Hilla university college Journal For Medical Science

Mesioclusion or Class III malocclusion is one of the dental disturbances that represents the magnitude and complexity
of the entire problem of malocclusion. It is of special interest to the orthodontist because it offers a therapeutic challenge.
The aim of this study is to review the common treatment options for Class III malocclusion and determine which
approach is superior. Numerous studies have recommended intervention at an early stage, such as during the the
deciduous dentition or prepubertal growth phase. Early treatment of skeletal Class III malocclusion can be achieved by
several appliances including Bionator, Frankle, chin cup, face mask. Orthopedic protraction of the maxilla is a popular
treatment modality, although it has some limitations. In addition, rapid maxillary expansion has been recommended as
a routine component of treatment, even in the absence of maxillary constriction. Although there are multiple treatment
possibilities, the protraction face mask is the common and most effective treatment option for Class III malocclusion
before maxillary suture maturation is encountered, during the early mixed dentition years.

Background: Escherichia coli (E. coli) strains have been classied into eight distinct phylogenetic clusters as per a novel
quadruplex PCR method. However, the exact phylogenetic relationship among these bacterial lineages is still uncertain.
Objectives: The current study employed the Clermont phylotyping method to enhance the understanding of phylogenetic clusters of E. coli and evaluate antibiotic resistance in uropathogenic E. coli (UPEC) strains in Iraq.
Materials and Methods: A total of forty-two UPEC isolates were evaluated for antibiotic susceptibility using a disk
diffusion test, while the innovative Clermont phylotyping method was employed for the phylogenetic classication of
the isolates.
Results: The results showed that different phylogroups were found at the hospitals in Babylon Governorate, Iraq.
Phylogroup B2 was the most common, accounting for 47.61% of the samples. It was followed by Clade I (14.28%),
B1 (11.90%), A (9.52%), D (4.76%), C (2.38%), and an unidentied phylogroup (9.52%). Furthermore, 37 (88.09%) and 5
(11.90%) of the 42 uropathogenic E. coli isolates under study exhibited multidrug resistance (MDR) and extensive drug
resistance (XDR), respectively. There are many MDR and XDR UPEC isolates within phylogroup B2, as evidenced by
the fact that MDR and XDR strains within the group accounted for 17 out of 37 cases (45.24%) and 3 out of a total of 5
cases (60%), respectively. Additionally, two new phylogroups were discovered, called C and clade I, which are connected
to cryptic E. coli and E. coli sensu stricto, respectively.
Conclusion: Therefore, more research must be done to better understand the characteristics of antibiotic resistance as
well as the prevalence of various phylogroups in Iraq

Background: Candida albicans is commonly found in the oral cavities of individuals with denture stomatitis, especially in middle-aged and elderly adults who use dentures and orthodontic appliances.
Objectives: This study aims to investigate the in uence of orthodontic appliances on oral Candida albicans and
demonstrate the isolation and identication of C. albicans from orthodontic patients.
Materials ans Methods: Eighty swab samples were collected for culture preparation. The swabs were cultured on various culture media (such as In uence of Orthodontic Appliances on Oral Candida albicans and Molecular Study of their
virulence factors, SDA, and Chrom agar) and the culture is examined for microbial growth. Microscopic examination
and PCR technique were also used for identifying the isolated yeasts.
Results: The current investigation showed an infection with opportunistic microorganisms as follows: 17% of C.
albicans from two times (T1 and T2) are positive for Candida albicans in orthodontic patients and negative in (baseline
T0). In orthodontic isolates, the (ALS1) gene was strongly found in C. albicans.
Conclusion: Oral Candida albicans was more prevalent in orthodontic patients. Among orthodontic patients, Candida
albicans was more prevalent than other Candida species. Oral Candida albicans with the gene (ALS1) was more prevalent
with biolm formation.

Background: Klebsiella pneumoniae is a signicant gram-negative, opportunistic bacterium. Among the many infectious disorders it can cause are infections of the bladder, bacteremia, pneumonia, and hepatic abscesses. Biolms slow
down the rate of bacterial growth, prevent antibiotics from penetrating the body, encourage the creation of persister
cells, and promote genetic exchange. Thus, biolms can lead to an outbreak of superbug infections.
Objectives: This study aimed to molecularly analyze the FimH gene in biolm-producing and multidrug-resistant K.
pneumoniae.
Materials and Methods: 250 clinical samples were collected from several hospitals in Baghdad and from different
clinical sources. Laboratory diagnosis was based on morphological and biochemical tests. Then, conrmation by the
VITEK 2 system compact. About 68 (27.2%) isolates of K. pneumoniae were obtained. Disk agar diffusion testing was
used to screen for antibiotic susceptibility in accordance with CLSI 2023. Consequently, 44 (64.7%) MDR bacterial isolates
were detected that were resistant to one or more of three classes of antibiotics. Biolm production was detected for these
MDR strains using the Congo red method.
Results: The number of black, crystalline-dry colonies regarded as test-positive was 32 (72.7%). DNA was extracted
from 24 strains, which were MDR and biolm producers. Following this, PCR technology was used to amplify the FimH
gene using specic primers. FimH was detected in all these isolates (100%). The products of PCR were sent to Macrogen
Corporation in Korea for sequencing. The analysis of sequences, carried out using bioinformatics software, and the
drawing phylogenetic trees between the locally isolated strains showed genetic variation among them.
Conclusion: There is a relationship between biolm formation and the spreading of drug resistance in K. pneumoniae
as well as an increase in the expression of FimH among biolm-forming strains.

Background: Vaginal candidiasis is the most prevalent illness among women and is mostly caused by Candida
albicans, which causes most clinic visits.
Objectives: The present study aimed to formulate and improve miconazole nitrate-containing thermosensitive
bioadhesive gel for vaginal drug delivery to achieve better therapeutic effectiveness and patient compliance in the
management of vaginal candidiasis.
Materials and Methods: Miconazole nitrate (MN) was prepared as a (2%) vaginal gel by using 18% poloxamer (PLX)
407, 2% PLX 188 as thermoresponsive polymers, and Carbopol (CP) 934 and CP 940 as bioadhesive polymers. The
prepared formulations were assessed for parameters such as gelation temperature, viscosity, bioadhesive strength,
spreadability, and in vitro drug release.
Results: The gelation temperatures for F1 were found at 35◦C, and the developed formula had optimum viscosity, good
bioadhesive strength, respectable spreadability, and (25%) in vitro drug release over 12 hours.
Conclusion: The mucoadhesive in situ gels of MN would be an alternative candidate for vaginal candidiasis treatment
since they have suitable gel properties and good vaginal retention

Background: Urinary tract infections (UTIs) are the most prevalent bacterial illnesses. Antibiotic resistance is a
common problem in E. coli bacteria, which can develop or acquire a wide range of resistance mechanisms. E. coli strains
B2 carry more virulence factors that cause antibiotic resistance.
Objectives: The study aims to detect the phylogeny of antibiotic resistance genes of Escherichia coli B2 and identify
the presence of the yjaA, chuA genes. It also aims to measure the susceptibility of antibiotic samples obtained from
individuals diagnosed with UTI in Babylon, Iraq.
Materials and Methods: The antibiotic susceptibility was measured using the disk diffusion method. These isolates
were previously identied using the VITEK-2 System. The presence of the yjaA and chuA genes was then detected using
specic primer pairs by polymerase chain reaction to phylogenetic E. coli B2.
Results: The total number of samples was 315, 210 (67%) positive growth and 105 (33%) showing no growth. Out of
210, 46 (22%) were E. coli. Out of 46 E. coli isolates, the percentage of B2 was 24 (52%). E. coli infection rate was 39 (85%)
in females and 7 (15%) in males. Ampicillin and cephalothin showed the highest resistance at 94%, while the antibiotics
Colstin and Nitrofurantoin exhibited the lowest resistance at 0% and 6%.
Conclusion: The study demonstrated that E. coli phylogenetics indicated that the most prevalent strain was B2. The
antibiotics colstin, Imipenem, and Nitrofurantoin showed the lowest resistance among other antibiotics, Beta-lactam
antibiotics, such as ampicillin and cephalothin exhibited the highest resistance among other antibiotics.

Background: Gingivitis is an in ammation of the gums often caused by bacterial infections related to dental plaque,
which forms a biolm on teeth and in uences oral health. The microbial composition in the mouth changes with
environmental factors and pH uctuations, impacting conditions like gingivitis, dental caries, and periodontitis. Saliva
plays a crucial role in maintaining oral pH, buffering acids, and containing antimicrobial agents. Epstein-Barr virus
(EBV), prevalent in the oral cavity, might affect periodontal health and systemic conditions.
Objectives: The study aimed to explore the connection between salivary pH levels and the presence of Epstein-Barr
virus (EBV) in individuals with gingivitis compared to healthy controls.
Materials and Methods: A total of 90 participants (60 gingivitis cases and 30 healthy controls) were recruited from the
Dental Specialized Center (Babylon) and the University of Babylon College of Dental. Saliva samples were collected
and processed for pH measurement using pH test strips. EBV detection was performed via polymerase chain reaction
(PCR) targeting the BNLF2a gene.
Results: The mean of pH values was 6.7 ± 0.78 for gingivitis patients and 7.1 ± 0.84 for controls, with no signicant
difference (p = 0.074). EBV was detected in all samples from both groups (patients and control), conrming a 100%
prevalence. Gel electrophoresis revealed distinct 121-bp bands of BNLF2a for EBV-specic PCR products in all samples.
Conclusion: This suggests a more acidic salivary pH may be associated with poorer periodontal health; the relationship
is complex and not solely dependent on pH levels. The study ndings on the prevalence of Epstein-Barr virus (EBV) in
both gingivitis patients and control samples emphasize the need to consider viral factors in periodontal disease.

Acute renal failure can be attributed to Contrast-Associated Nephropathy (CAN), which remains a threat due to
population variation and the increasing use of contrast media in various techniques. Thus, this review aims to discuss
the pathophysiology, factors and risk factors for CAN, measures for prevention, and approaches to its management. The
pathophysiology of CAN is extensive and encompasses various factors. Vasoconstriction and medullary hypoxia in the
renovascular bed area are crucial in the pathogenesis of CAN. Several contrast media can provoke the formation of free
radicals and reactive oxygen species (ROS), leading to oxidative stress, an in ammatory response, and enhancing renal
injury. Hypotoxicity to tubular cells and osmotic stress contribute to the damage caused by contrast agents. Further,
metabolic changes such as alterations in nitric oxide synthesis pathways and imbalances in antioxidant enzymes also
contribute to the cause of CAN. It is noted that when the concentration of contrast media is high and the glomerular
ltration rate is low, the condition is often seen in patients with compromised kidneys. The factors that predispose a
patient to CAN are compromised renal function, diabetes mellitus, the patient’s age, lack of adequate hydration, and the
administration of a high volume of contrast media. Possible measures involve managing these risks, promoting adequate
hydration, and avoiding unnecessary translational imaging whenever possible. Early diagnosis and management of
CAN components are crucial to decrease the risk of worsening renal dysfunction and other severe complications. This
may involve prescribing suitable medications such as intravenous uids, diuretics, and other nephroprotective drugs.
Further research and enhanced understanding of the mechanisms will advance the improvement of prevention and
treatment of this challenging condition. Collaborative care efforts among healthcare practitioners should enhance
decision-making to reduce the high risk associated with this severe condition