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Article
HIGH SENSITIVITY C-REACTIVE PROTEIN (HS-CRP) AND METABOLIC SYNDROME: CORRELATION WITH NUMBER AND TYPE OF METABOLIC SYNDROME COMPONENTS IN IRAQI PATIENTS
البروتين التفاعلي نوع عالي الحساسية والمتلازمة الايضية: العلاقة مع عدد ونوع مكونات المتلازمة الايضية في المرضى العراقيين

Author: Nazar S.Haddad نزار سمير حداد
Journal: The Medical Journal of Basrah University المجلة الطبية لجامعة البصرة ISSN: 02530759 Year: 2012 Volume: 30 Issue: 1 Pages: 49-54
Publisher: Basrah University جامعة البصرة

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Abstract

Background: Metabolic syndrome (MetS) is clustered risk factors that arise from insulin resistance and is associatedwith risk of coronary heart disease, as well as diabetes. American Heart Association (AHA) defined MetSon the basisof 5 components: fasting blood glucose, blood pressure, triglycerides, HDL-C, and waist circumference. HighsensitivityCRP (hs-CRP) is a measure of systemic inflammatory conditions and is considered as a risk factor indiabetes mellitus.Aim: To investigate the correlation of hs-CRP with the number and type of components of MetS diagnostic criteria inIraqi patients and to find out the cutoff point for hs-CRP level that might predict the development of metabolicsyndrome.Methods: This study involved 78 diabetic patients consulting the outpatient clinic at Al Sadr Teaching Hospital. Forall patients anthropometric measures were obtained and fasting blood samples were taken for determination of bloodglucose, lipid profile and hs-CRP level.Results: Mets was diagnosed in 48 patients. The level of hs-CRP was found to be significantly increased withincreasing number of components of MetS. The lowest value of (0.07 mg/dl) was found in people with absentcomponents of metabolic syndrome and the highest level of (4.05 mg/dl) in subjects with 4 components. A significantpositive correlation was observed between hs-CRP and waist circumference, FBG, and triglycerides(r=0.514, 0.531,0.592 respectively, P<001) and a negative correlation with HDL-cholesterol (r=-0.332, p=0.021). Using the level of0.65 mg/dl, hs-CRP can predict the development of metabolic syndrome with sensitivity and specificity of 81.3% and93.3% respectively.Conclusion: Hs-CRP shows a significant correlation with the number of MetS components and its level correlateswell with waist circumference and other biochemical features of MetS. Hs-CRP can predict the development of MetSwith high sensitivity and specificity.

فرع الكيمياء/كلية الطب/ جامعة البصرة / العراقالمقدمة:متلازمة التمثيل الغذائي (المتلازمة الأيضية) هي إحدى عوامل الخطورة التي تنشأ من مقاومة الأنسولين وترتبط مع مخاطر الإصابة بأمراض،HDL-C، القلب التاجية، والسكري. تعرف المتلازمة الأيضية على أساس خمس مكونات هي: مستوى الكلوكوز، وضغط الدم، الدهون الثلاثيةعالي الحساسية إحدى علامات الالتهاب العامة و بوصفه عاملا من عوامل خطورة الإصابة بالسكري. C ومحيط الخصر. يعتبر البروتين التفاعليمع عدد ونوع مكونات تشخيص مرض بالمتلازمة الأيضية في المرضى (hs-CRP) عالي الحساسية C الهدف:تقصى العلاقة بين البروتين التفاعليالذي قد يتنبأ بتطور المتلازمة الايضية. HS-CRP العراقيين ومعرفة مستوى الالنتائج:من بين 78 مريضا بالسكري شملتهم الدراسة، تم تشخيص المتلازمة الايضية في 48 منهم. و قد لوحظ زيادة في مستوى البروتين التفاعلي منعالي الحساسية و كل من C مع زيادة عدد مكونات المتلازمة الايضية في المرضى. كما تبين وجود ارتباط ايجابي معتمد إحصائيا بين البروتين التفاعليوعند اتخاذ مستوى HDL –C مستوى الكلوكوز و محيط الخصر و مستوى الدهون الثلاثية في حين كانت العلاقة سلبية بينه و بين مستوى ال.% 0.65 وجد ان حساسيته للتشخيص تقدر ب 81,3 % و خصوصيته التشخيصية 93,3 mg/dl عن الحد C بروتين التفاعليارتباطا كبيرأ مع عدد العناصر المكونة للمتلازمة الايضية ومستواه يرتبط بشكل جيد مع محيط الخصر c الاستنتاج:يظهر مستوى البروتين التفاعليالتنبؤ بحدوث المتلازمة الايضية بحساسية وخصوصية عالية.


Article
DIAGNOSTIC VALUES OF COPPER, ZINC AND COPPER/ZINC RATIO COMPARED TO HISTOPATHO-LOGICAL EXAMINATION IN PATIENTS WITH BREAST TUMORS

Authors: Nazar S Haddad --- Hanaa H Haddad --- & Wassan M Al-Elwee
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2010 Volume: 16 Issue: 2 Pages: 107-110
Publisher: Basrah University جامعة البصرة

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Abstract

Trace elements copper (Cu) and zinc (Zn) have a role in many biochemical reaction as microsource, their metabolism are profoundly altered in neoplastic diseases and since breast cancerrank the first of female cancers, this study aims to evaluate the diagnostic significance ofcopper/zinc ratio in 70 patients with breast tumor and compared to the grade andhistopathological examination. result had been shown that there is significant difference in levelof zinc and copper and copper/ zinc ratio between benign and malignant tumor and thisdifference persist to be present between different grade of malignant breast tumor and it hadbeen found that copper/zinc ratio have diagnostic significance of 78.5% in discriminatingbetween benign and malignant tissue and this had been increased to about 95.1 % indifferentiating between grade of malignant breast neoplasm. So we conclude that copper/zincratio is higher in malignant breast tissue and could be a better indicator of grade of cancer.


Article
Evaluation of Manual Hb A1C Determination Methods in Diabetic Patients with Sickle Cell Trait
تقييم الطرق اليدوية لقياس خضاب الدم السكري في مرضى السكري الحاملين لصفه فقر الدم المنجلي

Author: Dr.Nazar S. Haddad ا.م.د. نزار سمير حداد
Journal: Thi-Qar Medical Journal مجلة ذي قار الطبية ISSN: 19929218 Year: 2018 Volume: 15 Issue: 1 Pages: 96-104
Publisher: Thi-Qar University جامعة ذي قار

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Abstract

Background and Aim HbA1c is an irreversible non-enzymatic glycation at one or both NH2- terminal valines of the β –chain. Sickle hemoglobin, or HbS, has a valine for glutamic acid substitution at position 6 of the β chain. The prevalence of sickle cell trait reported to be 2.5% in Basrah city. The hemoglobin A1C (A1C) test can lead to false outcomes resulting in over- treatment or under-treatment of diabetes in people with inherited hemoglobin variants. This study focus on the evaluation of sickle cell trait effect on HbA1c measurement by the minicolumn ion exchange resin methods and compare them with Biorad Variant (HPLC method).the one of methods certified by national glycohemoglobin standardization program (NGSP) Materials and Methods 60 diabetic patients identified with sickle cell trait were recruited in this study .Blood sample collect in EDTA tubes and were assessed for hemoglobin A1c using 3 methods commercially available and most fequently used for routine investigations. Stanbio Glycohemoglobin (Pre- Fil), HUMAN Glycohemglobin HbA1-Test ( Fast Ion Exchange Resin Separation Method ) ,and the Bio-Rad VARIANT Hemoglobin A1c (HPLC ) methodResults Mean age group for patient were 39.6 yrs with their mean blood glucose level of about 203 mg/dl , the average glycohemoglobin was 9.1% measured by Biorad Variant, compare to 7.57% and 7.99% for both Stanbio method and Human Method respectively, which show statistically significant difference (p<0.05). It also had been found that average difference between both manual methods (|Stanbio and Human) and Automated method (biorad variant HPLC) about (1.5, 1.15) . These difference show a significant statistical correlation with hemoglobin S level with r =0.856; p value<0.001.Conclusion This study demonstrate the significant difference in Glycated hemoglobin measurements between different methods commercially available in local markets which had been shown to give false negative results in sickle trait patients when compared to those methods standardized by NGSP system. And recommend that such methods to be avoided in patient with sickle cell trait.

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Article
Biochemical Risk Determinants of Osteoporosis in Overweight and Obese Postmenopausal Women with Type 2 Diabetes Mellitus

Author: Ikhlass . H . Ibrahem* , Abdulkader . A . Al-Shakour ** , Nazar .S. Haddad**
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2018 Volume: 14 Issue: 1 Pages: 33-36
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Several studies suggested that skeletal system is adversely affected by diabetes and is associated with increased risk of osteoporosis and fragility fractures Objectives: The study was a case-control study that designed to assess the level of bone turnover markers (BTMs) among patients with type 2 diabetes mellitus (T2DM) and to investigate the effect of body weight and diabetic control on the level of bone turnover Type of the study: Cross- sectional study.Methods: The present study included 100 postmenopausal women with type 2 diabetes mellitus. Sixty-six non-diabetic postmenopausal women were enrolled as a control. Fasting blood samples were collected to measure Alkaline phosphatase (ALP),stoeocalcin(OC), fasting blood sugar (FBS)and glycated hemoglobin (HbA1c). Urine samples were collected to measure deoxypyridinolin(DPD). The results were expressed as a ratio to urine creatinine Results: The mean level of serum osteocalcin was significantly lower in the diabetic group than in the control group,while the level of urinary deoxypyridinolin was significantly higher in the diabetic group than in the control group . There was no significant difference in the level of Alkaline phosphatase between diabetic patients and control. An inverse association was found between osteocalcin with body mass index(BMI), glycated hemoglobin and fasting blood sugar. On the other hand appositive association was found between the level of deoxypyridinolin with body mass index Conclusions: Altered bone metabolic markers in patients with T2DM with more significant alterations in those who hsd poor glycemic control . Decrease in formation marker osteocalcin and increased resorption markers such as (DPD) has been found.


Article
SERUM MAGNESIUM AND SEVERITY OF DIABETIC RETINOPATHY
العلاقة بين مستوى المغنيسيوم وشدة داء الشبكة السكري

Authors: Nazar S. Haddad --- Salah Zuhair م.م.د.نزار سمير1، م.م.د.صلاح زهير2
Journal: The Medical Journal of Basrah University المجلة الطبية لجامعة البصرة ISSN: 02530759 Year: 2010 Volume: 28 Issue: 1 Pages: 36-39
Publisher: Basrah University جامعة البصرة

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Abstract

ABSTRACTBackground: Diabetic retinopathy is the most frequent cause of new cases of blindness among adults aged 20–74years. Magnesium deficiency is a possible metabolic factor involved in the pathogenesis of diabetic micro - and macro- vascular complications.Aim: To assess magnesium level in relation to the stages of diabetic retinopathy.Methods: The study enrolled 136 diabetic patients consulting Ophthalmology Outpatient Department. Theophthalmologist assigned the patients into 5 categories; background, preproliferative, proliferative, advanced andmaculopathy. Serum magnesium, random blood glucose and glycated hemoglobin were determined.Results: Among the 136 patients with diabetes mellitus, 94 patients had diabetic retinopathy and 42 had noretinopathy. There is a significant statistical differences (P-value <0.05) between diabetic retinopathy and controlgroups in serum magnesium, random blood glucose, glycated hemoglobin and duration of diabetes. It had been foundthat serum magnesium remained statistically significant among the groups of patients with different stages ofretinopathy. Patients with maculopathy had the lowest value for the serum magnesium level (1.35 mg/dl)Conclusions: Serum magnesium level decreased in patients with diabetic retinopathy with lowest level beingobserved in patients with advanced retinopathy and maculopathy.

1 فرع الكيمياء الحياتية/كلية الطب/جامعة البصرة، 2 فرع الجراحة /كلية الطب/جامعة البصرة/العراقخلفية الدراسة: إن اعتلال الشبكية السكري هو السبب الأكثر شيوعا للحالات الجديدة من العمى بين البالغين الذين تتراوح أعمارهم بين 20-74 سنة. و يمثل عوز المغنيسيوم عاملا محتملا لمرض السكري والمضاعفات الوعائية المجهري و الكبيرة للسكري. الهدف: تحديد مستوى المغنيسيوم بحسب مراحل اعتلال الشبكية السكري. الطرائق: شملت الدراسة 136 مريضا مصابا بداء السكري كانوا قد راجعوا العيادة الاستشارية للعيون. وتم توزيع المرضى من قبل اختصاصي العيون الى خمس مجاميع على وفق حالة الشبكية: المرحلة الأساس و مرحلة ما قبل التكاثرية و التكاثرية و المتقدمة و اعتلال بقعة الشبكية.النتائج: كان من بين 136 مريضا مصابا بداء السكري، 94 مريضا لديهم اعتلال الشبكية السكري (69.1%) و هناك فرق معتد إحصائيا (P<0.05) بين المجموعة المصابة و غير المصابة باعتلال الشبكية السكري بما يخص مستوى المغنيسيوم والغلوكوز في الدم وخضاب الدم السكري وكذلك مدة داء السكري. وقد وجد إن مستوى المغنيسيوم بقي معتدا" إحصائيا بين مجاميع المرضى بحسب المراحل المختلفة لاعتلال الشبكية. وكان لدى المرضى المصابين باعتلال بقعة الشبكية القيمة الأقل لمستوى المغنيسيوم في مصل الدم (1.35 ملغم /100 مل).الاستنتاج: إن مستوى المغنيسيوم في مصل الدم ينقص عند المرضى المصابين باعتلال الشبكية السكري والمستوى الاوطأ تمت ملاحظته في المرضى الذين لديهم اعتلال الشبكية المتقدم وكذلك في اعتلال بقعة الشبكية.المجلة الطبية لجامعة البصرة ص36-39

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Article
C-REACTIVE PROTEIN IN PATIENTS WITH OPEN ANGLE GLAUCOMA

Authors: Ahmed Mohammed Al-Samak --- Sajid Yousef Shehab --- Wigdan Nazar Ibraheem --- Nazar S Haddad
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2018 Volume: 24 Issue: 2 Pages: 46-48
Publisher: Basrah University جامعة البصرة

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Abstract

Abstract This study aimed to evaluate the C-reactive protein (CRP) levels in patients with open angle glaucoma. This cross sectional study included 36 patients diagnosed with glaucoma compared to 36 healthy controls. Each patient went through a complete ophthalmic examination and blood sampling for CRP. A thirty six cases (23 males, 13 females, mean age 60±11.7 years) with glaucoma and 36 age-matched controls (18 males, 18 females, mean age 58.25±10.45 years) were evaluated. Serum CRP levels were significantly higher in glaucoma cases than in controls (median 3.43, range 0.2-8.47 mg/dL) compared to 0.97, 0.17-6.30, P<0.002. The mean serum CRP levels were significantly elevated in the glaucoma cases compared with the controls (3.27±2.79 mg/dL and 1.50±1.56mg/dL respectively). Conclusion: The findings of this study suggest that higher CRP levels are associated with glaucoma. It is possible that there is a link between vascular inflammatory process and glaucoma.


Article
PENETRATION OF CEFOTAXIME INTO INTERVERTEBRAL DISCS REMOVED FROM PATIENTS UNDERGOING DISCECTOMY

Authors: Thamer A Hamdan --- Mohammed S Hashim --- Nazar S Haddad --- Abdullah M Jawad
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2019 Volume: 25 Issue: 1 Pages: 3-9
Publisher: Basrah University جامعة البصرة

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Abstract The intervertebral disc is an avascular tissue, and penetration of antibiotics occurs by passive diffusion. Cefotaxime penetration has not been well studied. The aim is to investigate the penetration of cefotaxime into the intervertebral disc removed from patients undergoing discectomy. Twenty-six patients undergoing discectomy were recruited for this study. They were given one gram of cefotaxime intravenously as a prophylactic antibiotic. Cefotaxime was extracted from nucleus pulposus and serum and analyzed using an HPLC method with cefuroxime axetil as internal standard. Cefotaxime penetrated into all the 26 samples of nucleus pulposus resulting in a mean concentration of 0.66±0.13 µg/gm. The mean serum concentration at time of disc removal was 13.61±3.54 µg/ml. The concentration in 16 samples were below the minimum inhibitory concentration against Staph. aureus with an average of 0.27±0.03 µg/g. There is a statistically significant correlation between time after intravenous cefotaxime administration and its concentration in the nucleus pulposus. The greater increase is in the third hour after administration. Factors like age, body weight, gender, number of associated diseases and surgical history did not seem to affect nucleus pulposus cefotaxime concentration. In conclusion, cefotaxime can penetrate into the nucleus pulposus but its concentration is relatively low. This concentration has a strong positive correlation with time after cefotaxime intravenous administration. Cefotaxime, therefore, needs to be given at least two hours before disc removal, with re-dosing immediately before operation to maintain high serum concentration. Keywords: Surgery, cefotaxime concentration, intervertebral disc, nucleus pulposus, discectomy

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