Table of content

Journal of the Faculty of Medicine

مجلة كلية الطب

ISSN: 00419419
Publisher: Baghdad University
Faculty: Medicine
Language: English

This journal is Open Access

About

Journal of the Faculty of Medicine – University of Baghdad

A peer- reviewed journal published Quarterly by the college of medicine –Baghdad University

ISSN: 0041-9419

E-ISSN 2410-8057

The Journal interested in publication of clinical and basic medical research.


The first issue of this Journal was published under the name of (Journal of the Royal Iraqi Medical College) in April /1936, approved by the council of the College as a general journal dealing with the news of the college and few scientific articles to encourage the teaching staff for research publication. The journal was published randomly and ceased during World War II due to financial difficulties.
In 1946 Prof. Dr. Hashim Al Witri, the college dean, assigned republication of the journal and urged the teaching staff to participate and publish their research in the journal. Despite his effort the journal remained irregular in publication. In 1959 Prof. Dr. Faisal Al-Sabih became the Editor in Chief of the journal when he returned from the United Kingdom and appointed on the teaching staff, restructured the journal and changed its name to (The Journal of the Faculty of Medicine) and used new scientific system for publication of articles.
The first issue of the new series started in June 1959. The journal continued to be published on a regular basis since then without interruption in (four issues during the year). The journal became registered the international number (ISSN) in 2000 and entered in many important international indexes.
After 2003 the journal continued despite the difficulties involved in every aspect of the country and by the beginning of 2004 the journal progressed through a series of changes to reach a level that can be recognized internationally.
After 2010 the journal became published electronically of the same edited issues.
Recently the journal became recognized by the (Index Copernicus) and publicised internationaly.

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Contact info

e-mail:iqjmc@comed.uobaghdad.edu.iq
mobile:+96407709826825

Table of content: 2007 volume:49 issue:4

Article
The Role of White Blood Cells inAcute Coronary Syndrome

Authors: Hilal B. Shawki )
Pages: 362-368
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Abstract

Background:
Inflammation has been shown to play a role in atherosclerosis and acute coronary
syndromes. An elevated total WBC count has been associated with increased cardiovascular
risk, but which leukocyte subtypes carry this risk. is uncertain. This study was designed to
determine the effect of WBC count and other inflammatory markers on severity and
outcome of patients with UA/NSTEMI.
Patients and Methods:
Seventy (70) patients with UA / NSTEMI admitted to CCU at the Iraqi Center for Heart
Diseases were subjected to thorough history and physical examination and WBC indices to
find their relation to clinical severity and outcome for both in-hospital and/month after
discharge. The results were compared with other thirty (30) patients with chronic stable
angina and thirty (30) healthy persons as two control groups.
Fac Med Baghdad
2007; Vol.49, No.4
Received Sept. 2006
Accepted Oct .2007
Results:
High total baseline total WBC was more prevalent in patient with UA/NSTEMI than in
those with stable angina and normal persons (94.1%, 5.9%. and 0%) respectively. High
baseline neutrophil was found only in those with UA./NSTEMI (100%, 0%, and 0%). High
baseline Neutrophil/lymphocyte (N/L ratio) and Positive CRP were more prevalent in
patients with UA/NSTEMI than in other two groups (92.3%. 7.7%. 0%) and (98.5%, 1 .5%.
0%) respectively.
Higher total baseline WBC count was significantly found in more severe Braunwald's
class of those with UA/NSTEMI 6.3%. 31.3%. and 50.5% for patients with class I, II, III
respectively. The same was true for baseline high neutrophil count (6.7%. 33.3% to 60%),
high Baseline N/L ratio (7.7%, 15%. and 21.6%).
Patient in the UA/NSTEMI group with higher baseline WBC count had higher risk for
death as compared to those of low and intermediate WBC count (0.00%. 0.00%. and
100.00%). The same was true for those with higher baseline neutrophil count (0.00%.
1.90%, 20.00%) and those with higher baseline N/L ratio (0.00%. 25.000%. 75.000%)
respectively.
Conclusions:
Total baseline WBC and differential count is simple, cheap and widely available
bedside test that predicted the severity of CAD and one month survival.

Keywords

WBC count --- differential count --- CRP --- UA/NSTEMI


Article
Serum Lactate Dehydrogenase Level in Acute Leukemias

Authors: Mutaz Fawzi Hussain
Pages: 369-374
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Background: Acute leukemias are clonal neoplastic proliferations of immature cells of the hemopoietic system. They are divided into acute myeloid leukemia (AML), acute lymphoblastic leukemia (ALL) and acute undifferentiated leukemia (AUL). LDH has been suggested as a possible non-specific tumor marker for many years, and total serum LDH is frequently elevated in neoplastic diseases. The aims of the study are to evaluate the significance of increased serum LDH levels in patients with acute leukemia and to determine the importance of serum LDH level in the follow up and assessment of treatment responses. Patients, Materials and Methods: This study was conducted at Baghdad Teaching Hospital in Medical City during the period of October 2003 till October 2004. It included 108 patients with acute leukemias. The patient groups were compared with 21 apparently healthy control subjects. All patients had full medical history, complete physical examination, and routine investigations and other specific investigations e.g. BM aspiration and biopsy. Serum lactate dehydrogenase LDH level was estimated in all patients serially during diagnosis and after chemotherapy as well as in control subjects. Results: Total serum LDH levels were significantly higher among patients with acute leukemias compared to that of the controls. Comparing the three types of leukemic patients, no significant difference was observed in total serum LDH levels between AML, ALL and AUL patients. Regarding treatment, levels of total serum LDH were significantly decreased in both remitter and non-remitter patients with acute leukemia with no significant difference between them. Conclusion: Although total serum LDH is higher in all acute leukemic patients, it is hardly discriminator between subsets of acute leukemia and is of little value in the prognosis and prediction of treatment response and outcome.

Keywords

LDH --- acute leukemia.


Article
Complete Rectal Prolapse

Authors: Ibtesam K.S. Al-Shadydy
Pages: 375-377
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Background and Objective: There are many treatment modalities in managing complete rectal prolapse (CRP) current study present simple technique of cauterization plication operation in the treatment of complete rectal prolapse. Methods: The study include 30 patients present with CRP their mean age (74.3 ± 4.6), 19 females and 11 males. With the patient under- general anesthesia in litliotomy position the proolapsed rectum pulled outside the anal canal, the mucosa was cauterized, the muscle layer was plicated by 2/0 dixon suture. Posterior levtorplasty were done in 10 adult patients when it is indicated. Results: The postoperative follow up was 12-24 months. Six had postoperative mucosal prolapse and two had recurrence 5 months after operation. Fecal impaction, stricture and fistula formation were not encountered. Conclusion: The cauterization - plication operation is a simple and easy operation fix the treatment of CKP. It gave satisfactory results with minimal complications.


Article
Respiratory Distress Syndrome in Neonatal Care Units in Medical City

Authors: Numan Nafie Hameed
Pages: 378-385
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Introduction: Neonatal Respiratory distress syndrome (RDS) remains one of the major cause's neonatal morbidity and mortality despite advances in perinatal care especially in developed countries. Objectives: The aims of this study were to find out me risk factors of mothers and newborns (NB) which increase the incidence, morbidity, and mortality of RDS. Patients & Methods: A prospective descriptive cross-sectional study was conducted on 100 live NR infants born at neonatal care units in Baghdad hospital & private nursing home (medical city complex) / Baghdad in the period from the first of March to the end of June 2006. They were presented with RDS, which was diagnosed clinically and radio-graphically. The study includes preterm and mil term N8 with all birth weights. Results: In tins study, there was an increase in the incidence of RDS in preterm NBs 3.5 times more than in mil term, and 2.0 times more in small for gestational age (SGA) than in appropriate for gestational age (AGA). It was found that the risk of death from RDS with air leak was 11 times more than those without air leak, and from RDS with pneumonia 4.0 times more than those without pneumonia. The risk of death among NB delivered by elective Caesarian section (C/S) was 2.4 times more than those born by emergency C/S. and 5.1 times more in NB of diabetic mothers than those without diabetes. Conclusions: We conclude that prematurity and SGA are risk factors for the development of RDS, and air leak and pneumonia are most important complications that increase the risk of death from RDS. So we recommend a proper and regular antenatal care and. management of high risk pregnancies to avoid premature delivery and SGA, and proper respiratory care of NB to decrease the complications of RDS especially air leak and pneumonia to decrease the risk of death.


Article
Quality of life among students in University Of Science And Technology In Jordan

Authors: Maha S. Younis
Pages: 386-393
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Objective: To assess the subjective rating of quality of life of college students in University Of Science And Technology in Jordan as a sample of healthy educated young population through applying the WHOQOL-BREF instrument as a field trial in Jordan and to compare the finding with similar previous study. Methods Three hundreds forms of Arabic version of the self-reporting questionnaire WHOQOL-BREF were distributed to students of third class attending the lecture halls in three colleges (college of Engineering, college of science, college of medicine) in the university campus in AL Ramtha–Jordan from the first of March to first of may 2007., with respect to university regulations,interested participants were only included in the study. Results The rate of response was 100%, the majority of the sample were of single healthy Jordanian nationals of comparable age and sex distribution. About 68.6 %of the students described their quality of life as good or very good while 3o%as acceptable, or fair, the remaining 1.3% reported bad or very bad. Fac Med Baghdad 2007; Vol.49, No.4 Received July 2006 Accepted Jun.2007 Regarding the mean scores distribution of the four domains there were no significant statistical differences between the demographic variables and type of academic discipline. This study findings showed a higher scoring than the previous one done In Iraq. Conclusion The overall psychological profile of college students in Jordan assessed by the WHOQOL-BREF is good manifested through their satisfaction with their life quality ,no important association with given variables was found ,The study revealed better reporting than the Iraqi study reflecting the cultural differences and environmental effects. The investigator recommends re application of the same instrument on other population sample.

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Article
In Vitro Fertilization of Immature oocytes by Testicular Sperm: Animal Model for Azoospermic Infertile Patients

Authors: Saeeda A. M. Alanssari
Pages: 394-399
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Background: Men with azoospermia require testicular and epididymal sperm aspiration for intracytoplasmic sperm injection. Women over 37 years of age demonstrate an increase number of immature oocytes after induction of ovulation. The development of a technique for in vitro maturation (IVM) and fertilization (IVF) of the oocytes using testicular, epididymal and vassal sperm (TS, ES, VS, respectively) will be of therapeutic value for the treatment of azoospermic patients. Objectives: The goal of the study was to develop an animal model for the treatment of infertile couples with obstructive azoospermia and immature oocytes. Materials and Methods: Canine ovaries and testes were collected from a local animal clinic. Immature oocytes were retrieved from the ovaries and cultured in modified tissue culture medium (MTCM). The mature oocytes were in vitro fertilized by TS, ES, and VS. The normality of the fertilized oocytes was studied. Results: Sperm motility index was significantly higher (P<0.01) in sperm retrieved from the vas deference compared to ES and TS. The concentration of the sperm was significantly higher (P<0.05) in the testes compared to epididymis and vas deference while VS and ES normal morphology were significantly (p<0.01) better than TS. Viable oocyte percentage was significantly higher (P


Article
Epidemiology of Poisoning In Hospitalized Children

Authors: Ahmed S Al-Naaimi
Pages: 400-406
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Background and Objectives: Poisoning is an important cause of childhood and adolescence hospital emergency presentations and admissions and a major health problem in this population sector. The present study was designed to describe the epidemiology and pattern of poisoning in addition to its case fatality rate. Methods: A total of 1450 pediatric cases with poisoning admitted to the Central Teaching Hospital of Pediatrics, Baghdad, during the 10 years study period extending from the 1st of January 1993 to 31st of December 2002, were analyzed. Results: The peak age for poisoning cases in the present study was 1-4 years, constituting about three quarters of total pediatric admissions with poisoning. Males were more frequent than females in the present work, and this gender bias was more evident in younger ages and less evident in teenagers. Non-medicinal substances were responsible for the major part (three- quarters) of poisoning cases, especially petroleum products and pesticides. The overall case- fatality rate was 2.6%. The risk of death was higher in the more vulnerable age groups (infants and neonates). It was also higher in males and in cases with poisoning by other noxious substances eaten as food, followed by metals (mainly lead), systemic antibiotics and pesticides. However out of a total of 37 deaths attributed to poisoning that occurred during the present study period of 10 years, non-medicinal substances (especially petroleum products, pesticides and metals) were responsible for three-quarters of these deaths. Conclusion: Children under 5 years of age are the most-vulnerable group for poisoning incidents. In addition Petroleum products, insecticides and lead metal were responsible for the highest proportion of poisoning admission and fatality necessitating special steps directed towards the prevention of these problems.


Article
Epidemiological, Clinical Profiles and Outcome of Bronchiolitis in Iraqi Children

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Background: Bronchiolitis is the first episode of wheezing associated with low-grade fever, rhinitis, tachypnea, and increase respiratory effort in a previously healthy infant during the winter months. It is the most common disease of the lower respiratory tract. Methods: This is a case control study carried out on one hundred infants with a mean age of 3.9 months ± 2.2 months admitted to Children Welfare Teaching Hospital in Medical City – Baghdad with acute bronchiolitis during the period from 1st January 2006 to 1st April 2006. epidemiological risk factors, clinical presentations, chest X-ray findings, treatment, complications and outcome were analyzed. Another one hundred infants (age and sex matched) were seen in the outpatient clinical in the same period and for health problems other than bronchiolitis were taken as a control group. Chi square test was used and a P<0.05 was considered significant. Results: It was found that 64% of patients were males and 36% were females M/F: 1.9/1, 80% were <6 months and 20% were >6 months of age. Most cases (87%) were admitted on January and February. Bronchiolitis was uncommon and less severe in neonatal period. There was a significant association between urban residence and acute bronchiolitis. There was no significant association between each of family history of atopy, parental smoking, pets at home and crowding index > 30 with bronchiolitis. Fever >38.1C was significantly more common in infants with bronchiolitis > 6 months of age than those less than 6 months. Conclusions: The mean clinical scores of severity, the mean duration of hospitalization and Chest X- ray findings were higher in: male sex, age <6 months, infants who were on exclusive breast feeding. Corticosteroids did not reduce the duration of hospitalization in children with acute bronchiolitis.

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Article
Genetic characteristics and β-cell Autoimmunity in T1DM Children

Authors: Eman M. Saleh
Pages: 414-424
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Background: TIDM is known to be polygenic disease that appears from the interaction of mutation in multiple genes including HLA. The autoimmune mediated destruction of pancreatic β-cells is reflected by the presence of autoantibodies against prominent antigens in the pancreatic β-cells. Objective: This study was designed to investigate the role of HLA-class I and class II antigens in the etiology of type 1 diabetes mellitus (T1DM) and also assessment of glutamic acid decarboxylase (GAD65) autoantibodies in the patients at the onset of the disease. Patients & Methods: Sixty T1DM patients who were newly onset of the disease (diagnosed less than five months) were selected. Eighty apparently healthy control subjects, matched with age, sex and ethnic backgrounds underwent the HLA-typing by lymphocytotoxicity assay. Finally 50 healthy individuals were selected randomly to undergo serological assessment of GAD65 autoantibodies using IRMA method. Results & Conclusion: At HLA-class I region, T1DM patients showed a significant increased frequency of antigen A9 (40.0 vs.18.75%) and B8 (28.33 vs.8.75%) as compared to control subject. At HLA-class II region, DR3 and DR4 were significantly increased in patients (53.33 vs.26.25% and 50.0 vs. 12.5% respectively) as compared to controls. In addition to that, T1DM was significantly associated with DQ2 (33.33 vs.15%) and DQ3 (40.0 vs. 20%) antigens as compared to controls, suggesting that these haplotypes had a role in disease susceptibility, while the frequency of DR2 and DQ1 antigens were significantly lowered in patients compared to controls (6.66 vs. 25% and 6.66 vs. 22.5% respectively). These molecules might had protective effect. Anti-GAD65 autoantibodies were present in 50% of T1DM children especially in older ages and in females more than males. High proportion of GADA was found in the patients carrying HLA-DR3/DR4 heterozygous. In conclusion, susceptibility to T1DM is genetically controlled.


Article
A Study Of Angiogenesis In Human Colorectal Tumors By Using Anti-Cd34 Antibody

Authors: Nabil Salmo
Pages: 425-433
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Background: Angiogenesis plays a crucial role in tumorigensis; several reports have described a significant increase in microvessel density (MVD) in colorectal carcinogenesis There are several methods to measure the angiogenesis in neoplasms, but immunohitochemistry seems to be the mainstay of all. This method enable us to measure the tumor microvessel densities highlighted by using antibodies directed against endothelial cell markers like CD31,CD34 or others; then assessment of MVD by manual count of the number of microvessels in what appears to be the most vascular area of the tumor(called the hot spot) using a protocol described by Weidner et al.Automated cellular imaging system is used to analyze immunohistochemically stained slides .studies have shown that the device offers accurate precision and reproducibility of immunostained slide analysis exceeding that possible with manual evaluation which was the prevalent method . Aims of the study: To assess the angiogenesis in normal, adenomatous (benign) and malignant colorectal tissues using CD34 and the microvessels will be measured both manually by hot spot method as the MVD and by the use of computerized image analysis system as fraction area ,we correlate between microvessels density and fraction area with various clinicopathological parameters in colorectal cancer (CRC), and to a compare between the results which obtained from both methods. Methods: Paraffin embedded archival materials from 50 cases including three normal resection (non tumoruos) margins, 12 benign colonic lesions and 35 colonic adenocarcinoma were used . 5mm section were cut and they were stained by anti CD34 antibody Angiogenesis was measured as MVD by two methods : manually by light microscope and by a computer image analysis system (as fraction area). Then the MVD and fraction area were correlated with different clinicopathological parameters. Results : This study demonstrate that there is a statistical difference in MVD and fraction area in both hot spot method and CIAS respectively between benign and malignant tumors . P value < 0.05 in hot spot method and less than 0.001 in CIAS and there was highly significant correlation between MVD and fraction area with the grade . There was significant increase in MVD and fraction area from well differentiated to moderately differentiated and to poorly differentiated .There was no significant correlation between MVD and lymph node involvement by hot spot method but CIAS proved a significant correlation between fraction area and lymph node involvement.Both methods (hot spot and CIAS) proved no significant correlation with age , sex , size of the tumor , site of the tumor , stage of the tumor and the number of lymph node involverment . Conclusions: Assessment of tumor vascularity by counting the microvessels using anti CD34 antibody is useful in quantifying angiogenesis in colorectal adenocarcinoma . Intratumoral microvessels count (by manual and computerized method) is important in the assessment of the biological behavior of CRC. Microvessel count is higher in malignant tumors than benign tumors and it is correlated with the tumor grade and higher MVD is associated with lymph node metastasis . Statistically no significant correlation was found between MVD and age, sex of the patients, tumor size, site, stage, histological type and number of lymph node metastasis . The use of CIAS for assessment of angiogenesis is reliable, reproducible and more precise than the manual method.


Article
The possible Association of HLA Class II with Bladder Cancer in Iraqi Patients

Authors: Shatha M.J.Al-Khateeb
Pages: 434-437
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Background: - Genetic Factors have a major role in the development of bladder cancer. Objectives: - This study was carried out to shed a light on the possible association of HLA class II antigens and BC patients and to correlate this finding with the family history. Patients and Methodes :- Lymphocytotxicity assay had been used to assess HLA- typing of 65 BC patients and 50 healthy controls. Results:- comparison between BC patients and healthy controls showed several antigens deviations in their frequencies. HLA-DR1, HLA-DQ1 and HLA-DQ3 antigens were observed with increased frequencies in patients group with significant differences (P=0.000, 0.000 and 0.017 respectively). Moreover there was decrease frequency of HLA-DR7 in patients group (P=0.010). Stastical analysis showed non significant correlation of the specific HLA –Ags with family history. Conclusions: - This finding demonstrated that HLA-DR1, DR7, DQ1 and DQ3 might play a role in BC susceptibility. • Department of clinical biochemistry. Collage of Medicine Al-Mustansyriah University • Department of Microbiology. Collage of Medicine. Baghdad University • Ministry of Health.


Article
B-Natriuretic Peptide Level as a Predictor for the Severity of LV Dysfunction

Authors: Tharwet H. Nasser
Pages: 438-448
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Background: B -Natriuretic peptide is a neurohormone normally synthesized in ventricular heart muscle and known to be released in situations when left ventricular wall stress increases, it has a variety of physiological functions on its own, that are thought to be compensatory. Objective: The aim of this study was to apply B-natriuretic peptide (BNP) as a biomarker and to correlate its levels with the severity of heart failure using certain selected parameters as indicators of cardiac function. Patients and Methods Forty Six (46) patients with provisional diagnosis of heart failure were chosen for this work, thirty six (36) males and ten (10) Females, their age ranged between 33 and 80 Years. All underwent complete physical examination and ECG tracing together with ECHO/DOPPLER examination for heart failure. Eleven (11) healthy Subjects were chosen as control group for purpose of comparison. The patients were divided into groups, according to Age , Gender, BMI, whether they had the following selected associated diseases: (IHD, hypertension, and diabetes mellitus), smoking habit, Drugs intake, cardiac chambers dilatation including (LV in systole and diastole, RV, and LA), EF%, FS%, degree of diastolic impairment, LV Segmental wall motion abnormalities. Five ml (5ml) specimen of venous blood were aspirated from each patient, and also the control group for estimation of BNP level, using ELIZA technique. Results There was a significant difference in mean serum BNP levels between cases of congestive heart failure and control group. Considering the subject as a positive for heart failure if his BNP level was ≥ 375pmol/l, at this cutoff value there will be a sensitivity of 80.4% and specificity of 100%. Also the study showed highest values of mean BNP in those patients having restrictive pattern of diastolic dysfunction. Conclusion: BNP was used as a biomarker for the first time in Iraq to diagnose congestive heart failure. The role of BNP as a guide to determine the severity of heart failure and the efficacy of treatment was promising, so BNP fulfill most of the criteria in patients with suspected heart failure. At this point it was found that the mean of the right ventricular dimensions were significantly higher in the group with highest BNP quartile compared to lowest quartile BNP group, probably reflecting more severe form of impaired cardiac function and heart failure, a finding which has not been mentioned in any earlier studies in the same field.


Article
Hypolipidemic effect of Silymarin in Dyslipidaemia of Different Etiologies

Authors: Bahir Abdul Razzaq Mesheimish
Pages: 449-456
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Background: Many drug and non drug approaches are utilized for the treatment of dyslipidemia; flavonoids, the major constituents of silymarin, have been proved to positively modify lipoproteins in experimentally – induced dyslipidemia. Objective: This study was designed to evaluate the effect of silymarin, when used alone or in combination with other hypolipidemic agents, on the lipid profile in dyslipidemic patients. Patients and Methods: Fifty seven patients with dyslipidaemia of various etiologies are involved in this clinical trial. They are randomized into three groups treated with either 400mg / day silymarin (gr. A) or 20 mg / day lovastatin (gr. B) or a combination of 200 mg/day silymarin and 10 mg/day lovastatin (gr. C) for 2 months, only 45 patients complete the study . Serum lipid profile (total cholesterol, triglycerides, LDL- C, VLDL-C and HDL-C) and liver functions indices (SGOT, SGPT, total bilirubin) were evaluated each month during the follow up period. Results: Treatment with silymarin results in a significant decrease in TC, TG, LDL-C and VLDL-C levels, with a significant elevation in HDL-C levels, without any significant changes in liver function. Meanwhile, adjunct use of silymarin with lovastatin widens the scope of lovastatin-hypolipidemic effect, without increasing in the score of adverse effects, and ameliorating the hepatic damage emerged due to its use. Conclusions: The results presented in this study indicated that silymarin can be used alone in clinical practice for the treatment of dyslipidemia, and when combined with other hypolipidemic agents like lovastatin, improves therapeutic profile and ameliorate some of its adverse effects.

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Article
Use of Prophylactic Antibiotics in Clean Surgical Operations A Clinical Trail in

Authors: Ali Mohammad Batarfi
Pages: 457-460
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Summary: This is a randomized controlled clinical trial carried out to assess the necessity of the use of prophylactic antibiotics for clean surgical operations in the surgical wards of Ibn- Sina teaching hospital during the period from December 2002 to April 2003. A total of 80 patients with clean surgical operations and eligible for the study were randomly allocated to either treatment or control group (40 patients in each group). Fac Med Baghdad 2007; Vol.49, No.4 Received July 2006 Accepted Jun.2007 Only 7.5% of patients who were not given antibiotics postoperatively developed wound infection while none of the control group, without statistical significance (P>0.05). Neither age nor sex have statistical significant association (P>0.05). All the surgical wound infections were observed in patients were operated for inguinal hernia. The study concluded that use of postoperative prophylactic antibiotic is not necessary for wound healing in case of clean surgical operations except for hernia operations.


Article
Viral Load Among the Sera of Iraqi Hepatitis C Virus Patients

Authors: Batool A. Al-Haidary
Pages: 461-466
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Summary: Background: Hepatitis C Virus is the main causative agent of hepatitis among blood transfused patients, in which most chronic cases result in liver carcinoma. Materials & Methods: Enzyme-Linked Immunosorbent Assay for HCV, FNF-¬ and IL-12p40 estimation with Recombinant Immunoblotting Assay (RIBA) as a confirmatory test for HCV, have been applied for HCV detection in 80 HCV patients' samples in comparison with 30 samples for apparently healthy control, while viral load has been estimated using Branched-DNA (b- DNA) technique for 32 randomly selected positive cases for HCV. Liver function test has been applied for patients' sera in comparison with control. Results & Conclusions: This study reveals highly specificity & sensitivity of ELISA technique for HCV detection which results in 100% positivity by RIBA methods. Moreover, Viral load estimation shows that (71.9%) of HCV sera samples with viral load >615 IU /ml and only (28.1%) with viral load <615 IU/ml with highly significant difference between them (P = 0.013). Furthermore, there is a highly significant variations between liver function test in comparison with control group (P< 0.01), while SGPT is the only parameter which significantly affected by viral load (P= 0.01 1). Beside that, neither INF-¬ nor IL-12p40 level has been affected by viral loads more or less 6151U /ml. It was concluded that ELISA technique is still the best accurate reliable method for viral detection and SGPT is a good marker for highly viral loaded samples.

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Article
Brucellosis as trigger for autoimmune hepatitis in susceptible individual

Authors: Eman Sh. Al-Obeidy
Pages: 467-469
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Background: Autoimmune hepatitis (AIH) is a rare chronic liver disease of unknown etiology, characterized by hypergammaglobulinemia, characteristic autoantibodies, and a favorable response to immunosuppressive treatment. Strong circumstantial evidences denoted that there is quite long list of environmental factors such as (food additives and drugs), viruses and toxins which play an important role in precipitating this disease. Brucellosis is endemic in Iraq. It may involve any organ in the body. Liver is frequently involved. Doxycycline used for treatment occasionally may lead to hepatotoxicity. Objective: the aim of the study is To show the relationship between brucellosis , AIH, and hepatotoxicity of doxycycline . Methods: the study was performed on 2 Iraqi patients with brucellosis, attending the teaching hospital for gastroenterology and liver disease in the period between November 2003 and July 2004. Brucella were studied by Rose Bengal test and confirmed by indirect immuno florescence assay (IIF). Results: anti-SLA/LP Abs was detected in 2 patients with brucellosis. Conclusion: brucellosis or doxycycline is a trigger of AIH

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Article
CME The Vibrio Cholera

Authors: Jaafer Sataaa
Pages: 470-476
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Vibrios are gram negative rods bacteria that are all widely distributed in nature the vibrose are found in marine and surface waters. They are curved aerobic rods and are motile, possessing a polar flagellum. V.vibrios sero group 01 and related Vibrios cause cholera cause sepsis or enteritis Vibrio cholerae The epidemiology of cholera closely parallels the recognition of V.cholerae transmission in water and the development of sanitary water system (1,2,6,9). V. C is a comma-shaped, curved rod 2-4 long .It is actively motile by means of polar flagellu on prolonged cultivation. Vibros may become straight rod that resemble the gram-negative enteric bacteria (1,2,6,9). V.C. grow well at 37OC on many kinds of media .including defined media containing mineral salt sand asparagines as sources of carbon and nitrogen V. C. produce convex, smooth round colonies that are opaque and granular in transmitted light V.C. grows well on thiosulfate-citrate yellow colonies . V. are oxidasepositive, vibrio grow at Avery high Pi-Land are rapidly killed by acid (1,2,3,6). V.C. and related produce a heat-lebile entero toxin with molecular weight of about 84,000 consisting of subunits A and B .The genes for V.C. enterotoxin are on the bacterial chromosome-cholera enterotoxin is antigenincally related to LT of E-coli and can stimulate the production of neutralizing antibodies .However, the precise role of antitoxic and antibodies in protection against cholera is not clear. (3,6) Its structure was determined with one and two dimensional NMR spectra (COSY, HMBC, HMQC, HOHAHA on nuclei 1H, 13C and 31P) and was further confirmed with HPLC (18).

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Article
Investigation of Circulating anti- Coxsackie B, anti- Polio and anti- Adeno IgG in newly diagnosed T1DM Children

Authors: Eman M. Saleh
Pages: 477-481
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Back ground: Viruses may be involved in the pathogenesis of Type 1 Diabetes Mellitus (T1DM), either through direct β-cell infection or as triggers of autoimmunity. Objective: To investigate the presence of specific anti- viral IgG antibodies for Coxsackie virus type B (CVB5), Poliovirus, and Adenovirus which proposed to be involved in the etiology of T1DM. Subjects & methods: A total of 60 Iraqi T1DM children were included in the presents study. They were new onset of the disease (diagnosis was from one week up to five months). For the purpose of comparisons, 50 apparently healthy control subjects were selected. Serum IgG against Coxsackie virus type B5, Adenovirus type 3, 4, and 7, and Poliovaccin Trivalent were detected quantitatively with an indirect ELISA. Results: High proportion of anti-CVB5 IgG (20%)(p<0.05) and anti- Polio IgG (31.67%) were found in T1DM children compared to controls (8%, 26% respectively), while anti- Adeno IgG were detected in diabetic patients only (6.67%)(p<1.0001).


Article
Estimation of Some Trace Elements in Severe Head Injured Patients

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Abstract

Objectives: Severe head injury is the most devastating neurosurgical condition and it is only next to cancers as the leading cause of death in developed countries. Because trace elements (TEs) are involved in most of enzymes that drives the biochemical reactions, so they are considered as a window to the biochemical environment of the body in general and in brain in specific. Aim of the Study: This study measured six TEs (Fe, Zn, Mg, Cu, Mn and Co) in 29 patients with severe head injury (GCS Score 3-9); their ages between 5-50 years. Collection and estimation performed at both Neurosurgical Hospital (NH) in Baghdad and Medical Research Center (MRC) of College of Medicine, Kadhimiyah between January 2004 and August 2004. 17 of healthy Iraqi volunteers of age- and sex- matched were used as a comparable control group in TEs measurement. Results: The analysis showed that serum Cu level has a striking significant positive correlation with GCS (P<0.01) followed by serum Mg (P<0.01), serum Fe (P<0.05) with mode of correlation is linear except for that of serum Fe has three phases of correlation. Serum Mg is the only TE showed statistical significant lower value in patient group than the control group (P<0.01). Zn is the only TE that is correlated with the mode of intake, significantly lower among patient on IVF than those on N/G (P<0.01). Serum zinc correlated in linear relation with serum Mg (P<0.05), serum Fe with serum Mg (P<0.05).


Article
Exploration of Problem-Based Learning in Hadramout University College of Medicine (HUCOM)

Authors: Ali Mohammed Batarfi
Pages: 490-494
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Abstract

Background: Problem-based learning is becoming increasingly adopted in universities of higher education throughout the world. Objective: This study is carried out to evaluate the application of this innovative approach in teaching in Hadramout University College of Medicine (HUCOM) in Yemen. Methods: A cross-sectional study was designed to collect data from students through a well structured questionnaire. Students were classified into two groups: students in preclinical phase (1-3 levels) and students in clinical phase (4-6 level). Results: Out of 372 students participated in the study; 19% in the preclinical phase know about PBL before joining the college while only 16% of students in clinical phase. About 44% students in preclinical phase and 46% of students in clinical phase used all methods for explanation of their learning objectives. A higher percentage of students in preclinical phase (72%) reported that they use library as a source for self-directed learning (SDL) while only 60% of students in clinical phase did. Conclusion: Increased awareness and satisfaction of students toward PBL over time.

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Article
Age Related Changes in Cardiovascular Response to Oxidative Stress Induced by

Authors: Affan E. Hassen
Pages: 495-503
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Abstract

Background: There are many circulatory changes that occur during exercise in order to supply the tremendous blood flow required by the muscles during the stimulatory effects on circulation by the mass sympathetic discharge, the increased arterial pressure and cardiac output. The metabolic effects and the oxidative stress as a result of the work load on cardiac and skeletal muscles could also show changes. Objective: This study was designed to investigate the effects of aging process on the vascular response during exercise and also in the oxidative stress according to age. Subjects and Methods: Eight healthy Iraqi subjects were enrolled in this study. Divided into three groups according to age, group I (age range 20-29), group II (age range 30-39), and group III (age range 40-49). They were asked to exercise according to modified Bruce protocol. Blood samples were taken from each subject pre and post exercise for biochemical tests. The test included were creatine kinase, uric acid, malonedialdehyde (MDA) , lipid profile (triglycerides, cholesterol, high density lipoprotein HDL). Low density lipoprotein LDL was calculated. Results: There is a statistical significance increase in heart rate and systolic blood pressure after exercise in all groups however diastolic blood pressure showed a decrease. A positive linear correlation is present. Mean serum levels of uric acid was shown to be elevated after exercise, meanwhile triglycerides levels decreased significantly in all age groups after exercise and also cholesterol. LDL on the other hand showed a decrease in the younger age group. Conclusion: The results obtained set a normative data for the studied parameters for the age group included in the study to be used in the future for the detection and differentiation of any cardiovascular abnormality from age related changes. These data have important clinical implications if we are to prevent the frailty and morbidity associated with old age.


Article
Variations in the Origin and Contributions of Arteries supplying the Human Hippocampus

Authors: Nameer T. George
Pages: 504-507
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Abstract

Background: Variations in the arterial supply in the human brain are not uncommon. Of particular interest is that of the hippocampus. Knowledge of the vascular anatomy is a key to the surgical treatment of pathologies in this region. Objectives: The aim of the work is a detailed description of the variations and contribution of the anterior choroidal artery and the branches of the posterior cerebral artery to the supply of the hippocampus and comparing the results with previous studies. Materials and Methods: Formalin-fixed brains from 15 adult cadavers (30 hemispheres) were examined using a magnifying lens. The hippocampus is identified, and the arteries that are in the vicinity to hippocampus were carefully dissected and studied. Results: The anterior choroidal artery (AchA), and the lateral posterior choroidal arteries (LPChAs) were present in 100% of the specimens examined. AChA anastomosed with the anterior branches of LPChA in 31% of specimens. The hippocampal artery, a brunch of the posterior cerebral artery, was present in 82.8% of specimen. The anterior and middle temporal arteries were present in 80% of hemispheres. Conclusions: ACA has the most constant origin, course and distribution. It supplied the rstra1 and middle portions of the hippocampus and in the absence of the hippocampal arterial branches of the posterior cerebral artery (PCA), AchA supplied the major portion of the hippocampus. The branches, mainly from P-2A and P-2P segments, of the PCA supplied the middle and posterior portions of the hippocampus. Variations in their origin from different segments were noted. The major branches were: the LPChAs, the hippocampal arteu, the anterior and middle temporal arteries. The common temporal arterydid not contribute to the arterial supply of the hippocampus.

Table of content: volume:49 issue:4