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Abstract : Chronic granulomatous disease [CGD] is a rare congenital defect of phagocyte function characterized originally by chronic suppurative lymphadenitis, hepatosplenomegaly, pulmonary infiltrates, and eczematoid dermatitis. Autoimmune lymphoproliferative syndrome (ALPS) is a rare inherited disorder of lymphocyte homeostasis, characterized by persistence of autoreactive cells (double-negative TCR αβ cells) that often manifest with chronic nonmalignant lymphadenopathy, hepatosplenomegaly, and recurring multilineage cytopenias. Unfortunately, some of these features are also involved in other conditions, such as Chronic Granulomatous Disease, which can confound the diagnosis. This report describes a 4-year-old girl with chronic hepathosplenomegaly, thrombocytopenia, recurrent respiratory infection, elevated double-negative TCR αβ cells and hypergammaglobulinemia. These criterias misdiagnosed as ALPS and planned to be treated with corticosteroids and immunosuppressive drugs, but the genetic evaluation revealed a mutation in NCF2 leading to CGD. This observation should alert pediatricians to pay extreme attention and include CGD in the differential diagnosis of a child with hepathosplenomegaly, cytopenias, and recurrent infections, obtain discriminating screening laboratory assays, such as Nitroblue tetrazolium test (NBT), and Dihydrorhodamine (DHR) flow cytometry assay.

Abstract : An infection occurs to the patient during their stay in hospital is said to be Hospital Acquired Infection (HAI). It can be defined as the patient gets infection after 48 hours or more after admission in any hospital. Hospital Acquired Infections are unanticipated infections that develop during medical or surgical treatment may result in significant patient illness and death. A quantitative evaluatory research approach with a pre-Experimental one group pre test - post test research design was used in this study. 140 Staff Nurses were selected as samples by non-probability convenient sampling technique. A Structured knowledge questionnaire and a practice checklist were used to collect the data. With Knowledge, in pre-test, among 140 Staff nurses, 38 have poor knowledge, 71 have Average level of Knowledge and 31 have good level of knowledge. In post-test, 16 have poor knowledge, 82 have Average level of Knowledge and 42 have good level of knowledge on Infection Control Practices. With Practice, in pre-test, 37 have inadequate practice, 103 have Adequate level of Practice. In post-test, 16 have Inadequate practice and, 124 have Adequate level of Knowledge and 42 have good level of knowledge on Infection Control Practices. The present study concluded that predominant of staff nurses have Average level of knowledge and Adequate practice on infection control practices in pretest. After intervention the knowledge and practice level were increased which shows the Information Booklet has an impact to increase in knowledge and Practice.

Abstract : Primary open-angle glaucoma (POAG) is the most common type of glaucoma. Corneal thickness is a biomarker for glaucoma genotype, that was significantly thinner in patients receiving topical antiglaucoma, beta-blockers, prostaglandin analogues, carbonic anhydrase inhibitors, and alpha-2 agonists. This study was an analytic observational study with cross sectional design to analyze corneal thickness in patients with POAG who received glaucoma medication. The subjects were POAG patients that received glaucoma medication for more than 6 months. Corneal thickness measurements were performed using Anterior Segment-Ocular Coherence Tomography (AS-OCT). From 60 POAG subjects, the mean age was 54.60±10.021 years old and female subjects was accounted for 55%. From total of 75% subjects who received multi-therapy treatment, most type of treatments were beta blockers and prostaglandin analogues. The average duration of treatment was 21.97±13.062 months. This study found statistically significant and negative correlation in superior paracentral (p=0.037, r-0.231) and superonasal paracentral (p=0.029, r- 0.241) corneal thickness with the duration of treatment. The study revealed that there was a significant relationship between the use of beta blockers and prostaglandin analogues. The relationship between corneal thickness and duration of treatment was found, which was thinning of corneal thickness in all areas but statistically, a significant relationship was only found in the superior paracentral, superonasal paracentral, and inferonasal paracentral areas. There was a significant correlation between the type, amount, and duration of treatment on central corneal thickness. Anterior segment OCT might be helpful to evaluate the effect of antiglaucomatous medications on corneal epithelial thickness.

Abstract : Pseudomonas aeruginosa is an ubiquitous bacteria, has ability to adapt to different environments and causing in humans specially in Immunocompromised persons and hospitals. So the study aimed to detect the correlation between gene expressions of oprD and each of mexA and mexB genes in Pseudomonas aeruginosa isolates, fifty P. aeruginosa isolates were isolated from different clinical samples, detection of efflux pumps activity in P. aeruginosa phenotypically was done by Cather wheel method. Study genes expression of efflux pump genes under ciprofloxacin antibiotic stress and Et.Br. Results of oprD Ct values ranged from 20.56 to 24.98 with an average of 23.141. mexA Ct values were ranged from 32.1 to 36.79 with average 34.337 and results of mexB Ct values were ranged from 14.74 to 19.96 with average 16.791 compare to rpsL (Ct = 11.14) reference gene. The results showed that mean of Ct of gene expression was noticed when put them under stress of Et.Br. + CIP and CIP in mexA was 37.195 and 34.702, respectively, compare to control 34.337, on the other hand the gene expression between both treatments was over expressed in treatment of CIP 32 compare to CIP+Et.Br. The results of Cather wheel method expression was noticed when put them under stress Et.Br. + CIP and CIP in mexB gene expression was 19.626 and 18.872, respectively compare to control 16.791, In conclusion the both treatments compare to control not induce the expression of mexB genes, on the other hand the gene expression between both treatments was expressed in treatment of CIP 32 compare to CIP+Et.Br.

Abstract : The aim of this experiment is detect the leptin levels and cholesterol levels and other lipid profile parameters in children with giardiasis. The current experiment was done among children aged 7 years to 13 years in Kirkuk city. The feces and blood samples collected from Children's Hospital between May to end of October 2021. 80 children used in current, who diagnosed with acute watery diarrhea and abdominal pain. The outcomes of this experiment demonstrated significant (P<0.05) decreased in levels of leptin in infected children compared with healthy children. Total cholesterol, triglyceride and high density lipoprotein (HDL) exhibited significant (P<0.05) decreased in infected children compared with healthy. While, the results of low density lipoprotein (LDL) and very low density lipoprotein (VLDL) in infected children demonstrated significant (P<0.05) reduce compared with healthy children. So, the infection with giardiasis leads to decrease leptin levels and cholesterol levels and other lipid profile parameters in children.