SARS-CoV-2 by the direct cytopathic effect or indirectly through the propagation of pro-inflammatory cytokines could cause endothelial dysfunction (ED) and oxidative stress (OS). It has been reported that OS is triggered by various types of viral infections, including SARS-CoV-2. Into the bargain, allopurinol is regarded as a potent antioxidant that acts through inhibition of xanthine oxidase (XO), which is an essential enzyme of purine metabolism. Herein, the present study aimed to find the potential protective effects of allopurinol on the biomarkers of OS and ED in patients with severe Covid-19. This single-center cohort study recruited 39 patients with mild-moderate Covid-19 compared with 41 patients with severe Covid-19. Nineteen patients with severe Covid-19 were on the allopurinol treatment because of underlying chronic gout 3 years ago compared with 22 Covid-19 patients not on this treatment. The recruited patients were allocated into three groups: group I, mild-moderate Covid-19 on the standard therapy (n = 39); group II, severe Covid-19 patients on the standard therapy only (n = 22); and group III, severe Covid-19 patients on the standard therapy plus allopurinol (n = 19). The duration of the study was 3 weeks from the time of hospitalization till the time of recovery. In addition, inflammatory biomarkers (D-dimer, LDH, ferritin, CRP, procalcitonin), neutrophil–lymphocyte ratio (NLR), endothelin-1 (ET-1), uric acid and oxidative stress index (OSI), CT scan score, and clinical score were evaluated at the time of admission and discharge regarding the effect of allopurinol treatment adds to the standard treatment of Covid-19. Allopurinol plus standard treatment reduced LDH, ferritin, CRP, procalcitonin, and ET-1 serum level significantly (P < 0.05) compared with Covid-19 patients on standard treatment. Besides, neutrophil (%), lymphocyte (%), and neutrophil–lymphocyte ratio (NLR) were reduced in patients with severe Covid-19 on standard treatment plus allopurinol compared with Covid-19 patients on standard treatment alone (P < 0.01). OSI was higher in patients with severe Covid-19 than mild-moderate Covid-19 patients (P = 0.00001) at admission. At the time of discharge, the oxidative status of Covid-19 patients was significantly improved compared with that at admission (P = 0.01). In conclusion, Covid-19 severity is linked with high OS and inflammatory reaction with ED development. High uric acid in patients with severe Covid-19 is correlated with high OS and inflammatory biomarkers. Allopurinol with standard treatment in patients with severe Covid-19 reduced oxidative and inflammatory disorders with significant amelioration of ED and clinical outcomes.
Coronavirus disease 2019 (COVID-19) is caused by a novel virus known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). SARS-CoV-2-induced hyperinflammation together with alteration of plasma proteins, erythrocyte deformability, and platelet activation, may affect blood viscosity. Thus, this review aimed to study the link between SARS-CoV-2 infection and alteration of blood viscosity in COVID-19 patients. In order to review findings related to hyperviscosity in COVID-19, we suggested a protocol for narrative review of related published COVID-19 articles. Hyperviscosity syndrome is developed in different hematological disorders including multiple myeloma, sickle cell anemia, Waldenstorm macroglobulinemia, polycythemia, and leukemia. In COVID-19, SARS-CoV-2 may affect erythrocyte morphology via binding of membrane cluster of differentiation 147 (CD147) receptors, and B and 3 proteins on the erythrocyte membrane. Variations in erythrocyte fragility and deformability with endothelial dysfunction and oxidative stress in SARS-CoV-2 infection may cause hyperviscosity syndrome in COVID-19. Of interest, hyperviscosity syndrome in COVID-19 may cause poor tissue perfusion, peripheral vascular resistance, and thrombosis. Most of the COVID-19 patients with a blood viscosity more than 3.5 cp may develop coagulation disorders. Of interest, hyperviscosity syndrome is more commonly developed in vaccine recipients who had formerly received the COVID-19 vaccine due to higher underlying immunoglobulin concentrations, and only infrequently in those who have not received the COVID-19 vaccine. Taken together, these observations are untimely too early to give a final connotation between COVID-19 vaccination and the risk for development of hyperviscosity syndrome, consequently prospective and retrospective studies are necessary in this regard.
Fungal diseases are the common cause of death in wild animals and birds of prey. This study was designed to investigate the development of fungal infections among wild birds in Denmark. In this study, fungal samples were isolated from such sources as Barn swallows' feathers, White stork, and birds of prey. The fungal species were isolated by direct culture of feathers on SD Agar with chloramphenicol and incubated at 28±2ºC. The fungal genomic DNA was isolated from each species, PCR reaction was performed, and the resulting fragments of the 18S rRNA DNA were sequenced and used for identification. A comparison between the resulting fragments was made to find out the percentage of similarity among the different fungal species. The multiple sequence alignment showed percentages of similarities ranging from 39% to 99%. To sum up, the 18S rRNA DNA sequence has been evolved dramatically even within the same species, while still conserved in others. It is a useful tool to be used for the identification of fungal species as it reduces time. Moreover, according to the results, there were no comprehensive high homology percentages among the species infecting the same bird.
Hyperviscosity syndrome (HVS) recently emerged as a complication of coronavirus disease 2019 (COVID-19) and COVID-19 vaccines. Therefore, the objectives of this critical review are to establish the association between COVID-19 and COVID-19 vaccines with the development of HVS. HVS may develop in various viral infections due to impairment of humoral and cellular immunity with elevation of immunoglobulins. COVID-19 can increase blood viscosity (BV) through modulation of fibrinogen, albumin, lipoproteins, and red blood cell (RBC) indices. HVS can cause cardiovascular and neurological complications in COVID-19 like myocardial infarction (MI) and stroke. HVS with or without abnormal RBCs function in COVID-19 participates in the reduction of tissue oxygenation with the development of cardio-metabolic complications and long COVID-19. Besides, HVS may develop in vaccine recipients with previous COVID-19 due to higher underlying Ig concentrations and rarely without previous COVID-19. Similarly, patients with metabolic syndrome are at the highest risk for propagation of HVS after COVID-19 vaccination. In conclusion, COVID-19 and related vaccines are linked with the development of HVS, mainly in patients with previous COVID-19 and underlying metabolic derangements. The possible mechanism of HVS in COVID-19 and related vaccines is increasing levels of fibrinogen and immunoglobulins. However, dehydration, oxidative stress, and inflammatory reactions are regarded as additional contributing factors in the pathogenesis of HVS in COVID-19. However, this critical review cannot determine the final causal relationship between COVID-19 and related vaccines and the development of HVS. Prospective and retrospective studies are warranted in this field.
Objectives: To detect the epidemiological trend of coronavirus disease-19 (COVID-19) in Iraq, the distribution of cases by age, gender, and governorates, and to assess its burden on the health system by estimating morbidity and mortality rates. Methods: This biometric study was carried out in 2021. The distribution, incidence, mortality, and case fatality rates in a 17-month period was sketched in a biometric design. A semi-structured questionnaire was distributed to a number of decision makers in the Ministry of Health regarding health system challenges that have been faced during this pandemic. Results: More than half (55.1%) of the cases were among males, and 67.5% were in the age group 30-60 years. Mortality was also predominant among males (62.7%), and 50.0% of the deaths were in the age group >50 years. The predominant age group for both genders was 30-60 years. Case fatality rate was 1.2%; again higher among males (1.3% versus 1.1%). Conclusion: The trend of COVID-19 in Iraq showed 2 peaks, August-October 2020 and March-July 2021, with males being more affected by morbidity, mortality, and fatality. The main challenge faced by the Iraqi health system was the rapid increase of COVID-19 cases with limited bed capacity and medical equipment.
Chemical pollutants, such as methyl orange (MO), constitute the main ingredients in the textile industry wastewater, and specifically, the dyeing process. The use of such chemicals leads to huge quantities of unfixed dyes to make their way to the water effluent and consequently escalates the water pollution problem. This work investigates the incorporation of hydrophobic carbon nano-spheres (CNS) prepared from the pyrolysis of acetylene using the chemical vapor deposition technique with poly(vinylidene fluoride-co-hexafluoropropylene) (PVDF-HFP) in order to enhance its hydro-phobicity. Moreover, a deep eutectic solvent (DES) was used to enhance the membrane's porosity. The former was based on the quaternary ammonium salt (N,N-diethyl-ethanol-ammonium chloride) as a chemical addition throughout the membrane synthesis. Direct contact membrane distillation (DCMD) was employed to assess the performance of the modified membrane for treatment of MO contaminated water. The phase inversion method was used to embed various contents of CNS (i.e., 1.0, 3.0, and 5.0 wt.%) with 22:78 wt.% of PVDF-co-HFP/N-Methyl-2-pyrrolidone solution to prepare flat-sheet membranes. The membrane embedded with 5 wt.% CNS resulted in an increase in membrane hydropho-bicity and presented considerable enhancement in DCMD permeation from 12 to 35 L/h.m 2 with salt rejection >99.9%. Moreover, the composite membrane showed excellent anti-biofouling and mechanical characteristics as compared to the pristine counterpart. Using this membrane, a complete rejection of MO was achieved due to the synergistic contribution of the dye negative charge and the size exclusion effect. Citation: Aljumaily, M.M.; Ali, N.S.; Mahdi, A.E.; Alayan, H.M.; AlOmar, M.; Hameed, M.M.; Ismael, B.; Alsalhy, Q.F.; Alsaadi, M.A.; Majdi, H.S.; et al. Modification of Poly(vinylidene fluoride-co-hexafluoropropylene)
The upsurge of type 2 diabetes mellitus is a major public health concern in the Middle East and North Africa (MENA) and Africa (AFR) region, with cardio-renal complications (CRCs) being the predominant cause of premature morbidity and mortality. High prevalence of cardiometabolic risk factors, lack of awareness among patients and physicians, deficient infrastructure, and economic constraints lead to a cascade of CRCs at a significantly earlier age in MENA and AFR. In this review, we present consensus recommendations by experts in MENA and AFR, highlighting region-specific challenges and potential solutions for management of CRCs. Health professionals who understand sociocultural barriers can significantly increase patient awareness and encourage health-seeking behavior through simple educational tools. Increasing physician knowledge on early identification of CRCs and personalized treatment based on risk stratification, alongside optimum glycemic control, can mitigate therapeutic inertia. Early diagnosis of high-risk people with regular and systematic monitoring of cardiorenal parameters, development of region-specific care pathways for timely referral to specialists, followed by guideline-recommended care with novel antidiabetics are imperative. Adherence to guideline-recommended care can catalyze utilization of sodium glucose cotransporter 2 inhibitors and glucagon-like peptide 1 receptor agonists with demonstrated cardiorenal benefits-thus paving the way for overcoming care gaps in a cost-effective manner. Leveraging digital technology like electronic medical records can help generate real-world data and provide insights on voids in adoption of newer antidiabetic medications. A patient-centric Alper Sonmez and Hani Sabbour contributed equally to this study.
Nanotechnology involves developing, characterising, and applying structures ranging in size from 1 to 100 nm. As a key advanced technology, it has contributed to a substantial impact across engineering, medicine, agriculture and food. With regards to their application in food, nanomaterials posses the ability to lead the quantitative and qualitative development of high-quality, healthier, and safer foods by outperforming traditional food processing technologies for increasing shelf life and preventing contaminations. Although rapid progress has been made in nanotechnology in food products, the toxicity of nanoparticles and nanomaterials is not very well known. As a result, nanomaterials are potentially toxic, therefore, considering the constantly increasing employment in food science, they need to be further characterised, and their use must be better regulated. We may face a crisis of nanotoxicity if the molecular mechanisms by which nanoparticles and nanomaterials interact with food and within living organisms is not fully understood. Food safety can be guaranteed only if we are thoroughly aware of nanomaterial properties and potential toxicity. Therefore, it is urgently necessary to have in the food sector a regulatory system capable of managing nanofood risks and nanotechnology, considering the health effects of food processing techniques based on nanotechnology. This present review discusses the impact and role nanotechnology play in food science. The specific application of Nanomaterials in food science, their advantages and disadvantages, the potential risk for human health and the analysis to detect nanocomponents are also highlighted.
Background: Sacroiliitis has been considered as the keystone in the diagnosis of axial spondyloarthritis (SPA). The diagnosis can be challenging in early stages of sacroiliitis, as conventional radiographs may be normal. Pain provocative tests can be very helpful to give a clue whether sacroiliitis is present in suspected patient by reproducing the patient’s pain. Objective: To assess the validity of clinical sacroiliac joint pain provocation tests for sacroiliitis in comparison with magnetic resonance imaging (MRI). Patients and methods: A total of 65 patients were selected from cohort of patients with persistent inflammatory low back pain during their attendance to the Rheumatology Consultant Clinic at Baghdad Teaching Hospital. Data were collected using questionnaire and interview. Socio-demographic characteristics, disease duration and clinical data were recorded for all patients. Data from four different clinical examination tests (Flexion Abduction and External Rotation [FABER], direct compression, distraction, and lateral compression) with subsequent MRI findings of sacroiliac joint for each patient were analysed. Positive MRI findings were further subdivided into active and chronic lesions according to the new ASAS (association of spondyloarthritis international society) criteria of positive imaging in spondyloarthropathy. Results: A total of 65 patients were included in this study, age range 18–39 years, 69.2% were men. The prevalence of sacroiliitis in the study was 67.7% (43.1% bone marrow oedema, 18.5% erosions, 15.4% sclerosis, 6.2 % for each of effusion; ankyloses and capsulitis). In the whole study group, the highest association with sacroiliitis was for FABER test with sensitivity of 75% while the most specific one was the lateral compression test (71.4%). In men, sacroiliitis was associated with sacroiliac joint (SIJ) clinical tests assessed in multi-test regimens; significant association was found by combining direct compression and FABER test with sensitivity of 51% and specificity of 28.5%. Conclusion: This study identified the reliability of a number of clinical examination tests of SIJ, which increase as they are used in multi-test regimen rather than each one alone, this had a significant association for men only.
In this manuscript, we are getting some novel inequalities for convex functions by a new generalized fractional integral operator setting. Our results are established by merging the k , s -Riemann-Liouville fractional integral operator with the generalized Katugampola fractional integral operator. Certain special instances of our main results are considered. The detailed results extend and generalize some of the present results by applying some special values to the parameters.
Introduction: The misconception and misuse of antibiotics among the public has been widely outlined to be one of the main reasons for bacterial resistance. The aim of the present study was to assess the practices, level of knowledge and attitudes regarding the rational and self-medication use of antibiotics in the general public in different districts of Baghdad province, Iraq. Methodology: A descriptive, cross-sectional study conducted among 384 participants through an interview using a structured 3-parts questionnaire, consisting of 24 items assessing the demographic characteristics, practices, level of knowledge and attitude towards rational antibiotics use. Results: 45.8% of the study participants reported self-medication of antibiotics without prescription. Flu/common cold and sore throat represented the majority of medical conditions for antibiotics intake without prescription (44.9%, 31.3%) respectively. Oral amoxicillin (34.1%) was the most common non-prescription antibiotic. 50.3% had education about the rational use of antibiotics. 41.4% reported intake of antibiotics after having medical advice, 44% suggested their antibiotics not to be used by other members, and 52.9% stated the importance of antibiotic education among the public. However, 57% of the respondents had negative attitudes regarding antibiotics use for sore throat/fever, the effectiveness of antibiotics for cold/flu (54.7%) and cough (49.2%), to keep antibiotics for future use (40.9%) and not completing the antibiotic course after feeling well (49.2%). Conclusions: A widespread use of antibiotics without prescription was reported, providing some crucial gaps and a lower level of practice, knowledge and attitudes regarding the use of antibiotics among a sample of the Iraqi population.
Several high-rise buildings, transmission towers, retaining structured, bridges are braced by piles foundation. These buildings tolerate axial load and succumb to large lateral loads, source from quakes, slope failure, and vehement winds. So, the lateral bearing capacity of the pile is essential for the structure of deep basics. This study gives the outcomes from three models for a single pile embedded in medium dense, dry sand to determine the effect of slenderness ratio (L/D) on the response of the lateral load pile and on the adjacent soil deformation, joined with parallel and perpendicular displacement fields measured using a particle image velocimetry (PIV) technology. The results for this study illustrate that the embedment ratio (L/D) is an essential parameter that has an effect on the ultimate lateral load. It shows that when the embedment ratio (L/D) increased, the ultimate lateral load is also increased. It is found that the ultimate lateral load increased by 16.7% and 28.6% when L/D increased to 25 and 30, respectively, compared to L/D = 20. The pile deformation due to the lateral load is influenced by pile slenderness ratio (L/D) and magnitude of the applied lateral load and depending on these two parameters, the deflection values altered to positive and passed over zero. The digital image analysis (PIV) shows that the profile effect region and the displacement fields are increased as a lateral load increased. It is observed that the sand close to the ground surface behind the pile travels downward while it moves upward in front of the pile. In this research, a numerical study is done by the PLAXIS 3D analyses and compares the numerical study and experimental work on the load–deflection curve of a single pile. The result of the numerical analyses is in good alignment with those found from the laboratory work for all the (L/D) ratios.
Niemann-Pick disease (NPD) type A is a fatal autosomal recessive lysosomal storage disorder. This rare condition impairs the metabolization of lipids, leading to their accumulation within the cells. Consequently, it causes growth retardation, pancytopenia, and cellular malfunctioning in various organ systems, including ocular, hepatic, pulmonary, brain, and neuronal tissues. Although rare, these patients present in both emergency and outpatient settings. Here, we report the case of a seven-month-old male infant who presented to the emergency department with continuous fever for one week, poor feeding, and failure to thrive. After a thorough history, examination, and laboratory workup, NPD type A was diagnosed. The patient received symptomatic therapy with the continuation of conservative management. In addition, the parents received detailed counseling regarding the genetics, progressive disease course, and prognosis of this condition.
Objective This analysis examines governorate-level disease incidence as well as the relationship between incidence and the number of persons of concern for three vaccine-preventable diseases—measles, mumps, and rubella—between 2001 and 2016. Methods Using Iraqi Ministry of Health and United Nations High Commissioner for Refugees (UNHCR) data, we performed descriptive analyses of disease incidence and conducted a pooled statistical analysis with a linear mixed effects regression model to examine the role of vaccine coverage and migration of persons of concern on subnational disease incidence. Results We found large variability in governorate-level incidence, particularly for measles (on the order of 100x). We identified decreases in incident measles cases per 100,000 persons for each additional percent vaccinated (0.82, 95% CI: [0.64, 1.00], p -value < 0.001) and for every additional 10,000 persons of concern when incorporating displacement into our model (0.26, 95% CI: [0.22, 0.30], p -value < 0.001). These relationships were insignificant for mumps and rubella. Conclusions National level summary statistics do not adequately capture the high geospatial disparity in disease incidence between 2001 and 2016. This variability is complicated by MMR vaccine coverage and the migration of “persons of concern” (refugees) during conflict. We found that even when vaccine coverage was constant, measles incidence was higher in locations with more displaced persons, suggesting conflict fueled the epidemic in ways that vaccine coverage could not control.
During the day, the ground usually becomes hot because of solar radiation. The lowest atmospheric layer absorbs heat from the ground, expands, and rises, producing the worst turbulence and atmosphere refractive change. This refractive index along the atmospheric path will produce an aberration in the image of the object and destroy the image quality at the image plane. The slant path refractive index in the atmosphere path is more complicated than the horizontal direction and need numerical methods to calculate it. In this work, the image quality for different slant path was studied. The effects of angle of observation (Zenith angle Z0=0, 5, 50, 60, 70, 80, and 90 degrees) on the image merit functions (Optical Path Difference (OPD)) are discussed in detail. It is shown that the result is sensitive to the range and angle of observation.
The aim of this research is to prepare a healthy psychological course and study its impact on the levels of serum uric acid (SUA) and pessimism and depression. The research sample was limited to teaching staff of the Iraqi State Universities in Baghdad, who were retired at 63-65 years of age. Data were collected by independent group experimental approach via pre- and posttest measurements. The study sample consisted of 21 people with cases of pessimism and depression. The sample was randomly chosen based on their consent to do pre- and posttests and to be subjected to healthy psychological approach. After collecting the data obtained from the samples and processing them statistically, the results showed that the healthy psychological course had a positive effect on the levels of SUA, pessimism, and depression of the research sample.
Background: Self-medication (SM) is the usage of medicines to resolve self-identified health issues, and it is quite common in many countries. The current study aimed to assess the knowledge and practices of SM among attendants at an outpatient clinic of a Baghdad teaching hospital at Baghdad Medical City as well as to determine association of SM practice with some socio-demographic factors. Subjects and methods: The current cross-sectional study was conducted with about 460 people attending outpatients at Baghdad teaching hospital from January 1, 2019 to June 30, 2019. Results: The highest proportion of participants, 176 (44%), was found in the age group of 18-30 years, with 290 (72.5%) females representing the study sample. Around two-thirds (266) of participants were married, and a higher proportion of participants, 218 (54.5%), were government employees; in all, 77 (19%) of participants were either unemployed or housewives. A total of 241 (60%) participants of the study sample were graduates and 74 (18.5%) postgraduates. Considering monthly income, 140 (35%) participants were earning below Iraqi Dinar 5,00,000. Of all the participants, 12 (43%) of them were concerned about the side effects of taking medicines, and 9 of them (32%) due to require medical experiences, 5 of them (18%) due to the risk of missing a diagnosis, and another 4 of them (14%) and 100 of them (27%) of participants used medicine leaflets, 86 (23%) of them used previous prescription, while 67 (18%) of study participants asking the nurse or health assistant, and reminder 41 (11%) used the mass media as a source of information about medicines. The majority of participants, 331 (89%), depended on private pharmacies and only 37 (10%) of them depended on paramedics. About half of the participants, 167 (45%), mentioned name of the medicine while requesting, and 115 (31%) participants mentioned symptoms of the disease to pharmacist, and only 90 (24%) purchased the drug container (bottles, boxes, etc.). Conclusion: SM is a common healthcare practice among the attendants outpatients at Baghdad teaching hospital with different socio-demographic characteristic. SM is more prevalent in young age group and among low-income people, hence there was a significant association between age and SM practice, as elderly people practice less SM because of chronic diseases and their use of multiple medicines. In addition, SM practice has increased due to the availability of medicines and their easy access from pharmacies.
A new type of prefabricated fibre reinforced polymer (FRP) composite jacket with an innovative joining system consisting of two interlocking edges and a locking has been developed for effective repair of damaged reinforced concrete (RC) columns. In this paper, the results of the experimental investigation on the evaluation of the effectiveness of this novel prefabricated FRP jacket in repairing RC columns with different levels of corrosion damage are presented. Full scale RC columns with 25% and 50% simulated steel corrosion damage and repaired with the novel FRP repair system was tested under concentric compressive load. The corrosion in the steel reinforcement was simulated by discontinuing the longitudinal bars in the middle part of the column and replacing with non-structural PVC pipes. The stiffness and strength capacity of these repaired columns was compared with damaged and undamaged columns. The results showed that the provision of the FRP jacket fully restored the axial stiffness and up to 99% and 95% of the axial strength capacity of columns with 25% and 50% corrosion damage, respectively. Theoretical analysis was also developed to predict the axial load capacity of the repaired columns considering the partial confinement provided of prefabricated composite jackets.
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