The Rate of Systemic Hypertension in Type 2 Diabetes Mellitus in Baquba Teaching Hospital

Background: Hypertension is a common disease effect high incidence of population, hypertension more in diabetic patient than other population so if associations of these tow diseases in same patients lead to increase the rate of morbidity and mortality from micro and macro vascular complications of diabetes. Objective: To evaluate the incidence of systemic hypertension in patients with typ2 diabetes mellitus in Diyala province. Materials and Methods: Nine hundred patient were divided in 2 groups  Group A:450 diabetic patient  were evaluated for hypertension group B: 450 patient  without diabetes mellitus  as  control study measuring  blood pressure for all patients  including in this study  by  using a sphygmomanometer at consultation medical  unit and diabetic clinic  in Baquba Teaching Hospital,  patient include in this study usually between age 32 to 70 years. Other data obtained included age, gender, type of DM, weight, height, body mass index and waist hip ratio. Results: In group A: 450 diabetic patient (225 were male and 225 were female) were included in this study. 244 (54.22 %) patient of them have hypertension, 124 were male (50.8%) while 120 patient were female (49.2%) and we found 206 from total number of diabetic patient have no hypertension. While in group B (control group) from 450 non-diabetic patient we found 100 patient (22.2%) of them have hypertension and 350 (77.8%) patient from total number have non-hypertension. Conclusions: Hypertension is more in patient with diabetes type 2than those with no diabetes. Studies have shown that adequate treatment and well control of the blood pressure will reduces the complications of DM

Echocardiographic Predictors of Non Rheumatic Atrial Fibrillation

Objective: to assess echocardiographic structural&functional changes in non rheumatic AF Patients And Methods: 200 Patients were divided into 3 groups: Group A: Patients with AF,Group B: Patients have one or more of risk factors (hypertension, IHD, DM, HF, old age) without AF,Group C: normal healthy individuals. A full medical history and complete physical examination and the following investigation were arranged: FBS, RBS, ECG, CXR and echocardiograph. Result :The study show there is a significance increase in LAD ,LVEDS ,LVEDD and decrease in fractional shortening in group A &B And group A greater than group B and both groups greater than group C. Conclusion: Subjects with increase LA size, LVEDS, LVEDD and decrease in fractional shortening were at a significance increase risk for development of AF. This study clarifies the role of cardiac structural& functional characteristics’ in relation to susceptibility to AF .so the best method for reducing the adverse complication of AF through prevention of development of AF

Bacteriological Study of the Bacteria Cause Urinary Tract Infection of Patients Admitted to Cardiac Care Unite a Baqubah General Teaching Hospital

Background:Urinary tract infection patient Urinary Tract Infection ( UTI ) one of commonest types of  patient admitted to CCU ( cardiac care unit )  of other medical wards this is occur directly from contact to infected hand or material or during catheterization. Objective:To evaluation common bacterial cause UTI in patients admitted Cardiac Care Unite to show the antimicrobial agent and bacteria resistant and production the biofilm. Patients and Methods: Collection of samples from urine aseptically for culture.Isolation and identification of uropathogens using biochemical tests and testing ability of these bacterial isolation for virulence production and testing the antimicrobial susceptibility test. Results: It is A total of 135 catheter samples  were collected from  patient (135) catheter samples from patients in CCU at Baqubah General Teaching Hospital for the period from  1st November 2016 to 1st   March 2017 frommales and female, and the samples and cultured on the medium blood agar and MacConkey agar.  Then growing bacterial farms subjected to microscopic and biochemical tests for the diagnosis of bacteria. Escherichia coli with a ratio 31.8% , and (20)isolations of Proteus mirabilis with a ratio 18.2%, 16 isolates of  Klebsiella pneumonia,  (14) isolations of Pseudomonas aeruginosa with a ratio  12.7% .The Antimicrobial sensitivity is investigated for (9) antibiotics  from different groups including; The results show a high resistance to most of the antibiotics under study, and resistance all isolates ware of Aztreonam ,Cefotaxime , Co-Trimoxazol with ratio   95% , Naldixic acid with ratio 100%,  Tetracycline  75% , Gentamycin  70%  and Antimicrobial sensitivity to antibiotics  to Amikacin  45%  followed by Ciproflaxcin  50%  and tobramycin  80% . All kinds of bacteria were produced in biofilm in the ELISA method with a ratio 100% ,while Congo red with a ratio 50%. Conclusion: It was observed that multiple antibiotic resistance was common among local isolates of the bacteria under study and Biofilms are important in protecting the bacteria inside the catheter from antibiotics. Key words:Gram Negative bacteria, Antibiotics ,Biofilm ,Urinary Tract Infection , cardiac care unit

Evaluation of Auto-antibody Profiles in Patients with Tuberculosis

Background: Tuberculosis remains a major public health problem internationally, causing 9.6 million new cases and 1.5 million deaths worldwide, Tuberculosis (TB) has become one of the most important diseases in the past two decades. It leads to organ dysfunction, mortality and various clinical manifestations. Previous studies have shown that sera from patients with active TB may contain autoantibodies that are unique in autoimmune diseases. Objective: To detect the prevalence of wide array of autoantibodies in sera    of patients with tuberculosis compared with healthy control subject. Patients and Methods: A consecutive patients with recently diagnosed pulmonary and extra pulmonary {axial & peripheral joints TB} , mean age 36.2 years . 41 males and 21 females . the autoantibodies are R.F lgM, ANA , anti cls DNA. P-ANCA , ACL, ENA,SSA, SSB . RNP SM SCL70}. Results: Mean duration of symptoms 15.69 & 15.70(SD) months . 82% had fever , 39.3% had cough and hemoptysis . 27% had arthralgia and myalgia , 31.1% are diabetic and 24% are smoker serum level above the upeer normal limits were found in 25.7% of patients with RF ,ANA was 8.8% , 20% , 6.3% in pulmonary , peripheral , axial TB respectively , P-ANCA 10% , 6.3% & for anti DNA was 5% , 10% ,7 6.3% for pulmonary , peripheral & axial :ACL was 33.3 , 12.5 pulmonary , axial TB,ENA was {SCL70 3.2% , SM 3.2% , RNP3.2%, SSA 8.1%   SSB 6.5%}. Conclusion: R F: Rheumatoid Factor--Anti ds DNA: Anti-deoxyribonucleic acid (double strand).-ACL: Anti cardiolipin Antibody.-ANCA: Anti neutrophil cytoplasmic Antibody.-ANA: Anti nuclear Antibody.-ENA: Extractable Nuclear Antigen. S: Significant.    N-S: Not Significant.Pul: Pulmonary.TB: Tuberculosis .AFB:Acidfastbacilli

The role of Interleukin 6 , C Reactive Protein ,C3and C4 Complement in Immunopathogenesis of Myocardial Infarction

Background:Coronary artery disease is the leading cause of premature death in the developed world and is estimated to become, by 2020, the major cause of death worldwide. Objective:To Evaluate the role of interleukin 6 and acute phase proteins in immunopathogenesis of myocardial infarction. Patients and Methods: This study was conducted in Baquba Teaching Hospital in Diyala province .Ninety blood sample were collected from patients with myocardial infarction, 62 (68.9%)were males and 28 (31.1%) were females with age range (25-90) years, control group (35) patient, a males were 28 (77.14%) , and females were 8 (22.86%) with age range (25-70) years. Results: The results showed levels of Interlukine-6 was higher in patients (47.44 ± 30.50) pg / ml than control (37.13 ± 12.08) pg / ml with no significant difference and the positivity of C-reactive protein in patient group was (81.3%) than control group was (0%) ,with highly significant different , the level of C3 and C4 in present study was lower in patient than control group.The C3 complement level was (112.88) pg / ml which is lower  than control group (121.48 ±) pg / ml ,while C4 level was (19.73) pg / ml also lower than control group (26.81) pg / ml and significant difference was noticed among C4 .   Conclusion:We concluded that there is high level of IL-6 in patients with myocardial infarction and significantly high levels of C-Reactive Protein in patients of Myocardial infarction while showed there are low concentration levels of C3 and C4complement in patients with myocardial infarction

Mineral Derangement and Bone Diseases in Uremic Patients on hemodialysis in Ibn-Sina Hemodialysis Center / Diyala

  Background: Chronic kidney disease is an international public health problem affecting 5–10% of the world population. As kidney function declines, there is a progressive deterioration in mineral homeostasis, with a disruption of normal serum and tissue concentrations of phosphorus and calcium, and changes in circulating levels of hormones. Objective: To determine the severity of bone and mineral disease in chronic renal failure and how efficiently controlled by drugs and hemodialysis procedure in Ibn sina dialysis center. Patients and Methods: A case control study was carried out among 75 patients with chronic kidney disease (stage5) on regular hemodialysis in Ibn Sina dialysis center. Blood was taken before dialysis session and measurements of serum calcium, phosphorus, serum alkaline phosphatase, .protein and albumin levels, Serum parathyroid hormone and VIT D3   were determined.  and another group of 25 normal peoples from surrounding area. Results: The mean parathyroid hormone level was 145.62pg/ml, with 57.33% having normal acceptable rang of parathormone level, 41% of patients having hyperparathyroidism and 1.33% having hypoparathyroidism. There was no significant correlation between serum PTH and dexa scan. Hypocalcemia was found in 52% of patients, 33% with hypercalcemia patients . There was a significant correlation found between Hypocalcemia and dexa scan results. Majority of patients had high serum phosphate levels (54.6%).and normal phosphate level in 40% while the hypophosphatemia result 5.33% and mean phosphate level is2.24 mmol/l.Total serum protein mean is 61.51 a 37.33% of them had hypoproteinemia and 62.66 %of them had normal serum protein. Also our results show 97, 33%of uremic patients have low vit D While 2.33% have normal level of serum vit D. There was a significant correlation between dexa scan and vit D level, calcium, alkaline phosphatase, female gender, smoking and body mass index. Conclusion: The current study demonstrated that we can predict the chronic kidney diseases- Metabolic bone disorder from mineral scores before potentates the diagnosis by dexa scan