Modern treatment approaches and effective early diagnosis in reducing antibiotic resistance mortality: A review Safaa Ehssan Atta, Lujain A. Ghannawi, Lina Al-jameel, Omar Yasir Shakir, Haidar Fadhil Al-Rubaye Journal of University of Anbar for Pure Science, 2026 Antibiotic resistance (ABR) has emerged as a critical global health challenge, posing considerable threats to effective infection management and public health. Antibiotics are increasingly ineffective against a wide range of pathogens because of the rising rate of microbial resistance. Misuse and overuse of antibiotics in both clinical and agricultural settings have contributed to the proliferation of resistant strains. A substantial number of deaths are attributable to drug-resistant infections, underscoring the urgency of addressing this crisis. This review aims to inform stakeholders in mitigating the impact of antibiotic resistance on global health. It focuses on the multifaceted nature of ABR, highlighting mechanisms by which bacteria avoid antibiotic action, including horizontal gene transfer, genetic mutations, and biofilm formation. The review also emphasizes the need for an integrated, modern approach to reduce antibiotic resistance, incorporating advances in diagnostic techniques and novel therapeutic strategies to protect public health.
ANALYSIS OF MECA GENE IN METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS ISOLATED FROM A DIVERSE OF CLINICAL SOURCES SPECIMENS Safaa Ehssan Atta, Lujain A. Ghannawi, Karam Gharab, Omar Yasir Shakir, Asmaa Hamid Khleef, et al. Eastern Ukrainian Medical Journal, 2025 Background: Conventional method was the best method for identifying the Methicillin-resistant gene in Staphylococcus aureus(mecA) due to various species of staphylococci that were expressed for various resistance levels. Objective: This study aimed to get an accurate detection of the mecA gene in S. aureus isolates, which mediates methicillin resistance in bacteria using the primers (mecA) to detect the mutations that occur in the mecA gene encoding for penicillin-binding protein (PBP2a) that is responsible for the intrinsic resistance to all β-lactams. Methods: Fifty clinical isolates were determined as S. aureus according to molecular and bacteriological ways. The susceptibility tests were performed on all bacterial isolates by disc diffusion and MIC methods using methicillin and six fluoroquinolones antibiotics. Results: From fifty isolates, 12 isolates were resistant to methicillin and all six antibiotics; 12 were resistant, three were intermediate, and 38 were sensitive to three or more tested antibiotics, in addition to confirming the resistance of S. aureus isolates by minimum inhibitory concentration test. The primary sources of S. aureus isolates were burns (10%), nose (16%), wounds (8%), operation room (10%), ear (20%), urine (8%), skin (6%), and throat (22%). Twelve resistant isolates were used to examine the mutations in the mecA gene. A direct sequence analysis found no mutations detected in mecA. The methicillin resistance was due to the mecA gene responsible for methicillin resistance. Conclusion: The absence of mutations in the mecA gene implies that resistance may be ascribed to alternative mechanisms, potentially including enhanced expression of penicillin-binding proteins or efflux pumps.
IMPACT OF HIGHLY SELECTIVE VERSUS RELATIVELY SELECTIVE COX2 INHIBITORS ON INSULIN SENSITIVITY IN IRAQI PATIENTS DIAGNOSED WITH TYPE 2 DIABETES Isam Noori Salman, Safaa Ehssan Atta, Baydaa Ahmed Abed, Noor Ulhuda G. Mohammed, Karam Gharab, et al. Eastern Ukrainian Medical Journal, 2025 Background: A worldwide health epidemic, type 2 diabetes mellitus was significantly influenced by chronic inflammation, which led to increased insulin resistance (IR). The most widely practiced form of therapy used to control musculoskeletal pain in people with diabetes is non-steroidal anti-inflammatory drugs (NSAIDs), which provide their action by inhibiting cyclooxygenase enzyme (COX). COX1, COX2, and COX3 are distinct isoforms of the cyclooxygenase enzyme. The potential anti-inflammatory benefits of cyclooxygenase-2 (COX-2) inhibitors, both selective and non-selective, have been investigated concerning the management of type 2 diabetes patients. Objective: the purpose of this research is to explore the impact of highly selective celecoxib and relatively selective diclofenac (COX-2) inhibitors on insulin sensitivity in type 2 diabetes patients. Methods: A sample of 136 patients with T2DM (92 females, 44 males) and 64 healthy controls (36 females, 28 males) was formed. Two groups of patients, Group 1 (hyperlipidemia) and Group 2 (normolipidemic), were created. Each group received treatment with either diclofenac or celecoxib in half. Insulin sensitivity was ascertained using the quantitative insulin sensitivity check index (QUICKI) formula. Results: Both normolipidemic and hyperlipidemic diabetics had higher fasting plasma glucose levels (p-value) and lower QUICKI scores compared to the controls. Diclofenac significantly increased serum insulin and decreased fasting glucose in hyperlipidemic diabetics, while celecoxib also reduced fasting glucose and QUICKI scores in hyperlipidemic. In normolipidemic diabetics, diclofenac decreased fasting glucose and increased insulin, whereas celecoxib increased insulin but decreased QUICKI scores. Conclusion: Targeted COX-2 inhibitors such as celecoxib may considerably provide valuable benefits, including enhanced insulin sensitivity, metabolic function, and overall health.
The impact of metformin therapy on serum leptin levels in Iraqi obese individuals with type 2 diabetes mellitus Journal of Krishna Institute of Medical Sciences University, 2025
Assessing Serum Asprosin Levels among Iraqi Individuals Diagnosed with Acromegaly Omar Yasir Shakir, Safaa Atta, Karam Gharab, Lujain Ghannawi, Abbas Rahmah Experimed, 2025 Objective: Asprosin (ASP) is a modern adipokine produced from white adipose tissue that is linked to metabolic disorders such as obesity and diabetes. Acromegalic syndrome results from excessive pituitary growth hormone (GH) secretion, leading to increased insulin-like growth factor-1 (IGF-1) production, usually due to a pituitary adenoma. The serum ASP levels were higher in acromegaly patients (AC-PTs) than in healthy controls. The aim of the study was to explore ASP levels in AC-PTs compared with healthy controls, considering gender, diabetes status, treatment duration, and hypertension.Materials and Methods: Fifty AC-PTs with different body mass index, sex, age, diabetes, and blood pressure were enrolled in this study. IGF-1, GH, and fasting blood glucose (FBG) levels were measured alongside 30 healthy controls. In addition, enzyme-linked immunoassay (ELISA) was used to measure ASP.Results: There was no significant difference in ASP levels between AC-PTs and healthy controls (p>0.05). Moreover, the current study showed no statistically significant difference in ASP levels among the subgroups categorized according to the patient’s gender, diabetes status, hypertension, and treatment course.Conclusion: ASP levels revealed no difference between Iraqi AC-PTs and control group; ASP is not affected by hormonal changes that are typically associated with acromegaly.
Evaluation of prothymosin alpha, trimethylamine-N-oxide, and ischemia-modified albumin in type 2 diabetes mellitus patients with dysregulated lipid profile Karam Mazin Gharab, Mohammad Ahmad Bik, Safaa Ehssan Atta, Ghufran S. Jawad, Eissa Almaghrebi, Isam Noori Salman, AIi Unlu Qatar Medical Journal, 2025 Background: Prothymosin alpha (PTMα) is a small acidic polypeptide from the thymosin family with immune activity and protective properties against oxidative stress induced by reactive oxygen species trimethylamine-N-oxide (TMAO), produced in the liver from gut bacterial metabolite trimethylamine and associated with increased cardiovascular disease risk and higher all-cause mortality. Ischemia-modified albumin (IMA) is a significant oxidative stress biomarker, particularly in ischemia-reperfusion conditions. This study investigates PTMα, TMAO, and IMA levels in type 2 diabetes mellitus (T2DM) patients, both with and without hyperlipidemia, to explore their relationships and their potential role as biomarkers or therapeutic targets. Method: The study received ethical approval from the Selcuk University Faculty of Medicine Hospital committee under approval number 2024/33. The study included male and female T2DM patients aged 30–60, with 30 having hyperlipidemia and the rest being non-lipemic. TMAO was performed using API 3200 LC-MS\\MS while PTMα was analyzed using an ELISA kit from BT LAB, serum IMA levels were evaluated by the spectrophotometric method. Results: Comparisons were made between those with T2DM and control groups. In the T2DM group, PTMα was significantly higher in females (p = 0.047), while TMAO and IMA showed no significant gender difference. The control group had no significant differences in PTMα, TMAO, and IMA levels. Comparisons among healthy controls, non-lipemic T2DM patients, and hyperlipidemic T2DM patients revealed significantly decreased PTMα levels with no change in IMA levels across groups. In contrast, TMAO was significantly higher in the patient group. Conclusion: The findings of this study have potential implications for the field, suggesting that PTMα might serve as a prognostic indicator for T2DM and that reduced TMAO levels might play a role in T2DM pathogenesis, opening up new avenues for research and treatment.
Evaluation of asprosin levels in growth hormone-deficient children Journal of Krishna Institute of Medical Sciences University, 2024
SERUM VISFATIN IN PATIENTS WITH TYPE 2 DIABETES MELLITUS AND DIABETIC RETINOPATHY I. N. Salman, N. U. G. Mohammed, S. E. Atta, B. A. Abed, R. Salim Diabetes Mellitus, 2024 BACKGROUND: The primary cause of blindness in diabetics is diabetic retinopathy (DR), the most common microvascular complication of diabetes, and visual impairment. Visfatin is an adipocytokine that aids in insulin activity during gestational diabetes and pregnancy.AIM: This study aimed to estimate serum visfatin levels in DR, proliferative (PDR), non-proliferative (NPDR), and healthy subjects (HS).MATERIALS AND METHODS: A 120-patient case-control study with a history of T2DM for more than 5 years as well as 30 healthy subjects enrolled in the study. Patients group divided into three sub-groups, DM, PDR, and NPDR. Visfatin levels were measured using a commercially available enzyme-linked immunosorbent assay kit. Triglyceride (TG), serum cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) levels and glycated haemoglobin (HbA1c) were assessed.RESULTS: The PDR patients and patients with poor glycemic control showed significantly increased visfatin levels compared with the HS group and T2DM patients without DR. The TC, TG, and DR group’s LDL-C levels were noticeably higher and significantly greater in PDR than in the group of HS.CONCLUSION: Visfatin levels have been linked to both the severity and existence of DR. and more in patients with poor glycemic control. Elevated lipids were associated with DR risk.
Molecular Investigation of gyrA Mutations in Clinical Isolates of Methicillin-Resistant Staphylococcus aureus Derived from Diverse Sources Safaa Ehssan Atta, Lujain Ghannawi, Omar Yasir Shakir, Karam Mazin Gharab Al Rafidain Journal of Medical Sciences, 2023 Background: Fluoroquinolones are the most effective antibiotics against Staphylococcus aureus isolates. In hospitals, excessive use of antibiotics has led to the emergence of highly resistant strains of S. aureus isolates. Objective: The aim of this study was to detect the mutations that occur in the gyrA gene encoding for DNA gyrase, which is one of the targets for fluoroquinolone resistance. Methods: Fifty clinical isolates were diagnosed as S. aureus according to molecular and bacteriological methods. The susceptibility tests were performed on all bacterial isolates by the disc diffusion method using methicillin and six fluoroquinolone antibiotics. Results: Out of fifty isolates, twelve were resistant to methicillin and all six antibiotics (nalidixic acid, lomefloxacin, ciprofloxacin, norfloxacin, ofloxacin, and levofloxacin). From the fifty isolates, 12 were resistant, 3 were intermediate, and 38 were sensitive to three or more tested antibiotics. The resistance of S. aureus isolates was also confirmed by the minimum inhibitory concentration test. The main sources of isolates were burns (10%), nose (16) wounds (8%), operation room (10%), ear (20%), urine (8%), skin (6%), and throat (22%). Twelve resistant isolates were used to examine the mutations in the gyrA gene. A direct sequence analysis found eight mutations in the gyrA gene; these mutations included 2 (25% missense mutations), 1 (12.5%) deletion mutation, and 5 (62.5%) silent mutations at various sites. Conclusion: gyrA mutations resulting from the excessive use of antibiotics may be one of the mechanisms leading to fluoroquinolone resistance.
