The assessment of urinary NAG could be considered as a useful marker in prediction of the (vesicoureteral reflux, hydronephrosis) .Urinary NAG is elevated in children with pyelonephritis and it can be considered as a further criterion in the diagnosis of upper urinary tract infection.

. Among all other viruses, human cytomegalovirus (HCMV) is the most frequent cause of congenital infection worldwide. Strain variation in HCMV may predict severity or outcome of congenital HCMV disease. Previous studies have associated a particular genotype with specific sequelae or more severe illness, but the results were contradictory. There are no previous studies addressing the genotype of HCMV in Iraq. Therefore, the present study is aimed at molecular detection and genotyping of HCMV isolated from symptomatic congenitally/perinatally infected neonates. This prospective study comprised 24 serum samples from symptomatic neonates with congenital/perinatal infection. Viral DNA was extracted from these serum samples; nested polymerase chain reaction was used to amplify the HCMV gB ( UL55 ) gene. Polymerase chain reaction products of the second round of amplification were subjected to direct Sanger sequencing. Bioedit and MEGA5 software (EMBL-EBI, Hinxton, Cambridgeshire, UK) were used for alignment and construction of a phylogenetic tree. Human cytomegalovirus DNA was detected in 23 of 24 samples (95.8%). According to the phylogenetic analysis, three genotypes of the virus were identified; gB1, gB2, and gB3 genotypes. However, the gB4 genotype was not detected. Human cytomegalovirus gB3 was the most frequent genotype: 14 of 24 (58.33%) among symptomatic infected infants, followed by gB1 (6/24; 25%) and gB2 (4/24; 16.67%). A mixed HCMV infection with gB3/gB1 was detected in only one case. Human cytomegalovirus gB3 was the most predominant genotype among symptomatic congenitally/perinatally HCMV-infected neonates. No association was found between B3 genotype and specific clinical presentation. Jaundice was the most common clinical feature among symptomatically infected neonates, followed by hepatosplenomegaly.

Background: Nutritional disorders still represent a major problem faced by developing countries. Surveying such problems is a step towards planning proper interventions, which contributes significantly to declines in under-five mortality rates. Aims: To study the state of nutritional trends in children under five years of age, attending a primary healthcare center in Al Shoula district, Iraq, in 2006 and 2012. Demographic features and feeding practices that may have had an effect on the nutritional status of children were also studied. Subjects and methods: Two cross-sectional surveys were conducted on children aged two to five years, in a primary healthcare center in Baghdad. Children attending for immunization were included (500 in 2006 and 570 in 2012), their mothers were interviewed, and the body mass index of the child was calculated. Children who were overweight and obese were identified, according to the Centers for Disease Control and Prevention charts, as those suffering from stunting. Nutritional parameters were compared between the two study groups, using the chi-square test, as well as various epidemiological factors that may have affected the outcomes. Results: The prevalence of both types of nutritional disorders (stunting and overweight and obesity) declined remarkably according to the 2012 survey; overweight and obesity declined from 20% to 7.2%, while stunting decreased from 51.2% to 30.9%. The age group showing the highest rate of improvement were the four to five year olds, as well as children from lower-income families. A higher rate of breastfeeding was reported in 2012, and breastfed babies suffered the least from both types of nutritional disorders, in both study groups. Overall, the study findings showed a high prevalence of stunting (30.9%), together with a significant level of overweight and obesity (7.2%). Conclusion: Children in Iraq suffer from high rates of stunting. With a moderately high rate of obesity, there is an urgent need to evaluate local data available and plan for an active intervention to combat these nutritional problems.

Background: Human respiratory syncytial virus (hRSV) is a major cause of viral lower respiratory tract infection among infants and young children less than 2 years old. Multiple methods are used for the laboratory diagnosis of hRSV infections, including chromatographic immunoassay, enzyme linked immunosorbent assay (ELISA) and reverse transcription polymerase chain reaction (RT-PCR) technique for detection hRSV-antigens, hRSV-antibodies and hRSV-RNA, respectively. Objective: To compare the efficiency of three diagnostic methods in detection of hRSV in infants and young children with chest infection. Methods: This study included 100 hospitalized infants and young children (39 females and 61 males) aged from (1) month to (24) months, their mean age (6.87 ± 6.03) months, who required hospital admission at the Pediatric Department in Al-Imamein AL-Kadhimein Medical City Hospital, Central Teaching Pediatric Hospital, and Al-Kadhimiya Pediatric Hospital in Baghdad-Iraq. Samples were collected over a three-month winter period from January 2017 to April 2017. Fresh nasal swab specimens were collected and testes for hRSV antigens by using chromatographic immunoassay as a rapid test, in addition, nasopharyngeal/throat swabs specimens were processed for detection of hRSV-RNA by RT-PCR, both for direct detection. Also, ELISA was done to measure anti-hRSV IgM antibodies in serum for indirect detection of RSV infection. Results: hRSV was found to be positive in (27%), (56%) and (44%) of specimens by rapid chromatographic immunoassay, ELISA and RT-PCR technique, respectively. Comparing with RT-PCR, the sensitivity of rapid test was (59.09%) ranged from (44.41) to (72.31) and the specificity was (98.21%) ranged from (90.55) to (99.91) with likelihood ratio equal to (33.09), while the sensitivity of ELISA test was (75.61%) ranged from (60.66) to (86.17) and specificity was (59.62%) ranged from (46.07) to (71.84) with likelihood ratio equals to (1.87). Conclusion: The RT-PCR technique was more sensitive than antigen or antibody detection methods for the diagnosis of hRSV Keywords: hRSV, rapid chromatographic immunoassay, ELISA, RT-PCR Citation: Al-Shuwaikh AMA, Ali SH, Arif HS. Detection of respiratory syncytial virus in infants and young children with chest infection: a comparison of reverse transcription-PCR technique to chromatographic immunoassay and enzyme linked immunosorbent assay. Iraqi JMS. 2018; 16(3): 319-326. doi: 10.22578/IJMS.16.3.11

The aim of this study is to evaluate the hospital-based management of acute asthma in south Asia and to compare practices over a 10-year period. Adult patients (n = 102) admitted at a teaching hospital with acute asthma were studied. Documentation of precipitating factors, family history and physical signs were inadequate in more than half of patients. Pulse oximetry was documented in 95 (93%) patients, but peak flow monitoring was performed only in 50 (49%) patients. Ten-year trend showed deterioration in history and physical examination skills, under use of peak flow readings, and poor pre-discharge instructions. Some aspects of improved care included frequent use of pulse oximeter, preference of inhaled over systemic bronchodilators and increased use of systemic steroids. Significant deficiencies were identified in hospital-based management of acute asthma. Most aspects of asthma care continued to fall short of asthma guidelines.