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Article
Effect of HLA-B27 on Development of Psoriatic Arthropathy
تأثيرمستضدات التطابق النسيجي نوع B27 على حدوث التهاب المفاصل في مرض الصدفية

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Abstract

Background: Psoriatic arthritis is a type of arthritis that can often affect some patients who suffer from psoriasis. Approximately 40-50% of individuals with psoriatic arthritis have the HLA-B27 genotypeObjective: To investigate whether we could confirm the role of HLA-B27 alleles and psoriatic arthritis in Iraqi Arab Muslims patients.Method: A cross sectional case control comparative study included thirty Iraqi Arab Muslims who had psoriatic arthritis that consulted the Dermatological and Rheumatological Department in AL-Kindy Teaching Hospital from November 2014 to June 2015. HLA-genotyping for HLA-B27 were assessed. A control group consisted of fifty-one healthy volunteers among the staff of Al-Kindy College of Medicine that did not have psoriatic arthritis or family history of psoriasis. HLA-B*27allele was done by using an Exicycler TM 96 Real-time Quantitative Thermal Block (Bioneer, Daejeon, Korea) and Accupower, HLA-B27 real-time PCR kit (Bioneer, Daejeon , Korea) Results: Plaque type psoriasis is more common than other types of psoriasis (66% versus 34%). There is no association between psoriatic arthritis and HLA-B27 with p-value of 0.1197 and Odds ratio (confidence interval) of 2.9375 (0.755-11.415).Conclusions: HLA B*27 is not associated with psoriatic arthritis in Iraqi Arab Muslims patients.

الخلفية: ان التهاب المفاصل الصدفي هو أحد أنواع التهاب المفاصل والذي قد يظهر في بعض المرضى الذين يعانون من مرض الصدفية . يبدا التهاب المفاصل في بعض المرضى بعد ما تظهر أعراض الصدفية وفي بعض الحالات يبدأ التهاب المفاصل قبل ظهور أعراض الصدفية. الأهداف: تقصي العلاقة بين مستضدات كريات الدم البيضاء البشرية نوع class I B27 وتكرارها في نماذج مأخوذة من مرضى عراقيين مصابين بمرض التهاب المفاصل الصدفي مع مجموعة مقارنة من الأشخاص الأصحاء. طرق العمل: اشتملت الدراسة على 30 مريض عراقي مصابين بمرض التهاب المفاصل الصدفي تم جمعهم من قسم الجلدية والمفاصل في مستشفى الكندي التعليمي للفترة من شهر تشرين الثاني 2014 إلى شهر حزيران 2015 وتم مقارنتهم بمجموعة من الاصحاء والبالغ عددهم 51 شخصا وتم اجراء التحليل الجزيئي بطريقة “Real Time PCR” لكلا المجموعتين لغرض اثبات او نفي وجد الاليل B27 .النتائج: أظهرت النتائج عدم وجود أي علاقة احصائية بين التهاب المفاصل الصدفي والآليل B27 ( p-value) =0.1197 و Odds ratio = confidence interval)l 2.93 (0.75-11.4 بالتعاقب.الاستنتاج: ليس هناك علاقة بين النوع الجزيئي لمستضد كريات الدم البيضاء B27 مع الاصابة بمرض التهاب المفاصل الصدفي.

Keywords

psoriatic arthritis --- HLA-B*27 --- PCR.


Article
Molecular and Serologic Detection of HLA-B27 among Ankylosing Spondylitis Patients with Some Clinical Correlations

Author: Mayada MA Abdulhadi*, Bassam MS Al-Musawi**, Mohammed H Al-Osami***
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2018 Volume: 17 Issue: 3 Pages: 261-270
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND: HLA-B27 can effect clinical presentation and course of ankylosing spondylitis. Different detection techniques of HLA-B27 are available with variable sensitivities and specificities. OBJECTIVE: To compare serologic and molecular diagnostic techniques of detecting HLA-B27 status and to correlate it with some clinical variables among ankylosing spondylitis patients.PATIENTS AND METHODS: A cross-sectional study was conducted on 83 Iraqi patients with ankylosing spondylitis. Clinical and laboratory evaluations were reported. HLA-B27 status was determined in all patients by real-time PCR using HLA-B27 RealFast™ kit; ELISA method was used as well to detect soluble serum HLA-B27 antigens using Human Leukocyte Antigen® kit. RESULTS: The mean age of patients ± SD was (38.4±9.8) years. Male to female ratio was 9:1. Disease onset occurred <30 years in 78% of cases. All (100%) cases had lower back pain, 44 (54%) patients had enthesitis, 14 (16.9%) had peripheral arthritis, 12 (14.5%) had eye involvement, while cardiovascular disease and psoriasis were present in one patient (1.2%) each. HLA-B27 was detected in 55 (66.3%) patients by real-time PCR. The disease onset was earlier and disease duration was longer in HLA-B27-positive patients (p-value<0.05 for both). Uveitis was significantly associated with HLA-B27 positivity (p=0.032). HLA-B27 positive cases by ELISA test were 32 (38.6%) patients. Comparing HLA-B27 gene detection by real-time PCR with sHLA-B27 detection by ELISA revealed that the sensitivity of ELISA was 38.18%, specificity was 60.71% and positive predictive value (PPV) was 61.8%.HLA-B27 typing by microlymphocytotoxicity (MLCT) test from initial old serologic typing was available for a subgroup of 28 (33.7%) cases. Comparison of ELISA and MLCT results with real-time PCR in this subgroup of 28 cases revealed that ELISA method showed a sensitivity of 60.6%, specificity of 72.72% and PPV of 86.95%, while MLCT showed a sensitivity of 68.96%, specificity of 80%, and PPV of 90.9% CONCLUSION: Real-time PCR detection of HLA-B27 status is superior to serological techniques (ELISA and MLCT) as the latter two yielded high false results, with MLCT being relatively better than ELISA.


Article
Using of TLR2 and TLR4 as Biomarker of Sepsis Severity Detection

Authors: Farah Q. Younis --- Ali H. Alwan --- Neihaya H. Zaki
Journal: Al-Mustansiriyah Journal of Science مجلة علوم المستنصرية ISSN: 1814635X Year: 2018 Volume: 29 Issue: 2 Pages: 83-92
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Sepsis syndrome is a complicated clinical dysfunction, which caused by a systemic inflammatory response to bacteria and/or their products .The quantitative real-time PCR technique has been used for measure TLR2 and TLR4 gene expression in whole blood, and ELISA technique has been used for detection of cytokines TNF-α, IL-10 and soluble HLA-DR from 75 septic syndrome cases (nineteen of patients showed symptoms of systemic inflammatory response syndrome (SIRS); twenty eight patients have sepsis, seventeen patients suffered from severe sepsis and eleven patients have septic shock) and 55 healthy controls (HC). TLR2 and TLR4 mRNA expression was high and significant in the all patients (P< 0.05). TNF-α, IL-10 and sHLA-DR serum levels were significantly elevated in the serum of patients group with septic syndrome compared with controls (P<0.05). However, the level of HLA-DR in SIRS patients was non-significant in comparing with healthy control group. Furthermore, TLR2 and TLR4 showed that there are significant differences between the severity stages of sepsis. The correlation between TLR 4 with concentration of sHLA-DR was significant and positive. The results of a recent study conclude that the possibility of using TLR 2 and TLR 4expression to determine the severity of sepsis as diagnostic biomarker.

متلازمة الإنتان هو اختلال وظيفي سريري معقد، سببه استجابة التهابية جهازية للبكتيريا و/أو منتجاتها. تم قياس مستوى التعبير الجيني لكل من المستقبلات الشبيهة بالتول 2 و 4 في كامل الدم بإستخدام تقنية تفاعل البوليميريز المتسلسل اللحظي الكمي Quantitative Real-Time PCR. ومن خلال تقنية ELISA تم قياس مستوى كل من عامل النخر الورمي الفا والانترلوكين 10 و مستضد كريات الدم البيضاء البشرية-در الذائب في 75 عينة دم من المرضى المصابين بمتلازمة الانتان (19 مريضا تم تشيخصهم بمتلازمة الاستجابة الالتهابية الجهازية و 28 مريضا مصاباً بالانتان (SIRS) ، 17 مريضا مصابا بالانتان الحاد و11 مريضاً مصابأ بالصدمة الانتانية). تمت المقارنة مع 55 شخص كعينات سيطرة. اظهرت النتائج ارتفاع مستوى التعبير الجيني لكل من TLR2 و TLR4 في جميع المرضى مقارنة مع عينات السيطرة (P< 0.05) ). بالاضافة الى الارتفاع الملحوظ في مستويات كل من عامل النخر الورمي الفا و الانترلوكين 10 و مستضد كريات الدم البيضاء البشرية-در الذائب( (P<0.05مقارنة مع مجموعة السيطرة ما عدا مستوى مستضد كريات الدم البيضاء البشرية-در الذائب لم يشكل اي اختلاف ملحوظ في المرضى المصابين بمتلازمة الاستجابة الجهازية مقارنة مع مجموعة السيطرة. اظهرت النتائج ايضا اختلافات واضحة في التعبير الجيني لكل من TLR2 و TLR4 على مستوى كل مرحلة من مراحل الاصابة بالمتلازمة, كما لوحظ وجود ارتباط موجب بين التعبير الجيني لـ TLR4 و مستوى مستضد كريات الدم البيضاء البشرية-در الذائب في المصل. ومن خلال النتائج الظاهرة، يمكننا الاستخلاص بإمكانية استخدام التغيير في التعبير الجيني للمستقبلات الشبيهة بالتول 2 و 4 كعلامة بايلوجيه تشخيصية لشدة الاصابة بمتلازمة الانتان.


Article
Marriage variables relation to abnormal cervical Pap smears results in Nineveh governorate patient's women

Authors: Nada A. Mijthab --- Israa H. Saadoon --- Ehsan M. A. Almola --- Duha A. Mijthab
Journal: The Medical Journal of Tikrit University المجلة الطبية لجامعة تكريت ISSN: 18131638 Year: 2018 Volume: 24 Issue: 2 Pages: 148-158
Publisher: Tikrit University جامعة تكريت

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Abstract

ABSTRACT: Background The cervical Pap smear test is a standard screening procedure used for cervical cytology testing for the diagnosis of premalignant and malignant cervical lesions .The risk factors for cervical cancer are early age at first intercourse, multiple sexual partners, nutritional status, hormonal changes, parity, host immune status, smoking, viral oncogenic Human Leukocyte Antigens (HLA) types and coinfection with other viruses such as human immunedeficiency virus-1 and herpes simplex virus. Aim: is to study the relation of some of the marriage variants as risk factors for cervical cancer with abnormal Pap smears results for women in Nineveh governorate. Materials and Methods: A cross-sectional study was carried out on patients' women attended the Obstetric and Gynecological Mosul Hospitals for the period from June 2013 through June 2014, after the collection of data through direct meeting and a questionnaire comprising patients' characteristics and the results of Pap smear. Five hundred fifty one Pap smears were collected from women between the ages of 11 and 76 years. The personal characteristics of women included the mean age at 1st marriage which was 18.9 years; 18.8 years mean age of duration of marriage, and mean age at 1st delivery as 20.3 years. Other features included the sequences among wives or husbands which were found to be higher in 1st sequence (who had one husband or those who her husbands never had another wife): 464, 84.21% and 508, 92.20% respectively. Results: abnormal Pap smears were 99/551(17.97%). A significant relation were observed between abnormal Pap smear in highest percentage at age (25-45) years 51.52% (P=0.032), and mean age at early forty 41.6± 12.21(P=0.002). The highest rate of women with epithelial abnormal Pap smears results were 1st sequence among wives and husbands (79.80% and 91.92% respectively). The mean ± SD of women with epithelial abnormal Pap smears were 18.3 ± 4.66 years of age at 1st marriage, and 19.7 ± 4.90 years of age at 1st delivery. Non-significant relation was detected between abnormal Pap smears and each of (the sequence among wives or husbands, age at 1st marriage, and at 1st delivery). Mean ± SD of women with epithelial abnormal Pap smears results were 21.1 ± 12.41years of duration of marriage, and there was significant effect for duration of marriage by using the same test between the two mean ages (P=0.028). Conclusion: the age, and duration of marriage were strongly related to abnormal cervical Pap smear results, while age at 1st marriage , 1st delivery , sequence among wives or husbands were not related with epithelial abnormal cervical Pap smear in Nineveh governorate women.

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