IRAQI JOURNAL OF MEDICAL SCIENCES

After water, tea is the most consumed nutrient on the planet. However, black tea accounts for 78% of global tea consumption, while green tea accounts for only 20%. Except for flavored tea, all types of tea are made from the dried leaves of the tea bush. The type of tea is determined by the degree of oxidation of the leaves. Unoxidized tea leaves are used to make tea leaf, which is one of the less processed varieties of tea. It therefore, contains the most powerful antioxidants and beneficial polyphenols. Green tea polyphenols include epigallocatechin gallate (EGCG), epicatechin gallate, epicatechins, and flavanols, all of which are being studied in the lab for their potential in vivo effects. Kaempferol, quercetin, and myricetin are three types of flavonoids found in various parts. Although the caffeine in green tea can improve mental alertness, there is only weak, inconclusive evidence that it reduces the risk of most cancers or cardiovascular diseases, and there is no evidence that it aids weight loss. Using green tea as a health supplement has been linked to a slight improvement in general well-being. In a 2020 review, the Cochrane Collaboration identified a few potential negative effects, including gastrointestinal issues, higher levels of liver enzymes, and, more rarely, insomnia, elevated blood pressure, and skin reactions. Its anticancer and anti-inflammatory properties are well-known. Catechins are the main antioxidant dealers among the biologically active compounds found in Camellia sinesis. According to recent medical studies, the presence of function structural agencies and the range of hydroxyl agencies have a major impact on catechins' antioxidant activity. Unfermented inexperienced tea is the best source of those compounds.
The review on green tea and its catechins focused on language literature in English. The literature search was conducted in the following databases: Pubmed (1997-2020), EMBASE (1997-2020), Allied and complementary Medicine Database (AMED, 1997-2020) and China Journals Full Text Database (1997-2020). The keywords used were selected from the following terms: green tea, catechins, anticancer, diabetes, polyphenols, in vivo studies, general pharmacology and toxicology. The health benefits and adverse effects of green tea and its catechins were reviewed.
Keywords: Green Tea, Human, diseases, weight loss
Citation: Al-Harbi SJ, Gatea FK. Therapeutic role of green tea on human body function, some diseases and weight loss: A review. Iraqi JMS. 2023; 21(1): 1-10. doi: 10.22578/IJMS.21.1.1

Background: Despite the presence of glycemic control guidelines, and the global trends in the delivery of patient care, especially on the primary health care level, many diabetics do not achieve the needed glycemic, blood pressure and cholesterol levels. Better glycemic control is critical in allowing patients to perform at their best in terms of diabetes management and preventing long-term complications.
Objective: To identify barriers that may contribute to poor glycemic control in a sample of Iraqi diabetic patients in Kirkuk city, Iraq.
Methods: A cross-sectional study conducted during 2019 in outpatient's diabetic clinic in Azadi Teaching Hospital in Kirkuk, Iraq on diabetic patients with poor glycemic control.
Results: The study included 195 diabetic patients with mean age of 55.54±9.260 years; while their mean HbA1c was 9.74±1.696 mg/dl. Duration of diabetes was 6 to 10 years among 86 (44.1%) patients, 154 (74.4%) patients used oral antidiabetic drug, 5 (2.6%) used insulin treatment. Regarding barriers, 126 (65.3%) lack of confidence in using insulin regimens, lack of necessary knowledge about insulin therapy 117 (60.6%), difficulty to perform exercise 125 (64.4%) and influence of complications or other chronic disease 100 (51.8%).
Conclusion: Main barriers against good glycemic control reported by type 2 patients in this study were mainly poor knowledge regarding treatment, side effects of the disease itself or the medication and some social factors like unemployment and poor access to health care.
Keywords: Glycemic control, barriers, diabetes complication
Citation: Rashid ZA, Naji AA, Ismaeel ZH. Barriers to blood glucose control in type 2 diabetic patients with poor glycemic control in Kirkuk City/Iraq. Iraqi JMS. 2023; 21(1): 11-22. doi: 10.22578/IJMS.21.1.2

Background: Exposure to polycyclic aromatic hydrocarbons (PAHs) can cause many genetic alterations, which may contribute to cancers because PAHs derivatives can bound to DNA induces mutations and tumorigenesis. Some cancer-related proteins differentially expressed in exposed workers such as Human epididymal protein 4 (HE4) therefore, it considers a good biomarker for PAHs adverse effects that can progressed to tumors.
Objective: To estimate HE4 level in refinery workers to predict related adverse effect of PAHs that can developed to occupational cancer.
Methods: This study included 168 participants divided in three groups (control, office workers and in field workers). PAHs and HE4 were measured for each participant by GC/MS, ELISA respectively.
Results: PAHs were negative in controls blood whereas they were elevated in office and field workers. Concentration of HE4 was significantly higher in field than in office workers and controls, as well as significant correlation between concentration of PAHs and HE4 levels with duration of exposure was found.
Conclusion: PAHs and HE4 levels were significantly increased in refinery exposed workers (both field and office workers).
Keywords: Polycyclic aromatic hydrocarbon, air pollution, Human epididymal protein4, mutation, tumor marker
Citation: Shaker AW, Al-Wasiti EA. The Association between human epididymal protein 4 and exposure to poly aromatic hydrocarbons in samples of Al-Daura Refinery Workers-Baghdad. Iraqi JMS. 2023; 21(1): 23-29. doi: 10.22578/IJMS.21.1.3

Background: The neutralizing antibodies (nAbs) are the main factor for the protective immunity against viruses.
Objective: To evaluate the level and duration of anti-receptor-binding domain (RBD) nAbs for 8 months in convalescent Coronavirus disease-2019 (COVID-19) patients with a history of mild-moderate and severe disease.
Methods: Up to 160 sera from COVID-19 convalescent hospital healthcare workers (HCWs) with a history of mild-moderate and severe disease at 1-, 3-, 5-, and 8-month post-recovery using in-house developed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-RBD neutralizing competitive enzyme-linked immunosorbent assay (ELISA).
Results: SARS-CoV-2 nAbs persisted till 8 months post-recovery in most convalescent patients, the level of nAbs in severe disease group was higher than in mild-moderate disease group; moreover, anti-RBD nAbs mean concentrations in COVID-19 convalescent HCWs tend to increase over time after infection. Similarly, frequency of samples with positive anti-RBD nAbs also tends to increase over time post-recovery.
Conclusion: The protective immunity to SARS-CoV-2 in HCWs was found to last for a long time exceeding 8 months after recovery. The increase in the mean level of nAbs over time in COVID-19 convalescent HCWs might be attributed to the frequent asymptomatic re-exposures in HCWs.
Keywords: COVID-19, neutralizing antibodies, anti-RBD nAbs, long-term immunity, SARS-COV-2-RBD neutralizing ELISA assay
Citation: Mousa ZS, Abdulamir AS. Evaluation of the level and duration of SARS-Cov-2 neutralizing antibodies in COVID-19 convalescent healthcare workers. Iraqi JMS. 2023; 21(1): 30-42. doi: 10.22578/IJMS.21.1.4

Background: It is well known that cryopreservation procedure may result in negative impact on spermatozoa function throughout relative overproduction of reactive oxygen species (ROS). However, ROS overproduction can be corrected by antioxidants.
Objective: To find out the effect of vitamin A on cryopreserved spermatozoa throughout measuring their motility rate and DNA fragmentation and compare it with vitamin E effect.
Methods: Forty seminal fluid specimens were individually collected from forty healthy, non-drug and non-alcohol consumers, normozoospermic males in Um Al-Baneen Center for Infertility Management and In Vitro Fertilization in Baghdad. To facilitate comparing between used vitamins and experimenting each one alone, those specimens were distributed into 4 groups of 10 specimens each. Following deriving their own controls without any vitamin treatment, specimens of these groups, in general, were treated with two concentrations of vitamin A (20 µg/dl and 30 µg/dl), and two concentrations of vitamin E (10 µmol/l and 20 µmol/l). Then, each specimen was incubated for 1 hour before being cryopreserved in liquid nitrogen for 14 days. Motility percentage and DNA fragmentation were assessed following cryopreservation and thawing of spermatozoa.
Results: Results revealed that there were significant statistically differences in post-thawing motility and DNA fragmentation means between specimens treated with vitamin A and their relevant control; between specimens treated with vitamin E and their relevant control; and between specimens treated with vitamin E and those treated with vitamin A among all groups of the study.
Conclusion: These results lead to the conclusion that both of vitamin A and E play an important role in improving and protecting sperm motility and DNA integrity following cryopreservation, and vitamin E is more effective than vitamin A.
Keywords: Seminal fluid analysis, vitamin A, vitamin E, reactive oxygen species, sperm cryopreservation, sperm DNA fragmentation, sperm motility assessment
Citation: Al-Anbari SA, Ibraheem MM, Farhan TM. Evaluation of the level and duration of SARS-Cov-2 neutralizing antibodies in COVID-19 convalescent healthcare workers. Iraqi JMS. 2023; 21(1): 43-62. doi: 10.22578/IJMS.21.1.5

Background: Prediabetes is a serious health condition where blood sugar levels are higher than normal, but not high enough yet to be diagnosed as type 2 diabetes. Diabetes mellitus (DM) is a disease characterized by elevated blood glucose levels due to the inability of the body to yield or use insulin or both. It is believed that oxidative stress may play an important role in the development of vascular complications in patients with type 2 diabetes mellitus.
Objective: To evaluate the serum levels of endogenous melatonin and its association with superoxide dismutase (SOD) and glutathione peroxidase (GPx) in prediabetes individuals in comparison with normal individuals as controls.
Methods: Endogenous melatonin and SOD concentrations were measured in sera of 50 prediabetes individuals in comparison with 50 volunteers enlisted as normal controls aged from 20 to 65 using enzyme-linked immunosorbent assay (ELISA); volunteers enlisted as normal. Serum levels of lipid profile, urea, creatinine, GPx, fasting blood glucose and plasma level of glycated hemoglobin (HbA1c) were measured. All individuals were matched for body mass index and sex.
Results: Serum levels of melatonin, SOD and GPx enzymes in prediabetic patients were significantly lower than those of controls (p=0.036, p=0.024, and p=0.044; respectively) in prediabetic individuals when compared with controls with a significant positive correlation of theses biomarker levels in prediabetic individuals as compared with the control group.
Conclusion: Decreased levels of melatonin in prediabetic subjects may play an essential role by influencing decreased levels of SOD and GPx enzymes, which are considered major defense mechanisms against ROS that may lead to the development of diabetes (type 2).
Keywords: Melatonin, superoxide dismutase, glutathione peroxidase, oxidative stress, prediabetes
Citation: Abd Ali ZA. Evaluation the levels of melatonin, glutathione peroxidase and superoxide dismutase enzymes in prediabetic individuals. Iraqi JMS. 2023; 21(1): 63-70. doi: 10.22578/IJMS.21.1.6

Background: Chronic kidney disease is a worldwide health problem, with increasing prevalence and adverse outcomes. Children's nutritional status reflects the degree to which physiologic needs for nutrients are being met. Impairment of growth is associated with all stages of chronic renal failure
Objective: To assess the nutritional status and the severity of malnutrition in children undergoing hemodialysis (HD) in all pediatrics dialysis centers in Baghdad.
Methods: A total of 86 participants (41 males and 45 females), with end stage renal disease (ESRD) undergoing HD, from all pediatric HD centers in Baghdad City, recruited in this cross-sectional study with analytic components, among six months’ period. A structured interview questionnaire was used with the children or their care givers, included: demographic and clinical characteristics of patients, nutritional assessment of studied children using pediatric subjective global nutritional assessment (SGNA) tool and also growth parameters to assess the growth status of the study group.
Results: The overall proportion of estimated nutritional status was as follow: Thirty-three children (38.4%) were normal/well nourished, 39 patients (45.3%) were moderately malnourished and 14 patients (16.3%) were severely malnourished. Uremic symptoms were more significantly associated with severe state of nutritional deficiency (p=0.002). The duration of dialysis was significantly higher in children with severe nutritional deficiency in comparison with children with normal or moderate nutritional deficiency, their mean and interquartile range were 41.00 (76.00) months versus 24.00 (27.00) months and 24.00 (38.00) months, respectively (p = 0.001).
Conclusion: Nutritional assessments are complex and critical in pediatric patients with ESRD. Using a comprehensive tool such as pediatric SGNA is more reflective of their nutritional status than when compared to other parameters.
Keywords: Nutritional status, pediatrics end stage renal disease, pediatrics subjective global nutritional assessment (SGNA)
Citation: Rashid ZA, Ali BM, Azat NFA. Assessment of nutritional status and growth in children with end stage renal disease undergoing maintenance hemodialysis: A multicenter study. Iraqi JMS. 2023; 21(1): 71-80. doi: 10.22578/IJMS.21.1.7

Background: Interferon-inducible T-cell alpha chemoattractant (I-TAC, CXCL11) is a novel chemokine that used as immunotherapy. CXCL11 develops an effective anti-tumor immune response that relies on the coordinated interactions between immunocompetent cells, suppress angiogenesis and leading to an anti-tumor effect.
Objective: To investigate the anti-tumor effect of CXCL11 on breast cancer transplanted in an animal’s model.
Methods: CXCL11 adoptive immunotherapy inducible, was intratumorally injected in mice breast cancer model one dose weekly for three weeks, each dose concentration 20 ng/100μl. Weight of mouse and size of tumor were recorded every 48 hr until 25 days. Parameters examined on mice transplanted with murine mammary adenocarcinoma (AMN3) cells (to study the therapeutic of CXCL11 in vivo) were included growth inhibition (GI%), relative tumor volume (RTV), relative mice weight (RMW) and survival time in mice.
Results: In-vivo CXCL11 treatment showed to induce GI% from day 3 and continued to day 25 with significant increase in mice weight in comparison to non-treated control group during 25 days (P<0.0001). Also, the CXCL11 treatment exhibited a significant reduction in RTV and improving survival time in mice.
Conclusion: CXCL11 showed an anti-cancer effect on breast cancer AMN3 implanted in mice compared to control. CXCL11 may have immunotherapeutic effect on breast cancer by triggering the activation of immunity against cancer.
Keywords: Breast cancer, CXCL11, immunotherapy, AMN3
Citation: Mohammed HA, Al-Shuwaikh AM, Al-Shammari AM. The effect of interferon-inducible T cell alpha chemoattractant (I-TAC) on transplanted mice with breast cancer. Iraqi JMS. 2023; 21(1): 81-87. doi: 10.22578/IJMS.21.1.8

Background: Diabetic nephropathy is the major cause of end-stage kidney disease in patients with diabetes mellitus.
Objective: To identify risk factors for occurrence of Diabetic nephropathy among group of Iraqi children with type 1 diabetes mellitus.
Methods: A cross-sectional study was conducted at Department of Chemistry and Biochemistry, and department of Pediatrics, College of Medicine, Al-Nahrain University from November 2019 to April 2020. Total of 80 children with diabetic nephropathy were divided into two groups: 40 patients without diabetic nephropathy and 40 patients with diabetic nephropathy. Blood and urine samples were taken for biochemical tests.
Results: Each of age, duration of diabetes mellitus, fasting blood sugar and HbA1c were significantly associated with diabetic nephropathy. However, duration showed higher predictive value (OR = 18.69, 95% CI = 5.48-63.74, p<0.001). Very low-density lipoprotein (VLDL-c) was the most powerful lipid test as predictor for diabetic nephropathy (OR = 15.07, 95% CI = 3.98-57.1, p<0.001). Albumin-creatinine ratio was the most powerful renal function test predictor for diabetic nephropathy (OR = 107.6, 95% CI = 20.3-569.6, p<0.001). When all variables were entered in multivariate regression model, only 3 (out of 14) remained significantly associated with the development of diabetic nephropathy. Of those, albumin creatinine ratio >25 mg/g was the most powerful independent predictor (OR = 11.78, 95%CI = 7.45-42.82, p = 0.009). In contrast, estimated glomerular filtration rate, was a negative predictor of diabetic nephropathy (OR = 0.26, 95% CI = 2.79-18.93, p = 0.026). HbA1c level >9% was a positive predictor of diabetic nephropathy (OR = 4.15, 95% CI = 3.88-36.91, p value = 0.031).
Conclusion: Albumin creatinine ratio and estimated glomerular filtration rate, are the strongest predicting factors for development and progression of diabetic nephropathy in Iraqi children with type 1 diabetes mellitus.
Keywords: Diabetes mellitus, diabetic nephropathy, children, risk factors
Citation: Hammoud MS, Alawsi FAF, Ali SH, Baban RS. Risk factors of diabetic nephropathy among a group of iraqi children with type 1 diabetes mellitus. Iraqi JMS. 2023; 21(1): 88-98. doi: 10.22578/IJMS.21.1.9

Background: The increasing rate of births through caesarean sections (CS) had become a source of concern in many countries. Maternal beliefs may influence the mode of delivery. Knowledge of pregnant women regarding CS and its complications is an important tool to assess their choice for birth modality.
Objective: To assess women knowledge toward complications of CS and to find out the relationship between level of knowledge and their demographic characteristics.
Methods: A cross sectional study with analytic elements was conducted in Baghdad Teaching Hospital, Medical City Complex in 2022 on women visited Gynecology and Obstetrics Consultation Outpatient Clinics and Ward for different reasons.
Results: The study included 400 women, 67.5% (270) aged <35 years. The majority 78% (312) of study participants were with poor level of knowledge. Most women did not know about (weakness of bowel movement after delivery as a complication of CS), and (placenta progressing and adhesion in the next pregnancy) (260; 56.0%) and (252; 63.0%) respectively.
Conclusion: Two third of the patients had low knowledge level regarding complications of CS. knowledge was better in those who were older than 35 years, highly educated and had a job.
Keywords: Cesarean section, knowledge, pregnant women, wound infection
Citation: Abood FM, Alsafi AMH. Assessment of women knowledge toward cesarean section complications in Baghdad Teaching Hospital 2022. Iraqi JMS. 2023; 21(1): 99-107. doi: 10.22578/IJMS.21.1.10

Background: Nephrotic syndrome (NS) is a frequent chronic illness marked by changes in permselectivity at the glomerular capillary wall, as a result, it is unable to limit protein loss through the urine. Bacterial and viral infections are more common in patients with NS. Human Bocavirus (HBoV) is an emerging pathogen suspected to cause respiratory and GIT infections in children.
Objective: To investigate the frequency of HBoV in children with NS who have acute upper respiratory tract infections, and compare it with normal controls.
Methods: A case-control study carried out on 120 nasal swabs from children divided into three groups; 40 children each group (nephrotic syndrome and immunocompetent children with acute upper respiratory tract infections, and apparently children in good health without respiratory infections as control group). Viral DNA extracted from these samples and HBoV detected using real-time polymerase chain reaction.
Results: HBoV was detected in 30 (75%) of patients with NS, and 18 (45%) in normal children with acute upper respiratory infections, while it was 3 (7.5%) in apparently healthy control group. The mean cycle threshold (CT) of HBoV in the three groups were 18.99 in nephrotic patients, 20.21 in normal children with acute upper respiratory infections and 24.33 in control group
Conclusion: HBoV is relatively common among nephrotic children with acute upper respiratory infection, with a lowest CT (high viral load) as compared to the apparently normal children with acute upper respiratory infections and children in good health.
Keywords: Nephrotic syndrome, Human Bocavirus, acute upper respiratory infections, children
Citation: Lazim HH, Ali SH, Salim AB. Detection of Human Bocavirus in nephrotic syndrome children with acute upper respiratory tract infections. Iraqi JMS. 2023; 21(1): 108-112. doi: 10.22578/IJMS.21.1.11

Background: Chronic lymphocytic leukemia (CLL) is a hematological malignancy characterized by the accumulation of immunologically mature cluster of differentiation (CD) 5+ B-lymphocytes in the blood, bone marrow and lymphatic tissues. Hyperthyroidism can occasionally be caused by non-thyroid cancers infiltrating the thyroid and cause hyperthyroidism.
Objective: To assess the thyroid function of patients with CLL.
Methods: Patients and participant controls are subjected to prevalence tests of thyroid function as thyroid stimulating hormone (TSH), thyroxine (T4) and triiodothyronine (T3). Serum samples were analyzed by specialized kits of immunodiagnostic mini VIDAS Industry system (BioMérieux, France).
Results: Out of 37 males and 17 females CLL patients and 60 volunteer controls (36 males and 24 females), only two male patients at their sixth decade were diagnosed with hyperthyroidism, these patients were classified as Stage (A) to the Binet staging system. The test results were showed as follow: TSH; <0.05 miu/ml (Normal range 0.25-5.0 miu/ml); T4; 172.11, 182.34 nmol/l (Normal range 60-120 nmol/) and T3 3.4, 3.6 nmol/l (Normal range 0.9-2.3 nmol/l) for both patients respectively. All controls subject’s thyroid function test results were normal.
Conclusion: Accurate assessment of thyroid function and determination the origin of hyperthyroidism to identify any thyroid gland infiltration by chronic lymphocytic malignant cells in CLL patients using medical advanced diagnostic techniques can help treating hyperthyroidism.
Keywords: Chronic lymphocytic leukemia (CLL), hyperthyroidism, malignancy, metastasis, infiltration, thyroid gland
Citation: Saeed WH. Hyperthyroidism in patients with chronic lymphocytic leukemia. Iraqi JMS. 2023; 21(1): 113-117. doi: 10.22578/IJMS.21.1.12

The communal Myrtus of Linn (Myrtus communis L.) can be defined as one of the most potent medicinal plants in the world is (family: Myrtaceae). The Mediterranean and Middle Eastern regions are home to the common myrtle, Myrtus communis L. The fruit of the myrtle has a distinct flavor and comes in either black or white. It is frequently used to treat a variety of ailments, including gastric ulcers, diarrhea, dysentery, vomiting, rheumatism, bleeding, deep sinusitis, leucorrhoea, and cosmetic issues including hair loss. Wine and cuisine are flavored with the blades, berries, and branches. Due to its high vitamin content, mature fruits were once utilized as a food integrator. It has been demonstrated in numerous studies that the myrtle plant's various parts contain a variety of bioactive substances. The plant's fruit and leaves both contain phenolic chemicals and anthocyanin, as well as quercetin, catechin, and myricetin. Numerous biologically active compounds are produced by the plant, including tannins, flavonoids, coumarins, strong oil, essential oils, fibers, carbohydrates, citric acid, malic acid, and antioxidants. The bioactive chemicals found in various myrtle plant sections are regarded to have beneficial benefits on health. According to earlier research, the plant has antioxidant, antibacterial, antidiabetic, anti-inflammatory, anti-ulcerative, anti-diarrheal, analgesic, and hair-growing properties. More human researches are required because it has been shown that the majority of these investigations are conducted on animals.
Keywords: Myrtus communis Linn; antioxidant activity, antidiabetic and anti-inflammatory activity, antiulcerative and antidiarrheal activity; analgesic effect and effect on hair growth
Citation: Abass HA, Mahmeed BA, Omran ZS. Myrtus Communis Linn and its potential health effects: A review. Iraqi JMS. 2023; 21(1): 118-123. doi: 10.22578/IJMS.21.1.13

Background: Toxoplasma gondii (T. gondii) is well-known to cause congenital diseases, or ocular diseases, and miscarriage in pregnancy. Earlier infections are threatening in pregnant women. The activity of Toll-like receptors (TLR) in defense against T. gondii infections was observed such as TLR-5 molecule, and some interleukins (like IL-6, and IL-12) that may lead to abortion.
Objective: To study association between TLR-5 gene polymorphisms (rs2072493) with the susceptibility to toxoplasmosis in a sample of women with miscarriage and to study the association of TLR-5 polymorphisms (rs2072493) with the serum level of TLR-5, IL-6 and IL-12.
Methods: This is a case-control study was conducted on 200 women, of which, 50 pregnant women seropositive (IgG, IgM) for T. gondii (Group1), 50 pregnant women seronegative (IgG, IgM) for T. gondii (Group2) as a control group, 50 women with miscarriage seropositive (IgG, IgM) for T. gondii (Group3), and 50 women with miscarriage seronegative (IgG, IgM) for T. gondii (Group4) as a control group. They were recruited from Balad General Hospital, Salah al-Din and private laboratory in the period from January 2021 to December 2021. The serum level of TLR-5, IL-6 and IL-12 were measured. The selected single-nucleotide polymorphism (SNPs) (rs2072493) in TLR-5 were detected by using real-time polymerase chain reaction with specific primers.
Results: The frequency of the heterozygous genotype (TC) for SNPs TLR-5 gene (rs2072493) was significantly higher in Group1 than Group2 (P=0.004). At allelic level, the frequency of mutant allele (allele C) was significantly higher in Group1 than in Group2 (p=0.009), and in Group3 than in Group4 (P=0.025). There was significant increase in serum level of TLR-5 in Group1 and in Group3. There was significant increase in serum level of IL-6 and IL-12 in Group1.
Conclusion: There is significant association of toxoplasmosis with mutant allele (allele C) of the SNP rs2072493, which may be considered as a risk factor for toxoplasmosis and stimulate miscarriage in pregnant women. TLR-5 level is high in both groups.
Keywords: TLR-5, polymorphism, Toxoplasma gondii, IL-6, IL-12
Citation: Al-Baldawy AN, Al-Marsomy HD, Khaleel II. Association between single-nucleotide polymorphism (rs2072493) and serum level of TLR-5 and interleukin-6 and interleukin-12 response to Toxoplasma gondii in women with miscarriage and pregnant women. Iraqi JMS. 2023; 21(1): 124-134. doi: 10.22578/IJMS.21.1.14

Background: Psychological stress may cause stress peptic ulcers, regardless of Helicopecter pylori (H. pylori) infection or use of non-steroidal anti-inflammatory drugs (NSAID). Studies of sociodemographic characteristics and peptic ulcers identified various risk factors, such as low salary, household member crowding, unemployment, marital strain, and psychological and physical stress.
Objective: To determine the clinical picture of stress peptic ulcer in a sample of Iraqi patients.
Methods: A cross-sectional study was performed in Al-Imamein Al-Khadimein Medical City, Iraq to determine the clinical features of stress peptic ulcer in a sample of Iraqi patients. Sample collection was done in a period of two years, from April 2021, to April 2023. At first, the process was explained to the patients and informed consent taken from all enrolled individuals. The diagnosis of stress peptic ulcer was done by gastroduodenoscopy, or by laparotomy for acute abdomen (perforated stress ulcer). All selected patients were tested for the presence of active H. pylori infection by stool antigen test (and it was negative). The patients were divided into two groups; Group A patients were presented as an (emergency cases) with complications of stress peptic ulcer either perforation or upper gastrointestinal bleeding stress ulcer; and Group B patients were presented with dyspepsia (as a cold cases), proved by gastroduodenoscopy to be due to stress peptic ulcer.
Results: A total of 86 patients with stress ulcer, 37 (43.02%) males, and 49 (56.97%) females, their age ranged from 13-76 years (mean age 36.16±76 years). Group A were 31 (36.04%) patients, their presentations were either acute abdomen proved to be due to perforated stress ulcer by laparotomy in 8 (9.30%) patients, or hematemesis in 23 (26.74%) patients. Group B were 55 (63.59%) patients. The incidence of stress ulcer was 0.02% and the incidence of operations for perforated stress ulcer was 0.01%. The mortality rate was one (1.16%) old female patient with perforated stress ulcer.
Conclusion: Stress ulcer can bleed and perforate, so there should be awareness about management of pain, stress and anxiety in all age groups. There should be good and effective postoperative analgesia, reassurance and empathy for patients and advice for protections against stress ulcer when needed.
Keywords: Stress ulcer, bleeding, perforation
Citation: Atiyah TS. Stress peptic ulcers in a sample of Iraqi patients. Iraqi JMS. 2023; 21(1): 135-144. doi: 10.22578/IJMS.21.1.15

Background: Hepatitis E virus (HEV) is one of the prevalent nosocomial transmitted agents among patients on maintenance hemodialysis. Innate immunity's main actors, Toll-like receptors (TLRs), are able to identify the chemical patterns linked to pathogens.
Objective: To investigate the seroprevalence of HEV in hemodialysis (HD) patients and study the TLR4 polymorphism (rs4986790 and rs4986791) in association with HEV in HD patients.
Methods: One hundred and fifty patients on maintenance HD attending the HD centers of Al-Karama Hospital and Al-Yarmouk Teaching Hospital in the period from March to November 2021. Using enzyme-linked immunosorbent assay (ELISA) kit, serum samples were examined for the existence of anti-HEV (IgG and IgM) antibodies and conformation by using molecular technique quantitative reverse transcription polymerase chain reaction (qRT-PCR). The selected single nucleotide polymorphisms (SNPs) (rs4986790 and rs4986791) in TLR4 were amplified by using conventional PCR and then confirmed by sequencing their polymorphism.
Results: Out of 150 hemodialysis patients, the seropositive result for HEV-IgG and IgM was 10 and 6, respectively. While 14 patients were positive by PCR. On the other hand, the result of IgM was negative for all control group. The analysis of TLR4 rs4986790 SNPs were 24 (80%) AA and 6 (20%) AG in patients while 6 (60%) AA and 4 (40%) AG in control group with insignificant difference. In addition, the TLR4 rs4986791 SNPs were 24 (80%) CC and 6 (20%) CT in patients while 6 (60%) CC and 4 (40%) CT in control group with insignificant difference.
Conclusion: Patients undergoing HD are susceptible to HEV infection, the sero-prevalence of HEV in patients considered as risk factor. The genotypes of TLR4 SNPs (rs4986790 and rs4986791) have no significant association with HEV in HD patients.
Keywords: HEV, seropositivity, hemodialysis, TLR4
Citation: Salih HS, Abbas AA. Detection of hepatitis E virus and toll-like receptor 4 (rs4986790 and rs4986791) genotypes among A sample of hemodialysis patients. Iraqi JMS. 2023; 21(1): 145-153. doi: 10.22578/IJMS.21.1.16