IRAQI JOURNAL OF MEDICAL SCIENCES

Early phases of coronavirus disease-2019 (COVID-19) are characterized by hypoxemic arteries that do not result in gasping, clinical deterioration may occur rapidly if hypoxemia is exacerbated by intra-pulmonary forcing, pulmonary vaso-compression fitness is not managed, and intravascular microthrombi are present with impaired lung diffusion. The goal of this hypothesis is to propose that COVID-19 may interfere with the glycolytic pathway by changing the amounts of intracellular metabolites, especially 2,3-bisphosphoglycerate (2,3-BPG), to aid in the release of oxygen from hemoglobin into the tissues, therefore preventing or treating hypoxia.
As a conclusion, focusing on hypoxia as the primary cause of severe morbidity in COVID-19 patients is thought to result from an increased stability of the relax (R-form) of hemoglobin at the tissue level due to a decrease in glucose metabolite produced from glycolysis process in RBCs (decrease 2,3-BPG concentration in the blood). This theory proposes raising 2,3-BPG levels, which is to free up more O2 from the R-form of Hb in the tissues.
Keywords: COVID-19, glucose metabolism, hemoglobin- oxygen binding, 2,3-bisphosphoglycerate
Citation: AbdulKareem NGh, Mohammad FA. Interference of Coronavirus with glucose metabolism and its effect on affinity of hemoglobin binding to oxygen: A review. Iraqi JMS. 2024; 22(1): 1-12. doi: 10.22578/IJMS.22.1.1

Background: Stereotactic radiosurgery (SRS) is the use of a high dosage of radiation, usually to an intracranial target. Healthy brain tissue often surrounds the target when therapies are delivered inside the skull, and this is usually the main organ that is at risk (OAR). To reduce the possibility of normal tissue toxicity and its associated side effects, it is imperative to establish a steep dosage falloff from the target's periphery to normal tissue when using these kinds of treatments.
Objective To evaluate the plans of vestibular Schwannoma using the latest version of gamma knife “lightning by estimating the correlation between the overall sphericity degree and, most important the evaluation parameters such as coverage, selectivity, homogeneity index (HI), selectivity, gradient index (????I), and shot density.
Methods: A cross-sectional study. The sphericity degree (φ) was determined by using planning for each target volume (TV) of the fifty patients who had stereotactic radiosurgery (SRS) performed on them in order to treat vestibular schwannoma, Calculating this parameter required developing a theoretical concept for operational sphericity, which was done and following are some of the measurements that are used in the analysis of the values that were found: coverage (????), selectivity (S), gradient index (????I), Paddick conformity index (????I Paddick), and dosage distribution (IV/TV).
Results: The mean age of patients was 44.54±11.93 years ranging from (20-80) years and the prevalence of females in this study was 35 (70%) more than the males 15 (30%). The prescribed dose for vestibular Schwannoma patients was 12????y. The mean target volume is 5.367±0.058 cm3, ranging from (0.079-26.497) cm3. This study showed that dividing the tumor into 2 spheres, the first sphere delineates the regular part of the tumor, and the second sphere is delineated irregular cancer components, since the reference plan is a spherical target, the degree of sphericity is an excellent parameter to use when evaluating the dose distribution of a plan for the treatment of vestibular Schwannoma.
Conclusion: According to the findings of this study, dividing the tumor into two spheres provides valuable information regarding the dose distribution both inside and outside the desired volume.
Keywords: Stereotactic radiosurgery, Acoustic neuromas, gradient index, selectivity, coverage
Citation: Jasim MH, Abdullah SS, Faraj MK. Assessment the planning by using gamma knife indices for the patient with vestibular Schwannoma. Iraqi JMS. 2024; 22(1): 13-19. doi: 10.22578/IJMS.22.1.2

Background: Cervical radiculopathy is defined as a pathological process affecting the cervical nerve root(s). Electromyography (EMG), nerve conduction studies (NCS), and somatosensory evoked potentials (SEPs) are frequently used to evaluate spinal cord and nerve root function.
Objective: To evaluate the sensitivity of different SEP components in detecting cervical nerve root lesions, as well as to test the NCS, and EMG, in patients with cervical radiculopathy.
Methods: In this case control study, 41 patients with cervical radiculopathy and 40 healthy volunteers took part. Sensory and motor NCS of the ulnar and median nerves, EMG of the deltoid, biceps brachii, and abductor brevis, and SSEP of the median nerve were performed on each participant.
Results: There was no difference in the motor and sensory NCS data between the study groups. The EMG of the muscles under investigation differed significantly between the two groups in terms of both duration and amplitude, with the exception of the abductor brevis muscle, which did not exhibit any differences. SEP data indicates that the patient's N9, N13, P14, and N20 latencies were all increased, as well as the patient's N13-N9, N20-N13, and N20-N9 interpeak latencies. The N13 and P14 latencies exhibited the highest sensitivity and specificity.
Conclusion: SEPs are more sensitive in identifying mild posterior column dysfunction in patients with cervical radiculopathy, which is at least imperceptible on routine NCS. SEP testing is an essential adjunctive diagnostic method for evaluating the spinal cord and nerve roots electrophysiologically. The N13 and P14 components have the highest sensitivity and specificity when comparing the patient and control groups.
Keywords: Cervical radiculopathy, NCS, EMG, SEP
Citation: Kaddoori HG. Electrophysiological study in patients with cervical radiculopathy. Iraqi JMS. 2024; 22(1): 20-30. doi: 10.22578/IJMS.22.1.3

Background: The Corona virus disease 2019 (COVID-19) is a complicated respiratory syndrome caused by novel Corona virus that spread swiftly throughout the world.
Objective: To study correlation between IgG spike protein-1 and soluble inhibitory immune checkpoints and among checkpoints in individuals vaccinated with booster dose of BNT162B2 vaccine.
Methods: This research is cross-sectional, performed on 180 healthy adults (above 18 years old) vaccinated with BNT162B2 vaccine, 21-30 days after booster dose at community dwelling from December 2021 to April 2022. Measuring serum level of IgG toward spike protein-1 and soluble negative regulatory markers by enzyme-linked Immunosorbent assay.
Results: This study showed a significant negative correlation between IgG titer and soluble inhibitory immune checkpoints, soluble CTLA-4 (r = -0.23, P value = 0.001), soluble PD-1 (r = -0.12, P value = 0.04) and soluble PD-L1 (r = -0.204, P value = 0.006), while Inhibitory immune checkpoints had a positive significant correlation among them (p value <0.001).
Conclusion: This study showed a significant negative correlation between IgG titer of Pfizer BNT62b2 COVID-19 and soluble immune checkpoint markers and a moderate positive highly significant correlation among soluble inhibitory immune checkpoints.
Keywords: BNT162b2, soluble inhibitory immune checkpoints, anti-S1 IgG response, mRNA vaccine
Citation: Ezzaldeen SS, Kadhim HS, Tawfiq MA. IgG titer of Pfizer BNT62b2 COVID-19 negatively correlated with soluble inhibitory immune checkpoints. Iraqi JMS. 2024; 22(1): 31-35. doi: 10.22578/IJMS.22.1.4

Background: Urinary tract infection (UTI) is the leading cause of bacteremia in hospitalized patients and the most prevalent nosocomial infection, making up as much as 35% of all infections in healthcare facilities. Clinical microbiology labs deal with many cases of UTI, and the most common cause of UTI is still enteric bacteria, namely Escherichia coli (E. coli).
Objective: To isolate and identify E. coli in urine and determine their connection to antibiotic resistance.
Methods: A consultant doctor from many hospitals oversaw the patients and a nurse was collected of 100 urine samples from patients suffering from UTI. Due to the large number of E. coli isolates (50 in total) and the use of polymerase chain reaction (PCR) technology for molecular detection of the diagnostic element 16SrRNA, the conventional techniques of bacterial identification were verified before PCR.
Results: A total of 50 (50%) of the bacterial isolates were determined to be E. coli after culturing, biochemical, and molecular testing. E. coli was shown to be multidrug resistant (MDR) after an antibiotic susceptibility test. Assessment of antibiotic resistance was done on 25 isolates, and revealed that one (4%) is resistant to Nitrofurantoin, seven (28%) to Gentamicin, fifteen (60%) to Ciprofloxacin, and sixteen (64%) to Tetracycline. A total of 24 (96%) bacterial isolates are Carbenicillin-resistant; 18 (72%) of these isolates are resistant to Novobiocin, 20 (80%) to Cefotaxime, 22 (88%) to Ceftazidime, 23 (92%) to Rifampin, and 24 (96%) to Carbenicillin. Based on PCR results, all E. coli bacteria had the diagnostic gene 16SrRNA.
Conclusion: This study found that nitrofurantoin is the antibiotic of choice for treating E. coli UTI, and the 16SrRNA gene is a confirmative diagnostic gene for E. coli infection.
Keywords: E. coli, antibiotics, multidrug resistance, 16SrRNA
Citation: Abbood SA. Isolation and molecular identification of multidrug resistance Escherichia coli isolated from patients with urinary tract infections. Iraqi JMS. 2024; 22(1): 36-44. doi: 10.22578/IJMS.22.1.5

Background: Nephrotic syndrome is one of the most common chronic kidney diseases in children. Its management requires outpatient follow-up and family engagement.
Objective: To evaluate the adherence of patients with nephrotic syndrome to the scheduled follow-up visits to the outpatient clinics, and to assess the possible risk factors for non-adherence.
Methods: A prospective observational study was carried out on 96 patients with nephrotic syndrome over a period of 1 year. Both regularly scheduled and urgent visits to the outpatient nephrology clinic were recorded. If a patient missed more than 20% of their scheduled clinic appointments throughout the follow-up period, they were considered to be non-adherent.
Results: Frequent relapse was the most common presentation encountered in 43.75% of the patients, and the median disease duration was 3.12 years (range 0.25-13.0 years). The study showed that 71 patients (73.96%) had good adherence, while 25 patients (26.04%) were non-adherent. More than half of non-adherent patients (56%) were rural residents. The median disease duration in adherent and non-adherent patients was 3.0 and 4.0 years, respectively, with a significant difference. Furthermore, frequent relapse was more common among non-adherent than adherent patients (64% vs. 36.62%), while steroid-resistant nephrotic syndrome was more common among adherent (21.13%) than non-adherent patients (4%) with a significant difference.
Conclusion: Non-adherence was significantly correlated with residency in rural areas and longer disease duration. Frequently-relapsing nephrotic syndrome was more common among non-adherent than adherent patients, while steroid-resistant type was more common among adherents, with a significant difference.
Keywords: Nephrotic syndrome, non-adherence, risk factors
Citation: Hussein SA, Ali SH. Medications and follow-up adherence of children with nephrotic syndrome. Iraqi JMS. 2024; 22(1): 45-53. doi: 10.22578/IJMS.22.1.6

Background: Thyroid cancer is the fifth most common cancer in women, worldwide; and the second in Iraqi women according to the statistics of global cancer observatory Iraq fact sheets at 2021. Papillary thyroid carcinoma comprising 90% of thyroid cancers. Annexin A6 is an immunohistochemical marker developed from polyclonal IgG antibody to Annexin A6 protein, which aids in modulating adenosine triphosphate-induced calcium (Ca2+) signaling in thyrocytes.
Objective: To evaluate immunohistochemical expression of Annexin A6 in papillary thyroid carcinoma and its correlation with age and sex of patients, stage of cancer and lymph node involvements.
Methods: This is a retrospective case control study done at Baghdad, including 30 tissue samples (paraffin block) of papillary thyroid carcinoma, obtained from Al-Yarmouk Teaching Hospital Laboratory and a private laboratory in Baghdad (Dr. Raji Hussein Alhadithi Laboratory) during the period from January 2021 until October 2021. The patients divided into groups according to their age, sex, cancer stage and lymph node involvement, then correlated with Annexin A6 immunohistochemical score of staining. For each sample, 2 serial sections of 4 µm were taken, one stained with Hematoxylin and Eosin and the other stained immunohistochemically with Annexin A6.
Results: Annexin A6 expression was positive both membranous and cytoplasmic ??? in (70%) of cases. The intensity was weak in 3 (14.3%), intermediate in 7 (33.3%) and strong in 11 (52.4%) of cases. High, moderate and low expression level was observed in (43%), (38%) and (19%) of patients, respectively. Mean age of patients were 39 years old. Females positive for Annexin A6 represents 77% of patients. Annexin A6 were positive in 75% of patients with lymph node metastasis. Annexin A6 expression more commonly expressed in patient with stage 2 papillary thyroid carcinoma (80% of them).
Conclusion: Annexin A6 is highly expressed in thyroid tissue with papillary thyroid carcinoma. No significant correlation between Annexin A6 and any of clinicopathological parameter.
Keywords: Annexin A6, ANXA6, papillary thyroid carcinoma, tumor progression
Citation: Aziz ZM, Ahmed BS. Immunohistochemical evaluation of Annexin A6 in papillary thyroid carcinoma: A clinicopathological study. Iraqi JMS. 2024; 22(1): 54-64. doi: 10.22578/IJMS.22.1.7

Background: One of the most prevalent kidney disorders in children is nephrotic syndrome (NS). It is characterized by massive proteinuria, hypoalbuminemia, and edema.
Objective: To study demographic and clinical characteristics of NS, hospitalization characteristics and the occurrence of complications during hospitalization, with comparison of some characteristics between hospitalized and non-hospitalized patients.
Methods: Ninety NS patients, aged 1 to 15 years, who were either admitted to the Pediatric Ward of Al-Imamein Al-Kadhimein Medical City or followed in the Pediatric Nephrology Consultation Clinic between April 1, 2021, and May 31, 2022, were included in this prospective observational study. The main parameters studied were demographic and clinical characteristics of NS, complications during hospitalization, with comparison of some characteristics between hospitalized and non-hospitalized patients.
Results: Male patients made up the majority (66.7%), of age group 5.1-10 years (44.4%), living in urban areas (70%), disease onset age of ≤5 years (66.7%), disease duration of >4 years (35.6%), and those with frequent relapses being the most prevalent kind (44.4%). Most patients stay in the hospital for 4-7 days (68.5%) and are admitted to the hospital an average of 45.6% of the time per year. The most prevalent complications were anasarca (76%), acute kidney injury (AKI) (17.8%), and scrotal edema (15.1%). Comparison between hospitalized and non-hospitalized children with NS, detected no significant difference according to age of patients, gender, age of onset, type of NS, residency and duration of disease.
Conclusion: Complications of NS, especially serious ones during hospitalization, are not uncommon. High index of suspicion for complications, not to miss them.
Keywords: nephrotic syndrome, hospitalization, children
Citation: Shaker AT, Ali SH, Ali LQH. Hospitalization of children with nephrotic syndrome. Iraqi JMS. 2024; 22(1): 65-73. doi: 10.22578/IJMS.22.1.8

Background: There are many cases of neonatal intensive care unit (NICU) admission due to sepsis; many of them have bacterial sepsis, and others have a serious health risk from fungemia, particularly infections brought on by fungal infection. Numerous variables, including gestational age, birth weight, and the use of invasive medical procedures, might affect the incidence of fungemia. It is important to know how often fungemia happens in NICUs and what the risk factors are in order to improving infection control strategies and come up with effective strategies to prevent infections.
Objective: To determine the prevalence of fungal infection in newborns who had risk factors by using conventional diagnostic techniques.
Methods: This study included 100 newborns who were admitted into NICUs in Children Welfare Teaching Hospital and Baghdad Teaching Hospital at the period from December 2022 to the end of April 2023. They were having one or more of these risk factors; history of invasive procedures, antibiotic usage, and hospital care management techniques. Conventional blood culture procedure.
Results: The findings showed that none of the newborns who were recruited had any evidence of candidemia, which was unexpected considering the known risk factors and the well-acknowledged sensitivity of these diagnostic techniques.
Conclusion: Traditional diagnostic methods in neonatal candidemia detection may lack sensitivity, highlighting the potential for molecular techniques like polymerase chain reaction (PCR), though further research is warranted due to study limitations.
Keywords: Candidemia, Conventional Methods, Neonatal Intensive Care Unit (NICU), Risk
Factors and Efficacy
Citation: Nasif MS, Al-Attraqchi AA, Mohammad AA. Detection of Candidemia in a sample of Iraqi neonates admitted to the neonates' intensive care unit (NICU) by conventional methods. Iraqi JMS. 2024; 22(1): 74-78. doi: 10.22578/IJMS.22.1.9

Background The World Health Organization lists the Pseudomonas aeruginosa (P. aeruginosa) bacteria as a major antibiotic-resistant priority pathogen, which function as an opportunistic pathogen and causes nosocomial infections.
Objective To biosynthesize selenium nanoparticles (SeNP) using bacteriocin from Acinetobacter bumannii (A. bumannii) and to evaluate the effect on the expression of MexB gene that is responsible for the multidrug resistance (MDR) in P. aeruginosa.
Methods Using an agar well diffusion assay, the first screening process evaluated the effect of bacteriocin-like inhibitory substance (BLIS) derived from A. baumannii on MDR P. aeruginosa. SeNP were synthesized biologically then analyzed and characterized using several techniques. The biosynthesized nanoparticles were identified, and the chemical and physical characteristics of the final product were determined, using atomic force microscope (AFM), scanning electron microscope (FESEM), energy dispersive X-ray (EDX), X-ray diffraction (XRD), and UV visible spectrometry.
Results The findings revealed a 24 mm substantial inhibitory zone of peptone water was shown to be the most appropriate supply of nitrogen, and glucose to be the best carbon source under the ideal circumstances for the synthesis of bacteriocin-like BLIS. The hexagonal structure was confirmed by XRD, and the dispersion and roughness of the nanoparticles were shown by AFM investigation revealed the 81.23 nm size range. MexB gene were found in each of the nine strains. The effect of the SeNP on the expression of the MexB gene demonstrated a considerable downregulation of MexB expression in these isolates. This can be a useful antibacterial agent against multiple drug resistance P. aeruginosa infection.
Conclusion SeNP showed a major down-regulation in MexB expression in P. aeruginosa isolates.
Keywords BLIS, Sodium selenite, SeNps, MexB gene
Citation Salman MF, Al-Mudallal NHAL Ahmed ME. The effect of selenium nanoparticles on the expression of MexB gene of Pseudomonas aeruginosa Isolated from wound and burn infections. Iraqi JMS. 2024; 22(1): 79-92. doi: 10.22578/IJMS.22.1.10

Background: Early osteogenesis and bone formation are key for treating bone injuries and bone diseases like osteoporosis. β-Tricalcium phosphate (β-TCP) is a popular synthetic bone graft substitute with excellent osteoconductive properties and absorbability.
Objective: To evaluate the histological and immunohistochemical changes by using β-TCP on fracture healing in rabbits.
Methods: Experimental study on animal model using 40 male adult albino rabbits, (Oryctolagus cuniculus). The control group included 20 rabbits and subdivided into 2 periods; two weeks and four weeks each one used 10 rabbits, and the treated group was also 20 in number and subdivided into 2 periods, two weeks and four weeks, each one used 10 rabbits. General anesthesia was induced with an intramuscular injection of xylazine 20 mg (0.2 ml/kg body weight) and ketamine HCl 50 mg (20 mg/kg body weight). The new bone formation length was measured histologically and by immunohistochemistry.
Results: Histological findings for the bone healing process in the treated group with β-TCP showed early bone marrow, trabecular bone, mineralization, and compact bone formation in comparison to the healing process in the control group. The comparative histomorphometric study showed a significant P value in comparison between 2 and 4 weeks the control group P value <0.001 and the treated group with β-TCP, P value <0.011. Immunohistochemical findings expression of anti-osteocalcin revealed that there were significant differences in the treated group with β-TCP between (2 weeks mean+SD 0.43±0.04 and 4 weeks mean+SD 0.5±0.05).
Conclusion: β-TCP has a major osteogenesis role in the early bone formation in the treated group as compared with the control group.
Keywords: Beta-Tricalcium phosphate, osteocalcin
Citation: Majeed AA, Abdulameer HH. Early healing of rabbit bone fracture using beta tri-calcium phosphate and osteocalcin antibody. Iraqi JMS. 2024; 22(1): 93-102. doi: 10.22578/IJMS.22.1.11

Background: Epistaxis is defined as bleeding from the nose. It is the most common emergency encountered by otolaryngologists. It affects all age groups and both genders. Several different modalities can be used to control nose bleeds.
Objective: To study the association of different health conditions with epistaxis, effectiveness of emergency interventions to control it, and the outcome of each approach.
Methods: One hundred eighteen patients with epistaxis were selected during the period of one year. Examination was done for all patients after securing the airway to determine the site of bleeding followed by the proper management. Different managements were studied for efficacy and outcome.
Results: The mean age for epistaxis was 53.81 years with 71.2% of patients being older than 45 years, male to female ratio was 1.68:1. There was a strong association between the incidence of epistaxis and increasing age (P = 0.002) with male predominance. The anterior septum was the most implicated area in epistaxis (58%). The most commonly encountered intranasal pathology was a deviated nasal septum (25.4%). The most commonly associated systemic disease with epistaxis was hypertension (43%). Forty one percent of the patients were on anticoagulants. Collectively, only 25.4% of epistaxis were idiopathic in nature. The most commonly used intervention to stop the bleeding was silver nitrates cauterization (45%). Ninety two percent of the patients underwent a non-surgical method to stop the bleeding, and 78% underwent a direct approach. Most failures were observed in endoscopic assisted cauterization (41.6%). Seventy five percent were treated in an outpatient setting, while the rest were hospitalized. The use of a direct approach for epistaxis management was associated with significantly lower hospitalizations (P <0.001).
Conclusion: Epistaxis affects adults in all age groups and incidence increases with age. The bleeding can be associated with a nasal pathology and/or a systemic abnormality. Epistaxis should be managed with a direct approach whenever possible to minimize hospitalizations.
Keywords: Adults' epistaxis, endoscopic assisted cauterization, nasal packing
Citation: Saeed SS, Kadhim JM. Epistaxis in adults: Management and outcome. Iraqi JMS. 2024; 22(1): 103-114. doi: 10.22578/IJMS.22.1.12

Background: A biodegradable, biocompatible and natural topical tissue adhesive fibrin glue, help in starting and replicating the last phases of the coagulation cascade. The platelets contain thrombosthenin, actin and myosin filaments, which when activated produces tension and motion that is similar to that produced by skeletal muscle.
Objective: To create the fibrin glue both with and without the addition of platelets, and investigate the biomechanical behavior of both formulas in terms of tension and stretching (elasticity).
Methods: Creating the "ordinary fibrin glue" by using fibrinogen (from cryoprecipitate) and thrombin. In a different preparation, platelets were added to the cryoprecipitate and thrombin to create "platelets added fibrin glue". Next, the elasticity and tension of the synthetic fibrin glue were assessed—both regular and platelet-added fibrin glue—at various times using displacement and force sensors.
Results: When platelets are added to fibrin glue, the elasticity outcomes at one hour and one week are significantly reduced. As well as, there were a significant higher tension results were observed at one-hour and one-week intervals when comparing regular fibrin glue with platelets added.
Conclusion: The inclusion of platelets caused the glue's biological behavior to alter, showing as an increase in tension and a decrease in elasticity (stretching). When the applicator has to use this mixture to manage various body parts (such as bone regeneration, graft stabilization, regeneration of periodontal ligament and treating joints arthritis), this modification should be taken into account.
Keywords: Fibrin glue, Platelets, tension, elasticity
Citation: Mahmood IA, Al-Ani FS. Effects of platelets addition on tension and elasticity of the fibrin glue. Iraqi JMS. 2024; 22(1): 115-122. doi: 10.22578/IJMS.22.1.13

Background: The primary reproductive organs in females are the ovaries, which produce hormones like estradiol and progestins as well as release mature ova. The ovary is made up of two layers; the outer layer, known as the cortex and the medulla is the inner layer. E-cadherin is a single-span transmembrane glycoprotein with five repetitions and a cytoplasmic domain. It plays a variety of roles, including ensuring tissue integrity and resistance to stretching, cell signaling, regulation of cell proliferation, apoptosis, survival, and carcinogenesis.
Objective: To assess E-cadherin level as predicting parameter for ovarian reserve.
Methods: Female's rabbits (Oryctolagus cuniculus) of age (10 to more than 108 weeks), weighting 600-3000 grams were randomized into two groups: group A (25 sample, young group), group B (25 sample, old group). All groups' animals prior to euthanasia, blood was collected from the heart for assessment of plasma level of E-cadherin and then euthanized the animals. Specimens of ovaries were placed on standard glass slides for Hematoxylin and Eosin stain for demonstration of the cellular components of the ovary and follicles at various developmental stages.
Results: The current study showed significant differences of plasma E-cadherin levels (P = 0.003), primordial follicles count (P <0.001) and antral follicles count (p<0.001); however, there was no significant difference of ovarian weight (P = 0.457) between group A and group B right ovaries respectively. Comparisons between group A and group B left ovaries were also showed significant differences of plasma E-cadherin levels (P = 0.003), primordial follicles count (P < 0.001), antral follicles count (P <0.001) in addition to ovarian weight (P <0.001). There were significant differences (P <0.05) of primordial, primary, secondary and antral follicles count between group A and group B both right and left ovaries.
Conclusion: E-cadherin plasma level is negatively correlated with animal age and ovarian weight. Higher E-cadherin plasma level associated with higher primordial follicles count. The primordial and primary follicles count was higher in young rabbits while the secondary and antral follicles count was higher in old rabbits.
Keywords: E-cadherin, rabbit ovary, ovarian reserve and folliculogenesis
Citation: Hanoon ZY, Farhan TM. Assessment of rabbit ovarian reserve and folliculogenesis by E-cadherin plasma level estimation. Iraqi JMS. 2024; 22(1): 123-134. doi: 10.22578/IJMS.22.1.14

Background: Primary brain tumors are a diverse group of neoplasms. More than 120 histological types of these tumors have been classified by the World Health Organization (WHO). Brain tumors exhibit different behaviors according to age, histological type and location. In Iraq, few epidemiologic reports have highlighted the national and regional epidemiologic data regarding primary central nervous system (CNS) tumors.
Objective: To identify the frequency of different histopathological types of primary brain tumors in samples of Iraqi patients, and to study the association with some clinicopathological parameters like age, gender, location and grade.
Methods: A cross-sectional study including analysis of (200) patients who were presented with primary brain tumors. The samples are collected from Neurosurgery Teaching Hospital, Ghazi Al-Hariri Surgical Specialties Hospital and privet lab from January 2021 to January 2022.
Results: The mean age was 42.94 years, ranging from (18 to 76) years, females were more than males as (55% and 45% respectively). Regarding anatomical location; supratentorial was 71% and infratentorial was 29%. With regard to histological types; diffuse glioma (43%) (from which glioblastoma most common subtype 59.3%) followed by meningioma (38%) (from which meningothelial meningioma represent 66.4). However, the ependymal tumors were only (3.5%). There was significant association between histological type and age (P = 0.005), and between histological type and grade (P = 0.001). However, there was no significant association between histological type and sex (P = 0.701).
Conclusion: Diffuse glioma was the most common type that occur commonly in female and majority of cases situated in supratentorial region, also there was significant association between histological type with age and grade.
Keywords: Adult tumors, glioma, histopathology, meningioma, primary brain tumor
Citation: Hilal MS, Latif AH. Primary brain tumors in a sample of adult Iraqi patients (Clinicopathological study). Iraqi JMS. 2024; 22(1): 135-146. doi: 10.22578/IJMS.22.1.15

Background: Siderophores are crucial for the proliferation of many disease-causing bacteria and also have significant functions in the transportation of non-iron metals, defense against oxidative stress, antibiotic effectiveness, interactions between different species, and the ability to cause disease.
Objective: For extraction and purification of siderophores from uropathogenic Escherichia coli (E. coli) standard strain.
Methods: Isolation and identification of E. coli was carried out only for urinary tract infection (UTI). Enhancement of the production of siderophores was done by investigating the elements that impact their production. Siderophores were detected by using Chrome azurol S (CAS) assay quantitatively in M9 minimal medium salts 5x. Extraction of siderophores using the Jadhav and Desai (1992) technique. Purification of siderophores by Sephadex LH-20 column and high-performance liquid chromatography (HPLC).
Results: A quantitative calculation revealed that 44.6% of siderophores were extracted and purified from uropathogenic E. coli.
Conclusion: Uropathogenic E. coli rely heavily on iron uptake or siderophores in the development of UTI in individuals. CAS assay is the most reliable technique for detecting siderophores.
Keywords: Siderophore, Sephadex LH-20, HPLC, UPEC, UTI
Citation: Jaber RA, Mushrif MH, Al-Mudallal NH. Extraction and purification of siderophores produced by Uropathogenic E. coli local Iraqi virulent strains. Iraqi JMS. 2024; 22(1): 147-153. doi: 10.22578/IJMS.22.1.16

Background: Utilizing Pseudomonas aeruginosa (P. aeruginosa) to biosynthesize silver nanoparticles (AgNPs). Antibiotic resistance poses a formidable challenge, particularly against multidrug-resistant (MDR) bacteria. The employment of supernatant as a cost-effective and straightforward approach enhances the efficacy of AgNPs biosynthesis.
Objective: To explore the biosynthesis of AgNPs by P. aeruginosa with the aim of achieving cost-effective and environmentally friendly production methods while ensuring novel morphological characteristics of AgNPs furthermore evaluated of antimicrobial and toxicity.
Methods: Preparation AgNPs by biological method (Green synthesis). Ultraviolet-visible spectrophotometer (UV–Vis), energy dispersive of X-ray spectroscopy (EDX), scanning electron microscopy (SEM), atomic force microscopic (AFM), X-ray diffraction (XRD) Zeta potential analysis. These techniques were applied for physical characterization. Disc diffusion assay and minimum inhibitory concentration (MIC) (16 μg/ml), were evaluated against different strain of Gram negative and positive bacteria, and study cytotoxicity assay normal human dermal fibroblasts (HdFn) and cell line A549.
Results: The UV–Vis showed the peak absorption at 421 nm wavelength, SEM showed nanoparticles were homogeneous and spherical shape with average size 24.5 nm and energy dispersive EDX confirmed the purity of the synthesized nanoparticle, where it was observed that the AgNPs showed strong antibacterial activity against MDR bacteria and the best MIC was 32 μg/ml concentration and showed the best efficacy against resistant strains of Gram-positive and negative bacteria Furthermore, AgNPs did not show any cytotoxic effects on carcinoma cell line A549.
Conclusion: The biological method used in this research is suitable to prepare AgNPs according to the size of particle and homogeny of the product and show strong antimicrobial property against MDR pathogens without having toxicity effect on cell line tissue.
Keywords: Silver nanoparticles, Pseudomonas aeruginosa, antibacterial activity, cytotoxicity, biomedical applications
Citation: Huseen DA, Ahmed ME, Hamid MK. Biosynthesis of silver nanoparticles by Pseudomonas aeruginosa and evaluation of their antibacterial activity and cytotoxicity assay properties. Iraqi JMS. 2024; 22(1): 154-163. doi: 10.22578/IJMS.22.1.17

Background: Hepatitis B virus (HBV) infection can lead to a chronic state of infection, and cytokines play a critical role in viral infections. Interleukin 17 (IL-17) has a role in many chronic inflammatory diseases like pulmonary infection, psoriasis, inflammatory bowel disease, and rheumatoid arthritis, and many studies confirmed that the IL-17 associated with a progressive inflammation during infection by lymphocytic choriomeningitis virus. Therefore, IL-17 may play a role during HBV infection.
Objective: To compare the serum level of IL17 in patients with chronic HBV infection to those in control group, additionally, to assess the correlate IL-17 in the patient groups with viral load, liver enzyme levels, such as alkaline phosphatase (ALP), aspartate transaminase (AST), alanine transaminase (ALT), total serum bilirubin (TSB).
Methods: In a case–control study, IL-17 (ELISA) kits, viral load by real-time polymerase chain reaction, and liver enzymes kits from Randox and Bio Merieux were measured in the 70 untreated chronic HBV patients gathered from Baghdad Medical City's Hepatology and Gastroenterology Teaching Hospital compared with eighteen volunteers as control group in winter of 2023.
Results: IL-17 significantly increased in chronic HBV patients (75.35±33.58 pg/ml) than in the control group (58.23±10.33 pg/ml) (p-value 0.036). Serum IL-17 levels showed no correlation with ALT, AST, ALP, TSB, or viral load.
Conclusion: Patients with chronic HBV had elevated serum levels of IL-17, a sign of ongoing immune activity. Moreover, there was no discernible relationship between IL-17 with liver enzymes and viral load.
Keywords: HBV, IL-17, ALT, AST
Citation: Al-Jizani ASN, Al-Ubaidi AEM, Khassaf SA, Al-Jaryan EAJ. Investigating the potential of IL-17 in chronic HBV Infection. Iraqi JMS. 2024; 22(1): 164-169. doi: 10.22578/IJMS.22.1.18

Background: Diabetic polyneuropathy (DPN) is a prevalent long-term consequence of type 2 diabetes mellitus (T2DM). The cause of DPN is still a subject of controversy, but it is possible that proinflammatory cytokine mediators such as interleukin-6 (IL-6) play a role.
Objective: To assess the correlation between pro-inflammatory marker (Il-6) and the development of DPN in T2DM patients.
Methods: A case-control study, involved randomly selected 140 T2DM patients attended to Al-Numan Teaching Hospital at Baghdad during the period from October 2023 to January 2024. Their age ranged from 25 to 80 years, 57 males and 83 females. The patients have been divided into two groups; those with DPN and diabetic patients without neuropathy. For both groups' patients, whole blood sample was centrifuged and serum was prepared and used as biological material for IL-6 levels determination by enzyme-linked immunosorbent assay (ELISA) technique. This study compared IL-6 levels between the two groups.
Results: The mean age of study samples was 58.69±10.51 years. The female to male ratio 1.45:1, as well as females were dominant among cases and that of controls group, but such differences were not statistically significant. The mean value of IL-6 was found to be significantly higher among cases group than that of controls group (117.68±27.38 vs. 57.3±13.24 pg/ml) respectively. The optimal cutoff value of IL-6 for detection of diabetic patients with high risk of neuropathy development was 72.46 pg/ml with sensitivity of 97.1%, and specificity of 87.1% with good area under the ROC curve (AUC) (P <0.001). The mean level of glycated hemoglobin (HbA1c) was significantly higher among cases group than that of controls group (8.27±1.92 vs. 7.19±1.61) %.
Conclusion: Current study concluded that IL-6 is significantly elevated levels in T2DM patients with DPN, the proinflammatory cytokine could be used as a useful indicator for development of DPN.
Keywords: Diabetic neuropathy, IL-6, type 2 diabetes mellitus
Citation: Abdulrhaman DM, Khalil NS, Fahad HM. Evaluation of interleukin-6 (IL-6) level in serum of type 2 diabetes patients and correlation with neuropathy. Iraqi JMS. 2024; 22(1): 170-177. doi: 10.22578/IJMS.22.1.19

Background: Male infertility is a prevalent issue affecting couples worldwide. Human Papillomavirus (HPV) is known to cause cervical cancer in women, but its association with male infertility is gaining attention. High-risk HPV (HR-HPV) infection has been linked to oxidative stress (OS), an imbalance of reactive oxygen species (ROS) in the body. This OS may impact sperm function and fertility in men.
Objective: To find out the association of ROS with HR-HPV infection and sperm parameters with group of infertile Iraqi patients with unknown causes.
Methods: A case-control study of 68 seminal fluid samples (34 fertile and 34 infertile males) submitted to real time polymerase chain reaction (PCR) for detection of HR-HPV types (16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, 68) and the plasma of seminal fluid samples were tested for ROS by using enzyme-linked immunosorbent assay (ELISA).
Results: The outcomes showed high statistically significant association of ROS level with sperm parameters and HR-HPV infection (P <0.001), twenty-nine (42.6%) of infertile men were with high level of ROS. Twenty-five (36.8%) of asthenozoospermia samples were had high ROS levels, while only 4 (5.9%) samples had low level of ROS. The abnormal sperm morphology was found in 34 (50%) of samples, 29 (42.6%) and 5 (7.4%) of them were with high and low levels of ROS, respectively. Furthermore, 17 of positive HR-HPV samples were showed 16 (23.5%) with high level of ROS.
Conclusion: HR-HPV infection may cause elevated level of ROS, and this may potentially affect sperm parameters in idiopathic infertile males.
Keywords: High risk human papillomavirus, idiopathic infertility, sperm parameter, reactive oxygen species
Citation: Dawood MA, Al-Shuwaikh AM, Al-Kawaz UM. The association of reactive oxygen species with high-risk Human Papilloma virus infection and some sperm parameters in a sample of Iraqi idiopathic infertile males. Iraqi JMS. 2024; 22(1): 178-187. doi: 10.22578/IJMS.22.1.20