Table of content

IRAQI JOURNAL OF MEDICAL SCIENCES

المجلة العراقية للعلوم الطبية

ISSN: 16816579
Publisher: Al-Nahrain University
Faculty: Medicine
Language: English

This journal is Open Access

About

Iraqi Journal of Medical Sciences
Aims and Scope
Iraqi Journal of Medical Sciences is published by College of Medicine, Al-Nahrain University. It is a quarterly multidisciplinary medical journal since 2000 . High quality papers written in English, dealing with aspects of clinical, academic or investigative medicine or research will be welcomed. Emphasis is placed on matters relating to medicine in Iraq in particular and the Middle East in general, though articles are welcomed from anywhere in the world.
Iraqi Journal of Medical Sciences publishes original articles, case reports, and letters to the editor, editorials, investigative medicine, and review articles. They include forensic medicine, history of medicine, medical ethics, and religious aspects of medicine, and other selected topics.
عنوان المجلة :
College of Medicine
Baghdad, Iraq
Tel and Fax: + 964-1-5224368
P. O. Box 14222, Baghdad, Iraq.
E-mail: iraqijms@colmed-alnahrain.edu.iq

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Table of content: 2009 volume:7 issue:1

Article
COMPARISON BETWEEN VDD AND DDD PACING IN SYMPTOMATIC SECOND DEGREE AND COMPLETE HEART BLOCK
مقارنة بين نوابض القلب الأصطناعية نوع (VDD) و نوابض القلب الأصطناعية نوع (DDD) لدى مرضى يعانون من قطع من الدرجة الثانية و قطع كامل في حزم القلب

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Background: VDD pacing provides the physiological benefits of atrioventricular synchronous pacing with the convenience of a single lead system, but is hampered by uncertainty regarding long term atrial sensing and development of sinus node disease. Objective: To evaluate the efficacy and sensitivity of two different types of dual chamber pacemakers: (VDD and DDD pacemakers) by various electrophysiological and operative parameters in an attempt to determine whether VDD pacemakers are a viable alternative to DDD pacemakers in treatment of patients with 2nd and 3rd degree heart block with normal sinus node function. Method: The study was conducted during the period between April 2006 to September 2007 on 48 patients with symptomatic 2nd degree and complete heart block, attending the Cardiac Care Unit in Al-Kadhimiya Teaching Hospital. Those patients divided into two groups: VDD group and DDD group; each consisted of 24 patients. The VDD and DDD pacemakers were implanted in the patients and the tests of efficacy and sensitivity were done at implantation and in the follow up periods (2nd day of implantation, 10 days, 1 month, and 3 months after implantation) for both groups. These tests were: Atrial sensitivity, atrial lead impedance, P-wave amplitude, event histogram (% of atrio-ventricular synchronous pacing), duration of implantation, and duration of fluoroscopy. The outcomes of these tests were compared in both groups. Results: Forty eight patients were implanted; half of them received DDD pacemakers, and the other 24 received VDD pacemakers. At the time of implantation and during the 3 moths of follow up, the DDD group showed significant higher efficacy and sensitivity than the VDD group. After implantation; the mean P-wave amplitude, atrial sensing threshold, atrial lead impedance, and % of AV synchrony were 3.42±1.1 mV; 3.46±1.3mV; 568±103.42Ω; 95%±7% respectively in DDD group, while they were 2.91±1.3 mV; 2.46±1.18mV; 624.2±136.26Ω; 90%±8% respectively in VDD group. Implant time was significantly reduced in VDD patients (61.82±14.6 min.) compared with DDD group (72.62±10.4 min.) (p<0.05). The exposure to radiation (fluoroscopy time) was significantly reduced in VDD patients (6.53±2.9 min.) in comparison with DDD patients (10.37±3.4 min.) (p<0.05). Conclusion: the dual lead DDD pacing is superior to single lead VDD pacing for long term maintenance of AV synchronous pacing in symptomatic 2nd degree and complete heart block with preserved SA node function. The lower cost, high reliability, and abbreviated implantation time suggest that a VDD pacing is a viable alternative to DDD pacing. Keywords: DDD pacemaker, VDD pacemaker, AV blocks, AV synchrony and atrial sensitivity threshold.


Article
CAUSES OF DEATH AMONG HOSPITALIZED CHILDREN UNDER 5 YEARS OF AGE IN SULAYMANI PEDIATRICS TEACHING HOSPITAL
أسباب وفيات الاطفال دون سن الخامسة من العمرالراقدين فى مستشفى أطفال السليمانية التعليمي

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Back ground: Knowledge about the causes of death in children is important to evaluate health system progress and provide what is needed for an efficient design of health care delivery system. Objective: To find out the main causes of death in children under 5years & evaluate the effects of different variables like: age, gender, body weight, residency, and months of year for the causes of death. Patient& Method: This is a retrospective study which was carried out in order to find out the main causes of death among admitted children younger than 5 year in Sulaymani Pediatrics Teaching Hospital for the period of 5 years from of January 1st 2001 to December 31st 2005 included. The total numbers of admitted cases was 137,739 out of which 1455 had died. We obtained the information from case files of the deceased patients. Results: The incidence of death among admitted patients was (1.06%), the rate was higher in male gender (59.3%), while in female it was (40.7 %), with a P-value of <0.05 which is significant statistically with male to female ratio 1.48:1. Deaths were mainly in neonates (61.8 % of all age groups in the study) with a p-value of <0.05. Death was mainly in those with body weights <2.5kg, which accounts for (42.1%). The main cause of death in neonate was prematurity (54.7%) while diarrhea and Acute Respiratory Infections (ARI) were main causes during infancy (57.4%, 15.9%) respectively. Seasonal variation of died cases showed that were two peaks of death, one in June and another in November with a p-value of <0.05. The percentage of death in the rural and urban area were (64.5%, 35.5 %) respectively, with a p-value of <0.05 which is also significant. Conclusion: This study has revealed that prematurity was the main cause of death among neonate while diarrhea and acute respiratory diseases were the main causes of death during infancy. Malignancy was the least common cause of death. Deaths were mainly in neonates. There was a significant association between deaths and gender, body weight, residency& the months of the year. Key words: mortality rate, death cause, children under five.


Article
IFN-γ VERSUS IL-10 IN SITU EXPRESSION IN RECURRENT SPONTANEOUS ABORTION
التعبير الموضعي للانترفيرون كاما مقابل الانترلوكين-10 في حالات الاجهاض التلقائي المتكرر

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Background: The possible immunological bases of recurrent spontaneous abortion (RSA) are still largely unknown, aberrant type 1 cytokine production; interferon-γ (IFNγ), and a defective type 2 cytokine; Interleukin-10 (IL-10) has been suggested to be related to the incidence of unexplained RSA. Objective: To study the relation between the in situ expression of IFNγ and IL-10 in women with recurrent spontaneous abortion. Materials and Methods: The study included three groups of women; Group A: patients had recurrent abortion (n=24), Group B: patients had spontaneous abortion for the first time (n=10), Group C: women with elective pregnancy termination (n=6). Curate samples obtained from these women were subjected for in situ hybridization technique to detect and determine the in situ expression of IFN-γ and IL-10. Results: The in situ expression of IFN-γ was significantly higher in women with RSA as compared with normal pregnant and first abortion groups (p=0.000 and 0.002 respectively), while IL-10 expression was significantly lower in women with RSA as compared with first abortion group (p=0.005), and the ratio of IFN-γ/IL-10 was 1.97 in women with recurrent abortion, while that of normal pregnant and first abortion groups were 0.67 and 0.73 respectively. Conclusion: The data of this study strengthened the possibility that type-1 immune response may have the upper hand in the pathology of RSA in association with reduction in the type-2 immune response. Key words: RSA, IFN-γ, IL-10


Article
THE ASSOCIATION OF HELICOBACTER PYLORI MUCOSAL DENSITY WITH LOW SERUM FERRITIN
علاقه كثافه H.pylori في الغشاء المخاطي مع مستوى المصلي المنخفض للحديد

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Background: Although there are several methods to detect Helicobacter pylori infection, there is no simple validated test to quantify the density of infection, which is believed to play a major role in the pathogenesis of H. pylori-associated Gastritis and serum Ferritin level. Objective: The aim of this study was to assess the association of low serum Ferritin level with the intensity of H. pylori infection. Patients and Methods: Sixty four patients mean age of 34 years (14-66 years) who underwent upper gastrointestinal endoscopy because of gastrointestinal complaints, were studied. Patients were grouped as H. pylori positive group, n=47and H. pylori negative group, n=17. A number of both invasive and non-invasive diagnostic tests were used for the diagnosis of H. pylori infection (Ultra Rapid Urease Test (URUT), slide impression smear test and H.pylori IgG ELISA Test). Fasting serum Ferritin were determined using VIDAS Ferritin (Enzyme Linked Fluorescent Assay). Results: Forty seven of the 64(73%) patients were H.pylori positive group. patients were classified according to the age group and gender. The rates of the H.pylori infection were higher in female age group 21-30 years. A total 16 of the 47 (34%) infected patients showed low serum Ferritin values with high rate in female with age group 21-30years. Twenty eight of the 47(60%) patient biopsies showed positive microscopic examination with slide impression smear test.Twenty seven of the 47(57%) infected patients showed seropositive results to anti-H.pylori IgG antibody and also positive with URUT,10 individuals of this group showed low serum Ferritin values. While ten of the47 (21%) infected patients showed seronegative results to anti-H.pylori IgG antibody but positive with URUT,5 individuals of this group showed low serum Ferritin values. Conclusion: The possible relationship between mucosal H.pylori loads with low serum Ferritin level. Keywords: Helicobacter pylori infection, serum Ferritin, anti-H.pylori IgG antibody ELISA test, Ultra Rapid Urease, Enzyme Linked Fluorescent Assay.


Article
SODIUM IMBALANCE IN PREECLAMPSIA
إختلال توازن الصوديوم عند الحوامل المصابات بارتفاع ضغط الدم اثناء الحمل (قبل الشنج)

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Background: Preeclampsia is a form of high blood pressure manifested during pregnancy. It is a common major complication causing significant morbidity and mortality; however, its etiology is unknown. Moreover, data on cation pattern during pregnancy are conflicting, and its relation with endothelial derived nitric-oxide and sex hormones have not been described adequately. Objective: to demonstrate the pattern of sodium during preeclampsia with respect to normal pregnancy, and the correlation of the above parameter with nitric-oxide pathway. Subject and methods: the present study is a cross-sectional case-control study includes measurement of nitric oxide NO), nitric oxide synthase (NOS) , serum and urinary sodium in 60 patients with preeclampsia. They were classified into two groups according to the gestational age: • Preeclamptics in the second trimester G1: (n=30). • Preeclamptics in the third trimester G2: (n=30,). The results were compared with 60 apparently healthy pregnant women (as controls). They were classified according to the gestational age into two groups: • Pregnants in the second trimester G3: (n=30). • Pregnants in the third trimester G4: (n=30). Results: showed a significant reduction in serum NO and NOS in the preeclamptics with significant increase in serum sodium accompanied by urinary retention of this cation (expressed as urinary sodium per urinary creatinine ), as compared to the controls. The regulatory effect of NO on fluid balance is supported by the positive correlation between NO and urinary sodium excretion indicating that NO had different effects on renal tubular reabsorption of sodium. Conclusion: preeclamptics (in different gestational age groups) experienced vasospasm (manifested by low s.nitrite)s and altered sodium status when compared with healthy pregnant women matched with their age and gestational age. Keywords:preeclampsia, nitric oxide , Sodium.


Article
ANATOMICAL STUDY OF ANOMALOUS TESTICULAR ARTERY
دراسة تشريحية للشريان الخصوي الشاذ

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Background: The testicular artery arises from aorta below the level of renal arteries, most commonly at the level of L2 vertebra. Variations in the site of origin of the testicular artery may be accounted; it may arise from anomalous origin rather than aorta, or may originate from aorta higher than L2 level or arises from the main renal artery or accessory one. Objectives: study the sites of origin of testicular artery and its clinical importance. Materials & Methods: study the origins of 40 testicular arteries, in both sides of 20 male cadavers in the anatomical laboratory prepared and embalmed for teaching purposes in the medical college. Examine both sides to see the possible origins of the testicular arteries either from aorta or from somewhere else. Results: During dissection of 20 male cadavers, examining 40 testicular arteries on both sides, a different site of origin of the testicular artery was encountered. The right testicular artery was found originated from the right main renal artery. On the other hand, the left testicular artery was found originated from the left accessory renal artery in two cases out of twenty. In the other 17 cases, all the testicular arteries whether right or left were originated from abdominal aorta. Discussion: Variation in the renal and gonadal vasculature has been known since early days of human autopsy. The anomalous origin of testicular artery from accessory renal vessel has important clinical implications, since any surgical intervention with the kidney, during transplantation for example, may lead erroneously to injury of the anomalous testicular artery leading to atrophy of the male gonad. Conclusion: • Testicular artery may originate from anomalous origin rather than aorta. • The anomalous testicular artery is the aberrant one, and no more accessory artery present. • The encountered anomalous origin may comprise a potential risk of bleeding from injured artery during surgery. Keywords: accessory renal arteries, testicular artery, vascular variation.


Article
INCREASED EXPRESSION OF ESTROGEN RECEPTORS AT THE MATERNO-FETAL INTERFACE IN PATIENTS WITH RECURRENT PREGNENCY LOSS
ارتفاع نسبة التعبير الموضعي لمتلقيات الايستروجين في حالات فقدان الحمل المتكرر

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Background: Estrogen hormone has been implicated in the pathogenesis of different genital tract pathologies and in counteracting the progress of normal pregnancy. Objective: Localization and semi-quantization of estrogen receptors at the materno-fetal interface in patients with recurrent pregnancy loss (RPL). Methods: Immunohistochemistry analysis of estrogen receptors using paraffin embedded sections of curate samples obtained from 40 women, who where divided into three groups: 24 women with RPL, 10 women with abortion for the first time, and 6 women with induced abortion. Results: The mean value of the expression of estrogen receptors was (71.2 ± 2.3), which is significantly higher than that of the second group (52.2 ± 3.2), and the third group (43.7 ± 4.2), (p=0.001). Conclusion: High expression of estrogen receptors in women with RPL may give a clue to its prominent role in the pathology of pregnancy loss. Key wards: Estrogen receptor, RPL.


Article
THE ROLE OF TESTOSTERONE IN PREECLAMPSIA
دور الشحمون الخصوي عند الحوامل المصابات بارتفاع ضغط الدم اثناء الحمل (قبل الشنج)

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Background: Preeclampsia is a form of high blood pressure manifested during pregnancy, it is a common major complication causing significant morbidity and mortality; however, its etiology is still unknown. The systemic vasculature is a target tissue for sex steroid hormone. Estrogen, androgen, and progesterone all influence the function and pathophysiology of the systemic circulation by influencing endothelial derived nitric-oxide pathway. Objective: was to demonstrate the pattern of sex steroid (testosterone) in preeclampsia with respect to normal pregnancy, and the correlation of the above parameter with nitric-oxide pathway. Subject and methods: The present study is a cross-sectional case-control study includes measurement of nitric oxide, nitric oxide synthase, and sex steroid (testosterone) in 60 patients with preeclampsia. They were classified, according to the gestational age, into two groups: *Preeclamptics in the second trimester G1: (n=30). *Preeclamptics in the third trimester G2: (n=30). The results were compared with 60 apparently healthy pregnants (control group), who were, also, classified according to the gestational age into two groups: o Pregnants in the second trimester G3: (n=30). o Pregnants in the third trimester G4: (n=30). Results: showed a significant reduction in serum NO and NOS in the preeclamptics as compared to the controls which was accompanied by a significant increase in serum testosterone. The inhibitory effect of testosterone on NO production is supported by negative correlation between these parameters. The disturbance in vasodilation state and testosterone can be attributed to malfunction placenta, and it varies according to the gestational age and advancing disease state; being the best in G4 (normal pregnants in the third trimester), and the worse in G2 (preeclamptics in the third trimester) as indicated by NO measurement. Conclusion: preeclamptics (in different gestational age groups) experienced vasospasm, hyperandrogenemia when compared with healthy pregnants matched with their age and gestational age. Key words: preeclampsia, nitric oxide, testosterone,Testosterone in preeclampsia.


Article
COMPLICATIONS DURING HEMODIALYSIS IN ARTERIO-VENOUS FISTULA VERSUS TEMPORARY VASCULAR ACCESS
مضاعفات الديال الدموي عند المصابين بالعجز الكلوي المزمن المستخدمين الناسور الشرياني الوريدي مقارنة بالمدخل الوعائي المؤقت

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Background: Dialysis is procedure that removes excess fluid and the toxic end products of metabolism. The major forms of dialysis are hemodialysis, and peritoneal dialysis. Access to the blood circulation is achieved by the use of central venous catheter or artificial arteriovenous fistula. Objective: To detect and compare prevalence of complications occurs in uremic patients using central venous catheter or arteriovenous fistula in dialysis unit in Al-Kadhimiya Teaching Hospital. Patients and methods: One hundred patients with renal failure (chronic or acute) undergoing hemodialysis were questioned and examined for the Complications occurred during or after the hemodialysis process using arteriovenous fistula or temporary vascular access. Results: The results showed significant of fever and blood flow obstruction in temporary vascular access (<0.05) as a complications in hemodialysis. Other complications such as hepatitis (B&C), hypotension, exit site infection, nausea, itching, muscle cramp, vomiting, backache, fainting and disequilibrium syndrome are similar in arteriovenous fistula and temporary vascular access. Conclusion: The main complications during hemodialysis in this study were fever, malfunction of the catheter, and exit site infection in catheter more common in temporary Catheter than arteriovenous fistula so advice to do arteriovenous fistula before end stage renal disease Keywords: Hemodialysis, arteriovenous fistula and temporary catheter.


Article
SIGNIFICANCE OF PLATELET VOLUME INDICES IN PATIENTS WITH CORONARY ARTERY DISEASES
أهمية فهارس حجمِ صفيحةِ الدمّ عند مرضى تصلب الشرايينِ التاجيةِ

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Background: Platelets play an important role in the development of intravascular thrombosis, the major cause of acute coronary syndromes. Platelet size has been considered to reflect platelet activity. Objectives: The aim of this study is to investigate the clinical value of platelet volume indices (PVI) in the spectrum of ischemic heart diseases and the possibility of being a risk factor for acute myocardial infarction (MI). Patients &Methods: Thirty six (36) patients were included in the study: 22 of them have myocardial infarction (MI) and 14 have unstable angina (UA). Risk factors and history of stable angina (SA) were reviewed and studied by Chi square. Complete blood count and platelet volume indices (PVI): mean platelet volume (MPV), platelet large cell ratio (P-LCR), and platelet distribution width (PDW) were done using automated hematology analysis system and studied by t-test and correlation analysis. All P values were two sided and P value of < 0.05 was considered statistically significant. Results: It is found that MPV and P-LCR were the most significant parameters that showed statistical difference between patient with UA and those with MI (P=0.042 & P=0.031) respectively unlike other parameters (platelets count or PDW) (P=0.703 & P=0.094). There were no correlations between MPV & other platelet indices with existing past history of SA as well as other risk factors for acute coronary syndrome (P=0.811). Conclusion: Because it is simple, economic, and practical, MPV and P-LCR can be used in predicting the possibility of acute thrombosis in patients with coronary artery diseases. Key words: Platelets, platelet volume indices, atherosclerosis, myocardial infarction, unstable angina, coronary artery disease.


Article
HEPATITIS A INFECTION AND OCCURRENCE OF INSULIN DEPENDENT DIABETES MELLITUS IN A SAMPLE OF IRAQI CHILDREN
إلتهاب الكبد الفيروسي نمط A والاصابه بمرض السكري عند عينه من الأطفال العراقيين

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Background: Hepatitis A is an important endemic disease in Iraq. And Insulin dependent diabetes is one of serious chronic disease that affect children. Objective: To study the possible relationship between viral hepatitis A infection and occurrence of diabetes mellitus (DM) in Iraqi children. Method: A case control study was done on hundred newly diagnosed diabetic children, who were compared to hundred control children.Serological test were done to both groups to detect antibodies against Hepatitis A by using ELISA method .This study started on 1st of November 2006 and ended at 20th of December 2008 Both groups were collected from Al-Kadhimiya Teaching Hospital and Al-Noor General Hospital. Result: There was slight increase incidence of diabetes mellitus in females (56%) than males (44%) and there was significant negative correlation between Hepatitis A and diabetes mellitus since 11% of diabetic children had positive serological test while 26% of control children had positive result. Conclusion:there was no relationship between hepatitis A infection and occurrence of IDDM. Keywords: Hepatitis A, diabetes mellitus, children.


Article
SPIROMETRIC REFERENCE VALUES IN HEALTHY, NON-SMOKING, IRAQI POPULATION
القيم المرجعية لفحص وظائف الرئة لعينة من العراقيين الاْصحاء من غير المدخنين

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Background: Pulmonary function test depends on a number of physiological factors as height, age, gender and race. Reference mathematical equations are used to determine a normal range of spirometric results which in turn are used clinically to determine whether the results measured in any individual fall within a range to be expected in a healthy person of the same gender, height and age. Objectives: To derive the prediction equation for healthy, non smoking Iraqi subjects. Methods: The study was conducted in Baghdad (IRAQ) on one hundred eighty two (182) healthy, nonsmoking subjects between 20 to 60 years of age were included in the study. The subjects included were 79 males and 103 females whose pulmonary volumes and capacities were measured by spirometry. Results: The prediction equation was derived first and then the reference values were then calculated for forced expiratory volume in 1st second (FEV1) and force vital capacity (FVC). The values for both parameters were found to be lower by about 5.58% and 6.14% in females and 4.78% and 12.65% in males, respectively, when compared to researchers done on Caucasians. Conclusion: Pulmonary function test reference values and prediction equations for both sexes between the ages of 20-60 years were derived for a sample of healthy, nonsmoking, Iraqi population. A considerable difference was found between prediction equations and reference values obtained in present study compared with other studies conducted in western countries. Keywords: FEV1, FVC, Spirometry, Iraqi subjects, smoking


Article
ELEVATED SERUM β-hCG LEVELS IN SEVERE PREECLAMPSIA
ارتفاع الهرمون المنشط المنسلي المشيمي البشري( بيتا – اج سي جي ) في حالات طليعة الارجاج الشديدة

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Background: Pregnancy induced hypertensive disorders are common complications responsible for fetal, neonatal and maternal morbidity. Current hypothesis regarding the pathophysiologic mechanisms of pregnancy induced hypertension point to early placental abnormalities. Objective: To determine whether measurement of serum human chorionic gonadotropin might reflect a different secretory trophoblastic response of preeclampsia. Study design: A prospective study. Setting: Department of Obstetrics & Gynecology in Al-Kadhimiya Teaching Hospital. Patients and methods: A total of 80 pregnant women were studied during the period from October through July 2005. They included 40 patients with severe peeclampsia were matched with 40 healthy normotensive women in the third trimester with singleton pregnancies and without congenital malformations. Serum levels of β-hCG were measured by immunoenzymometric assay before delivery and neonatal outcome was recorded. Results: Serum β-hCG levels were found to be significantly higher in severe preeclamptic women compared with controls (P<0.05). Elevated β-hCG levels in severe preeclampsia was associated with higher rate of preterm delivery (50% vs. 7.5%), higher rate of intrauterine growth restriction of birth weight <10th centile (47.5% vs. 5%), higher rate of low birth weight of < 2500 gm (70.25% vs. 12.5%) and higher rate of fetal death (7.5% vs. 0). Conclusion: Elevated serum β-hCG levels in severely preeclamptic women reflect a significantly pathologic change and abnormal secretory function of the placenta with subsequent pregnancy outcome. Keywords: preeclampsia, Human chorionic gonadotrophin, pregnancy


Article
Y CHROMOSOME AZOOSPERMIA FACTORS (AZF) MICRODELETIONS IN AZOOSPERMIC MEN.
الحذوف الدقيقة لعوامل اللانطفية على كروموسوم Y عند الرجال العقيمين.

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Background: It becomes now evident that the abnormalities of chromosome Y espicially the microdeletions role the major causes of infertility and a number of studies linked the region Yq11 which contain the AZF factors to azoospermia. Objectives: The current study was aimed to detect chromosomal abnormalities and Y microdeletions (AZFs deletions) among a number of azoospermic men. Materials & methods: Five ml from peripheral blood was collected from 25 azoospermic men and four controls (one female and three fertile men) and used for DNA, PCR analysis and cytogenetic examinations in order to detect any kind of microdeletion in the AZF regions. Results: Six individuals which accounts 24% of the total azoospermic men have a microdeletion in the AZF regions.The cytogenetic analysis revealed morphologically normal Y chromosome in all examined samples. Conclusions: The microdeletions of the AZF regions cause quantitive loss in spermatogenesis. Keywards: Infertility,AZF a,b,c , Y chromosome


Article
ISOLATION AND DIAGNOSIS OF THE CONJUNCTIVAL NORMAL FLORA BEFORE AND AFTER CATARACT EXTRACTION SURGERY
عزل وتشخيص النبيت الطبيعي في ملتحمة العين قبل وبعد ازالة الماء الأبيض (الساد)

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Background: The conjunctival flora is opportunistic microorganisms because under certain circumstances they can cause endogenous infections. Objective: This study aimed to diagnose conjunctival flora before and after cataract surgery and their role in post-cataract surgical infections. Method: Specimens from ninety-one patients were collected from the conjunctivas and eyelid margins of ninety-one eyes of ninety-one patients both immediately before and one day after experiencing cataract surgery. These specimens were subjected to microbiological and biochemical tests. Susceptibility of ninety isolates obtained preoperatively was performed toward fifteen antibiotics. Results: Staphylococcus epidermidis followed by Staphylococcus aureus were the predominant bacteria isolated from the conjunctiva and eyelid margin of the eyes before and after cataract extraction surgery. Vancomycin followed by ciprofloxacin and amikacin were significantly responsive against conjunctival isolates. In this study two patients suffered from postoperative endophthalmitis with the predominant of Staphylococcus epidermidis and Staphylococcus aureus. Conclusion: It was predicated that the most causative microbes of post cataract surgical infections were the normal conjunctival flora. Keywords: conjunctival Normal Flora, Endophthalmitis, Ciprofloxacin, Vancomycin, Amikacin.

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