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Abstract: This study was carried out on twenty normal subjects (women) in order to evaluate (Sysmex Automated Hematological Analyzer KX-21N) for the estimation of blood hemoglobin level. Two processes where used for evaluation, the first is the systematic error to determine the accuracy of the device by comparison with the standard device (the Sahli's) and the second process is to test the random error or reproducibility of Sysmex. The result of this study indicate that values of Hb measured by Sysmex KX-21N were slightly higher than that measured by Sahli's method (P<0.005) And the result of random error test indicates that the Sysmex KX-21N is reproducible device which is improved by using the statically equation: (2SD/mean x 100%) to determine 95% tolerance limit of the device which indicate that the device is greatly reproducible.

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Abstract: Background and aim: Comorbidity between tension type headache TTH and other disorders is a topic of interest. At the present time, no study examine comorbidity of irritable bowel syndrome (IBS) with TTH as separate entity ; presence of such association have great impact in diagnosis and management of TTH patients for which this prospective cross sectional comparative controlled study have been conducted. Methodology: In this Cross Sectional Controlled Comparative Study , 360 patients ;200 female and 160 male ; age ranges from 15-60 years with diagnosis of TTH depending on International Headache Society (IHS) criteria have been enrolled and compared with age and gender matched 200 controlled individuals ; 116 female and 84 male . The prevalence of IBS (diagnosis made depending on symptoms based criteria Rome II and III criteria) among 2 group were estimated with further evaluation of IBS prevalence made in relation to age , gender and type of TTH ; Statistical analysis done by means of person Chi-square tests with P value < 0.05 was used as a level of significance. Results: TTH is more common in woman , with female to male ratios of 1.25:1, TTH affecting age peaks between 20 and 60 years. There was significant high prevalence of IBS among TTH group versus control healthy group (79.7%, 10% respectively; p value was 0.0001 ) with very high significant prevalence among chronic TTH versus episodic TTH (93.3%, 72.9% respectively ; p value was0.000056). The prevalence of IBS among TTH group was more common among female versus male (62.7%, 37.3% , respectively).The age peak affected was among thirties and forties ( 29.6% and 28.6% respectively): the sex and gender differences were not significant statistically . Conclusion: patients with TTH have significant associations with IBS as comorbid disorder, such relationships is important from diagnostic and therapeutic point of view . Strength of this association suggests a common pathophysiologic mechanisms which needs further evaluation in future.

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ABSTRACT: Background: Pregnancy is a normal physiological phenomenon with many biochemical changes ranging from alterations in electrolyte concentrations to more complex changes in cortisol and calcium metabolism. These changes together with fluid retention can lead to repetitive strain illnesses like carpal tunnel syndrome and these changes may be subclinical, yet could be chronic and might lead to serious complications. Aim of the study: Is to know which of the pregnant females are at more risk of developing subclinical CTS. Results & discussion: The effect of some factors like the gestational age, gestational history, occupation of the pregnant females and some blood parameters on the presence of the subclinical CTS have been tested and it was shown that there were no statistically changes in most parameters other than the BMI, gestational age and part of the gestational history with the ESR. These results can be explained by the increment in fluid retention that is accompanied with maternal weight gain with the progress of the gestational age, also due to recurrent exposure to pathophysiological changes into the median nerve function that take place during repetitive pregnancies.

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Abstract:- Fifty paraffin blocks of colorectal carcinomas cases included in this study were randomly selected from January 2007 to Juan 2007 from the histopathological department in AL-Sadr Teaching Hospital.Of the fifty paraffin blocks of the studied colorectal carcinomas' cases; 29 cases (58%) were males and 21 cases (42%) were females. Their ages range was (16-80) years with an overall mean age (56.44±13.558) years , (58%) cases in distal colon (26%) cases were rectal , well differentiated carcinoma in (40%) cases , their stages by Dukes they were (36%) Dukes C followed by (30%) Dukes B then (18%) Dukes D and (16%) Dukes A. Fifty cases were submitted for immunohistochemical stain for P53 antibody, 39 cases (78%) were positive , and positive cases classified as weak positive in 18 cases (36%) and strong positive in 21cases (42%) ,also as faint staining pattern in 15 cases (38.4%) and dense staining pattern in 24 cases (61.6%).TP53 expression was more in distal colon cases (82.7%) , higher stages Dukes C (83.3) and D ( 88.8%) and poorly differentiated cancer (94.7%) , With no significant correlation of TP53 expression and site and stage of tumor but with significant relationship with grade of tumor

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The aim of the study: To elucidate the maternal & fetal out comes of burn in pregnancy & to put guidelines for their management. Abstract: From Dec. 1999 to Dec. 2010, there were (60) burned pregnant women' (mostly domestic accidents), nine (15%) of them treated as out patient cases, and fifty one (85%) were admitted to the hospital (Hilla teaching hospital and Al-Kindy teaching hospital) and were studied prospectively, nine cases (15%) had minor injuries, six cases (10%) moderate injuries, and forty five (75%) major burns. Sixteen cases (26.6%) were in the first trimester, sixteen cases (26.6%) in the second and twenty eight cases (46.6%) in the third trimester. Fourteen cases (23.3%) treated surgically in form of wound excision and skin graft. Interferences with pregnancy performed only in two cases in form of induction of labor and caesarian section. Twenty two patients (36.6%) and twenty seven (45%) fetuses died. We conclude that the prevention is better than treatment and management of these cases is a difficult task and conservative approach gives good results.

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Aim: This study was designated to investigate the changes of some hematological and biochemical parameters in patients affected with hereditary thrombosthenia. Method: The study included 30 patients (males & females) with hereditary thrombosthenia who admitted to the hereditary bleeding disorder center at Babylon maternity and pediatrics teaching hospital in Hilla city and at the hereditary bleeding disorder center in AL-Zahraa maternity and pediatrics teaching hospital in AL-Najaf city. Their age was ranged 3-≤ 18 years (mean age 11 years ± SE 5 years). The patients were classified into 2 groups according to the age which are group I (3-≤10 years) and group II (10-≤18 years) and each age group was subdivided into males and females subgroups. Thirty apparently healthy subjects (15 males and 15 females) of matched age and gender were also included in this study. Results: Concerning the hematological parameters, it was found that hemoglobin (Hb), packed corpuscular volume(PCV), means corpuscular volume (MCV), means corpuscular hemoglobin (MCH), and means corpuscular hemoglobin concentration (MCHC) show significant decrease in most groups of hereditary thrombosthenia in comparison with the control groups. Regarding the biochemical parameters, it was found that serum iron and serum ferritin are significantly decreased and serum total iron binding capacity(TIBC)are significantly increased in most groups of hereditary thrombosthenia compared to the control groups. Conclusion: In view of the changes summarized, the increase or decrease in some hematological and biochemical parameters may be attributed to recurrent blood loss which is the most important manifestation of the diseases.

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Garlic contains hypolipidemic and antioxidant compounds acts on prevention of cardiovascular and other metabolic diseases, such as atherosclerosis high-lipidemia, thrombosis hypertension and diabetes .This study have investigated the efficacy of garlic-apple vinegar mixture intake for prevention of dys-lipidaemia which considered as the major cause of arterial dysfunction. Study the effects of low dose of mixture for a period of sixty days, and attempt to bridge the gap between studies on apple vinegar alone and garlic studies to get benefits of their combination. The study carried on male rabbits received hyper-cholesterolemic diet (1%cholesterol) with treatment (mixture group) for 8 weeks which compared with control and hyper-cholesterolemic groups reveal significant decrease in total cholesterol(TC)low density lipoproteins(LDL)and triglyceride (TG) with significant increase in high density lipoproteins(HDL).Moreover the histological changes sustenance these results. Conclusion: the mixture of garlic apple-vinegar have a clear role in reducing the level of lipids in the serum and thus reduce the risk of atherosclerosis, as the low dose therapy of the mixture gave an excellent results with low side effects of both components. The present study prove okay results after obtaining their synergistic benefits as a mixture compared to the results discovered by histological examinations of abdominal aorta in the hyper-cholesterolemic group on one hand and the treated group with mixture on the other hand.

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Background: Free prostatic specific antigen (PSA) is the predominant molecular form of serological PSA increase in a significant proportion of breast cancer patients and that free PSA levels decrease significantly after surgery. Given the heterogeneity of the population of breast cancer patients, additional studies with larger cohorts of patients are required for the examination of molecular forms of PSA with regard to individual parameters such as risk of relapse or metastasis. Finally, the physiological mechanism behind the free PSA increase in breast cancer and its ramifications with respect to tumor progression should be further investigated. Objective: To measure and compare : 1:- free PSA in the serum of women with breast cancer before and after surgery and 2:-the serum of women with benign breast mass as a diagnostic tumor marker. Patients and Methods: A prospective study was done in AL Sader teaching Hospital in AL-Najaf city between 15th January 2010 and 1st of November 2010, where 60 cases of breast mass were taken to measure the expression of free PSA in their serum, 30 cases of theme have breast carcinoma diagnosed by cytology and other ways of diagnosis, and their serum were taken before the operation and at 10th-14th post-operative day. The other 30 cases have benign breast tumor . We also took the age of all the 60 patients. Results: In the 30 patients with breast carcinoma the level of free serum PSA was between 1.380ng/ml- 5.000 ng/ml before operation, but highly decreased to become 0.011ng/ml – 0.292 ng/ml post-operatively. While in the benign tumor patients the level was 0.000ng/ml – 0.893 ng/ml. Conclusion and Recommendation:There is an association between the serum level of free PSA before and after surgery of ca breast patients, so it is regarded as a marker for diagnosis of breast cancer . We advise to send every patient with breast lump for serum free PSA level for early detection of ca breast . Our study show that the free serum PSA is a diagnostic tumor marker like in the diagnosis of prostate carcinoma and also may be use PSA as a prognostic factor in patients with ca. breast like progesterone and estrogen receptors as showed by other studies, but we need further studies in the future to confirm

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Serum ferritin was measured in 40 term normal pregnant mothers and the corresponding cord blood samples. All of the mothers had received prophylactic oral iron and folate irregularly during pregnancy. The mean (±SD) maternal serum ferritin at the end of pregnancy was 58 ± 36 µg/l (range 19-204 µg/l), compared to a mean of 186 ±61 µg /l (range 67-319 µg/l) in thier newborns. No correlation was found between the serum ferritin of mothers and babies, nor between the serum ferritin and serum iron of mothers at the end of pregnancy or between these parameters in the newborn.

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Background: There were conflicting results regarding clinical studies of effect of smoking on the coronary angiographic findings, our aim was to study the effect of smoking on angiographic results in Iraqi patients with history of coronary artery disease submitted to routine coronary angiography. Methods: 393 consecutive patients with history of coronary disease submitted to coronary angiography in cardiology center divided into two major groups: smokers group (198 patients) and non smokers group (195 patients) and comparison had been done between two groups in the number of diseased coronary arteries, distribution of obstructive lesion and morphological severity Results: RCA and LMS (58% &57%) were more likely to diseased in smoking group rather than non smoker and the prevalence of two vessel disease(63% Vs 37%)(P= 0.02) and to lesser extent the three vessel disease pattern(53% Vs 47%) was more common in smoking group compared to non smoking group. On the other hand, no significant association was found between smoking and morphological severity of coronary artery disease regarding multiple or total cut lesions (P value > 0.588). Abbreviations:

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Introduction: The umbilical cord is the lifeline between the fetus and the placenta of the mother. It functions throughout pregnancy to protect the vessels that travel between the fetus and the placenta. Histological & histochemical changes of the umbilical cord can have serious deleterious effects on the health of the fetus and newborn. Macroscopic and microscopic integrity of the umbilical cord is vital for its proper functions. Materials& methods: Sample of seventy five umbilical cords with inclusion criteria (full term newborns) whose mothers were (normal) collected from labor room of (Al-Kadhmiya teaching hospital).These umbilical cords were examined as follows: • Macroscopically (length and umbilical coiling index) and the cords divided into three groups according to the coiling index into (hyper, hypo and normocoiled groups). • Histochemically (by use of four types of lectin). Results: Lectin histchemistry showed variability in the strength of the lectin binding in different regions of the umbilical cord connective tissue with different coiling indices. Conclusion: The variability in the (umbilical coiling index) was found to be reflected on the histochemistry of the umbilical cord and probably may have effects on the perinatal outcome of the newborn.

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Objectives: The aim of this study is to investigate the changes in hemodynamic variables in response to head down tilting. Methods: This study was carried out on 60 normal healthy subjects, 40 males and 20 females in order to study the cardiovascular reflexes in response to 20° head down tilting by using non-invasive techniques including mercury sphygmomanometer for measurement of blood pressure , pulse oximeter for measurement of heart rate, Doppler echocardiography for estimation of velocity time integral (VTI) ,stroke volume (SV) and cardiac output (CO).The subjects were divided into two groups: the first group includes subjects with age between 20-40 years and this group consist of 32 males and 8 females.The second group includes the subjects with age between 41-60 years and this group consist of 8 males and 12 females. Results: In the first group there is significant increase in velocity time integral (VTI) , stroke volume (SV) and cardiac output (CO) and significant decrease in heart rate (HR) and total peripheral vascular resistance (TPVR) in response to 20°head down tilting. While there are no significant differences in systolic, diastolic and mean blood pressure. In the second group there is significant increase in velocity time integral (VTI), stroke volume (SV), cardiac output (CO), systolic, diastolic and mean blood pressure in response to 20° head down tilting. While there are no significant differences in heart rate (HR) and total peripheral vascular resistance (TPVR). Keywords: head down tilt, cardiac output.

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Back ground: Infertility is one of the most important and underappreciated reproductive health problems in developing countries. The causes of infertility can be found in about 90% of cases, while about 10% of patients don’t know why they can not conceive .The causes of this case (unexplained infertility) seems to be heterogeneous, with suggested potential causes ranging from disturbances in endocrinological, immunological , genetic and reproductive physiological factors. One of the main causes of unexplained infertility is the reactive oxygen species (ROS). Therefore this study is aimed to estimate and calculate the ROS and to determine the relationship between free radicals, antioxidant enzymes activities and unexplained infertility. To carry out this aim, ROS has been estimated in both sera and cervical mucus secretions among healthy fertile women (control) and patients with unexplained infertility ; in form of malondialdehyde (MDA). In addition, catalase (CAT), glutathione level (GSH), vitamin C and vitamin E (as antioxidant agents ) for both fertile women and infertile women studied groups have estimated and calculated. Patients and method: The study groups were attended to Babylon Maternity and Pediatric Hospital and privet clinics. All studied patients are suffering from primary or secondary unexplained infertility types and are diagnosed by gynecologist. The study is carried out on (30) apparently healthy fertile women as a control group, their mean age (30.133±8.011years) and (60) infertile women as patient group, their mean age (29.866 ±7.195 years). Results : The results of the tests have shown that the malondialdehyde (MDA) were increased significantly (p<0.01) in serum and cervical mucus secretion(3.105± 1.441µM and 6.729±3.055)µM in patients group comparing with control group which where (1.524±0.518 µM and 3.201± 1.028µM) respectively. Catalase levels decrease significantly (p<0.05) in serum and cervical mucus.secretion (0.303± 0.286 k/ml and 0.331±0.302 k/ml) in patients group comparing with (0.479±0.342 k/ml and 0.508±0.301 k/ml) in control group. The glutathione levels, on the other hand, decrease significantly (p<0.05) in serum and cervical mucus. secretion (17.977±8.506 µM. and. 51.602 ±27.335µM) in patients group comparing with (27.384 ±13.547µM and 65.327±18.217µM) in control group.Vitamin C levels decrease insignificantly (p>0.05) in serum and cervical mucus secretion (9.944 ± 1.549mg/l and14.233 ±3.458mg/l) in patient group comparing with (10.383±3.655mg/l and (16.447± 4.042mg/l) in control group.Vitamin E levels decrease significantly (p<0.05) in serum and cervical mucus secretion(5.272 ± 1.228mg/l and 4.644 ± 1.343 mg/l) in patient groups comparing with (7.337±3.535 mg/l and 7.023± 0.754 mg/l) in control groups. Conclusion: The present study shows that the oxidative stress plays an important role in human fertility which is significantly increased in sera and cervical mucus secretion in patients with unexplained infertility.

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Bachground: Segmental demyelination occurs when there is dysfunction or death of the Schwann cell or damage to the myelin sheath Segmental demyelination with slowed nerve conduction, of these, wallerian and axonal degeneration cause denervation and reduce the amplitude of compound action potential, whereas demyelination slows the nerve conduction with or without conduction block. Infection with HBV is one of the most common viral diseases affecting man; extrahepatic symptoms may result from deposition of antigen-antibody complexes formed when these particles are neutralized by anti-HBsAg antibodies. The pathogenesis of these extrahepatic disorders has not been fully elucidated but likely involves an aberrant immunologic response to extrahepatic viral proteins. The neurological manifestations of chronic hepatitis B viral are most often a peripheral sensory neuropathy characterized by numbness, burning and sensation of “pins and needles” peripheral motor neuropathy, mononeuropathy, mononeuropathy multiplex. Objectives: To assess the peripheral nerves abnormalities and detected the segmental demylination in chronic viral hepatitis B patients by using Nerve conduction study and to evaluate the relation between the sensory and motor peripheral neuropathy on different type of chronic viral hepatitis B

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Objective: To evaluate the relationship between markers of inflammation markers, C-reactive protein (CRP) and leukocytes, and stroke. Design: A prospective clinical study. Setting: Al-Sadr Teaching Hospital, Basrah, Iraq Patients and Methods: In this prospective study,73 patients (42 males and 31 females) with acute stroke and 75 control subjects (45 males and 30 females) were included. CRP concentration, leukocyte count, fasting blood glucose (FBG), total cholesterol (TC), triglycerides (TG ), high density lipoprotein- cholesterol (HDL-C), and low density lipoprotein-cholesterol (LDL-C) level were determined in patients and controls. Results: CRP and leukocytes were significantly higher among male patients with acute stroke compared to controls (p<0.001). FBG, TC, TG and LDL-C concentrations were significantly higher whereas HDL-C level was significantly lower among patients compared to controls ( p<0.001). In females, CRP (P<0.05) and leukocytes (P<0.001) were also significantly higher among patients in comparison to controls. FBG, TC, TG and LDL-C concentrations were significantly higher while HDL-C level was significantly lower among patients compared to controls (p<0.001).

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Background: Dynamic Compression Plating (DCP) has been the most accepted available surgical fixation method for fractures of humerus shaft in our country. DCP has biological shortcomings. By giving priority to biology, the "internal fixator" principle, has been popularized, bearing some similarity to an external fixator (EF). Aim of the study: EF is being evaluated as an acceptable definitive fixation for this injury. Methods: Between January 2005 and April 2009, 31 patients with acute fracture of the humeral shaft requiring surgical stabilization were treated using simple unilateral bar EF. Reduction achieved either closed or open. Time till union, time till removal of EF, and elbow & shoulder range of motion were recorded, and compared with corresponding values from studies using DCP or EF. Results: Average time till surgery was 5.32 days. Average time for union and dynamization of EF was 11.55 weeks. And for removal of EF was 15.1 weeks. Conclusion: Monolateral bar EF for treatment of humerus shaft fractures is reliable, effective, low risk, with maximum protection of soft tissue. Considering the renewed attention in biological approaches, it’s a reasonable alternative to DCP, the only surgical alternative available in our country.

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Having a tracheostomy is considered to be a safe and straightforward procedure, but as with many surgical procedures it does carry a risk of complications. Aim: To evaluate tracheostomy early complications at Medical City Complex, Baghdad. Patients and methods: A prospective study of (125) consecutive tracheostomies that were performed during one year period from May 2006 through May 2007 in Medical City, Baghdad. Results: Ninety three patients (74.4%) were males. Thirty seven patients (29.6%) were in their third decade. Complications developed in fifty three patients (42.4%); wound infection was the commonest in twenty three patients (43.4%), followed by subcutaneous emphysema in fourteen patients (26.4%) and haemorrhage in ten patients (18.8%). One tracheostomy related death was encountered (0.8% of the total no. of patients). The complication rate was significantly higher in urgent tracheostomies (50.6%) than elective procedures (26.1%) and in those performed with local anaesthesia (48.3%) compared to (25%) under general anaesthesia. Conclusions: Most of early complications were due to the urgency of the procedure and inadequate postoperative nursing care. Wound infection was the commonest complications.

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30 experimental animals of three species of vertebrates was used; 10 adult Carp fishes, 10 adult doves, and 10 adult Albino rats. Both eyes were taken. 5 paraffin sections were prepared from each eye with 6 µm thickness for histochemical study with 5 lectins which are: UEAI, PNA, SBA, Con-A, and LFA. The aims of the study were comparing the types of carbohydrates by lectin histochemistry that present in the retina of three vertebrates species habituating in different environmental conditions. This study found a clear variation in types of carbohydrates in each one of the ten layers of vertebrates' retina.

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require prolong therapy. A newly prepared formula of 1% clotrimazole eye ointment was formulated then in vitro study was done to assess its potential in treatment of human keratomycosis. Methods: Clotrimazole eye ointment of 1% strength was formulated (formula A). The zone of inhibition of the prepared clotrimazole eye ointment for Candida species and the degree of growth inhibition for Aspergillus and Fusarium species were studied then compared with that of commercially available 1% topical clotrimazole (formula B). Results: Both formula A & B has good inhibition zone for Candida species, formula A inhibits the growth of Aspegillus species in all concentrations used, while it inhibits the growth of Fusarium species in high concentrations only. Conclusion: a newly prepared 1% clotrimazole eye ointment is effective in vitro against pathogens that cause keratomycosis, further in vivo study will be done to prove its effectiveness.

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Introduction: Due to the increased use of modern diagnostic imaging techniques; a growing number of small renal tumors are being diagnosed incidentally. The standard treatment for these small lesions is partial nephrectomy, with equivalent oncologic results to that of radical nephrectomy, and better renal function preservation. Patients and methods: Fifteen patients with renal lesions, ranging in size from 4 to 7.5 cm, had been submitted to our study; with their ages ranging from 22 to 80 years. Partial nephrectomy using manual compression was done. Patients are then followed 3 monthly by US checking of renal dimension, echogenicity and for recurrence. The follow up period ranges between 3- 24 months. Results: Of 15 patients enrolled in our study; the provisional diagnosis was hydatid cyst in 3 patients, and renal tumor in 12 patients. From those 12 cases with provisional diagnosis of renal tumors:2 cases had their histopathology proved to be hydatid cyst in one patient, and chronic inflammatory lesion in the other, and the other 10 cases were malignant renal tumors. Two patients (16.6%) with provisional diagnosis of renal tumor had proved to be malignant on frozen sections with positive margins, for which further resection was done and the new edges proved to be negative. All other lesions (83.4%) with provisional diagnosis of renal tumor were proved to be malignant on frozen section with negative margins. Conclusions: Manual compression is the technique of choice for control of bleeding in partial nephrectomy for polar or peripheral lesion, with zero warm ischemia. Hydatid cyst resection is a feasible surgical procedure for polar or peripherally situating cyst, leaving no chance for recurrence. Longer follow up is needed to make sure that the incidence of recurrence and progression remains stable over time, and to confirm that the higher incidence rate of positive surgical margin does not translate into a worse survival rate.

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This study was performed on twenty normal females in order to assess the accuracy of (Sysmex automated hematology analyzer KX-21N) for estimation of red blood cell count (RBCs). Two processes were used for this evaluation, the first is by calculating the systematic error to determine the accuracy of this device by comparison with the standard method and the second process is by testing the random error or reproducibility of the device. The results of this study indicate that values of RBCs count measured by Sysmex automated analyzer were slightly higher than that measured by the standard methods, although they were statistically not significant. The results of the random error which was improved by the statistical equation : (2 SD/mean × 100%) indicate that the Sysmex automated hematology analyzer was accurate and reproducible and can be used in routine service and research.

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Green tea (leaves of camellia sinensis) has been associated with a reduced risk of cardiovascular disease.The mechanism of this risk reduction involves inhibition of lipoprotein oxidation by antioxidant polyphenolic compounds derived from tea .This Study was designed to test the hypolipidemic activity of aqoueous green tea extract in cholesterol-fed rabbits for a period of 2 months. The rabbits were received a cholesterol-enriched diet(1% cholesterol) for 2 months and the results were compared to the control, treatment and prevention groups. The results showed that there is a significant decrease in total serum cholesterol(TC), triglycerides(TG),Low density lipoproteins (LDL)( P < 0.01) and a significant increase in high density lipoprotein (HDL) (P < 0.01). Conclusion : aqueous green tea extract has a hypolipidemic and antiatherosclerotic potentials.

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Scanning electron microscopy (SEM) revealed two types of bile canalicular-ductular junctions in rats. 1- Several bile canaliculi converged to form an ampulla .The ampulla was about 3x6 micro meter. Some ampulla walled mainly by hepatoctytes and partly by a few ductular cells. 2- Bile canaliculi connected directly to bile ductule as aside branchs. In this case, a part of the wall of the canal of Hering was formed by the hebatocytes at the junction of the bile canaliculus with the canal of Hering. Scanning electron microscopy (SEM) of corrosion cast revealed canal of Hering as a blind canal originated from the hepatic lobule as a collection of bile canliculi forming ampulla which descended toward the portal tract increasing in size and receiving bile canaliculi as a side branches.

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Background: This study aimed to determine the significance of p53, evaluated by immunohistochemistry, and its possible correlation with clinicopathological parameters of laryngeal cancer. Methods: FFPE (Formalin fixed, paraffin-embedded blocks) from 50 patients with laryngeal cancer were included in this study. We considered the uninvolved vocal cord that have no any pathological changes of thirty cases out of the fifty cases was evaluated as a non-tumoral sample were included as a comparative group. Labeled Streptavidin-Biotin Complex (LSAB) method was employed for immunohistochemical detection of p53. Results: Our study showed significant p53 positivity among malignant cases (35)cases were positive for p53. P53 showed no positive immunoexpression in normal tissue sections with significant difference from that of malignant cases (p<0.05) . p53 showed no significant difference in relation to age ,sex and stage of the tumor. Furthermore p53 showed significant difference in relation to grade , site ,size(P<0.05). Conclusion: Based upon the findings of this study, it can be concluded that p53 play an important role in the pathogenesis of laryngeal cancer and supports the evidence of its role in evolution and cell survival of this aggressive tumor . This study recommended that the blocking of p53 may be a target for blocking the evolution and hence improving the efficacy of anti-cancer therapy against this type of cancer.

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Objective: To determine the mean of spermatozoal creatine kinase (CK) concentration in idiopathic obese subfertile males with normozoospermia and healthy normal fertile control group. And to compare spermatozoal CK concentration between idiopathic obese normozoosperpmic subfertiles and healthy normal fertile volunteers (control group). Design: A prospective study. Setting: Maternity and Childhood Hospital, Najaf province, during period from April 2006 to January 2007. Patients and Methods: The present study determined the mean of spermatozoal CK concentration in 47 idiopathic obese male subfertiles with normozoospermia ,their ages ranging between 25-45 years ,and sperm count million ml, motility% , morphology %, vitality% are registered as normozoospermia according to WHO criteria. Fifteen apparently healthy normal fertile were regarded as control group. Traditional semen analyses and sperm parameters were assisted by same examiner. CK concentrations were measured using CK kit after the sperm enzyme was extracted within triton –X. The results of spermatozoal CK concentration was determined and compared between both groups. Result(s): There was a statistically significant differences (P<0.05) in active sperm motility % and sperm immotility % in comparison to sperm mean CK concentration in both groups. And sperm mean CK concentration was significantly higher in idiopathic obese male subfertiles with normozoospermia in comparison to control group. Conclusion(s): Elevated levels of spermatozoal CK concentration in idiopathic normozoospermic obese subfertile males may suggest an indication of sperm oxidative stress status which could play a role in idiopathic normozoospermic obese subfertility and fecundity that warrants more detail studies. Recommendation(s): creatine kinase concentration could be use an indication of sperm oxidative stress in idiopathic obese subfertile males with normozoospermia

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Background:Hyperbilirubinemia is a common and, in most cases, benign problem in neonates.Phototherapy is the mainstay of treatment of hyperbilirubinemia, The efficacy of phototherapy depended on the light spectrum (wavelength), flux of light, and surface area of the infant exposed to phototherapy. A measure of the efficacy of phototherapy is the dramatic reduction in the number of exchange transfusions being performed. Objectives:The aim of this study was to evaluate the efficacy of increased surface area of phototherapy (360 ◦) compared with conventional single surface fluorescent phototherapy in the management of neonatal hyperbirubinemia, and in decreasing the rate of exchange transfusion. Patients and Method:A total 73 neonates present with significant jaundice 50 % of the maximal total serum bilirubin (TSB) level and need phototherapy were included in the study, they were term and near term. According to the level of TSB and availability of highly intensive phototherapy the cases divided in to tow groups. First group: 37 newborns who received conventional phototherapy and the second group include 36 newborns who received highly intensive 360 ◦ phototherapy. Results:The mean starting TSB in group 1 was 14.5 ± 2.6 while in group 2 20.6 ± 3.74 and it was statistically significant (p<0.001) and it was also significant for ending TSB (p=0.004). The TSB difference in bilirubine was 1.8 ± 1.1 mg/dl for group 1 and 5.5 ± 3.10 mg/dl for group 2 (p<0.001), and the duration of phototherapy needed in both groups was 8.6 ± 2.2 hr for group 1 and 4.1 ± 1.25 hr for group 2 (p<0.001). The decline rate in group1 was 0.2 mg per hour while in group 2 was 1.3 mg per hour which was statistically significant (p<0.001), there was a significant decline in the number of exchange transfusion in 2010 (p<0.026) when the highly intensive 360 degree phototherapy started to be used. Conclusion: Increasing surface area of intensive phototherapy to 360 degree was more effective than single-surface conventional phototherapy in reducing bilirubin level in the treatment of hyperbilirubinemia. Exchange transfusion rate was much decreased when highly intensive phototherapy was started in the management of neonatal jaundice.

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BACKGROUND Study effect of carbon dioxide water bath therapy (carbothera) in treatment of patient with diabetic foot which they are not response to convention treatment such as daily dressing, debridement, antibiotic and laser therapy in our diabetic and endocrine Najaf centre. SUBJECT One hundred patient with diabetic foot sixty female and forty male with average age 50 years(range from 30 to 70 year) attending to diabetic and endocrine Najaf centre use as subject in our study followed in two year period(from1/1/2009 to1/1/2011) treated by carbon dioxide water bath therapy . METHOD Artificial carbon dioxide containing water for foot bathing was generated using CO2 enriching water production unit manufactured by Mitsubishi Rayon engineering com..Ltd .The carbon dioxide concentration was set at about 900 to 1000 part per million ( ppm) and water temperature was set at 37c( fig1). Diabetic patient immersed foot in water bath start 20 minute then 30 minute at each set done daily or in alternative day ,water usually put in plastic bag and discarded after end of set for each patient then clean plate with disinfectant ,to be use for other patient, we isolated special plate for patient with gangrene .no. of set depend on diabetic foot response , in addition daily dressing and removing dead necrotic tissue and giving antibiotic usually according to culture and sensitivity test is also done. FBS measure on each set, B.U , Serum cretin in and HbA1c done every three month. Patient with oesteomylitis, congestive heart failure, sever varicosity of leg excluded from study. RESULT One hundred patient with diabetic foot attend to alnajaf endocrine and diabetic centre treated by carbothera ( CO2 water bath therapy ) 60 female and 40 male with average age 50 year ,result in 65% of patient have complete cure and 35% have partial response to treatment or recurrence after cure of same lesion or recurrence in another area of foot. CONCLUSION CO2 is a natural, chemical and technical therapeutic mean which is effective in treatment of diabetic foot and has no side effects when used for the proper indications and in proper dose and can be used for other patient with vascular disease other than diabetic (atherosclerosis’ ,burger disease) and also can be use in treatment of diabetic neuropathy which is my next research.

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Background: Uveitis is a significant cause of visual impairment and immune mechanisms are thought to be involved in the pathogenesis of disease. The main aim of this study is to find a relationship between specific HLA antigen pattern in patients with chronic uveitis and in patients with Behçet’s disease presenting with chronic uveitis in Iraqi patients. Patients and methods: A total number of 44 Iraqi patients (male=18 & female=26) with mean age 31,4 years that had been referred and examined at the ophthalmology center from January 2009 to march 2011 were enrolled in our study. Only 6 patients enrolled in the study (13,6%) fulfilled the criteria of Behçet’s disease according to international classifications. Results: There was no significant statistical association between HLA antigen and chronic uveitis in our study (p value = 0.98) and anterior uveitis occurred in about 24 patients (54.5%) and pan uveitis in 20 patients (45.5%) while intermediate uveitis was not diagnosed in our patients enrolled in this study. The 6 patients (13,6%) that fulfilled criteria for Behcet’s disease (3 with anterior uveitis and 3 with panuveitis) and all the patients showed strong association with HLA B51 which is the more prevalent antigen in the patients enrolled in this study (27%).

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Background: Diabetes Mellitus is a common disease and About25% of the newly diagnosed diabetics have already established diabetic complications. HbA1c is familiar to clinicians, widely used as the basis for assessing glycemic control in established diabetes. It is also useful as diagnostic test. Aim of study: To determine the usefulness of HbA1c measurements in the Screening and diagnosis of diabetes mellitus. Patients and methods: In this cross section observational analytic study randomized 100 patients from the attendance to al-Najef center of endocrinology , the emergency unit and to the medical clinical unit at Al-Sader Medical city in Al-Najaf city were studied during the period from July 2010 to April 2011 as suspected as new cases of diabetes mellitus .Each patient was subjected to detailed history taking & through physical examination with assessment of RBS , FBS , HbA1c. Results: 45% patients have Diabetes 55% were not diabetic. From diabetic patients 17 were male, 28 female. There is high correlation between the elevated level of HbA1c and the new diagnosis of diabetes. Also the study shows no relation between the age or gender and the development of diabetes mellitus.HbA1c is highly specific at 7% level for diagnosis new diabetes mellitus cases (94%)it is 85% sensitivity at (5.5%) level. Conclusion: Testing HbA1c doesn't require the patient to be fasting and it reflects larger term glycemic control than does plasma glucose, thus it is a useful diagnostic and screening test for DM. Recommendation: HbA1c is a useful test for diagnosis of new cases of DM. Especially in patient with normal or border line RBS.

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Background: Soft tissue management around the lower third of the leg and foot presents a Considerable challenge to the reconstructive plastic surgeon. The options in this region are limited. Durable flap is the preferred option for coverage of such defects. This study was conducted in Alsadder medical city in Alnajaf city over a period of 3 years to evaluate the efficacy of distally based Sural flap in the coverage of the lower third of leg, and foot defects, in 22 patients. Methods: A study was conducted in the department of Plastic and Reconstructive Surgery in alsadder medical city in Alnajaf. Twenty two patients with soft tissue defects over the distal leg and foot were included in this study. Distally based sural fasciocutaneous flap was used for defect coverage in all patients. In this study we did not extend the flap proximally on a random pattern, instead of this, we extend the flap only to that part of leg that coincide with the supra fascial course of sural nerve. the limitation of flap size in such manner was restricted flap applicability for larger and more distal type, but we over come this by using contra lateral reverse sural flap for covering a more distal defect that couldn’t covered by ipsilateral flap or when proximal calf tissue of ipsilateral limb was unsuitable for flap harvesting . Ipsilateral reverse sural flaps were used in 15 cases, and 7 cases the flap used in contra lateral limb (cross leg flap). Results: from January 2008 to March 2011, 22 patients, their ages ranged between 5-42 years. (Average age was 17 years), with soft tissue defect in the distal leg and foot, (45.5 % in distal leg), trauma was the cause in 68.2%. Reverse sural flap from ipsilateral limb have been used in 68.2%, and from the conteralteral limb in 31.8 %, complete flap survival in 100 % of cases with no major complication in the donor or recipient site apart of flap venous congestion in 9.1 % which resolve with few days. Conclusions: The distally based sural flap is a versatile and reliable flap for the coverage of soft tissue defects of the distal third of the leg and foot. It is safer to apply the flap from contra lateral limb rather than its extension proximally, if micro vascular surgical facilities are not available

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The present study was carried out to evaluate the role of T-helper-17 through measuring serum level of IL-17 in infection with Toxoplasma gondii among women with abortion. The present study was carried out on(35) women patients ,all of them having abortion and proved by confirmatoy tests that they have an active form of toxoplasma infection. It also included twenty apparently healthy women as a control group . The patients were between 15 to 50 years of age, they were attending AL-Zahraa Maternity and Child Teaching Hospital, AL-Hakeem Hospital and some private clinics, in Najaf governorate during the period between May 2010 to May 2011. The Cytokines that were measured by ELISA technique were Interleukin-17(IL17),Interleukin-10(IL10) and Gamma Interferon(IFNγ). The study showed a high significant increase in serum level of IL-17 in patients with IgM seropositivity (266.589pg/ml) when compared with serum levels in control and post treated groups (54.875pg/ml,54.182pg/ml) respectively, whereas there was no significant differences in serum levels between those with seropositivity with both IgM and IgG and levels in post treated and control groups. The role T-helper-17 in the immune response against toxoplasmosis was studied in the current infection, it was found that there was a concomitant increase of IL-17 with the increase of T-helper-1 cytokine.

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The present study is conducted to detect the prevalence of expression of heat shock protein (Hsp 70) by infection with Toxoplasma gondii among 90 aborted women only 70 of them with recurrent abortion due to toxoplasmosis infection and 20 without toxoplasmosis (10 feverish aborted women and 10 healthy aborted women) as control group. The concentration level of Heat Shock Protein (Hsp70) in aborted women was measured by ELISA technique according to many parameters such as age and number of abortion. Comparison between Latex, IgG- ELISA and IgM- ELISA concentration with Hsp 70 concentration expressed by T. gondii was carried out. The total number of studied cases of toxoplasmosis were 70 (100%) by LAT and 20 (29.5%) by IgM-ELA. and 69 (98.5%) by IgG-ELA. The present study revealed that the concentration of Hsp70 was elevated among those with 3 number of abortion 4.26% and 9.47% among those 4 number abortion.

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Background:-Lower gastrointestinal bleeding is about 20% of all gastrointestinal hemorrhage. (1) Gastrointestinal bleeding has previously classified into upper or lower relative to the ligament of Treitz. However, with advances in endoscopic methods for the diagnosis, it is suggested to be classified into upper, mid, and lower. (2) Objectives:-To evaluate the diagnostic yield of colonoscopy in lower intestinal bleeding and to investigate the common causes of lower intestinal bleeding in our community. Patient and method:-This is a prospective study done in the Gastroenterology center in Al-najaf city during the period from May 2008 to April 2011.332 patients were selected for this study according to specific criteria. Once an upper gastrointestinal source of bleeding is excluded and the patient is hemodynamically stable, colonoscopy were done to define the cause of lower intestinal bleeding. The study include 290 patients colonoscopied as outpatient (standard care colonoscopy) while 61 patients colonoscopied as inpatient(urgent colonoscopy).Abnormal area of colorectal mucosa was identified and biopsies were sent for histopathological examinations. Result:-The study includes 332 patients presented with bleeding per rectum underwent colonoscopy. Patient’s age range from 5-70 years. Complete colonoscopy to cecum was successful in 311 (93.67%) patients while incomplete in 21(6.33%) patients. No complications were recorded. The study revealed that 88 (26.51%) patients showed normal colonoscopy, of them 31(9.34%) patients found to have upper gastrointestinal cause of bleeding. While 244 (73.49%) patients have abnormal colonoscopic finding. Conclusion:- 1-Colonoscopy is safe procedure and has a high diagnostic yield which is about 73.49% in evaluation of lower gastrointestinal bleeding. 2-The most common causes of rectal bleeding in colonoscopic and histopathological examinations are hemorrhoid, proctocolitis, colorectal adenocarcinoma and colorectal polyp. 3- The age is important factor to predict the aetiology of lower gastrointestinal bleeding. 4-Anorectal pathology should raise the suspension of proximal pathology rather than considering it as the source of bleeding. 5-Left sided lesions are the source of the lower gastrointestinal bleeding in the majority.

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Aim: The aim of the study was to evaluate the role of some hematological parameters in early diagnosis of preeclampsia. Patients and methods: The study was conducted in Maternity and Pediatrics Teaching Hospital in Hilla city during the period from November 2009 to May 2010. Seventy women(45 preeclamptic pregnant women as patients,15 healthy pregnant women and 10 healthy nonpregnant women as control groups) at the age of reproduction were included in this study. For every subjects participate in this study the following parameters were measured; the level of vWF, fibrinogen, packed cell volume and platelets count. Results preeclampsia was (60%) more common in PE of > 35 and < 20 years. While, the remainder (40%) in PE of < 35 and > 20 years.PE seems more frequent (62%) in primigravida than of (38%) in multigravida.Our data confirm that percentage of PE in pregnant women lived in rural areas (60%) more than urban areas (40%).Parameter of family history show that 26 out of 45 (58%) had have family history, while 19 out of 45 (42%) hadn’t have PE family history. Hematological investigate results observe high significant increase in vWF concentration in PE patient group compare with non pregnant group. As well as, to significant increase in fibrinogen levels in PE group than in non pregnant and pregnant control groups.Also, obtained data detect significant increase in PCV ratio in PE group than in the two control groups.Finally, the platelets count show highly significant decrease (P < 0.001) in PE group than in those two control groups. In addition to present of significant differences between the two control groups. Conclusion We conclude from this study that there are some parameters may be give an early diagnostic evidence for occurrence of preeclampsia .

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Ginger has become a subject of interest because of its beneficial effect on human health. The purpose of the present study was to investigate the effect of daily intraperitonial injection of ginger extract for four weeks on some biochemical parameters (serum cholesterol, RBS, HDL, LDL) and kidney functions (urea, uric acid, creatinine). 24 Mice were divided into three groups, normal control group and two treated groups, each group contain eight mice. They were injection intraperitoneally with 0.1ml distill water to control group while two treated groups received the same dose of ginger extract (1mg,2mg/mice) respectively for four weeks. Biochemical's parameters (blood glucose, serum cholesterol, LDL) showed significant decrease (p<0.01), while (HDL) appeared significant increase when compared with control group. On the other hand study of kidney function showed significant decrease in (urea, uric acid, and creatinine) when compared its with control group.

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Objective: this study was conducted to determine the prevalence of obesity and overweight and some associated factors among teachers in medical college in Kufa university. Design and methods: A cross sectional study on obesity and overweight covering 96 medical teachers in medical college in Kufa university was carried out during the period 1st of April to 1st of august 2011, data collection done by using questionnaire and measurement of weight and height by using weight display instrument which is present in community medicine department Results : results of this study shows that there is 36.5% of participants suffering from overweight and 18.8% suffering from obesity. In the current study no significant association between sex and body mass index (BMI) (P=0.417) and also no significant association between BMI and obesity in first degree relatives (P=0.944). This study shows no significant association between BMI and having chronic disease (P=0.856). This study shows significant association between BMI and number of meals taken between the main meals (P=0.024) also significant association between BMI and exercise (P=0.023) Conclusion: the results show that the problem is big among this group of community and the need to change their lifestyle from sedentary lifestyle to more active one and change dietary habits and establish a center for exercise inside the university and encourage all medical teachers to participate in it.

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The present study is investigate the effect of vitamins A and vitamin E and their combination on the relief of the toxic effect of cobalt exposure on some hematological, and biochemical parameters. The study was showed that the treatment with cobalt chloride is caused significant increased in the RBC, PCV and decreased in Hb. The total number of WBC count was elevated. Biochemical tests show significant increase in the level of total cholesterol, triglyceride, LDL-c and significant decrease of HDL-c compared with control group..The present study shows the positive role of vitamin A and E in the improvement of the physiological and biochemical alterations which resulted from the exposure to cobalt.

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Aim To assess the role of color doppler ultrasonography (CDUS) resistive index (RI) parameter as a predictor test for spermatogenesis and infertility. Patients and Methods: This is a prostpective study done on 80 patients,40 individuals with normal sperm counts, the other 40 individuals with abnormal pathologic sperm counts , those individuals examined by CDUS ,RI were calculated on both sides using two parenchymal arteries at upper &lower pole of testes the data were analyzed statistically by SPSS soft ware using t-test at level of significance P<0.05. Results: Individuals with normal sperm counts had mean(SD) RI = 0.566(0.0342),those with abnormal pathological sperm counts had mean(SD) RI =0.673(0.093). Statistical analysis show significant difference between the two groups P=0.002 Conclusion : These results suggest that CDUS RI parameter can be used as a simple, safe, rapid and non invasive predictor test for spermatogenesis and infertility .

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Tuberculosis has affected humans for centuries and the number of mycobacterium tuberculosis infections have been shown to be increasing worldwide, mainly due the increased number of patients with HIV infection and AIDS disease worldwide, an increasing number of elderly patients and the emergence of multidrug resistant tuberculosis. The disease is caused by a bacterium called Mycobacterium tuberculosis (MT) and is also called tubercle bacilli (TB). Inhalation is the predominant pathway of MT infection, making pulmonary tuberculosis the most common form of tuberculosis. Tuberculosis may arise either from a recent infection with MT, or from the reactivation of dormant bacilli, years or decades after initial infection. Extrapulmonary tuberculosis mainly results from reactivation of a tuberculous focus after hematogenous dissemination or lymphogenous spread from a primary, usually pulmonary focus. Tuberculosis may demonstrate a variety of radiological features depending on the organ site involved and may mimick other pathologies. The final diagnosis of tuberculous

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Background: Doxorubicin based regimen is the most common treatment of breast cancer which is highly complicated by cardiotoxicity. Aim: To clarify the possible effects of carvedilol on serum CK-MB and Troponin I in doxorubicin based regimen in females with breast cancer. Patients and Methods: A total of 16 females with breast cancer were included in this study. The patients were randomized into 2 groups , 8 patients each. Group I included patients were treated with doxorubicin based regimen for 6 cycles with 21 day apart. Group II included patients were received doxorubicin based regimen with carvedilol 3.125 mg , orally , twice daily for 5 days , for 6 cycles. Serum CK-MB and Troponin I were measured at zero time and 3 days after 2nd, 4th and 6th cycles in both groups. Results: The following results were obtained: 1- Treatment with doxorubicin based regimen caused highly significant elevation in serum CK-MB and Troponin levels after 2nd, 4th and 6th cycles in comparison to baseline readings (P < 0.01). 2- Combined CAF + Carvedilol 3.125 mg orally twice daily for 5 days caused highly significant decrement in serum CK-MB and Troponin I levels compared with that of doxorubicin based regimen group (P < 0.01). Conclusion: From the present study , we can conclude that Carvedilol causes highly significant decrease in serum CK-MB and Troponin I levels in doxorubicin treated patients.

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Background: Uveitis is a significant cause of visual impairment and immune mechanisms are thought to be involved in the pathogenesis of disease. The main aim of this study is to find a relationship between specific HLA antigen pattern in patients with chronic uveitis and in patients with Behçet’s disease presenting with chronic uveitis in Iraqi patients. Patients and methods: A total number of 44 Iraqi patients (male=18 & female=26) with mean age 31,4 years that had been referred and examined at the ophthalmology center from January 2009 to march 2011 were enrolled in our study. Only 6 patients enrolled in the study (13,6%) fulfilled the criteria of Behçet’s disease according to international classifications. Results: There was no significant statistical association between HLA antigen and chronic uveitis in our study (p value = 0.98) and anterior uveitis occurred in about 24 patients (54.5%) and pan uveitis in 20 patients (45.5%) while intermediate uveitis was not diagnosed in our patients enrolled in this study. The 6 patients (13,6%) that fulfilled criteria for Behcet’s disease (3 with anterior uveitis and 3 with panuveitis) and all the patients showed strong association with HLA B51 which is the more prevalent antigen in the patients enrolled in this study (27%).

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Background: Oxidative stress is accepted as a critical pathophysiolog mechanism in different human disorder like cardiovascular diseases, cancer , diabetes mellitus and neurodegenerative diseases, because of accumulation of radical oxygen species (ROS) & radical nitrogen species(RNS).Garlic(Allium Sativum) has been used as a spice & as a medicine in treatment of these diseases because it contains antioxidants & regarded as an effective hydroxyl radical scavenger. In the present work the antioxidant effect of processed garlic was studied by measuring its effect on the level of reduced glutathione (GSH) & malondialdyhyde(MDA). Design of study: Experimental follow up study. Methods & materials: The level of erythrocyte GSH & plasma MDA were measured in 12 apparently healthy volunteers before & every 10 days for 1month during taking garlic tablets. Results: The level of GSH was significantly increased by 31.30%(P<0.01)&MDA level was significantly decreased by 26.42% (P<.0.01) after 30 days of ingestion of garlic tablets.. Conclusion: The results suggest that processed garlic has lowering effect on MDA & increasing effect on erythrocytes GSH.

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Objectives:To estimate the rate of BRCA1 and P53 immunoexpression in different histological types of female breast cancer and to assess whether these biomarkers are significantly correlated with each other and to assess the coexpression of these two biomarkers . To show the correlation of these biomarkers to common clinicopathological parameters such as : tumor grade , size , lymph node involvement, and recurrence of breast carcinoma for old age group . Methods:Thirty patients with breast carcinoma ,their ages ranging between 38-60 years with a mean age of 49 years, were included in this study and conducted in the Department of Pathology, Faculty of Medicine, Kufa University from November 2010 through September 2011. Labeled Streptavidin -Biotin (LSAB+) method was employed for immunohistochemical detection of BRCA1 and p53. Results:28 cases (93.4%) were of ductal carcinoma while2 cases (6.6%) were of lobular type. The detection rate of BRCA1 and p53 was92.9% and50% respectively . Conclusion: There was significant difference of BRCA1 overexpression between ductal and lobular carcinoma, while therewas no significant difference of BRCA1 overexpression with different tumor sizes, lymph nodal involvement, age of the patients, and recurrence of breast carcinoma.. P53 immunoexpression was not significantly different among tumor sizes ,while there wasa significant difference with axillary lymph node involvement, tumor grade, and recurrence of breast cancer. However, p53 positively correlated with tumor grade . Moreover, both biomarkers were positively correlated with each other, and cases coexpressing both BRCA1 and p53 have shown the most unfavorable biopathological profile.

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Background:There is an association between increasing size of pterygium and the degree of induced corneal astigmatism. Objectives: To assess the relation between pterygium size and induced corneal astigmatism and to conclude whether astigmatism secondary to pterygium is an indication for surgery. Methods: Ninety patients were included in this study with primary unilateral pterygium of different sizes, we evaluate pterygium using: • Slit-lamp beam measurements of size of pterygium (in millimeters) from the limbus. • Corneal topography using OPD (SCAN II NIDEK). • Best corrected visual acuity was determined using Snellen's chart and subjective clinical refraction. Results: Primary pterygium induces with-the-rule astigmatism, significant astigmatism was found in 5 (16.6%) of eyes with pterygium size less than 2 mm and in 18 (47.3%) of eyes with pterygium of 2-4mm in size. 20 (90.9%) of eyes with pterygium of more than 4 mm in size showed significant astigmatism. Conclusions: When primary pterygium reaches more than 2mm in size from the limbus, it induces astigmatism( ≥ 1.0 diopter) this astigmatism tends to increase with any increase in the size of the lesion. Recommendations: According to the results of our study, early surgical removal of pterygium is indicated when the lesion is more than 2mm from the limbus to correct clinically significant pterygium induced astigmatism. Keywords: pterygium, astigmatism

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Objective: The aim of this study was to determine the level of plasma fibrinogen and C-reactive protein in pre-eclampsia and their associations with severity of the disease. Study design: C-reactive protein and plasma fibrinogen levels were investigated in 26 cases of normal pregnant women,26 cases with mild pre-eclampsia ,26 cases with sever pre-eclampsia in the third trimester of pregnancy.Mean atrial pressure(MAP)was used as indicator of the severity of the disease .Analysis of variance with kruskal- wallis test used when the three groups were compared. Result: C-reactive protein and plasma fibrinogen levels in mild and sever pre-eclampsia patients were markedly higher than that of normal third trimester pregnant women. Conclusion: we found higher levels of plasma fibrinogen and C-reactive protein and presence of a good correlation between C-RP and MAP in pre-eclampsia.

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Background: Psychiatric unit in Al-hakeem general hospital is unique psychiatric unit in the Najaf province which support one million and three hundred of citizens. It's open in 2007 with 10 beds, group therapy, Electro convulsion therapy and outpatient departments as well as it is content another support divisions such as pharmacy, registration, electroencephalography (EEG) and patients social activity hall. The bed rooms consist fro 2-3 beds, five bed to each gender. The staff of psychiatric unit is consist of two social workers, four nursing staff ( one of them is psychiatric nurse ), one nursing pharmacist, two psychiatric specialist, one psychiatric senior office , one service employer. Psychiatric unit is responsible for many mental health objectives. The aims of this study is to highlight the new cases of mental disorders and its incidence among peoples.

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BACKGROUND: The corneal endothelial cellular monolayer cannot regenerate after injury. Endothelial cell loss is a commonly studied relevant postoperative variable because it is associated with the long-term risk for corneal decompensation.Analysis of cell shape and pattern is a more sensitive indicator of endothelial damage than cell density alone. PURPOSE: To evaluate hysteresis changes that occur in the corneal endothelium at different times (one week, three months, six months) after cataract extraction with phacoemulsification using noncontact specular microscope . PATIENTS AND METHOD: Seventy-five patients scheduled for cataract extraction with phacoemulsification were examined with non contact specular microscopy (SP-3000P) performed at the center of the cornea. Corneal thickness (T), average cell area (AVG), cell density (CD), and percentage of cell hexagonality (HEX) were measured. Statistical analysis was performed using a 2-tailed Student t-test, Pearson correlation. RESULTS: In all patients there was an increase in corneal thickness, widening in cell area, decrease in cell density, and extreme variability in their hexagonality after surgery. The results were as follows:- mean T was 480.5µm, 526.8µm, 534.3µm, and 541.3µm; mean AVG was 380.25mm2, 465.4mm2, 492.97mm2, and 527.77mm2; mean CD was 2809.00 cell/mm2, 2220.72 cell/mm2 , 2053.56 cell/mm2 , and 1899.97 cell/mm2 ; mean HEX was 72.27%, 27.35%, 39.35%, and 51.76% preoperatively, one week, three months, and six months postoperatively respectively. P value was <0.01 for all the findings (significant). DISCUSSION: Although endothelial cell density in the early postoperative period is highly deranged but it is not the only valuable parameter to maintain corneal morphology. The ability of endothelial cells to function properly and rearrange themselves is a potential element for corneal architecture. Significant changes in the measured parameters were obtained during the entire period of the study reflecting the effect of phacoemulsification on the corneal endothelial features and function. CONCLUSION & RECOMMENDATIONS: Corneal endothelial cells can be damaged by many factors during and after cataract surgery. Future refinements of the phacoemulsification techniques should aim to minimize early postoperative compromise of corneal endothelial function. A comparative study of the effect of phacoemulsification and other variety of surgeries will be a good indicator of endothelial cell damage induced by either technique

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the pulmonary venous flow pattern in patients with ASD has received little attention. We sought to study this pattern and attempt to shed light on its pathophysiology Patients and methods: the left upper pulmonary vein was interrogated by pulse wave Doppler during trans-esophageal echocardiography in 32 consecutive patients with secundumASD or sinus venosus ASD in sinus rhythm;we observed several parameters including the waveform pattern, the maximal amplitude of the S and D waves, and the magnitude of the atrial reversal wave (a wave). Results: in all 32 patients, a unique waveform pattern was noted, characterized by a single continuous antegrade pattern spanning systole and diastole without interruption, ending at the onset of atrial contraction. The peak flow velocity was exaggerated, ranging from 40.5 to 108 cm/sec (mean ± SD 74.11 ± 15.96). The atrial reversal wave had a peak velocity of _2.4-_5.0 (mean ± SD _3.6±2.75) which is lower than normal. Conclusion: atrial septal defect causes an altered pattern of blood flow in the pulmonary veins, characterized by a single waveform pattern with increased velocity of flow and could aid in the diagnosis of the condition.

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Hypospadias is a relatively common congenital anomaly of the penis that arises in 2 to 8 of 1000 live births, often as an isolated anomaly. This anomaly is repaired surgically in the first year of life to improve the cosmetic appearance and establish a glanular position of the urinary meatus for voiding and deposition of semen later in life. The aim of this study is to evaluate the effectiveness of HCG hormonal manipulation in inducing penile growth in hypospadias boys before surgical repair , and the pattern of this growth and response , in addition to that this thesis try to add more knowledge to the etiology and pathogensis of one of these relatively common urogenital disorder. Patients and methods :-This small series thesis included 16 boys with an age ranged from 3-48 ms who had proximal and penoscrotal hypospadias with sever cordea .All boys received a full course of HCG treatment using the standard WHO protocol of HCG therapy in pediatric age group. The degree and rate of response to HCG therapy together with the pattern of penile growth have been measured and evaluated before and one week after HCG therapy using the student T – test for statistical analysis. Results :-At the end of HCG treatment penile growth has been achieved in all boys. The cordee decreased and penile length increased in all cases. The mean stretched penile length was changed from 18.68 pre HCG to 31.97 post treatment (P value < 0.001). The average penile length was nearly doubled after HCG treatment with an increase of 40% to 180% (mean 83%, P value < 0.001)What was very interesting and major finding that emerge during this study , is that the penile response and growth to HCG treatment was not universal over the whole shaft of the penis, with by far most of increment in penile length occurred proximal to urethral meatus and the percentage of penile growth was 262% (P value < 0.001) proximal to meatus , while it was only 24% not significant (P value > 0.001 ) distal to it . This disproportional penile growth causing the meatus to advance distally in all cases with a mean distal migration of urethral meatus was 9.75 mm (P value < 0.001). Conclusion :- HCG treatment in hypospadias was very effective in achieving sufficient penile growth that might facilitate the surgical outcome, the other finding is that hypospadias even the sever one is not at a fixed stage or degree, but it can easily be manipulated by hormonal treatment in addition to that, this study suggest that post natal response of hyposadias penis to HCG might provide a mirror that reflect its intra natal response during organogenesis and embryogenesis, and this thesis might provide a different insight toward the pathogenesis of hypospadias-chordea complex by diverting more attention and focusing toward a localized endocrinopathy that affect the tissue responsiveness to androgen.

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Intertrochanteric fracture, one of the most common osteoporotic fractures in the elderly (6,19), occurs in approximately 185.2/100,000 of the northern Thai population (38). Surgical repair is now considered as the standard care .The exception to this rule is when the patient’s medical co morbidity precludes surgery- Ideally, surgery is recommended within 2days after the injury(4,48,50). The aim is to provide a stable construct, which allows early mobilization and some weight bearing to minimize the sequelae of long term recumbence .It may also restore the patient’s previous level of independence and function.(32,35 The dynamic hip screw (DHS),is an ideal implant for the operative treatment of stable pertrochanteric femur fractures (AOclassification31-A.1 (25) The dynamic hip screw(DHS),initially introduced by Clawson in1964,remains the implant of choice because of its favorable results and low rate of nonunion or hard ware failure .(11,16,39) McLoughlin et al. found no difference in the biomechanical stability of two and four-hole DHS and supported the clinical use of the two-hole side-plate for intertrochanteric fractures (36). Bolhofner et al. reported no failure in the two-hole side-plate DHS fixation in 69 patients (8) The superiority of sliding hip screw devices over fixed devices for the fixation of trochanteric fractures of the femur has been clearly established( l,2,24). However , failure of the fixation to hold the fracture until union of the order of (10%) are still reported, and this may rise to 16 % for unstable fractures (13,24,33,34)

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Aim: To study the effect of major surgical operation on renal function and to evaluate the role of age, gender and body weight. Methods: seventy patients (39 males, and 31females) aged (20-60 years), who admitted to Al-Sader Teaching hospital for major surgical operation in Al- Nagaf Al-Ashraf, from October 2009 to September 2010. For every patient participate in the study plasma concentration of sodium, creatinine, urea, urine sodium , urine creatinin, creatinine clearance and fractional excretion of sodium were determined. Results: The were statistically significant increase in plasma level of creatinine, urea, and fractional excretion of sodium ( P≤ 0.001, P≤ 0.0001 and P≤ 0.0001) and statistically significant decrease in creatinine clearance ( P≤ 0.0001) after surgical operation in comparison with preoperative values in elderly patients(41 - 60 years). A similar statistically significant changes observed in obese patients when preoperative values are compared with postoperative values. While there was no significant changes in the preoperative and postoperative values of these parameters in younger age groups(20-40 years) or when patients classified into males and females. Conclusion: major surgical operation had significant effect on renal function, specially on elderly and obese patients.

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The aim of this study is to evaluate the effects of the quality and bacteriological content of water on the health of consumer . Locally prepared bottled water was stored at room temperature for three months and undergone bacteriological examination monthly for three successive months . Household RO and tap waters also examined bacteriologically . pH ,EC, TDS , total hardness , minerals(Mg , Ca) and chlorides were determined in each type of water . Household RO water has given to male rats for two months and three animals were sacrificed at two weeks intervals. Liver , kidney and heart were removed and pathologically studied . It was found that bottled water was not sterile and contain low number of bacteria that naturally present or accedentaly introduced during processing . Household RO water showed pathological changes in sacrified animals studied .

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