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Article
Polymorphism in promoters of TLR-2 gene in Iraqi patients with tuberculosis

Author: Awatif H. Issa , Mazin S. Salman
Journal: Iraqi Journal of Biotechnology المجلة العراقية للتقانات الحياتية ISSN: 18154794 Year: 2017 Volume: 16 Issue: 3 Pages: 116-121
Publisher: Baghdad University جامعة بغداد

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Abstract

Despite the existence of Tuberculosis control programs globally, TB remains one of the major public health problems worldwide. It is one of the greatest challenges, which face health systems in the 21st century. A defect in the genes of the immune response is the most plausible explanation for susceptibility of some individuals and resistance of others to TB. TLR2(CD282) is one of the toll-like receptors and plays a role in the immune system. TLR2 is present on the surface of certain cells and it distinguishes foreign bodies, also it have role in passing of adequate signals to the cells of the immune system. The main goal of this study is to produce molecular analysis for promoter of TLR-2 genes in Iraqi patients with TB. Seventy-four blood specimens were collected from 74 patients in the Institute of the Tuberculosis and Chest Disease–Basra city's, blood specimens also collected from 74 healthy individuals as control. Extracted DNA was amplified using set of specific primers for promoter regions TLR-2 gene; amplified amplicons were sequenced and analyzed. Genotyping of TLR-2 gene promoter revealed that out of 74 found with TB, 38 (51.3%) patients found to possess C allele (T→C), while 36 (48.7%) possessed T allele. C allele presents only in heterozygous state in Iraqi society, and closely correlated with increasing susceptibility of some individuals to TB.


Article
Knowledge about Tuberculosis among Secondary School Students in Baghdad City
معلومات طلاب المدارس الاعدادية حول مرض التدرن في بغداد

Author: Intisar J. Mohammed انتصار جاسم محمد
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2017 Volume: 30 Issue: 2 Pages: 76-78
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Abstract:Background: Community awareness in general and in young generations in particular is of vital importance in combating tuberculosis which is a leading cause of morbidity and mortality in developing countries. Tuberculosis is still a prevalent disease in our country. Objective: To assess the knowledge of secondary school students regarding tuberculosis. Methods: This descriptive cross-sectional study was conducted in Al-Karkh district of Baghdad during the period from November 2015 to April 2016. The sample size was determined at 1000 students from the total number of 63464 students.A simple random sampling technique was adopted to select schools from each of the ten sectors; this resulted in collecting a total of 20 schools (ten schools for males and ten for females). The students were randomly selected from those schools, 500 male &500 Female, using a systematic random sampling technique by choosing every other student from the selected classes.The study instrument included multiple choice questions about the cause of the disease, the route of transmission, vaccination, symptoms, availability of treatment, transmission and prevention. The questionnaire was developed by the researcher making use of previous studies and WHO standards. Results: On average, 42% of the questions were answered correctly, only 27.2% knew that TB was caused by bacteria, 40.8% knew that TB’s first symptom was a cough of more than 3 weeks, 56.5% knew that TB is associated with loss of appetite & weight loss, 39.8% knew that TB is associated with fever & night sweats, only 38% of students knew that it is transferred by respiratory droplets, 60.6% knew that the first organ most commonly affected by TB is the lung, 44% knew that the TB vaccine is BCG, only 23.1% knew that sputum examination is used to help identify TB, 56.3% knew that covering your mouth during coughing & sneezing helps prevent disease spread, only 33.4% knew that TB treatment is available in all primary health care centers(PHCC).Conclusion: Only about one third of the student sample had good knowledge regarding Tuberculosis, also female students had a higher level of knowledge than male students.


Article
The Value of Ultrasonography in The Diagnosis and Evaluation of Early Therapeutic Response of Cervical Tuberculous Lymphadenitis

Authors: Sarab M. Zeki Radhi --- Lamia H. Al-Nakib --- Khairallah Muzhir Gabash
Journal: Journal of baghdad college of dentistry مجلة كلية طب الاسنان بغداد ISSN: 16800087 Year: 2017 Volume: 29 Issue: 1 Pages: 76-82
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Tuberculosis is a worldwide infectious disease in spite of advancement in health care system. Tuberculous lymphadenitis is the most prevalent form of extra pulmonary tuberculosis with predilection of cervical lymph nodes.Objectives: To evaluate the reliability of grey scale ultrasonography together with color Doppler in the diagnosis of cervical tuberculous lymph adenitis and evaluation of early therapeutic response.Subjects and methods:From July 2015 to May 2016 in Al-Karama teaching hospital /Kut city- Wasit-Iraq, 25 patients (14 males and 11 females) with ages range from (6-50) years. Ultrasonography examination was done for all patients and grey scale criteria (distribution, size, shape, echogenicity, echogenic hilum, intranodal necrosis and ancillary features) and vascular distribution were recorded to help in tuberculous lymphadenitis diagnosis. Excisional biopsy was done to confirm the diagnosis histopathologically. After chemotherapy the Patients were followed up after 46 days of treatment, again the grey scale criteria were recorded and compared with the 1st reading.Results: Ultrasonography could identify 88% of the patients (22/25) as having cervical tuberculous lymphadenitis while histopathology proved that only 80% of patients really have the disease. This mean that ultrasonography had good sensitivity (100%), specificity (60%) and accuracy (90%) with no false negative and 8% false positive.In following up the patients, grey scale ultrasonography criteria showed a significant difference for the same patients before and after 46 days of treatment.Conclusions: Ultrasonography was found to play a paramount role in detection, localization and delineation of cervical tuberculous lymph nodes hence grey scale and color Doppler are reliable in diagnosis of the disease and the evaluation of therapeutic response of the patients

Keywords

diagnosis --- lymph node --- neck --- sonography --- tuberculosis


Article
Serodetection and Molecular Confirmation of Mycobacterium tuberculosis Infections in Dogs

Authors: Ahlam Ali Soghi Al-Galebi --- Mithal Kareem Abass Al-Hassani --- Ebtesam Thamer Jeaz
Journal: Journal of Education for Pure Science مجلة التربية للعلوم الصرفة ISSN: 20736592 Year: 2017 Volume: 7 Issue: 3 Pages: 109-119
Publisher: Thi-Qar University جامعة ذي قار

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Abstract

AbstractThe aim of the present study was to detect the prevalence rate of IgG-antibodies specific for M.tuberculosis in dogs by application of indirect ELISA and confirming the infection in seropositivesamples by using a molecular test (PCR). For this purpose, 178 stray dogs were selected randomlyfrom some regions of Al-Qadisiyyah governorate / Iraq, for blood samples collection. The totalprevalence rate of seropositive was 11 (6.18 %) that subjected for culture, and the suspected sampleswere tested by PCR technique that revealed on 6 (3.37 %) positive samples. Also, the relationships,between the positive infections with sex and age factors, had been studied. The study revealed thatthe infection ratio in males and females was 5.41 % and 6.38 % serologically, and 2.7 % and 3.55 %molecularly, respectively. In concerning to age factor, the morbidity rate of tuberculosis in


Article
The Impact of Tuberculosis on Immunomodulatory Markers: A Clinical Study

Author: Rafal Jaleel Al-Saigh
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2017 Volume: 14 Issue: 3 Pages: 567 -576
Publisher: Babylon University جامعة بابل

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Abstract

This study aims to investigate the levels of immunomodulatory markers like interluekin-6 (IL-6), tumor necrotizing factor-α (TNF-α), cell differentiation-4 (CD4) and CD8 levels in those patients with active tuberculosis (TB) disease in comparison with control group.41 Adults diagnosed with TB were included in comparison to 32 healthy individuals at Babylon health center for pulmonary diseases and TB. Descriptive data for patients and control group were collected by well-trained researcher following a structured questionnaire. In parallel, peripheral blood collected to determineIL-6, TNF-α, CD4 and CD8. Then the assessment for the association between clinical and descriptive data and immunomodulatory markers levels was investigated statistically.The majority of TB patients were males (56%) and 71% were resident in rural areas;47% of them were living in middle socioeconomic state, moreover, 47% of TB cases had diabetes, furthermore, 51% had chronic obstructive pulmonary diseases, 12% had hypertension and 39% of them had chronic anemia with 47% smokers with no significant difference versus control. Following to that, there was highly increased in IL-6 and TNF-α levels in TB patients versus control (P<0.001), with low CD4 level versus control (P<0.001). While there was no significant change shown in CD8 levels versus control and this might highly be correlated with 30% of abnormal liver function tests among TB patients. A high proportion of TB patients have low CD4 level mostly associated with active disease. Moreover, the increase of IL-6 and TNF-α levels suggests a inverse impact on CD4 level which closely associated with the outcome of the disease.

Keywords

Tuberculosis --- Immunomodulatory markers --- IL-6 --- TNF-α --- CD4 --- CD8.


Article
The Yield of Genexpert in Pulmonary Tuberculosis & Rifampicin Resistance.

Author: Mohammed Waheeb AL.Obaidy
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2017 Volume: 16 Issue: 2 Pages: 184-190
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND :Earlier and improved tuberculosis (TB) case detection, including smear-negative disease & expanded capacity to diagnose multidrug-resistant tuberculosis (MDR-TB) are global priorities for TB control. The development of the Genexpert of mycobacterium tuberculosis and rifampicin resistance (MTB/RIF) assay for the Genexpert platform was completed in 2009 and is considered an important breakthrough in the fight against tuberculosis (TB). For the first time, a molecular test is simple and robust enough to be introduced outside conventional laboratory settings.Genexpert MTB/RIF detects M. tuberculosis as well as rifampicin resistance-conferring mutations using three specific primers and five unique molecular probes to ensure a high degree of specificity. The assay provides results directly from sputum in less than 2 hours. It is commercial real-time polymerase chain reaction (PCR) assay (Xpert™ MTB/RIF).OBJECTIVE: To assess the accuracy of the Cepheid Xpert™ MTB/RIF in the detection of M. tuberculosis from respiratory samples in the setting of data collected from TB center in Medical city complex.MATERIALS& METHODS:This is primarily laboratory -based study, used stored data from a previously reported retrospective evaluation of 56 patients suspected of having TB from clinical point of view. 9 patients subjected to the examination of sputum & broncoalevoaler lavage (BAL) at the same time rendering the total specimen number about 65 specimens. The results of Genexpert & RIF sensitivity for each patient were discussed &compared with that of direct AFB smear & culture of sputum and broncoalevoaler lavage (BAL). RESULTS: The result s of Gene xpert was compared with direct smear microscopically examination which considered as a primary diagnostic test although the highly sensitivity of Genexpert in diagnosing viable tubercle bacilli ,additionally it diagnose the the non-viable one with the same efficiency, such a feature considered an Achilles tendon of this test.The study revealed high sensitivity& extraordinary specificity in diagnosing TB making this technology the most rapid,simple&accurate diagnostic test of TB .CONCLUSION:The results demonstrate that rifampin-resistant M. tuberculosis can be detected in DNA isolated from sputum samples in a single-tube assay that takes less than 3 h to perform; the assay is extremely specific and extraordinarily sensitive. More over the assay is simple to perform and readily automatable for high-throughput screening.


Article
Evaluation of T-Spot TB test to detection tuberculosis in Al- Muthanna province

Author: Haider Hameed Mitab
Journal: Muthanna Medical Journal مجلة المثنى الطبية ISSN: 2226146x Year: 2017 Volume: 4 Issue: 1 Pages: 35-49
Publisher: Al-Muthanna University جامعة المثنى

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Abstract

Tuberculosis (TB) stands as a major public health problem worldwide. The rapid diagnosis of individuals with active TB and detection of individuals with latent TB and rapid introduction of effective treatment to prevent them from spreading of disease. The aim of study was to evaluation the IGRA in the diagnosis of TB in comparison to other tests (conventional and molecular tests) during the period from October/2015 to June/2016 in advisory clinic for respiratory diseases and thoracic in Al-Samawa city in Al- Muthanna province. Sixty sputum and blood specimens were taken in this study was conducted with randomly selected people for evaluation of immunological detection of active and non-active tuberculosis compare with control individuals by using T-Spot. TB test, compare with tuberculin skin test (TST), conventional and molecular tests. The diagnostic sensitivity and specificity that estimated for T-Spot.TB test compare to TST were 51% and 47% respectively, and ORA was 50 %. This study concludes capability of T-Spot.T B test in diagnosis of active, under- treatment and latent PTB cases with more benefit to diagnose of extra pulmonary cases. Also, the study confirmed the failure of TST test in evaluation of PTB positive and negative incidences in respect of vaccinated or non- vaccinated status.


Article
Assessment of the Major Anti-Tuberculosis Drugs Available to Patients at Primary Health Care Centers in Baghdad City
تقييم الأدوية الرئيسية المضادة للتدرن المتوفرة للمرضى في مراكز الرعاية الصحية الأولية في مدينة بغداد

Authors: Eqbal G. Ali اقبال غانم --- Ammar A. Okab عمار عباس
Journal: nursing national Iraqi specility المجلة العراقية الوطنية للعلوم التمريضية ISSN: 18122388 Year: 2017 Volume: 30 Issue: 1 Pages: 96-102
Publisher: Baghdad University جامعة بغداد

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Abstract

Objective: To assess the major anti-tuberculosis drugs available to patients at primary health care centers in Baghdad city. Methodology: A descriptive cross-sectional study design is carried out in order to achieve the objectives of the study by using the assessment technique in primary health care centers from December 29th, 2014 to July 10 th, 2015. probability sampling is select based on the study design. Eighteen primary health care centers are select according to criteria of sample to the study and for the purpose of the study, is select (6) sectors and (11) Primary Health Care Centers (PHCC) from Baghdad Health Department/Al-Rusafa Directorate and (6) sectors and (7) primary health care centers from Baghdad Health Department/Al- Karkh Directorate in Baghdad city. The data is collect by special questionnaire to obtained general information about primary health care centers (county, Sector, named of primary health care centers, estimated number of population and the number of patients use Tuberculosis drugs available in primary health care centers. Data analysis is done by using program of (SPSS) version 20 , Descriptive data through determination of: Frequencies , Percentages and, Inferential statistical data analysis is done applying Chi –square test for determining the association between the study main domains. Results: 22% of drugs KIT (HRZE)and KIT (HR) and present highly significant association between number of patients use Tuberculosis drugs and preventive drug (Izenazahid) .. Recommendations: based on the study’s findings, it is highly recommends that the Ministry of Health maintains providing the anti-tuberculosis medications on a regular basis.

الهدف: تقييم الأدوية الرئيسية المضادة للتدرن المتوفرة للمرضى في مراكز الرعاية الصحية الأولية في مدينة بغداد .المنهجية : : دراسة مقطعية متقاطعة وصفية أجريت من 29 كانون الأول 2014 لغاية 10 تموز 2015، وتم اختيار العينة بطريقة العينة الاحتمالية (عينة عشوائية) من (18) مركز رعاية صحية أولية واختيارها وفقا لمعايير عينة الدراسة ،موزعين كالأتي : تم اختيار(6) قطاعات و (11) مركز رعاية صحية أولية من دائرة صحة بغداد الرصافة و(6) قطاعات و(7) مركز رعاية صحية أولية من دائرة صحة بغداد الكرخ. الاستبيان تكون من جزئين رئيسيين: جزء المعلومات العامة : ويشمل ذلك (5) وحدات وجزء أنواع أدوية التدرن المتوفرة في مراكز الرعاية الصحية الأولية و تم تحليل البيانات باستخدام برنامج SPSS النسخة 20 عن طريق البيانات الوصفية من خلال تحديد: التكرارات والنسب المئوية وجدول إحصائي و استدلالي لتحليل البيانات الإحصائية من قبل تطبيق الاختبار كاي- سكوير الذي يستخدم لتحديد الارتباط بين جزئي الدراسة.النتائج: أظهرت الدراسة إن ما نسبته 22% من الأدوية كان دواء كت الرباعي وكت الثنائي و أظهرت أيضا أن هناك علاقة واضحة بين عدد المرضى الذين يستعملون أدوية التدرن والعلاج الوقائي ايزونازايد.التوصيات: وبناء على نتائج ألدراسة يوصى بشدة بأن تقوم وزارة الصحة بتوفير الأدوية المضادة للسل على أساس منتظم.


Article
Outcome Of Surgical Treatment Of Tuberculosis Of The Spine In Patients With Motor Deficits

Author: Bassam Mahmood Flamerz *
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2017 Volume: 13 Issue: 1 Pages: 56-62
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Significant numbers of patients with spinal tuberculosis (TB), especially in developing countries, still present late after disease onset with severe neurological deficits. Objective:This study was conducted to assess the outcome of surgery in patients with tuberculosis of the spine with motor deficits.Type of the study: Retrospective study.Methods: We retrospectively analyzed data obtained in all the patients with severe motor deficits due to spinal TB admitted to and surgically treated in four hospitals in Baghdad/Iraq during the period from January 2012 to January 2014. History, examination, imaging, histological, postoperative, and follow-up data were retrospectively culled from hospitals records and then analyzed. Data obtained in 48 patients with 6-24 months of follow up (mean follow-up period 12.8 months) were analyzed. The disease in 34 patients was characterized by Frankel Grade A/B and in 14 patients by Frankel Grade C at admission. Results: Thirty (88%) of the 34 patients with Frankel Grade A/B status and 13 (92.8%) of the 14 patients with Frankel Grade C status at admission experienced improvement to Frankel Grade D/E (walking with or without support) at the last follow-up examination after surgery. The degree of improvement exhibited by patients with a Frankel Grade A/B spinal cord injury was comparable to that shown by patients with Frankel Grade C status. Even patients with flaccid paraplegia, gross sensory deficit, prolonged weakness, spinal cord signal changes demonstrated on magnetic resonance imaging, and bladder involvement have experienced dramatic improvement in motor function since surgery. A significant number of the patients have shown remarkable improvement in other symptoms such as pain (91.6%), spasticity (88%), and bladder symptoms (88%).Conclusions: A significant proportion of patients with spinal TB and severe motor deficits experience remarkable improvement after surgical decompression and hence should undergo surgery even though they may be suffering from paraplegia of considerable duration.


Article
Bacterial profiling of healthy bone marrow using polymerase chain reaction technique

Authors: Vidyut Prakash --- Deepak Kumar --- Saurabh Singh --- Gopal Nath
Journal: Iraq Joural of Hematology المجلة العراقية لامراض الدم ISSN: 20728069/25432702 Year: 2017 Volume: 6 Issue: 2 Pages: 69-73
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

BACKGROUND: The bone marrow of healthy individuals is conventionally considered sterile like otherbody fluids, but recently the scientists found genetic material from the bacteria inside their stem cells.The findings raise the possibility that other infectious agents may also reside in the bone marrow.OBJECTIVES: The study was planned to look for the presence of all type of bacteria by amplifying16S rDNA sequences using eubacterial universal primers.MATERIALS AND METHODS: A total of 18 bone marrow samples of apparently healthy individualswere collected from patients admitted having closed bone fractures. The DNA was isolated and wassubjected to nested polymerase chain reaction (PCR) using Universal eubacterial 16S rDNA primers.The samples positive by universal PCR was further checked for the presence of Salmonella Typhi,Salmonella Paratyphi A, and/or Mycobacterium tuberculosis (Mtb) if any using a second nestedPCR reaction.RESULTS: A total of 16 (89%) samples could yield the desired amplicon through universal PCR.The secondary PCR of 16 samples, the desired amplicons were detected 3 (18.8%) for Mtb, 4 (25%)for S. Typhi, and 1 (6.2%) for S. Paratyphi A.CONCLUSIONS: Even in asymptomatic cases, other infectious agents such as Mtb, Salmonellaspp., and many other microorganisms may be present as commensal.

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