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Abstract Background: One of the efflux pump inhibitors is carbonyl cyanide 3-chlorophenylhydrazone (CCCP) that has often been found to increase the susceptibility of a number of multi-drug resistant (MDR) MDR bacteria, isolated from human clinical specimens. Objectives: To investigate the role of active efflux system to aminoglycoside and quinolones resistance in clinical isolates of Enterobacteriaceae using the efflux pump inhibitor CCCP. Materials and Methods: Enterobacteriaceae isolates were recovered from different clinical samples from hospitalized patients. The minimum inhibitory concentrations (MICs) of antibiotics (levofloxacin, ciprofloxacin, and gentamycin) were compared with and without the efflux pump inhibitor (CCCP) in order to confirm the effective role of the efflux pump in our isolates. Results: The results found that out of 280 clinical samples, only 134 (47.1%) isolates belonged to Enterobacteriaceae. Polymerase chain reaction (PCR) results showed that six (42.8%) out of 14 selected MDR isolates were positive for efflux pump gene oqxA. However, no isolates showed positive results for the efflux pump oqxB. The results of MIC for 14 Enterobacteriaceae isolates against these three antibiotics showed that all isolates had MIC ≥128 μg/mL in the absence of CCCP for levofloxacin, ciprofloxacin, and gentamycin. The results showed the MIC of levofloxacin and ciprofloxacin were reduced for isolates, and the growth of bacteria was inhibited in presence of the CCCP. However, all Enterobacteriaceae isolates showed high MIC values (≥128) even in the presence of the CCCP which indicates no effect the inhibitor in reducing the MIC of the isolates for Gentamycin. Conclusion: From this study, we can conclude that high prevalence of efflux pumps gene (oxqA) was detected among MDR and XDR Enterobacteriaceae isolates and the efflux pump inhibitor (CCCP) has a positive effect and improves the sensitivity of MDR isolates to ciprofloxacin, levofloxacin but not gentamicin.

يهدف البحث إلى تحديد العلاقة بين القيادة الخضراء كمتغير مستقل ودورها في تعزيز الريادة المستدامة ولأجل تحقيق ذلك اعتمدت القيادة الخضراء كمتغير مستقل، في حين اعتمدت الريادة المستدامة بأبعادها (الريادة البيئية، الريادة الاقتصادية، الريادة الاجتماعية) كمتغير معتمد. تمثلت مشكلة البحث في (هل للقيادة الخضراء دور في تعزيز الريادة المستدامة في الشركة المبحوثة) وتم بناء مخطط فرضي الذي يحدد طبيعة العلاقة والتأثير بين المتغيرات، وتم صياغة فرضيتان رئيسيتان اشتقت منها فرضيات فرعية. ولتحقيق أهداف البحث استخدم الباحث المنهج الوصفي التحليلي، اشتمل مجتمع البحث على القيادات الادارية (مديرو الهيئات والاقسام والمشاريع) والبالغ عددهم (70)، وبلغت عينة البحث من (70) فرداً جرى استطلاع اراءهم بموجب استبانة استبيان محكمة لهذا الغرض، تم تحليلها باستخدام وسائل إحصائية متقدمة ضمن البرنامج الاحصائي الجاهز (SPSS). استخلص البحث مجموعة من النتائج كان من أهمها: وجود علاقتي ارتباط وتأثير ذات دلالة معنوية بين القيادة الخضراء والريادة المستدامة، اختتم البحث بمجموعة من التوصيات وكان من أبرزها ضرورة خلق ثقافة تنظيمية خضراء من خلال تعزيز وانشاء التوجهات الخضراء لتمكين العاملين من المساهمة في الحفاظ على الموارد الطبيعية حماية البيئة على المستوى الفردي والتنظيمي وتمكينهم من مواجهة وحل المشاكلات بشكل مناسب وتحقيق الأهداف الريادية المستدامة.

Background: The hypertensive pregnancies complicated by preeclampsia show an increase in maternal and perinatal morbidity and mortality.Color Doppler ultrasound has been employed for fetal surveillance. Objective: To evaluate the role of Doppler study in the prediction of adverse pregnancy outcomes in hypertensive pregnant women at the third trimester of pregnancy. Patients and Methods: A clinical prospective follow up study conducted in Outpatient Ultrasound Clinic at Al-Imamein Kadhimein Medical City, Baghdad, Iraq from 1st July, 2018 till 31st of July 2019 included 50 pregnant women with hypertensive disorder of pregnancy at the third trimester. The fetal and neonatal outcome was reported poor when intrauterine fetal death occurs during follow-up of pregnant women or more than two of the reported neonatal complications were poor. Results: Means of the middle cerebral artery and umbilical artery-resistance and pulasatility indices ratio were significantly decreased among pregnant women with poor neonatal outcomes. Similarly, the umbilical artery end-diastolic flow and Ductus Venousu waveforms were Conclusion: The middle cerebral artery and umbilical artery indices of pregnant women with hypertensive disorders are good predictors for neonatal outcomes.

Background: Data on the effect of obesity on seminal fluid and men fertility are inconsistent. The aim of this study was to evaluate the impact of obesity on semen characteristics in infertile men. Patients and methods: A cross-sectional study was conducted on seventy-four infertile men who met inclusion criteria. Semen sample were collected and sperm concentration, progressive motility, total motility and normal sperm morphology were assessed in accordance with WHO 2010 criteria. For each patient weight and height were measure and patients were divided by BMI into normal weight (BMI: 18.5–24.9 kg/m2, n = 30), overweight (BMI: 25–29.9 kg/m2, n = 30) and obese (BMI: ≥30 kg/m2, n = 14). Seminal fluid parameters were compared among the three groups. Results: Sperm concentration was lower in obese men but it did not differ significantly from those of normal weight and overweight infertile men (25.71 ± 22.16, 34.33 ± 31.11, 36.07 ± 31.24 and million/ml respectively, P > 0.05). Sperm progressive motility, total motility and normal sperm morphology also were not significantly different among the three groups. Conclusion: Our findings suggest that obesity may have no influence on sperm concentration, motility and normal morphology in infertile men. Keywords: Male, Infertility, Semen, Body mass index, Obesity

Background: The hypertensive pregnancies complicated by preeclampsia show an increase in maternal and perinatal morbidity and mortality.Color Doppler ultrasound has been employed for fetal surveillance. Objective: To evaluate the role of Doppler study in the prediction of adverse pregnancy outcomes in hypertensive pregnant women at the third trimester of pregnancy. Patients and Methods: A clinical prospective follow up study conducted in Outpatient Ultrasound Clinic at Al-Imamein Kadhimein Medical City, Baghdad, Iraq from 1st July, 2018 till 31st of July 2019 included 50 pregnant women with hypertensive disorder of pregnancy at the third trimester. The fetal and neonatal outcome was reported poor when intrauterine fetal death occurs during follow-up of pregnant women or more than two of the reported neonatal complications were poor. Results: Means of the middle cerebral artery and umbilical artery-resistance and pulasatility indices ratio were significantly decreased among pregnant women with poor neonatal outcomes. Similarly, the umbilical artery end-diastolic flow and Ductus Venousu waveforms were Conclusion: The middle cerebral artery and umbilical artery indices of pregnant women with hypertensive disorders are good predictors for neonatal outcomes. [ABSTRACT FROM AUTHOR]

Background: Elastosonography is a promising non-invasive technique that developed in recent years for evaluating thyroid nodules. It assesses nodule stiffness or displacement depending on the applied force to differentiate malignant from benign thyroid nodules. Objectives: The aim of this study was to evaluate the diagnostic utility of real time US elastography in the differentiation the benign from malignant thyroid nodule. Patients and methods: A cross-sectional was carried out on 40 patients attending ultrasound unit/radiology in Al-Imamein Al-Kadhimein Medical city in Baghdad/Iraq from September 2018 to August 2019. All patients were examined by B-mode ultrasound, color Doppler, and real-time elastography by Voluson-E6 Ultrasound machine. Final diagnoses obtained from histological and/or cytological evaluation. Results: The mean age of 40 patients was 43.7±11.7 years with the range of 25-70 years. 28 (70%) of them were female and 12 (30%) were male. Of the 40 lesions 34 (85%) were benign and 6 (15%) were malignant lesions. Malignant thyroid nodules were significantly hypoechoic, with irregular margin, taller than wider, showed microcalcification and exhibited a significant increase in vascularity with varying rate of sensitivity and specificity. Orientation (taller than wider) was the most ultrasound predictive pattern of malignancy with sensitivity, specificity, and accuracy of 66.7%, 100%, and 92.5% respectively. The mean strain ratio of all nodules was 2.7±2.1 ranged 0.4-13.5 with significant result. The optimal strain ratio cutoff value was >2.5 and showed to have a sensitivity of 100%, specificity 88.2%, positive predictive value 67%, negative predictive value 100%, and accuracy rate 90%. Conclusion: Elastosonography can assist in the differential diagnosis of malignant and benign thyroid nodules, as strain elastosonography improve the diagnostic performance in differentiating the benign and malignant thyroid nodule. strain ratio is higher in malignant than benign nodules. [ABSTRACT FROM AUTHOR]