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Article
Abdominal Tuberculosis: Clinical Presentation, Diagnosis, Outcome and Experience with 11 Cases

Author: Ibrahim Falih Noori
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2015 Volume: 12 Issue: 3 Pages: 581-591
Publisher: Babylon University جامعة بابل

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Abstract

Tuberculosis is a common health problem. Abdominal tuberculosis constitutes about 2% of all tubercular cases and it’s the sixth most common extrapulmonary tuberculosis. The aim of this study was to evaluate the clinical presentation, diagnosis and effective treatment of abdominal tuberculosis. This is a retrospective study including 11 patients (4males and 7 females), with clinical features of abdominal tuberculosis. They were divided according to the clinical presentation into two groups. The first group included patients presented as acute abdominal pain mainly due to bowel obstruction or as peritonitis and were prepared and treated by explorative laparotomy and definitive diagnosis of abdominal TB was made by tissue biopsy. The second group included patients with chronic symptoms. The results observed in this study were that abdominal pain was the commonest symptom followed by abdominal distention, anorexia, weight loss and fever. Tender right lower abdominal quadrant was found in 7 patients(63.6%) and right iliac fossa mass was found in 3 patients (27.3%). Explorative laparotomy was needed for 5 patients (45.5%) who presented as acute abdomen. Strictures were found in 3 patients (27.3%), adhesion in one patient (9.1%) and peritonitis caused by perforation in the terminal ileum was recorded in one patient. Ascitic fluid analysis for AFB stain and culture confirm the diagnosis of abdominal tuberculosis in patients who presented with chronic symptoms of tuberculosis. All patients showed good response to ATT therapy. No mortality or recurrence was recorded during ATT treatment or during follow up period. We concluded that abdominal tuberculosis is difficult to diagnose due to vague and non specific symptoms and signs such as abdominal pain, anorexia, weight loss and fever. High index of suspicion and clinical awareness is needed for definite diagnosis which depends on PCR or histopathology or AFB stain.


Article
Characteristics of Multidrug Resistance Tuberculosis Cases in Baghdad

Authors: Arwa Tahrir Ramadhan --- Layth Salihi --- Mohammad Yahya Abdulrazaq --- Hayder H.Ali Al-Sikafi
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2015 Volume: 14 Issue: 1 Pages: 65-70
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND: Multidrug-resistant tuberculosis (MDR-TB) is caused by strains of Mycobacterium tuberculosis resistant to at least isoniazid and rifampicin, the two most effective bactericidal agents currently available for TB treatment.It has emerged as a global public health emergency . It requires treatment with combination therapy consisting of four to six medications for up to 2 years . Additionally, the treatment is generally more toxic and far more expensive than the standardized treatment regimen used to treat drug-susceptible TB . The latest estimates of the World Health Organization (WHO) arrive at 650 000 prevalent MDR-TB cases among the 12 million tuberculosis cases worldwide.OBJECTIVE: To identify the Characteristics of multidrug resistance tuberculosis cases attending the specialized center for chest and respiratory disease in Baghdad during the period 9th of September 2012 – 9th of December 2012.METHODS :A cross sectional study was done in the specialized center for chest and respiratory disease in Baghdad during the period 9th of September 2012 – 9th of December 2012.Any patient attending the specialized center for chest and respiratory disease in Baghdad during the study period diagnosed as a case of MDR TB was enrolled in this study. RESULTS: The sample is composed of 42 MDR-TB patients (29 male and 13 female ) , with age mean of 38.3±12.8 year . Male sex significantly dominates and exceeds two thirds of the sample (69.0%) (P < 0.05). The study find ages between 25-45 year contribute to about two thirds (62.0%) of patients, and ages between 55-65 years constitute about one fifth (19.0%) of the sample. (P < 0.05). Body habit significantly showed that half the sample (50.0%) were underweight and only 10% were overweight or obese (P < 0.05).Smoking is found in 21.4% of total sample.The duration of taking first line antituberculosis drugs (FLD) before being labeled as MDR-TB varied from 14 to 72 months, with mean duration of 27.3±15.2 months with no significant difference in mean duration between the two sexes (P > 0.05,). Time required to diagnose these cases as MDR-TB varied from 0 to 24 months with mean time of 9.0±6.5 months. There was no significant difference in mean diagnosis time between males and females (P > 0.05). This study found that around one fifth (19.0%) of the sample have a history of default from treatment with FLD. Only one female was significant to be a case of primary MDR-TB (P > 0.05). Two cases (both were males) significantly had history of reaction to FLD treatment (P < 0.05). None of the sample had positive HIV testing.CONCLUSION: Most MDR patients in this study were males aged between 25-45 years .Most cases had acquired MDR TB and primary MDR-TB was rare finding in this study. Around one fifth of the sample have a history of default from treatment with FLD.


Article
Molecular Detection of Mycobacterium tuberculosis in Urinary Bladder FFPET Samples Could be a Proposed Specific Entity Of Bladder Carcinoma.
كشف جزيئي عن عصيات السل في نماذج سرطان المثانة الشمعية المثبتة بالفورمالين وإمكانية اعتبارها مؤثر خاص لسرطان المثانة.

Authors: Zina Mohammed Abdul-Hussein --- Hashim Raheem Tarish --- AsaadAljanabi
Journal: kufa Journal for Nursing sciences مجلة الكوفة لعلوم التمريض ISSN: 22234055 Year: 2015 Volume: 5 Issue: 2 Pages: 111-121
Publisher: University of Kufa جامعة الكوفة

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Abstract

Bladder cancer is one of the most common human cancers in Iraq and the world. While smoking, age,gender, and occupational exposure to aromatic amines are the most prominent among the risk factors identified, long term Inflammation and chronic infection may largely play some role in urinary bladder cancer (UBC) development.The association between bacterial inflammation and cancer appears to be stronger especially in chronic type of infection, many studies mentioned the role of chronic Escherichia coli (E. coli) infection and UBC but there was no study mentioned the role of chronic Mycobacterium tuberculosis (MTB) infection in association with UBC. There are many cellular and immune responses that occur during chronic Mycobacterial infection such as irritation, long term inflammatory cytokine production and DNA damaging due to bacterial metabolic products are some factors that may give chance for UB neoplastic changes. In the present study we worked on urinary bladder cancer and noncancerous Formalin-Fixed Paraffin Embedded (FFPE) Tissue specimens of Iraqi patients, the current study used polymerase chain reaction (PCR) for detection of Mycobacteriumtuberculosis genome.Objectives:investigation for the role of Mycobacterium tuberculosisand its associationwithurinary bladder cancer.Methods: The current study used urinary bladder cancer (UBC) formalin-fixed paraffin embedded tissues (FFPET) specimens of Iraqi patients collected from several private histopathology labs in AL-Najaf Governorate, the specimens were 50 samples of UBC patients and 25 different noncancerous pathological bladder samples. 84% of UBC cases were male and the predominant age group was 61-80 years (60%) for both gender. low grade cases were the most common which recorded (64%) and they were mostly TaN0M0 staging(42%). Large part of the study was performed at the Medical Education Research Facility (MERF)/Carver collage of medicine/University of Iowa/United States of America. Samples of DNA were extracted and DNA quantitation was performed using NanoDrop DNA quality was evaluated using human β-globin gene amplification.Results: human β-globin gene amplification used in DNA quality evaluation, PCR results showed that 80% of samples were β-globin positive and many samples showed appearance of multiple copies. Detection of Mycobacterium tuberculosis complex (MTBC) DNA using IS6110-PCR amplification showed 33% of UBC samples with positive results and 4% of noncancerous samples showed positive result, with high significant difference P<0.01. Identification of MTB subspecies was performed using Internal Transcribed Spacer Regions-PCR (ITS-PCR), 55.56% of UBC IS6110-PCR positive cases were ITS-PCR positive.Conclusions: A high percentage of MTBC and MTB detected among patients with UBC in comparison to noncancerous cases, suggesting that MTBC- associated bladder carcinoma is a proposed specific entity of bladder cancer which need to be more clarified. Recommendations: Modern techniques should be used for MTBC and MTB detection in laboratories and further study for the relationship between chronic MTB infection and UBC.

خلفية البحث : سرطان المثانةِ هو أحد ألأمراضِ السرطانية الإنسانيةِ الأكثر شيوعاً في العراق والعالم. ويعتبر التدخين، الجنس ,العُمرِ، والتعرض ألمهني إلى الأمينِ العطريِ من بين عواملِ الخطورة الأبرز َ لهذا المرض, يضاف إلى هذه العوامل عاملا الالتهاب لفترة طويلة و ألإصابات ألمرضية المُزمنةِ واللذان قَدْ يَلْعبانِ دورِ كبير في نشوء سرطانِ المثانةِ.الارتباط بين الالتهاب الجرثوميِ والسرطانِ يَبْدوانِ أقوى خصوصاً في النوعِ المُزمنِ مِنْ العدوى، ذَكرتْ العديد مِنْ الدِراساتِ دورَالإصابة ألمُزمنة ب Escherichia coli وارتباطها بسرطان المثانة لكن لم نجد دراسةَ تذَكر دورَ الإصابة بعصيات السُلِّ المُزمن وعلاقتها بسرطان المثانة. في الدراسةِ الحاليةِ عَملنَا على عينات نسيجِ المثانة المحفوظة في الفورمالينَ لمرضى عراقيينِ وقد شملت العينات عينات سرطانِ المثانةِ وعينات لإصابات مرضية غير سرطانيَة، أجريتْ الدراسةُ الحاليةُ للكشفِ عن عصيات السُلِّ في الإنسان باستعمال تقنية تفاعل أنزيم البلمرة المتسلسل. الهدف : الكشف عن دور عصيات السُلِّ وتأثيرها في سرطانِ المثانةِ.المنهجية : الدراسةُ الحاليةُ عملت على 75 نموذج من الأنسجة المثبتة بالفورمالين للمثانة خمسون عينة مِنْ العيناتِ كانت لمرضى سرطان المثانة وخمس وعشرون عينة مثانةِ لإصابات غير سرطانيةِ مختلفةِ جمعت العينات من عِدّة مختبرات خاصة في محافظةِ النجف. 84 % مِنْ عينات سرطان المثانة كَانتْ المجموعةَ السائدةَ فيها من الذكورَ والفئة العُمرية كَانتْ 61-80 سنة (60 %) لكلا الجنس. حالات انتشار من مستوى الدرجةِ واطئِ كَانتْ الأكثر شيوعاً وقد سجّلتْ (64 %). جزء كبير من ألدراسةِ تم إجراءه في مركز البحوث الطبية في كلية الطبِّ / جامعة آيوا/ الولايات المتحدة الأمريكية. تم استخلاص الحامض النووي من العينات وقد تم تقييمه كميا ونوعيا بواسطة جهاز النانودروب وباستخدام جين البيتا كلوبين على التوالي .النتائج :تم استعمال جين البيتا كلوبين في التقييمِ النوعي للحامض النووي، أظهرت نَتائِجَ تفاعل البلمرة المتسلسل (PCR) بأنّ 80 % مِنْ العيناتِ كَانتْ إيجابية والعديد مِنْ العيناتِ أظهرَت وجود نسخِ متعدّدةِ.الكشف عن بكتريا السل الرئوية تم باستعمال تفاعل PCR,IS6110-33 % من النَتائِجِ كانت إيجابيةِ بالنسبة لمرضى سرطان المثانة بينما العينات الغير سرطانية كانت ايجابية بنسبة 4 % مِنْ العيناتِ، باختلافِ إحصائي هامِّ P<0.01. تم تشخيص النوع الدقيق للبكتريا باستعمال PCR-,ITSالتصنيف النوعي تم باستعمال مناطقِ تفاعل متسلسلِ داخلية مَنْسُوخة وقد استعمل في هذا الاختبار العينات التي أظهرت نتيجة ايجابية باختبار تفاعل PCR,IS6110-( 55.56 % ) من الحالات أظهرت نتيجة ايجابية.الاستنتاجات : تم الكشف عن وجود نسبة عالية من عصيات السل في سرطان المثانة مقارنة بحالات إصابات المثانة الغير سرطانية. MTBC- لها ارتباط مؤثر باستحداث سرطان المثانة وهذا المقترح يحتاج إلى دراسة أكثر.التوصيات : اعتماد التقنيات الحديثة في التشخيص الجزيئي للكشف عن علاقة عصيات السل وتحديد العلاقة بين الإصابة المزمنة بعصيات السل وتأثيرها في استحداث سرطان المثانة.


Article

Authors: Rafid Abdul Jabbar Mohammed --- Dheyaa Al-Rubeai --- Mohammed Salim Yaseen --- Ali Wafi Ghazi --- et al.
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2015 Issue: 2 Pages: 76-81
Publisher: Basrah University جامعة البصرة

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Abstract

Abstract This article aimed to study the risk factors of extra pulmonary tuberculosis (EPT) in Basrah. A case-control study of 78 known cases of extra pulmonary tuberculosis (EPT) and 156 control subjects studied in “TB and Respiratory Diseases Center” in Basrah from December 2014 to March 2015. Forty four (56%) of EPT cases were females (P>0.05) and the males were 34 (44%). Lymph nodes were the commonest site for EPT (33%), followed by tuberculosis pleural effusion and osteal tuberculosis (19% each). 34.6% of EPT patients consume raw milk while only 4.5% of the control group (free from EPT) consume raw milk with an odds ratio of 11.2, P<0.01. Some 6.4% of EPT patients had family history of having tuberculosis, and the odds ratio is 10 and P<0.01. The risk of development of EPT in people of less than 120.000 ID monthly incomes is 3.2 times greater than those with higher income, P<0.01. Regarding Body Mass Index (BMI), when comparing people having normal BMI (18.5-25 Kg/M2) with people having subnormal BMI, the risk of having EPT is 3.9 times in underweight patients, P<0.01. In conclusion, risk factors for EPT are; consumption of raw milk, family history of TB, BMI<18 (Kg/M2) and a monthly income <120.000 ID.


Article
Mode of Presentations and Management of Presumed Tuberculous Uveitis at a Referral Center

Author: Faiz Al- Shakarchi
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2015 Volume: 14 Issue: 1 Pages: 91-95
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND: The diagnosis of tuberculous uveitis is often presumptive, because of the difficulty in obtaining microbiological evidence. The diagnosis has to rely on characteristic ocular findings, and possibly a therapeutic treatment trial. OBJECTIVE: To illustrate the mode of presentations and management of presumed tuberculous uveitis at a referral eye center in Iraq.METHOD AND SUBJECTS:This prospective case series study included patients with presumed ocular tuberculosis presented consecutively at uveitis clinic/ Ibn Al-Haetham teaching eye hospital, from January 2007-January 2013. Ocular tuberculosis was presumed when findings were consistent with possible intraocular tuberculosis, intractable to steroid therapy, and no clinical or laboratory evidence for other causes of uveitis. Strongly positive tuberculin skin test result (more than14 mm area of induration/necrosis) supported the diagnosis, but was not a prerequisite for initiating therapy. All patients were treated with anti tuberculosis therapy. Clinical findings and response on treatment were documented in a special follow up cards.RESULTS: 64 patients with presumed TB uveitis were included in this study. Mean age of the patients was 35.7 years with no significant sex predominance. Majority of patients were from urban places (79.7%). Bilateral involvement was recorded in 62 patients. Vitritis was a universal finding, while multifocal choroiditis was the most common fundus lesions (104 eyes; 82.5%). All patients responded well to anti tuberculosis therapy. Systemic corticosteroids were added after few days in 14 patients to decrease inflammatory reaction, retinal vasculitis, macular edema and macular scaring. CONCLUSION: According to this study; vitritis with multifocal choroiditis is the most common mode of presentation in patients with presumed TB uveitis. All cases responded well to anti-tuberculosis therapy, systemic corticosteroids can be added to decrease inflammatory reaction, retinal vasculitis, macular edema and macular scaring.


Article
Rapid Direct Detection and Differentiation of Mycobacterium tuberculosis complex in Sputum by Real-Time PCR
الكشف والتمييز المباشر السريع لعصيات السل المركبة في القشع بأستخدام تفاعل البوليميراز المتسلسل اللحظي

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Tuberculosis status as the second leading causes of significant morbidity and mortality from an infectious disease worldwide, after human immunodeficiency virus (HIV). Sample collection was conducted at the Institute of Chest and Respiratory Diseases/Baghdad Medical City in Baghdad. The collection interval was from August to October 2014, 629 suspected TB patients were examined during this period. The results revealed among total 629 specimens, 56 (8.9%) of the specimens were positive by direct examination and 573 (91.1%) negative specimens by smear microscopy. Fifty six DNA samples were extracted from positive ZN smears of sputum specimens and 40 samples from healthy persons (as control) were subjected to molecular diagnosis by real time PCR to detect and differentiate of M. tuberculosis, M. bovis and M. bovis BCG. The results were clarified that the 48 samples (85.72%) were M. tuberculosis, 2 samples (3.57%) were mixed of M. tuberculosis and M. bovis, no M. bovis BCG was detected, and 6 (10.71%) were negative. These findings propose that M. bovis plays a minor role compared to M. tuberculosis in the etiology of pulmonary tuberculosis in Baghdad.

يعتبر مرض السل المسبب الرئيسي الثاني للهلاك و الوفاة في جميع انحاء العالم من بين الأمراض المعدية، بعد فيروس نقص المناعة المكتسب (HIV). تم جمع العينات في المختبر المرجعي التابع لمعهد الأمراض الصدرية و التنفسية/مدينة بغداد الطبية في بغداد، للفترة من بداية شهر آب الى نهاية شهر تشرين الأول 2014، أذ تم فحص 629 من المرضى المشكوك بأصابتهم بمرض السل، أكدت النتائج وجود 56 (8.9%) عينة موجبة للفحص المجهري المباشر، بينما 537 (91.1%) عينة كانت سالبة لهذا الفحص. تم أختيار 56 عينة الموجبة للكشف المجهري المباشر و 40 عينة سالبة للكشف المجهري المباشر لأغراض الدراسة الجزيئية بأستخدام تفاعل البوليميراز المتسلسل اللحظي و بعد أستخلاص الجينوم (DNA) منها لتشخيص عائدية البكتريا الى جنس Mycobacterium كذلك لمعرفة عائدية هذه الجراثيم لمجموعة عصيات السل المركبة Mycobacterium tuberculosis complex وهي M. tuberculosis ، M. bovis ، M. bovis BCG . أظهرت النتائج وجود 48 (85.72%) مريض مصاب بـ M. tuberculosis، 2 (3.57%) مريض مصاب بخليط من M. tuberculosis و M. bovis، ولم تشخص اي حالة أصابة بـ M. bovis BCG، بينما أظهرت 6 (10.71%) عينات نتيجة سالبة لهذا الفحص. و تشير هذه النتائج الى أن M. tuberculosis تلعب دوراً كبيراً و بارزاً في التسبب في مرض السل الرئوي في بغداد مقارنة بـ M. bovis.


Article
The evaluation of some hematological parameters of human tuberculosis in Thi-Qar Province
تقييم بعض المعايير الدموية للمرضى المصابين بالتدرن الرئوي البشري في محافظة ذي قار

Authors: Nafaa. F. M. Al-Farhan نافع فرحان مفتن --- Manal B. Al-Tamemi منال بادي صالح --- Khalid G. Al –Fartosi خالد كاطع الفرطوسي
Journal: JOURNAL OF THI-QAR SCIENCE مجلة علوم ذي قار ISSN: 19918690 Year: 2015 Volume: 5 Issue: 2 Pages: 27-30
Publisher: Thi-Qar University جامعة ذي قار

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Abstract

The present study aimed to evaluation of erythrocyte sedimentation rate (ESR), hemoglobin (Hb.) levels, white blood cell count (WBCs) in active and latent tuberculosis patients in Thi-Qar province,Iraq. This study included 210 samples (70 patients, 70 household contacts and 70 control ) with age's ≤10 to ≥70 years who were referred to AL-Nasiriya Center of Tuberculosis and Chest Diseases from the period September 2012—July 2013.The study showed that the values erythrocyte sedimentation rate indicated a significant increase (P≤0.05) in patients and HHCs groups when compared with the value of control group (42.64, 22.93 vs. 8.79 mm/h, respectively). While the results showed a significant decrease (P≤0.05) in the hemoglobin, (Hb.) levels of patients group and HHCs when compared with control group (8.63 and 11.84 vs.13.17 gm/dl, respectively). The means of white blood cell (WBCs), showed a significant increase in patient and household when compared with correspondent value of control groups.

الدراسة الحالية هدفت الى تقييم معدل ترسيب كريات الدم الحمراء، مستوى خضاب الدم و العدد الكلي لكريات الدم البيض لمرضى التدرن الحاد والكامن في محافظة ذي قار-العراق . هذه الدراسة شملت 210 عينة (70 مريضا، 70 مخاليط المنزل و70 سيطرة) الاعمار 10≥ الى 70≤ ستة، الذين كانوا يراجعون الى مركز الناصرية للتدرن والامراض الصدرية للفترة من ايلول 2012 الى حزيران 2013. اوضحت الدراسة ان معدل ترسيب كريات الدم الحمراء اظهر ارتفاعا معنويا (P≤ 0.05) لدى مجموعة المرضى والمخاليط مقارنة مع مجموعة السيطرة (42.64 , 22.93 vs. 8.79 mm/h على التوالي ) . في حين اظهرت النتائج انخفاضا معنويا (P≤ 0.05) في مستوى خضاب الدم لدى المرضى ومخاليط المنزل بالمقارنة مع مجموعة السيطرة ( 8.63 , 11.84 vs. 13.17 gm/dl على التوالي ) . معدلات خلايا الدم البيضاء أظهرت زيادة كبيرة بالمقارنة مع المجموعة المقابلة من السيطرة.


Article
Immunological study among Tuberculosis patients in Baghdad
دراسة مناعية بين مرضى التدرن في بغداد.

Authors: May. Y. Abdul-Hussein مي يحيى عبد الحسي --- Oruba Kh. Abbas عروبة خالد عباس --- Ahmed A. Mankh احمد اسمر منخي
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2015 Volume: 28 Issue: 4 Pages: 202-206
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background: Mycobacterium tuberculosis (Mtb) infection may cause overt disease or remain latent. Interferon gamma release assays (IGRAs) detect Mtb infection, both latent infection and infection manifesting as overt disease, by measuring whole blood interferon gamma (IFN-Ɣ) responses to Mtb antigens such as ESAT-6, CFP-10 and TB7.7. Biomarkers are crucial to the development of new diagnostic tools for tuberculosis diagnosis and could be instrumental in reducing morbidity and mortality and curtailing spread of tuberculosis. In this study, cytokines such as Tumor necrosis factor –alpha (TNF-α) and Interleukine-10 (IL-10) in addition to IFN- Ɣ were assessed as biomarkers of tuberculosis infection and reactivation; tuberculosis disease and tuberculosis cure.Objective: This study was designed to evaluate the immune status of patients with respect to Mycobacterium tuberculosis. A prospective study was conducted to obtain more clarification about the impact of causative agent . The study included immunological diagnosis by Quantiferon –TB Gold-Test (QFT) and estimation the serum levels of IFN-ɣ, TNF-α and IL-10 in TB patients and control.Methods: The present study included fifty TB patients attending the National Reference Laboratory of Tuberculosis /Baghdad during the period April to July 2014 were recruited for this study. For the purpose of comparison, 50 control samples (respiratory disease and healthy ) matched by age and gender were also included. The patients and control groups were examined for the presence of TB by Quantiferon TB Gold test.Results: Forty five samples of TB patients with significance difference (p≤0.01) were positively detected by Quantiferon-TB Gold Test. The present study revealed significant difference in IFN-ɣ, TNF-α and IL-10 levels between TB patients and control groups.Conclusion: High levels of Interferon-gamma, Tumor necrosis factor-alpha and Interleukine-10 in tuberculosis patients serum indicate an important role of this cytokines in the pathogenesis of tuberculosis, so they could be considered as a good biomarkers for diagnosis and considered as a target for future therapy.

الخلفية: ان الاصابة ببكتريا التدرن ممكن تسبب مرض ظاهر او تبقى الاصابة كامنة. حساب الانترفيرون كاما المتحرر يستخدم لتشخيص الاصابة سواء كانت كامنة ام ظاهرة من خلال قياس استجابة الانترفيرون المتحرر لمستضدات البكتريا مثل ESAT-6 ,CFP-10,TB 7.7 . المؤشرات الحيوية ذات اهمية لتطوير ادوات تشخيصية لتشخيص مرض السل ويمكن ان تكون مفيدة للحد من الوفيات وللحد من انتشار المرض. في هذه الدراسة تم حساب حركيات خلوية (سايتوكينات ) مثلTumor necrosis factor- alpha,Interleukine-10 بالاضافة الى Interferon-gamma كمؤشرات حيوية للاصابة ولتنشيط المرض او الشفاء منه. الهدف: تم تصميم هذه الدراسة لتقييم الحالة المناعية عند المرضى فيما يتعلق ببكتريا التدرن وقد اجريت هذه الدراسة لتسليط الضوء اكثر حول تأثير البكتريا المسببة لهذا المرض. تضمنت الدراسة تشخيص مناعي باستخدام اختبار Quantiferon-TB Gold Test وتقييم المستوى المصلي للحركيات الخلوية (IL-10,TNF-α,IFN-ɣ) في مرضى التدرن ومجاميع السيطرة(مرضى الجهاز التنفسي و الاصحاء) .المواد و طرائق العمل : أجريت الدراسه على50 مصاب بمرض التدرن ممن كانوا يراجعون المختبر المرجعي للامراض الصدرية والتنفسية في بغداد , ولغرض المقارنه اعتمد 50 شخصا من السيطرة (مرضى الجهاز التنفسي و الاصحاء) متوافقين بالعمر و الجنس مع المرضى. كل من المرضى و مجاميع السيطرة تم التحري عن المرض باستخدام اختبار Quantiferon-TB Gold test.النتائج : اظهرت النتائج ان 45عينة من عينات المصابين كانت موجبة باستخدام اختبار . QFTكما اظهرت النتائج فروق معنوية في تراكيز IFN-Ɣ, TNF-α , IL-10 بين المرضى و مجاميع السيطرة

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