ROLE OF DIMETHYL FUMARATE (NRF2 ACTIVATOR) IN REDUCING OF CIPROFLOXACIN-INDUCED HEPATOTOXICITY IN RATS VIA THE NRF2/HO-1 PATHWAY.

OBJECTIVE: The aim: The present study aims to study the effect of DMF on ciprofloxacin-induced liver damage as assessed by liver function and liver pathology and to study this effect if it is thought to activate the Nrf2 antioxidant defense mechanism. PATIENTS AND METHODS: Materials and methods: G1 (control), G2 (ciprofloxacin group), G3 and G4 (two DMF groups rats treated with DMF 50mg and 100mg), and G5 and G6 (two DMF groups rats treated with DMF 50mg and 100mg) (two ciprofloxacin Plus DMF at 50 mg and 100 mg). The tests included study of liver function, Nrf2 analysis, and anti-oxidant enzyme analysis. RESULTS: Results: The serum blood Nrf2, HO-1, and tissue anti-oxidant enzymes all increased after ciprofloxacin treatment. The serum levels of Nrf2 and HO-1 were higher in the ciprofloxacin plus DMF groups, but anti-oxidant enzymes were lower. DMF increased Nrf2 expression in rats when ciprofloxacin caused hepatotoxicity. CONCLUSION: Conclusions: DMF lowers experimental hepatotoxicity in vivo. This effect is thought to activate the Nrf2 antioxidant defense mechanism.

USE OF INFLIXIMAB TO ATTENUATE CEREBRAL APOPTOSIS INDUCED BY CEREBRAL ISCHEMIA/REPERFUSION IN MALE RATS.

OBJECTIVE: The aim: The purpose of the research was to study the role of infiximab global cerebral ischemia-reperfusion injury. PATIENTS AND METHODS: Materials and methods: The rats were split into five groups: Sham group; Control group: occlusion of the common carotid artery for 60 minutes, and sub-sequently reperfusion for an hour without receiving any medication; Vehicle group: as the control group, but 72 hours before to the ischemia, they were given the medication 0.9 NaCl intraperitoneally (i.p); Treated group-1: as the control group, plus 3 mg/kg of IFX intraperitoneally (i.p) 72 hours prior to ischemia; Treated group-2: as the control group, plus 7 mg/kg of IFX intraperitoneally (i.p) 72 hours prior to ischemia. RESULTS: Results: Pre-treatment with IFX significantly reduced the percentage of infarct area, but in the IFX (7 mg/kg) group, the infarct area was smaller than at the low dose. The ischemia group had a significant elevated of TNF- α and caspase-3 while a significant lowered in CAT and SOD levels. The pre-treatment with IFX, the TNF- α and caspase-3 levels lowered significantly, furthermore, significantly increased CAT and SOD levels activity (P≤0.05) as compared with IR group. Among effective groups, I/R+IFX (7mg/kg) group more effective in lowering TNF- α and caspase than I/R+IFX (3mg/kg) group. CONCLUSION: Conclusions: Infiximab has neuroprotective effective due to its powerful TNF- α blocker and limit ROS release and cell death signaling which protects the neurons from injury during cerebral ischemia reperfusion.

EVALUATION OF COVID-19 VACCINES EFFICACY IN IRAQI PEOPLES.

OBJECTIVE: The aim: The present study was carried out on patients recovered from COVID-19, including those patients who have taken vaccine and those who have not. PATIENTS AND METHODS: Materials and methods: The patients were recruited via an online panel and surveyed at different regions of Iraq from June 1, 2021, to August 30, 2021. RESULTS: Results: Our results demonstrated that the highest percentage of people recommended Pfizer vaccine followed by Sinopharm, while AstraZeneca vaccine was least recommended. CONCLUSION: Conclusions: The efficacy of different vaccines differed significantly; the highest effectiveness was observed with Pfizer vaccine followed by AstraZeneca and Sinopharm with effectiveness ranging from 94%, 89%, and 74%, respectively. Further, the highest percentage of re-infected patients was observed with Sinopharm vaccine followed by Astra Zeneca and Pfizer vaccine, respectively. Also, the highest percent of re-infection with masking used was seen in the case of Sinopharm vaccine followed by AstraZeneca and Pfizer vaccine. Although, we observed that post-vaccination symptoms were lowest than pre-vaccination symptoms, the percent of asymptomatic cases post-vaccination was highest than pre-vaccination cases for all vaccines.

CORRELATION BETWEEN RS6265 SNP IN BDNF AND THE CONTEXT OF DIABETES TYPE II INVOLVEMENT IN IRAQI PATIENTS.

OBJECTIVE: The aim: In this study, we looked into the possible link between the G196A polymorphism in the BDNF gene and DM in Iraqi patients. PATIENTS AND METHODS: Materials and methods: By using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) approach, 100 subjects were genotyped for the G196A SNP of the BDNF gene, 50 as DM and 50 as controls, age-sex and ethnically matched healthy controls. Analysis of covariance (ANCOVA) was used to assess the association of this polymorphism, and genotype frequencies were compared between patients and healthy controls. RESULTS: Results: Our result show that patient with the AG (Val-Met) genotype had a 40%of total DM patients than those and GG (Val-Val) genotypes. Therefore, we concluded that as a future aspect of the report the work can be further extended on proteomic level wherein the corresponding change occurred due to the mutation in the protein can be further detected at structural and functional level. CONCLUSION: Conclusions: conclusion of our result was any patient with covid-19 must need to follow up for at least 1 month after recovery to notified of the post-Covid symptoms especially the male gender.

ROLE OF PRE-CESAREAN SECTION CEFOTAXIME IN AMELIORATED POST-CESAREAN COMPLICATION.

OBJECTIVE: The aim: The purpose of this study was to examine the efficacy of cefotaxime before and after skin incision in avoiding post-operative infection complications in caesarean section women, also evaluation the efficacy of cefotaxime in reducing post-caesarean section complications. PATIENTS AND METHODS: Materials and methods: We conducted 150 women who undergoing caesarean section in the Obstetrics & Gynecological Department, Babylon government from January, 2021 to March, 2021. The caesarean operations were done by using standard protocols. Each patient was examined daily and post-operative infectious. Women were randomly divided into three groups; each group contains 50 women; Group 1: (control) given normal saline 12 hr. before and after skin incision. Group 2 (pre-operation antibiotic): given single dose of cefotaxime 1 g intravenously 12 hr. before skin incision, and Group 3 (post-operation antibiotic): given single dose of cefotaxime 1 g intravenously 12 hr after operation. RESULTS: Results: The outcome measures were post-operative febrile morbidity, healing period and urinary tract infections, in addition to socioeconomic state of each woman. CONCLUSION: Conclusions: cefotaxime pre-cesarean section could ameliorate post-operative problems such as infection of surgical wound, febrile, and urinary tract infections.

GASTROINTESTINAL AND METABOLIC DISTURBANCES IN POST-COVID-19 DISEASE OUTCOMES.

OBJECTIVE: The aim: Recognizing gastrointestinal symptoms that precede COVID-19 respiratory difficulties may be crucial for effective early detection and treatment. PATIENTS AND METHODS: Materials and methods: A total of 200 individuals with the post-covid-19 symptoms for both genders in clinical private and hospital COVID-19 verified by polymerase chain reaction were tracked until they recovered. To evaluate the duration of symptoms as a predictor of COVID-19 prognosis, we proposed a link between gastrointestinal symptoms, metabolic disturbances and disease severity. Glucose disturbances were observed in 65 percent of participants, higher D-Dimer plasma levels have been found in 77 percent of participants, and ferritin plasma levels were found in 62 percent of participants. RESULTS: Results: While gastrointestinal symptoms were common, with nausea accounting for 51% of participants, an increase in appetite accounting for 76% of patients, and anal fissure accounting for 30% of participants. Both metabolic and GIT symptoms disturbances impact a large percentage of men. CONCLUSION: Conclusions: Our conclusion was any patient with covid-19 must need to follow up for at least 1 month after recovery to notified of the post-covid symptoms especially the male gender.

MENTAL HEALTH AND PSYCHOSOCIAL CONSIDERATIONS POST COVID-19 OUTBREAK.

OBJECTIVE: The aim: To determine the pandemic's impact on worldwide psychological suffering and its consequences for vulnerable groups. PATIENTS AND METHODS: Materials and methods: 200 participants (mean 66.5% males) from 6 provinces of central and southern Iraq responded to the survey for 6 months. Mental signs and symptoms were assessed using the Patient Health Questionnaire and State Trait Anxiety Inventory, respectively. Over 55% of the post-Covid respondents had depression; the male gender was higher than female gender (56% vs. 44%). About 44% of the post-Covid respondents had Nervousness, 59% of them was male. Participates had moderate level of confusion & memory loss about 73%, however, the male gender was greater suffering from it than female (72% vs. 28%). RESULTS: Results: Results show that Post Covid-19 patients have high depression, Nervousness, and memory loss, and also Male gender with Covid-19 have a severe level of depression, Nervousness, memory loss as compare with the female gender. CONCLUSION: Conclusions: Post Covid-19 patients have high depression, Nervousness, and memory loss as compared with those without covid-19 one. Patients who have a history of psychological problems inpatient with Covid-19 must be taken and treated in combination with a protocol of covid-19 management. The male gender with Covid-19 has a severe level of depression, Nervousness, memory loss as compared with the female gender.

The Nrf2 Activator (DMF) and Covid-19: Is there a Possible Role?

INTRODUCTION: COVID-19 is a new viral illness that can affect the lungs and airways with lethal consequences leading to the death of the patients. The ACE2 receptors were widely disturbed among body tissues such as lung, kidney, small intestine, heart, and others in different percent and considered a target for the nCOVID-19 virus. S-protein of the virus was binding to ACE2 receptors caused downregulation of endogenous anti-viral mediators, upregulation of NF-κB pathway, ROS and pro-apoptotic protein. Nrf2 was a transcription factor that's play a role in generation of anti-oxidant enzymes. AIM: To describe and establish role of Nrf2 activators for treatment COVID-19 positive patients. METHODS: We used method of analysis of the published papers with described studies about COVID-19 connected with pharmacological issues and aspects which are included in global fighting against COVID-19 infection, and how using DMF (Nrf2 activator) in clinical trial for nCOVID-19 produce positive effects in patients for reduce lung alveolar cells damage. RESULTS: we are found that Nrf2 activators an important medication that's have a role in reduce viral pathogenesis via inhibit virus entry through induce SPLI gene expression as well as inhibit TRMPSS2, upregulation of ACE2 that's make a competition with the virus on binding site, induce gene expression of anti-viral mediators such as RIG-1 and INFs, induce anti-oxidant enzymes, also they have a role in inhibit NF-κB pathway, inhibit both apoptosis proteins and gene expression of TLRs. CONCLUSION: We are concluded that use DMF (Nrf2 activator) in clinical trial for nCOVID-19 positive patients to reduce lung alveolar cells damage.

Combinación de bardoxolona y DMF Mejora la isquemia cerebral/reperfusión Lesión en ratas macho / Combination of Bardoxolone and DMF Ameliorates Cerebral Ischemia / Reperfusion Injury in Male Rats

Background: Ischemic stroke has been ranked as the second cause of death in patients worldwide. Inflammation which is activated during cerebral ischemia/reperfusion (I/R) is an important mechanism leading to brain injury. The present study aimed to investigate the effect of Berberine on cerebral I/R injury and the role of inflammation in this process. Material and Methods: The study was carried out on 36 Wistar-albino rats, divided into four groups including: Sham group, I/R group, I/R+ (control-vehicle DMSO) and I/R+ Berberine 5 mg/kg injected intraperitoneally 1 hour before induction of ischemia. Measurement of brain tissue IL-1ß, ICAM1, caspase-3, Notch 1 and Jagged 1 was done after one hour of reperfusion in addition to assessment of the brain infracted area and histopathological analysis. Results: Berberine attenuates cerebral I/R injury induced increase in inflammatory cytokine (IL-1ß), adhesion molecule (ICAM-1) and proapoptotic enzyme (caspase-3). Additionally, it reduces the size of infracted area and histopathological damage; such protective effect could be mediated by Notch 1 signaling pathway since Berberine further unregulated the increased levels of Notch 1 and Jagged 1 seen in brain with I/R injury. Conclusions: Berberine has a neurocytoprotective outcome against cerebral I/R injury which is manifested as anti-inflammatory anti-apoptotic effect that preserved cell structure and viability, in the meantime this effect could be mediated by Notch 1 signaling pathway.

Age Distribution of Clinical Symptoms, Isolation, Co-morbidities and Case Fatality Rate of COVID-19 Cases in Najaf City, Iraq.

INTRODUCTION: The first case of coronavirus disease 2019 (COVID-19) in holy Najaf city in February 22, 2020. The outbreak then rose up all over Iraq from 519 cases and 20 deaths in June 2, 2020 to 3484 cases and 72 deaths per day in August 10, 2020 per 24 hours. AIM: The aim of the study is to describe the distribution of confirmed cases by age, demographic factors, isolation, comorbidities and case fatality rate. METHODS: Prospectively collected and analyzed data on patients with laboratory-confirmed 2019-nCoV infection by real-time RT-PCR and next-generation sequencing. The demographic and clinical outcomes data of 1153 diagnosed patients were collected from consecutive patients, analyzed, and described. About two third of cases 789 (68.4%) acquired infection through contact with positive patients. RESULTS: The reported cases were 743 (64.4%) males and 410 (35.6%) females with large number among age range 21 to 50 years. The most frequent presenting symptoms were fever, sore throat and dyspnea or cough, most of patients; 868 (75%) patients were isolated at home versus 285 (24.72) patients required hospitalization which represented the intermediate and sever cases. The overall case fatality rate was 2.4%. CONCLUSION: Most of COVID-19 cases in this locality were male from urban areas. The common onset symptoms were the fever, sore throat and dyspnea or cough. Majority of cases were isolated and treated at home. The estimated case fatality rate was within the global range (2.4%).