kerbala journal of pharmaceutical sciences

Etodolac, a chiral nonsteroidal anti-inflammatory drug (NSAID), is widely used for pain management and arthritis treatment. However, it suffers from various side effects, including gastrotoxicity and cardiovascular risks. This study investigated the potential of zinc oxide nanoparticles (ZnO NPs) as a delivery platform for etodolac to improve its efficacy and mitigate these adverse effects.
ZnO NPs possess several attractive properties for drug delivery applications, including low toxicity, biodegradability, and the ability to target specific tissues. In this study, etodolac was successfully loaded onto ZnO NPs, and the resulting nanocomposites were characterized using Fourier-transform infrared spectroscopy (FT-IR) and scanning electron microscopy (SEM).
FT-IR analysis confirmed the successful loading of etodolac onto the ZnO NPs. Additionally, SEM images revealed morphological changes on the surface of the nanocomposites compared to pure ZnO NPs, further indicating successful drug loading.
These findings demonstrate the feasibility of developing etodolac-loaded ZnO NPs as a promising approach for targeted drug delivery. Further studies are warranted to investigate the vivo efficacy and safety of these nanocomposites, paving the way for their potential clinical application.

The receptive patient and the bacterium serve as the two defining criteria for opportunistic bacteria. Theoretically, no saprophytic or typical commensal microbes can infiltrate a healthy receptive person. Only specific "undesirable" commensal species, "such as Vargues' Specific Pathogenic Bacteria", can infect this person. Several species from the typical commensal flora, or opportunistic bacteria in the wide meaning of the word, “may infiltrate an otherwise healthy host if their immune defences temporarily deteriorate”. Even species that were previously thought to be non-virulent may assault an immunosuppressed patient with a significant and protracted immune system depression, “including various saprophytic and commensal microbes”. Several bacteria that are typically found in water, food, and the air have recently become opportunistic pathogens in both people and animals. The issue is made more difficult by the introduction of many antibiotic-resistant strains of these opportunistic pathogens, which make hospital-acquired infections in susceptible hosts challenging to treat in the setting of illness.

Background: One of the leading causes of female infertility is polycystic ovarian syndrome (PCOS). Adiponectin is one of many adipokines adipose tissue releases that affect insulin resistance (IR).
Objective: To measure PCOS participants' IR, adiponectin, and serum insulin levels.
Materials and procedures: a case-control study involving 80 patients with PCOS (40 obese and 40 nonobese) and 80 controls (40 obesity and 40 nonobese). Adiponectin was measured using an enzyme-linked immunosorbent assay, while serum levels of insulin and FBS were measured using a chemiluminescent automated immunoassay system (ECL).
Results: Regardless of body mass index and PCOS, women had lower levels of adiponectin and higher levels of blood fasting glucose, insulin, and IR compared to the relevant with a p-value of ≤0.001 for controls.
Conclusion: According to weight, blood adiponectin levels inversely correspond to IR. It can, therefore, act as an indicator in PCOS-affected women.

Background: A chronic inflammatory process of the airways is a common characteristic of asthma, representing a primary health problem. This disease can infect people of all ages, about 3.5-20 % of the population, but it usually begins in childhood.
Objective: To evaluate the relationship between interleukin-15 and pediatric asthma severity.
Methods: The current study is a case-control study that includes 60 asthmatic participants as the patient group and 60 non-asthmatic participants as the control group. Sandwich ELISA using an ELISA kit can be used for the measurement of IL-15 and IgE serum levels.
Results: Elevated serum level of IgE in the patients group compared with a control group with significant (P= 0.005) was a result of this study, and there were no significant differences between patients and control about IL-15 serum levels with (P= 0.968) in asthmatic children.
Conclusions: According to the present study, there was a non-significant association between the severity of asthma and the serum level of IL-15 in children.

One of the main organs targeted by hypertension, which is now understood by science to be an inflammatory disease, is the kidney. Urinary microalbumin, serum blood urea nitrogen, and creatinine are examples of clinical biochemical indicators for kidney illness that are often employed. This study aimed to study the role of Urinary microalbumin as a marker of inflammation in hypertensive chronic kidney disease patients. Evaluate the association of Urinary microalbumin levels in chronic kidney disease with/without hypertension. Possible usage of this marker as a predictive index for regular kidney disease occurrence. A case–control study was conducted on 100 participants, including 48 individuals identified as male and 52 individuals identified as female; in addition, their ages ranged from (20 to 70), these 100 participants, including (35) chronic kidney disease patients with hypertension (35) chronic kidney disease patients without hypertension, and (30) healthy control group, were evaluated concerning Urinary Micro Albumin using an immunochromatographic test kit. The results illustrated that Urinary microalbumin, Urea and Creatinine in CKD with the HBP group showed a highly significant increase (p˂0.05) compared to the control group according to case/ control, sex and age. In contrast, the most negligible value was in the Control group.
In conclusion
The research findings indicate a correlation between hypertension and chronic kidney disease (CKD). The presence of hypertension resulted in elevated levels of Urinary microalbumin, urea, and creatinine in patients as compared to the control group. Urinary microalbumin has the potential to serve as a marker for the assessment of glomerular and tubular function in adults. It performs comparably to the Cr-based estimating equations as an indicator of renal function.

Background: Fibrocystic breast disease is the most typical benign breast disease, which is seen in women worldwide with features of pain and feeling of nodules. Its diagnosis is based on clinical symptoms, ultrasound, mammography, and in doubt cases, biopsy is indicated. For assessment of the breast, we clinically examined the breast, axilla, and both supra and infraclavicular regions for lymph node assessment, followed by ultrasound examination. Detection of lesions in any breast quadrant assessed by BI-RADs, Breast Imaging Reporting, and Data System grouped in five brackets. Scanning by sonography using B-mode and Doppler study was improved for detecting and characterizing benign and malignant lesions.
Objective: To assess a breast lesion by ultrasound with features suggestive of a benign or malignant nature.
Method: This study included 210 women aged 20 - 45 who visited a clinic from October 2020 to April 2022 and were examined by ultrasound machine Samsung HS50 (KOREA) with an LA3-14AD probe. B-mode images obtained detection of the lesion, and we also used Doppler ultrasound for assessment of the vascularity of the lesion. The BI-RADS system was used for the categorization of all findings.
Result: In 210 women, complaints of lumps were involved in our study. Imaging by B-mode ultrasound using the Doppler study assesses the vascularity of the lesion and provides more characterization of benign and malignant lesions. By B–mode imaging, 99 patients had regular ultrasound study, and 79 patients had simple cysts that appeared well defined, had familiar outlines, and had an anechoic rounded or oval shape with posterior enhancement. Twenty-eight patients with fibroadenoma visualized as round or oval-shaped hypoechoic lesions horizontally oriented to the planes of the breast with lateral shadowing. 2 patients had complex cysts that appear as well-defined, irregular outlines, rounded shape, a thick wall with internal echoes with posterior enhancement. 2 patients have a malignant lesion that appears ill-defined rough outline vertically oriented with breast planes and show posterior shadowing.
Conclusion:
Ultrasound was established as the most suitable imaging modality for the categorization of breast lesions and exclusion of malignancy, which is helpful for evading unnecessary biopsies.

The association of heart diseases with type 2 diabetes, especially myocardial infarction, calls for a search for biomarkers that have a relationship between the two. Which facilitates the process of reducing the development of myocardial infarction in patients with type 2 diabetes. The most prominent of these associations is long-term inflammation and its first and largest factor is interleukin 6, and its close association with A disintegrin and metalloprotease 17 (ADAM-17) and its inverse relationship with type 2 diabetic patients with and without myocardial infarction. This study aims to investigate the role of ADAM-17 in the pathogenesis of diabetic type 2 Iraqi men patients with and without MI by comparing them with a apparantely helthy as control group and to see their association with interleukin-6 levels and other biomarkers. The current study was conducted on 90 Iraqi men between Ja., 2023 and Aug. 2023, 60 samples with T2DM with or without MI and the remaining 30 as apparently healthy control. The patients were selected from the visitors of the coronary care unit (CCU) and Al-Hassan Center for Diabetes and Endocrinology in Kerbala, and they were diagnosed clinically and by laboratory investigations. Various biomarkers such as ADAM-17 and IL-6 have been determined by different biochemical techniques. As a result The highest ADAM-17 and IL-6 level in type 2 diabetes without myocardial infarction was seen as comparison serum levels of IL-6, and ADAM-17 for T2DM (with or without myocardial infarction) with the control group. The correlation between IL-6 and ADAM-17 is strong in type-2 diabetes without MI and between IL-6 and electrocardiogram represented by the two types STEM and NSTEMI in type-2 diabetes with MI. In conclusion, The current study found that ADAM-17 and IL-6 have a negative effect on chronic inflammation as in T2DM without MI is more severe than acute inflammation as T2DM with MI , du to elevation of ADAM-17 and IL-6 levels in type 2 diabetic patients without MI than type 2 diabetic patient with MI.

Introduction: Chronic renal failure CRF is a widespread, irreversible disease that develops gradually and is classified into five stages depending on the glomerular filtration rate GFR. Anemia is a considerable complication of CRF that becomes serious as GFR decreases, erythropoietin-stimulating agent ESA is used for treating anemia, but the resistance to it stands against its goal in many patients. Studying the genetic polymorphism in one of the erythropoietin-activated pathway store-operated calcium channels SOCs gene is a trial for investigating the cause of resistance.
Method: In this study, 174 subjects were included. Among 112 hemodialysis patients with CRF, 54.5% were non-responders, and the enrolled participants ranged from 20 to 79 years; a single nucleotide polymorphism in the ORAI1 gene was selected. Genotyping was done using an allele-specific polymerase chain reaction technique, and the data was analyzed through the Statistical Package for the Social Sciences.
Results: The results showed that hemoglobin levels differ significantly between the genetic groups, while erythropoietin levels showed no significant variation.
Conclusion: ORAI1 genetic polymorphism has no significant role in erythropoietin resistance in Iraqi hemodialysis patients with CRF, but this genetic variation significantly affects hemoglobin levels, depending on this study.

The COVID-19 pandemic has raised concerns about the impact of the virus on pregnant women and their unborn babies. This review aims to provide a comprehensive summary of the outcome of COVID-19 in pregnancy
Studies have shown that the possibility of developing severe illness increased in pregnant women compared with non-pregnant women infected with COVID-19. They have higher rates of ICU admission, mechanical ventilation, and mortality. Additionally, the risk of preterm birth has been increased in pregnant women infected with COVID-19, with several research reporting higher rates of preterm delivery among infected pregnant women.
Cesarean section delivery rates are also higher among pregnant women with COVID-19, possibly due to the need for expedited delivery in cases of severe illness or fetal distress. However, the transmission of the virus from mother to fetus is rare during pregnancy or delivery. The virus is transmitted vertically from mother to fetus, with most infants born to mothers with COVID-19 testing negative for the virus.
While vertical transmission is rare, there is evidence suggesting a potential impact of COVID-19 on fetal development. Some studies have reported cases of fetal growth restriction and abnormal placental findings in pregnant women with COVID-19. However, further research is needed to fully understand the long-term consequences.
Abbreviations: WHO: World Health Organization, SARS: Severe Acute Respiratory Syndrome, MERS: Middle Eastern Respiratory Syndrome, FIGO: International Federation of Gynecology and Obstetrics, ACE2: angiotensin-converting enzyme 2, TMPRSS2: primes the S protein using transmembrane serine protease 2, NK: natural killer, PDCs: plasmacytoid dendritic cells, TLRs: Toll-like receptors, DIC: disseminated vascular coagulopathy, CMV: Cytomegalovirus, HSV: herpes simplex virus, VZV: varicella-zoster virus, ZIKV: zika virus.
Conflict of interest
The author declared that they have no conflict of interest.

Ischemic heart diseases (IHDs), like coronary artery disease, remain a significant global health burden. While established risk factors such as low-density lipoprotein cholesterol (LDL) and hypertension are well-recognized, the role of triglyceride (T.G.) and high-density lipoprotein cholesterol (HDL-c) remains complex and multifaceted. This work was designed to examine the role of the T.G./HDL-c ratio in the IHD group and their effect on the effect of age, gender, and biomass index (BMI).
Method: A total of 90 samples, including 60 samples (30 male, 30 female) for the IHD patients group with an age range of 40-85 years, and 30 samples (15 male, 15 female) for the control group with matching age ranges, were randomly selected. Lipid profile parameters (HDL, LDL, VLDL, T.G., Cholesterol) were estimated according to Kit Shenzhen Mindray Bio—Medical Electronics—Germany's manual procedure. Then, the ratio TG/HDL-C was calculated.
Results: IHD patients illustrated a significant increase in the mean levels of all lipid profile panels, including [total cholesterol (T.C.), triglyceride (T.G.), LDL, and the ratio of T.G./HDL-c], except HDL, which was lower in patients group compared to the healthy control. The level of T.G./HDL-c was increased in IHD patients with increasing BMI associated with the healthy participants; it was also elevated in male IHD patients than in IHD female patients.
Conclusion: The ratio of T.G./HDL-c represents a valuable indicator for valuing IHD risk and personalized therapeutic approaches. Future research should delve deeper into the underlying mechanisms and refine strategies for effectively managing T.G./HDL-c for improved IHD prevention and management.
Key points:
•Elevated T.G./HDL-c ratio, rather than individual T.G. or HDL-c levels alone, emerges as a stronger predictor of IHD risk. This ratio reflects increased atherogenic lipoprotein burden (high T.G.) and impaired cholesterol efflux capacity (low HDL-c).
•Mechanisms underlying the adverse effects of high T.G./HDL-c involve:
•Increased inflammation and oxidative stress
•Remnant lipoprotein formation and plaque instability
•Impaired endothelial function and vascular relaxation
•Increased postprandial lipemia and triglyceride-rich lipoprotein accumulation
•Heterogeneity exists within both T.G. and HDL-c, further influencing IHD risk. Particle size and apolipoprotein composition of these lipoproteins play crucial roles.
•Therapeutic strategies targeting T.G./HDL-c should consider diverse mechanisms and individual patient profiles. Lifestyle modifications, lipid-lowering medications, and novel HDL-raising therapies hold potential.

Gestational diabetes mellitus (GDM) is a condition in which the ability of the mother's pancreatic β-cells to function properly is compromised. This leads to inadequate insulin production and, therefore, poor glucose regulation throughout pregnancy. In recent years, there has been a significant surge in interest in determining the impact of inflammation on the progression of GDM.
Inflammatory factors may function as antagonists to insulin and induce insulin resistance. Interleukin -6 (IL-6), a kind of cytokine, significantly impacts the development of glucose intolerance and may be used as a possible indicator in the blood for early detection of glucose intolerance. This study aims to assess the potential role of IL6 as a prospective diagnostic marker for Gestational Diabetes mellitus.
Our study is a case-control study started from September 2022 to June 2023 and enrolled 200 pregnant women aged between 15 and 45 years; cases included 100 patients selectively collected with a confirmed
diagnosis of gestational diabetes mellitus in Kerbala obstetrics and gynecology hospital, and the control group included 100 healthy pregnant women also gathered from the obstetrics and gynecology hospital in Kerbala governorate. Results show that the mean of Interleukin 6 was significantly higher in pregnant women with GDM, with p-values of 0.05 and 0.001. these results suggest that Interleukin6 (IL6) can be used as a prospective diagnostic marker for GDM.

Diabetes mellitus, a significant cause of mortality around the globe, can result in several secondary complications, including diabetic foot syndrome, which is brought on by diabetic neuropathy and ischemia. Approximately 15% of diabetic patients suffer from diabetic foot complications, which results in high rates of morbidity and mortality of people with Diabetes mellitus. The study's objective is to measure serum levels of IL-37, IL-38 & IL-17A in diabetic mellitus (type 1 & 2) patients with and without diabetic foot ulcer complications and in the control group as well as the possibility of using them as early biomarkers for diagnosis of diabetic mellitus complications & future prevention. Overall, of 193 participants included in this case-control study, they were divided into three groups: the first one contains patients with type 1 diabetes mellitus (29 with diabetic foot ulcer DFU+ 35 non-diabetic foot), the second group includes type 2 diabetes mellitus patients (41 with DFU + 38 Non). The third group includes (50) as apparently healthy controls. Serological techniques of sandwich ELISA did laboratory tests for specific serum human IL-37, IL-38, and IL-17A. The study revealed that IL-37 and IL-17A levels were significantly high (P<0.01) in all diabetic groups compared to the control healthy group. The results of IL-38 show substantially higher levels of T1DM and T2DM (P<0.05) compared to the control group. In addition, the DFU group of T2DM illustrated higher levels of IL-37, IL-38, and IL-17A compared with other diabetic groups.
In conclusion, Iraqi DM subjects with and without complications had higher values of interleukins, IL-37, IL-38, and IL-17A, than healthy controls, which suggests an inflammatory state in these patients. In addition, the DFU of T2DM patients expressed higher levels of interleukins than other diabetic groups. This can be focused on using them as novel therapeutic targets for preventing and treating DM complications. As well as the possibility of using them as markers of inflammation and progression for complications in DM patients.

Background: Lepidium sativum is a by-product remaining after the oil is extracted from Garden cress seeds. This herb is considered one of the popular medicinal herbs used in Arabian countries and has traditionally been used to control many clinical problems. The present study aims to uncover these seeds' free radical-scavenging properties and their Role in improving the testicular tissues and seminal properties.
Material and methods: Thirty-two sexually mature mice were used, and the treated groups were divided into three groups; the first one (G1) was treated with 0.1 ml of GC seed extraction in a dose of 5mg/kg BW, the second one(G2) was treated with 0.1 ml sodium nitrate as oxidant, and the last treated group (G3) was treated with 0.1 ml of GC seed extraction after one hour of injection of 0.1 ml sodium nitrate.
Results: The results showed improvement of the testicular tissue and a significant elevation in sperm viability, in addition to significant enhancements of RBC count and Hb concentration. By its Role as a free radical scavenger, sodium nitrate removed the negative effect on blood parameter values.

Background: Postpartum hemorrhage is a leading cause of maternal mortality and morbidity globally. The third stage of labor begins after the baby is born and ends with the delivery of the placenta. During this stage, the uterus needs to contract effectively to prevent excessive bleeding. Active Management of the Third Stage of Labor was introduced as a strategy to reduce the risk of postpartum hemorrhage. The study aimed to investigate nurses' knowledge of active management of the third stage of labor to control postpartum hemorrhage and investigate associated factors.
Results: The study examined participant characteristics, revealing an average age of 35.93 (SD=8.52). Around 65.0% of nurses in the study had graduated from preparatory nursing. Most nurses (56.7%) had 5-10 years of hospital experience. A majority (65.0%) worked in postpartum areas. Over half (58.3%) had 4-6 years of experience without training. The study evaluated nurses' knowledge of active management of the third stage of labor, with responses on a scale ranging from 37-64. The overall expertise indicates that 75.0% of nurses needed a better understanding. The results highlighted that factors like nurses' education level (p= .024) and training courses (p= .041) predicted their knowledge of active management of the third stage of labor.
Conclusions: The study found that nurses' knowledge of active management of the third stage of labor varied, overall indicating a poor understanding of nurses. The results highlighted significant predictors of this knowledge, including education level and participation in training courses. To enhance nurses' proficiency in active management of the third stage, it is recommended to focus on targeted educational programs and regular training opportunities.

Background: COVID-19 is a disease caused by SARS-CoV-2 that can cause respiratory infections. It may affect the sinuses, the upper airways of the nose and throat, or the lower airways of the trachea and lungs. Infections range from mild to deadly. Older people and people of all ages with medical comorbidities such as hypertension and diabetes may have a poorer prognosis and be at greater risk for hospital and intensive care unit admissions.
Objectives: The present study aimed to determine the effects of pre-COVID-19 comorbidities on the progression of disease severity and outcome in Iraqi patients.
Method: This descriptive cross-sectional study was carried out on COVID-19 patients using an online electronic questionnaire in Google form all over Iraq from September 2021 to July 2023. The total number of participants was 789, of whom approximately 282 were excluded, and the net was 507; they received an online questionnaire,
The questionnaire literature review was completed after debuting in Arabic after a thor. This self-administered questionnaire consisted of 15 closed-ended questions and six open questions.
Result: < 40 was the highest group affected by COVID-19, and those> 60 years were the most minor group involved. Females are affected more than males. Most of the cases were from the middle region of Iraq. 87.8% of participants have no smoking history. Fever, headache & fatigue were the most prevalent symptoms of patients. Past medical history of hypertension presented in 11.8% of patients, while diabetes mellitus represented 9%, asthma 5.5%, and cardiovascular diseases 4.9%. Other comorbidities were present in lower percentages. The history of hospitalization was positive in 37 patients with past medical comorbidities. Of those patients who were admitted to the hospital, 18 required Intensive care unit admission. Among them, 7 had hypertension, 4 had asthma & 3 had diabetes mellitus. Steroid treatment was given to 9% of patients with COVID-19.
Conclusion: The need for hospitalization and Intensive care unit admission was higher among COVID-19 patients with comorbidities, especially hypertension, followed by diabetes, then asthma, and cardiovascular diseases.