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Article
Diagnostic potential of soluble TNF alpha receptor 1 in diabetic and hypertensive patients with renal impairment and UTI.
الامكانية التشخيصية لمستقبل ألفا 1 عامل نخر الورم البولي في مرضى السكري وارتفاع ضغط الدم للمصابين باعتلال الكلية والتهاب المجاري البولية

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Background: Chronic kidney disease is one of the most common diseases. Health care workers in all countries of the world are concerned with the early detection and prevention of kidney diseases. Several novel diagnostic markers are being under investigation nowadays. Tumor necrosis factor-alpha and its receptors are examples. Aim: The present study was conducted to evaluate the role of tumor necrosis factor α receptor 1 (TNFR1) as a biomarker for detection of renal dysfunction.Materials and Methods: The study was carried out for the period from February to June 2019 and included 180 patients (their ages were between 19 and 85 years old) and were divided into 60 patients with renal impairment, 60 hemodialysis patients, and 60 patients with normal renal function (as a control group). Each group included patients with hypertension, patients with diabetes mellitus, and hypertensive- diabetic patients. The patients were attended to Center of Kidney Disease and Transplantation, Dialysis Unit of Baghdad Teaching Hospital – Medical City , Dialysis Unit of Tikrit Teaching Hospital and private laboratory in Samarra City.Urine sample was collected from each patient for bacteriological study and detection the level of TNFR1.Results: The most common pathogen isolated from cultured samples was Escherichia coli. Concentration of urinary TNFR1 in hypertensive and or diabetic with normal kidney function compared with hypertensive or and diabetic renal impairment did not differ statistically significant. Conclusion: Urinary level of tumor necrosis factor receptor 1 (TNFR1) is not important in the diagnosis of renal impairment with the presence of hypertension and or diabetes mellitus. Through statistical comparisons of patients with urinary tract infection (UTI) group and those without UTI group , it seems that UTI does not affect the diagnostic ability of urinary TNFR1. We recommend future studies focusing on serum level of the receptors mentioned above to test their diagnostic potential in renal impairment. In addition, investigating the effect of the immunological causes of renal impairment on the level of TNFR, both in urine and serum.

مرض الكلى المزمن هو واحد من أكثر المضاعفات شيوعا لمرض السكري وارتفاع ضغط الدم، والتي تعتبر حالة التهابية لذلك يمكن توقع تركيز مرتفع من السيتوكينات الالتهابية في مرضى ارتفاع ضغط الدم ومرضى السكري. في هذه الدراسة، تم استخدام مستقبل ألفا 1 عامل نخر الورم البولي كعلامة تشخيصية مبكرة لضعف الكلية في مرضى ارتفاع ضغط الدم ومرض السكري، وفحصت تأثير عدوى المسالك البولية على القدرة التشخيصية لمستقبل ألفا 1 عامل نخر الورم البولي. شملت الدراسة 180 عينة من مرضى ارتفاع ضغط الدم والسكري مقسمين إلى مجموعات تبعا لوظيفة الكلى عن طريق اختبار الكرياتينين في مصل الدم والاستبيان، شملت مجموعة مرضى ارتفاع ضغط الدم ومرضى السكري الذين لديهم وظيفة كلوية طبيعية، وشملت مجموعة ضعف الكلى مرضى ارتفاع ضغط الدم ومرضى السكري الذين يعانون من اختلال وظائف الكلى وشملت مجموعة الفشل الكلوي مرضى ارتفاع ضغط الدم ومرضى السكري من وحدة غسيل الكلى. تم اخذ عينات دم وعينات بول من كل هذه المجموعات. واستخدمت عينات الدم لاختبار الكرياتينين وعينات البول لاختبار الزلال والسكر عن طريق شريط فحص الادرار، تم فحص مستقبل ألفا 1 بواسطة جهاز الاليزا. بعد زرع وحضانة البول، تم تشخيص النمو عن طريق الفحص الكيميائي الحيوي الذي استخدم الوسائط التفاضلية. كانت البكتيريا الأكثر شيوعًا المعزولة هي E. coli. من خلال المقارنات الاحصائية للنتائج تبين أن مستقبل ألفا 1 عامل نخر الورم البولي لا يمكن استخدامه كعلامة تشخيصية لضعف الكلى في مرضى ارتفاع ضغط الدم ومرضى السكري مع أو بدون عدوى المسالك البولية حيث لا تؤثر على القدرة التشخيصية على مستقبل ألفا 1 عامل نخر الورم البولي


Article
Relation between Serum Leptin, Lipid Profiles and other biomarkers levels in patients with type 2 diabetic nephropathy
علاقة مستوى اللبتين مع شاكلة الدهون وبعض المتغيرات الكيمياحياتية في مصل دم مرضى السكري من النمط الثاني المصاحب بأعتلال الكلى

Authors: Sahar Abdul W- Shaban سحر عبد الواحد شعبان --- Esam Noori Al-Kirwi عصام نوري --- Khitam Abdul W. Ali ختام عبد الوهاب
Journal: Baghdad Science Journal مجلة بغداد للعلوم ISSN: 20788665 24117986 Year: 2010 Volume: 7 Issue: عدد خاص بمؤتمر العلمي النسوي 1 Pages: 678-686
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: In advanced diabetes mellitus, serum levels of the most hormones are altered due to several interplaying mechanisms.Objective: To assess the relation of serum leptin and lipid profile in type 2 diabetic nephropathy.Patients and Method: Serum leptin levels and its relation to lipid profile were estimated in 62 patients with type 2 diabetic nephropathy attending the National Diabetes Center in Al- Mustansiriya University, and (26) healthy individuals considered as control group. The diabetic patients were classified into three groups, (24) pathients with normoalbuminuria (21) patients with microalbuminuria and (17) patients with macroalbuminuria.Fasting plasma glucose, serum creatinine, Hb A1c %, lipid profile (Total cholesterol, LDL- Cholesterol, HDL- Cholesterol and Triglyceride) and urinary albumin, were measured to establish the possibility of using these biomarkers as a supplementary to serum leptin to be a diagnostic test for type 2 diabetic nephropathy.Results: Serum leptin levels showed a significant elevation in microalbuminuria (20.08± 4.50 ng/ml) and macroalbuminuria groups (22.35± 6.89 ng/ml) as compared to nondiabetic normal control group (10.64 ± 3.17 ng/ml). There was no significant differences observed in serum leptin levels between the normoalbuminuria group (13.96 ± 5.73 ng/ml) and healthy controls, but a significant positive differences were noticed in the levels of fasting plasma glucose, serum creatinine, Hb A1c% and lipid profile in the three patient groups in comparison with the control group. While no significant correlation was observed between these biomarkers levels and serum leptin values.Conclusion: It might be concluded that serum leptin levels were elevated in type 2 diabetic patients with microalbuminuria and macroalbuminuria, suggesting that renal leptin degradation is impaired in early stage of kidney damage and this impairment increase with the progression of this disease. Leptin hormone may consider according to these results as a risk factor for progression of kidney disease in diabetic patients.

1-( المقدمة) : في المراحل المتقدمة لمرضى السكري يحدث تغير في مستويات معظم الهورمونات نتيجة لتداخل ميكانيكية التفاعلات الحيوية المختلفة.2- (هدف البحث) : دراسة العلاقة بين مستوى اللبتين مع شاكلة الدهون لدى مرضى السكري من النمط الثاني المصاحب بأعتلال الكلى.3- (طريقة البحث) : تم قياس مستوى اللبتين وعلاقته مع شاكلة الدهون في مصل (62) مريض يعانون من مرض السكري النمط الثاني والمصاحب بأعتلال الكلى والذين حضروا الى مركز السكري في الجامعة المستنصرية.وشملت الدراسة كذلك (26) شخص سوي (كمجموعة ضابطة) لغرض المقارنة.قسمت اعداد المرضى الى ثلاثة مجاميع (24) مريض (نسبة تركيز البومين البول الى الكرياتين اقل من 30 ملغم/ غم ) كمجموعة اولى ، (22) مريض (نسبة تركيز البومين البول الى الكرياتين يتراوح بين 30-300 ملغم/ غم) كمجموعة ثانية ، اما المجموعة الثالثة فتضمنت (17) مريض (نسبة تركيز البومين البول الى الكرياتين اكثر من 300 ملغم/غم). تم قياس تراكيز كل من الكرياتين ، شاكلة الدهون والتي تشمل (الكوليسترول الكلي ، كوليسترول البروتينات الدهنية واطئة الكثافة ، كوليسترول البروتينات عالية الكثافة وثلاثي الكليسرول) في مصل الدم مع قياس تركيز البومين البول كمتغيرات كيمياحياتية مساندة لامكانية اعتماد قياس مستوى هرمون اللبتين في مصل الدم كفحص مختبري مساعد في تشخيص مرضى السكري النمط الثاني المصاحب لاعتلال الكلى.4- (النتائج) : مستوى اللبتين اظهر زيادة واضحة في مصل دم المجموعة الثانية للمرضى (4.50 ± 20.08 ng/ml ) وكذلك في مصل دم المجموعة الثالثة (6.89 ± 2.35 ng/ml ) مقارنة بالمجموعة الضابطة (3.17 ± 0.64 ng/ml ) بفرق ذي دلالة احصائية (P< 0.05 ) ولم يلاحظ فرق احصائي موجب في مستويات هرمون اللبتين بين المجموعة الاولى من المرضى (5.73 ± 13.96 ng/ml ) والمجموعة الضابطة ، ولوحظ ان هناك فرق احصائي موجب (P< 0.05 ) في مستوى الكلوكوز ، الكرياتين في مصل الدم ، الهيموكلوبين وكذلك عند مقارنتها مع المجموعة الضابطة. ولم تظهر دلالة احصائية بين مستوى هذه المتغيرات الكيمياحياتية ومستويات هرمون اللبتين في مصل الدم.5- (الاستنتاج) : يستنتج ان مستوى هرمون اللبتين يرتفع بصورة واضحة عند مرضى السكري النمط الثاني المصاحب بأعتلال الكلى ، وخاصة في مراحله المتقدمة نتيجة لضعف قابلية الكلى على تجزئة هذا الهرمون وتحلله في مراحل المرض المختلفة ، وان هذا الارتفاع يزيد من تطور المرض.من نتائج هذه الدراسة يمكن اعتماد هرمون اللبتين كعامل قياس لمدى تطور وخطورة امراض الكلى.


Article
Role of Antioxidant on Nephropathy in Alloxan Induced Diabetes in Rabbits

Authors: Israa F. Jaffar Alsamaraee --- Huda Arif Jasim
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2009 Volume: 8 Issue: 4 Pages: 398-402
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT:BACKGROUND:The development and progression of diabetic nephropathy is dependent on glucose homeostasis and many other contributing factors. Diabetic nephropathy is a leading cause of end-stage renal failure, accounting for 35 to 40% of all new cases that require dialysis therapy worldwide. Recent clinical studies clearly demonstrated that hyperglycemia and oxidative stress is an important causal factor in mediating the development and progression of diabetic kidney disease.OBJECTIVE:To evaluate the therapeutic effect of levamesole in diabetic nephropathy .METHODS:The study included 10 rabbits Weight (1kg ±20 gm); they were followed up for 7months. Blood was aspirated from marginal ear vein after agitation with xylol for estimation of fasting blood glucose and malondialdehyde (MDA) which is used as marker of oxidative stress. Rabbits were given 110 mg / kg alloxan to induce diabetes. In the second month rabbits became diabetic without development of nephropathy. After 1 month from being diabetic a bosture dose of alloxan was given (125 mgkg). After 1 month of the bosture dose blood glucose level further increased and rabbits developed albumin urea. Once rabbits developed albumin urea they received levamesole 2 mgkg EOD for 6 weeks.RESULTS:The study results showed that diabetic nephropathy is associated with high blood glucose level (300-400mgdl) and oxidative stress (significant increase in MDA level). The nephropathy (albumin urea) and oxidative stress can be reversed by levamesole.CONCLUSION:The antioxidant effect and immune modulating properties of levamesole provided a protective therapy against the development of diabetic nephropathy.KEY WORDS: diabetic nephropathy, levamesole, MDA.


Article
Prevalence of Microalbuminuria

Author: Assist. Prof. Safaa Ali Khudhair
Journal: KUFA MEDICAL JOURNAL مجلة الكوفة الطبية ISSN: 1993517X Year: 2009 Volume: 12 Issue: 1 Pages: 462-467
Publisher: University of Kufa جامعة الكوفة

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AbstractBackground: Diabetic nephropathy accounts for a significant reduction in life expectancy of diabetic patients, approximately 80% of Type 1 diabetic patients and 30% of type 2 diabetic patients with microalbuminuria progress to overt nephropathy after 10–15 years.Objective: To determine the prevalence of micro- and macro-albuminuria in diabetic patients in AL-Najaf city and the predictive value of some risk factors.Method: Urinary albumin-creatinine ratio (ACR) in a spot early morning urine sample was used and the patients were categorized as normo-albuminuric when ACR<30 mg/g, micro-albuminuric when 300>ACR≥30 and macro-albuminuric when ACR≥300 mg/g.Results: Prevalence of albuminuria among Type1 patients was 4(67%) microalbuminuria, 0% macroalbuminuria, i.e. 67% had abnormal urinary albumin-creatinine ratio (ACR). The corresponding prevalence for Type 2 patients was 26(52%) micro-albuminuria, 4(8%) macro-albuminuria and total of 30(60%) for abnormal urinary albumin-creatinine ratio (ACR).Conclusion: The occurrence of microalbuminuria detected in this study was much higher than previously reported in other studies and the duration of diabetes was the strongest predictor.


Article
Screening for Diabetic Nephropathy in Teenage Diabetes
التحري عن الاعتلال الكلوي لدى المراهقين المصابين بداءالسكري

Author: Abdul Munem Al Dabbagh د.عبد المنعم يونس الدباغ
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2009 Volume: 22 Issue: 1 Pages: 9-17
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Background: Diabetic nephropathy is the leading known cause of end-stage renal disease (ESRD). Epidemiological studies have demonstrated that diabetic nephropathy occurs in approximately one-third to one half of all diabetes and, today, diabetes is the most important cause of renal failure in the industrialized world. Recent studies have demonstrated that the onset and course of diabetic nephropathy can be ameliorated to a very significant degree by several interventions but these interventions would have their greatest impact if instituted at a point very early in the course of the development of this complication.Objective: To screen the problem of diabetic nephropathy in teenage patients with type I diabetes Mellitus (TIDM), by detection of Microalbuminuria (MA) which consider the best predictor of high risk for developing diabetic nephropathy.Patients and Methods: A cross-sectional design and a convenient sampling procedure were adopted to enroll 230 patients (118 males and 112 females) who met the inclusion criteria, from those attending the National Center for Treatment & Research of Diabetes in Al-Mustansirya Collage of Medicine-Baghdad during the period from the 1st of September 2006 to the end of December 2007. Micral test II was used to screen early morning (spot) urine samples for increased albumin excretion rate while the Schwartz formula made possible estimating the glomerular filtration rate (GFR) from serum creatinine and demographic characteristics. The results were used for evaluating the relationship between microalbuminuria and GFR. Some important risk factors including patient's age, disease duration, body mass index, and hypertension have also been evaluated with reference to the impact of hyperglycemia measured as the prevailing (HbA1c). -Conclusion: Micro-albuminuria manifested by increased urinary albumin excretion was encountered in 47.82% of our teenage DM patients showing significant association with hyperfiltration state, increasing level of HbA1c, and hypertension. But not gender or body mass index. Key words: Screening, Diabetic nephropathy, Teenage diabetes

المقدمة: يعتبر الاعتلال الكلوي بسبب السكري من الاسباب الرئيسية للاصابة بالعجز الكلوي .اثبتت البحوث الوبائية ان الاعتلال الكلوي يحدث لحوالي ثلث الى نصف المصابين بداء السكري .من الممكن التقليل من الاعتلال الكلوي بسبب السكري الى حد كبير اذا ما تم التدخل بشكل مبكر من بداية حدوث هذا الاعتلال .اهداف البحث:التحري عن الاعتلال الكلوي بسبب السكري لدى المرضى المراهقين المصابين بداء السكري من النوع الاول بالتحري عن الالبومين المجهري في الادرار.طريقة البحث:دراسة مقطعية على عينة مناسبة مكونة من 230 مريض (118 ذكر و 112 انثى) من المرضى الذين يراجعون المركز الوطني لعلاج وبحوث السكري في كلية الطب في الجامعة المستنصرية في بغداد . تم استخدام فحص Miscal test 2 للتحري عن الالبومين في الادرار ومعادلة شوارتز لحساب معدل التنقية الكلوي .النتائج: كانت نسبة الالبومين المجهري لدى المرضى 47.82% . معدل التنقية الكلوي كان 18.69% والذي يمثل 60.46% من المرضى المصابين بالادرار المصحوب بالالبومين المجهري و39.53% لغير المصابين.كان خطر الاصابة بالادرار المصحوب بالالبومين المجهري مرتبط بمستوى HbA1c وطول الفترة الزمنية للاصابة بالسكري وارتفاع ضغط الدم التقلصي والانبساطي .الاستنتاج:الادرار المصحوب بالالبومين المجهري تم اكتشافه في 47.82% من المرضى المراهقين المصابين بالسكر وكانت له علاقة بمستوى التصفية الكلوي وزيادة نسبة HbA1c وارتفاع ضغط الدم ولم تظهر له علاقة مع جنس المريض ومؤشر كتلة الجسم .


Article
Role of serum IL-18 in type 2 diabetic patients with and without microalbuminuria

Authors: Ali Naser Mohammed Ali AL-Alglani --- AbduladheemYaseen Abbood --- Hazim Abdul Razak Abdul Wahab --- Abbas Mahdi Rahma
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2015 Volume: 14 Issue: 1 Pages: 58-63
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Background: Microalbuminuria is a well-known indicator of poor renal outcomes in patients with type 2 diabetes that leads to diabetic nephropathy (DN), but there are many proinflammatary markers that are elevated during injury to the nephrons which lead to chronic kidney disease, one of those is interleukin - 18 (IL-18). Objective: To confirm the role of serum IL-18 as a novel predictor before DN onset. Patients and Methods: The microalbuminuria levels were measured by immunoturbidimetric method, serum IL-18 levels were measured by ELIZA sandwich method, both serum and urine creatinine levels were measured by colorimetric method and hemoglobin A1c (HbA1c) levels were measured by ion exchange - high performance liquid chromatography (HPLC) in 90 individuals, 20 individuals apparently healthy (group I), 40 diabetic patients without microalbuminuria (urinary albumin to creatinine ratio (UACR) ˂ 30 mg/g) (group II) and 30 diabetic with microalbuminuria (UACR 30 -300) (group III).Results: The mean of serum IL-18 in group I, II and III was 189.30 pg/ml ± 3.269 S.E., 220.83 pg/ml ± 0.900 S.E. and 246.67 pg/ml ± 22.341 S.E. respectively. The difference between group I and II, group I and III, and group II and III was significant (P=0.000 for all). The mean of UACR in group I, II and III was 4.25 mg/g ± 2.359 S.E., 4.20 mg/g ± 1.518 S.E. and 34.17 mg/g ± 0.629 S.E. respectively. The difference between group I and II was not significant (P=1. 000) but between group I and III, and group II and III were significant (P=0. 000 for both). The mean of serum creatinine in group I, II and III was 0.885 mg/dl ± 0.0302 S.E., 0.883 mg/dl ± 0.0240 S.E. and 0.933 mg/dl ± 0.0237 S.E. respectively. The difference between group I and II, group I and III, and group II and III was not significant (P=0.998, 0.331 and 0.145 respectively). The mean of hemoglobin A1c (HbA1c) in group I, II and III was 5.9 % ± 0.0211 S.E., 7.7 % ± 0.0445 S.E. and 8.135 % ± 0.0519 S.E. respectively. The difference between group I and II, group I and III, and group II and III was significant (P=0.000 for all). The correlation between urinary albumin to creatinine ratio (UACR) and IL-18 in group III was significant (r=0.983 with P=0.000). The correlation between hemoglobin A1c and IL-18 was significant (r=0.641 with P=0.000) in group II. The correlation between serum creatinine and IL-18 in group III was not significant (r=0.041 with P=0.830). Conclusion: while the increased IL-18 levels were positively correlated with both HbA1c and UACR that leads to the progression of the diabetic nephropathy and it can be one of the cytokines which opens the possibility of its application in clinical treatment in the future.


Article
Contrast Induced Nephropathy In Diabetic And Non-Diabetic Patients Underwent Percutaneous Coronary Intervention In Erbil City

Authors: Abdul Hameed Al Qaseer عبد الحميد القصير --- Mohammad Hasan Alwan محمد حسن علوان --- Aram Taher. Aziz ارام طاهر عزيز
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2017 Volume: 16 Issue: 1 Pages: 9-14
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Background: Since the advent of coronary angioplasty more than 3 decades ago, the volume of percutaneous coronary interventions has been rising progressively. Contrast medium was used in diagnostic coronary angiography and percutaneous coronary intervention. The use of iodinated contrast medium is a common precipitator of contrast-induced nephropathy.The objective of this study was to evaluate the incidence for the development of Contrast induced nephropathy in diabetic and non diabetic patients underwent percutaneous coronary intervention which was not studied in Erbil before.Patients and methods: One hundred twenty five consecutive patients,64 diabetic and 61 non diabetic underwent Percutaneous coronary intervention were included in this study which was conducted in Erbil surgical specialty center in Erbil. The renal function has been assessed before the procedure , 24hours and 1 week post procedure.Results: The incidence of contrast induce nephropathy was 5.6%(7patients) one day and 13.6% (17patients) one week post procedure. There were a statistically significant association between development of contrast induce nephropathy in diabetic patients (P value<0.001), non-diabetic (P value 0.001). hypertensive patients (p value 0.03), ,contrast volume (P value 0.001),those who receieved intravenous fluid (p value 0.01) . Comparing diabetic with non-diabetic group there were a statistically significant association between volume of contrast in diabetic group (p value 0.001) and non-significant association with the non-diabetic group (p value 0.1).Conclusions: Contrast induce nephropathy is an important complication developed after percutaneous coronary intervention and ,it is more in diabetic patients .


Article
Elevated ceruloplasmin and leucocyte count in Type 2 diabetic nephropathy

Authors: Huda Mundher Mahdi --- Khaleed J. Khaleel --- Waleed H.Yousif
Journal: Iraq Joural of Hematology المجلة العراقية لامراض الدم ISSN: 20728069/25432702 Year: 2015 Volume: 4 Issue: 1 Pages: 82-90
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Background : Type 2 diabetes mellitus is chronic disorder that requires proper medical careand education of patients to reduce long term complication like nephropathy .Patients and methods: Forty-five Type 2 diabetic nephropathy patients in early stage wererecruited for this study. Twenty-nine control subjects matched for age were also included.Results : this study demonstrated a significant increase in glycosylated hemoglobin ,randomblood glucose , blood urea , creatinine and total White blood cell count while a significantdecrease in , estimated glomerular filtration rate in Type 2 diabetic nephropathy patientscompared with healthy control . Urine markers including microalbumin and ceruloplasminshowed a significant increase in level in Type 2 diabetic nephropathy patients when comparedwith the healthy control.Conclusion: leucocyte count can be considered as indicator for an inflammatory marker and aceruloplasmin a good urinary marker.


Article
Value of Apparent Diffusion Coefficient (ADC) in the Assessment of Renal Insufficiency in Diabetic Patients

Author: Ammar Mosa Jawad*, Mohammed Abd Kadhim ،Israa Muhe Salh
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2019 Volume: 18 Issue: 3 Pages: 197-203
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

BACKGROUND:diabetic nephropathy is being recognized as a worldwide public problem with high cost and pooroutcomes, there is increase in the incidence and prevalence of renal failure all over the world.Functional renal imaging methods such as diffusion- weighted magnetic resonance imaging (DWMRI),has been shown to be a promising technique in the evaluation of renal functionOBJECTIVE:To study the value of apparent diffusion coefficient (ADC) in the detection and evaluation ofdiabetic nephropathy, correlating these values with the clinical stage of diabetic nephropathy and tocompare these findings with diabetic patient without nephropathy.PAT IENTS AND METHODS:A cross sectional analytic study was conducted in MRI unit of Radiology department at Al-ImameinAl-Kadhimyain medical city through period form 1st oct.2017 to 30 of July 2018, 80 diabeticpatients were classified according to GFR into two groups; group I 40 patients (diabetic patient withno nephropathy) group II 40 patients (diabetic patients with nephropathy). DWI ( b value ,0 and1000 s/mm2) was performed in two group of the study . The mean ADC value of renal cortex wascalculated from three regions positioned in the upper, mid and lower third of the kidney.The Relationship between ADC value and stage of diabetic nephropathy were assessed.RESULTS:In comparing diabetic patients (with no nephropathy) with patient with diabetic nephropathy, therewas significant decline in mean ADC value among patients with advanced stages of diabeticnephropathy(p< 0.001). The mean ADC value with diabetic nephropathy was significantly loweramong patients with type I DM (P<0.001).CONCLUSION:The magnetic resonance imaging-apparent diffusion coefficient value is an appropriate method forassessment and evaluation of diabetic nephropathy and is a reliable diagnostic tool for


Article
RENAL AND MYOPATHY LESIONS OF DIROFILARIA IMMITIS IN NATURAL INFECTED DOGS

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Abstract

BackgroundDirofilaria immitis has been increasingly recognized worldwide as inadvertent human pathogens. The epidemiological survey usual hosts of theses nematodes are domestic and wild carnivores. The disease is regarded as one of the most dangerous threat for the dog health. The adult worms take up residence in the heart, lungs and surrounding blood vessels.ObjectiveThis study attempts to shed the light on relationship between glomerular lesions and heart filarial (Dirofilaria immitis) infection.MethodsDirofilaria immitis was isolated from 98 dogs out of 457 dogs that were autopsied for the time between April 2008 and May 2010, in Al-Hindya area, Karbala province. Parameters concerning parasitological and pathological changes are used in this study to determine the significance of the results.ResultsGrossly many adult heartworms were found in the right ventricle of infected hearts and the cross section revealed body cavity, thick cuticle with coelomyarian and polymyarin muscle type, accompanied by infiltration of inflammatory cells mainly eosinophils and lymphocytes between muscle fibers. The microscopical changes in the kidney were necrotic and sloughing of epithelial cells, cystic dilation of collecting tubules of medulla containing hyaline casts, with glomeruli showing membranous nephropathy.ConclusionsThis is the first histological report of canine filariasis in Iraq particularly in Karbala province. It is important to keep in mind that pathologic changes in heartworm disease may be well advanced before the appearance of clinical signs of the disease. In heartworm disease the circulatory system is not the only system affected. The renal, hepatic & pulmonary systems can be secondarily affected. In our work the observations support the previous hypotheses of immature and possibly adult worms, contribute to the glomerulonephropathy.Key wards Canine heartworm, interstitial nephritis, membranous nephropathy.

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