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: 2015 volume:12 issue:2

Article
Cauda Equina Syndrome (CES) Due to Lumbar Disc Herniation; Correlation between Delayed Decompression and Clinical Outcome

Authors: Mousa Imran Alghazali
Pages: 323-328
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Abstract

Twenty-six patients presented with fully developed CES with delay of 48 hrs to two months, with average age of 40 years ranging from 20-60 years. The follow-up of patients was for two years post-operatively. All patients underwent surgical decompression. The result is not dramatic, but it takes time, leg and back pain relieved in all patients, nineteen patients regained full control of urination, five patients urinate with straining and two patients remained needing catheterization to treat retention. We concluded that surgical decompression is beneficial for those patients presenting late with fully developed CES. So we recommend to do decompression to all patients with CES in spite of the delay in presentation. Further urodynamic studies and monitoring of the intrathecal pressure preoperatively is required.


Article
Most Common Causes of Repeated Abortion in Women in Naseriya

Authors: Amani Mahmmod Tuama
Pages: 329-334
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Abstract

This study was designed as a seroprevelance of human Cytomegalovirus antibodies in a group of pregnant women in Naseriya at first trimester of pregnancy. A total number of (100) serum samples were included belong to a healthy pregnant women with gestational age ranging from 4-12 weeks some of them, with a history of abortion, and non-pregnant women with no history of abortion. All the samples were examined by Enzyme Linked ImmunoSorbent Assay (ELISA) in Laboratory of Central Naseriya Hospital. The results of (100) serum samples are described as follows: The age of both pregnant and non-pregnant women ranged from (15-40) years. The percentage of HCMV-IgG-Ab among pregnant women was 73 from 75 (97.3%) and in non-pregnant women all sample 25 (1005) recorded positive results. The percentage of HCMV-IgM-Ab were detected in 8 from 75(10.7%) of pregnant women. The HCMV-Abs (IgG and IgM) found to be positive in 6 pregnant women, (3)(50%) of them were with a history of abortion and the other (3) (50%) women with no such history. and there are only 2 pregnant women who have only CMV-IgM, one of them is with previous abortion(50%) and the second one has never been aborted. In other wise, when only IgG-Ab are positive, there are 22(32.8%) pregnant women with history of abortion, and 45(67.2%) have no history of abortion.


Article
Immunohistochemical Expression of p53 in Squamous Cell Carcinoma of the Lip (A Clinicopathological Study)

Authors: Hanan A Abdulla --- Ameera K. Khaleel
Pages: 335-347
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Abstract

Lip carcinoma is most commonly seen after skin carcinoma in the head-neck region. Mutation of the p53 gene has been reported in a variety of human malignant tumors like squamous cell carcinoma (SCC) and is frequently associated with over expression of p53 protein. The purpose of this study was to analyze the immunohistochemical over expression of p53 in SCC of the lip in relation with the clinicopathologic pictures. The materials used in this study consist of (40) formalin fixed, paraffin-embedded lip biopsy specimens of squamous cell carcinoma. p53 immunoreactivity was evaluated in 1000 cells examined under the microscope at 40 magnification and recorded as percentage of p53 positive tumor cells in relation to different clinical and histopathological factors. The p53 index for squamous cell carcinoma of the lip was ranging between 0.5%-58%, and (72.5%, 29 case) showed positivity for p53 and (27.5%, 11 case) were negative. The highest number and percentages of p53 positive cases were seen associated with males (74.19%), ≥60 year’s age group(73.33%), patients with outdoor occupations (100%), upper lip (75.0%), >2cm size lesions(73.68%), patients with palpable lymph node (74.91%), moderately and poorly differentiated type (77.78%), and positive involvement of surgical margins (78.57%). Statistical analysis showed no significant relation of the mean labeling indices with the sex, site, tumor size, the presence or absence of palpable lymph node, grade of differentiation, and involvement of surgical margins(p>0.05), but it showed significant relation with the patient age and occupation (p<0.05). The old age patients (≥60 years) and patients with outdoor occupations showed the highest p53 labeling index significantly.


Article
Deficiency of Protein C and Protein S in Recurrent Pregnancy Loss

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Recurrent pregnancy loss (RPL) is a common disorder that affects around 3-5% of pregnant women. It has different causes and in about 50% it is of unknown etiology. Normal pregnancy is associated with increased procoagulants, decreased fibrinolysis and decreased anticoagulants to maintain placental hemostasis during pregnancy. However, hypercoagulability or thrombophilia might be a risk factor with these changes especially in women with deficiency of any of natural anticoagulant factors. Protein C and protein S are natural anticoagulants and their deficiency was found to be associated with placental thrombosis, hypo perfusion, fetal death and fetal loss. The aim of the study is to identify protein C and protein S deficiency in women with recurrent pregnancy loss. 90 women were involved in the study, 45 of them have three or more miscarriages in the first and second trimester considered as patient group, 45 healthy women at time of full term delivery with at least one alive child as control group. Full history was taken from patients and controls. Blood investigations were done for protein C and protein S levels by using ELISA (enzyme linked immune sorbent assay).Platelets count was performed by auto analyzer (Ruby). The results showed a significant relation of low protein S with recurrent miscarriage (P =0.002) OR=2.250 (95%C.I. 1.764-2.870), while the relation of low protein C with recurrent miscarriage was not significant (P>0.05).There was a significant association of low protein S andlow protein C with the abortion occurred in the second trimester (P<0.05). Positive family history for thrombosis was significantly associated with recurrent abortion (p<0.05). Platelets count has non-significant association with recurrent miscarriage. There is a significant association of protein S deficiency with recurrent miscarriage especially in the miscarriages occurring in the second trimester.Thepositive family history of thrombosis is considereda risk factorfor recurrentmiscarriage.Protein C deficiency had no statistical significant.


Article
Detection of IVS 1-110and IVS 1-5 Mutations in β-Thalassemia Major Patients in Babylon Province

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One hundred blood samples of beta thalassemia major patients were collected in Thalassemia center of Babylon hospital for Maternity and children in Hilla city. In addition, blood samples were collected from 40 apparently healthy subjects as a control group (without Hemoglobinopathy disorders). All samples of blood were subjected to isolation of DNA and molecular characterization of two β-thalassemia mutations {IVS 1-110 (G-A) and IVS 1-5(G-C)} using a PCR-ARMS technique. The result revealed that IVS1- 110 mutation was the most common in the patient's samples as (21%) whereas IVS1-5 mutation was present with a relatively less incidence as (10%). These point mutations are recorded for 1st time in Babylon governorate.

Keywords

thalassemia --- mutation --- globin


Article
Effects of Black Seed on Lung Cancer/in Vitro Study

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Abstract

This study was done to evaluate the possible cytotoxic effects of black seed on lung cancer cells and to determine its IC50 alone and in combination with cisplatin, and to study its effects on the expression of each of p53 and EGFR.QU-DB lung cancer cells were cultured in Eagle's MEM medium with 5% FBS and antibiotics. The cells were seeded in 96 well plate and the cytotoxic effects of each of cisplatin [25-0.195 µl/ml (or µg/ml)] and black seed [300-1.1719 µl/ml (each one µl is extracted from 25 µg of dried seed)] was determined using neutral red uptake (NRU) assay for 24, 48, and 72 hours in comparison with their corresponding control groups.Combined effect of black seeds with cisplatin was determined also using NRU assay. Cytotoxicity was further assessed by trypan blue exclusion assay at IC50 of each agent for 48 hours duration. Immunocytochemistry assay was performed also to detect p53 and EGFR expression. Cisplatin induced a directly proportional, dose-dependent and time-dependant cytotoxic effect with an IC50 of 8.5µg/ml and 7.3 µg/ml after 48 hrs and 72 hrs of exposure respectively. Significant differences (p<0.05) were observed in optic density of cisplatin group from that of the control for all tested concentrations. Black seed extract induced a directly proportional, dose-dependent and time-dependant cytotoxic effect in experiments with 48 hrs and 72 hrs of exposure with an IC50 of 149.5 µl/ml and 130 µl/ml respectively (each one µl is extracted from 25 µg of dried seed). While it produces a protective effect in 24 hrs exposure experiment. Significant differences (p<0.05) were observed in optic density of black seed from that of the control at concentrations of 75 µl/ml and above. Black seed produce an antagonistic action when combined with cisplatin, combination index (CI) >1.3.Cisplatin highly significantly (p<0.005) increased EGFR expression at different concentrations. While black seed extract highly significantly (p<0.005) reduced EGFR expression at 300 µl/ml (each one µl is extracted from 25 µg of dried seed). Cisplatinand black seed highly significantly (p<0.005) decreased the expression of P53. In conclusion: monotherapy of black seed have anticancer effects on lung cancer cell line, but an antagonizing effect to cisplatin when combined with it. Black seed may have a beneficial therapeutic effect in decreasing EGFR expression and decreasing mutant p53 expression.


Article
Respiratory Dysfunction in Textile Factory Workers

Authors: Amjed H. Abbas
Pages: 378-384
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Abstract

Dust generated during the handling and processing of cotton causes ill health of workers. Over 60 million people worldwide work in the textile or clothing industry. Recent studies have recognized the contribution of workplace exposures to chronic lung diseases, in particular chronic obstructive pulmonary disease [COPD]. The study aimed to assess the effect of exposure to cotton dust in textile industry on the respiratory system. A cross-sectional study was conducted among 75 randomly women selected textile factory workers in Al-Madhatiya Textile Factory in Babylon Province. Information was collected through interview, in addition to physical examination and some needed investigations were performed including: white blood cell count [WBC], erythrocyte sedimentation rate [ESR], random blood sugar [RBS], blood urea, serum creatinine, electrocardiography [ECG], chest x-ray [CXR] and general urine examination [GUE], in addition to pulmonary function tests using portable medical spirometer, the results were compared to 50 control healthy subjects. The study showed no significant difference in ages between active and control group, the mean age was 39.6±6.15 years while in control group it was 47.14±11.82 years, all subjects in both groups were females, mean duration of exposure of workers to cotton dust was 15.67±4.86 years, the highest percentage of them complain from shortness of breath [45.3%], some of them had no symptoms [17.3%], respiratory symptoms occured occasionally [52%], severity of symptoms was moderate restriction in most workers [24%], the study also showed negative non-significant relation between duration of exposure and severity of respiratory impairment. This study provides evidence of a strong relationship between exposure to cotton dust and respiratory impairments. Preventive measures are warranted in order to reduce the high prevalence of respiratory dysfunction and other respiratory disorders in textile manufacturing.


Article
Rosemary Leaves Aqueous Extract for Protection against Acute Doxorubicin-Induced Cardiotoxicity in Mice

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Doxorubicin (DOX) is a cancer chemotherapy widely used to treat a many types of human malignancies, DOX is potent anthracycline antibiotic. As a complicating effect of DOX cardiotoxicity has long been recognized; To explain this cardiotoxicity there are several hypotheses and the most thoroughly investigated one is free radical hypothesis. Our study was designed to investigate if the aqueous extract of rosemary leaves has a protective effect against cardiotoxicity induced by DOX in mice. Twenty eight male Swiss Albino mice were randomly divided into four groups including group1 (negative control), treated with distill water (D.W), group 2 (positive control), treated with 15 mg/kg DOX as a single intraperitoneal (i.p) injection, groups 3 and 4 received 15mg/kg and 30mg/kg respectively of the aqueous extract of Rosmarinus officinalis leaves (ROE) orally (p.o), once daily for 2 weeks, then injected i.p with 15 mg/kg DOX. Two days after DOX or D.W (in control group) injection, animals in all groups were scarified and the levels of the cardiac biomarkers including serum creatine kinase (CK-MB) and serum lactate dehydrogenase (LDH) were measured. Also the cardiac histopathological sections were prepared, stained by hematoxylin and eosin stains and examind under light microscope. The administration of 15mg/kg DOX caused cardiomyopathy which was manifested by extremely significant elevation (p<0.001) in serum CK-MB and LDH levels. In addition, cardiac histopathological sections showed moderate cytoplasm vacuolization and inflammatory cells infiltrate with vascular congestion. Oral administration of 30mg/kg ROE for 2 weeks prior to DOX provided significant protection which was evidenced by extremely significant reduction (p<0.001) in the levels of CK-MB and LDH. Moreover, histopathological sections revealed only mild cytoplasm vacuolization, infiltration of inflammatory cells and vascular congestion in comparison to DOX positive control group (p<0.01). Whereas oral administration of 15mg/kg ROE for 2 weeks prior to DOX showed no significant protection neither in CK-MB and LDH levels, nor in the histopathological sections. Administration of 30mg/kg ROE protect against DOX-induced cardiotoxicity. This might serve as novel adjuvant therapy with DOX.


Article
Antimicrobial Activity of Some Plant Extracts on Microbial Pathogens Isolated from Hilla City Hospitals, Iraq

Authors: Hiba Jassim Hamza
Pages: 398-407
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Abstract

Medicinal plants such as Garlic and Onion (Allium sativum and Allium cepa) respectively, can be described as those plants in which one or more of its organs contain substances that can be used for chemotherapeutic purposes or precursors for the synthesis of useful drug. The use of plants in treating ailments has been in practice since a long time ago. The present study aimed to determine the antimicrobial activity of both aqueous and oil extracts of garlic and onion singly and mixed in vitro. Antimicrobial effects of aquatic garlic, onion and garlic-onion combination extract then garlic oil, onion oil and garlic-onion oil combination against five Gram-positive and eight Gram-negative bacterial isolates and one yeast (Candida albicans) were determined. Antimicrobial activity of these aqueous and oil extracts by well-diffusion method were characterized by inhibition zones of five Gram-positive, eight Gram-negative and one yeast pathogenic microbes. All organisms tested were highly sensitive to garlic-onion combination (aqueous and oil extract), then garlic (aqueous and oil extract), whereas all organisms tested were slightly sensitive to onion (aqueous and oil extract). Natural spices of Garlic and Onion (aqueous and oil extract) possess antimicrobial activity against our natural enemies like bacterial and fungal pathogens and further evaluation is necessary.


Article
The Role of Urodynamic Study in Evaluating Children with Non Neurogenic Voiding Dysfunction

Authors: Jasim abdoalhasan
Pages: 408-412
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Abstract

To evaluate the role of Urodynamic study (UD) in children with non neurogenic voiding dysfunction. A total number of 52 children (age 5 to 12 years) with non neurogenic voiding dysfunction symptoms (frequency, urgency, incontinence, with or without nocturnal enuresis) were evaluated in a period from February 2013 to October 2014 in AL-Sadar Medical City, Najaf. All patients had a noninvasive screening assessment consisting of a detailed voiding history, physical examination, urinalysis, ultrasonography and measurement of post voiding residual urine. All the patients had also undergone Urodynamic (UD), 12 of them the Urodynamic study was done under light general anesthesia (low dose ketamine) or sedative (midozalam) due to patient's un-cooperation. The following urodynamic parameters were measured for maximum bladder capacity (the infused volume immediately before the initiation of micturition), maximum detrusor pressure (Pdet max), bladder compliance and residual urine volume (measured by urethral catheterization). Children with clinical neurological problem were excluded from the study. 41 (78.8%) of 52 children with non neurogenic voiding dysfunction have abnormal Urodynamic findings (detrusor instability, low compliance, reduce bladder capacity). Urodynamic study have a important role in evaluation of children with non neurogenic voiding dysfunction.


Article
Immunological and Hormonal Changes in Thyroid Goiter Patients in Correlation with Histopathological Types

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The patients with thyroid goiter presented in hyperthyroidism, hypothyroidism or euothyroid state, included multinodular goiter (MNG), Hashimoto thyroiditis and thyroid tumor, these type of diseases suffering from different immunological changes in correlation with thyroid function test and histopathological types. The present study was conducted in Hilla city from November 2013 to August 2014. This study was included 101 cases dividing into three groups according to the histopathological diagnosis after total thyroidoctomy. The first group included sixty eight cases of MNG patients, the second group included nineteen cases of patients with thyroid tumor, and the third group included fourteen cases of patients with thyroiditis. For all cases, thyroid function test, the immunological analysis studies included immunoglobulins (Igs) and complement componants were done. Results of present study were showed that the IgM was highest among patients with MNG meanwhile; the mean IgA was highest among patients with thyroid tumor. The mean IgG was highest among patients with MNG. There were significant associations between thyroid diseases and IgA, IgG and C3, p<0.05. Other result show the mean C3 was highest among patients with tumor changes meanwhile; the mean C4 was highest among patients with tumor changes. Also other result show there was significant association between thyroid diseases with TSH, patients with thyroiditis were most likely to be hypothyroidism, p<0.05. The aim of study to determine the types of immunological changes in correlation with histopathological types and hormonal changes. So as the immunoglobulin level (Ig) was high in different types of thyroid disease especially IgG. The complement component (C3) level was high in different thyroid disease, while the C4 level was low in different thyroid diseases.


Article
Complications of Endoscopic Sinus Surgery

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Endoscopic sinus surgery (ESS) is obtained to restore paranasal sinus function which usually will lead to reestablishing the physiologic pattern of ventilation and muco-ciliary clearance. To evaluate the complication of endoscopic sinus surgery (ESS) after management of different sinonasal diseases and how to deal with these complications ninety patients with different sinonasal diseases who were underwent functional endoscopic sinus surgery were seen and evaluated in department of otolaryngology. They had been submitted to clinical and endoscopic examination of the nose. All patients had a coronal and axial CTscan preoperatively, and all procedures were performed under general anesthesia. The extent of surgery was mainly decided depending on the findings in pre-operative CT scan of paranasal sinuses. The main presenting symptoms of patients were nasal obstruction (71.1%), anterior nasal discharge (65.5%), facial pain (63.3%), headache (55.5%), postnasal drip (50%) & hyposmia/anosmia (31.1%). Most of the patients have got partial or complete symptomatic relief. The minor complications of endoscopic sinus surgery occurred in 18 cases (19.97%) which include adhesions (11.1%), minor epistaxis (5.55%), periorbital ecchymosis (2.22%) & infection (1.1%). Major complications occurred in 6 cases (4.27%) which was Major epistaxis (2.22%), CSF leakage (2.22%), Meningitis (1.1%) Pneumocephalus (1.1%). It was concluded that endoscopic sinus surgery (ESS) is an efficient method for treating different sinonasal diseases and can be performed with success rate to alleviate symptoms with less morbidity especially when there is good clinical and preoperative CT scan assessment with endoscopic sinus surgery training courses and proper hypotensive anaesthesia and good postoperative care.


Article
Traumatic Diaphragmatic Injuries, A Hospital Based Study at Al-Yarmouk Teaching Hospital

Authors: Raid Jasim Ahmed --- Haitham Abid Hammoud
Pages: 428-436
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Traumatic Diaphragmatic injury [TDI] is not uncommon accompaniment to blunt or penetrating trauma to the abdomen or thorax; it may present acutely with hemodynamic and respiratory compromise and be associated with significant injury to other organs or may not be diagnosed at the initial trauma at all and later present as a diaphragmatic hernia. This study examines the incidence, site of injury, time of diagnosis, available diagnostic tools and surgical approaches used to treat these patients. A retrospective study of 67 patients proved to have TDI between February 2009 to February 2012 at Al-Yarmouk Teaching Hospital who have sustained blunt or penetrating trauma to chest and or abdomen. Out of 67 patients identified to have TDI, 51 patients [76 %] have sustained penetrating type of trauma, while only 16 patients [24%] have history of blunt trauma. Patients' age ranges between 5 – 67 years, median age is 32 years. Penetrating trauma is most common in males 39 patients [58.3%] in comparison to 12 females [17.9%] while in blunt trauma it was equal [11.9%]. Most penetrating TDI were on right side 23 patients [34%] while in blunt TDI left side 13 patients [19%]was most common. Abdominal visceral injuries were the most common, 52 patients [77.6%] followed by associated thoracic injuries 48 patients [71.6%]. Most cases of TDI were diagnosed preoperatively 49 patients [73.1%] while only 12 patients [17.9%] were diagnosed postoperatively and six patients [8.9%] were diagnosed later. Computerized Tomography was most helpful diagnostic radiological test in 12 patients [17.9%] while focused assessment with sonography in trauma [FAST] was the least helpful in diagnosing TDI 2 patients [3%]. Most cases 57 patients [85%] of TDI were repaired via abdominal approach. Most common morbidity was atelectasis in 16 patients [23.8%]. During whole study, five patients died [7.4%]. Morbidity was due to other associated injuries and hemorrhagic shock Preoperative diagnosis of TDI was made in a small number of patients by the surgical team by radiological studies.A better radiological interpretive skills by the surgical team might improve preoperative detection of TDI. Due to high incidence of associated abdominal injuries, most cases of TDI can be managed through abdominal approach. TDI alone is not a predictor of mortality rate; it is the severity of associated injuries that predict higher mortality.

Keywords

Diaphragm --- Blunt --- Penetrating --- trauma --- hernia --- Abdominal --- thoracic.


Article
Biochemical Evaluation of Metabolically Active Urinary Stones

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Abstract

The current study had been conducted to assess the clinical significance of lipid peroxidation (malondialdehyde (MDA) concentration), (total antioxidant capacity (TAC) and superoxide dismutase (SOD), and biochemical test of [urea, creatinine (Cr), uric acid (U.A), calcium (Ca+2), potassium (K+), sodium (Na+), phosphorus (PO4-2)] in serum of urinary stone patients and also assess biochemical test of [urea, creatinine (Cr), uric acid (U.A), calcium (Ca+2), potassium (K+), sodium (Na+), phosphorus ((PO4-2) and pH] in 24 hour urine sample. Sixty patients with metabolic active urinary stones had been admitted to AL-Hilla Teaching Hospital, Urology Department during the period of November 2013 to April 2014. All patients underwent full history and physical examination including: age, gender, family history of urolithiasis, past history of recurrent stone and any current medical diseases. The urinary stones group composed of sixty patients (48 male and 12 female), the control group includes apparently healthy individuals (18 males and 12) females. A highest occurrence of urinary stones is in the age 31-40 years. The results of the present study showed non-significant difference in urea and Cr and the result showed a significantly increase in U.A. Also the study showed a significant increase in the level of Ca+2 and non-significant in the level of Na and K and a significant decrease in the level of PO4-2 .This study showed significant increase in MDA concentration and significant decrease in TAC and SOD , however showed significant increase in concentration of urea. Cr, U.A, pH, Na; and decrease in the level of Ca+2 and P and non-significant in level of K in 24 hour urine in the urinary stones group compared to the control group. In conclusion, urinary stone disease is affected by lipid peroxidation and antioxidant enzyme.


Article
Cardiovasular Manifestations of Primary Hypothyroidism

Authors: Sabah M. Zangana
Pages: 446-454
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Hypothyroid patients are liable for cardiovascular complications, especially arrhythmias hypertension, ventricular dysfunction ischemic heart disease, and pericardial effusion. To detect the above-mentioned cardiovascular manifestations in hypothyroid patients before and after treatment. 92 cases of hypothyroidism, )Collected within 25 years) diagnosed by hormonal assay were studied for their cardiovascular manifestations, clinically, by ECG, chest X-ray, echocardiography and sometimes exercise ECG at time of diagnosis (from 1988-2002 ) and followed for the first 10 years from the starting point of the treatment. Among 92 hypothyroid patients studied, cardiovascular manifestations were not high before treatment, while after treatment and during the first 10 years of follow-up, no relevant cardiovascular disease could be detected. Although hypothyroid patients are liable for cardiovascular complications, in this study cardiovascular manifestations are not common in hypothyroid patients neither before nor after the treatment.


Article
Metabolic Syndrome among overweight and Obese Children Attending Central Pediatric Teaching Hospital in Baghdad

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Metabolic syndrome is one of the serious problems that facing children all over the word, as it can lead to multiple health problems including psychological, cardiovascular, endocrinology and school performance. The aim of this study is to estimate the frequency of Metabolic Syndrome among overweight and obese children, and to detect the relation of age and gender, A cross sectional study conducted on 49 children in Central teaching hospital for children in Baghdad for one year (from 1/1/2013– 1/12/2013). Weight, height, blood pressure, waist circumference were taken. Blood glucose and lipid profile (triglyceride, high density lipoprotein, and cholesterol) were done for all children. Children mean ages were 8.28 ± 2.5 year. Percentage of Metabolic Syndrome among the study group was 28.6%.There was a high significant association of obesity, blood pressure, high density lipoprotein and cholesterol with Metabolic Syndrome (p-value<0.005), and only significant association with hyperglycemia, cholesterol and waist circumference (p-value <0.05), but no association with triglyceride. The difference in distribution of overweight and obese children by risk factors categories was highly significant and there was no significant association between the numbers of risk factors with gender. The prevelance of Metabolic Syndrome was 28.6%. Both age, gender and triglyceride have no significant association. The obesity, hypertension, high density lipoprotein were found to be highly significant association, while hyperglycemia and hypercholesterolemia were just significant association.


Article
Immunopathological Study of The Effect of Bile Salts on Secondary Hydatidosis Development inWhite Mice

Authors: Hawrra M. Murad --- Inam B.Faleh
Pages: 463-472
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Abstract

This study was carried out to investigate theimmunopathological effects of bile salts on the immune response against hydatid cyst infection in mice.The treated groups of mice dividedinto two groups,the first group immunized with 0.3ml of2mg/mlof bile salts and the second group immunized with 0.2ml of1mg/mlof bile salts in 0 time after two weeks the same doses as repeated against secondary hydatidatid cysts, then delayed type hypersensitivity test was done on these groups and compared with the third group(that had been inoculated with 0.2 ml of sterile phosphate buffer saline as a control group)at day 27 post immunization using soluble bile salts.At day 30 half number of animals from each group were scarified to perform humoral immunity tests (ELISA).Then challenge with 2000 protoscolices were done for the remaining half ofall 3groupsand left them for three months then kill them for histopathologicalresults post challenge showed marked growth of cysts in the livers of the control infected group, with some degenerative and necrotic lesions accompanied byamyloidosis in spleen. While the immunized groups with bile saltsrevealed presence of focal mononuclear cellsinliver,kidney and lung tissue with lymphoid hyperplasiain spleen.Finally,this study showed that the bile saltswere highly immunogenicand this may related to the fact that one ofthecomponentsh of bile salts hasDeoxycholic acid init´s structure has the lysis effect on the protoscolsis against hydatid cyst infection in mice.

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Article
The Role of Vaccinia Virus Vaccination in Protection against Molluscum Contagiosum Infection

Authors: Wisam Ali Ameen
Pages: 473-478
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Abstract

Molluscum contagiosum virus (MCV) is classified within the Poxvirus family in a specific genus, the molluscipox and has features intermediate between the orthopox and parapox groups. The virus occurs throughout the world, most commonly causing disease in childhood. Infection with MCV is worldwide. Three groups are primarily affected: young children, sexually active adults, and immunosuppressed persons, especially those with HIV infection. Vaccinia virus vaccination protect against smallpox infection. The aim of this across secessional study was to assess the role of vaccinia virus vaccination in the protection against molluscum contagiosum infection. Three hundred patients (165 male, 135 female) with molluscum contagiosum were included in this study their ages ranged from 1 to 80 years with a mean of 28.91 years ±19.53SD. The patients were divided in two groups, the 1st group including the age of the patients less than thirty five years. The 2nd group includes those patients equal and more than thirty five years. Complete history was taken regarding the age and sex and history of the recurrence of the same lesions. Complete physical examination was done including vaccinia vaccine scar, and BCG scar. 1st group those patient were their age less than 35 years were 150 patients with mean 8.38 years ±7.97 SD which they already were unvaccinated with vaccinia virus vaccine, while in 2nd group which those patients were their age 35 years and older were also 150 patients with mean 46 years ±7.88SD. 110 (73.33%) patients of these group were unvaccinated with vaccinia virus vaccine, while the others 40 (26.66%) patients of these group were vaccinia virus vaccination scar positive, P value less than 0.001( highly significant). BCG scar was found in 145 (96.66%) patients and the other 5 (3.33%) patients had negative BCG scar in group 1st group, while in 2nd group the BCG scar was found in 98 (65.33%) patients, p value less than 0.0001; confidence interval 95% = ( 0.2245,0.4021) and the other 52(34.66%) patients were had negative BCG scar. History of the recurrence of the lesions were found in 51(34%) patients in the 1st group, while the recurrence of the lesions were found in 41 (27.33%) patients in the 2nd group, p value more than 0.05 not significant, confidence interval 95%= (- 0.0377, 0.1710). The result of the 2nd group was subdivided in to two groups, A and B. Group A those unvaccinated with vaccinia virus vaccine patients with age equal and more than 35 years which were 30 (20%) patients, while group B patients with age equal and more than 35 years with positive vaccinia virus scar which were 11 (7.33%) patients, p value was 0.003 which is significant. According to our knowledge, this study may be the first study in Iraq showed that the vaccinia virus vaccine may have the protective effect in the prevention of molluscum contagiosum and decrease recurrence rate of this infection.

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Article
Blood Group and Infertility Relationship

Authors: Huda Jabbar Dibby
Pages: 479-483
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Abstract

The study carried out on 510 females with age ranges 20- 35 years from those attending the obstetrics & gynecology outpatient department in gynecology & pediatric hospital in Al-Diwaniya city and some private clinic , the study achieved during the period from march 2013 to July 2014, including 245 fertile & 265 infertile females. Determination of ABO blood group using antisera was done for each female, then measurement of FSH level was done for infertile females, it was found that blood group O is more predominant in infertile females, also FSH level is significantly higher among those females.

Keywords

blood groups --- ABO --- FSH --- infertility --- Women


Article
Probiotic Induce Macrophage Cytokine Production via Activation of STAT-3 Pathway

Authors: Neama Y. Habil
Pages: 484-494
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Macrophages are mononuclear phagocytes generated from monocyte emigrated from blood circulation. Macrophages mediated the innate and adaptive immunity through different routes, and cytokine production is one of these routes. Signal transducer and activators of transcription (STATs) are cytoplasmic transcription factors that are key mediators of cytokine and growth factor signalling pathways. STAT-3 is implicated in macrophage cytokine signalling and production. It's well reported that the microbiota is very important as it primes the immune system for the antigens encountered later in life. Probiotics defined as ‘Live microorganisms which when administered in adequate amounts confer a health benefit on the host. Therefore, the aim of this project was to answer the question whether probiotics induced cytokine production via activation of STAT-3 signalling pathway. Results showed that probiotic of Lactobacillus casie strain Shirota was successfully induced cytokine production via activation of STAT-3 by anti-inflammatory macrophages induced by TNF-α. The findings of this study will open new strategy to modulate the immune response by probiotic bacteria leading to treat the diseases that related with irregular cytokine production.

Keywords

(macrophages --- probiotics --- cytokines --- STAT-3)


Article
Kirkuk Technical Institute Students Opinions Regarding the Risk Factors, Health Effects and Protective Measures of Obesity

Authors: Wafa Mahmood Jasim
Pages: 495-501
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Abstract

Obesity is the excessive accumulation of adipose tissue to an extent that health is impaired. The aim of the study was to assess the students knowledge regarding the risk factors of obesity. A descriptive cross- sectional study has been conducted in Kirkuk Technical Institute from the period of 1st April to end of May 2014. Randomly selected sampling students from first and second stage of two scientific departments and a special questionnaire form was prepared by interviewing with the study sample. 70 students were included, 35 students from Electrical department and 35 students from Survey dept . Majority of study students are male (37- 52.8%), aged < 20 years (45- 64.3%), and from first class (45- 64.3%). Most of students from both departments (Electrical and Survey) agree with the psychological effect of obesity (17- 48.6%), (18- 51.4%). Most of study students go with the effect of gender as a risk factor in obesity. The study concluded that most of study students go with the eating sweet diets, soft drinks, and exercises > 30 minutes are the major risk factors for obesity occurrence.


Article
Client’s Satisfaction in Primary Health Care Centers Toward Immunization Services in Erbil -IRAQ

Authors: Kareem F. Aziz
Pages: 502-508
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Abstract

Monitoring is necessary in order to maintain public confidence as vaccines are usually administrated to healthy persons, monitoring in most countries has relied on passive surveillance systems such as the vaccine adverse event reporting system. An immunization continues to reduce the incidence of vaccine preventable diseases; there is increasing interest in vaccine safety. The study aimed to identify clients’ satisfaction toward immunization services in primary health care centers and to identify association between socio demographic characteristics and their satisfaction. It is a descriptive, cross sectional study; the sample study is 100 clients who attend Primary Health Care Centers (P.H.C) in Erbil and the study began from 1-6-2013 to 1-10-2014. A questionnaire was used for data collection by using an interview technique. The sample was chosen convenient and SPSS program version 18 is used for analyzing the data. Results of the study indicated that majority of the clients were from city center %89, and in primary school %38 while their age was between 17-27 %51 and most of them were female %79. Other results of the study indicated that there was no significant association between clients’ satisfaction and most of variables, while other results indicated that there was a significant association between place of residency and immunization services satisfaction. Other results indicated that the majority of them were satisfied with immunization services in the primary health care centers. Majority of study group was satisfied with immunization services, immunization items and staff practices, sterilization and standard technique during their work. There was no significant association between clients’ satisfaction and variables such as (age, sex, and level of education). There was significant association between clients’ satisfaction and their place of residency.


Article
Histopathological Assessment of Anti-Ulcerogenic Effect of Montelukast Against Acetyl Salicylic Acid Induced Gastric Ulcer in Male Rabbits

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Abstract

The effects of anti-ulcerogenic drugs are dependent on the increase in prostaglandin production and reduction in leukotriene production in the gastric mucosa. This study aimed to evaluate the gastro-protective effect of montelukast both macroscopically and microscopically .Thirty local domestic male rabbits had been used in this study, divided randomly into 5 groups as follows: control group, acetylsalicylic acid (ASA) group, Omeprazole group, montelukast group and montelukast alone group. At the end of the experiment, the stomachs of rabbits were removed then the mucosa was examined to determine the ulcer parameters by means of dissecting microscope. Furthermore, stomach tissue sections were prepared for histological examination. The results of this study revealed as aministration of acetyl salicylic acid in dose of 500 mg/kg significantly increased the mean ulcer index and showed necrosis of gastric mucosa associated with submucosal edema and inflammatory cell infiltrate. But in presence of montelukast significantly decreased the ulcer index with antiulcerogenic activity about 81%, mild edema and inflammatory cell infiltration. In this study, it was observed that montelukast behaved as an anti-ulcerogenic drug both macroscopically and microscopically.


Article
AmpicillinCloxacillin Antibiotic for Prevention of Surgical Site Infections in Clean Orthopaedic Surgeries

Authors: Malath Azeez Al-Saady
Pages: 520-525
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Abstract

Post-operative surgical site infection pose large health burden and use of prophylactic antibiotics in the surgical treatment is well- established however, the duration and dosage of prophylaxis varies substantially among surgeons. To assess the prophylactic efficiency of AmpicillinCloxacillin (ampiclox) in two antibiotic regimen for prevention of surgical site infection in clean orthopaedic surgery. This is a prospective observational study conducted for 1 year, 96 patients of either sex of 7-45years age were included in this study. Forty eight patients receive antibiotic regimen 1 AmpicillinCloxacillin vial intravenously 500 mg, 8 injectable doses, the first dose was given during induction of anaesthesia before tourniquet use, followed by every 6 hours dose. Then oral antibiotic Augmentin (amoxicillin clavulinic acid 250 or 500 mg for 5 days) was taken. In addition, Forty-eight patients received Regimen 2: AmpicillinCloxacillin vial intravenously 500 mg 4 doses, the first dose given during induction of anaesthesia before tourniquet use, followed by every 6 hours dose. Patients followed up for 3 months. Postoperatively 6.24%of patients treated by regimen 1were infected at day 10 while 10.41% of patients treated with regimen 2 were infected at day 10. Type of microorganism involved mostly was Pseudomonas. As a conclusion, Ampicillincloxacillin (ampiclox) is good prophylactic antibiotic to prevent post-operative surgical site infection in clean orthopaedic surgery and may replace the commonly used 1st generation cephalosporin. Using of Ampicillincloxacillin (ampiclox) in four divided doses provide enough post-operative prophylaxis. Type of infection was commonly superficial and microorganism was commonly pseudomonas.


Article
Spermatic Cord Lipomas: A Common Finding But A Subtle One

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Abstract

True lipomas of the spermatic cord, as defined in surgical pathology textbooks, are rarely encountered during inguinal hernial surgical repair procedures. The most commonly encountered finding is a prolongation and/or extention of the retroperitoneal fat through the deep inguinal ring along or within the spermatic cord contents. This study tries to investigate the incidence, clinical significance and the best methods to predict the presence of the misnamed lipomas of the spermatic cord versus the true lipomas of the spermatic cord using classical open Lichtenstein and laparoscopic hernioplasty. A retrospective study of the records of (150) patients submitted to (160) surgical intervention for open/laparoscopic hernioplasty over a period of three years had been thoroughly investigated. Hernioplasty was conducted using laparoscopic total extraperitoneal (TEP) in (50 = 31.25%) cases while the remaining (110 = 68.75%) cases were managed using open Liechtenstein hernioplasty. The study showed that the ratio of indirect: direct inguinal hernia was (2.33:1). The proportion of right: left: bilateral inguinal hernias was (5.78:3.12:1). The incidence of spermatic cord lipomas was (20 = 12.5%) cases. Among these spermatic cord lipomas only (2 = 1.25%) cases were true lipomas in terms of surgical pathology. There is some difficulty in clinical diagnosis of these lipomas and it is easy to be misdiagnosed as cases of irreducible and/or obstructed inguinal hernias. Spermatic cord lipomas can cause symptoms similar to that of inguinal hernia with the absence of any associated hernial sac. It is easy to miss these lipomas when using laparoscopic hernioplasty especially when employing the procedure of (TAPP) with the persistence of the preoperative symptoms. Such postoperative complaints may constitute a source of problematic distress to the laparoscopic surgeon. Accordingly, surgeons should be aware of the possible co-existance of spermatic cord lipomas during any type of inguinal hernioplasty.


Article
Prevalence of Coronary Atherosclerosis in Babylon Governorate; Histopathological, Postmortem Prospective Study

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Abstract

There is no previous postmortem study about coronary atherosclerosis in the Arab Homeland, including Iraq. Coronary atherosclerosis is the leading cause of death worldwide, and represents a major problem in Iraq causing death to many young people suddenly. The purpose of the present study was to evaluate the prevalence and severity of coronary atherosclerosis among Babylon Governorate resident. This is a prospective randomized cross-sectional study, which included autopsy material from 80 cases collected during the period from 1112013 to 172014, referred to the Office of Forensic Medicine in Babylon. The cases were divided into 7 groups according to age. After extracting the heart, three representative specimens from each main coronary artery were obtained for Histopathological Examination, after staining with hematoxylin and eosin (H & E) stains. The atherosclerotic lesions were classified into fibro-fatty and advanced lesions, thereafter the results were subjected to statistical analysis. The results were as follow: 70% of the cases were males and 30% females, their ages ranged between 13-79 years. More than 60% of cases fallen in the age range 21-40 years. The overall prevalence of coronary atherosclerosis was 91.25% for all age groups; 92.9% of males and 87.5% of females were affected. This prevalence increased with age progression to become almost 100% after age of 40 years old for both (males and females). Moreover the prevalence for advanced lesions only was (61.25%),also it was increasing with age and becoming 100% after age of 50 years old for both (males and females). There is an unexpectedly high prevalence of coronary atherosclerosis in Iraqi people, which is the highest in Asia when compared to results of other similar studies conducted in other countries. Also it was observed that atherosclerosis started as early as 17 years old. An increased prevalence of atherosclerosis was found in the present studied population, specifically the young individuals' accentuate that is necessary to institute the prevention early. It is hoped that the data obtained in this study will be a baseline data for further studies by other investigators throughout all Iraqi Governorates to study atherosclerosis in Iraq overall.


Article
Estimation The Effect of two Types of Honey ″Natural and Artificial″ on The Viability of Escherichia coli in vitro and in vivo

Authors: Sabaa Hilal Hadi
Pages: 536-540
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Abstract

In pre-Ancient Egyptian times more than five millennia ago used honey, the beneficial properties of honey have been explored in modern times. The present study were aimed to examine the effect of two types of honey ( Anchusa natural) and artificial in deferent concentration effect on Escherichia coli, The bioassay applied for determining of antimicrobial effect the well-agar diffusion method. The present study showed different honey concentrations (100, 75, 50, 25, 12,5 and 6,25 % v/v) against Escherichia coli with zones of inhibition ranges from 26 in 100% v/v to 6.5 mm in 25% v/v concentration and 0.5 mm for honey artificial, as in vitro examination. The differences between two types honey results were significant with Anchusa honey in compered with artificial honey. The BALB/c mouse model using for detect of shortens the duration of bacterial diarrhea by natural honey as in vivo colonization of Escherichia coli. The results obtained for the antibacterial characterization of honey when used as (100% v/v concentration – 0.1cc dose -4 times/daily) were disappear clinical signs of acute diarrhea within two to three days. The natural honey showed significant P< 0.05 effect to kill of E.coli bacteria compared with the control group and with artificial honey.


Article
Molecular Characterization and Antibiotic Susceptibility of Diarrheagenic Escherichia coli from Children

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Abstract

In Thi Qar there are relatively few studies have been done to reveal and classify diarrheagenic Escherichia coli (DEC) strains among children with diarrhea. This study focused genetically at investigating DEC among hospitalized children under 2 years in Thi Qar city. A total of 200 children (Below 12 years) with diarrhea and 75 without diarrhea were their stools investigated using culture on Mac¬Conkey and EMB agar, and E. coli isolates were examined for detection of diarrheagenic E. coli types, antimicrobial susceptibility pattern. Virulence genes detected using PCR. A multiplex PCR system method was used to detect a species specific gene for E.coli and ten different virulence genes for detection of five pathogroups of DEC namely enteroaggregative- (EAEC), enteropathogenic- (EPEC), enterotoxigenic- (ETEC), enteroinvasive- (EIEC) and enterohemorghagic- Escherichia coli (EHEC). The study has indicated that diarrheagenic E. coli isolates were found mostly in stools of children with diarrhea. DEC diarrhoeagenic E. coli was significantly detected among diarrheic children (44.8%) compared with control children (16.4%). Of the DEC pathotypes examined, EAEC was found in (64.73%), ETEC in (19.5%), EPEC in (10.5%) and EHEC in (5.27%) of diarrheic. Virulence-gene factors in DEC isolated from children with diarrhea and from controls. The distribution of virulence gene was; pCVD432 93.6%, 87.3%; eaeA 64.2%, 8.5%; bfpA 59.1%, 2.05%; stx1 22.8%, 0.8%; stx2 18.6%, 0%; estA1 heat-stable (ST) 8.14%, 1.3%; estA2-4 heat-stable (ST) 14.6%, 0.2%; eltB heat-labile (LT) 43.1%, 0.4% in DEC and control children respectively. This study revealed high incidence of diarrheagenic E. coli isolates and high prevalence of antimicrobial resistance among normal intestinal E. coli with typical EAEC and typical EPEC predominating. The use of primers for both variants of ST useful to detect the sensitivity for detection of ETEC strains of hospitalized children in Thi Qar.


Article
Hemotological and Coagulatory Alteration in Splenectomized Versus Non-Splenectomized Transfusion Dependant Β-Thalassemic Major Patients

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Abstract

β-Thalassemia is an inherited hemolytic disorder caused by a partial or complete deficiency of β- globin chain synthesis. Profound hemostatic changes have been observed in patients with β-thalassemia major with history of thromboembolic or haemorrahgic manifestation. The aim of this study was to assess the coagulation parameters; PT, PTT, factor V, factor VIII level in β-thalassemia major and to compare the effect of splenectomy on each and to evaluate the patients for increased risk of thrombosis and/ or bleeding. Sixty patients with transfusion dependent β-thalassemia major ;thirty of them splenectomized (16 females and 14 males), and thirty non-splenectomized (13 females and 17 males) aged between (3-38) years at different stages of the disease were included in this study from Babil hospital for maternity and pediatrics from the first of April 2012 to the 15th of July 2012. Seven milliliters of venous blood were collected from each patients and control persons included in this study by clear venipuncture under aseptic conditions from antecubital fossa with easy withdrawal of blood , subdivided as follows: 1*1.8ml in o.2 ml trisodium citrate with gentle mixing for coagulation testing include PT,PTT, factors V and VIII. 2*2ml in EDTA tube for routine haematological screening tests include: PCV,WBC, platelet count. Normal pooled plasma for factor assay obtained from 20 normal healthy persons ,plasma was mixed and divided into aliquot each containing about 1ml stored at -40C0 for 3-4 weeks as a control for factor assay study. The mean age was 18.2 years in splenectomized patients and 8.9years in non splenectomized patients. The PCV level was low in both groups 26.8,24.6 in splenectomized and non splenectomized patients respectively with statistical significant difference between them (p value <0.05). WBC and platelets count were both within normal limit ,however there was a statistical difference in platelets count between splenectomized and non splenectomized groups with mean value were 259.6 and 218.7 x109 /L respectively, p value <0.05. WBC count mean were 8.2 and 7.0x109 /L in splenectomized and non splenectomized patients respectively with no statistical significant difference between them p value >0.05. These patients (splenectomized and non splenectomized) have normal mean PT,PTT, which were 14.4 sec, 33 sec for splenectomized and 14.1 sec,33.2 sec for non splenectomized patients respectively with no statistical significant difference between them p value >0.05. Factors V,VIII level were 103%,127.8% for splenectomized patients and 100.3, 128.9% for non splenectomized patients respectively with no statistical significant difference between them p value>0.05 ,but there was statistical significant difference between the control group and the total thalassemic patients (P value <0.05),however splenectomized patients had more episodes of bleeding and thrombotic manifestations than non splenectomized patients which might be due to causes unrelated to coagulation factors V and VIII level. Splenectomy could affect PCV but had no effect on coagulation factors V and VIII.-Bleeding manifestations were more frequent in splenectomized patients with normal factor V,VIII and platelets count.-Thalassemics in Babylon thalassemic center were under transfused.


Article
Removal of Brain Hydatid Cyst Through Burr-Hole Operation (Case Report)

Authors: Ali Abbas Hashim Al-musawi
Pages: 561-565
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Abstract

Brain involvement occurs in 2–3% of patients with systemic echinococcosis. Children are most often affected and, in countries where echinococcosis is common, up to 50% of all childhood CNS “tumors” prove to be echinococcal cysts, life saving rapid burr hole aspiration of cyst with total removal of cyst membrane with the use of hypertonic solution as cidal agent with pre and post operative antiprotozoal is very successful procedure in emergency deteriorating patient with brain hydatid disease.


Article
Liver Hydatid Cyst:The Advances

Authors: Hazim Naif Barnouti
Pages: 566-568
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Abstract

Dramatic advances developed lately in Diagnosis and Treatment of Liver Hydatid Disease upon the understanding that it is a very wide spectrum entity, and not just a single Disease.The Diagnosis is based upon an ultrasound study showing a liver hydatid cyst or cysts combined with a positive immune-serological test for Antibodies against Echinococcusgranulosusantigens.Once Diagnosis is made,it should always be followed by Staging(Classification)of the Cyst upon which the Treatment and Prognosis will depend. There are two staging systems,The Gharbi and the W.H.O. This liver hydatid cyst staging will unify the information for each stage and allow audit to be performed[1].The Gharbisystem classifies liver hydatid cysts as follows: Stage-1:simple cyst. contains pure hydatid fluid. Stage-2:cyst with a detached germinal layer(water lily sign). Stage-3:cyst contains daughter cysts(honey comb appearance). Stage-4: cyst filled with amorphous mass(wheel spoke sign). Stage-5: cyst with a thick calcified wall.The WHO staging reveals also whether the cyst is viable(infective), or non-viable(non-infective),or is in an intermediate stage between the two. In selected cases,CT scan which is 98% accurate and is very precise for anatomical localization may be used.It identifies intraperitoneal cysts.M.R.I. provides a much better view of liquid areas within tissues. Diffusion weighted M.R.I[2]IS recently introduced. AHydatid cyst will appear Hyperintense while a non-parasitic cyst will not. Intra operative ultrasound: is crucial in radical liver hydatid cyst surgery to delineate cyst extent and its relations to major vessels and important structures to safe guard them.

Table of content: volume:12 issue:2