role of autoantibody and antioxidant enzymes in patients with type 1 diabetes

To determine autoantibodies and antioxidant enzymes as well as the correlation between them. This study included 80 individuals, 40 patients with type 1 diabetes and 40 healthy individuals without diabetes [as a control group]. The study was carried out during the period from December 2010 to the end of December 2012 at Al-Tahreer General Hospital, Al-Basra Maternity and Pediatric Hospital, and Al-Sader Teaching Hospital. Laboratory investigations were performed to estimate glutamic acid decarboxylase antibody [GADA] and islet cell antigen-2 antibody [IA-2A] by enzyme-linked immunosorbent assay [ELISA], antioxidant enzymes [glutathione peroxidase [GPX] and superoxide dismutase [SOD]], and glycosylated hemoglobin [HbA1c] [as a marker of glycemic control] for these patient and control groups. The high prevalence of GADA and IA-2A had been demonstrated among patients with type 1 diabetes, which was significantly higher [P < 0.001] [72.5%] in comparison to 0% in the control group. These results are suggestive of the autoimmune characteristic of type 1 diabetes. The age of onset of type 1 diabetes is found to affect the frequency of these autoantibodies. The frequency was significantly higher in patients who developed the disease in early childhood [91.7% for GADA and 58.3% for IA-2A] in comparison with those who developed the disease later on [40% for GADA and 20% for IA-2A]; this probably occurred due to genetic and non-genetic factors. Although the statistical analysis of the correlation between gender and autoantibodies showed no significant difference, female patients with type 1 diabetes were found to be more affected than male patients. The frequency of these autoantibodies was found to decrease as the duration of type 1 diabetes increased. The prevalence of GADA and IA-2A in patients with duration of disease less than 5 years was 78.3% and 43.5%, respectively, and began to decrease to 0% for GADA and IA-2A in those with disease duration more than 12 years. These results are attributed to the depletion of islet cell autoantibodies with time. Additionally, HbA1c levels were significantly higher in islet cell autoantibodies-positive patients than in islet cell autoantibodies-negative patients [P < 0.001]. The difficulty in achieving glycemic control despite oral hypoglycemic drug and insulin therapy is attributed to the fact that the pathogenesis of disease in developing type 1 diabetes and latent autoimmune diabetes [LADA] in adults is due to beta-cell destruction rather than insulin resistance as in classical type 2 diabetes. The mean activity of both antioxidant enzymes [SOD and GPX] in red blood cells [RBCs] was significantly lower than the control [P < 0.001]. Also the lower mean activity of both antioxidant enzymes [SOD and GPX] in RBCs showed a higher significant value in patients who had uncontrolled diabetes [HbA1c level > 8%] [P < 0.001]. Patients with LADA who were tested positive for GAD and IA-2A showed a significant decrease in the mean activity of SOD and GPX in comparison to patients with type 2 diabetes who were tested negative to autoantibodies; most of the patients with LADA also had a higher HbA1c level > 8% [P< 0.001]. There is a strong evidence of the role of autoimmunity in the pathogenesis of type 1 diabetes. The oxidative stress SOD and GPX are depleted as well. The correlation reflects the more oxidative stress with poor diabetic patients may progress the complications

role of cytokines among women with spontaneous miscarriage

To evaluate cytokine production in women with unexplained pregnancy loss. The study enrolled 84 women age 15-41 years with a mean age of 25.07 +/- 6.6, during the period from September 2011 till March 2012 from Basrah Hospitals, Iraq. The patients group comprised 46 women with first trimester miscarriage. The control group included 38 women with first trimester successful pregnancy with no history of miscarriage. Cytokines were measured by ELISA. There were significantly higher levels of IFN-gamma, TNF-alpha, IL-2 and IL-10 in the aborted women as compared to the controls. In relation to IL-4 and IL-6 non-significant difference was detected between women with miscarriage and control groups. Significant effect of age on serum IL-2 and IL-10 in women with first trimester miscarriage was recorded while no effect observed in the levels of IFN-gamma, TNF-alpha, IL-4 and IL-6. Furthermore, significant higher level of all Th-1 cytokines for miscarriage group than control group for women aged 25-34 years was noticed. In contrast, non-significant differences were found between estimated level for miscarriage and control groups of all Th-1 cytokines for age group >34 years. This study supports the hypothesis of role of Th-1 produced cytokines in the pathogenesis of miscarriage

Microsporidiosis among children with malignant diseases in Basrah, Iraq

To estimate the prevalence of microsporidiosis among children with malignant diseases. Stool samples were collected from 58 children [37 males and 21 females] with malignant diseases and 107 apparently healthy children [55 males and 52 females]. Direct smear method was done for all stool samples to detect the intestinal parasites. Fecal smears were prepared and stained by Trichrome stain method for the recovery of Microsporidium spores. The results showed that acute lymphocytic leukemia [ALL] was the most prevalent [55.2%] malignant disease among the studied patients. The highest rate of Microsporidium infection among the 12 types of malignant diseases was found in patients with Hodgkin and non-hodgkin lymphoma [83.3%]. Prevalence of various species of intestinal parasites [including Microsporidium] was 48.3%. The highest rate of parasitic infections was observed in patients with ALL [34.4%]. No Microsporidium spores were observed in stool samples of the control group. The clinical symptoms among patients included weight loss [77.6%], fever [29.3%] and diarrhea [27.6%]. Microsporidium and other intestinal parasites should be considered among the patients with malignant diseases in order to minimize their symptoms

[Trace elements levels in patients with some different parasitic infections]

To evaluate serum levels of zinc, copper and iron in regard to some different parasitic diseases. A case-control study was carried out during the first 9 months of 2007 in Basrah, Southern Iraq. Blood samples were collected from 230 subjects aged 1 -65 years.One hundred samples out of 230 collected from patients with parasitic infections [35 patients with toxoplasmosis, 32 patients with leishmaniasis, 24 patients with amoebiasis and 9 patients with giardiasis] while the rest 130 were apparently healthy subjects and considered as control group. The absorbance of each serum sample against blank was measured by flame atomic absorption spectrophotometer. Serum zinc levels were decreased significantly in patient group when compared with healthy subjects [p<0.001], while both serum copper and serum iron were increased significantly in patient group when compared with control group [p<0.001]. There was no significant difference in regard to the effect of age and sex on serum trace elements levels in patients and control groups. The significant decrease in serum zinc level and an increase of serum copper and iron in patients might be related to the parasitic infection

Cryptosporidiosis and immunological status in children with malignant diseases

To investigate the relationship of Cryptosporidium and immunological parameters among children with malignant diseases. Stool samples were collected from 101 children with malignant disease and 107 apparently healthy children. Direct smear method and then formalin-ether sedimentation method were done for all stool samples to identify intestinal parasites. Fecal smears were prepared from the sediment and stained by the modified Ziehl-Neelsen method for the recovery of acid-fast oocysts of Cryptosporidium. Phagocytic activity, complement C3 and C4 estimation, immunoglobulin levels and CD3, CD4, CD8, CD19 marking and phenotyping were carried out for 30 patients with acute lymphocytic leukemia [ALL] and 20 control group. ALL was the major type [47.52%] of malignant cases in the studied subjects. The other type ranged from 0.99% to 10.9%. Out of the 101 patients, 50 [49.5%] were found to be positive for intestinal parasites compared to 13 [12.15%] of the control group [P<0.01]. Cryptosporidium oocysts were found to be excreted by 10[9.0%] patients and 1[0.93%] of the control group [P<0.01]. The phagocytic activity, levels of IgM, IgA, IgG and CD3, CD4 cell numbers were lower in patients than in control group while higher in case of C3, C4, CD8 and CD19. Children with malignancy are immunocompromised. Therefore, Cryptosporidium and other intestinal parasites must be considered in the differential diagnosis in this risky group in order to reduce the suffering often faced by those children

Anticardiolipin antibody in women with recurrent spontaneous miscarriage

To determine the association between the presence of anticardiolipin antibody [ACA] and history of recurrent spontaneous miscarriage. Also, to evaluate the association between raised ACA and activated partial thromboplastin time [APTT]. This is a case-control study which was carried out in Basrah Hospital for Maternity and Children, Basrah, Iraq during January to September 2004 on 91 women with recurrent spontaneous miscarriage, matched with 109 women with no history of pregnancy wastage. Sera were collected from these 200 women and analyzed for ACA by enzyme linked immunosorbent assay [ELISA]. In women with pregnancies that ended with a loss, 17.6% were positive of ACA, compared with none among the control group. Women with 4 or more miscarriages had almost higher percentages of ACA [26.3% and 22.2%] than women with only 3 miscarriages [13%] but with no statistical significance. Prolonged APTT was detected among 18.8% of patients having positive ACA while only 1.6% of patients who were negative for this antibody. A significant association was observed between recurrent spontaneous miscarriage and the presence of ACA. Also, there was a significant relationship between positive ACA and prolonged APTT

Intestinal parasitic infections including cryptosporidiosos and immunological aspects among malnourished children

This is a case control study which involved 194 malnourished children below 5 years of age who were attending Basrah Maternity and Children Hospital during 2001 About 84% have marasmus, 8.24% marasmun kwashiorkor 6.18% kwashiorkor and 1.55% under weight Parasitic infections were more frequent among malnourished children [59.8%] than wellnourished children [33%] with increased frequency among malnourished children with diarrhea [32.5%] Cryptosporidiosis was found in 6.85% of children below 5 years with increased frequency among malnourished children with diarrhea 14.89% compared to 11% in malnourished children without diarrhea Only 2% were noticed among wellnourished children with diarrhea while no case has been recorded in wellnourished children without diarrhea. Depressed cellular immunity characterized by decrease in total lymphocytes [particularly T-lymphocytes] was found among malnourished children either with or without diarrhea While humoral immunity [IgG, IgM, IgA] was significantly elevated among malnourished children with or without diarrhea in comparison to wellnourished children. C3 and C4 were increased in malnourished children without diarrhea with significant difference in C4 only. While they were decreased in malnourished children with diarrhea, with significant difference in C3. In addition, Phagocytic activity showed a significant decrease in malnourished children with or without diarrhea compared to wellnourished children

Cryptosporidiosis and other intestinal parasitic infections in patients with chronic diarrhea

To consider the relationship of the parasitic infections including cryptosporidium with chronic diarrhea. Also the effect of chronic disease as pulmonary tuberculosis [TB] and nosocomial infection on the occurrence rate of parasites in cases of chronic diarrhea. Stool samples were collected from 205 patients in teaching, general, child and maternity hospitals in Basrah, Iraq, suffering from chronic diarrhea during 2000. Out of these patients, there were 40 patients with pulmonary TB and 50 inpatients with nosocomial infection. Also 175 apparently healthy individuals who have no episodes of diarrhea for at least 2-months were served as a control group. Direct smear method and then formalin ether sedimentation method were carried out for stool samples to detect intestinal parasites. Fecal smears were prepared from the sediment and stained by the modified Ziehl Neelsen stain for the recovery of red pink oocysts of cryptosporidium. Out of the 205 examined patients, cryptosporidium oocysts were found to be excreted in 20 [9.7%] patients in comparing to 1.1% of the control group. The difference is statistically significant. There were 109 [53.2%] patients found to be positive for intestinal parasitic infections compared to 26 [14.8%] of the control group. The difference is also statistically significant. Out of the 40 TB patients, 2 [5%] were found to excrete cryptosporidium oocysts and also 27 [67.3%] were positive for intestinal parasites. In addition, there were 4 [8%] excreting cryptosporidium oocysts and 23 [46%] infecting by intestinal parasites among the in patients with nosocomial infection. Both acid and non-acid fast parasites should be considered in the differential diagnosis of undiagnosed chronic diarrhea especially among patients with pulmonary TB or nosocomial infection

effect of breast feeding on amoebiasis, giardiasis, and cryptosporidiosis in children below the age of two years

To determine the effect of breast feeding on amoebiasis, giardiasis and cryptosporidiosis in infants in our region. Stool samples were collected from 180 children below 2 years of age who suffered from acute diarrhea. There were 81 breast fed, 49 bottle fed, and 50 mixed bottle and breast fed children. The direct smear method and then formalin-ether sedimentation were carried out to detect intestinal parasites. Fecal smears were prepared from the sediment and stained by the modified Ziehl-Neelsen method for the recovery of acid-fast oocysts of Cryptosporidium. Intestinal amoebiasis, giardiasis and cryptosporidiosis were found at the highest rates [53%, 55% and 64% respectively] among bottle fed children. Collectively, 16.3% of the bottle fed children with diarrhea tested positive for parasitic infections. Breast feeding appears to reduce the risk of these parasitic infections and should be encouraged

Toxoplasmosis among women with habitual abortion

The role of maternal toxoplasmosis as a risk factor for habitual abortion was investigated. The indirect haemagglutination test was positive in a titre of 1:32 to 1:2048 much more frequently in women with habitual abortion [18.5%] than in the normal pregnancy group [5.9%]. The overall prevalence of antibodies gradually increased with age, reaching 23.7% in the age group 35-45 years. No differences were found among women in different socioeconomic groups. The study suggests that toxoplasma antibodies are more prevalent in women with cats at home than in women who do not possess cats

Neonatal intestinal amoeblasis in Iraq: a report of 6 cases

From January to May too 5, first 6 cases of neonatal amoebiasis [3 boys and 3 girls] aged 3-35 days were reported. Four patients were breast fed. The range of family size was 3-15 members. There were 4 patients from urban region and only 2 from rural area. Stool samples were collected and examined before and after metronidazole treatment by direct smear method. All patients were recovered and the parasite disappeared from their stools

First report of cryptosporidiosis among Iraqi children

Of 240 Iraqi children under five years old with a primary diagnosis of gastroenteritis and dehydration, 22 were excreting Cryptosporidium oocysts in their stools. This is the first reported occurrence of cryptosporidiosis among Iraqi schoolchildren. Samples were collected and examined by the modified Ziehl-Neelsen method between March and November 1994. The frequency distribution of Cryptosporidium among 114 positive cases with intestinal parasites was 18.3%. The boy-to-girl ratio was 1:2 among the Cryptosporidium-positive children. Most patients complained of abdominal colic and watery diarrhoea and were clinically dehydrated. The associated symptoms were fever and vomiting. Cryptosporidium and Giardia appeared to be associated

Trichomonas tenax in Basrah, Iraq

One hundred and fortythree swabs from diseased mouths and 271 from healthy controls were examined by direct wet smear method for Trichomonas tenax. Negative swabs were cultured on suitable media. The frequency of trichomonas tenax was 8.4% and 4.1% in diseased and controls respectively. Of 23 positive samples, 14 [3.3%] were positive on direct wet smear method and 9 [2.1%] were positive on culture method. There were 12 males and 11 females. Highest frequency of infection [6.7%] was found in 6-10 years age group and lowest [3.7%] in 11 -20 years group. Only 1% university students were positive

Pulmonary hydatidosis in man and his livestock in Southern Iraq

Human pulmonary hydatidosis was studied in 22 surgically established cases at the Tahreer and Teaching hospital of Basrah during 1984. The age of the patients varied from 8 to 45 years and most of them were from rural areas; there were 13 females and nine males. A survey was carried out on animal pulmonary hydatidosis at Basrah abattoirs during the first 9 months of 1985. A total of 85 424 slaughtered animals were inspected and the results revealed that 5.43% of 60 556 sheep, 1.23% of 22 040 cattle and 3.96% of 2828 buffaloes were infected