IRAQI JOURNAL OF MEDICAL SCIENCES

In virology, the term ‘virome’ refers to commensal viruses that typically replicate and persist within healthy individuals, without causing harmful effects to the host; this concept is familiar to microbiologists. Torque Teno Virus (TTV) is one of common commensal viruses which is very ubiquitous in the environment and infects both humans and animals. Multiple modes of transmission of TTV enhance the spreading of these viruses within ecosystems and infect new hosts. Recently, TTV has emerged as a promising biomarker for medical and environmental applications. This review article examines the widespread presence of the TTV and discusses its potential as a biomarker for exciting future uses. Also, explore the extensive global distribution of TTV, highlighting the intriguing variations in its frequency observed across diverse populations. By inspecting the factors contributing to these disparities, including geographical location, and host demographics, this review sheds light on the enigmatic nature of TTV’s prevalence.
Keywords :Torque Teno Virus, Virome, Biomarker
Citation: Salman MH, Al-Shuwaikh AM. From virome to biomarker: Insights into the role of Torque Teno virus in health and ecosystems. Iraqi JMS. 2025; 23(2): 190-199. doi: 10.22578/IJMS.23.2.1

Background: Melasma is a skin condition that disrupts the skin on the face. Tyrosinase enzyme (TYR) increase and decrease the antioxidants naturally produced in the body, leading to melasma. TYR is a key enzyme in melanogenesis. Tyrosinase\'s various mechanisms are enhanced by genetic, environmental, and endocrine factors.
Objective: To investigate the relationship between serum TYR enzyme levels and the severity of melasma as a biomarker for diagnosis and treatment.
Methods: A case-control study was executed during the term of March to October 2023. The study included 60 patients with melasma and 60 control participants, all female, ranging in age from 20 to 50 years. All participants were examined using Wood\'s light. Blood samples were collected from each individual, and sera were used after separation to measure TYR by enzyme-linked immunosorbent assay (ELISA) method levels in different stages of melasma severity.
Results: Increased concentration TYR with different stages of severity (7.36±0.19 U/ml) compared to the control (3.89±0.08 U/ml) utilizing an independent t-test. Additionally, the serum TYR levels significantly increased as the severity of melasma increased. Furthermore, the one-way ANOVA test indicated substantial serum TYR level and melasma area and severity index (MASI) scores for mild, moderate, and severe were 6.19±0.1 U/mL, 7.69±0.07 U/mL, and 9.38±0.31 U/mL, respectively. These results strongly suggest that TYR plays a crucial role in the formation and progression of melasma.
Conclusion: The result of this study refers to a significant correlation between the level of TYR and the degree of melasma.
Keywords: Melasma, Tyrosinase enzyme, melanogenesis, MASI score, ELISA
Citation: Muhsen SA, Alwasiti EA, Farhood IG. Exploring the correlation between tyrosinase enzyme levels and the severity of melasma in women: A case-control study in Baghdad. Iraqi JMS. 2025; 23(2): 200-206. doi: 10.22578/IJMS.23.2.2

Background: Psoriasis is a protracting disorder of the skin that is immune mediated with a prolapsing characteristic making it difficult to fully treat.
Objective: To investigate the effect of Myricetin in Imiquimod induced-psoriasis in mouse model and its possible therapeutic effect.
Methods: Twnety-eight albino mice were randomly divided into 3 groups, 1st group involved healthy mice did not receive any medication, 2nd group (induction group) received only topical Imiquimod, and the 3rd group involved mice that received a topical Myricetin 10% ointment. All the mice received the test substances on the shaved back for 7 consecutive days and scoring for skin inflammation severity (scaling, erythema and thickness) was recorded on daily basis, and the animals were sacrificed on day 15. Skin samples were collected to evaluate the histopathological scores (Baker's and Psoriasis area and severity index (PASI), in addition to measurement of tissue inflammatory biomarkers Interleukin (IL)-10, IL-17, tumor necrosis factor- alpha (TNF-α) and vascular endothelial growth factor (VEGF) by enzyme-linked immunosorbent assay (ELISA).
Results: Psoriasis induction was successful by Imiquimod, and psoriasis like lesions developed on the skin and decreased the IL-10 and increased levels of other studied biomarkers. Topical Myricetin showed a significant increase in IL-10 levels (P <0.001) and a significant reduction in TNF-α (P <0.001), VEGF (P <0.05) and IL-17 levels (P <0.001). There was also a significant reduction in Baker's score and PASI.
Conclusion: Topical Myricetin possesses anti-psoriasis activity and could be used successfully for the alleviation of psoriatic symptoms and further studies of the skin inflammatory diseases.
Keywords: Myricetin, Imiquimod, interleukin-10, interleukin-17, tumor necrosis factor-alpha, vascular endothelial growth factor
Citation: Almudaris SA, Gatea FK. Effects of topical Myricetin on imiquimod induced psoriasis in mice model. Iraqi JMS. 2025; 23(2): 207-221. doi: 10.22578/IJMS.23.2.3

Background: The Gamma Knife (GK) is a radio surgical method to treat malignant and benign brain tumours, atrioventricular malformations (AVM), and functional disorders.
Objective: To investigate the tumor shrinkage after six months of GK with hypofractionation.
Methods: A study at Dr. Saad Al-Witry Hospital for Neurosciences and Al-Altaj Hospital involved 50 patients with large brain tumors. Each patients underwent a magnetic resonance imaging and computed tomography images before and after treatment.
Results: The mean dose distribution was higher in metastasis. After irradiation, gliosis around the tumor was observed, with 86% showing a positive response to radiation treatment. The results of tumor shrinkage were classified according to the number of treatment fractions, with highly significant shrinkage observed in those treated in three fractions and those treated after four fractions.
Conclusion: The hypo fractionated GK appears to be a viable and effective method of treating various brain tumors that are benign or malignant. The method has a favorable outcome that involves both a decrease in tumor size and a minimum of side effects.
Keywords: Large brain tumor, volumetric change, gradient index (GI), gamma knife, stereotactic
Citation: Kadhem MH, Ahmed RS, Hamandi YMH. Assessment of large tumor shrinkage using hypofractionated gamma knife radiosurgery. Iraqi JMS. 2025; 23(2): 222-228. doi: 10.22578/IJMS.23.2.4

Background: Chronic kidney disease (CKD) has emerged as a prominent cause of mortality, following cardiac disease and cancer, exhibiting a substantial surge over the past two decades. One biochemical indicator that reflects cellular damage is lactate dehydrogenase (LDH), a key intracellular enzyme involved in the interconversion of pyruvate and lactate during glycolysis. Under normal conditions, LDH remains confined within cells; however, tissue damage can lead to its release into the bloodstream, resulting in elevated serum levels.
Objective: To assess the LDH in CKD patients compared with healthy control.
Methods: A total forty (40) patient with CKD were studied among them twenty (20) female and twenty (20) male patients and forty (40) healthy as controls, of them were eighteen (18) females and twenty-two (22) males. Their ages (patients and controls) were ranged from (18-70). Blood samples were collected from patients and control to evaluate serum levels of serum LDH and evaluate the routine markers (urea, creatinine, alanine aminotransferase (ALT), aspartate aminotransferase (AST), and this was done by spectrophotometry.
Results: This result showed the LDH levels in the patients were significantly higher (224.64±113.39 U/L) than in the control group (176.26±38.99 U/L) (P = 0.014). ALT and AST levels in the patients were lower than in the control group, but the difference was not statistically significant for ALT (P = 0.132) and was significant for AST (P = 0.03). The urea, and serum creatinine levels in the patients were all significantly higher than in the control group (P <0.001).
Conclusion: Serum LDH levels were significantly elevated in CKD patients undergoing hemodialysis compared to healthy controls, suggesting that LDH may serve as a useful biomarker for tissue damage and disease severity in patients with CKD.
Keywords: Chronic kidney disease, lactate dehydrogenase, hemodialysis.
Citation: Saleem AA, Hamza MI. Investigating serum LDH in Iraqi patients undergoing dialysis for chronic kidney disease. Iraqi JMS. 2025; 23(2): 229-236. doi: 10.22578/IJMS.23.2.5

Background: The second leading cause of cancer-related death globally, colorectal cancer (CRC) is the malignant neoplasm with the third highest diagnosis rate. It is the primary cause of cancer-related morbidity and mortality in Iraq and ranks second in terms of frequency of death after cardiovascular disorders. An inflammatory cytokine called tumor necrosis factor-alpha (TNF-α) plays a critical role in the immune response and may contribute to CRC development. Patients with CRC who had elevated serum levels of C-C motif chemokine ligand 3 (CCL3) had a worse prognosis than those who had low levels of this chemokine.
Objective: To evaluate the role of TNF-α and CCL3 in CRC patients by assessing the serum level estimation of TNF-α and CCL3 in addition to the demographic data analysis.
Methods: The study has been approved by the College of Medicine, Al-Iraqia University and included 100 samples from male and female patients from the Medical City, Al-Imamein Al-Kadhimein Medical City, Al-Amal Hospital, and also from Al-Bilad Private Hospital suffering from problems in the colon and rectum. The study lasted for five months (from November 2023 until March 2024). The participants were divided into 2 groups: the 1st one contained CRC patients, while the 2nd contained colorectal problems other than CRC. Five ml of blood was taken from each participant for estimation of TNF-α and CCL3 serum level by using enzyme-linked immunosorbent assay. Demographic data were collected from the study participants (such as age, gender, address, and medical history). Ten samples were discarded due to hemolysis.
Results: The serum levels of TNF-α and CCL3 in CRC patients showed a higher significant difference (P <0.05) compared with the 2nd group.
Conclusion: TNF-α and CCL3 significantly appeared as indicators for the progression of CRC cancers.
Keywords: TNF-α, CCL3, colorectal cancer
Citation: Abdulhamid AQ, Abdullah AR. The role of tumor necrosis factor-alpha and C-C motif chemokine ligand 3 serum levels in some Iraqi colorectal cancer patients. Iraqi JMS. 2025; 23(2): 237-245. doi: 10.22578/IJMS.23.2.6

Background: Both natriuretic peptides, NPs (BNP and CNP), and neutrophil gelatinase-associated lipocalin (NGAL) were reported to rise in chronic kidney disease (CKD) and type2 diabetes mellitus (T2DM). Their role in detecting and follow up of these two diseases has been well elucidated.
Objective: To evaluate the use of a combination of NPs and NGAL in detecting renal insufficiency (per se) or early diabetic nephropathy.
Methods: The study included 40 patients with CKD (mean age 50.63±9.25 years), 41 patients with T2DM (mean age 53.66±8.32 years) and 38 apparently healthy normal subjects (mean age 52.42±8.81 years) as controls. Natriuretic peptides, and NGAL were measured by enzyme linked immunosorbent assay (ELISA), and glycated hemoglobin (HbA1c) by fully automated boronate affinity assay. Renal function tests, glucose, and electrolytes were estimated by routine laboratory methods.
Results: There was an increase in NGAL, N-terminal pro-C-type natriuretic peptide (NT-proCNP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) in both groups of patients. The HbA1c was high in the T2DM group only. Receiver operating characteristic (ROC) curve revealed good sensitivity and specificity when using NGAL and NT-proBNP to discriminate between CKD and T2DM or between CKD and controls, or T2DM and controls.
Conclusion: Combined use of NGAL and NT-proBNP in T2DM may be a better diagnostic marker for an early deterioration in renal function of diabetes mellitus than the HbA1c level alone.
Keywords: Natriuretic peptides, neutrophil gelatinase-associated lipocalin, glycated hemoglobin, renal failure, diabetes mellitus
Citation: Al-Shamma GA, Malik AS, Al-Mayah QS, Kurshead RS. Significance of combined use of natriuretic peptides and neutrophil gelatinase-associated lipocalin for diagnosis of renal failure and type 2 diabetes mellitus. Iraqi JMS. 2025; 23(2): 246-254. doi: 10.22578/IJMS.23.2.7

Background: Osteoporosis is characterized by low bone mass and micro-architectural deterioration.
Objective: To measure a quantitative magnetic resonance imaging (MRI)-based score (M-score) for the diagnosis of abnormal bone mineral density in postmenopausal female and compare the results with standard control taking dual-energy x-ray absorptiometry (DEXA) scan measurements as a reference.
Methods: This case-control study was conducted with 50 postmenopausal females who underwent DEXA exam for back pain. Another 50 healthy young females aged 20-29 years were used as a control group, and an MRI of the lumbar spine was done to all participants. From sagittal T1-weighted spin-echo sequence, Signal to noise ratio of L1-L4 was measured to all patients and controls and used to obtain M-score.
Results: DEXA revealed that 19 patients had a normal T-score, 14 patients had osteopenia, and 17 patients had osteoporosis (mean T score -1.737), M-score were significantly higher among cases than controls (P = 0.0001). The SNR L1–L4 and M-score are negatively correlated to T-score (r = -0.864; P = 0.0001) and bone mineral density (BMD) (r = -0.863; P = 0.0001). The receiver operator characteristic (ROC) analysis revealed an M-score threshold of 2.63434 with 88.2% sensitivity and 78.8% specificity (P = 0.0001) for the discrimination of osteoporotic from non-osteoporotic females. For distinguishing normal from low-BMD patients, the ROC curve estimated an M-score threshold of 1.34413 with 100% sensitivity and specificity (P = 0.0001). According to the calculated M-score, 19 patients were normal (M-score <1.334), 9 patients found to have osteopenia (M-score 1.334 - 2.634), and 22 osteoporotic patients (M-score >2.634).
Conclusion: M-score obtained from T1WI sequence of lumbar spine study is a useful quantitative method for the diagnosis of osteoporosis and osteopenia in postmenopausal females as compared to DEXA scan. The best cut off value for osteoporosis is 2.634. The best cut off value for osteopenia is 1.344.
Keywords: Lumbar spine MRI, postmenopausal women, bone mineral density
Citation: Mudhahir DA, Kadhim MA. Lumbar spine MRI signal intensity measurements in the assessment of abnormal bone mineral density in postmenopausal women. Iraqi JMS. 2025; 23(2): 255-263. doi: 10.22578/IJMS.23.2.8

Background: Toll-like receptor 4 (TLR4) is a pattern recognition receptor involved in the innate immune response, capable of recognizing certain molecular patterns found in bacteria and viruses, including the severe acute respiratory syndrome coronavirus 2 (SARS–CoV2) virus responsible for Corona virus disease 2019 (COVID-19).
Objective: To investigate the potential relationship between the severity of COVID-19 and a specific genetic variation in the TLR4 gene known as Thr399Ile.
Methods: A cross-sectional study conducted on 90 patients with COVID-19 in Baghdad. The researchers genotyping of Thr399Ile polymorphism in DNA extracted from blood samples of patients was done using polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) analyses.
Results: Two genotypes were found CC and CT, and no patients exhibiting the TT genotype. The CC genotype was associated with a DNA fragment size of 407 base pairs, while the CT genotype showed a size of 378 + 29 base pairs. In the non-severe infection group, the CC genotype frequency was 95.55%, while the CT genotype frequency was 4.44%. In the severe infection group, the CC genotype frequency was 93.33%, and the CT genotype frequency was 6.66%. This indicates no significant association between Thr399Ile polymorphism and COVID-19 severity. Thr399Ile mutant allele frequency among the 90 COVID-19 patients was found to be 5.5% (5 out of 90).
Conclusion: Functionally effective Thr399Ile polymorphism of TLR4 gene have apparently no influence on the individual susceptibility for COVID-19 severity infection.
Keywords: COVID-19, TLR4, Thr399Ile polymorphism, mutant allele frequency.
Citation: Jaber MF, Khudhair AM. Thr399Ile Polymorphism of toll-like receptor 4 gene and COVID -19 severity in samples of Iraqi patients: Baghdad province. Iraqi JMS. 2025; 23(2): 264-271. doi: 10.22578/IJMS.23.2.9