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PURPOSE Primary open-angle glaucoma (POAG) is a clinical progressive neuropathy which can lead to irreversible blindness if left untreated. A low level of serum Vitamin D3 is a major risk factor for glaucoma, and hence, represents a second target for glaucoma therapy following intraocular pressure (IOP). However, there is still controversy about whether there is a direct correlation between Vitamin D3 deficiency and the risk of increased IOP. This study aims to investigate the correlation between low serum levels of 1,24-dihydroxycholecalciferol and the development of open-angle glaucoma. METHODS The study included a total of forty-one patients with POAG. Patients were classified into whether they have chronic illnesses such as type 2 diabetes and hypertension. Matching control subjects of 20 healthy controls were also included in the study. Anthropometric measures and venous blood samples were taken from all participants for serum analysis of various biochemical markers including serum 1,25-dihydroxycholecalciferol (1,25(OH)2D) levels. RESULTS Overall, serum Vitamin D3 levels were 15% significantly lower in the patient’s cohort with open-angle glaucoma as compared to the healthy participants (P < 0.05). Among those, 63% of type 2 diabetic participants had significantly low levels of Vitamin D3 (P < 0.01). There was also a significant 70% reduction in serum Vitamin D3 levels among the hypertensive participants, (P < 0.001). CONCLUSION We concluded that lower serum 1,25(OH) 2D levels were significantly associated with an increased risk of open-angle glaucoma in patients with chronic illnesses.

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Conference poster re oral presentation

Aims: Diabetic nephropathy (DN) is a serious microvascular complication of a longstanding hyperglycemia. This study aims to evaluate whether urinary neutrophil gelatinase-associated lipocalin (NGAL) and urinary Interleukin-18 possess a better diagnostic value than albumin creatinine ratio in assessing the severity of nephropathy in patients with type 2 diabetes mellitus (T2DM). Material & methods: Ninety participants diagnosed with T2DM were recruited and they were divided into three study groups according to their albumin/creatinine ratio (ACR): (Normoalbuminuria group, Microalbuminuria group, and Macroalbuminuria group). A matching of Ninety healthy subjects were included as controls. Blood and urine samples were collected to measure various markers of glycemic control and kidney function. Results: IL-18 levels were not changed significantly between all study groups (P > 0.05), despite a significant positive correlation between IL-18 and urinary albumin levels. NGAL levels were significantly increased in Microalbuminuria group and Macroalbuminuria group as compared to the control and Normoalbuminuria groups. NGAL was also positively correlated with urinary albumin and ACR, but negatively correlated with the age and body mass index. Receiver Operating Characteristic curves revealed that for early detection of DN, the best cutoff values to discriminate DN and diabetic without nephropathy groups were �� 21.4 ng/ml for NGAL (94.67 sensitivity, 26.67% specificity), ���0.34 pg/mL for IL-18 (72% sensitivity, 53.33% specificity), and ��29.8 mg/g for ACR (80% sensitivity, 100% specificity). Conclusion: We conclude that the urinary ACR is a more accurate individual biomarker of DN when compared to both NGAL and IL-18.

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Objective: The response to metoprolol therapy in patients with acute coronary syndrome (ACS) is variable and a substantial element of this variability is linked to variation in CYP2D6 enzyme and adrenoreceptor (ADRB1) alleles, genotype polymorphism, affecting the phenotype in terms of both rate of metabolism of the active metoprolol (and hence its metabolic ratio) and the responsiveness of ADRB1 receptors to bound metoprolol. This study aims to investigate different clinically relevant allele variants (allele frequencies) of ADRB1 genes: (Arg389Gly: Gly/Gly, Gly/Arg, Arg/Gly) and to determine whether a specific genotype of Beta-1 adrenergic receptor genes (based on genetic polymorphism "allelic types" and combination) have impact on metoprolol effectiveness (clinical outcome) in Arabic Iraqi patients with ACS. Methods: Two-hundred and fifty patients with ACS were enrolled in this study and divided into 2 study groups: Group 1 (125 ACS patients receiving metoprolol) and Group 2 (125 ACS patients received no metoprolol therapy). Two millilitres of venous blood samples were collected and stored at -20 C for DNA extraction. Urine samples were also collected to assess the metabolic ratio using High-performance liquid chromatography (HPLC). Results: There were significant variations in the distribution of the Iraqi patients with respect to CYP2D6 allelic polymorphism in comparison with nearby, Western and Eastern countries and that significant difference contributed to patients��� outcome in terms of morbidity and mortality in respect to variable genotypes and phenotypes. Conclusion: These findings suggest that individualization of metoprolol in patients with ACS is essential to improve patients��� outcome.

Citrus bioflavonoids are polyphenolic plant-derived pigments found in high levels in oranges, lemons, grapefruits and other citrus fruits. The three most abundant types of citrus bioflavonoids are hesperidin, naringenin and eriocitrin. Citrus bioflavonoids have long been known to possess powerful free radical-scavenging properties and cardioprotective effects. The study involved the analysis of 10 commercially available citrus bioflavonoid supplements from three different countries: Australia, the United States and Canada. The supplements were tested for their citrus bioflavonoid content which varied from 0.8 to 33.3% w/w. The daily bioflavonoid dose varied from 19 mg to 560 mg. Hesperidin was the major citrus bioflavonoid in nine out of ten supplements. One supplement was found to contain less than 10% of the quantity of rutin claimed to have been added. The DPP-4 inhibitory potential, compared through an estimation of rutin equivalence, ranged from 1.9 mg to 400 mg per day. This data highlights the variability between the supplements in their potential to inhibit DPP-4 for subsequent health benefits.

Aims: This study aims to examine the role of TLR-4 gene polymorphisms in Type 2 Diabetes Militias (T2D) and its complications. 400 T2D patients were enrolled in this study. Patients were distributed into three clinical groups: normal albuminuria (n=145), microalbuminuria (n=162), and macroalbuminuria (n=93) groups. Multi-nominal logistic regression analysis applied to study genotype and allele frequencies for gene polymorphism,for the (+194C/T). The genotypic frequencies of Micro albuminuria group were (n=116, 71.4%) normal CC and (n=32 20.0) heterozygous CT. Mutant homozygous was found inTT (n=14, 8.6%). The results in Normo albuminuria group demonstrate (n=73, P.0) wild type CC, (n=45, 31.25%) heterozygous CT and mutant homozygous TT 18.75% (n=27). The odds ratio for the 194CT was 1.27; p=0.56. The TLR-4 gene of Thr399Ile polymorphism was correlated to the early onset of diabetic kidney disease, while Asp299Gly polymorphism of the TLR-4 gene seems to act as a protective factor for diabetic nephropathy.

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Background: Acute Myocardial Infarction (AMI) is one of the major causes of mortality and morbidity. Vitamin D deficiency plays an important role in pathophysiology of CAD, including atherosclerosis and endothelial dysfunction. Objectives: This study aims to highlight the short-term effects of vitamin D3 supplementation on inflammation levels in hospitalized patients with acute ST-segment elevation myocardial infarction (STEMI). Study group: Forty-four patients with clinical diagnosis of STEMI were included in this study. Methods: Participants were randomized into two groups: Group I (intervention Group) received the standard treatment for AMI plus vitamin D3 5000 IU/day for 5 days. Group II (Control Group) received the standard treatment with no vitamin D3 supplementation. After taking history, performing clinical examination and electrocardiography, venous blood samples were taken at two intervals: Time zero (during hospital admission), and after 5 days follow-up for the measurement of 25-hydroxy vitamin D and selected inflammatory markers (troponin I, high sensitivity Creactive protein, Interleukin-6) and WBC counts. Results: There was a significant increase in the level of 25- hydroxy vitamin D in the Intervention Group (30.1 �� 13.2 ng/ml) after 5 days of its supplementation, as compared to the baseline (24.2 �� 13.3 ng/ml), P

The present study aims to evaluate the effect of pre percutaneous coronary intervention (PCI) atorvastatin reload on peripheral monocyte of toll-like receptor 2 and toll like receptor 4 expression and their correlation with cardiac injury markers (troponin I and creatine kinase Muscle brain isoenzyme) in a patient with stable angina. A double-blind randomized prospective trial in which 60 stable angina patients scheduled for an elective PCI were randomly allocated into two groups after, control group: 30 patients who received low dose atorvastatin 40 mg daily without reload. Atorvastatin reloads group: 30 patients who were already on the usual dose of atorvastatin with further 80 mg and 40 mg at 12 & 2 hrs. before PCI, respectively. TLR2 and TLR4 levels were assayed in peripheral monocyte by flow cytometry and cardiac troponin I, CK-MB, MCP-1 and HMG-box-1 protein were also measured before and at 4 hrs, 12 hrs after PCI. Stent implantation was associated with an elevation in TLR2 and TLR4 expression in peripheral monocyte in both study groups after stenting but significantly higher expression level was observed among the control group (P

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Background: Stroke is a major cause of morbidity and mortality in patients with sickle cell anemia (SCA). Silent cerebral infarctions commonly occur and are poorly understood. Hence, evaluation and treatment of risk factors are the most important preventive measures. Hydroxyurea supplementation can be used to decrease the vascular complications of sickle cell anemia (SCA) and frequency of sickle cell crises. Transcranial Doppler ultrasonography (TCD) predicts the risk of cerebral infarction in patients with SCA. This study aims to explain the effect of hydroxyurea on the velocity of middle cerebral artery (MCA) in patients with SCA. Methods: Thirty patients with SCA were invited to participate in this study. They were divided into two study groups. Group (A) received no hydroxyurea treatment and were considered as a control group. Group (B) received hydroxyurea (Droxia 500mg capsule, 20mg/kg/day, given as a single dose for three months). Blood samples were obtained for hematological tests and hemoglobin electrophoresis; examination with TCD was then performed for both groups. Results: The systolic velocity of group A was significantly higher (150.2 �� 10.2 cm/second) than that in group B (119.8 �� 5.5 cm/second) (p < 0.05). At the same time, the diastolic and mean flow velocities of MCA were significantly higher (70.6 �� 11.9 cm/second and 118.4 �� 13.5 cm/second, respectively) in group A as compared to group B (40.1 �� 3.04 cm/second and 79.4 �� 5.5 cm/second) (p < 0.05). In addition, the hydroxyurea group showed a significantly smaller pulsatility index as compared to the control group. Conclusion: Hydroxyurea supplementation may decrease the risk of cerebral infarction in patients with SCA by decreasing the systolic, diastolic and mean flow velocity in MCA, as detected by TCD examination.

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© 2020 Diabetes India Background and aims: Several commercially available phytosterol supplements are promoted for their cholesterol-lowering effects. However, limited information is available about their potential anti-hyperglycaemic effects. This study aimed to evaluate the dipeptidyl peptidase-4 (DPP-4) inhibitory effects of phytosterol supplements in silico and in vitro to determine their potential for anti-diabetic activity. Methods: Docking studies were carried out in silico to evaluate the potential for interactions between three major phytosterol compounds (stigmasterol, β-sitosterol, campesterol) and the DPP-4 enzyme, the enzyme that is inhibited by the anti-diabetic gliptins. Gas chromatography–tandem mass spectrometry (GC-MS/MS) was used to analyse three different supplements for phytosterol content. DPP-4 inhibitory activity was tested in vitro for these phytosterol supplements and two major phytosterol standards. Results: In silico calculations predicted free binding energies for DPP-4 with the phytosterols to be: stigmasterol −8.78 kcal/mol; β-sitosterol −8.70 kcal/mol; campesterol −8.40 kcal/mol. These binding energies indicated a potential for significant DPP-4 inhibition. However, these results were not supported by the in vitro studies. Stigmasterol and β-sitosterol had an IC50 > 50 mg/ml (maximum tested concentration) and the Thompson's Cholesterol Manager® and Mega Strength Beta Sitosterol® supplements gave an IC50 > 100 mg/ml (maximum tested concentration). Blackmores Cholesterol Health® gave an IC50 value of 40 mg/ml which was attributed to β-carotene content. Conclusions: Phytosterol supplements do not appear to offer any anti-diabetic activity potential via pathways that involve the inhibition of DPP-4.

© 2019 Informa UK Limited, trading as Taylor & Francis Group. Introduction: Various pressures exist for curricular change, including economic forces, burgeoning knowledge, broadening learning outcomes, and improving quality and outcomes of learning experiences. In an Australian 5-year undergraduate medical course, staff were asked to reduce teaching hours by 20% to alleviate perceived overcrowded preclinical curriculum, achieve operating efficiencies and liberate time for students’ self-directed learning. Methods: A case study design with mixed methods was used to evaluate outcomes. Results: Teaching hours were reduced by 198 hours (14%) overall, lectures by 153 hours (19%) and other learning activities by 45 hours (7%). Summative assessment scores did not change significantly after the reductions: 0.4% increase, 1.5% decrease and 1.7% increase in Years 1, 2 and 3, respectively. The percentage of students successfully completing their academic year did not change significantly: 94.4% before and 93.3% after the reductions. Student evaluations from eVALUate surveys changed little, except workload was perceived to be more reasonable. Conclusions: Teaching hours, particularly lectures, can be moderately reduced with little impact on student learning outcomes or satisfaction with an undergraduate medical course.

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@Advanced Scientific Research. This study aims to evaluate the effects of FTO gene polymorphism (rs17817449andrs1588413) as predictor/ risk factors of type 2 diabetes mellitus in obese Iraqi population. Four hundred obese participants clinically diagnosed with type 2 diabetes were enrolled in this study. A similar matching group of obese non-diabetic control group was also included in this study. Multi-nominal logistic regression analysis applied to study genotype and allele frequencies for FTO gene polymorphism (rs17817449, rs1588413) in patients and control groups. The homozygous genotype significantly (OR= 4.61, CI 95% 2.61-8.12, P

Background & Aim of the Study: Increased levels of many biomarkers, including liver enzymes, blood urea and serum creatinine as well as glycemic markers have been reported following coronavirus (COVID-19) infection, leading to the development of acute disease. This study aims to measure and follow-up the following biomarkers (fasting blood glucose, blood urea, serum creatinine, total serum bilirubin, as well as the liver enzymes AST, ALT, and ALP) in otherwise healthy participants and patients with liver disease, renal disease and diabetes following COVID-19 infection. Materials and Methods: This is cross section study, included 144 participants who were infected with COVID-19 and admitted to the Sheikh Zayed Hospital, Baghdad, Iraq. Participants were divided into 4 study groups, Group 1: 46 participants with no pre-existing medical condition (Control), Group 2: 30 patients with existing liver disease. Group 3: 28 patients with existing renal disease and Group 4: 40 patients with diabetes mellitus. Participants were followed up for 14 days following COVID-19 infection to monitor the progression of the biochemical markers. Results: There were significant changes in serum levels of all the markers of this study between the four study groups (p

© Advanced Scientific Research. The main objective of the present research is to assess the effects of Achillea-fragrantissima on humoral & cellular immunity in the rat model. Achillea fragrantissima flowers are subject to much biochemical analysis with the aim of extracting fatty acids, whether saturated or unsaturated. The lethal dose 50 of the oil extract was 192.5 mg/kg under the surface of the skin, and 687.8 mg/kg oral and a total of 120 mice were included in this research as this group was divided into three study groups (peritoneal injection of Achillea fragrantissima oil extract at 10, 20 and 40 mg/kg of body-weight, (2/day for 10 days), respectively. Group IV has been injected with propylene glycol and used as an mg Ah control. There was significant improvement in the hem agglutination index in the 3 studied-groups when comparing to the control-group (P

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