Table of content

Iraqi Academic Scientific Journal

المجلة العراقية للاختصاصات الطبية

ISSN: 16088360
Publisher: The Iraqi Borad for Medical Specialization
Faculty:
Language: English

This journal is Open Access

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E-mail:IPMJ2000@yahoo.com

Table of content: 2011 volume:10 issue:4

Article
Level of Resistin in Acute Myocardial Infarction Patients and its Relation to Lipid profile and Cardic Troponin I

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ABSTRACT: BACKGROUND: Inflammatory responses are involved in the initiation and progression of atherosclerotic plaques. Myocardial Infarction (MI) is most commonly due to occlusion of a coronary artery following the rupture of a vulnerable atherosclerotic plaque. It has been suggested that the adipose tissue may play an important role in mediating this chronic inflammatory process. Resistin is a cysteine-rich polypeptide that is expressed at relatively lower levels in human adipocytes but higher levels in macrophages. Troponin is found in cardiac muscle and used for diagnosis of AMI. OBJECTIVE: To investigate the level of resistin and its effect on lipid profile and Troponin I levels in acute myocardial infarction patients. SUBJECT AND METHODS: The study included 50 patients with AMI and forty healthy subjects as control group. In this study resistin , lipid profile and Troponin I were measured. RESULTS: The levels of resistin, cholesterol, LDL-C were significantly elevated with (p<0.001), while HDL-C was significantly lower with (p<0.001), there was positive correlation between resistin with cholesterol, LDL-C, triglyceride and VLDL, while there was negative correlation between resistin with HDL in acute myocardial infarction. CONCLUSION: There was a significant increase in resistin level, in acute myocardial infarction patients and this increase may be related to inflammation. Resistin negatively correlated with HDL and positively correlated with triglyceride and LDL this relationship makes us consider this hormone as possible atherosclerotic factor


Article
Study of Serum Uric Acid in a Group of Insuline Dependant Diabetes Mellitus Iraqi Patients

Authors: Dhammyaa H. Salih --- Wifaq M.Ali Al-Watar*
Pages: 436-440
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ABSTRACT: BACK ROUND: The long duration of insulin dependant diabetes mellitus eventually ends with complications like renal impairment especially if it was badly controlled ,the first sign of renal involvement is the elevation of serum uric acid above or near upper normal values(1). OBJECTIVE: One hundred and thirty type1 diabetic patients were enrolled in the study, they represent a selected sample of patients who attend the Specialized Center for Endocrinology and Diabetes (Baghdad Russafa Directorate) during the period from November 2006 to April 2007 compared with forty healthy individuals as control group of similar age group. METHOD : The determination of fasting blood sugar ,uric acid and blood urea were done by enzymatic colorimetric test following the Procedure performed by manufacturers. RESULTS: The level of serum uric acid and blood urea were normal in all cases of juvenile diabetes but as the duration of the disease increases the values of the serum uric acid started to raise and could be the first sign of renal impairment in diabetic patients even before albuminuria.. CONCLUSION: The concentration of uric acid in the blood is an independent marker of failing kidneys and may even play a causative role in the decline of renal function.

Keywords

serum uric acid --- IDDM --- blood urea)


Article
Pancytopenia Adult Patients At Baghdad Teaching Hospital

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ABSTRACT: BACKGROUND: pancytopnia is a triad of findings caused by different diseases affecting bone marrow primarily or secondarily, causing manifestations of anemia, thrombocytopenia, and/ or leucopenia OBJECTIVE: To identify causes, and presenting symptoms of pancytopnia in patients attending Baghdad teaching hospital. PATIENTS AND METHODS: One hundred and five patients, found on complete blood count having Pancytopenia were included, excluding patients that had been exposed to chemotherapy, and/or radiotherapy RESULTS: Causes in decreasing frequency were acute leukemia (30.47%), aplastic anemia (17.14%), megaloblastic anemia (13.33%), NHL (14.47%), MDS (8.57%), PNH (4.76%), TB, SLE, HD (2.58%) for each, and kalazar, and MM and HCL (1.9%) for each. Manifestations were fatigability (67.6%), bleeding tendency (55.8%), and fever (48%). CONCLUSION: Incidence of Pancytopenia may vary according to geographical, and genetic factors, and depending on parameters, and criteria of inclusion and exclusion. Acute leukemia was found the most common cause, followed by megaloblastic anemia.


Article
Correlation of Angiographic Findings and Clinical Presentations in Unstable Angina

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ABSTRACT: BACKGROUND: Unstable angina is usually related to acute thrombosis superimposed on a disrupted plaque. The highest; level of Braunwald classification of unstable angina can be used to assess the severity of clinical presentation. However the highest classes have not been directly correlated with thrombotic and complex lesions. OBJECTIVE: The study was done to clarify the correlation between angiographic findings and the most acute and / or severe clinical presentation in unstable angina. PATIENTS AND METHOD: We conducted a prospective study of 110 patients of unstable angina at Ibn-Albitar Center for Cardiac Surgery. All of these patients underwent cardiac catheterization, culprit lesion was identified in 80 patients and in 30 patients there was no an identifiable culprit lesion .Complex lesions including complex morphology, intracoronary thrombus, or total occlusion were also quantitatively analyzed and Thrombolysis in Myocardial Infarction (TIMI) flow grade was assessed. Patients were classified according to Braunwald classification in instable angina .We compared patients with and those with no culprit lesions in regarding Braunwald classification. We sequentially compared the highest Braunwald classes II, C, 3 with classes


Article
Hypolipoproteinemia as Biological Marker in Acute Leukemia

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ABSTRACT: BACKGROUND: Acute leukemia is a clonal hematopoietic malignant disease that arises from malignant transformation of an early hematopoietic stem cells .Seeking for biochemical markers that are associated with acute leukemia may help us for better understanding of the leukemic process &improve our lines of management.Hypolipoproteinemia is one of these markers&it is the target of this study. OBJECTIVE: To study the association between the hypolipoproteinemia ´ leukemia &the ability of using hypolipoproteinemia as a biological marker that is helpful in follow up of acute leukemia. PATIENT&METHODS: A total of fifty patients with acute leukemia diagnosed by blood film&bone marrow examination were compared with control group of twenty healthy persons regarding fasting lipid profile(TC total cholesterol,LDL low density lipoprotein,HDL high density lipoprotein,TG triglyceride). RESULTS: In this study there is close association between hypolipoproteinemia´ leukemia. The mean values of lipoproteins were significantly lower in patient with acute leukemia compared to control group(P value is 0.0001 for total cholesterol&0.045 for triglyceride). CONCLUSION: These data suggest that hypolipoproteinemia could be useful as a marker for follow up of acute leukemia.


Article
Hepatitis C Virus Infection Assessment Among Chronic Hemodialysis Patients in AL-Kadhmiya Teaching Hospital

Authors: Jawad K. Mnuti --- Fadhil A. AL- Abbudi
Pages: 460-464
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ABSTRACT: BACKGROUND: Hepatitis C virus (HCV) has been recognized as an emerging problem in dialysis patients, and viral hepatitis remains a major hazard for both patients and medical staff of hemodialysis (HD) units. The reported yearly incidence of anti-HCV antibody worldwide between HD patients ranges from 10.5% to 24%, while the prevalence of anti-HCV antibody among dialysis patients varies in different countries (5-85%) worldwide, and may exceed 95% in the Middle East OBJECTIVE: To asses the prevalence of anti-hepatitis C virus (HCV) among the hemodialysis unit in AL-Kadhmiya Teaching Hospital and to identify the risk factors of infection in relation to age, sex, blood transfusions and duration of dialysis PATIENTS AND METHODS: Across-sectional study was conducted in AL-Nahrain College of Medicine in AL-Kadhmiya Teaching Hospital in dialysis unit during the period from April 2008 to December 2010. 100 patients(58 male and 42 female their ages ranged from (15—75). are known cases of end stage renal failure on regular haemodialysis. All patients underwent a history and physical examination at baseline and investigations include blood urea nitrogen, creatinine, serum calcium, phosphorus, liver function test and screen for hepatitis C virus antibodies were tested by using Murex anti-HCV ELISA , Positive cases were confirmed by polymerase chain reaction RESULTS: The prevalence of HCV infection in patients in the dialysis unit was 41%. This study showed that there was an association between the history of blood transfusions, duration of the dialysis and kidney transplantation and the prevalence of HCV infection,( P.value <0.001.) Although the levels of AST and ALT were higher in the positive HCV marker group, there was no statistically significant difference between them. CONCLUSION: HCV infection is high in hemodialysis unit in alkadhmiya teaching hospital, HCV-related liver disease in patients on long-term dialysis often appears clinically mild, with only modest elevations in AST and ALT levels but most of them asymptomatic. Observation of appropriate preventive measures in the hemodialysis center is highly recommended


Article
Gastro-Esophageal Reflux Disease in a Sample of Healthy Iraqi Population

Authors: Amira H. Shubbar --- Layth Rafea Taqa
Pages: 465-472
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ABSTRACT: BACKGROUND: Symptoms consistent with GERD occur in more than one third of the American adults on a monthly basis and weekly in as many as 10%, while 4-10% on daily basis OBJECTIVE: To survey the prevalence of symptoms of GERD in a sample of healthy Iraqi population sample. METHOD: Prospective study from Jan 2000- Jun 2000 at the deferent wards of Al-Yarmook teaching hospital, Baghdad. Questionnaires were distributed to 950 healthy persons of different age group attending Al-Yarmouk teaching or visiting their patient at the hospital. The questionnaire included: Taking full history of symptoms suggestive of GERD, including habits and Body Mass Index. RESULTS: Heartburn was experienced by 239 (40.6%) once or more in their life, 30.6% on monthly basis, 11% on weekly basis, 8.3% on daily basis.6.2% of the respondents fulfill the criteria of the European expert panel (EPAGE) criteria for diagnosis of symptomatic GERD. CONCLUSION: Symptomatic GERD is common in our population. Chronic duration of the illness was recognized in one third of them predisposing them to the risk of barrett’s esophagus. Early referral is indicated for better diagnosis to prevent serious complications


Article
Homocysteine ,Folic acid ,Vitamin B12 and Pyridoxine : Effects on Vaso-Occlusive Crisis in Sickle Cell Anemia and Sickle –Thalassemia

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ABSTRACT: BACKGROUND: Hemoglubiopathies include sickle cell anemia and the Thalassemia . S/ β0- Thalassemia have a clinical course similar to HbSS. Elevated concentration of Homocysteine contribute to thrombosis , a frequent event in sickle cell anemia . Vitamin B12, Pyridoxine , and folic acid deficiencies lead to dangerous increase in plasma Homocysteine. OBJECTIVE: 1- To test whether children with sickle cell anemia and Sickle cell – Thalassemia have elevated concentration of serum Homocysteine with diminished level of folate, B6, B12. 2- To determine whether hyperomocysteinaemia has a correlation with the frequency of Vaso-occlusive crisis. PATIENTS AND METHOD: A case- control study was carried over a period of one year from Jan.- Dec. 2010 inclusive, 30 patients were collected from the Thalassemia centre in Ibn –AL-Baldy Hospital together with healthy 30 cases, age and sex matched ,were taken from AL- Kadhimiyia Teaching Hospital. Venous blood sample were aspirated from both groups to estimate serum Homocysteine, Folic acid, B12 and B6 level. Statistical analysis was done, using the student T-test ( P. value < 0.05 is considered as statistically significant) . Pearson correlation analysis was performed. RESULTS : The age of the patients range between (5-29) years, the majority of the patients were between ( 10 -19 ) years , 10 cases ( 38 .46 %). More than one half were male ,16 cases ( 61.54 %) . Sickle cell – Thalassemia constitute 20 cases (76.93%). Vaso-occlusive crisis was mainly involving the large joints, 15 cases (57.69 %). Mild attacks constitute more than half of the patients, 16 cases (61.54 %).Homocysteine level was higher in the patients group compared with control group with a mean and standard deviation of (44.52 ± 23.008) and (18.65 ± 4.56)μmol/L respectively . Folic acid level was lower, B12 level was higher, B6 level was lower in the patients group compared with control group with a mean and standard deviation of (11.32± 3.23) and (14.71 ± 3.39)ng /ml, (172.57± 61.34) and (103.45 ± 30.45)pg /ml, (4.43± 3.93) and (10.23 ± 2.30) ng/ml respectively, the results were statistically not significant, P. value > 0.05. Significant inverse correlation was found between Homocysteine level and B6 level. A strong positive correlation between Homocysteine level and the frequency of Vaso-occlusive crisis was found. CONCLUSION: Patients with sickle cell disease have high serum level of Homocysteine with low level of folic acid and pyridoxine. This Hyperomocysteinaemia is significantly inversely correlated with pyridoxine deficiency , but positively correlated with the frequency of Vaso-occlusive crisis.


Article
The Detection of Neutrophiles in Gastric Mucosa of Patients Suspected to be Infected with Helicobacter Pylori Using Leukostix

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ABSTRACT: BACKGROUND: Helicobacter pylori has been detected in many populations and associated with inflammation of gastro duodenal mucosa. Colonization of the stomach by Helicobacter pylori occurs in more than half of human population worldwide. It is the principle cause of chronic active gastritis, peptic ulcer and gastric cancer. OBJCTIVE: To detect neutrophiles in homogenates biopsied gastric mucosa semiquantitatively using rapid leukocyte strip test (leukostix). METHODS: A total of 115 patients (74 males, 41 females) referred to The Gastrointestinal Tract Center and Gastroscopy Department of Baghdad Medical City and subjected to gastroscopy were included in this study during the period from November 2004 to May 2005. RESULTS: The sensitivity and specificity of leukostix at the initial examination were 95.8%, 88.23% respectively. CONCLUSION: The leukostix test, using biopsied samples of gastric mucosa was excellent for quantitative determination of neutrophils in patients infected with H pylori


Article
Prosthesis-Patient Mismatches in Aortic Valve Replacement a Study in Ibn Al-Bitar Hospital for Cardiac Surgery

Authors: Darya Akram Faqe Mahmood
Pages: 484-492
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ABSTRACT: BACKGROUND: Use of new generation small prostheses for aortic valve replacement has decreased the need for annular enlargement and rarely increased the incidence of severe patient-prosthesis mismatch; OBJECTIVE: Of this study is to evaluate the impact of using this type of prosthesis (St.Jude. HP, Regent) on operative mortality. PATINETS & METHODS: We reviewed our experience (59) consecutive patients who had isolated and combined aortic valve replacement in our hospital between February 2001 and February 2007. RESULTS: The mean age was 36, and 60 % of patients were female.valvular disease was primarily pure aortic regurgitation 47%, combined aortic disease 29% and pure aortic stenosis was present in 24%. CONCLUSION: Evaluation of the impact of newly designed small prosthesis on thirty-day mortality revealed: thirty-day mortality was 8% and the strongest independent predictors in multivariate analysis in decreasing order of statistical power were functional class IV, patient-prosthesis mismatch, advanced age (65 year), very small valve size (labeled valve size 17-mm), isolated aortic valve replacement surgery without other concomitant procedure (P=0.022) and obese patients (body mass index >33 kg/ m²).


Article
Evaluation of Vermilion-Mucosa Flaps for Reconstruction of Oral Commissure Burn Microstomia

Authors: Ari R. Qader --- Kurdo A. Mohmmad
Pages: 493-498
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ABSTRACT: BACKGROUND: The reconstruction of the oral commissure microstomia is one of the complex tasks in plastic surgery and the most important issue to be considered is to provide a good functional and acceptable aesthetic result. Various local and regional flaps have been described for this purpose. The vermilion - mucosa flaps are frequently used flaps in reconstruction of small to medium sized microstomia. The reliable blood supply, minimal donor site morbidity and excellent texture and color match are some of the advantages of these flaps. OBJECTIVE: This study is to evaluate our results with vermilion-mucosa flaps in the reconstruction of oral commissure. PATIENT AND METHOD: This prospective study was done in Sulaimani plastic, reconstructive and burn hospital from April 2008 to September 2009 with minimum follow-ups of 6 months. The total number of patients was fifteen, the age of patient arranged between 1month to 47 years, the flaps designed as vermillion advancement flaps in 7 cases, vermilion-mucosa flaps in 4 cases, and tri -lobes buccal mucosal flaps in 4 cases. The cause of the deformities was , post burn scaring and contracture involving oral commissure, of which twelve cases treated bilaterally, and only three cases treated by unilateral commissuroplasty. RESULTS: The flaps were survived and most of the patients were satisfied with the outcome of the operation. Marginal necrosis of one flap was encountered; drooling was encountered in only one patient and it gradually disappeared with time. CONCLUSION: The oral vermilion mucosa flaps are reliable tools for reconstruction of small to moderate- sized commissure microstomia. The flaps provide good functional and aesthetic results with reduced necessity for prolonged splinting and secondary procedure and minimal donor site morbidity


Article
Mortality Rate Among Low Birth Weight Infants in Al- Battool Teaching Hospital , Diyala Province, Iraq

Authors: Dawood Salman Hameed Alazzawi
Pages: 499-503
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ABSTRACT: BACKGROUND: An analytic cross-sectional study through which a review for the records of all patients admitted to neonatal nursery in Al-Battool teaching hospital,Diyala province, Iraq during the first six months of 2003 and 2009 were performed. OBJECTIVE: To demnstrate the deterioration of the condition of low birth weight infants. PATIENTS AND METHODS: This study about mortality rate among low birth weight infants who delivered in Al-Battool teaching hospital Diyala governorate including the records of 366 patients admitted during first six months of 2003 and compared with records of 558 patients admitted during the same period of 2009. Information has been studied extensively for gestational age, birth weight, predisposing factors and mortality. RESULTS: Mortality rate is increased to 30% during 2009, while it was 12% during 2003. Increase percentage of low birth weight infants (28-36wks) during first 6months 2009 (49%), as compared to first 6 months 2003 (45%). Increase in congenital abnormalities rate (ranging from cleft palate to congenital heart diseases) (42%) on 2009 as compared to (29%) on 2003. Increase number of low birth weight infants to total deliveries at hospital (13.1%) during 2009 as compared to (11.7%) during 2003. CONCLUSION: High mortality rate, increase percentage of low birth weight infants and increase cases of congenital abnormalities during 2009, to be studied extensively and thoroughly regarding the environmental causes and health services availability.


Article
Autism Among Children Attending Pediatric Psychiatric Department in Child's Central Teaching Hospital in Baghdad: a Descreptive Study

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ABSTRACT: BACKGROUND: Autism is a spectrum of neuropsychiatric disorders that affects children from all ethnic and socioeconomic backgrounds. The diagnosis is based on their developmental and medical history as well as observations of their social, communicative, and play behaviors that usually begin before age of three years. OBJECTIVE: A descriptive study of autism to describe the prevalence of autism among childhood psychiatric disorders, the age for diagnosis of autism, sex distribution, family history and the clinical features of autism. PATIENTS AND METHODS: A cross-sectional study included a sample of 208 children with psychiatric disorder, who were attending pediatric psychiatric department evaluated for the criteria of autism. Data collected were including (the age at the diagnosis, sex, family history and clinical characters included the main clinical features and other associated features of autism). RESULTS: Of the 208 patients registered psychiatric problem, 33(15.87%) met criteria for autism, the mean age for the diagnosis of autism was 5.45 years with the boys more predominant than girls. Three main clinical features of autism are communication abnormality, social abnormality and behavioral abnormality. The communication abnormality were the most commonest features. Other associated features included enuresis (the commonest), encopresis, sleep problems, over activity and anxiety. Macrocephaly and seizure are important clinical characters of autism presented in 12% and 9.1% respectively. CONCLUSION: Autism is not rare and autistic children represent a significant subgroup of children with serious psychiatric disturbance. Speech delay and abnormalities in language are the hallmark features of autistic disturbance.


Article
Knowledge and Preference of Mothers Delivering at ALKadhumyia Teaching Hospital Regarding Caesarean Section and Normal Vaginal Delivery

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ABSTRACT : BACKGROUND: Caesarean section rates are progressively rising in many parts of the world. One suggested reason is increasing requests by women for caesarean section in the absence of clear medical indications. OBJECTIVE: To determined the medical and non medical reasons behind the caesarean section. To identify the mothers preference to the mode of delivary and reasons behind this preference. MATERIALS AND METHODS: Across sectional study of 480 mothers was interviewed .The data was collected using a questionnaire form includes information under two main headings: 1) Information related to the mother; these include demographic and some obstetrical information, obstetrical 2) Knowledge of mothers regarding reasons behind their caesarean section.3) Information related to mother preference. RESULTS: The majority of mothers 317(66%) were delivered by Caesarean section ,the majority of Caesarean section mothers (41%) were of (36-45) years of age , (47.3%) completed primary education., ( 89%) of them reported medical reasons behind their Caeserean section, (25.9%) of mothers with medical reasons reported a history of Caeserean section as the main medical reason .Regarding the non medical reasons the majority of mothers (45.7%) reported Fear of vaginal delivery as the main non medical reasons . The majority 384(80%) of mothers prefer NVD while only (20%) reported their preference to C-section CONCLUSION: The caesarean section rate was high, history of Caeserean section were the main medical reason behind caesarean section , fear of vaginal delivary was the main non medicval reason behind caesarean section. Majority of mothers prefer NVD than C-section


Article
Whether Selective or Routine Episiotomy is more Useful to Protect Anal Sphincter in Primiparous Women

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BACKGROUND: Perineal trauma is a common event, affecting up to 90% of first time mothers. It is a cause for concern for many women and in some countries has led to a large increase in the numbers of women requesting elective caesarean section. OBJECTIVE: To highlight when episiotomy can be useful in preventing anal sphincter injury in primiparous women. MATERIALS AND METHODS: This study is a prospective interventional clinical study conducted at AL-Elwiya Maternity Teaching Hospital in Baghdad throughout the period between Jan. 2009- Dec. 2009. Three hundred term primiparous ladies at time of their delivery with cephalic presentation were collected and subdivided into 3 equal groups randomly. The first group, women who were subjected to routine mediolateral episiotomy, while the second group of the participants were delivered without doing episiotomy, and the third group, a mediolateral episiotomy was done selectively to them when we found it is necessary (selective episiotomy). State of the perineum, length of 2nd stage, weight of the baby, fetal head position and the occurrence of anal sphincter injury were all notified and carefully recorded on special form designed for the study. RESULTS: Selective episiotomy was found to be more useful than routine episiotomy in preventing anal sphincter injury (the incidence of anal sphincter injury was 2% for those in whom episiotomy was performed selectively, while it is 8% for those with routine episiotomy and 7% for those delivered without episiotomy), and the difference is statistically significant (P value 0.045). There was a significant effect of the length of second stage of labour on the incidence of anal sphincter injury (P value 0.017), similarly for the weight of baby (P value 0.017). CONCLUSION: Selective episiotomy is more useful intervention than routine episiotomy in protecting the anal sphincter when delivering a primiparous lady.


Article
Intraoperative Albumin Plus Crystalloid Solution Versus Crystalloid Alone in Renal Transplant Surgery

Authors: Alaa Hussein Ali
Pages: 526-530
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ABSTRACT: BACKGROUND: Chronic renal failure is defined as an irreversible deterioration in renal function which classically develops over a period of months or years. renal transplantation is the treatment of choice for end stage renal failure and during surgery the maintenance and restoration of intravascular volume are essential tasks to achieve sufficient organ function in renal transplants. OBJECTIVE: To study the comparison between normal saline 0.9% with glucose 5 % and normal saline 0.9% , glucose 5 % with albumin in renal transplantation. METHODS: The study data from 50 patients 47 patients underwent living donor kidney transplants three were excluded because they are diabetics .twenty three patients received normal saline 0.9% , glucose saline 5%,and twenty four received normal saline 0.9 with glucose 5% and albumin 100 milliliter . RESULT: There was no statistical difference between the two groups in the primary measurement of outcome measure in the urine output in the 1st day and the serum creatinine in the 1stand 3rd day . CONCLUSION: Although statistically there was no difference in the two groups, it might be its useful to combine a colloid with a crystalloid in the fluid management regimen to improve microcirculation, oxygen perfusion and to ovoid large volumes of crystalloid.


Article
The Role of P53 nuclear Protein in Prediction of Progression and Recurrence of Superficial Tumor of the Bladder in Response to Intravesical Chemotherapy

Authors: Montadhar Hameed Nima --- Rasha Abbas Azeez
Pages: 531-535
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ABSTRACT: BACKGROUND : p53 gene is the most common mutation in human cancers.In bladder cancer, p53 mutations have been associated with high tumor grades and advanced stages.Moreover,p53 nuclear over expression appears to be an independent predictor of disease progression and decreased survival after cystectomy. OBJECTIVE: To identify the role of p53 nuclear protein in prediction the progression and recurrence of superficial tumor of the bladder in response to intravesical chemotherapy PATIENTS AND METHOD : The expression of p53 protien was studied by immunohistochemical analysis from 71 patients with superficial tumor bladder and all of them were treated by intravesical chemotherapy followed periodically every three months by cystoscopy RESULT : P53 over expression was observed in 38out of 71(54%) patients with superficial tumor of the bladder. A statisticaly significant relation was noticed between P53 over expression and tumor grades , however statistical significant relation between p53 negative expression and response to intravesical mitomycin C chemotherapy was noticed , moreover , patients who received intravesical mitomycin C chemotherapy , 71% showed response with in 3 month , while 29% showed recurrence . Moreover, it seems that P53 status did predict response to intravesical mitomycin C chemotherapy. CONCLUSION : The response of intravesical chemotherapy in patients with superficial transitional cell carcinoma was higher in p53 negative expression.


Article
Bladder Mucosal Pathological Changes Accompany High Grade and Squamous Cell Bladder Tumors

Authors: Jassim Mohammad Alkhazraji
Pages: 536-541
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ABSTRACT: BACKGROUND: Carcinoma of the bladder is the second most common cancer in Iraq. The status of the bladder urothelium other than the principal lesions can provide distinct diagnostic information with regard to treatment response and outcome. Positive mucosal biopsy results are a significant indicator of intravesical recurrence. Currently, in our urological practice, the importance of performing this step in cystoscopy is relatively underestimated. OBJECTIVE: The objective of this study is to carry out a histological assessment of 'extra-tumor' bladder mucosa for dysplasia, and correlate the resulting findings of dysplasia with the grade, the type, and the macroscopic appearance of the tumor. MATERIALS AND METHODS: A total of 350 biopsies were taken by cystoscopy from 68 patients admitted with bladder tumors, either by cold-cupped biopsy forceps or resectoscope as part of TUR of the tumor. Normal-looking mucosa of the bladder was included in each patient's biopsy in a four quadrant way. All biopsies were examined by the same histopathologist. All patients were managed according to their presentation, cystoscopic and histopathological findings. RESULTS: Statistical analysis showed that the highest significant difference was obtained in patients with tumor grade, low against high grade (p<0.005). However, a noticeable difference was found in the other two comparison groups, namely, the type, transitional against squamous and the macroscopic appearance, papillary against solid (p<0.05). CONCLUSION: The high grade, solid tumors and squamous cell carcinoma are associated with general bladder mucosal dysplastic changes which may exclude the bladder preserving procedures as an option of surgical treatment. In Iraq, more extensive studies are necessary to come out with appropriate guidelines for a better treatment and outcome of bladder carcinoma which is a major health problem


Article
Medico-Legal Applications of Multiplex STR System to Show Allel Frequencies of D16S 539, D13S317, and D7S820 in Iraqis

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ABSTRACT: BACKGROUND: Disputed paternity is one of the most important medico-legal problems in Iraq. In addition to identification of unknown corpses. Paternity cases are resolved by doing ABO typing and HLA serotyping and both are less accurate than DNA typing. To our knowledge this is the first study of such type in Iraq. OBJCTIVE: To show the medico-legal importance of determination of allel frequencies in Iraqi population. SUBJECTS AND METHODS: Whole blood was obtained in EDTA tubes by venepuncture from 38 individuals. The DNA was extracted using the Wizard Genomic DNA Purification Kit and the quantity was estimated by UV-absorbance. The multiplex analysis of D16S539, D7S720, and D13S317 was performed using the Gene Print STR Multiplex system. Amplification was performed in eppendorf thermal cycler. The PCR products were typed by vertical electrophoresis on 0.4 mm thick 7% denaturing polyacrylamide gel and silver staining. RESULTS: In our study the DNA fingerprinting test has high accuracy rate. CONCLUSION: Since the DNA typing is the most accurate method so it can be routinely used as a paternity test, it is the only test that can meet the increasingly imperative demand to resolve the social and judicial problems involved in paternity suits and other medico-legal problems

Keywords


Article
Serum Enzyme Activities in Human Thyroid Diseases

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ABSTRACT: BACKGROUND: The study enrolled a total of 76 patients with thyroid gland diseases, hyperthyroidism and hypothyroidism. The activities of the enzyme amylase, gamma glutamyltransferase and alkaline phosphatase were evaluated in these diseases state and were compared with normal healthy thyroid gland. The specimens were obtained from different hospitals in Baghdad and from routine clinical works. OBJECTIVE: Diagnosis of patients with thyroid gland diseases hyper and hypothyroidism by evaluation of enzymes activity of amylase, GGT and ALP. METHOD: Two groups of patients were used: The first consists of 38 patients with hyperthyroidism, the second consists of also 38 are patients with hypothyroidism. Twenty five of each group was investigated for amylase, GGT, ALP and were compared with third group of 25 normal healthy thyroid gland. The remaining 13 out of 38 patients of each group were tested for enzymes, amylase, GGT, ALP, GOT, GPT and evaluate the hormones, they were compared with third group of 10 normal healthy thyroid gland. RESULTS: There was a highly significant increase and decrease in the activity of amylase, GGT and ALP in hyper and hypothyroidism patients (P<0.001) when compared with third group normal. CONCLUSION: Diagnosis of patients with thyroid gland diseases can be confirmed by enzymes investigation in blood serum and hormonal assay


Article
Etiologies of Adult Onset Epilepsy: Clinical and Paraclinical Study in the Governorate of Babylon

Authors: Kareem Al-Tameemi
Pages: 555-561
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ABSTRACT: BACKGROUND : Adult onset epilepsy (AOE) is considered the epilepsy that start after the age of 18 years. It is a common disorder, and it’s etiology is variable from one place to another. OBJECTIVE : to study the etiologies, diagnosis and treatment of AOE in one governorate of Iraq and to compare it’s different clinical and paraclinical abnormalities in different age groups. PATIENTS & METHODS: 106 patients with AOE were enrolled in this prospective study, and included all patients who developed seizure after the age 18. The study was done in a heavy neurological clinic in north of Babylon governorate, Iraq, for 3 years from Sept. 2007 to Sept. 2010. RESULTS: A total of 102 patients met the criteria. Brain tumors were found in 24 (23.5%). No cause could be found in 25 (24.5%) of cases. Generalized tonic clonic seizure was registered in 47 patients (46%). EEG was positive in (57.3%) of cases and the MRI was conclusive in 63.7% of them. CONCLUSION: Brain tumors, CVD, post traumatic and inflammatory disease are the four major causes of AOE in Iraq. The most common type of seizure among different groups of etiologies of AOE is focal epilepsy.

Keywords

pilepsy --- seizure


Article
Effects of Herbs – Containing Phytoestrogens on Rat Testis: A Histological, Histochemical and Biochemical Study

Authors: Malak A. Al-Yawer
Pages: 562-572
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ABSTRACT: BACKGROUND: Estrogens has traditionally been known as the female hormone, but this idea has been challenged in early 1990’s and an essential physiological role for estrogen in male fertility was identified. Phytoestrogens are naturally occurring non-steroidal plant chemicals that can act like the female hormone estrogen. The herbs ( anise alfalfa and vervain ) chosen in this study contain phytoestrogens. OBJECTIVE: Previous studies demonstrated controversy of the effects of phytoestrogens on the rat testes .Hence, the present investigation was undertaken to investigate the influence of typical dose of herbs containing phytoestrogen on the rat testis. MATERIALS AND METHODS: Twenty-four apparently normal mature male rats were divided into four groups of 6 animals each. The first "control" group received only 4ml of distilled water as a placebo. The second group received 40mg/kg of anise seed; the third group received 53.3 mg/kg of dried herb of vervain and the fourth group received 400 mg /kg of alfalfa seeds. All experimental groups received the doses through oro-gastric tube daily for fourteen days. Testicular histology was evaluated by light and enzyme histochemistry. Plasma FSH and testosterone concentrations were taken to support our results. RESULTS: Histological examination of anise, alfalfa and vervain – treated groups showed an increase in the height of germinal epithelia. There was marked lipoprotein lipase activity in the whole of the interstitial tissue which is more in amount in experimental groups than that in control group. Acid phosphatase granules were infiltered the seminiferous epithelia mildly in control group , moderately in anise and vervain groups and markedly in alfalfa group. The number of interstitial cells showing marked acid phosphatase activity was higher in all experimental groups than that in control group. Alkaline phosphatase exhibited intense activity in the boundary tissue of the seminiferous tubules in testes of control and experimental groups but it appeared thicker in the latter. CONCLUSION: The low dose and short duration of treatment used in our study made these phytoestrogen – containing herbs to have a stimulatory effect on leydig cell steroidogenesis. This study also demonstrated that aniseed being the most potent of the three herbs followed by alfalfa in stimulating testosterone synthesis. This is possibly attributed to the coumarin constituent of aniseed and alfalfa.


Article
Primary Orbital Yolk Sac Tumor

Authors: Adel Rabea Alsaadawi
Pages: 573-575
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Abstract

ABSRACT: PURPOSE: To report unusual case of a girl with primary orbital yolk sac tumor

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Article
Undifferentiated (Embryonal) Sarcoma of the Liver. Case Report and Review of Literature

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Abstract

ABSTRACT: Undifferentiated (embryonal) sarcoma of the liver was first defined as a separate clinicopathological entity in 1978. it is uncommon hepatic tumor of mesenchymal origin, usually observed in children and teenage, but also infrequently encounter in adult. It represent about 9-15% of all hepatic tumor in children. We report a case of undifferentiated embryonal sarcoma of the liver in a 6 year old girl who presented with non specific right hypochondrial pain and mass with fever. Laboratory studies of the liver function were normal and the other tests were non specific. Ultrasonography and CT scan showed a large heterogeneous mass ranging from cystic tissue with multiple septa to more predominant solid component in the right lobe of the liver. Exploratory laparotomy was performed and revealed a large mass in the right lobe and part of the left lobe of the liver. Tumor resection was performed and about 70% of the total liver was resected. Macroscopically, tumor was large solitary globular firm predominant solid mass weighing 1100gm and measuring 18 x 12 x 8 cm, with variegated cut surface of solid, cystic, necrotic and hemorrhagic areas. Microscopically, the tumor has a variable but distinctive sarcomatous appearance, composed of spindle, oval and stellate-shaped sarcomatous cells, with marked nuclear pleomorphism, closely packed in whorls or scattered loosely in a myxoid ground substance. Numerous bizarre multinucleated giant cells, containing large intracytoplasmic hyaline globules with ample mitosis many of which are atypical. Tumor cells entrapped hyperplastic bile ducts. Accordingly the diagnosis of *Pathology Department, College of Medicine, University of Mosul. **Pathology Lab, Al-Khansa'a Maternity Teaching Hospital, Mosul. *** Department of Surgery, Nineveh College of Medicine, University of Mosul. ****Department of Pathology, College of Medicine, Baghdad University, Iraq. undifferentiated embryonal sarcoma of the liver was performed. Conclusion: Prompt detection of this aggressive tumor with complete surgical resection is the key to a successful outcome. Prognosis recently improved following postoperative chemotherapy.

Table of content: volume:10 issue:4