Table of content

Medical Journal of Babylon

مجلة بابل الطبية

ISSN: 1812156X 23126760
Publisher: Babylon University
Faculty: Medicine
Language: English

This journal is Open Access

About

Medical Journal of Babylon (MJB) is a quarterly medical journal concerned with clinical and basic medical researches. MJB follows the Publication Ethics Statements suggested by Committee on Publication Ethics (COPE) and International Committee of Medical Journal Editors (ICMJE).

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العنوان البريدي: العراق-محافظة بابل- الحلة –ص ب 473 جامعة بابل –كلية الطب – مجلة بابل الطبية
عنوان البريد الالكتروني medjbabylon2004@gmail.com

Table of content: 2005 volume:2 issue:2

Article
Heparin Induced Thrombocytopenia in Ischaemic Heart Diseases

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Abstract

Heparin is widely used antithrombotic agent for the treatment and prevention of thromboembolic disorders in medical and surgical patients. One of the most important side effect is thrombocytopenia which may lead to life threatening haemorrhagic and thrombotic complications. The condition is known as heparin induced thrombocytopenia (HIT type 2). [1-3] To determine the frequency, timing of HIT and its complications in the patients receiving unfractionated heparin (UFH) . The study done on the patients who were admitted to cardiac care unit in Merjan teaching hospital in Babylon city, suffering from acute myocardial infarction( AMI) or unstable angina (UA).The patients received UFH for a period varies between 5-10 days. The duration of the study was 6 months, from April 2004 to September 2004.60 adult patients included in the study, with age varies between (28-84) years old. 40 patients received intravenous heparin (IV) and 20 patients received subcutaneous heparin (SC). We considered that normal platelets count is (150-450 x10 9 /L) and thrombocytopenia type 2 with platelets count less than 150 x10 9 /L, or decrease in the platelets count to less than 50% from the baseline. Baseline platelets count, haemoglobin, haematocrit, leucocytes count, activated partial thromboplastine time (APTT) before commencement of heparin therapy.The diagnosis of HIT based on platelets counts (direct visual method) and not on serological tests. Mild thrombocytopenia (type 1) occurred in (12/40) in I.V route with a percentage of 30 % and in (3/20)(15%) in S.C route heparin. 5% of patients who received SC and IV heparin developed Type 2 HIT. The platelets count ranging from (90-120 x10 9 /L) in IV route and the platelets count was 60x 10 9 /L in SC route.The onset of thrombocytopenia was between the day 5to day 7.No clinical complications occurred in both routes. So HIT is a common complication of heparin.

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Article
Dual Blockade of Renin – Angiotensin System in Patients with Diabetic Nephropathy

Authors: Anwer G. Jabir
Pages: 146-149
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Abstract

Proteinuria and hypertention are predictors of poor renal and cardiovascular outcome in patients with diebetice . We tested the effect of dual blocked of the renin - angiotensin system (RAS ) in patients With diabetic nephropathy ( DN) . We performed a randomised trial with 2 months treatment of 80 mg valsartan added to catopeil ( 100mg /day ) . We included 12 patients with DN .At end of each treatment period , proteinuria , blood pressure and glomerular filtration rate (GFR) Were measured . Addidition of 80 mg of valsartan to patient on ACE inhibitor (captopril) induced a mean reduction in proteinuria of 40%( p- value <0.001 ) ,a reduction in arterial blood pressure of 10 mmHg systolic , and 6 mmHg diastolic ( p-value = 0.-09 and 0.012 respectively ) . GFR remained unchanged significantly . Dual blockade of the RAS offers an addition renal and cardiovascular protection in patiens with diabetic nephropathy .

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Article
Immunohistochemical Detection of MDA –DNA Adducts in Oral Mucosa of Smokers and Nonsmokers

Authors: Ali Hassan AL–Timimi --- Raad Ali Jassim
Pages: 150-157
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Abstract

Malondialdehyde (MDA) is a major lipid peroxidation product that is mutagenic and tumorigenic. MDA-modified DNA adducts have been detected in animal and human tissues and may be a marker of human cancer risk. An immunohistochemical method, using a previously generated monoclonal antibody specific for MDA–DNA adducts, has been developed for the detection and quantification of DNA damage in human oral mucosa cells. The method was used initially on mice liver cells treated with and without MDA, and then applied to the detection of adducts in oral mucosa cells of smokers and non-smokers. Levels of DNA damage were elevated in 25 smokers (mean relative staining intensity 97 ± 41) compared with 25 age-, and sex-matched non-smokers (74 ± 17, P < 0.02). These results demonstrate that MDA–DNA adducts can be measured in single cells of human samples by an immunohistochemical method. This methodology provides a simple way to monitor MDA–DNA damage and should be useful for studies investigating the role of exogenous and endogenous agents in oxidative stress and carcinogenesis.

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Article
Study of Proliferation Markers in Normal and Diseased Uterine Cervix

Authors: Ali Hassan Altimimi --- Layla Abdul Amir
Pages: 158-165
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Abstract

Carcinoma of the cervix is one of the most common malignancies. Papanicolaou (Pap) smear tests have reduced mortality by up to 70%. Nevertheless their interpretation is notoriously difficult with high false-negative rates and frequently fatal consequences. We have addressed this problem by using affinity-purified antibodies against human proteins that regulate DNA replication, namely Cdc6 and Mcm5. Our materials were obtained from 100 smears and 60 cervical biopsies specimens taken at colposcopy clinics. Twenty-seven biopsies showed high-grade squamous intraepithelial lesions (HSILs), and 14 showed low-grade squamous intraepithelial lesions (LSILs). Normal cervical tissue was obtained from age-matched patients undergoing hysterectomy for diseases unrelated to the cervix (n = 19). These antibodies were applied to sections and smears of normal and diseased uterine cervix by using immunohistochemical technique to detect abnormal precursor malignant cells. Antibodies against Cdc6 and Mcm5 stain abnormal cells in cervical smears and sections with remarkably high specificity and sensitivity. Proliferation markers Ki-67 and proliferating cell nuclear antigen are much less effective. The majority of abnormal precursor malignant cells are stained in both low-grade and high-grade squamous intraepithelial lesions. Immunostaining of cervical smears can be combined with the conventional Pap stain so that all the morphological information from the conventional method is conserved. Thus antibodies against proteins that regulate DNA replication can reduce the high false-negative rate of the Pap smear test .

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Article
Reticuloendothelial Clearance of Klebsiella pneumoniae

Authors: Alaa J.Hassan --- Mohammed A.K Al-Sa’adi
Pages: 166-168
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Abstract

A lapin adult and baby experimental model were elected to assess the bacterial RES clearance . The clearance indicator was Klebsiella pneumoniae (5 × 10 9 (viable cell/ml) / Kg),the inoculation route was intravenous (IV) , the clearance time was one hour post an IV injection and the judjment criteria for clearance ability were the remaining viable count of K. pneumoniae in tissue homogenate cultures . The highest clearing effeciency was that of blood followed by liver, lung and then spleen in babies, while the highest was blood , lungs , spleen , followed by liver in adults . The mean whole adult clearing efficiency was higher than in baby , comparing K. pneumoniae clearance to E. coli clearance indicates a lapin E.coli enhanced clearance than K. pneumoniae clearance.

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Article
Effect of proteinous compounds from Portulaca oleracea L. plant on some biochemical parameters in mice

Authors: Nahida Saieed AL – Chalabi
Pages: 169-176
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Abstract

Two proteinous compounds (A and B) were isolated by gel filtration chromatography of the acetone precipitate of the aqueous extract of Portulaca oleracea L. plant. Comparative apparent molecular weights determination by gel filtration using standard proteins gave a value of 28184 and 2291 dalton respectively.The effect of the isolated proteinous compounds A , B and the hormone of insulin on some biochemical parameters such as blood glucose , cholesterol , triglycerides ,total lipids levels and glycogen content in liver tissues was studied in fasting mice. A single intraperitoneal injection of the isolated compounds (A ,B) at a dose of 77.5 mg/kg B.W. was given to normal mice which showed a significant decrease of serum glucose, cholesterol, triglycerides, total lipids level and glycogen content in liver tissues when compared to the controlled group, wherease insulin and compound B showed a significant increase in glycogen content of liver tissues.

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Article
Anthropometric measurements and lipid Profile Study during Ramadan Fasting

Authors: Moayad Younis Altaee --- Akram J Ahamed
Pages: 177-182
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Abstract

This study was designed to examine the influencr of Ramadan fasting on various anthropometric measures and lipid profile in young healthy lraqi house physicians.The participants were 28 subjects , age range 25-33 years during Ramadan of 1415 Hijra. Anthreopometrics and plasma lipids were measured on first morning of Ramadan ,mid – Ramadan , and of Ramadan ,and two errks aftee Ramadan . Fasting in Ramadan changes the plasma lipids positively cholesterol is reduced , HDL is increased , and both LDL and triglycerides are reduced . Weight ,BMI , and skin fold thisknrss showed some parallel changes to that of lipids Mid – arm muscle circumference ( MAMC ) had boon altered , a point in favor of the sparing effect of fasting on muscle glycogen breakdown . This woek add a new data in relation to adaptive mechanism during Ramadan fasting and its hypolipidimic influence

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Article
Expression Immunohistochemical Study of CA-125 in Endometrial Hyperplasia in Correlation to its Grade and Progressive Endometrial Carcinoma.

Authors: As’ad Abdul Hamza Al-Janabi
Pages: 183-189
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Abstract

CA-125 tumor marker is encountered in most patients with ovarian carcinoma and little has been reported about its role in endometrial carcinoma. This study was designed to assess the immunohistochemical expression of CA-125 in paraffin blocks of patients with endometrial hyperplasia and endometrial carcinoma and to clarify any correlation between these two conditions. Forty four patients with different grades of endometrial hyperplasia ranging from 38 to 56 years and 16 cases of endometrial carcinoma ranging from 48 to 69 years were included in this study and conducted in Department of Pathology, College of Medicine, Kufa University, during the period from December 2001 to November 2003. CA-125 tumor marker immunohistochemical overexpression was reported in 38.6% of endometrial hyperplasia and 62.5% of endometrial carcinoma, it looks to be more frequently reported in those with adenomatus and atypical types than simple cystic type, and well correlation has been reported between the intensity of expression and the grade of endometrial hyperplasia as well as endometrial carcinoma. We conclude that endometrial hyperplasia and endometrial carcinoma may share the same pathogenesis in some aspect. CA-125 tumor marker expression could be considered as an early predictive parameter for the diagnosis of endometrial carcinoma and could be used as as screening test for assessment of malignant potential of endometrial hyperplasia. Up to our knowledge, we didn’t found any published sudy regarding CA-125 immunohistochemistry in endometrial hyperplasia in Iraq and surrounding areas.

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Article
Celiac Disease among patients with iron deficency anemia

Authors: Abbas Ali Mansour --- Sarkes Gregor
Pages: 190-195
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Abstract

Iron deficiency anemia (IDA) is one of the most common presenting features of coeliac disease (CD). The aim of this study is to find the prevalence of CD among patients with otherwise unexplained IDA and reviewing the literatures. This was a cross sectional study of patients with IDA. Gastroduodenoscopy was performed to determine the cause of anemia.Four biopsies were taken from the second part of duodenum. Small intestinal histologic features were interpreted according to the revised Marsh criteria. Total number of patients was 47, 28 males and 19 females. Mean age of 26.9±13.3 years. Twenty of 47 patients (42%) had biopsy result consistent with CD .All CD patients were at age of 28 year and below. Only one patient was at age of 45 year. Out of 20 CD patients, 16 were having Marsh grade IIIB and 4 with Marsh grade IIIC.Fourteen were males and 6 were females All patients with other wise unexplained IDA should have upper gastrointestinal endoscopy with at least four biopsies from the duodenum to exclude CD. Key words: Coeliac disease, iron deficiency anemia, duodenal biopsy

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Article
Survey of Reasons for Extraction of Permanent Teeth in Al-Tajiat and Al-Qaderia Villages

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Abstract

The purpose of the study is to collect information on the reason of extraction of permanent teeth, randomly selected, in rural areas, in two Iraqi villages (Al-Qaderia, and Al-Tajiat) in the sixth trial carried out the University of Baghdad. Oral examination of (847) individuals, were performed, 352 from the first village and 495 from the second village, between 5-85 years of age, were extracted during 10 days of working activity, males were (43.2%) while females were (56.5%).From 310 patients had tooth extracted, about (87.74%) of the teeth were extracted for dental caries and (12.26%) for periodontal disease. Significant difference was found between the first and second villages which were (30.65%) of caries of the 1 st village.(57.09%) of caries of the 2 nd village, not significant difference was found for periodontal disease which were (5.8%) of 1 st village (6.45 %) of 2 nd village. Caries was the most important reason for tooth extraction in both villages than periodontal disease. More teeth lost due to caries among females than males and significant difference was found between multiple and single tooth extraction. Dental practitioners should promote target initiatives for prevention and treatment of diseases in order to reduce in particular the incidence of tooth extraction because of caries and periodontal disease.

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Article
Detecting Leukocytospermia by Melyoperoxidase Staining Method for Patients of Baghdad IVF Institute

Authors: Saad S.Al-Dujaily
Pages: 200-204
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The objective of this study is to detect the leukocytes concentration in the semen of infertile and fertile patients The study include three hundred and forty men refered to IVF Institute, Baghdad Teaching Hospital,. They are 290 infertile men and 50 fertile men (control). Semen analysis was done and the patients divided into subgroups according to male infertility factors .Seminal myeloperoxidase cytochemical test (Endtz method) performed for all specimens to differentiate between the leukocytes and other round cells. The concentration of Leukocytes were account using high power field (HPF) method and Endtz. The results revealed Leukocyte concentration in normospermic patients(control) by using HPF method was significantly(P<0.01) higher than Endtz method. In oligospermic, asthenospermic and oligo-astheno- terato spermic men,the mean of leukocyte concentration by using HPF was significantly lower(P<0.05) compared to using Endtz method. There was a highly significant (P<0.01) decrease in the number of leukocytes by using Endtz method compared with the round cells detected by using HPF method. It was concluded that myeloperoxidase (Endtz) method can be detect the leukocytes concentration in the semen and differentiate them from other round cells. This method is easy to performed ,complete with short time with high accuracy ,not cost and can sustain the correct treatment.

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Article
The Value of Scrotal Ultrasound in Evaluation of Adult Hydrocele

Authors: Mohamad Noori Almusawi
Pages: 205-208
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Retrospective study to evaluate the role of scrotal ultrasound in assessment of patients with clinically diagnosed hydrocele was conducted. Hundred patients with provisional diagnosis of hydrocele checked by scrotal ultrasound 7.5 mega Hertz linear probe, scrotal ultrasound showed that 2 patients had testicular tumor, 3 patients had epidedymal cyst and 2 patients had communicating hydrocele. Scrotal ultrasound finding was confirmed by surgical exploration and histopathological examination if required. Scrotal ultrasound in our study proved to have 100% sensitivity, specificity and accuracy in evaluation of patients with hydrocele. We conclude that scrotal ultrasound is very essential in checking patients with hydrocele to choose the appropriate surgical approach

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Article
Bacterial translocation in surgical patients ( a prospective study)

Authors: Ali A.Al-kateb
Pages: 209-213
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Abstract

Bacterial translocation may be defined as the passage of intestinal microflora across the lamina propria to local mesenteric lymph nodes and from there to other normally sterile extraintestinal sites. It has been proposed that bacterial translocation may initiate a cytokine-mediated response from macrophages which may, under certain conditions, predispose the host to the development of septic morbidity and multiple organ failure

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Article
Intestinal Obstruction Caused by Malignant Disease (Incidence and Management)

Authors: Ali A. Al-katib
Pages: 214-226
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This prospective study was carried out on 229 cases of intestinal obstruction admitted to surgical unit at Babylon general hospital over three year’s period from April 1999 to December 2001. Sixty patients out of total number were concentrated in our study that cases intestinal obstruction due to malignant while (169 patients) were non-malignant intestinal obstruction excluded from our study. Five patients due to small to bowel obstruction and (55 patients) due to large bowel. The aetiology of malignancy in intestinal obstruction (26, 2%) of all intestinal obstruction was this is increase of cases during last three years. this percentage divided into (2, 2%) SBOand (24%) LBOso colorectal carcinoma most common causes of LBO. Left-sided colon most common site in large bowel than in right sided colon due to maligncies. Malignant small bowel obstruction was rare because the primary neoplasm of small bowel is rare right colonic obstruction by tumor can be managed by resection with primary anastmosis whil left colonic obstruction managed by decompression or resection with decompression. The patient with malignant intestinal obstruction has incidence of wound infection (16,7%) while cardiopulmonary complication (20%) greater than other complication .the mortality rate is(26,3%) in obstructing caseespecially for late presentation. So the aim of this study is to evaluate the incidence of malignant intestinal obstruction during last three years and also to evaluate the mortality and morbidity in this group of patients in Babylon general teaching hospital.

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Article
Left Ventricular Echocardiographic Changes in Chronic Anemia

Authors: Talib Hosain Kammona --- Hosain Aziz Nasir
Pages: 227-230
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The present study is undertaken to evaluate left ventricular size & function using echocardiography in patients with chronic anemia. Thirty patients with chronic anemia were studied prospectively. Thirty matched healthy control subjects with normal hemoglobin level were also taken. Both groups were examined by echocardiography. The patients with chronic anemia show a significantly increased stroke volume, fractional shortening & LV mass.

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Article
Electrocardiographic Resolution of ST- Segment Elevation after Thrombolytic Therapy in Acute Myocardial Infarction

Authors: Talib Hosain Kammona
Pages: 231-235
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This study is done to evaluate the effect of thrombolytic therapy in acute M.I utilizing a non-invasive method (i.e. ECG). Forty-five patients with acute Q-wave M.I whose ECG shows ST- segment elevation were given thrombolytic therapy. The sum of S-T segment elevation in 12-leads ECG were estimated prior to thrombolytic therapy, 2 hours later, and 24 hours after thromblytic treatment. Resolution of S-T elevation after thrombolytic therapy is taken as a parameter of efficacy of thrombolysis in these patients. Time of presentation (i.e. the time interval from the onset of chest pain until giving thrombolytic therapy) appeared as the most important factor in the response to thrombolysis.

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Article
Presence of Cryptosporidium Oocysts in Sewage Effluent and Water Surface in Mosul Area

Authors: Wisam M. Al-Saeed
Pages: 236-240
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A new method for detection of cryptosporidium oocysts in sewage was modified to investigate oocysts prevalence. Surface water and sewage effluent were filtered, elutet from the filter and concentrated using centrifugation. The resultant sedemented pellet was then homogenized and placed on sucrose gradient to separate oocysts from the supernatant. Then examined by modified Ziehl-Neelson method. The filter of sewage effluents had significantly lower numbers of oocysts, sand filtration may reduce the concentration of this parasite in waste water . A large no. of oocysts were encountered in surface water. Since cryptosporidium oocysts are frequently present in environmental water, they could be responsible for waterborne outbreaks of disease.

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Article
Diabetes Mellitus Correlation with Free Radicals and Creatine Kinase Isoenzymes Activity

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To explain the relationship between free radicals production in experimentally diabetic animals and expected glutathione (GSH) reducing levels with its enhancement due to feeding of cysteine, N-acetyl cysteine and to evaluate the action of antioxidant to relief the damage to the active site of creatine kinase (CK) caused by free radicals, three doses during 48 hours of 150 mg alloxan / kg body weight was injected to forty eight males albino mice to produce the diabetes mellitus. Blood glucose and serum glutathione were determined using colorimetric methods, whereas, fractionation of CK isoenzymes in sera of diabetic mice was conducted by mini column ion exchange chromatography using Sephadex A-50. Agarose gel electrophoresis was used to quantitize the CK isoenzymes. Results of present study show that after long period of induced diabets in males albino mice cause a change in CK isoenzyme distribution pattern The total serum CK activity decreased in 75% of animals and reached to 63.5% of the control value whereas CK - MM isoenzyme was also decreased to 54.1% of its initial activity. Other isoenzymes showed variation depending upon the period of diabetes induced which caused elevated levels after 30 days of CK -BB isoenzyme in 62.5% of the animal studied and reached to 68% more than its initial activity which in < 3%. CK - MB which is found in 25% of albino mice was elevated to 17.1% more than that found in control sera which is < 3%. Insulin affects total CK activity and its isoenzymes distribution pattern as a therapeutic agent, and CK activity found to be elevated Thiol containing compounds including cysteine, N-acetyl cysteine dithiothreitol and glutathione have been suggested to reactivate the CK activity.

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Article
Postmenopaul Bleeding Histopathological Study

Authors: Bushra Jabir Al-Rubiaii
Pages: 248-254
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Endometrial histopathological study of one hundred and fifty cases presented with post-menopausal bleeding to the Gynaecological Department in Baghdad Teaching Hospital from the period of Jan., 1991 to December, 1993. All patients underwent examination under anaesthesia, diltation and fractional curettage. The most frequent histopathological findings were atrophic endometrium 30.7 percent, followed by proliferative endometrium 26 percent. Hyperplastic endometrium was detected in 23.3 percent and endometrial polyp in 12 percent. Endometrial cancer was found in twelve cases (8 percent), eight of them adenocarcinoma 5.3 percent, four cases were uterine sarcoma 2.6 percent. The incidence of malignancy showed a definite rise with advancing age, increasing amount and duration of bleeding, and enlarged uterus. Endometrial cancer was associated in 41.7 percent of patients with obesity, diabetes mellitus, or hypertension.

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Article
Monitoring Ovarion Induction of Hypogonadotrophic Amenorrhoea with Abdominal Real Time Ultrasound Alone

Authors: Bushra J. Al-Rubiaii
Pages: 255-258
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To assess the possibility of monitoring ovulation induction in an out-patient basis in hypogonadotrophic amenorrhoea depending solely on abdominal ultrasound monitoring only. Out-patient infertility clinic attached to Babylon Maternity and Paediatric Teaching Hospital and private clinic.

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Article
Isolation of Candida species from normal individuals in Hilla-Iraq

Authors: Kareema Ameene Husein Al-Khafaji
Pages: 259-262
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A total of 186 of normal individuals {F (143), M (43)}, their ages ranged from 6months to 75yeas, was investigated for the presence of Candida species in the mouth, stool, as well as genital and high vaginal regions. The oral carriage of Candida species was found 31out of 100 individuals {M (44), F (66)}, in comparison to that found in the patients in the hospital ward on prolonged antibiotic therapy was 41.7% (10 out of 24 patients).The most prevalent isolated species of Candida from oral cavity of normal individuals was Candida albicans 17(54.8%). Out of 31, Candida tropicalis 10(32.3%), Candida Kefyer 3(9.6%), and 1(3.3%) Candida gullieromondii. 60% (30 out of 50) of the investigated females whose ages ranged from 29-40 years were found to carry Candida species in their external genital area, and 50% (9 out of 18) on high vaginal swabs. As well as Candida species was isolated from the stool of persons aged from 4months to 60years in 33.4% (6 out of 18 samples).

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Article
Sucessful Pregnancy of Aviable Fetus for Patients with Tubal Occlusions

Authors: Layla A.Al- Amir
Pages: 263-266
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Succesful Pregnancy of aviable and to bring hope and happiness for infertile couples. 42 selected reported and followed up . cases in Babylon teaching hospital for maternity and children . Main outcome measure Preguancy rate.

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Table of content: volume:2 issue:2