Evaluation of Current Diagnostic Tests for Typhoid Fever in Al-Kindy Teaching Hospital

Background: Typhoid fever is a potentially fatal multisystemic illness caused primarily by Salmonella enterica (S enterica) subspecies enterica serovar typhi and, to a lesser extent, related serovars paratyphi A, B, and C and others. Objectives: Is to assess different methods in diagnosing typhoid fever in the patients attending Al-Kindy Teaching Hospital and to know which one of them is the best in the diagnosis. Type of the study: A retrospective cross-sectional study. Patients and methods: Total 100 patients consulted Al-Kindy Teaching Hospital, laboratory department in Baghdad, Iraq for diagnosis of typhoid fever from December 2017 to March 2018. About 50 of them were tested for Widal test and the rest were blood culture done for them. Results: Widal test showed positive results in 14% of the patients and the rest were negative. There was a significant difference between two groups (p=0.002), while results of blood culture showed a negative result in 86% of cases and the rest 14% were positive with other bacteria like E. coli, Pseudomonas spp. and Staphylococcus spp. There were no significant differences between the two groups (p=1). Conclusion: Widal test is not useful in diagnosing the disease and blood culture was negative due to the inappropriate time of blood collections.

Role of adiponectin in patients with inflammatory bowel disease unclassified / Papel da adiponectina em pacientes com doença intestinal inflamatória não classificada

ABSTRACT Background: Inflammatory bowel disease (IBD) is a lifestyle idiopathic, chronic, and inflammatory intestinal disorders that required long-term medications and care. Aim of the study: Assess the level of adiponectin in IBDU and its relation with different parameters like lipid profile and Body Mass Index (BMI). Type of the study: A case-controlled study. Patients and methods: The total number of study groups was sixty individuals, forty of them were patients with inflammatory bowel disease unclassified and the rest were control healthy subjects. Serums were examined for lipid profile (cholesterol, triglyceride, HDLP, LDLP (Human-Germany), adiponectin (Human-Germany). Results: Adiponectin, cholesterol, triglyceride, LDL and LDL/HDL were significantly higher in patient group. The results showed that there was a negative correlation between adiponectin and height (r = -0.071), waist to hip ratio (r = -0.174), cholesterol (r = -0.417), HDL (r = -0.039), LDL (r = -0.451) while other parameters there are positive correlation. Conclusions: IBDU is associated with increased level of adiponectin which is positively associated with BMI and triglyceride. It is negatively correlation with height, waist to hip ratio, cholesterol, HDL and LDL.

RESUMO Fundamento: A doença intestinal inflamatória é um distúrbio intestinal idiopático, crônico e inflamatório devido ao estilo de vida que requer medicamentos de longo prazo e cuidados. Objetivo do estudo: Avaliar o nível de adiponectina na doença intestinal inflamatória não classificada e sua relação com diferentes parâmetros, como o perfil lipídico e o índice de massa corporal. Tipo de estudo: Estudo de caso controle. Pacientes e métodos: O número total de grupos de estudos foi de 60 indivíduos, quarenta deles eram pacientes com doença intestinal inflamatória não classificada e o restante era de indivíduos saudáveis controle. Os soros foram examinados para detecção de perfil lipídico (colesterol, triglicerídeos, HDLP, LDLP (Humano-Alemanha), adiponectina (Humano-Alemanha). Resultados: Adiponectina, colesterol, triglicerídeos, LDL e LDL/HDL foram significativamente maiores no grupo de pacientes. Os resultados mostraram que havia uma correlação negativa entre adiponectina e altura (r = -0.071), relação cintura-quadril (r =-0.174), colesterol (r = -0.417), HDL (r = -0.039), LDL (r = -0.451) enquanto que para outros parâmetros há uma correlação positiva. Conclusões: Doença intestinal inflamatória não classificada apresenta um nível aumentado de adiponectina que está positivamente associado a índice de massa corporal e triglicerídeos. Está negativamente correlacionada com altura, relação cintura-quadril, colesterol, HDL e LDL.

Relation between osteoarthritis and HLA-A in Iraqui patients

Relación entre osteoartritis y HLA - A en pacientes iraquíes. (HLA: acrónimo inglés de antcígenos leucocitarios humanos - Human Leucocyte Antigens). La osteoartritis e la afección más común que involucra el aparato osteo-articular. Representa a un grupo heterogéneo de condiciones resultante de cambios comunes histopatológicos y radiológicos. Existen múltiples factores de riesgo para la osteoartritis: edad, obesidad, y el antígeno genético. El leococitario humano (HLA) como parte del sistema inmune, teniendo un rol en el proceso nosológico. Diversos estudios han determinado la diferente asociación entre la clase HLA - I y la II. El objetivo de esta investigación fue el de determinar la eventualidad de una relación entre el HLA-I y el II en la osteocondritis. Los resultados obtenidos se discuten en el artículo.

Background: Osteoarthritis (OA) is the most common type of joint disease. It represents a heterogeneous group of conditions resulting in common histopathologic and radiologic changes. There are multiples risk factors for osteoarthritis includes the following: Age, Obesity and Genetics. Human leukocyte antigen (HLA) as part of immune system has a role in the disease process. Many reported studies have pointted to different HLA classs I and II association. Aim: To investigate whether there is an association between HLA class II and OA. Patients and methods: A cross sectional comparatives study including patient with primary osteoarthritis attending the department of orthopedic in Al-Kindy teaching hospital Baghdad, Iraq between September 2016-September 2017. Patient's selection was done by the orthopaedics. The HLA-A tuping was performed in HLA research unit at Al-Kindy College of Medicine using PCR-SSO according to the manufacturer instruction using both Amplification and Hybridization kit by Automated method using Autolipa - 48Innogenities-Belgium. The results ewre interepted using LIRAS version 5.0 software innogenetics - Belgium, odds ratio were used to test signifcant differences. Results: Thirty five Iraqi Arab Muslims patients with primary osteoarthritis. The control group was comprised from 75 healtht unrelated sex and age matched volunteers among the staff of Al-Kindey college of medicine that didn't have a history of osteoarthritis. There was an increased frequencies of HLA-A*0101,0202,6802 in patients with osteoarthritis compared with healthy controls (P value=0.001,<0.001,<0.001 respectively)

Human leukocyte antigen HLADRB1 determinants susceptibility to gastroesophageal reflux disease / Antígeno leucocitário humano HLADRB1 é determinante de susceptibilidade para a doença do refluxo

ABSTRACT BACKGROUND Gastroesophageal reflux disease (GERD) is characterized by diverse symptoms. There is an evidence for a genetic component to GERD as supported by familial aggregation of this disease. OBJECTIVE To investigate whether certain human leucocyte antigen genes HLA-DRB1 are associated with GERD. METHODS Patients and controls were prospectively recruited from GIT center at Al-Kindy Teaching Hospital (Baghdad-Iraq) between January 2014 and July 2016. Sixty Iraqi Arab Muslims patients with a history of heartburn and dyspepsia compared with 100 Iraqi Arab Muslims controls. All study patients and control groups underwent upper gastrointestinal endoscopic examinations and their serums were analyzed for CagA antibodies Immunoglobulin G (IgG) for H. pylori. HLA-DRB1 genotyping were done to both groups. RESULTS A total of 60 patients with erosive gastritis; GERD (Grade II and III) were evaluated, together with 100 controls. There is a significant increase of H. pylori infection (P=0.0001) in GERD patients than control group. HLA-DRB1* 15:01 was significantly increased in GERD patients in comparison with control group and an increased frequency of HLADRB1*11:01 in control group compared with patients group. CONCLUSION There is an association between HLA-DRB1 *15:01 in GERD patients with H. pylori positive patients.

RESUMO CONTEXTO A doença do refluxo gastroesofágico (DRGE) caracteriza-se por diversos sintomas. Há evidências de um componente genético para a doença de refluxo suportado pela agregação familiar desta doença. OBJETIVO Investigar se certos genes de antígeno de leucócito humano HLA-DRB1 são associados à DRGE. MÉTODOS Pacientes e indivíduos controles foram recrutados prospectivamente do centro GIT no Al-Kindy Hospital (Bagdá-Iraque) entre de 2014 janeiro e julho de 2016. Sessenta pacientes muçulmanos árabes iraquianos com uma história de azia e dispepsia foram comparados com 100 indivíduos controles. Todos os pacientes do estudo e grupos de controle foram submetidos a exames de endoscopia gastrointestinal alta e seus soros foram analisados para anticorpos CagA imunoglobulina G (IgG) para H. pylori. Genotipagem HLA-DRB1 foram feitas para ambos os grupos. RESULTADOS Um total de 60 pacientes com gastrite erosiva; GERD (grau II e III) foram avaliados, em conjunto com 100 controles. Houve aumento significativo de infecção pelo H. pylori (P=0,0001) em pacientes com DRGE em relação ao grupo controle. O HLA-DRB1* 15:01 aumentou significativamente em pacientes com DRGE em comparação com o grupo controle e houve uma maior frequência de HLADRB1* 11:01 no grupo controle em comparação com o grupo de pacientes com DRGE. CONCLUSÃO Há uma associação entre HLA-DRB1* 15:01 em pacientes com DRGE positivos para a infecção por H. pylori.

Frequency of HLA-DRB1 in Iraqi Patients with Guillain-Barre Syndrome.

Background: Genetic backgrounds play an important role in susceptibility to and protection against Guillain Barré Syndrome. Certain human leukocyte antigens have been found to be associated with Guillain Barré Syndrome. Aim of Study: This study aimed to study the relationship between the susceptibility of HLA Class II "DRBI" allele's frequencies in a sample of Iraqi's patients with Guillain Barré Syndrome compared with a healthy control group using PCR-SSOP method. Patients and Methods: Thirty consecutive Iraqi Arab Muslim patients with Guillain-Barre syndrome admitted in the Neurological Department in neurosciences Hospital between September-2012 to June-2013 were assessed for HLA genotyping for HLADRB1. A control group consisted from thirty healthy volunteers among the staff of Al-Kindy College of Medicine that did not have any neurological disorders whether recent or previously and had negative family history for this diseases or other neurological disorders. HLA genotyping for HLADRB1 was performed for each patient and for the control persons using the PCR with sequence-specific oligoneucleotide primers. Allele frequencies were compared across groups. Results: There was a significant higher rate of DRB1*03:01 frequencies in patients with GBS compared with healthy controls (p=0.007, Odds ratio=5.687, 95% CI: 1.59-20.33)Conclusions: HLA-DRB1*03:01 may have association with susceptibility to Guillain- Barre syndrome.

Bacterial diversity in patients with oral ulceration in behcet's disease.

Background: Behcet's disease is a chronic, relapsing, multi-system inflammatory disorder, clinically characterized by recurrent oral and genital ulcers, skin lesions, and uveitis. Environmental factors such as infectious agents have also been implicated in its pathogenesis. Aims and Objectives: to isolate different types of bacteria from patients with oral ulceration of Behcet's disease that may contribute in pathogenesis of these oral ulcers and tissue typing was done for those patients. Design: Cross-sectional study. Setting: Al-Karamma Teaching Hospital from January 2000 – Septomber 2000 at Baghdad city. Patients and methods: Study included 40 patients with Behcet's disease (BD). The other set was control group, consisted of 30 healthy volunteer's age- and sex-matched with first group from staff employees. Two swabs were taken from basal area of oral ulcer for direct exam and culture. Human Leukocytes Antigens typing was done for them by serological method.Results : Direct examination of their oral ulcer swabs showed significant difference regarding pus cells 87.5% (p= 0.0001) and red blood cells 75% (p= 0.0001). Gram stain showed significant increased in G+ cocci 95% (p= 0.0001). Other swab was cultured on Blood, Chocolate and MacConkey agar. The isolated bacteria were Streptococcus Pyogenes group A 75% (p= 0.0001)and Staphylococcus aureus 47% (p= 0.0001). HLA typing were done for them and 95% of them were HLA-B5 positive Conclusions: Microbial infection by Streptococci has been implicated in the development of Behçet's disease by trigger cross-reactive autoimmune responses in those patients. The frequency of the HLA-B51 allele is high among patients with Behçet's disease.

The role of T helper cytokines in indeterminate colitis.

Background: Indeterminate colitis is one of the inflammatory bowel diseases that cannot be classified over time as having ulcerative colitis or Crohn’s disease. Dysregulated immunity has been implicated in indeterminate colitis.Aim: to measure serum levels of pro-inflammatory cytokines (tumor necrosis factor (TNF-α), interferon-gamma (IFN-γ) and IL-6 and anti-inflammatory cytokines IL-10 in indeterminate colitis patients. Methods: A cross- sectional study carried out in Al-Kindi Teaching Hospital, Baghdad city from 2007 - 2010. Sixty patients with indeterminate colitis participated in the study. Serum levels of cytokines (IL-6, IL-10, TNF-alpha and IFN-gamma were done by Enzyme Linked Immuno Sorbent Assay (ELISA) and compared with age and sex matched thirty healthy controls. Results: There is a significant increased in IL-10 (p=0.003) and IFN-gamma (p=0.0001) in indeterminate colitis patients. TNF-alpha was significantly decreased (p=0.0001) while IL-6 showed no significance different with control group(p=0.735).Conclusions: There is increase in IL-10 and INF-gamma levels and decrease in TNF-alfa levels in patients with IC.