A review on breast cancer in Iraq and future therapies insights

Cancer is one of the most common diseases around the world and the second leading cause of death after cardiovascular disease. Breast cancer is the most prevalent cancer type among Iraqi women, as it represents the highest percentage of malignant tumors in women until 2018. Therefore, women should be aware of the aggravation of this disease, the importance of the periodic examination for early detection for breast cancer, and following the most appropriate means for the treatment to get recovered and, thus, to reduce mortality. To fight cancer, there is an urgent need to search for new effective anticancer therapies that alter the molecular biology of tumor cells, stimulate the immune system, or specifically deliver chemotherapy factors directly to cancer cells without affecting normal cells and reducing the side effects of treatments. In this context, this paper aimed to highlight the therapeutic approaches used in the current researches of breast cancer treatment. Accumulated evidence showed that medicinal plant extracts, and can serve as anticancer agents. The proposed mechanisms were discussed and presented in this review.

The correlation between serum resistin and toll-like receptor-4 with insulin resistance in hypertensive subjects with or without type 2 diabetes mellitus

Background: The most chronic disease prevalence in the Iraqi population are type-2 diabetes mellitus (T2DM) and hypertension (HT). One of the important causes of these chronic diseases is obesity. Resistin (RETN) is a major link between obesity and insulin resistance (IR) or T2DM (which induces IR). The action of RETN on IR is mediated by Toll-like receptor-4 (TLR4). TLR4 is a putative RETN receptor that has been suggested to participate in RETN-inducing inflammation and IR. Objectives: To study the association between serum RETN/TLR4 and IR in hypertensive patients with or without T2DM subjects. Methods: This cross-sectional study was conducted on 120 men that classified into four different groups. These groups consist of the following: 30 apparently control group, 30 patients with hypertension, 30 patients with T2DM but without HT and 30 hypertensive patients with T2DM. For all the subjects, serum RETN, TLR4 and serum insulin was estimated by using the ELISA technique. Results: Our results showed that mean levels of the serum RETN and TLR4 were significantly elevated in all patient groups when compared with the control group. Also, a positive correlation between serum RETN and TLR4 was found in hypertensive patients with T2DM patients. Conclusions: Serum RETN and TLR4 were higher in all patient groups when compared with the control group. In addition, a positive correlation between RETN and IR in all study groups was noted. Then, we suggested a close association between RETN and TLR4 and their positive correlations with IR.

The impact of vitamin D level on serum lipids in type 2 diabetes mellitus

Background: Vitamin D is considered an important regulator of many metabolic processes in the body. Its deficiency was reported to associate with many pathological conditions, with contradicting reports on its role in dyslipidemia. Objectives: To evaluate the role of vitamin D (total and/or free) in improving dyslipidemia of type 2 diabetes mellitus (T2DM). Methods: Sixty-four patients with T2DM, and 73 apparently healthy normal subjects were enrolled in the study from March to October 2020. Their fasting blood glucose, glycated hemoglobin, HbA1c, and serum lipids (cholesterol, its fractions and triglycerides) were measured in addition to total and free vitamin D. Results: There was a significant negative correlation between total vitamin D and each of cholesterol and LDL-C in the diabetic group. The correlations between serum vitamin D and all other lipid parameters (HDL-C, VLDL-C and triglycerides) were non-significant in the diabetic group, while in the control groups none of serum lipids showed significant correlations with vitamin D. Conclusions: The significant negative association of vitamin D with total cholesterol and LDLC in the diabetics reveals the important action of vitamin D in reducing the atherogenic indices, and consequent reduction in the rate of atherosclerosis and cardiovascular disease or stroke.

A clinical-statistical study on COVID-19 infection and death status at the Alshifaa Healthcare Center/ Baghdad

Background: COVID-19 is an ongoing disease that caused, and still causes, many challenges for humanity. In fact, COVID-19 death cases reached more than 4.5 million by the end of August 2021, although an improvement in the medical treatments and pharmaceutical protocols was obtained, and many vaccines were released. Objective: To, statistically, analyze the data of COVID-19 patients at Alshifaa Healthcare Center (Baghdad, Iraq). Methods: In this work, a statistical analysis was conducted on data included the total number, positive cases, and negative cases of people tested for COVID-19 at the Alshifaa Healthcare Center/Baghdad for the period 1 September – 31 December 2020. The number of people who got the test was 1080, where 424 were infected and the rest of them were not. Results: The study showed that males’ infection and death cases were higher than females by more than double, despite the population ratios of the two genders being almost equal. Furthermore, as the age of patients is older, the chance of death is higher. Death cases were lower in December than the previous three months, which could be attributed to lower infection cases compared with the previous months. Conclusions: We can conclude that the peak of infected ages was the same as the other countries. Hence, the number of checked children was low, while we have the peak around the 40s and 50s. Females’ death cases were much less than males, which could be attributed to the genetic influence and the higher responsibility that females showed than males to prevent the disease’s spreading.

Follicle-stimulating hormone (FSH) receptor gene polymorphisms in Iraqi patients with non-obstructive azoospermia

Background: Follicle-stimulating hormone (FSH) is a pivotal hormone for male fertility, and its action on gonads is exerted by FSH receptors (FSHRs). Objectives: To examine whether the presence of FSHR gene single nucleotide polymorphisms (SNPs), G919A and A2039G, involved in non-obstructive azoospermia (NOA) in Iraqi infertile men. Methods: Two common SNPs, A919G and A2039G, in the FSHR gene were analyzed in 104 subjects (70 infertile patients with NOO: 33 NOA patients were not receiving treatment and 37 were on infertility treatment, and 34 normozoospermic fertile men as controls). Results: The results revealed that the homozygous wild genotype (AA) of rs6165 FSHR gene SNP was more abundant than (AG) and (GG) genotypes in both groups of infertile NOA patients with a frequency of 49% in those who untreated, 81% in patients undergoing treatment and in the control group 41%. Whereas, the highest percentage of heterozygous genotype (AG) in the fertile control group was 41% when compared to NOApatients with a genotype frequency of 24% (for those who untreated) and 11% (for patients on treatment), respectively; with (A) allele frequency of 86% and the observed frequency of (G) allele was only 14% in the patients’ group as compared to that of controls that were (65 %) and (35 %), respectively. The rs6166 genotyping revealed that the homozygous wild genotype (GG) of FSHR gene was more abundant than (AG) and (AA) genotypes in NOA patients receiving infertility treatment with a frequency of (68%), in NOA patients who didn’t receive treatment 49%, while the lowest frequency was detected in the healthy fertile control group (47%). Conclusions: These results support the evidence that rs6165 and rs6166, FSHR SNPs, might be involved in the pathogenesis and protection against NOA, respectively.

Diagnostic methods and protocols used in investigating Toxoplasma gondii in humans: A review

Toxoplasmosis, a zoonotic disease, is a parasitic infection caused by a coccidian protozoan Toxoplasma gondii. In immunocompetent people, the infection is asymptomatic, while it can produce serious signs in immunocompromised people and in developing fetuses. Accurate diagnosis is dependent, mainly, on the clinical features. However, in immunocompromised patients, the diagnosis is very difficult and may lead to misdiagnosis and improper treatment. Today, molecular diagnosis and serotyping are widely used for the diagnosis of T. gondii in many countries. The aim of the present short review is to highlight the current diagnostic methods and protocols that are used for the diagnosis of T. gondii in humans.

The impact of ACE2 genetic polymorphisms (rs2106809 and rs2074192) on gender susceptibility to COVID-19 infection and recovery: A systematic review

Background: Epidemiological studies revealed there is a difference in susceptibility to infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) because of differences in gender with age and males being more inflicted. There is a clear indication that deaths caused by coronavirus disease 2019 (COVID-19) in males appeared at a higher rate than females across 35 nations. The implication of associated disease-risk genes, involved in the susceptibility of COVID-19 such as the angiotensin-converting enzyme 2 (ACE2), has recently received considerable attention due to their role in severe injury of lung and mediated SARS-CoV-2 entry as a host receptor. Objectives: Herein, we aimed to systematically review how two main genetic polymorphisms of ACE2 (rs2106809 and rs2074192) can affect the gender susceptibility to SARS-CoV-2 infection. Methods: To conduct this systematic review, a literature search in PubMed, Google Scholar, ScienceDirect, and Nature was made for the period 2004 to 2020. We searched for the impact of ACE2 genetic polymorphisms (rs2106809 and rs2074192) on gender susceptibility. Results: We noticed that there was a differential genotype distribution between males and females in various global populations whereas mutant variants were common in males compared to wild-type variants among females, which may reflect differences in gender susceptibility to infection with SARS-CoV-2. Females are less susceptible to coronavirus as compare to males because of the expression of ACE2 receptor. It has a double role in favour of COVID-19 and against COVID-19. Conclusions: Male mortality is greater than female mortality, which might be attributed to the ACE2 deficiency in women. Epidemiological studies have shown that the differences in sex and age have different susceptibility to SARS-CoV-2 infection.

Lactate dehydrogenase C4 (LDH-C4) is essential for the sperm count and motility: A case-control study

Background: The lactate dehydrogenase C4 (LDH-C4) isoenzyme is an important enzyme involved in metabolic processes that are needed for spermatogenesis and sperm motility. Objectives: This study aims to assess the activity and kinetic parameters (maximum velocity, Vmax and Michaelis constant, Km) of LDH-C4 in fertile and infertile (azoospermia and oligospermia) men in Baghdad City, Iraq. Methods: A total of 120 participants (80 infertile and 40 healthy fertile men) were included in the current study. The patients were sub-grouped into: 40 infertile men with oligospermia, and 40 infertile men with azoospermia. The oligospermia patients were further subdivided into subgroups based on sperm count and motility. Semen samples were obtained by masturbation after 3-5 days abstain for seminal fluid analysis. The microscopic test included the assessment of the count, motility and morphology of the sperms. In addition, the coulometric assay was used for measuring the activity and kinetic parameters of LDH-C4 enzyme. Results: The activity of LDH-C4 is significantly higher in fertile men when compared with infertile subjects (fertile: 403.13±189.90, oligospermia: 110.01±58.13, azoospermia: 39.06±28.15; p≤0.01). Statistically significant differences in LDH-C4 activity were also noted among patients with oligospermia based on sperms count and motility. Based on sperms’ count in patients with oligospermia, a significantly higher LDH-C4 activity (p≤0.01) was noted in those with higher sperm count (10-15 million/ml) when compared to others who have lesser count. Significant elevation in enzyme activity (p≤0.01) was also observed in oligospermia patients with higher percentages of motile sperms when compared with others who have fewer percentages of motile sperms. Moreover, the highest Vmax value (0.483 mmol/L.min) and the lowest Km value (0.39 mmol/L.min) were recorded in fertile men. While, the lowest Vmax value (0.174 mmol/L.min) and the lowest Km value (0.75 mmol/L.min) were detected in azoospermia patients. Conclusions: Our results suggest that LDH-C4 is essential for the count and motility of sperm and may be considered as a therapeutic approach for infertility.

Safety assessment and biochemical evaluation of biogenic silver nanoparticles (using bark extract of C. zeylanicum) in Rattus norvegicus rats

Background: Biosynthesized silver nanoparticles (AgNPs) are widely used in various biomedical applications. However, limited reports are currently available about the safety of biofabricated AgNPs using Cinnamomum zeylanicum bark extracts. Objectives: The current study is aimed to assess the potential toxicity of biosynthesized AgNPs (using C. zeylanicum) by subacute oral administration in experimental rats. Methods: AgNPs were biofabricated using methanol extract of C. zeylanicum bark and characterized by scanning electron microscopy (SEM) and atomic force microscopy (AFM). Twenty-four Rattus norvegicus female rats were divided into 4 groups (6 animals per group) as follows: Group-I was the control, while groups II, III, and IV were given 0.85, 1.76 and 3.53 mg/kg doses of AgNPs, respectively for 14 consecutive days. After 14 days of oral administration of AgNPs, serum levels of malondialdehyde (MDA), superoxide dismutase (SOD) and catalase (CAT) were measured using an ELISA technique. Serum concentrations of urea, creatinine, aspartate transaminase (AST) and alanine transaminase (ALT) were also determined as well as histopathologic features of the liver and the kidney. Results: AgNPs did not induce any changes in mean body weight, biochemical parameters (AST, ALT, urea and creatinine), oxidative stress biomarkers (MDA, SOD and CAT) and histopathologic features (of the liver and kidneys) of the treated groups when compared to control group. Conclusions: Our findings suggest that the oral administration of biogenic AgNPs (biofabricated using methanol extract of C. zeylanicum) to rats at a specific dose is relatively safe and does not show any signs of toxicity.

Serum vitamin D3 levels in pregnant women with preeclampsia at third trimester of pregnancy

Background: Preeclampsia (PE) is a pregnancy-specific condition, characterized by high blood pressure and proteinuria after 20 weeks of gestation. One of the hypotheses concerning the etiology of PE is vitamin D3 deficiency during pregnancy. Vitamin D3 is especially important during pregnancy as low maternal vitamin D3 stores may contribute to problems like low birth weight as well as an increased risk of maternal comorbidities. Objectives: To evaluate serum vitamin D3 levels and how they can be affected by the severity of PE at the third trimester of pregnancy. Methods: This case-control study included a total of 71 pregnant women at the third trimester of pregnancy (41 with PE and 30 without PE as controls). Vitamin D3 serum level was measured by enzyme-linked immune-sorbent assay (ELISA). Results: The study’s findings showed no significant difference in serum vitamin D3 level (p>0.05) between controls (14.41±1.41ng/ml) and PE patients (14.32±1.00). As well, subgroup analysis revealed non-considerable changes between mild PE cases (15.92±1.73 ng/ml) and severe ones (13.07±1.09 ng/ml). Conclusions: PE and its severity may have no significant effect on serum vitamin D3 levels of pregnant women at the third trimester of pregnancy.