IRAQI JOURNAL OF MEDICAL SCIENCES

Asymmetric dimethyl arginine, symmetric dimethyl arginine and uromodulin used as early biomarkers of diagnosis renal diseases. The early stages side effects of inveterate kidney malady are ordinarily not clear. Noteworthy decrease of the kidney work is the primary self-evident sign of infection. On the off chance that analyzed early stages 1 to 3, the movement of unremitting kidney infection can be changed and complications diminished. In stages 4 and 5 broad kidney harm is watched, which as a rule comes about in end-stage renal disappointment.
Keywords:Symmetric Dimethyl arginine, uromodulin and kidney
Citation:Ali NM. Asymmetric dimethyl arginine and uromodulin in the chronic kidney disease. Iraqi JMS. 2019; 17(3&4): 166-167. doi: 10.22578/IJMS.17.3&4.1

Background:The incidence of mortality and complications are high in patients with acute inferior wall ST-segment elevation myocardial infarction with right ventricular involvement, which has been reported to be an independent predictor of significant complications and in-hospital mortality.
Objective:To investigate the feasibility of using electrocardiographic changes in inferior myocardial infarction represented by ST-segment elevation ratio in lead II and III as a predictor of right ventricular infarction and in-hospital morbidity and mortality.
Methods:Ninety-nine patients were studied in this prospective study, their ages ranged from 19-90 years, average 58.12 (±12.7 SD). They were presented to the Coronary Care Unit of Basrah General Hospital with acute inferior ST-segment elevation myocardial infarction. The 12 leads plus right-sided precordial electrocardiograms were done to all patients within 12 hours of the onset of symptoms, and ST-segment elevation was measured. ST-segment elevation in lead III exceeding lead II was defined as a ratio of elevation in lead III: II>1. Patients grouped according to ST-segment elevation III:II ratio into either >1 or ≤1. In-hospital morbidity and mortality were studied in both groups.
Results:ST-segment elevation ratio > 1was detected in 68 patients (68.7%) with acute inferior myocardial infarction at time of admission. Right ventricular infarction was diagnosed in 33 (33.3%) patients, with the majority (32 patients) have ST-elevation ratio > 1. Thirty-Six patients had at least one of the in-hospital complications with significantly higher incidence (51.4%) in patients with higher ST elevation ratio. The mortality was statistically higher when ST segment elevation level in the lead III > than that in the lead II.
Conclusion:In patients with inferior STEMI, ST-segment elevation in the lead III more than lead II can be a potential marker of the presence of right ventricular infarction in association with inferior myocardial infarction. Short-term prognosis is possibly worse in the presence of a higher ratio between lead III and II ST-segment elevation. However, further studies are needed to validate this conclusion.
Keywords:Inferior MI, right ventricular infarction, ST-segment changes
Citation:Al-Mansouri LA, Al-Obaidi FR, Al-Humrani AH. Higher ST-Segment elevation in lead III than lead II in acute inferior myocardial infarction can be a predictor of short-term morbidity and mortality. Iraqi JMS. 2019; 17(3&4): 168-174. doi: 10.22578/IJMS.17.3&4.2

Background:Type-1-diabetes (T1D) also known as insulin-dependent diabetes mellitus (IDDM) or juvenile onset diabetes results from the progressive destruction of pancreatic beta cells resulting in insulin deficiency. Genetic factors are thought to be a major component for the development of T1D. The studies on the risk of developing T1D suggesting that the environmental factors, particularly viruses may be implicated in the initiation of beta cell destruction leading to T1D.
Objective:To investigate the possible relationship between Epstein-Barr virus and T1D.
Methods:The sera were collected from 56 T1D patients and 30 controls of age range 3-22 years old and from both sexes. The sera divided into two parts, one part for serology for detection anti-EBV EBNA-1 IgM and IgG antibodies by enzyme linked immunosorbent assay (ELISA) technique and the other for viral genomic extraction and conventional polymerase chain reaction (PCR) to detect the viral target gene.
Results:The results by ELISA technique indicated that only 7 (12.5%) of T1D patients were positive for anti-EBV IgM antibody and 24 (42.9%) of T1D patients showed positive results for anti-EBV IgG antibody. In contrast, the control group showed negative results for both anti-EBV IgM and IgG antibodies. The results of PCR technique revealed that 15 (26.79%) of T1D patients have EBV DNA compared with none of the controls have EBV DNA (P<0.001).
Conclusion:EBV infection may contribute to the pathogenesis or progression of T1D.
Keywords:EBV, Type 1 Diabetes Mellitus, ELISA, PCR
Citation:Mohammed AH, Sabr AI. THE possible association between Epstein-barr virus and type 1 diabetes mellitus. Iraqi JMS. 2019; 17(3&4): 175-182. doi: 10.22578/IJMS.17.3&4.3

Background:Normal pregnancy requires that the physical integrity of the fetal membranes be maintained until term delivery.
Objective:To detect preterm prelabour rupture of membrane in pregnant women with history of watery vaginal discharge by measurement of placental alpha microglobulin 1 in cervicovaginal fluid.
Methods:A case-control study done at the department of Obstetrics and Gynecology of Al-Imamein Al-Kadhimein Medical City, included 100 pregnant women attending the Outpatient Clinic with a gestational age ranging between 28-36 weeks +6 days, 50 cases with rupture of membrane (study group) and 50 cases without any complaint (control group). All women underwent sterile speculum vaginal examination then nitrazine paper used, finally placental alpha microglobulin1 level was measured by using enzyme linked immunosorbent assay kit in vaginal washing fluid.
Results:A highly significant association was found between mean of placental alpha microglobulin 1 in vaginal fluid of women with premature rupture of membrane compared to the control. The validity results of placental alpha microglobulin 1 findings regarding premature rupture of membrane include: sensitivity (100%), specificity (98.0%), +ve predictive value (98.1%), -ve predictive value (100%) and accuracy (99.0%), while for nitrazine; the sensitivity (94.0%), specificity (90.0%), +ve predictive value (90.4%), -ve predictive value (93.7%) and accuracy (92%) and for vaginal fluid sensitivity (80.0%), specificity (72.0%), +ve predictive value (74.1%), -ve predictive value (78.3%) and accuracy (76.0%).
Conclusion:The placental alpha microglobulin-1 immunoassay in vaginal fluid wash found to be accurate and noninvasive test, in identifying preterm prelabour rupture of the membrane.
Keywords:Placental alpha-microglobulin1, preterm prelabour rupture of membrane, prelabour rupture of membrane
Citation:Seger SH, Al-Moayed HA, Abdulrasul EA, Mushatat SH. Placental alpha-microglobulin 1 as a marker of preterm prelabour rupture of membrane. Iraqi JMS. 2019; 17(3&4): 183-190. doi: 10.22578/IJMS.17.3&4.4

Background:Staphylococci are a group of bacteria that cause diseases ranging from minor skin infections to life-threatening bacteremia. Biofilm formation was determined by a number of methods and is available to detect the capability of staphylococci to colonize the biomedical devices. The icaA and icaD have been reported to play a significant role in biofilm formation.
Objective:To achieve and detect the molecular basis of adhesion properties in respect to methicillin resistant Staphylococcus aureus.
Methods:Clinical samples were taken from Burn patients; identified and Methicillin susceptibility was tested. The genes icaA and icaD were amplified in methicillin resistant Staphylococcus aureus and the polymerase chain reaction products were sequenced and aligned with the previous recorded sequences online.
Results:There was a great correlation between the presence of icaD genes and the slime production. Methicillin resistant Staphylococcus aureus did not reveal any correlation between icaA and icaD and slime layer production; nonetheless, a correlation was noticed between icaD alone and a biofilm production
Conclusion:The present findings indicated that methicillin resistant Staphylococcus aureus was able to form biofilm. None of the methicillin resistant Staphylococcus aureus isolates harboured icaA; while 100% of them contained icaD.
Keywords:Methicillin resistant Staphylococcus aureus, icaA, icaD gene
Citation:Mohamad DA. Molecular study of biofilm production by methicillin resistant Staphylococcus aureus. Iraqi JMS. 2019; 17(3&4): 191-200. doi: 10.22578/IJMS.17.3&4.5

Background:One of the commonest genetic subtypes of acute lymphoblastic leukemia (ALL) is t (12;21) (ETV6/RUNX1) being associated with favorable prognosis and distinctive clinical and pathological features. There are few studies about this abnormality in Iraq.
Objective:To detect the expression ETV6/RUNX1 fusion gene in B-ALL pediatric patients by using FISH technique.
Methods:This cross-sectional study was conducted from April 2018 to September 2018. Forty-eight newly diagnosed children with B-ALL were enrolled in this study. Fresh peripheral heparinized blood sample (3 ml) were taken from the patient at admission before chemotherapy, and ETV6-RUNX1 probe was applied and reading done by florescent microscope.
Results:The mean age of study group was (4.01±0.19) years, their median age was 4.1 years, ranging between (2-7.2) years at diagnosis, ETV6/RUNX1 chimeric transcript product was found in 19 of 48 (39.6%) pediatric B- ALL patients.
Conclusion:The frequency of investigated translocation [t(12;21)/ETV6/RUNX1 in a sample of Iraqi pediatric B-ALL patients, was among the higher reported frequencies worldwide, and that ETV6/RUNX1 fusion gene is independent prognostic factor not related to other hematological and clinical parameters.
Keywords:ETV6/RUNX1 fusion gene, pediatric ALL, FISH
Citation:Mahdi YM, Hameed BM, Mahmood FM, Qassim KW, Al-Mamoori HS. Detection of ETV6/RUNX1 fusion gene using FISH technique detection in pediatric all patients. Iraqi JMS. 2019; 17(3&4): 201-206. doi: 10.22578/IJMS.17.3&4.6

Background:Human cytomegalovirus (HCMV) reactivation is one of the most risks that occur in immunosuppressed patients. The association and role of CMV and inflammatory bowel disease (IBD) exacerbation is still controversy.
Objective:To investigate the rate of occurrence and role of HCMV in patients with IBD including demographic and clinical features.
Methods:A cross sectional study involved sixty-five (65) IBD patients whom divided into 9 Crohn’s disease patients and 56 ulcerative colitis patients. The detection of local CMV reactivation (colon) was based on the presence of early and immediately early antigens (nonstructural proteins). The positive results for HCMV reactivation was considered according on Immunohistochemistry (IHC) and/or serological enzyme linked immunosorbent assay (ELISA) results.
Results:Among the 65 eligible IBD patients, nine patients (13.85%) gave positive result for IHC, compared to 56 patients (86.15%) with negative result. On the other hand, only two patients (3.08%) had a positive result for anti-HCMV IgM antibody, while almost all patients (except one) were positive for anti-HCMV IgG antibody. There was a significant difference between positive HCMV and patients with long duration of IBD and non-response to treatment.
Conclusion:IBD and its treatment may put those patients at risk of HCMV reactivation. Colonic active CMV was detected particularly in sever UC patients and significantly in patients with disease duration above 5 years and not response to treatment based on IHC technique for IE and E HCMV proteins detection.
Keywords:Cytomegalovirus, inflammatory bowel disease, ulcerative colitis, Crohn's disease, immunohistochemistry
Citation:Fadhil AH, Kadhim HS, Hussain RJ, Al-Atrooshi SA. The possible role of HCMV in inflammatory bowel diseases in sample of Iraqi patients. Iraqi JMS. 2019; 17(3&4): 207-214. doi: 10.22578/IJMS.17.3&4.7

Background:In prediabetes, neither individuals having diabetic range nor normal glycemic parameters in terms of fasting plasma glucose, impaired glucose tolerance or glycated hemoglobin. Two-thirds of those with prediabetes will ends eventually with type 2 diabetes. Early detection with the proper intervention will halt or reverse this progression. Data about prediabetes prevalence in Iraq are scarce.
Objective:To estimate the prevalence of prediabetes among adults in Baghdad/Iraq and to identify socio-demographic and associated risk factors among the studied population and to evaluate glycated hemoglobin in the detection of prediabetes.
Methods:This cross-sectional study enrolled adults (20-79 years) attending primary health care centers in Baghdad/Iraq for one year, those with known diabetes or on anti-diabetic drugs, pregnant women and those with other medical conditions that interfere with glycated hemoglobin level were excluded from the study. Data collected through direct interview. Anthropometric measurements and laboratory analysis after overnight fast were done to measure fasting plasma glucose, glycated hemoglobin and lipid profile.
Results:Prediabetes prevalence was 20.6%. Prevalence was higher in older people (40-60 years) and individuals with overweight, obesity, and dyslipidemia, the agreement between fasting plasma glucose and glycated hemoglobin was very good.
Conclusion:Prevalence of prediabetes in Iraq is higher than estimated and share the same risk factors to those with type 2 diabetes. Glycated hemoglobin compared to fasting plasma glucose, is a reliable test to screen for prediabetes in Iraq.
Keywords:Prediabetes; intermediate hyperglycemia; glycated hemoglobin; Iraq
Citation:Alogaily MH, Alsaffar AJ, Hamid MB. Prevalence of prediabetes among adults in Baghdad/Iraq. Iraqi JMS. 2019; 17(3&4): 215-222. doi: 10.22578/IJMS.17.3&4.8

Background:Undescended testis is one of the most common malformations seen in the field of pediatric surgery. The most problematic aspect of undescended testis is the diagnosis and treatment of nonpalpable testis. Laparoscopy has been widely used for the diagnosis and treatment of nonpalpable testis.
Objective:To evaluate the role of laparoscopy in the diagnosis and treatment of unilateral nonpalpable undescended testis.
Methods:This is a prospective study carried out in the period from December 2012 to December 2017 in the Pediatric Surgery Department of a tertiary hospital in Baghdad. We used laparoscopy in the diagnosis and treatment of 40 patients aged between one and 12 years (median age 4.9 years) with unilateral nonpalpable undescended testis. Boys with a palpable testis at any point were excluded from the study. Surgical procedure was individualized according to the laparoscopic findings either by one stage laparoscopic orchiopexy, two stage Fowler-Stephens procedure or laparoscopic orchiectomy.
Results:Laparoscopy was able to diagnose the site of the nonpalpable testes in all the patients. Out of 40 nonpalpable undescended testes, 26 testes (65%) were intra-abdominal (12 testes were low intra-abdominal, 14 testes were high intra-abdominal). In 9 patients, (22.5 %), the vas deferens and spermatic vessels were found entering the internal inguinal ring. In 3 patients, (7.5 %), the testes were vanishing, and the testes were absent in 2 patients (5%). All patients with low intra-abdominal testes (n=12) were subjected to one stage laparoscopic orchiopexy through the normal inguinal ring. Out of 14 patients with high intra-abdominal testes, 7 patients underwent two staged Fowler-Stephens laparoscopic procedures, while three patients were treated by laparoscopic Prentiss maneuver and the remaining 4 patients underwent immediate laparoscopic orchiectomy due to presence of an atrophied testis. Patients with the vas deferens and spermatic vessels entering the internal inguinal ring (n=9) were treated by orchiopexy via conventional inguinal approach.
Conclusion:Laparoscopy for unilateral nonpalpable testis has an excellent diagnostic yield combined with high success rate following repair.
Keywords:Laparoscopy, nonpalpable undescended testis, Fowler-Stephens procedure
Citation:Zain AZ, Mohammed NH, Fadil SZ, Abdul-Hassan BA. Efficacy of laparoscopy in the management of unilateral nonpalpable testis. Iraqi JMS. 2019; 17(3&4): 223-230. doi: 10.22578/IJMS.17.3&4.9

Background:Atopic dermatitis is a chronic inflammation of skin disease that is characterized by recurrent acute pruritus and dry skin. Mostly, atopic dermatitis is predominant in young children. The problems of increasing prevalence and high impact of disease on quality of patients and family's life, necessities identifying many atopic dermatitis prevention planes.
Objective:To determine the effect of Artemisia annua flavonoids fraction in comparison with tacrolimus in atopic dermatitis like mice model.
Methods:This study is a prospective, randomized, placebo and controlled animal designed. Thirty-two male Albino mice that six weeks age included in this study. The mice were randomly divided into four groups. Group I without treatment (Healthy). Group II only inducer, phthalic anhydride used. Groups II, III, and IV subjected to phthalic anhydride solution, which was applied on the dorsum of the back skin at 9 A.M. three times a week for four weeks. After three hours of phthalic anhydride application, treatment is used for group III (Tacrolimus 0.03% ointment), and group IV (flavonoids fraction 1.2 mg /kg ointment) topically once daily at 12 P.M. for three times a week for four weeks).
Serum IgE and immunohistochemistry of skin tissue IL-4 score, and IL-13 score were measured.
Results:High significant decrease in immunohistochemistry of skin tissue IL-4, and IL-13 in flavonoid fraction group were found.
Conclusion:The flavonoid fraction has an effect on the skin immunohistochemistry parameters and probably on atopic dermatitis like mice model.
Keywords:Atopic dermatitis, Artemisia annua, flavonoids
Citation:Hameed MF, Abu-Raghif AR, Kadhim EJ. Effect of topical flavonoid fraction from Artemisia annua in comparison with tacrolimus on induced atopic dermatitis in mice. Iraqi JMS. 2019; 17(3&4): 231-237. doi: 10.22578/IJMS.17.3&4.10

Nanoparticle is an artificial cell-like particle (antigen-presenting artificial cell that can be tuned to target a specific disease or infections). The outer surface of each particle is covered with universal adaptor molecules having attachment points for antigens, specific molecules on specific cells, and fight off the targeted disease.
Inside of each particle, there is either cytokines, cytotoxic drugs, antimicrobial drugs, genetic material, iron, gold, herbs, and others; each for different curative purpose, yet all of them act locally with high specificity to avoid devastating side effects of the contents if given systemically or to target certain tissue for curing diseases due to genetic deletions, or as a vaccine. Different nanoparticles differ in size, shape, contents, material of the outer shell, and purpose (i.e. for diagnosis of cancer, fighting that cancer, dealing locally with autoimmune diseases, treating a disease with genetic deletion mutations, fighting an infection, monitoring, and control of biological systems.
Keywords:Nanoparticles, diagnostic tool, therapeutic applications
Citation:Abdul Kareem IA, Hamzah MI. Nanoparticles technology in medicine, as a diagnostic tool, and therapeutic applications for many chronic and genetic diseases: A review. Iraqi JMS. 2019; 17(3&4): 238-253. doi: 10.22578/IJMS.17.3&4.11