Helicobacter pylori causes peptic ulceration and gastric adenocarcinoma. The aims were to study the influence of dupA1 positivity upon interleukin-8 (IL-8) secretion from gastric mucosa and determine the prevalence of mutations responsible for clarithromycin and fluoroquinolone resistance. DNA was extracted from 74 biopsies and the virulence factors were studied. Levels of IL-8 in gastric mucosa were measured using ELISA and the mutations responsible for clarithromycin and fluoroquinolone resistance were determined using a GenoType-HelicoDR assay. The prevalence of cagA in strains isolated from gastric ulcer (GU) and duodenal ulcer (DU) was significantly higher than those isolated from non-ulcer disease (NUD) (90% and 57.9% versus 33.3%; p 0.01). The vacA s1m1 genotype was more prevalent in patients with DU (73.7%) and GU (70%) than in those with NUD (13.3%) (p 0.01). The prevalence of dupA1 was higher in DU patients (36.8%) than those with GU (10%) and NUD (8.9%) (p 0.01). Multivariate analysis showed that a cagA+/vacA s1i1m2 virulence gene combination was independently associated with the developing peptic ulcer disease (PUD) with increased odds of developing PUD (p 0.03; OR = 2.1). We found no significant difference in the levels of IL-8 secretion in gastric mucosa infected with H. pylori dupA-negative and H. pylori dupA1-positive strains (dupA-negative: mean ± median: 28 ± 26 versus 30 ± 27.1 for dupA1; p 0.6). While 12 strains were clarithromycin resistant, only three isolates were levofloxacin resistant. A significant association was found between dupA1 genotype and A2147G clarithromycin resistance mutation (p <0.01). Further study is needed to explore the relationship between virulence factors and disease process and treatment failure.

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Background Infection with hepatitis C virus (HCV) is a public health problem that is associated with deleterious consequences such as liver cirrhosis and hepatocellular carcinoma (1). Recent estimates suggest that more than 150 million people are chronically infected with the virus and over 500 000 subjects die annually of the infection (2). With the approval of direct-acting antivirals for the treatment of HCV, outstanding progress has been made that made the elimination of the virus feasible (3). Successful treatment with the achievement of sustained virologic response (SVR) reduces the risk of complications such as cirrhosis and cancer. One of the challenges to treatment is the risk of late relapse after finishing the treatment. The prevalence of HCV in Iraq has been studied thoroughly and it has been reported to be low in all regions of the country (4-7). The most common HCV genotype in Iraq is genotype 1 followed by genotype 4 (8). Additionally, reports from our country showed a very high SVR rate in patients with hemoglobinopathy and end-stage kidney diseases (9,10). The aim of this study was to investigate the relapse rate of HCV 36 months after the completion of the treatment Materials and Methods Patients Annually, invitations were sent to patients who were previously infected with HCV and completed treatment course successfully as defined by negative RT-PCR results 12 weeks after the end of treatment in patients who received direct-acting antiviral therapy. This was performed for 3 years. HBsAg and HIV ELISA Commercial ELISA kit (DIA.PRO Diagnostic Bioprobes ELISA kit, Italy) was utilized to test HBsAg and HIV positivity. RNA Extraction HCV nucleic acid was extracted using QIAamp RNA Extraction Kit (Qiagen) following the manufacturer's instructions for automatic extraction in QIAcube extractor (Qiagen). Then, the purity and concentration of RNA were measured by NanoDrop. HCV Quantification and Genotyping Nucleic acid amplification was conducted using artus HCV RG-RT PCR Kit and was run on a Rotor-Gene

Cutaneous leishmaniasis (CL) is endemic in Iraq. After the last war in Iraq against Islamic State in Iraq and Syria (ISIS), the number of CL cases has peaked particularly in children. International guidelines do not provide an insight on how to choose treatment regimen of CL in children. The aim of this article was to study the efficacy of intralesional sodium stibogluconate (SSG) therapy for school age children with CL. In the period between June 2016 and June 2019, 288 internally displaced school age children (6-12 years old) from Ninewa city were recruited in the study. All patients received intralesional SSG twice a week for a maximum of 12 sessions. All patients were followed up for 12 weeks after the last treatment session. The mean age of recruited patients was 8.6 ± 2 years and 164/288 (56.9%) were male. 202/288 (70.1%) of the patients presented with single lesion. The total number of lesions was 417 of which 141/417 (33.8%) lesion were nodular and the rest were ulcerative lesions. The treatment success rate was (282/288) 97.91%. No significant association was found between age, gender, number of lesions, or duration of lesions and the treatment outcome. Mild local pain, mild bleeding at the site of injection, and itching at the site of injection were the most common side effects. Intralesional SSG infiltrate is effective and minimal side effects. Further studies including clinical trials are required to provide robust data on the efficacy and the safety.