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:3

Article
Hiplabral Tear Management In Athletics

Authors: Mohammed Elmajee
Pages: I-IX
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Abstract

Objectives • To review the most up-to-date evidence-based literature in managing patients with labral tear, particularly athletic population • To appraise the current understanding about labral tear management • To suggest some future recommendations and formulate new research questions


Article
Potential Effect of Electronic Indoor Insect Killeron Histological Structure of Kidney of Male Mouse Mus Musculus

Authors: Sanna Abadi Habaeb
Pages: 569-575
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During this study evaluated the efficiency of insect killer device electric one exposure periods of 1, 12, 24.36 an hour and a study of its impact on those conditions and periods of exposure of the device in the histological structure of the kidney of male laboratory mouse Mus musculus were divided into control group G1 and the group exposed to 1 hour G2 and 12 hours G3 and 24 hours G4 and 36-hour G5.The results showed that. Histological results showed that the group G2 and G3 kidney tissue appeared normal approach to animal control tissue either group G4 tissue animals showed a few pathological changes distress and Group G5 which got most of the pathological changes in the tissues studied.


Article
Detection of Human Rhinovirus (HRV) in Upper Respiratory Tract Infections by RT- PCR Technique

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Human rhinovirus (HRV) is the most common respiratory microorganism, which causes acute respiratory infections especially in healthy young children, elderly people, and the immunocompromised person. The diagnosis of rhinovirus infection by clinical and convenient means is more complicated because of the lack of sensitive, accurate tools for differentiation of the rhinovirus from other respiratory tract viral infections. Here, we had developed a rapid, specific and sensitive one step Reverse Transcription Real-Time PCR molecular method for the detection of human rhinovirus (HRV) from nasopharyngeal secretion specimens. The Primers designed from the highly conserved polyprotein gene of human rhinovirus. Our results that had shown a positive RT-PCR assay were specific in detection of HRV and observed in 41 out of 50 specimens (82%). We conclude that one-step RT-PCR assay was a highly specific and rapid technique for the detection of HRV RNA in nasopharyngeal secretions of patients with acute respiratory tract infections.


Article
Abdominal Tuberculosis: Clinical Presentation, Diagnosis, Outcome and Experience with 11 Cases

Authors: Ibrahim Falih Noori
Pages: 581-591
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Abstract

Tuberculosis is a common health problem. Abdominal tuberculosis constitutes about 2% of all tubercular cases and it’s the sixth most common extrapulmonary tuberculosis. The aim of this study was to evaluate the clinical presentation, diagnosis and effective treatment of abdominal tuberculosis. This is a retrospective study including 11 patients (4males and 7 females), with clinical features of abdominal tuberculosis. They were divided according to the clinical presentation into two groups. The first group included patients presented as acute abdominal pain mainly due to bowel obstruction or as peritonitis and were prepared and treated by explorative laparotomy and definitive diagnosis of abdominal TB was made by tissue biopsy. The second group included patients with chronic symptoms. The results observed in this study were that abdominal pain was the commonest symptom followed by abdominal distention, anorexia, weight loss and fever. Tender right lower abdominal quadrant was found in 7 patients(63.6%) and right iliac fossa mass was found in 3 patients (27.3%). Explorative laparotomy was needed for 5 patients (45.5%) who presented as acute abdomen. Strictures were found in 3 patients (27.3%), adhesion in one patient (9.1%) and peritonitis caused by perforation in the terminal ileum was recorded in one patient. Ascitic fluid analysis for AFB stain and culture confirm the diagnosis of abdominal tuberculosis in patients who presented with chronic symptoms of tuberculosis. All patients showed good response to ATT therapy. No mortality or recurrence was recorded during ATT treatment or during follow up period. We concluded that abdominal tuberculosis is difficult to diagnose due to vague and non specific symptoms and signs such as abdominal pain, anorexia, weight loss and fever. High index of suspicion and clinical awareness is needed for definite diagnosis which depends on PCR or histopathology or AFB stain.


Article
Hypertensive Patients Compliance with Medications in Marjan Teaching Hospital/ Babylon

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Hypertension is a major public-health challenge worldwide and one in every three adults has high blood pressure poor or noncompliance produce uncontrolled hypertension that will lead to more complications. The objective of this study is to evaluate compliance of hypertensive adults with their treatment, this is a descriptive cross sectional study was conducted at the medical consultation clinics of Marjan Teaching Hospital during the period from January through July 2013, 323 hypertensive patients aged over 25 years were interviewed and assessed using a special questionnaire format based on Morisky 8-Item Medication Adherence Scale. Weight, height , and blood pressure were measured. The study showed that mean age of patients was 51.28 ± 9.81 years. Good compliance with treatment was present in only 24.8% of the sample and 57.9% had poor compliance. Nearly 90% of patients tend to measure their blood pressure at governmental clinics, 34.1% do not remember their last blood pressure reading; 33.4% do not know the normal reading and 21.3% tend to measure their blood pressure every 3 months or more and good control of blood pressure was present only in 22.3% of patients. In conclusion the study revealed a low rate of medication compliance and low level of blood pressure control with strong association between them. Compliance increased with higher level of education, presence of complication, longer duration of disease and the use of single medication.


Article
Impact of Human Serum on Pharmacodynamic Action of Echinocandins against Aspergillus spp. : an in Vitro Study

Authors: Hussam Wahab Al-Humadi
Pages: 603-611
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Abstract

Echinocandins represent a class of lipopeptide antifungal agents that possess a high protein binding capacity which could have an impact on their activity. This study was focusing on the role of human serum on the activities of echinocannins (caspofungin, micafungin, and anidulafungin) against Aspergillus species (A.fumigatus, A.flavus and A.terreus). The aspergillus growths have been assessed by measuring minimal effective concentrations of each (caspofungin (0.5-1 mg/L), micafungin (0.06-0.12 mg/L) and anidulafungin (0.03-0.09 mg/L). Broth microdilution method was used to study in vitro activities based on the Clinical and Laboratory Standards Institute documentation (CLSI M38-A2) by using standard medium (Roswell Park Memorial Institute (RPMI 1640)) with or without 50% human serum. Each drug was diluted ranging from 0.03-4 mg/L, inoculated with 2x104 Colony Forming Units/ml for each isolate, then incubated at 37οC for 10 hrs to A.fumigatus and A.flavus and 15 hrs to A.terreus. The fungal growth was assessed by measuring the galactomannan index for each concentration with ELISA (Platelia Aspergillus); percentage of fungal growth inhibition was measured from galactomannan index and analyzed as maximal growth inhibition (Emax) and drug concentration with 50% of growth inhibition (IC50). IC50 values of echinocandins were ranged from 0.03-0.06 mg/L without serum and 0.09-0.25 mg/L in presence of serum while Εmax values were 50(44-56)% for A.fumigatus, 70(65-74)% for A.flavus and 65(63-66)% for A.terreus without serum and 94(92-96)% for A.fumigatus, 92(91-95)% for A.flavus and 80(75-83)% for A.terreus with human serum. The study concluded the effective concentrations of all echinocandins were increased concomitantly with more than 90% fungal growth inhibition with human serum.


Article
Effect of Zinc on Antibacterial Action of Bioactive Glass Coating for Dental Implant

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Peri-implantitis is one of the causes of implant failure. Attempts have been done to coat dental implant with bioactive glasses to enhance osseo-integration and reduce microbial attachment. However, the anti-bacterial action of these coatings was limited to certain bacterial strains . Metals such as zinc and silver have been added to these glasses to improve their anti-microbial action. In this study zinc (3 mole%)-containing and zinc-free bioactive glasses were synthesized using melt-derived route. The glass coatings on titanium discs were prepared using enameling technique. The antibacterial action of zinc-containing and zinc-free glass coatings was studied against Streptococcusmutants, Staphylococcus aureus and Porphyromonasgingivalis by disc diffusion method. These bacterial strains were obtained by swab samples. The results showed that zinc at 3 mole% had no effect on antibacterial action of bioactive glasses and both glass coatings exhibited similar effect on bacterial strains used in this study. Since these glass coatings have similar effect on aerobic and anaerobic bacteria, these glass coatings can be used in various medical applications.


Article
Study The Relationship of IL-33 with Adiponectin in Postmenopausal Female with and without Type 2 Diabetes Mellitus

Authors: Abeer Jabbar Hassan
Pages: 618-624
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Abstract

Postmenopausal women influence by several physiological changes such as coronary artery disease, obesity and insulin resistance. Interleukin-33 (IL-33) a cytokine which have a protective effect to cardiovascular disorders and regarded either pro- or anti-inflammatory. Adiponectin is a hormone with anti-inflammatory properties, associated with hyperlipidemia and insulin resistance. The aim of this study is to investigate the relationships of IL-33, adiponectin with atherogenicity as considered risk factor for heart disease in postmenopausal women with and without type 2 diabetes mellitus. Ninety women age between (54-62) years were enrolled in this study. Fasting blood glucose (FBG), glycated hemoglobin (HbA1c), body mass index (BMI), lipid profile, atherogenic index of plasma (AIP), IL-33 and adiponectin levels were determined in patients and control groups. The results revealed highly significant increase in FBG, HbA1c, BMI, TCh, TG, LDL-c, VLDL-c and AIP. While reduce HDL-c, adiponectin and IL-33 levels were founded in postmenopausal women when comparing to control group. Furthermore, a positive correlation was observed in IL-33 with HbA1c, also with AIP, but a negative significant correlation between IL-33 and adiponectin, also between IL-33 and BMI in diabetic postmenopausal women group. Conclusion from the results of present work lead to suggest that higher reduction in IL-33 and adiponectin levels in diabetic postmenopausal women may be useful in predict action of cardiovascular disorders.


Article
Evaluation The Serum Total Protein in Patients with Diabetes Mellitus (Type I and Type II) and Study Genetic Level of Glutathione-S-Transferaseµ 1

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Abstract

Diabetes mellitus is a group of metabolic diseasesdue to defect in insulin secretion or action or both.Hyperglycemia in diabetes creates free radicals .These free radicals produce oxidative stress and thus debilitate the endogenous antioxidant defense system.If the amount of insulin available is insufficient, cells response badly to the effects of insulin or if the insulin itself is abnormal. The net effect is persistently elevating levels of blood glucose, low protein synthesis. The current study evaluate the biochemical changes in diabetes mellitus patients in using different medications and investigate the glutathione S-transeferase M1 gene deletion in different treatments. The present study was conducted on (75) diabetic patients, (25) of them were treated with insulin, (25) were using insulin and metformin and the last (25) were on metformin and glibinclimide .The study also included (25) apparently healthy subjects were taken as control group. The blood sampleswere collected from Merjan Teaching Hospital from November 2013 to April 2014.The total serum protein was measured by colorimetric method described by Gornall. LSD test showed that there was significant difference between insulin & metformin group and metformin &glibinclimide in total serum protein (p ≤0.05). Metformin &glibinclimide group was less mean difference with the control group. In the gene level of the study, genotyping of glutathione S-transferase mu 1gene by PCR were defined as GSTM1 and GSTM0 or deletion association to the present and absences of the guanine nucleotide in the gene sequence. There was statistically significant difference in the genotyping distribution and the frequency of GSTM0 among study groups were 44% for insulin and metformin group, 68% for metformin and glibinclimide, 44% insulin and 28% for control healthy group. there was significant decrease in serum total protein in diabetic patients. Genetic polymorphism of glutathione S-transferase mu 1gene may be considered as risk factor for both types of diabetes mellitus.


Article
Genotyping of Cryptosporidium Isolates from Clinical Samples

Authors: Thanaa Ismael Jawad
Pages: 632-637
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Cryptosporidium is an intracellular protozoan that infects the gastrointestinal tract of human and other animals. Two main species of this parasite are known to infect human C. hominis and C. parvum with the latter has a zoonotic transmission. This study aimed to genotype the clinical isolates of Cryptosporidium from children with diarrhea. A total of 64 fecal samples were collected from children with diarrhea. Cryptosporidial infection was detected using modified acid fast stain. DNA of the parasite was extracted from oocysts of positive fecal samples and nested PCR method was used for TRAP-C2 gene amplification. Restriction fragment length polymorphism (RFLP) was applied for genotyping.Four fecal samples from 64 (0.625%) gave positive result for Cryptosporidium. RFLP-PCR suggested that 3 samples of these related to C. parvum and 1 sample of mixed infection with both C. parvum and C. hominis. From these results it can be concluded that most infections in children with cryptosporidiosis are of bovine origin.

Keywords

nested-PCR --- RFLP --- TRAP-C2 --- cryptosporidiosis


Article
Neovascularization in Psoriatic Patients

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Although angiogenesis may not be the main event in the pathogenesis of psoriasis, identifyingthe pathways leading to angio-proliferation mayaid in discovery of novel antipsoriatic drugs. Vascular endothelial growth factor is a principal regulator of physiological and pathologicalneoangiogenesis. The aim of the study is to assess the serum level of vascular endothelial growth factor in psoriatic patients and its correlation with Psoriasis area and severity index score (PASI score). One hundred consentingpsoriatic patients(males and females)aged 20-60 years who attended different medical centers including Al-Sadr Medical City and department of laser research in AL-Najaf city and Marjan Medical City in AL-Hilla-Iraq.Psoriasis area and severity index assessment was done for each patient. Blood samples were collected for vascular endothelial growth factor measurement. The serum level of vascular endothelial growth factor was significantly increased in all groups of,psoriatic,patients comparedto healthy controls as well as serum vascular endothelial growth factor showed positive correlation with PASI score.


Article
Molecular Characterization of Salmonella Typhi Isolated from Typhoidial Humans

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Present research work was carried out for detection and molecular characterization of Salmonella Typhi isolated from Blood plasma of person severing from Typhoid fever using biochemical test, and detection of virulence gene by using of polymerase chain reaction (PCR) techniques. A total of 12 clinical samples were collected from patients. The isolated strains were also investigated for antibiotic susceptibility patterns as a control measure. Microbiological and biochemical investigations revealed the presence of Salmonella typhi from 12 samples. PCR analysis confirmed these presence of fliC (Phage-1 flagellin gene), viaB (Vi antigen gene) and SipA genes. Antibiotic susceptibility test was carried out among the isolates against 12 antimicrobial agents. Results showed that 100 % resistance to only ampicillin and 100 % sensitivity to carbenicillin, chloramphenicol, clindamycin, gentamycin, kanamycin, and tetracycline.


Article
Normal and Abnormal Variations of Sella Turcica in Three Facial Types of Adolescent Iraqi Samples

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Sella(S) turcica is a structure resemble a saddle and based on the roof of the sphenoid bone. For cephalometric tracing, sella point is one of the most commonly used cranial landmarks and it is located in the centre of the sella turcica of the skull. This study were to assess the shape and size of sella in a sample of Iraqi adolescent and with different skeletal classes. The study sample consist of (91) Iraqi adolescent subjects aged 10-16 years (47 females, 44 males); every subject provided with true lateral cephalometric radiograph. The sample was classified into three skeletal classes according to ANB angle. The size of Sella was measured using three linear measurements (S. length, S. depth, and S. diameter). It showed that most of the measurements of sella turcica were not different statistically among the skeletal classes. Normal sella was the predominant over the other morphological aberrations, while these morphologies occurred more frequently in class II and III. throughout the pubertal period specific sella turcica linear measurements cannot be obtained for each specific skeletal class; except between class I and II patterns, Sella depth was statistically higher in the former.


Article
Measurement of Adenosine Deaminase Concentration in Serum of Breast Cancer by HPLC before and after Chemotherapy in Hilla City

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Abstract

Breast cancer (BC) is a type of malignancy appeared in breast tissue , occurs in both premenopausal and also in postmenopausal women's. Adenosine deaminase (ADA) is an enzyme participate in metabolism of purine. However, the level of adenosine deaminase increased in most cancers patients and it could be of value before and after chemotherapy. A total of 280 patient with (BC) divided in two groups, first group (n=40) women with breast cancer without chemotherapy, second group (n= 240 ) women with breast cancer with chemotherapy, this group was divided into six groups according to the doses used (1st – 6th doses). The control group (n= 40) apparently healthy women's matched with patient group. Women with (BC) have a significant higher serum level of ADA than those who are not diseased (p<0.001) and even than those who received chemotherapy (p<0.05 ).So, this lead to a conclusion that; breast cancer women have higher level of ADA . ADA level decreased upon administration of chemotherapy. The objective of this study is to assess ADA status in women's BC receiving chemotherapy treatment.


Article
The Socio-Demographic Profile of Thalassemia in Basrah

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The thalassemias is one of the most common inherited diseases worldwide with considerable frequencies in the Middle East region, including Iraq. As the diseases requires long-term care, establishment of an effective preventative program constitutes a major armament in the management. As part of this effort, we initiated this primary studyto determine the types of thalassemic patients based on family medical history, age, region, blood groups and consanguineous marriages.The results showed the geographical and social distributions of thalassemia in Basrah city of Iraq. For the later purpose, based on the present findings, we willinvestigate the molecular basis of this disease with the aim of establishing a proper preventive program.


Article
Molecular Study of Virulence Genes of Staphylococcus aureus Isolates from Various Clinical Origins by PCR

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Staphylococci pathogen was blamable for a huge scale of infections in human because of their invention of secreted and other cell-surface related virulence factors that regulate by various genes. This study was carrying out to realize the frequency of Staphylococcus species in Hillah city using specific genes for that purpose. PCR technique was applied to amplify the staphylococcal virulence genes like sea, see, eta, tst, coa, nuc, seb, femA, mecA, etb, cna, fib and fnbA, and they determined either multiplex or uniplex PCRs depending on the sizes of the PCR products amplicons. Out of 229 collected samples from different clinical sources, only 100Staphylococcus aureus (43.7%) were revealed. According to phenotypic and biochemical tests, the isolates can be distributed as follow; Urine 22 (9.6%), Pus 19 (8.3 %), Sputum 12 (5.2%), CSF 4 (1.7%), Blood 32 (14%), Pericardial fluid 9 (3.9%) and Peritoneal fluid 2 (0.9%). From the 13 examined genes, most abundant gene was fib (27 cases) followed by femA (25 cases). While tst gene reported as the least frequently detected gene. S. aureus isolated from Blood infection formed the highest ratio among genes reveals in this study (194; 38.6%) followed by pus infections isolates (120; 23.9%), urine infections isolates (102; 20.3%), sputum isolates (32; 6.4%), Pericardial fluid (28; 5.6%), CSF (19; 3.8%) and finally Peritoneal fluid (8; 1.6%).


Article
Effects of Laser Light on Vaccination with Hepatitis BVaccine

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Vaccination still the most important strategy in the prevention of infectious diseases, and the developing of powerful vaccine adjuvants is crucial to maximize the efficacy of these vaccines. Our objective was to introduce the laser adjuvant to increase the immunogenicity of Hepatitis B vaccine. Twelve wistar albino male rats were included in this study. The animals were divides into three groups; control, red laser, and infra- red laser groups. Rats were anesthetized by chloroform; the lower dorsal hair of the rats was shaved. The skin of laser groups was exposed next day to red laser (λ = 635 nm) or to IR laser (λ = 808 nm) for 60 seconds at 300mW after the rats were anesthetized similarly. The rats were then immunized by intradermal (i.d.) administration of (2 ug) of Hepatitis B virus surface antigen (HBsAg) into the laser-illuminated sites. Rats in control group were treated and immunized similarly except for no laser illumination.Laser therapies have diverse immunological effects; the most interesting effect is the change in the differential blood cells count after laser illumination which characterized by a significant increases in lymphocyte count and decreases in neutrophil count after one session of irradiation with red laser light.We found that 635 nm laser induce a significant increases in TNF-α level comparing with the other laser (808 nm) group or the control group. In conclusion the visible red laser has a significant boosting effect on HBsAg vaccine.


Article
The Role of Highly Sensitive Troponin I in Diagnosis and Prognosis of Dilated Cardiomyopathy in Pediatric Age Group

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The aim of this study, is to evaluate the role of highly sensitive serum troponin I in diagnosis and prognosis of children with dilated cardiomyopathy. This study included 48 children with dilated cardiomyopathy with left ventricular dysfunction, that diagnosed clinically by history, clinical examination ,electrocardiography and echocardiography, including 2D-echocardiography, M-mode and Doppler study. Echocardiography regarded as the corner stone in the diagnosis of dilated cardiomyopathy. Those patient were subdivided to 15 children present with acute heart failure (Acute DCM) (8 female and 7 male), and 33 children who are known cases of dilated cardiomyopathy reported in the cardiology out clinic with chronic cardiac dysfunction (18 female and 15 male),both groups followed for one year with regular clinical, laboratory and echocardiographic evaluation during treatment coarse for cardiac dysfunction , another 48 control healthy child with same age groups involved in the study (25 female and 23male), the age of both patient and control groups ranging from 1month- 12 years. All patient had cardiac dysfunction at the time of attendance . We found that most patient with Dilated cardiomyopathy with acute left ventricular dysfunction had high serum level of highly sensitive troponin I at the time of presentation. Those patients with chronic Dilated , usually had serum troponin above the detectable limit and significantly more than control group. During follow up all patient show to decrease their serum troponin I level with improvement of their cardiac function till reaching normal or nearly normal level if Left ventricular function improved toward normal value, while those remain with left ventricular dysfunction for longer period despite treatment shown to have higher troponin level. This negative relationship between highly sensitive troponin I indicates that the highly sensitive troponin I is important for both diagnosis and prognosis of patient with dilated cardiomyopathy.


Article
The Outcome of Dilated Cardiomyopathy in Pediatric Age Group After One Year Treatment for Acute and Chronic LV Dysfunction

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Dilated cardiomyopathy (DCM) means congestive heart failure as a result of dilation and systolic dysfunction of cardiac ventricles (mainly the left ventricle). It is a common type of cardiac muscle disease in pediatric age group. Many children with DCM are without symptoms, but known patients with DCM may present with acute heart failure, others may be developed ventricular abnormal rhythm and atrioventricular block, syncopal attack and sudden death . Dilated cardiomyopathy (DCM) in pediatric age group has a worse prognosis, the survival rate was 41% at 1 year and 20% at 3 years. The participants belongs to both 48 patients)15 patients with acute DCM , mean age (10.24±11.38 months; 8 females and 7 males) and 33 patients with chronic DCM (mean age (10.46±10.72 months;18females and 15 males) were selected and examined in the cardiology clinic of Karbala pediatric teaching hospital between April 2013 and October 2014. 2- D echocardiography, M- mode for assessment of cardiac function ( Ejection fraction (EF). At the time of attendance , all the patients with acute DCM (NO.=15) had low EF, with treatment , there was improvement in the EF during the period of treatment and follow up, after 1 year 66.7% of patients had normal EF. Also, all patients with chronic DCM (NO.=33) had low EF, with treatment , there was improvement in EF, after 1 year 60.6% of patients had normal EF. At the time of attendance , all the patients with acute and chronic DCM had low EF, with treatment, there was improvement in the EF during the period of treatment and follow up, after 1 year of treatment and follow up.


Article
The Role of NT- Probnp in The Diagnostic Workup of Patient with Chronic Dyspnea of Unexplained Etiology

Authors: Karim Obais Al-Naffi
Pages: 711-720
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Dyspnea is a common clinical complaint of diverse causes, it may be of acute or chronic onset. Diagnosis of dyspnea should depend on good history, proper physical examination with the logistic use of laboratory &radiological investigation. Yet some time, especially in patient with chronic dyspnea, we may be left with patient without clear clinical diagnosis. NT- proBNP is which is a hormone produced from the heart whenever there is stretch of cardiac muscle is proved of diagnostic value in acute dyspnea. This study is to examine the diagnostic value of NT-proBNP in the etiology of chronic dyspnea with unapparent clinical cause. From 425 patient presented complaining of chronic dyspnea, after full history, physical examination &conventional investigation, Sixty-two patient have no evident cause for their dyspnea. Those patients were studied to assess the value of NT- proBNP in the work up for the cause of their dyspnea &its relation to their BMI, age, HT, DM & IHD. Significant high level of NT- proBNP was found in patient who have higher grade of dyspnea &in those with chronic disease as HT, DM&IHD especially if they have IHD. Although many of the patient have high BMI but it does not significantly related to the level of dyspnea. NT- proBNP is a helpful diagnostic mean in patient with chronic dyspnea although other limitation factors as age, sex & BMI should considered.

Keywords

NT-proBNP --- Chronic Dyspnea


Article
Prognostic Significance of Immunohistochemical Overexpression of P53 And Bcl-2 Proteins in Patients with Non-Hodgkin’sLymphoma

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Non-Hodgkin's lymphomas are the hematologic malignancy with the most prevalence worldwide, they are generally classified as B-cell or T-cell lymphoma .Theincidence rate of NHL for the total population is 5.16 % according to Iraqi cancer registry (ICR) in 2010. This study was designed to asses’bcl-2 and p53 overexpression in Iraqi patients with NHL and correlation with different prognostic indices (age, sex, stage, grade, and International prognostic index). Samples included in this study represented as 50 formalin-fixed paraffin embedded lymph node blocks of patients with NHL,during the period from September 2013 till November 2014,and these blocks collected from the histopathology laboratories of Al-Hilla Teaching Hospital as well as many private histopathology laboratories in Hilla city, These blocks stained Immunohistochemically for bcl-2 and p53 protein expression by using L-SAB+ staining methods. Results revealed Significant correlation between bcl-2, p53overexpression and different grades of NHL (p-value < 0.05), while there are no significant relationship between bcl-2, p53 and age, sex, stage, and IPI score (p-value > 0.05). In conclusion there are up regulation of P53 protein associated with down regulation of bcl2 protein in patients with high, intermediate to low grades of NHL while no significant association with IPI score& factors.

Keywords

Non-Hodgkin lymphoma --- P53 --- Bcl-2


Article
The Significance of Serum C-Reactive Protein in Childhood Acute Meningitis

Authors: Russul Feihan Mussa
Pages: 730-738
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Abstract

Serum concentrations ofC-reactive protein is considered an important diagnostic test for sepsis because itincreases several folds in response to bacterial infection. All over the worldbacterial meningitis is asignificant cause of childhood morbidity and mortality, so early diagnosis and treatment are the most important ways in prevention of the complications.The aim of this study was toestimate the usefulness of serum CRP level in differentiation between septic and aseptic meningitis.We measured the serum CRP level in patients who were diagnosed by clinical and laboratory findings as pyogenic and aseptic meningitis. It was found that partially treated meningitis was most common in all age group,and there is significant correlation between high serum CRP titer and positive CSF culture p.value0.004. Serum CRP was of high titer in 23 (82%) patients with pyogenic meningitis, while its negative in70% of patients with viral meningitis. Fever was the most common presenting symptom in all age group 99(90%) of patients. Patients with Meningeal sign (neck stiffness) were 29(87.8%) in those more than one year from total 33 patients and headache 19(82.6%) from total 21 patients.There is a good sensitivity for serum–CRP, while there is a high specificity for CSF culture and a good specificity for CSF gram stain in pyogenic meningitis. CSF leukocyte polymorphs significantly increased in pyogenic meningitis ,p.value 0.008. while lymphocytes significantly increased in viral meningitis, p.value 0.002. CSF protein: Increase >100mg/dl in 86% of patients with pyogenic meningitis.CSF glucose was significantly decreased in pyogenic meningitis p.value 0.004. We conclude from this studythatserum CRP can helptodistinguish betweenpyogenicand aseptic meningitis. Children who present with clinical feature of meningitis in whom serum CRP values are determined at 12 hour after the onset of fever and are < 6 mg/L are less likely to have pyogenic meningitis. Serum CRP detection is not expensive, simple and dependable diagnostic indicator in meningitis.


Article
The Use of Tunica Vaginalis in Hypospadias Fistula Repair

Authors: Ahmed Ali Hassan Al-Kinani --- Redha Ali Taher
Pages: 739-744
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In hypospadias surgery urethrocutaneous fistula is the most common complication, or might be an iatrogenic fistula as part of the staged hypospadias repair. Carrying a supportive layer of vascularized tissue for closure between the urethra and the skin will provide safe closure and reduce the likelihood for fistula recurrence. Evaluation of hypospadias fistula closure by using tunica vaginalis fascia as an interpositional layer between the neourethra and the skin to prevent fistula recurrence. The tunica vaginalis fascia vascularized flap have been used for repair of hypospadias fistula. In 50 patients with age ranged from 1.5-15 years, from 2004 to the January 2015. All patients had undergone previous hypospadias repair, the fistulae were closed primarily and urethral suture line was covered with a flap of tunica vaginalis which was harvested through scrotal incision ,then the skin closed as a third layer of closure. A urethral catheter was kept for urinary diversion for 10-14 days.The repair was successful in all patients excepting only 6 cases where other factors affecting the repair, including catheter obstruction and direct trauma to the operation site. The repair with tunica vaginalis is very effective, so fistulae should be closed in three layers for better healing and preventing the recurrence to the lower minimum.


Article
Radiofrequency Ablation of Typical Atrioventricular Nodal Reentry Tachycardia in Dual and Multiple AV Nodal Pathways

Authors: Ameen Abd Al-Hassan Al-Alwany
Pages: 745-754
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Abstract

Typical atrioventricular nodal reentrant tachycardia (AVNRT) is the most common paroxysmal supraventricular tachycardia among adults. The concept of dual pathway physiology remains widely accepted. Slow pathway (SP) ablation is the first-line treatment approach with a high acute success rate and a low risk of inadvertent complete atrioventricular (AV) block and noninduciblility consider the primary end point of ablation. Aimsof study to determine the percentage of multiple AV nodal pathways in patients with only typical AVNRTs and to compare its electrophysiological data with usual dual AV nodal pathways. The study included 40 patients with only typical AVNRT(mean age 51 ± 6.8 years, 28 (70%) women) who underwent SP ablation using anelectrophysiological and anatomical approach. Electrophysiological analysis was performed for; differentiate dual from multiple pathways and potential predictors of acute success ablation. The patients were divides into two groups according to the number AH-jump as increase by 50 ms or more which was analyses after applied atrial programmed electrical stimulation. Group I 25 (62.5%) with dual AV nodal pathway and Group II 15 (37.5%) with multiple AV nodal pathways. The tachycardia cycle length seems to be faster in Group I (345 ±65 versus 410 ±70). Acute successful ablation was achieved in all patients 100%. More radiofrequency energy applications were required in group II (14± 5.6versus 7.8± 4.6) in Group (I). In patients with more than two AV-nodal pathways Group II, thecatheter intervention resulted more frequently in a modulationof slow pathway conduction than in an ablation ofthe slow pathway 10 (25%) was modulated versus only 5 (12.5%) were ablated. While 19 (47.5%) was ablated versus 6 (15%) were modulated in Group (I). One patient (2.5%) had developed persistent first-degree (PR 250ms) and transient second-degree AV block after ablation. There is unexpectedly high percentage of typical AVNRTs (37.5%) with more than two AV nodal pathways and these require good electrophysiological evaluation for successful ablation. The slow pathway SP ablation of typical AVNRTs using radiofrequency energy is a highly effective procedure with an extremely low risk of development AV block.


Article
Retroperitoneal HematomaA Continuous Challenge for Surgeons!

Authors: Haitham Abid Hammoud --- Raid Jasim Ahmed
Pages: 755-762
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Abstract

Traumatic retroperitoneal hematomas are associated with high mortalityrates and it is a common complication of abdominal or pelvic injuries and makes thediagnosis and treatment of the lesion complicated. Our aim from the study is to high lighten the causes and the rates of mortality in the cases of RPH. To analyze our experiences in patients with traumatic retroperitoneal hematoma and to find out the frequency of different visceral injuries and morbidity and mortality related to different zones in retroperitoneal hematoma due to trauma. A prospective study of 103 patients' data with traumatic retroperitoneal hematomas collected between1 January 2010 and31 December 2013 at Al-Yarmouk Teaching Hospital. The mechanism of injury was penetrating in 83(80.58%) patients, and blunt trauma in 20(19.41 %) patients. Zone III was most commonly involved 68(65.9%) followed by Zone II 25(24.3%), Zone I 7(6.7%) and pelvicentral zone 3(2.9%). Ninety-twopatients (89.4%) needed surgical exploration while 11(10.6%) patients were treated conservatively, 41(39.8%)died.Mandatory exploration of zone I and selective exploration of zone II and III isa valid policy in the management of retroperitoneal hematomas.

Keywords

abdominal --- retroperitoneal --- trauma --- hematoma --- penetrating --- blunt


Article
A Comparative Study of Hematological,Renaland Liver Function Criteria in Type I and Type II Diabetes Mellitus

Authors: Zainab Hadi Kamil
Pages: 763-773
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Abstract

Diabetes mellitus (DM) is a metabolic syndrome resulting from a deficiency in insulin secretion leading to disorders of carbohydrate metabolism.Two distinguish types of DM are found (type I; insulin dependent, and type II; insulin independent).The chronic, long period complications of diabetes, associate withvascular diseases and dysfunction of kidney and liver. The current study was considered to comparebetweentype I and type II Diabetes Mellitus (DM) and healthy adults insomehematological and biochemicalcriteria. The study was carried out at laboratories of Merjan Hospital and involved 80Diabetic patients (33 type I diabetes mellitus; 14 males and 19 females, and 47 type II diabetes mellitus; 19 males and 28 females) aged between 30-65 years and 35 healthy subjects (10 males and 25 females) aged between 33-60 years.The study included three groups; healthy subjects, type I DM and type II DM. Hematological criteria including red blood cell count (RBC), hemoglobin concentration (Hb), hematocrit (Hct), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC),red cell distribution width (RDW), white blood cell count (WBC), platelet count (PLT) and mean platelet volume (MPV) were determined by using hemato-analyzer. Serum glucose, serum urea and serum creatinine were measured.Additionally the liver enzymes Glutamic pyruvate Transaminase (GPT) and Glutamic Oxalatetransaminase (GOT) were obtained. The results of this study revealed significant differences (p<0.01) in serum glucose concentration, MCH (in males), RDW (in females) and MPV between the three groups involving in the study. Significant differences (p<0.05) in MCV, RDW (in males), MCHC (in females), serum creatinine, S.GPT and S.GOT within the three groups of the study. Diabetes mellitus is a high prevalent metabolic disease resulting in many health complications. RDW and MPV represent appropriate indicator for vascular complication due to DM. Serum creatinine is more sensitive test for renal dysfunction rather than serum urea in diabetic patients. Elevation in liver enzyme (GPT and GOT) levels is higher in type II DM as compared with type I DM. Hence non-insulin diabetic patient should be examine annually

Keywords

Diabetes Mellitus --- renaldysfunction --- liver dysfunction --- RBC --- WBC --- PLT --- urea --- creatinine --- GPT --- GOT


Article
Epidemiology of Drugs and Chemical Poisoning in Children In Babylon Governorate

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Abstract

Acute Poisoning in children is one of main public health problems and regarded a frequent cause of admission to hospitals. Its epidemiology is necessary to determine the extent and characteristics of this problem.A hospital based retrospective study was done to determine the epidemiology of chemical and drug poisoning in children admitted to Babylon Gynecology and Pediatrics Teaching Hospital during one year duration from June 2013 to May 2014. Two hundred and twenty seven patient's records were reviewed regarding poisoning. One hundred and fifty one (66.5%) of them were males. Hydrocarbons poisoning was the most prevalent poisoning followed by drugs. Patients from rural areas were more than the patients from the urban areas (57.7%, 42.3%) respectively.


Article
Assessment of Antioxidant Status and Ceruloplasmin in Early and Advanced Stages of Sporadic Colorectal Cancer Patients whom Receiving Adjuvant Chemotherapy

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Abstract

One of most frequent malignant disease in the developed countries is colorectal cancer and it is the seventh most common cancers among population of Babylon province/Iraq. It was reported that oxidative stress status is being play a very important roles in development of carcinogenesis. The purpose from this study was assessment of antioxidant status in early and advanced stages of patients with sporadic colorectal cancer whom received adjuvant chemotherapy. This investigate was done by measuring of total antioxidant capacity(TAO-C), Ceruloplasmin and its related trace elements ,copper and Zink. All patients included in this study were receiving adjuvant chemotherapy regimen and subdivided into two groups according to Duke´s classification of malignant into early stages (A+B) and(C+D) advanced stages, cancer site (colon and rectum), and according to the number of dosage of chemotherapy regimen(half dosage and total dosage). ELISA methods were used to assess serum Cp concentration and colorimetric method for measurement of serum TAO-C ,while concentration of Cu and Zn were determined by atomic absorption spectrophotometer ( AAS). Cu/Zn and Cu/Cp ratio were calculated mathematically. The results were showed highly significant decreasing(p<0.05) in T-AOC and Zinc concentration in stages (C+D) subgroup compared to (A+B) and control group. Both Ceruloplasmin and copper were found markedly increased in stages (C+D) compared to (A+B) stages and control group. Cu/Zn ratio was increased significantly in advanced stages and controls while Cu/Cp ratio was markedly decreased in advanced stages compared to early stages and controls. In conclusion the results of present study suggests that TAO-C and/or Cp and its related elements are monitoring factors and prognostic indicators could be valuable during the treatment with adjuvant regimen for sporadic colorectal cancer patients.


Article
Prophylaxis of Hydrocele after Varicocelectomy

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Abstract

Hydrocele comes on the top of complications after surgical repair of varicocele.To evaluate the efficacy of selective vein ligation procedure by the aid of loupe optical magnification with creation of a window in tunica vaginalis to prevent the formation of hydrocele after varicocelectomy. Two hundred patients with varicocele treated were analyzed. A study is applied on two patient groups, of each one hundred patient. Group 1: Conventional procedures for varicocele, without use of optical magnification including: Paloma, inguinal mass ligation and subinguinal selective ligation, and a group 2; underwent subinguinal selective varicocelectomy with the aid of optical magnifications and completed by creation of a window in tunica vaginalis. Hydrocele, as a complication following varicocelectomy, is reduced from 15% in group 1 to 3% in group 2. By theaid of optical magnification with creation a window in tunica vaginalis,a significant decrease in incidence of post varicocelectomy hydrocele in group 2 was found. So this procedure seems effective and we recommend its addition to the standard procedures of varicocelectomy.


Article
The Liver Aminotransferase Levels in Diabetes Patients

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Abstract

This study aim toinvestigate the levels ofliver aminotransferase in patients with diabetes and the effect of glycemic control on the levels of these enzymes.The study was conducted on 115 persons, 19 poorly controlled diabetic patients (glucose>300 mg/dl), 25 moderately controlled diabetic patients (glucose 200-300 mg/dl), 21 well controlled diabetic patients (glucose < 200 mg/dl), and 50healthy non diabetic subjects as normal control. Serum glucose, ALT and ASTwere assessed in all groups.There was no statistically difference in ALT and AST levels between control and total diabetes patient groups. Poorly controlled diabetic patients demonstrated highly significantly increase of ALT and AST when compared with the other two patient groups (well and moderate controlled diabetic). But there is no significant statistic for these enzymes between well and moderate controlled diabetic groups. In conclusion,increased levels of ALT and ASTmay contributory factor to induced liver disease observed in poorly glycemic control patients.


Article
Lipid Profile Changes in Women in Reproductive Age Group Using Injectable Medroxypogesterone Acetate Contraception

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To evaluate lipid profile changes in women of reproductiveage group using Depot Medroxyprogesterone Acetate contraceptive lasting for three months. A prospective study in Al- Imamein Al- Kadhemein medical city from July 2013 to January 2014. The study included a total of 40 healthy multi para women in reproductive age group, visiting family planning clinic in Al- Imamein Al- Kadhemein medical city seeking for contraception. Verbal consent obtained from participants. Baseline serum lipids wasassessed prior to the use of Depot Medroxyprogesterone Acetate and thenthree months after the use of injection in 10-12 hours fasting women. A detailed questionnaire was designed, to be fulfilled by each clientincluding; all relevant issues: age, general health history, obstetric and gynecological history, menstrual cycle and relevant medical diseases andprevious use of contraception.In this study there was significant increase in serum LDL (p value <0.001) and significant decrease in serum HDL (p value<0.001) after three months of depot-medroxyprogesterone acetate injections in comparison to pre-injection group. There was insignificant increase in serum cholesterol (p value >0.05) and no changes in serum triglyceride, also there was no significant changes in BMI three months after injections (p value> 0.05).Depot medroxy progesterone acetate used in women with reproductive age group as injectable contraception, can cause significant changes in lipid metabolism.


Article
Breast Carcinoma in Young Woman :Pathological and Immunohistochemical Study

Authors: Sura Salman Ejam
Pages: 817-827
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Abstract

The aim of study is to study the pathological types and the immunohistochemical properties of breast carcinoma young women and compared it with older women This study included 80 paraffin embedded samples from female patients with breast carcinoma which were collected randomly from period of November 2010- November 2013 in AL-Hilla Teaching hospital. The clinical informations were collected including ages of the patients, histopathological types, & tumor grades from clinical reports of the hospital. A manual avidin biotin peroxidase complex procedure (ABC) system was used in the imunohistochemical analysis (Dako Cytomation Copenhagen, Denmark). In this study, the histopathological examination of the 80 cases revealed that , 5 (6.25%) cases were of the pure in situ ductal type, 65 (81.25%) cases were of the invasive ductal carcinoma not otherwise specified, 7 (8.75%) cases were of the invasive lobular carcinoma, and 1 (1.25%) case was of each of the medullary, mucoid, squamous (metaplastic) types. In the 80 cases of breast carcinoma that were studied, ER expression was positive in 8 cases (17.39%), PR expression was positive in 22 cases (27.5%), HER2/neu expression was positive in 20 cases (23.75%). There were higher proportion of ER and Her2 negative breast carcinoma in early aged patients than the older patients so the early onset breast according to the immuno -histochemical parameters have the worse prognonsis than the late onset group.


Article
Dental Wear Its Prevalence and Patterns in Class I Malocclusion (A Comparative Study)

Authors: Kasem Ahmed Abeas
Pages: 828-835
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Abstract

Dental wear is a physiological process that occurs normally through a variety of mechanisms and age progression. It is aloss of tooth structure during masticatory forces. The study aimed to investigate patterns of tooth wear in adult with class I malocclusion (crowding) then the normal occlusion is compared with them. Our study sample consisted of 2 groups with an age range “18-25” years.The 1rstgroupwas (30 subject) with normal occlusion and the 2nd was (30 subject) with class I crowding. A modified version of the tooth wear index (TWI) was used to assess the amount of tooth wear. Tooth wear was greater statistically in incisal surfaces of central incisors of the upper arch and lateral incisors of both arches in class I malocclusion group than was in group of normal occlusion. While significant tooth loss was found in the buccal surfaces of the lower 1rst molar and the incisal surfaces of upper canines in normal occlusion than it was in crowding group. It was concluded that the irregularity of the dentition in class I malocclusion subjects lead to the differences in the pattern of tooth wear in both the normal and malocclusion groups.


Article
Evaluation of Cutaneous Approaches to The Orbital Skeleton Inmanagement of Facial Injuries

Authors: Majeed Abd Al-Razzaq Baheer
Pages: 836-848
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The aim of the study was to evaluate the cutaneous approaches to the orbital skeleton & making a comparison among various types of these approaches into each aspects of the orbit with consideration of intraoperative visibility, functional & esthetic results. 24 patients requiring 47 incisions for repairing their orbital fractures, had been reviewed,and distributed as following; 10 eyebrow incisions (21.2%),7 temporal incisions (14.9%), 7subciliary incisions (14.9%),6 inferior rim incisions (12.7%), 5 subtarsal incisions (10.6%),4 lacerated wounds or previous scars (8.5%),2 crow's foot incisions (4.2%), 3superolateral incisions (6.4%), 2 lynchincisions (4.2%) and 1 bicoronal incision (2.1 %). These approaches were evaluated according to their visual field, functional, cosmetic&post-operative complications depending on type and position of the incision, intraoperative time consuming and period of tissue manipulation. Scar appearance for each incision was graded as invisible,barely visible & visible.¬ The study recorded two cases of transient scleral show (16.6%) and one case of transient moderate ectropion (8.3%).The surgical access to various parts of the orbit, operating time, potential damage to adjacent anatomical structures, and acceptability of the scar and the development of postoperative complications are important factors which have to be considered when choosing the approach to the orbit.

Keywords

orbital --- Facial --- Injury --- Cutaneous


Article
Frequency of HLA-DR3 Alleles and Pedigree Analysis for Patients with Thyroiditis

Authors: Alaa Jawad Hassan --- Eman Wahab Kadhum
Pages: 849-856
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A study was performed to estimation the concentration of HLA-DR3 alleles and pedigree analysis in patients with thyroid diseases in Babylon province .The results showed that there was significantly increased (p<0.05) in frequency of HLA-DR alleles in all groups of patients (hyperthyroidism , hypothyroidism , euthyroidism and normal with family history ) compared with healthy subjects . Furthermore , the results reveals increased ratio of disease in females compared with males , also the ratio of thyroiditis patients were higher in second age categories compared with first and third age categories . The pedigree analysis showed genetic role in the frequency of disease depending on the genetic history of family , where more patients with thyroiditis were found in families, one of them (especially mother) or their uncles undergo from this disease .


Article
Risk Factors of Hypertension Among Apparently Healthy Workers in Al-Hilla Textile Establishment

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Hypertension is an increasing public health problem in developing countries including Iraq, the consequences of this chronic disease are very serious , the pathogenesis of essential hypertension is still not explained . The objectives of this study were to assess the prevalence of hypertension, prevalence of newly discovered cases and to identify some risk factors associated with arterial hypertension among a sample of apparently healthy workers in Hilla Textile Company. This was a case control study conducted on a sample of randomly selected 7o hypertensive workers as cases and 140 non hypertensive (healthy control group), data were collected using a structured questionnaire which included socio-demographic information, life style habits studded as potential risk factors, the prevalence of hypertension was calculated among the study group , the duration of the study extended from September 2014 through January 2015. This study showed that the overall prevalence of hypertension was 33% and it was higher in male workers 37% . the main risk factors that were significantly associated with hypertension were central obesity (OR=5.053), positive family history of hypertension (OR=2.184), diabetes mellitus (OR=5.4), drinking beverages (OR=2.403), smoking, alcohol consumption, using non-steroidal anti-inflammatory medications regularly and inactivity. there were no significant associations (P<0.05) between hypertension and the following variables: place of residence, educational level marital status and the gender of workers. In conclusion this study showed that hypertension is positively linked to positive family history of hypertension, central obesity, regular drinking beverages and inactivity.


Article
The Efficacy of SLT (Selective Laser Trabeculoplasty) as Primary Treatment For Patients with Primary Open Angle Glaucoma

Authors: Mustafa Tawfiq
Pages: 867-869
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To see the effectiveness of SLT as primary treatment for patients with primary pen angle glaucoma(poag) The study was conducted at my clinic in Al Hilla city Babylone Iraq 21 patients were treated 4 of them both eyes treated with slt all the patient were not receiving any anti glaucoma medication and follow up for one year . All the patients were having drop in their iop reading as compared to their first visit with a range of about 30% Slt is a very effective technique in lowering and controlling iop when it is used as primary treatment in patients with poag.

Table of content: volume:12 issue:3