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Article
Hypertension and Pregnancy in Karbala Maternity Hospital

Author: Muna Kasim Mahmood
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2013 Volume: 6 Issue: 2 Pages: 1625-1629
Publisher: Kerbala University جامعة كربلاء

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Abstract

background: Hypertension complicates 5-7% of all pregnancies. Preeclampsiacharacterized by development of hypertension, proteinuria and multisysteminvolvement after 20 weeks of pregnancy in a previously normal female anddisappear after peurperium and it is responsible for substantial maternal and fetal morbidity.Objective: the purpose of this study was to know the complications of hypertension infemale during pregnancy and postpartum period, the method of termination of pregnancy,fetal and neonatal outcome of female with hypertension in pregnancy.Methods: this is a prospective study involve 75 pregnant women with hypertension admittedto Karbala maternity hospital, we monitored their pregnancies and recorded the developmentof complications.Results: eclampsia developed in 25.33% of them, HEELP syndrome developed in 9.33% andintrauterine fetal death occur in 6.66% and no maternal mortality occurring during thisperiod, intrauterine fetal death occur in 6.66% of them and 32% of them delivered vaginally.Conclusion: lower incidence of eclampsia, maternal death, intrauterine fetal death and othercomplications due to preeclampsia due to good monitoring and the use of prophylacticmagnesium sulphate in severe cases.


Article
Assessment of Treatment Response of Iraqi Patients with Membranoproliferative Glomerulonephritis with Emphasis on Renal Function and Proteinuria Regression

Author: Faiz Rashid Abayechi
Journal: Diyala Journal of Medicine مجلة ديالى الطبية ISSN: 97642219 Year: 2015 Volume: 8 Issue: 1 Pages: 73-85
Publisher: Diyala University جامعة ديالى

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Abstract

Background: Membranoproliferative glomerulonephritis (MPGN) is a pattern of glomerular injury with characteristic light microscopic changes. It can be primary idiopathic renal disease or secondary to chronic infections, autoimmune diseases and complements dysregulation.Objective: To evaluate treatment response in a group of patients with MPGN regarding renal function and proteinuria regression.Patient and Methods: Thirty three adult patients with MPGN (above the age of 18 years) were included in the study. Males were 19 and females were 14. All patients were followed up for two years. Laboratory investigations included complete blood counts, urine examination, renal function test, lipid profile, virology screen (hepatitis B virus and hepatitis C virus), collagen diseases screen (antinuclear Ab, anti double stranded DNA, extractable nuclear antigens, complements C3 and C4), also screening for multiple myeloma was done with serum protein electrophoresis and urine bence jones protein. All patients were given standard form of treatment (Anti platelets, statins, diuretics, angiotensin converting enzyme inhibitors/angiotensin receptor blockers), some patients were given steroids, others, immunosuppressive drugs.Their responses to treatment were studied and compared.Results: The cause of MPGN in this study was idiopathic in twenty six patients (79%). It was secondary to HBV, HCV, and systemic lupus erythematosus in seven patients (21%). Four (58%) out of seven patients with normal RFT have partial response to steroid therapy and they showed decreased proteinuria. The remaining three (42%) patients showed no response. Two Patients with normal RFT who received mycophenolate mofetil, responds by decreasing their proteinuria to less than 1 g / 24h. nine patients with impaired RFT received steroid treatment only or steroid plus MMF, four (44%) patients have stabilized renal function, the remaining five (56%) patients had progressive decline in renal function. Three patients with HBV infection who were given alfa interferon or lamivudine showed stabilized RFT and decreased proteinuria. One patient with HCV infection showed progressive decline in renal function, he was maintained on standard treatment only. Two patients with SLE and impaired RFT were given cyclophosphamide and steroid, their RFT stabilized during the follow up period Conclusion: Patients who presents with normal RFT have better response to treatment. Than patients who presents with impaired RFT. Also patients with secondary MPGN (HBV and SLE) have responded at least partially to antiviral and /or immunosuppressive therapy.


Article
Screening of Hepatitis B- and C- Viral Markers in Iraqi Patients with Proteinuria

Author: Abdul Hadi K . Hussain
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2008 Volume: 7 Issue: 4 Pages: 362-368
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Viral hepatitis may lead to nephropathy as one of its multiple extra hepatic manifestations. Symptomatic proteinuria as detected by dipstick, and qualitative urine collection are simple tests in practice as well as useful cardinal test of underlying renal abnormalities. The aim of this study was to elucidate the impact of hepatitis B virus (HBV) and/or hepatitis C virus (HCV) infections on the occurrence of symptomatic proteinuria amongst adults and pediatrics.PATIENTS & METHODS :A prospective study included (143) adult and pediatric Iraqi patients presented with symptomatic proteinuria, and 108 (age- and sex-matched) apparently healthy individuals (as control group) who were serologically screened for HBV & HCV markers using third generation Enzyme linked immunosorbent assay (ELISA) techniques, screening for HIV by ELISA and other related immunological and biochemical profile.RESULTS :It was found that the prevalence of hepatitis B surface antigen (HBsAg), anti hepatitis B core antibody (anti-HBc-IgM), anti hepatitis B surface antibody (anti-HBs) and anti hepatitis C antibody (anti-HCV) in the proteinuria group as compared to control group, were (7.0% vs. 0.9%, P<0.05) for HBsAg, (2.8% vs. 0% ,P>0.05) for anti-HBc-IgM, (20.3% vs. 23.1%, P>0.05) for anti-HBs antibody, and (6.3% vs. 0%, P<0.01) for anti-HCV.CONCLUSION :Our study demonstrated a significant association between proteinuria and HCV, and HBV infection in the adult and pediatric population. The interpretation of serological patterns of viral hepatitis markers in patients with newly diagnosed proteinuria are important, it might suggest that detailed urinalysis and qualitative urine protein assessment is mandatory when managing patients with HCV or with HBV infections.


Article
HYPOMAGNESEMIA AND OBESITY IN RELATION TO INSULIN RESISTANCE AND GLYCEMIC CONTROL IN TYPE 2 DIABETIC PATIENTS

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Abstract

Background: Obesity and diabetes mellitus are the most common health problems with both macro- and micro-vascular complications and consequences of end organ damage. The alteration in trace elements could have deleterious effects on the health of the diabetic patients. Magnesium (Mg) is an important factor for enzymes involved in carbohydrate metabolism and good evidence suggests the presence of an important role for hypomagnesaemia in insulin resistance and metabolic control.Objective: To evaluate the relation of hypomagnesaemia with insulin resistance (IR), and glycemic control in obese and non obese diabetic people.Methods: The study included 65 patients with type 2 diabetes mellitus (Type 2 DM) who were all on oral hypoglycemic drugs only. They were divided according to their body mass index (BMI) and the presence or absence urinary protein, into three groups. The results were compared with those of another 52 normal controls grouped on the same bases.Fasting venous blood specimens were aspirated for the measurement of glycated hemoglobin (HbA1c) by A1c variant reader, glucose, urea, creatinine, protein and albumin by routine enzymatic chemical and colorimetric methods, insulin by immuno-enzymometric assay and magnesium by atomic absorption spectrophotometer, while Mg ions and Quicki test (for IR) were estimated by calculations. Morning urine specimens from each subject were examined for the presence of protein by dip Stick.Results: As compared with the healthy controls the study reveals a significant reduction in Quicki test (increased IR) and low serum Mg2+ in all diabetic patients, with the presence of a significant positive correlation between the two parameters. Serum Mg2+ was significantly lower in the normal weight non proteinuric diabetics than the normal weight controls. In diabetic patients the presence of proteinuria caused a further reduction in serum Mg2+. Glycated hemoglobin (HbA1c) negatively correlated with total serum Mg2+ in all diabetics and their controls. Conclusions: Insulin resistance and poor glycemic control are important events associating hypomagnesaemia in type 2 DM. Proteinuria is an additional factor which may aggravate hypomagnesaemia, which involves both ionized and total Mg to the same degree.Key words: type 2 diabetes mellitus, magnesium, Insulin resistance, HbA1C, proteinuria


Article
Comparison between some inflammatory biomarkers including ICAM-1, IL-6 and CRP in preeclamptic women in different gestational ages
مقارنة بين بعض المؤشرات الحيوية للالتهابات بما في ذلك ICAM-1، IL-6 و CRP في النساء مقدمات الارتعاج في سن الحمل المختلفة

Authors: Ihsan Mohammed A. Ajeena احسان محمد عجينة --- Muhannad Yahya I. Al-Muhanna مهند يحيى
Journal: Al-Kufa University Journal for Biology مجلة جامعة الكوفة لعلوم الحياة ISSN: 20738854 23116544 Year: 2016 Volume: 8 Issue: 3 Pages: 503-514
Publisher: University of Kufa جامعة الكوفة

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Abstract

Background: Preeclampsia is a disease of pregnancy characterized by a blood pressure of 140/90 mmHg or more on two separate occasions after the 20th gestational week in a previously normotensive woman. This is accompanied by significant proteinuria (>300 mg in 24 hours) and is associated with endothelial cell damage. The markers of endothelial activation or inflammation have been blamed to play an active role in preeclampsia. Subjects and materials and methods: This study included 97 pregnant with a confirmed diagnosis of preeclampsia as a patient group and 72 control pregnant women, with a gestational age ranging between 20-38 weeks. They are divided into three subgroups according to their gestational age (20-26 wk, 27-32 wk and 33-38 wk) and the mean of their age was 29.34±4.82, 30.14±5.33 and 32.54±6.22 respectively. Participants belong to both patient and control groups had underwent same procedure serological tests for Intracellular Adhesion Molecule 1 (ICAM I), interleukin-6 (IL6) and C-reactive protein (CRP). Results: Results showed that there were statistically significant differences (P < 0.05) in ICAMI, IL-6 and CRP values between patient and control groups and between the patient with moderate and those with severe preeclampsia in all tested gestational age subgroups. This supports the hypothesis stating a role of cytokines and inflammatory biomarkers in the mechanism underlying preeclampsia. Moreover, and at all gestational age subgroups, the ICAMI, CRP and IL-6 values were higher in patients with severe disease when compared with those having moderate disease. In conclusion, an inflammatory process is blamed to be the underlying mechanism of preeclampsia as proved by the elevated levels biomarkers in these patients.

خلفية: تسمم الحمل هو مرض من الحمل يتميز ضغط الدم 140/90 مم زئبق أو أكثر في مناسبتين منفصلتين بعد أسبوع الحمل ال20 في المرأة سوي ضغط الدم سابقا. ويترافق ذلك بروتينية كبيرة (> 300 ملغ في 24 ساعة) ويرتبط تلف الخلايا البطانية. وألقي باللوم على علامات تفعيل البطانية أو التهاب للعب دور نشط في دورية نيو انجلاند الطبية.      المواضيع والمواد والأساليب: شملت هذه الدراسة 97 حاملا لتأكيد التشخيص من دورية نيو انجلاند الطبية كمجموعة المرضى و72 مراقبة المرأة الحامل، مع سن الحمل تتراوح بين 20-38 أسبوعا. وهي تنقسم إلى ثلاث مجموعات فرعية وفقا لسنهم الحمل (20-26 أسبوع، 27-32 أسبوع و33-38 أسبوع) كان ومتوسط ​​أعمارهم 29.34 ± 4.82، 30.14 ± 5.33 و 32.54 ± 6.22 على التوالي. ينتمي المشاركون إلى كل من المريض والسيطرة الجماعات لديها خضع نفس الاختبارات المصلية الداخلي للالتصاق بين الخلايا جزيء 1 (ICAM الأول)، انترلوكين 6 (IL6) وبروتين سي التفاعلي (CRP).     النتائج: أظهرت النتائج أن هناك فروق ذات دلالة إحصائية (P <0.05) في ICAMI، IL-6 والقيم CRP بين جماعات المرضى والسيطرة وبين المريض مع المعتدلين والذين يعانون من تسمم الحمل الشديد في جميع المجموعات الفرعية سن الحمل اختبار. وهذا يدعم فرضية تفيد دور السيتوكينات والمؤشرات الحيوية للالتهابات في دورية نيو انجلاند الطبية الأساسية آلية. وعلاوة على ذلك، وعلى جميع المجموعات الفرعية سن الحمل، وكانت ICAMI، CRP و IL-6 قيم أعلى في المرضى الذين يعانون من مرض شديد بالمقارنة مع تلك التي لديها مرض معتدل. في الختام، ويلقى باللوم على العملية الالتهابية أن يكون الآلية الكامنة وراء تسمم الحمل وهو ما تؤكده المؤشرات الحيوية مستويات مرتفعة في هؤلاء المرضى.

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