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Abstract : Melasma is an acquired chronic pigmentary disorder occurring on sun-exposed areas. Was to differentiate dermoscopic features of melasma between treated and untreated and if there are any features to confirm ongoing ochronosis. This is descriptive cross-sectional study conducted in the Department of Dermatology in Al-Kindy teaching hospital from June 2021 to April 2022. Females of any age with melasma were included in study and then divided into those who were treated previously with topical steroid and hydroquinone for more than 6 months and non treated group, photos were taken for all by iPad 11 pro, and polarized DL4 dermlit dermoscopy connected to iPad 11 pro. A checklist features of dermoscopy for melasma and ochronosis were prepared and dermoscopic photos were taken for each patient. These photos were evaluated by 2 dermatologists independently to indicate which sign each patient has. Wood light examination was also done for each patient to indicate level of pigment whether epidermal, dermal and combined. Statistical analysis was conducted using Statistical Package for Social Sciences (SPSS) version 26. In this study, a total number of patients was 79 with a mean age 38.63 ± 6.3 years. Fifty-seven were treated previously with a mean age of 38.08 ± 5.9 years while untreated group only 19 patients with the mean age was 40.04 ± 7.1years. We noticed that the prevalence of pseudo articular, telangiectasia, perifollicular accentuation, annular or arcuate, Confetti like or dotted depigmentation, and curvilinear or wormlike were significantly higher (P < 0.05) in treated than untreated groups. The most common type of pigmentation by dermoscopy in the treated group was combined (50.9%); while epidermal type in untreated group (77.3%) which was statistically significant (P= 0.004), while dermal type of pigment was only obvious in only 7 (12.3%) of treated group. By wood lamp, epidermal type was 43.9% in treated group and 77.3% in untreated group, this difference was statistically significant. There was a significant agreement between dermoscopy and wood lamp. Telangiectasia, annular or arcuate pigmentation, dermal or dermo-epidermal level of pigmentation were mainly present in treated melasma and could be features of ongoing ochronosis in these patients.

Abstract : The respiratory tract has sites which are potentially inaccessible to microbes. But, microbes when enter, they caused Respiratory Tract Infections, which in turn become more resistant for treatment due to improper use of antibiotics, in addition they prescribed by unspecialized persons. This led to create microbes which are different from the original microbes by gaining new strategies for infection and persistence, antibiotic resistance, different virulence factors, various phenotypes and adaptive changes to cause host damage and disease. The generators produce harmful exhaust emissions such as; carbon monoxide, nitrogen oxides, hydrocarbons, particulate matter and sulfur dioxide. These exhaust emissions are harmful and can not be ignored especially for all the living creatures and surrounding environment. 184 Sputum samples from both workers and non-workers in electric generators who suspected had lower respiratory tract infection were collected. All samples were cultured and identification of bacteria and antimicrobial sensitivity tests were done by using a Vitek 2 system. Detection of some virulence factors was done. Out of 184 samples, 27 samples (14.67 %) produced a significant growth, The predominant bacteria was Klebsiella spp. The highest No. of Resistant bacterial isolates of Workers in electrical generators were for: Ampicillin, Cefazolin and Nitrofurantion. There were different levels of antibiotic resistance in both groups, in addition to different virulence factors presence (e.g. capsule, Lipase, protease and ESBLs, Efflux pump and string test). Statically, there were significant difference between both groups at (p<0.05) for biofilm formation.

Abstract : Peripheral arterial disease (PAD) is a progressive disorder characterized by stenosis and/or occlusion of large and medium-sized arteries. Systemic atherosclerosis remains the number one cause of morbidity and mortality in the western world and is the major cause of peripheral arterial disease (PAD), causing obstructions in blood flow in one or more of the major limb arteries. A case-control study was performed on 30 Intermittent and 30 Critical patients and 60 healthy controls during the period from February to May 2022.Focus on the estimation of ankle brachial index and lipid profile. detecting serum concentration of NGAL by using sandwich ELISA. The results of the statistical analysis showed a significant difference (P ≤ 0.01) between Intermittent & Critical patients groups and control group. The data showed an increase in NGAL levels in patients groups (intermittent& critical) compared with a control group where a significant difference (p<0.001), Observed the highest level in the intermittent PAD group (4.27±1.06 ng /ml), and the lowest value of NGAL was recorded in the control group (0.63±0.08 ng/mL). This study found that the highest value of the ankle-brachial index (ABI) was recorded control group (1.08±0.23) in the was highly significant with different groups. On the other hand, results showed that the highest level of TC, and TG in the critical group (276.65±78.13 mg/dL,225.34±62.96mg/dL, respectively), while the lowest level in the control group (207.39±74.97 mg/dL, 144.07±57.64mg/dL). The present data suggest a role for NGAL in the diagnosis as a biomarker for early detection of and prognostic factor in patients with peripheral arterial disease.

Abstract : Impaired fasting glycaemia (IFG) is a condition, in which a person's fasting blood glucose levels are consistently higher than the normal range, but below the diagnostic cut-off for diabetes mellitus (DM). ß-cell dysfunction and insulin resistance (IR) have a principal role in the pathogenesis of IFG. Patients with IFG are at high risk of progression to diabetes, and developing atherosclerotic cardiovascular disease (ASCVD), The present study was designed, to determine the degree of IR (HOMA-IR) and ß-cell dysfunction (HOMA-B) among patients with IFG, and also to correlate HOMA-IR and HOMA-B with biochemical and anthropometric variables. The study included 143 patients with IFG, 61 males and 82 females, 14 – 70 years of age, and 150 apparently healthy subjects, 62 males and 88 females, 15-70 years age as a control group. Physiological measurements include weight, height, waist circumference (WC), and blood pressure (BP). Biochemical measurements include fasting blood glucose (FBG), glycated haemoglobin (HbA1c), insulin, total cholesterol (TC), triglycerides (TG), high-density lipoprotein-cholesterol (HDL-C) and low-density lipoprotein-cholesterol (LDL-C). In addition, HOMA-IR and HOMA-B were also determined. Insulin level was significantly higher among patients with IFG in comparison to control subjects, (P < 0.000). There were no significant differences in FBG and HbA1c between IFG and control group, (P > 0.05). Concerning HOMA-IR and HOMA-B, patients with IFG showed a significantly higher HOMA-IR and a significantly lower HOMA-B values compared to control subjects, (P = 0.000). LDL-C was significantly higher among patients with IFG in comparison to control subjects, (P < 0.05). There were no significant differences in TC, TG and HDL-C between the two groups, (P > 0.05). Correlation analysis in patients with IFG revealed a positive correlation of HOMA-B with insulin, (P < 0.01) and a significant negative correlation with LDL-C, (P < 0.01). While, HOMA-IR showed a significant positive correlation with insulin, (P < 0.01), FBG (P < 0.01) and TG (P < 0.05). We concluded that patients with IFG have significantly higher insulin and HOMA-IR and significantly lower HOMA-B values compared with control subjects. This indicates that these patients are a high risk of progressing to T2D and its complications. In addition, the significantly higher LDL-C among patients with IFG in comparison to control persons may increases the risk of macro-vascular ASCVD.

Abstract : Amoebiasis is an enteric protozoan disease of the human gastrointestinal tract caused by E. histolytica, which is a public health problem in many developing countries. Especially in poor sanitation areas. The study aimed to estimate some immunological parameters in symptomatic amoebic children. The study was conducted in the Pediatric Teaching Hospital in Sulaymaniyah province during September - December 2021. The serum was taken from 80 amoebic infected children (patient group) and 80 parasite-free children (control group) for estimating IL-17, IFN- γ, and TNF-α levels by applying the ELISA technique and for CRP estimation using Cobas-C311. A highly significant difference was recorded in the serum concentration of CRP between the patient group and the control group (P<0.001). The serum concentration of IL-17 was not significantly different between the two studied groups (P>0.05); however, IFN-γ level was reported to be significantly different (P≤0.05), and TNF-α serum level noted a highly significant difference (P<0.001). The highest level of IL-17 was recorded in infected males compared to the females, with a significant difference. Regarding age and blood group, no significant difference was recorded in infected children. The immunological measurement of CRP and TNF-α revealed a highly significant difference in the patients compared to the controls, and the serum level of IFN-γ documented significant differences. Also, significant differences were recorded in serum IL-17 among infected children of different ages.