Chlorination has been the most widely practiced method of disinfection for potable waters since the turn of the century and principal means by which the microbial quality of water is maintained in Iraq. Khabur river is the main source of our drinking water in Zahko-Duhok city, here chlorine in form of hypochlorous at concentration 2 ppm are most used. In this paper, we have attempted to compare the sensitivity of microorganisms toward chlorine and also we have tried to the determination of chlorine resistant bacteria to antibiotics. Results from our experiment suggest that bacteria isolated from post-chlorinated water samples are more resistant to chlorine disinfection than prechlorinated water samples. the isolated organisms are Staphylococcus aureus, Micrococcus variants and Aeromonas hydrophila fully resistant to chlorine at this concentration and the most resistant bacterium of all isolates is Staphylococci. Although the strains were sensitive to abroad spectrum of antibiotics the strains show resistant to the most important clinical antibiotics. The suggestion that either the synthesis of unique proteins or aggregation of the bacteria as mechanisms of resistance to inactivation. This study will help us to suggest relevant changes in purification processes for the supply of better quality of drinking water to our Municipal Corporation.

The present study was performed to assess the immune response in women with human papilloma virus (HPV) DNA+ and DNA− cervical lesions. Eighty women with cervical lesions (age range = 25–70 years) and 20 healthy individuals (control group) were enrolled in the study. Lesions were cytologically classified into four groups: ASC-US (20), CINI (30), CINII-III (16), and cervical carcinoma (14) prior to HPV DNA detection. Estimation of interleukin (IL)-10 and tumor necrosis factor (TNF)-α levels in cervical secretions and serum of the studied patients was performed utilizing ELISA. PCR screening kits were used to detect HPV DNA in cervical smears obtained from the studied cases with the different lesions. IL-10 levels in cervical secretions of HPV DNA+ were significantly greater than those from DNA− patients (i.e., 88.73 vs 24.00 pg/ml) and from controls (i.e., 88.73 vs 8.27 pg/ml) and the levels were higher in DNA− patients than in controls (i.e., 24.00 vs 8.27 pg/ml). In comparison, serum IL-10 levels in these patients did not significantly differ from control values (i.e., 13.69 vs 12.16 vs 9.99 pg/ml, respectively). TNFα levels in cervical secretions of the HPV DNA+ and DNA− cases did not significantly differ from values for the controls (i.e., 12.18 vs 9.90 vs 7.90 pg/ml, respectively). Serum TNFα of these patients also did not differ significantly from controls (i.e., 11.59 vs 11.90 vs 10.83 pg/ml, respectively). The detected levels of IL-10 in cervical secretions of patients with HPV DNA+ lesions was significantly higher than in their sera, while secretion TNFα levels were nominally greater than sera values. Lastly, higher levels of IL-10 were observed in secretions of 10–14 (71.4%) patients who had progressive cervical lesions (HSIL and cervical cancer stages) who were HPV DNA+ than observed in 20 of 66 (30.0%) of DNA− patients with similar progressive lesions. In general, the higher levels of IL-10 than of TNFα suggested a potential down-modulation of tumor-specific immune responses to HPV-infected lesions. This phenomenon appears to provide a tumor ‘progressive’ microenvironment in these particular patients.

Background Human papillomavirus (HPV) is documented to be a causative agent of cervical cancer and detection rates of more than 90% were registered in some parts of the world. This study was undertaken to introduce polymerase chain reaction (PCR) for diagnosing HPV infection in women with different cervical lesions for the first time in Kurdistan region and to define the most prevalent high-risk (HR) genotypes (HR HPV). Methods Eighty women (aged 25–70 years) with different cervical lesions, cytologically classified as ASC-US (n = 20), CINI (n = 30), CINII-III (n = 16), and cervical carcinoma (n = 14) and 20 healthy individuals (control group) were enroled in this study. PCR screening kits were used to extract the entire genomic DNA from cervical cells scraped from cases and then PCR HR HPV genotyping kits were used to test the positive samples. Findings HPV DNA was detected at an estimated rate of 17.5% in the cases but was absent in the control group. In the cases, the detection rate of HPV DNA was 1.25% (1 of 20), 3.75% (3 of 30), 5.0% (4 of 16), and 7.5% (6 of 14) in the cytological categories ASC-US, LSIL (CIN-I), HSIL (CIN-II–III), and cervical cancer, respectively. Moreover, the results of this study showed the detection of seven HR HPVs 16, 52, 56, 35, 45, 39, and 33 at frequency rates of 28.4%, 21.4%, 14.3%, 14.3%, 7.1%, 7.1%, and 7.1%, respectively. Therefore, HPV 16 was the most commonly detected HR HPV genotype among the positive cases (28.4%). Interpretation This is the first PCR study done in the Kurdistan region. The detected rate of HPV DNA (17.5%) in this region verifies the use of PCR. Moreover, the detected rate of HPV infection correlated with the severity of the cytological findings and HPV 16 was the most commonly detected HR genotype among positive cases (28.4%). Knowing the rate of HPV infections and the HR genotypes are of utmost importance for HPV vaccine introduction, which is not yet scheduled in this region and other parts of Iraq.

Anti-phospholipid syndrome (APS) is an autoimmune disease. Cerebral ischemia associated with APS occurs at a younger age than typical atherothrombotic cerebrovascular disease, is often recurrent, and is associated with high positive IgG anti-phospholipid (GPL) unit levels. This study sought to determine the frequency rates of anti-cardiolipin (aCL) dependent on the presence of β2-GPI, anti-β2-glycoprotein I (aβ2-GPI), and anti-phosphatidyl serine (aPS) IgG autoantibodies among stroke patients, and thus demonstrate the importance of testing for aβ2-GPI autoantibodies. For these study, stroke patients and control subjects recruited from Mosul, Erbil, and Dohuk provinces in Northern Iraq between March 2004 and March 2005 were evaluated. All cases were under 50 years-of-age and had no recognizable risk factors. Using ELISA to evaluate the presence of IgG isotype of aCL, aβ2-GPI, and aPS autoantibodies in their blood, the results indicated that the frequency of aβ2-GPI was 14/50 (28%), aCL was 11/50 (22%), and aPS was 9/50 (18%) among stroke patients. In contrast, aCL was detected in 2/30 (6.7%) of control subjects; each of the other anti-phospholipid antibodies (APLA) was never observed. Of all the aβ2-GPI+ cases, the incidence of stroke patients having the combined profile of aβ2-GPI + aCL was 11/14 (78.6%) and of aβ2-GPI + aPS was 9/14 (64.3%). Only 2/14 (14.3%) of these aβ2-GPI+ patients also expressed aCL in the absence of aPS. The frequency of patients expressing all three markers was only 9/14 (64.3 %). In none of the APS/stroke patients were aCL or aPS expressed in the absence of the aβ2-GPI. Conversely, aβ2-GPI as a sole marker was seen in 3/14 (21.4%) of these patients (i.e., in absence of either other marker). It can be concluded from these studies that the among the three major forms of APLA examined, the presence of aβ2-GPI IgG autoantibodies appeared to correlate best with stroke in patients who were concurrently suffering APS.

Objectives: To determine whether antiphosphatidyl serine autoantibodies (aPS) are associated with increased risk of occurrence of coronary events in selected patients. Methods: This study compared 50 patients with coronary events with 30 controls, recruited from the cities of Mosul, Erbil, and Dohuk cities, Northern Iraq, between March 2004 and March 2005. The patient group consisted of 23 individuals with myocardial infarction and 27 with angina. We evaluated the presence of aPS antibodies (IgG and IgM isotypes) by an enzyme-linked immunosorbent assay. The studied cases were less than 50 years of age (mean ± SD, 39.6 ± 5.9) and had no recognizable risk factors. Results: The frequency of detecting IgG aPS was 10/50 (20%) among patients and 1/30 (3.3%) among controls, with a significant difference and with an adjusted odds ratio (OR) of 3.2 (95%CI, 1.1–9.1; p < 0.05). The IgM aPS frequency was 3/50 (6%) among patients and zero in the controls, with a non-significant difference. The three cases were also IgG positive (i.e. the frequency rate for detection of aPS of IgM was the same as for IgG). Moreover, this marker (aPS) was detected in 8/12 (66.7%) of cases with unstable angina, in 2/15 (13.3%) with stable angina, and in none of the cases with myocardial infarction. Conclusion: IgG aPS autoantibodies are associated with increased risk of coronary events especially angina of unstable subset.

Objectives: The aims of the study are to determine the role of anti-phospholipid autoantibodies (APLAs) among patients with stroke and/or transient ischaemic attacks (TIAs), to identify the types and effective isotype of some important APLAs which are lupus anticoagulant (LA), anticardiolipin (aCL), anti∼fi2 glycoprotein I dependent (afi2-GPI), and anti-phosphatidyl serine (aPS). Also, to find out any concomitant effect of non-APLAparameters not specific to antiphospholipid syndrome (APS). Subjects and Methods: This study was carried out on 50 patients attending mainly the Teaching and General Hospitals in Mosul, Duhok, and Erbil Cities, Iraq during the period between 1st March 2004 and 1st March 2005. The studied cases were under 50 years of age, and had no recognizable risk factors. The activated partial thromboplastin time (APTT) was used for LA estimation and ELISA assay was used to test for IgG& IgM isotypes ofaCL, aJ32-GPI, and aPS. The ANA, RF, VDRL, CRP, and C4 complement were tested by different immuoserological methods. The thrombocytopenic (TP) status was diagnosed by estimation of platelets counts. Results: The strokes and!or TIAs related to APS were diagnosed in 22/50 (44%) of patients and a significant correlation was reported among patients with IgG plus IgM aCL (p < 0.05), IgG afi2-GPI (p < 0.05), and IgG aPS (p < 0.05). In APLAs positive patients, raised CRP concentrations were reported in 36.4%, TP status in 22.7%, ANA in 22.7%, RF positive in 13.6%, and low C4 levels in l3.6%. Finally, the FP-VDRL test was found in 50 % of APLAs positive cases. Conclusions: The aCL, afi2- GPI, and aPS antibodies were shown to play a significant role in the development of stroke and!or TIAs among the studied cases. Read More: http://www.qscience.com/doi/abs/10.5339/qmj.2007.2.15

Effect of sanctions on hepatitis B vaccine availability and occurrence of viral hepatitis B among Iraqi children was studied. Between June 2000 and June 2001, families of patients attending the Public Health Laboratory, Mosul, for hepatitis B follow-up were screened. Enzyme-linked immunosorbent assay was used to test for HBsAg, HBeAg and anti-HBe. We diagnosed 74 children born 1994-1998 as HBsAg carriers. For 62 of 74 cases, parents had consulted vaccine centres promptly: 41 were not vaccinated and 21 had only one vaccine dose. HBeAg marker was positive for 9 [‎14.5%]‎ and anti-HBe for 50 [‎80.7%]‎. Parental reluctance was the reason for non-vaccination for 12. Vaccine shortages during the birth years of cases were documented, even after implementation of United Nations Security Council Resolution 986

OBJECTIVES The persistence of hepatitis B core immunoglobulin M (HBc IgM) antibody in hepatitis B surface antigen (HBsAg) carriers is a risk factor with hidden dangers and forecasts the existence of liver damage. A trial of lamivudine in such subset of carriers was carried out for the first time in this study. METHODS A total of 62 HBsAg with hepatitis e antibody individuals (age range, 25-45 years) with persistent HBc IgM antibody were randomized to receive either 100 mg lamivudine (32/62) or placebo (30/62) daily for 6 months. The study was performed from June 2000 to October 2002. The carriers were regular attendees of the Virology Center in Mosul, North Iraq for follow up. Enzyme-linked immunosorbent assay technique was performed to detect the different hepatitis B virus markers. RESULTS Among the lamivudine group, HBc IgM antibody seroclearance achievement rate was 81.3% and HBsAg seroconversion rate was 9.4% compared to 6.3% and 3.3% in the placebo group. Number of adverse clinical events were observed, but were of mild nature and tolerable by the participants who completed the study. CONCLUSIONS The trial of lamivudine in this subset of HBsAg carriers proved to be safe and efficacious. More studies are needed prior to recommending the drug for routine use on selected HBV carriers.

OBJECTIVES The aim of this study is to evaluate the clinical and prognostic values of persistence of anti-hepatitis B core immunoglobulin M antibody in asymptomatic adults chronic hepatitis B surface antigen anti-hepatitis Be carriers and its absence in others. METHODS Fifty-two hepatitis B surface antigen/anti-hepatitis Be carriers with and 32 without anti-hepatitis B core immunoglobulin M marker were enrolled in this study. The cases were regular attendees of Public Health Laboratory, Virology Center (the main referral center for viral hepatitis) Mosul, North Iraq, for follow-up and clinical evaluation. The study was performed from June 1999 to June 2001. The studied groups consisted of adults, with mean age of 35.5 year (standard deviation +/- 10). The results of histological findings of 23 carriers with and 12 carriers without anti-hepatitis B core immunoglobulin M who underwent liver biopsy were added to the study. Micro enzymed-linked immunosorbent assays was utilized to detect hepatitis B virus markers. RESULTS Existence of carrier in the family was significantly associated with persistence of anti-hepatitis B core immunoglobulin M in the studied individuals (p<0.005, odds ratio = 7.4; 95% confidence interval = 1.8 to 38.0), as was the case in the presence of family history of acute hepatitis (p<0.05, odds ratio = 4.6; 95% confidence interval = 4.6 to 21.2). The detection of this antibody was significantly associated with the presence of abnormal liver histology compared to carriers without this antibody (p<0.01, odds ratio = 7.2; 95% confidence interval = 1.8 to 28.7). The study revealed that clustering of carrier cases existed in statistically significant (p<0.001) pattern in family members of carriers with anti-hepatitis B core immunoglobulin M. CONCLUSIONS The detection of anti-hepatitis B core immunoglobulin M clinically is a reminder of recent exposure to the virus through different routes, mainly intrafamilial. Ongoing liver changes are observed in the majority of carriers with this antibody indicating the viral activity, albeit in a silent manner, but earlier progress to serious liver sequels may be inevitable. Foretelling that carriers with anti-hepatitis B core immunoglobulin M are more infectious than carriers without this marker is ascertained by the existence and clustering of carrier cases amongst their family members.

Pregnant women [‎60]‎ with and without serological evidence of active cytomegalovirus [‎CMV]‎ infection were followed until delivery to detect the incidence and types of overt congenital CMV infection in neonates in Mosul, Iraq. Infection was diagnosed by the detection of CMV-IgM, using ELISA. CMV-IgM was detected in cord blood samples of six [‎10%]‎ overtly sick infants [‎with different congenital malformations]‎ born to mothers with active CMV infection. Central nervous system abnormalities were detected in all six cases [‎two with microcephaly and four with hydrocephaly]‎. Congenital CMV infection should be suspected in infants born with congenital malformations, especially those of the central nervous system. The detection of a significant number of hydrocephalus cases in our study is notable