The concentration of total proteins, albumin and gamma-globulins was higher (P < 0.05) in the adult camels than in camel calves. The concentrations of beta1 globulins was higher (P < 0.05) in calves as compared to adult camels.

Background: Optimal immunosuppression in elderly kidney transplant recipients (KTRs) is not well defined, with mycophenolate mofetil (MMF) being poorly tolerated.Study aim was to compare MMF dose reduction incidence and reason(s) in elderly vs.nonelderly KTRs in the 1st year after transplant with a protocol dose of 1 g/day.Methods: In this single-center retrospective study, first or repeat KTRs receiving rabbit antithymocyte globulin (rATG), MMF 1 g/day, tacrolimus, and prednisone, were stratified by age [≥60 (elderly) or <60 years (nonelderly)]. Primary outcome was MMF dose reduction incidence in the first year. Secondary outcomes included dose reduction rationale, 1-year patient and graft survival, graft function, rejection, infection, hospital presentation, and time to dose reduction. Of 335 KTRs, dose reduction incidence was significantly greater in the elderly group (66% and 54%, p = 0.04), though this did not remain significant when adjusted for sex, race, and valganciclovir use. Most common rationale was leukopenia in the elderly group and CMV in the nonelderly group.There were no significant differences in secondary outcomes. Conclusions:Mycophenolate mofetil 1 g/day was poorly tolerated in both elderly and nonelderly KTRs receiving lymphocyte-depleting induction with a high incidence of dose reductions; however, no short-term adverse graft outcomes were identified.

A total of 275 dromedary camels (16 males and 259 females) of local “Arabiyat” breed suffering from different types and degrees of severity of toenail tumors were surgically treated. Histopathological examination of the tissue samples removed from 50 tumor-like growths (2 males and 48 females) revealed three types of tumors; squamous cell carcinoma (70%), spiny keratoderma (22%) and fibroma (8%). An increased incidence of tumors was recorded in the medial when compared to the lateral toenails in both sexes. In females, the incidence in the medial toenails was 90/259 (34.75%) and 71/259 (27.41%) in the right and left forelimbs respectively when compared to the lateral toenails which was 25/259 (9.65%) and 5/259 (1.93%) for the respective right and left forelimbs. In the hind limbs, this ratio was 29/259 (11.20%) and 20/259 (7.72%) for right and left medial toenails respectively, whereas it was 17/259 (6.56%) and 2/259 (0.77%) for the right and left lateral toenails respectively. Similar to the observations in female camels, male camels also showed a higher incidence of these tumors in the medial when compared to the lateral toenails in both fore and hind limbs. Based on these findings, we conclude that in the dromedary camels, the medial toenails of the fore limbs are most commonly affected with tumors; with the most common tumor being the squamous cell carcinoma.

Background: Kawasaki disease is the most common cause of acquired heart disease in developed countries. Kawasaki disease it has been increasingly reported from developing countries. The aim of this study was to assess the clinical and epidemiological characteristics of Kawasaki disease in children of Sulaimaniyah city. Subject and Methods: In this study all children diagnosed as Kawasaki disease included during the period between January 2010 and December 2014. The hospital records / pediatric cardiology clinic data were reviewed, and data were abstracted onto standardized forms. Results: During the study period from January 2010 to December 2014, 36 patients were diagnosed as Kawasaki disease. Their mean age at diagnosis was 2.8± 2 years (range 6 months -9years). Most of the patients (30 patients 83.3%) were under age of 5 years, and the median age was 2.1 year. Male to female ratio was 1.76. Most of cases occurred during winter and spring season. Out of 36 patients, 16 (44.4%) patients had coronary disease, and 4 cases of coronary cases were classified as A4 and A5 class according to Japanese Classification of Severity of Coronary Artery Lesions. There was non-significant difference between coronary and non-coronary group regarding hemoglobin level, platelet count, ESR and WBC count. Conclusions: Kawasaki disease is not uncommon in Sulaymaniyah, the clinical and epidemiological pattern is not different from other parts of the world. We need to increase the index of suspicion in order not to miss Kawasaki disease cases and avoid its serious cardiac complications.Duhok Med J 2017; 11 (2): 37-45.

Background: Dietary supplement use in living kidney donors (LKDs) and kidney transplant recipients (KTRs) provides care challenges due to drug interactions, limited data, and lack of management guidelines. The study purposes were to describe supplement use patterns and intra/postoperative complications in these populations. Methods: A single-center retrospective review of LKDs and KTRs from September 2016-2018 was conducted. Supplement information was collected at evaluation and preoperative visits. Supplement relationship to intra/postoperative complications was graded by Naranjo Adverse Drug Reaction Probability Scale. Results: One hundred and fifty-seven LKDs met inclusion with an average age of 45 (SD 11) years. Thirty-seven LKDs (24%) reported supplement use pre-donation. One hundred and eleven KTRs met inclusion with an average age of 46 (SD 13) years and 21 (19%) reported supplement use pre-transplant. No significant differences in sex, ethnicity, or education were found between LKDs or KTRs using supplements vs none. One complication in an LKD was "possibly" related to supplement use vs none in KTRs. Conclusion: Transplant providers should screen for supplement use in LKDs and KTRs at both the evaluation and pre-operative visits and review perioperative management. The low dietary supplement-related intra/post complication rate may be due to discontinuation of supplements preoperatively.