلرغم من حساسية قياسه الا انه مؤشر غير نوعي.

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