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:4

Article
Biochemical Characterization of Protease and Its Impact By Nano Particles in Sera of Iraqi Patients with Burns

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Abstract

Proteases have great medical and pharmaceutical importance due to their key role in biological processes and in the life-cycle of many pathogens. The present study aims to characterization of protease and evaluate their impact by Gold Nano Particles and Nickel Nano Particles. A total of 30 patients with burn and 25 healthy individual with matches were included in this study. Gold nanoparticle and nickel nanoparticle were prepared using Pulsed Laser Ablation in Liquid method .The activity of serum protease was determined using casein as substrate. The results indicated increased protease activity in sera of burn patients and inhibition effects of both gold and nickel nanoparticles on protease activity. Thermodynamically favorability of the reaction can depend on the temperature. We conclude that nanoparticles such as gold and nickel can be used as treatment of burns through their role in homeostasis due to their inhibition impact on protease activity.


Article
The Role of Estrogen Receptors Immunohistochemical Study in Prognosis of Bladder Transitional Cell Carcinoma

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Urothelial Bladder cancer (UBC) is a common and complex disease that have various internal and external risk factors and represent 90% of bladder cancer.Various studies involving immunohistochemical staining of estrogen receptors(ER) have rendered inconsistent results regarding the expression of ERα and ERβ for different bladder cancer stages and grades.Ninety five Paraff in embedded blocks of UBC (68 male and 27 female) were studied by immunohistochemical technique for detection of estrogen receptor expression and its correlation to some of prognostic parameters such as sex, age, grade and stage of UBC. The study was carried out in the Department of Pathology College of Medicine Babylon University during the period from November 2013 to Augest 2015. Mean age of all cases was 64.6 and they ranged from 30 to 90 years old. The results showed that there were low rate of estrogen receptor expression (only 15 positive cases) and no significant correlation between estrogen receptor expression and the involved prognostic parameters (p value > 0.05). So estrogen receptor expression cannot be used to assess the prognostic outcome for Urothelial bladder cancer.


Article
A Study The Effect of Nd: YAG Laser on The Adhesion of Candida albicans and Some other Properties of Heat Cure Denture Base Material

Authors: Raghdaa Kareem Jassim
Pages: 890 -901
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Denture stomatitis is a disease associated with colonization of Candida albicans on a denture surface. In a review of literature, a variety of topics used for the management of this case. And this especially include: systemic drug, treatment with chemical disinfectant or irradiation of denture with plasma. With the introduction of laser and its several applications in medicine and dentistry .the present study used Nd: YAG laser for this purpose. The present study evaluates the effect of diode pumped Nd: YAG laser (second Harmonic generation) on adherent Candida albicans on the surface specimen and other properties of heat cure acrylic including (Transvers strength, Impact strength, surface roughness surface hardness and FTIR test). Diode pumped Nd:YAG laser type second harmonic generation have wave length532nm&power 1watt were used.Specimens were made from heat cure denture base material .Evaluation the properties of this material has been done before and after laser irradiation of the specimens for 5&10 min. The distance between the source of laser and specimens was 100cm .All data analyzed with the use of statistical test (X ≤0.05). Results ofirradiation of heat cure specimens with Nd:YAG laser revealed a lower mean values (M=66.1,SD=11.779,M=0.753,SD=0.415)for transvers strength &surface roughness respectively at 10min.At the same time, the results appeared the highest mean values(M-80.20,SD=11.3,M=6.21,SD=1.324)for indentation hardness and impact strength respectively.Nd:YAG laser irradiation to heat cure specimens showed a decrease in the mean value of Candida albicans adherence test for two time:10&5min with statistically no significant difference at a level of (p≤0.05). According to the results of the present study it can be concluded that Nd: YAG laser can be used for the reduction of Candida albicans adherence to heat cure with minimal adverse effect on someother properties of material tested.


Article
Immunohistochemical Expression of Hypoxia-Inducible Factor-1α in Triple Negative Breast Cancer

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Triple-negative breast cancer is a malignant neoplasm characterized by absent expression of estrogen, progesterone and human epidermal growth factor-2 receptors. Hypoxia-inducible factor-1 alpha is up-regulated under hypoxia and associated with induction of angiogenesis resulting in proliferation, aggressive tumor phenotype and metastasis. Determination of the potential role of Hypoxia-inducible factor-1 alpha in the development and conventional clinicopathologic factors, and to demonstrate their prognostic relevance in Triple-negative breast cancer. A pro and retrospective study of 281 female patients with breast cancer. The fifty four triple-negative breast cancer formalin-fixed, paraffin-embedded Specimenspresented from all cases were immuno-stained by Hypoxia-inducible factor-1 alpha Immunohistochemical marker. The age groups distributed from 23-85 years old, mean age 51.23±11.26 years. Overall cases, triple negative breast cancer presented in 19.2%; most frequently younger,grade III, tumor size ≥ 2 cm, and positive lymph node metastasis or recurrent more than other subtypes. Hypoxia-inducible factor-1 alpha expression was strongly associated and significantly differentwith grade (p=0.001), lymph node metastasis (p<0.001) and Ki-67 expression (p=0.003). Detected Hypoxia-inducible factor-1 alpha expression has an important role in pathogenesis, drug resistance and in uncontrolled proliferation cells or as important conductor of the worst prognosis in triple negative-breast cancer.


Article
Isolation and Structural Investigations of Green Pigment (Gp) from Pineapple Peels

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This study describe the philosophy of Green Chemistry Principles when applied to the treatment of pineapple peels waste. Green pigments were isolated and identified from pineapple fruit peels extracts by using renewable methods like two phase system extraction (TPE) by ether: acetone at 40°C. The extract was analyzed and purified via flash column chromatography under certain condition (FCC) .The fractional components monitored with thin layer chromatography (TLC) at room temperature and identified utilizing spectroscopic analysis tools such as UV-visible, FT-IR, 1H-NMR ,13C-NMR and GC-Mass analysis .Two components of green pigments (GP) were identified .They are chlorophyll types(a) and (b) respectively.The advantages of this method include friendly environment, low cost of preparation, isolation, identification, and ease of scale detection.


Article
Levels of Incretin Hormones in Subjects with Type 2 Diabetes in Different Grads of BMI

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Incretins are gut hormones that potentiate insulin secretion after meal ingestion in a glucose-dependent manner. There are different types of incretin hormones like GLP-1, GLP-2 and GIP. DPP-IV is the enzyme that deactivate incretin hormone in the blood. The aim of this study was to evaluate the relationship between obesity and incretin hormones in patients with type 2 diabetes.The study was included (107) patients : (62) males and (45) females from Al-Hussein Medical City in Karbala province and Marjan Medical City in Babylon province. The control for this study was (32) healthy subjects: (14) males and (18) females.BMI, Waist circumference, blood pressure , HbA1c, lipid profile, AIP, GLP-1, GLP-2 , GIP and DPP-Iv were measured to all patients and control.The resultsshow significant decrease in GLP-1 (P=0.018) and GLP-2 (P=0.028) and there was no differences in GIP (P=0.74) in patients group in comparison also there was significant increase in DPP-IV (P<0.001) in patients group in comparison with control group.According to BMI grades there was some decrease in GLP-1 and GLP-2 in obese subjects but there was no differences in GIP in comparison with lean control group. Also there was significant increase in DPP-IV in obese patients in comparison with lean control. We conclude that the decrease in incretin hormones may come mostly from the increase in DPP-IV enzyme that degrade them in the blood quickly and according to the relation with obesity, DPP-IV enzyme increase significantly in obese diabetic patients in comparison with healthy lean subjects.

Keywords

Incretins --- Diabetes mellitus --- obesity --- GLP-1 --- DPP-IV


Article
Utilization of Molecular and Serological Methods to Investigation Toxoplasma gondii in Healthy Apparently Students in Babylon Province

Authors: Hayam Khalis Al-Masoudi
Pages: 934 -942
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Toxoplasmosis, an infection caused by Toxoplasma gondii, is generally asymptomatic or is associated with mild, non-specific clinical manifestations in immunocompetent patients. The present study consider the first trial in Babylon province to detection of toxoplasmosis among healthy university and secondary students, from February to May 2015, collect 112 blood sample from healthy apparently students. The results of serological test revealed that 57/112 (50.8%) was positive for T. gondii in LAT test, (25%) for university students and (25.8%) for secondary students, there isa significant difference (p≤ 0.05) between male (27.6%) and female (23.2%) in toxoplasmosis infection, where as 21.4% was positive for ELISA in which 13.8% positive for IgG antibodies and 8.0% positive for IgM, while nPCR results showed 19 out of 112(16.9%) was positive to toxoplasmosis. The presence of T. gondii antibodies in the serum regarded as the important criterion for the diagnosis of toxoplasmosis but these methods insufficient to diagnosis, it must be combine with molecular methods such as polymerase chain reaction which detect T. gondii DNA in five or ten parasites are present in blood.


Article
Chlamydial Antibodies , Pro-Inflammatory Cytokines and Bacterial Significance among Infertile Women

Authors: Abd-Alnabi Jouiad Abid --- Afrah Jawad Al-Zwaid
Pages: 943 -947
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The current study was done to investigate the relation between the bacteria different kindsandinfertility in women, the study include 108 specimen from infertile and fertilewomen with ages range (20-40years) these specimens collected from infertility and gynecology center of Maternity and Pediatrics Teaching Hospital in Babylon province. Urine, vaginal swabs and blood samples were used in this study. Bacteriological diagnosis for urine and vaginal swabs accomplished and showed variation in types and number of isolates.The isolates can be distributed as follows:Gram positive bacterial isolates include Staphylococcus aureus 48 (30%) 18 isolates urine and 30vaginal swabs, Escherichia coli24urine and 19 vaginal swabs43(26.8%). Female infertility divided according to their causesinto different types and the detection by anti-Chlamydia trachomatis antibodies reveals high concentration of IgG (46%) in the women with Polycystic ovary syndrome group,while the second high concentration (36%) in women with primary infertility . Immunological test of Cytokine IL-10 in patient show decreased in their concentration 11.5pg/ml compared with healthy at P< 0.05 especially at polycystic ovary syndrome group.


Article
Relation of Follicular Fluid C-Reactive Protein Level to Intracytoplasmic Sperm Injection Outcome at Al-Najaf Fertility Centre

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C-reactive protein is a protein that act as a sensitive marker in inflammatory processes, rises following hormonal stimulation it may affect fertility and intracytoplasmic sperm injection (ICSI) outcome. this study aimed to measure follicular fluid proinflammatory mediator as C-reactive protein and their relation controlled ovarian hyperstimulation protocols and to interpret these findings according to the cause of subfertility and subfertility treatment outcome. This study was carried out on 110 subfertile women aged between 18-45year (30.01±6.02), referred to fertility clinic in Al-Sadder teaching hospital at AL-Najaf city who classified into four group according to the cause of subfertility, estradiol(E2) also measured on day of HCG and CRP were measured in follicular fluid collected on day of pickup using special ELISA kit then correlate the result to ICSI outcome. The Result of this study reported that the pregnancy rate was 34.55% for embryo transferred after 48-72 hours, there was non-significant increment in pregnant than non-pregnant women regarding FF-CRP (P>0.05), also non-significant difference in FF- CRP in subfertile women according to cause of subfertility(p=0.303), higher FF-CRP value were in ovulatory factor female. Regarding ICSI parameters, there was positive non-significant correlation between FF- CRP and embryo number, Grade I, Grade II, embryo transferred, fertilization rate. so conclusion of this study minimal increment in these inflammatory markers would aid and share in success ICSI outcome.


Article
The Relationship between Oxidative Stress and Osteopontin Levelsin Diabetic Patient with Acute Coronary Syndrome

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This study was performed to determine osteopontin levels in sera of diabetic patients having acute coronary syndrome and finding the relationship betweenosteopontin and oxidative stress in the corresponding patients .A case –controlled study for 60Iraqi diabetic patients (33male and 27 female)with acute coronary syndrome (STEMI and NSTEMI) and 20 diabetic patients without myocardial infraction were selectedforthisstudy. Besides,Forty healthy subjects served as control group.The serum levels of Osteopontin (OPN),HbA1c,SOD,CAT and Malondialdehyde (MDA) were determined for the corresponding patients.The result obtained were compared with those 40 subject(20male and 20 female) who are apparently healthy (control group).All the selected patients were non -smokers,non –hypertensive and have no inflammatory disease which may affected the results of the measured parameters. Osteopontin levels were significantly increasedin patientswith DM,STEMI and NSTEMIcompared to the controls. The levels of MDA and HbA1Cin the patients were significantlyhigher compared to the controls whileSOD ,CATwere significantly lower compared to the controls, and a significant positive was found between osteopontin,HbA1C and MDA and negative correlation was found with SOD and CAT levels.The increase Osteopentin levels inrelevance to oxidative stress and HbA1C level may indicate the role of hyperglycemia in the induction of this acute inflammatory marker which can be considered as a prognostic indicator of diabetic complications especially diabetic patients with MI.

Keywords

OPN --- MDA --- DM --- STEMI --- NSTEMI --- SOD --- CAT and HbA1C --- MI.


Article
Evaluation of N Terminal –Pro B Natriuretic Peptide in Patients with Renal Dysfunction

Authors: Thana Mohammed Juda
Pages: 969 -976
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Natriuretic peptides and N terminal natriuretic peptide are peptide secreted from cardian atrium in response to stretch in cardiac muscle and considered marker in cardiac dysfunction , this study aiming to evaluate the level of NT-pro BNP in patients suffered from kidney failure . This study were established on patient suffering from renal dysfunction who were attended .nephrology unit in Merjan Teaching Hospital in Babylon city .All patients were undergone complete laboratory and clinical examination to establish diagnosis of renal impairment and degree of renal dysfunction as blood urea and creatinine and estimation of hemoglobin level for diagnosis of anemia . This study confirmed on patients with chronic renal failure and highlighted on the relationship between renal dysfunction and level of NT-proBNP. Serum NT-proBNP were analysed through ELISA technique among patients with CRF mean and standard deviation of level among patients and control groups were149 ± 36.5 u unit/ml ±,36± 6.5u unit/ml respectively and comparism mean of NT-proBNP between patients and control group was indicated that there is significant difference between two groups at p value< 0.05 as analysed by students t test . The study reveals there is positive correlation between duration of renal dysfunction and level of NT-proBNP . The study revealed there is no effect of gender on NT-pro BNP .

Keywords

NT-pro BNP --- BNP --- CRF --- ELISA


Article
Epidemiological Features of Child Labor in Babylon Province During The Year 2014

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Child labor is common social and health problem, One out of six children in the world today is involved in child labor which is dangerous to his mental, physical and emotional development, developing countries including Iraq are suffering from the various hazardous consequences of this problem, the objective of this study was to identify some factors associated with child labor in Babylon - Iraq. The research approach adopted descriptive study (cross-sectional comparative study). A total random sample of 200 male children between the age6-14 years (100 working male children and 100 nonworking male children) were included in this study who were interviewed during the period from July through December,2014 to collect information using a questionnaireto identify possiblfactors that may be associated with this problem. This study showed that broken family rate was significantly associated with child labor (p<0.05), most of the working children were belonging to low socio economic families as compared with the families of non-working group, this difference was statistically significant (p<0.05), school dropout is significantly higher among working children(0.05). The study explained that cigarette and water pipe smoking rates were high in working group as compare to the comparison group, working children were exposed more to child abuse (verbal, physical). Work injuries affected more than one third working children who were exposed to work mechanical hazards. In conclusion the study refer that there were many charachteristics associated with child labor like socioeconomic factors, tobacco smoking and different forms of child abuse.


Article
The Values of Osteopontin and Bone Specific Alkaline Phosphatase in Diagnosis of Osteoporosis. AComparative Study

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Dual-energy X-ray absorptiometry (DXA) is commonly used for diagnosis of osteoporosis, but it has its limitations. Bone turnover markers have advantages over DXA as they are cheap, non-invasive and can detect changes in bone turnover rates earlier. However, they do have disadvantages, particularly high within- and between-patient variability. The ability of bone turnover markers to predict of osteoporosis has yet to be established. The objective of this study is to assess the use of bone markers for diagnosis of osteoporosis in postmenopausal women and compare the results with those obtained by DXA method. This case- control study was conducted between October 2012 and April 2014. Forty-four postmenopausal osteoporotic women and forty-four healthy women as a control group, aged between 50-65 years old were involved in this study. They were recruited from the Al-Yarmouk Teaching Hospital, Baghdad, Iraq, and selected on the basis of inclusion and exclusion criteria. The physical characteristics were assessed using anthropometric measurements including height, weight, and body mass index (BMI). Bone mineral density (BMD) of lumbar and hipwere measured by the dual-energy X-ray absorptiometry (DXA) instrument. Serum Calcium and Phosphorous were measured using spectrophotometric kit while serum levels of osteopontin and bone specific alkaline phosphatase were measured by Enzyme-Link Immune Sorbent Assay (ELISA).Receiver operator characteristic (ROC) curves were constructed to plot sensitivity against specificity of lumbar and hip BMD, OPN and BAP levels as diagnosis tests for osteoporosis. The areas under the ROC curves (AUC) were calculated and compared with the AUC (0.5) of the non-diagnostic test (the line with slope of 1). The osteoporotic postmenopausal women had higher mean serum OPN and BAP levels compared to the healthy women (16.41 ± 6.33 vs 7.13 ± 5.88 ng/mL; P < 0.01); ( 47.08 ± 36.47 vs 24.42 ± 16.86; P < 0.01), respectively. When using a OPN concentration of 13.25 ng/ml as a cut off value for the diagnosis of osteoporosis sensitivity was 81.8%, specificity 86.4% and when using a BAP concentration of 31.05 ng/ml as a cut off value sensitivity was 81.8%, specificity 86.4%, Where is the sensitivity of lumbar and hipBMD was 100%, specificity 100% as a cut off value 0.925 g/cm2and 0.785 g/cm2respectively. There were no significant differences in mean values of Ca+2and P (p>0.05). The DXA is a more valid and reliable tool to utilize in diagnosis of osteoporosisin postmenopausal women than the measurement of serum OPN and BAP level.


Article
Depression among Parents of Children with Thalassemia in Babylon Province- Iraq During The Year 2014

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Thalassemia is not uncommon chronic disease in developing countries including Iraq it poses a heavy burden on the health care system as well as the tremendous pressure and psychological stresses that the parents suffer due to the presence of children with thalassemia in their families.The objective of this study is to identify the difference of the level and the score of depression between parents with thalassemic children and the control group. This was a case comparison study which included 300 parents , one hundred were considered as cases because they are parents of thalassemia children ,the control group included two hundred parents of healthy children, both groups are the attendees of Hilla children and maternity hospital in Babylon province during the period from the beginning of July through the end of November 2014 . Data collection was done by interviewing the two groups using a structured valid questionnaire prepared by the r0esearchers after obtaining the consents of participants.Beck Depression Inventory score was applied to mea in both groups. Results showed that there were a significant high depression scores among the parents of diseased children compared to parents of the healthy children( P<0.05 ) , no significant relation was found regarding the place of residence , in conclusion thalassemia put a stressful pressure on Iraqi families with diseased children especially mothers , a psychosocial support program is strongly requested to help them .


Article
Presentation and Options of Management of Undescended Testis in our Practice

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Undescended testis is a common congenital anomaly in pediatric population, associated with many complications if not managed properly. This study for clinical presentation, available investigations and the different modalities for treatment of undescended testis in our practice. One hundred twenty patients diagnosed with undescended testis in Hilla Teaching General Hospital and Private Hospitals during the period of June 2007 to June 2014. Age of patients included is from 6 months to 40 years age, intersex and ectopic testis were excluded. Ultrasonographydone for all patients, CT scan and MRI or diagnostic laparoscopy were added to investigate sonography undetectabletestis in groin. Management includes hormonal therapy for selected patients and surgical intervention for the others including those with failure of hormonal therapy. Diagnostic laparoscopy done for two cases. Presentation age were 42% at 2-5 years age and 33% were below 2 years. Best hormonal response were in bilateral than unilateral cases, 25% for bilateral versus 10 % for unilateral cases. One stage open orchiopexy was the common surgical procedure used (85.83%). The best results for surgical orchiopexy can be obtained when performed at age below two years. Hormonal therapy was benefit in some patients. One stage orchiopexy is a safe procedure in most of cases in our practice. We advise to start laparoscopic approach in diagnosis and treatment of intra-abdominaltestis.


Article
Role of Superoxide Dismutase Enzyme in Patients with Epilepsy

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Epilepsy is a disease of the brain in which at least two unprovoked (or reflex) seizures occurring within more than 24 hours apart Epilepsy is classified to idiopathic, cryptogenic, and mixed classification.Superoxide dismutase (SOD); an enzyme that catalyzes the dismutation of superoxide radicals have been purified by a simple procedure from bovine erythrocytes. This enzyme contains 2 equivalent of copper per mole of enzyme.The aim of the study to know the significance of antioxidant superoxide dismutase (SOD) enzyme in epileptic patients. This is a prospective study conducted in Al-Hussein Teaching Hospital in Holy Kerbalaa for the period from January to October 2014 .One hundred ten (110) patients were included in this study.Superoxide dismutase activityis determined by using a simple and rapid method. Superoxide dismutase enzyme level in epileptic patients was significantly lower (p<0.01) than its level in healthy control. It was significantly lower in all subgroups of patients when compared to control subgroups (p<0.01).It was significantly lower in patients group in both male and female when compared to control group (p<0.01). Epilepsy is linked with the defect in the antioxidant defense mechanism.

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Article
Association of The T45G Polymorphism of Adiponectin Gene with Polycystic Ovary Syndrome in Women of Babylon Province/ Iraq

Authors: Hawraa Sabah Al-Musawi
Pages: 1020 -1026
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Polycystic Ovarian syndrome (PCOS) is being the most frequent cause of anovulatory infertility, Adiponectin is the most abundantadipocytokine and may play a role in the regulation of insulin sensitivity and IR in PCOS and count for 0.01% or 3–30 μg/ml of total plasma proteinthe adiponectin gene contains 3 exons spans 16 kb on chromosome3q27.The aim of the present study was to evaluate the genetic influence of the adiponectin gene polymorphisms in the development of PCOS among women of Babylon Province/ Iraq. sixty three women were studied ,and were classified into two groups of : first group consists of 32 women infected with polycystic ovaries syndrome, the second consists of 31 healthy women to detect the presence of T45G polymorphism within the gene. From all subjects a whole-blood sample was taken and was used for isolation of peripheral blood leukocytes. The adiponectin T45G polymorphism, located in exon 2, was genotyped by amplification of genomic DNA.The present study included study of the relationship of this gene with PCOS women in reproductive age, A statistically significant difference was observed in the frequency of TT,TG and GG genotypes between women with PCOS and controls .


Article
The Association of Serum Iron, Zinc, and Copper Levels with Preeclampsia

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Preeclampsia is defined as hypertension associated with proteinuria arise for the first time after the 20th week of gestation in a previously normotensive woman & resolve completely by the 6th postpartum week. In the present study trace and ultratrace elements iron, zinc, and copper were estimated to know the role of them in pathogenesis of pre-eclampsia. Case control study included 120 women, sixty of them were patients diagnosed with preeclampsia in the third trimester and the other sixty were healthy pregnant women (controls) in the third trimester. Serum levels of copper was measured by using graphite furnace atomic absorption spectrophotometer technique. While total serum iron and zinc concentrations were measured by using spectrophotometric method. The results were expressed as mean ± standard error of mean. A P value of < 0.01 was considered to be statistically significant. The levels of serum zinc and copper were significantly lower in patients with pre-eclampsia compared to control groups. While the concentration of total serum iron was significantly higher in patients with pre-eclampsia compared to control group. As conclusion, alteration in the serum levels of trace and ultratrace elements could contribute to the pathogenesis of PE.


Article
Evaluation of Oxidative Stress Status and Some Biochemical Change in Adult Obese Individuals in Hilla City

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Obesity is a rapidly growing epidemic worldwide, influenced by both genetic and environmental factors. The onset of obesity is due mainly to low energy expenditure (such as from exercise) combined with high caloric intake. The study was conducted on fifty obese individuals and fifty apparently healthy control individuals; the age was between (18-60) years. Blood samples obtained from Marjan Medical City in Babylon Province. The aim of this study to evaluate the differences of oxidant malondialdehyde (MDA), antioxidantenzyme superoxide dismutase (SOD),catalase (CAT), glutathione peroxidase (GPx), insulin resistance (IR) and lipid profile in sera of adult obese individuals and the control group. The results of present study revealed a significant increase in MDA (p<0.001), blood glucose (p<0.001), insulin (p<0.001), insulin resistance (p<0.001), total cholesterol (p<0.05), TG (p<0.001), VLDL-cholesterol (p<0.001) and LDL-cholesterol (p<0.001) concentration in sera of obese individuals whencompared to those of the control group. Also this study show significant decrease in SOD (p<0.001), CAT (p<0.001), GPx (p<0.001) and HDL-C (p<0.05) concentration in sera of obese individualswhen compared to those of the control group. The study concluded that obesity is associated with increase oxidative stress. The increase of MDA concentration and decrease of SOD, CAT and GPxconcentration may contribute in the development of complications of obesity.


Article
Pulmonary Function Test in Asthmatic Pregnant Women at Different Trimesters

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A cross sectional study carried out in Gynecological consultancy department of AL-Zahraa Teaching Hospital for Gynecology and Pediatrics in AL-Najaf city for period from 1st of November, 2014 to end of May, 2015 on convenient sample two hundred pregnant women. The data were collected through direct interview (in private room) and fulfilling of prepared questionnaire. Pulmonary function test parameters (FEV1, FVC, FEV1% and PEFR) changes were estimated by using Spirolab III tool. A significant lower means of FEV1% and PEFR were observed among asthmatic pregnant women than non – asthmatic (p˂ 0.001), there is a statistically significant lower means of BMI and FEV1% of pregnant women in 2nd trimester than 3rd trimester (p˂ 0.001). A significant higher means of FVC, FEV1 and PEFR for pregnant women were observed in 2nd trimester than 3rd trimester (p˂ 0.001).


Article
Physical Aspects of School Age Children with Thalassemia Major in Al- Najaf Al-Ashraf

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Thalassemia major is a prevalent hereditary disease in Mediterranean region, the assessment of physical aspectof school age children,especially in those with chronic illness such as thalassemia is particularly important. The Objectives of this study is to assess physical aspect of school age children with thalassemia major andto found out the magnitude association between physical aspect and their demographic characteristics and their clinical characteristics. A Non Probability "purposive" sample of (100) school age children with thalassemia major and their parents are included in the present study. Researcher constructed special questioner to achieve objectives of the present study. Validity of the study instrument was determined through the panel of experts and the reliability of the study questionnaire was determined through Alpha correlation coefficient was computed for the determination of the internal consistency reliability which was α = 0.87 for the standardized alpha of the internal scale of the assessment of child physical aspects and α= 0.91 for standardized Alpha of the internal scale of the assessment of parents proxy information. Data analyses through use descriptive (frequency and percentage) and inferential statistical analysis procedures(t-test ,chi squire, and P- value) were used to data analysis. The present study results indicated that there was a significant relationship between thalassemia major and their physical aspects. The study concluded that the majority of the study sample of thalassemic childrenhad negative impact on physical aspects.In addition,non-significant differences between child and their parents regard to the overall physical aspects. The study recommends that a physical physician and psychologist should be present in all thalassemia centers in order to help in promotion a relationship between children, school representatives, the families, and the doctors and health oriented mass media should an important role in providing information to population about thalassemia and other inherited diseases.

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Article
Electrophysiological Study in Patients of Coronary Artery and Asymptomatic Peripheral Arterial Disease

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Atherosclerosis remains one of the major causes of death and premature disability in developed countries.It is a chronic inflammatory disease which may cause obstructions of the coronary, cerebral and peripheral arteries.The goal of this study to establish association between ankle brachial index(ABI) and nerve conduction study (NCS) with extent of coronary artery disease.Seventy eight patients (39 malesand 39 females)were studied. Seventy eight healthy volunteers match in age and sex were enrolled and accepted as a control group, the age distribution for study group ranged from (45-75 years).All patients were admitted to our hospital for elective coronary angiography with no symptoms of peripheral arterial disease and negative history of diabetic mellitus. For all patients and control the ankle brachial index(ABI) was measured and biochemical assessment (lipid profile) finally the electrophysiological test of the lower limbs peripheral nerve (Motor and Sensory) wasdone in the electrophysiological department. This study concluded that there is an association between ABI and NCS of lower limbs in patients with coronary and asymptomatic peripheral arterial disease, 41 % of patient with CAD was found to have asymptomatic peronealmononeuropathy.


Article
Efficacy of Combined Tramadol with Diclofenac in Comparison with Monotherapy Treatment Using Buscopan Diclofenac or Tramadol in Renal Pain Control

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Acute renal colic is a severe painful event; drugs used to treat this condition include anticholinergics, opioid analgesics and nonsteroidal anti-inflammatory drugs. To compare drug's efficacy in ureteric pain relief byusing monotherapy including Buscopan 20 mg IV, Diclofenac Sodium 75 mg IM and Tramadol 50 mg IV, with a combination of 2 drugs including Tramadol plus Diclofenac. 160 patients (110 males and 50 females), 16 to 75 years of age, with moderate to severe renal pain were treated in emergency department of Hilla Teaching General Hospital and private clinics. Parameters were observed after 10, 30, 60, minutes and 2 hours of drugs treatment. Assessment of analgesic effect of the drugs was done by using Numerical Rating Scale (NRS). Drug side effects also observed. Buscopan was the least effective drug in pain relief with higher side effects, while Diclofenac and Tramadol have comparable efficacy. Combination of Diclofenac plus Tramadol had a significant efficacy with rapid and sustained pain relief.Incidence of ureteric colic are more common in males than females (male to female ratio is 3/1). For quick pain relief in acute renal colic, a combination of intravenous tramadol with diclofenac sodium is superior to each of them alone, while Buscopan is the least effective, with higher side effects.


Article
Effect of Acitretin on Serum Biomarkers Levels in Patients with Psoriasis

Authors: Amina Hamed Alobaidi
Pages: 1077 -1082
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Abstract

Psoriasis is a multifactorial, chronic, inflammatory skin disease of unknown etiology, associated with cytokines and adipokines serum levels changes that may influence disease pathogenesis. To determine the effect of acitretin on serum IL-10, IL-23, adiponectin, Zn, Mg and copper levels in psoriasis patients. A case control study that include 50 psoriasis patients, conducted in Tikrit Teaching Hospital. They received acitretin orally for 4 weeks duration course. IL-10, IL-23, adiponectin, Zn, Cu and Mg in serum for all patients determined at the time of enrollement in the study and after 4 weeks of treatment with the drug. Acitretin reduced the mean PASI in 20 psoriatic patients from 20.97 before receiving treatment to 1.22 after receiving treatment (P=0.000). In addition, the mean serum levels for IL-10 reduced significantly (P=0.000) from (6.01±4.17) pg/ml before treatment to (1.85±0.54) pg/ml after treatment. Furthermore, Acitretin reduced the mean serum level for IL-23 from (72.08±34.14) pg/ml pre-treatment to (66.1±20.3) pg/ml, post-treatment (P=0.423). The mean serum levels of adiponectin in therapeutic group was lower (6.97±3.06) μg/ml than that of baseline value (8.9±3.96) μg/ml, but this result was statistically not significant (p=0.114). The mean serum levels of Zinc and copper in therapeutic group was lower than baseline value, but the difference was statistically not significant (p>0.05).


Article
Clinical Presentation of Partial Rectal Mucosal Prolapse and Its Outcome Following Submucosal Injection of 50% Dextrose Water

Authors: Kadhim Chaloub Hasan Al-Hamadani
Pages: 1083 -1088
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Abstract

The study investigated the clinical presentation and proctoscopic findings of anterior rectal mucosal prolapsed (ARMP) and to evaluate the effect of submucosal injection of 50% dextrose water( DW) as a sclerosing agent. All the cases which were diagnosed as anterior rectal mucosal prolapsed and treated by submucosal injection of 50% dextrose water during the period of 10 years were prospectively studied. The included cases were studied with regard to age, sex, symptoms and signs of presentation and the findings of proctoscopic examination and the number of medical consultations prior to final diagnosis. The patients were followed up to 18 months. The response of the patients was evaluated, and the number of injection settings for each case, complications, recurrences. 28 cases of ARMP, 24(85.71%) males, 4 (14,28%) females, age range 4-45 years. Among the symptoms of presentation, the most frequent were a bulging perimass 53%, straining at stool and delay in lavatory 50 %. The findings on proctoscopy; prolapsed anterior rectal mucosa 100%,anterior rectal ulcers 42.85% .Sclerotherapy was successful in 96.5%.24 patients improved after one session,3 cases required two sessions to improve while 1 case failed (P value < 0.001). We can conclude that ARMP affects all ages. The patients commonly present with obstructive defecation rectal bleeding associated with perianal bulging. sclerotherapy using 50% DW is simple and safe and effective procedure for ARMP.


Article
Prevalence of Tetracycline Resistant Aeromonas Hydrophila Isolated From diarrheic Patients in Hilla City, Iraq

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Abstract

The aim of this study was to investigate the prevalence of tetracycline resistant Aeromonashydrophila isolated from clinical sources in Hilla city, Iraq. A total of 822 samples were collected from fecal specimens from patients. Samples were collected from those who suffering from diarrhea. The period of the research was from October 2013 to February 2014 at public health lab, Hilla city. Results of this study revealed that out of 822 fecal samples, 13 isolates (1.58%) were belonged to Aeromonas spp. However, other bacterial isolates belonged to other genera similar to Aeromonaswere also recovered. Out of 13 Aeromonas spp., eight A. hydrophilaisolates (61.53%) were obtained, while the other isolates were distributed as: four isolates of A. salmoncidia (30.76%), and one of A. sobria. Isolation and detection of A. salmoncidia species was first recorded in Iraq. The susceptibly of A. hydrophila (NO. 8) to several antibiotics was determined using disk diffusion test (DDT). Results showed that 5 isolates (62.5%) were Multi-drug resistant (MDR) and three isolates (S2, S3, and S5,) were sensitive to most of antibiotic classes tested. The MIC of A. hydrophila to tetracycline was also detected using ager dilution mothed according to CLSI guidelines. Results found that only 2 isolates (25 %) were resistant to tetracycline. The MIC of these isolates ranged from 0.25-16 μg/ml. This result confirms tetracycline resistance by these isolates when tested using DDT.


Article
Impact of School Bag on Pulmonary Functions among Elementary School Children in Al-Hilla City-Iraq

Authors: Hasan Alwan Baiee --- Saraa Alaa
Pages: 1101 -1108
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Backpacks are used by school children to carry their materials. Heavy backpacks associated with several adverse effects on the health of children and may interfere with their school achievement. The objective to assess the effect of school bags on pulmonary functions of school children in Al- Hilla city. This is a descriptive school based cross sectional study which was carried out on a convenient sample of 220 healthy pupils, from the fifth and sixth grades, from four randomly selected primary schools during the period from February through May, 2015. Written and verbal consents were obtained from the pupils and their parents . Data were collected through interviewing the participants by using a structured questionnaire contained sociodemographic and school bag related information. Pulmonary function test was performed using an electronic portable spirometer (discovery-2 USA), after measuring the weight and height of the participants. Pulmonary function parameters were significantly reduced after carrying backpack (p value < 0.001) except the FEV1/FVC was increased after carrying the backpack . The results indicate that there was a significant reduction of the ventilatory functions of primary school children after carrying the backpack. Preventive measures are needed to protect school children.


Article
Rate of Faulty Horizontal Insulin Injections and Their Impact on Glycemic Control in a Sample of Diabetic Patients Attending Diabetic Clinic in Karbala Province

Authors: Amir Omran Al-Mokhtar
Pages: 1109 -1115
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Traditional correct at (90 degree angle) subcutaneous insulin injection is one of the essential aspects to achieve proper diabetic control strategies. The study aimed to establishpercentage of faulty horizontal insulin injection and its impact on glycemic control in comparison with correctangleinsulin injection. This prospective study was conducted among patients attending Diabetic clinic in the period between Jan 1st 2009 and Jan 1st 2014. The total number of patients attending diabetic clinic were 750 patients. Of this total, 300 patients using insulin injection were enrolled in the study. The study variables included demographic and treatment data ,gender, age, mode of insulin injection (faulty horizontalinjectionand correctangled insulin injection),glycemic control, attendance to the diabetic clinic frequency, site of injection and local skin complications. Among the total 110 malepatients, 95 patients(of them used faulty horizontal injection technique, while 15 patients used correct angle injection. The proper glycemic control in the horizontal andcorrectangledinjectiontechnique were 15 patients, and 10 patients respectively. Among female patients, 165 patientsapplied faulty horizontal injectiontechnique and only 25 patientsused correctangledinjection. The proper glycemic control in horizontal and at 90dereeangled injection was 27 patients and 18 patients respectively. The study discovered highpercentage of faulty horizontal insulin injection technique which was associated with poor glycemic control. The study also disclosed poor attendance ratio among diabetic patients.


Article
Construction a Three-Dimensional Model Fetus From Devices Ultrasound by Using Optical Scanning Hologram (Osh)

Authors: Aadnan Faleh Hassan --- Entidhar Jassim Al-Yasari
Pages: 1116 -1122
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Photos of the fetus lacks the resulting devices ultrasound two-dimensional to the clarity and precision, leading to the emergence of The need to provide three-dimensional vision of the fetus allows visualization of the width and height and angle, in order to obtain information additional disclosure of the fetus and fetal abnormalities. In this paper we explain the way we generate three-dimensional models of the fetus from two-dimensional images using a computer system without. The need to change the two-dimensional imaging equipment, and without the need for a sensitive site. Depends on the way we pass the sensor on the belly Pregnant above the fetus and conduct a survey of the entire manual body of the fetus from the top of his head and his feet until the bottom, and the survey Keota video store, then Send it to a computer is cut into several video images are stored and treated using the principles of digital image processing.The second simulation is build a program to implement the Optical scanning holography(OSH)technology,where the recorded hologram of original image using fast Fourier transform FFT2. High contrast images were used to demonstrate numerical reconstruction process by Matlab. Sine, cosin, and amplitude holograms were reconstructed .Can the doctor to get the most accurate details of the new image by changing the angle and view stereoscopic images to a specific part of the body of the fetus.


Article
Bacterial Evaluation and Some Allergic Mediators of Chronic Rhinosinusitis with Nasal Polyps

Authors: Oruba Ketoof Al-Bermani
Pages: 1123 -1128
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Chronic rhinosinusitis with nasal polyps (CRSwNPs) is a disorder characterized by persistent eosinophilic Th2 inflammation with sinonasal microbial colonization. It has been postulated that a compromised local mucosal immune response and microbial by-product like super-antigen underlies disease pathogenesis The affected sinuses fluid swabs and blood samples were collected from 50 a CRSwNP patients to isolate associated bacterial species and to measure serum IL-4 and total IgE and IgG levels. The same sample were collected from health subject as a control study. The sinonasal tract was colonized by S.aureus H.influenzae S.pneumoniae P.aeruginosa Morexella.catarrhalis S.pygenes S.intermedius, where the high prevalence rate was 34% of S.aureus , while the low prevalence rate was 2% of S. intermedius. ELISA revealed an elevation of serum IL-4, and total IgE and IgG levels in the CRSwNP patients compared with the control subject. Bacterial colonization in CRSwNp is implicated with pathgenesis of this disease. The high levels of serum IL-4 and total IgE and IgG which were synthesized locally in the mucosa and diffuse to the blood , serve as an indicator of eosinophilic Th2- inflammation disorder. of CRSwNP


Article
The Adequateness of Glycemic Control in Type 2 Diabetes Mellitus

Authors: Ali Nasir Sattar
Pages: 1129 -1136
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A survey study of 166 patients with type 2 diabetes on medical treatment was investigated for inadequate glycemic control. The study carried out at the outpatient clinic in Al–Hindeya general hospitalover a period of five months. The study aims to find the proportion of glycemic control in type 2 diabetes patients and the factors associated with inadequate control. Fasting blood glucose and glycosylated hemoglobin were used to assess glycemic control. Patients, socio-demographic characters were collected to evaluate the factors related to inadequate control. An HbA1c level of 7% and more was used as an indicator of inadequate control. We found 78.3% of the patients had HbA1c level ≥7%. In the multivariate analysis, female gender (P≤ 0.042), overweight (P≤ 0.005), illiterate (P≤ 0.002), and treatment with insulin (P≤ 0.03) were significantly associated with poor glycemic control.


Article
Relationship between Serum Lipoprotein Ratios and Insulin Resistance in Iraqi Women with Type II DM

Authors: Maha Fadhil Smaism --- Najla,a Jawad Hassani
Pages: 1137 -1145
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Type 2 diabetes confers an increased morbidity and mortality dueto macrovascular complicationssuch as CVDfor which dyslipidemia is themajor contributor. This study was designed toexplore the role of non-HDLcandlipoprotein ratios as CVD riskmarker in diabetic population. It was acase –control study , 68 female uncontrolled (HbA1c ≥ 6.5) diabetic were selected, 34 were diabetic who were treatment(Goup A) and 34 werediabetic without treatment (Group B)and 34 were non-diabetic subjects as control group . The lipidprofile including TC, TG and HDLc were measured and calculation of lipoprotein ratios.Lipoprotein ratios were significantly higher in group A, Non-HDL(P<0.001), TC/HDL and TG/HDL(P<0.01), LDL/HDL(P<0.05) In group B; Non-HDLc(P<0.01), TC/HDL, TG/HDL and LDL/HDL(P<0.05) in contrast tocontrols. There is significantly positive correlation of TG/HDLc, TC/HDLc, LDL/HDLc and Non-HDLc with HOMA-IR in group A and in group B. Lipoprotein ratio provide a simple means of identifying insulin resistance which could be used as a possible risk factor ofCVD in uncontrolledtype 2 diabetic.


Article
Measurements of Pressure Area for Different Pressure Indicating Materials

Authors: Reem Abdul Rahim --- Hadeel Adnan
Pages: 1146 -1153
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Pressure indicator during insertion of removable prosthesis can help identify potential areas of discomfort resulting from different errors during prosthetic work, correct diagnosis of specific problem relies on proper application of pressure indicator. A study was therefore, undertaken to measure pressure area of upper and lower complete dentures using different types of pressure indicating materials. Thirty two processed dentures were examined. All of them had a clear tissue surface with no sharp projections to minimize patient discomfort. Three different pressure indicating materials ; zinc oxide, alginate, and extra light silicon were used, surface area measurements were evaluated for each material. Setting time, ease of remove, no. of sites, and coast of the materials were also evaluated. The results of this study showed that there was a significant difference in pressure area measurements between the three different pressure indicating materials, while there was no difference between alginate and silicon- alginate and zinc oxide materials, while there was a significant difference between silicon and zinc oxide pressure materials. Setting time appreciation showed that silicon set in shorter time than alginate and zinc oxide materials, while for cost variable discussion silicon material revealed a higher cost means than both alginate and zinc oxide materials. In the present investigation data collected showed a significant difference in pressure area measurements between silicon and zinc oxide materials. Silicon, and alginate pressure materials showed no difference in pressure area readings between them.


Article
Idiopathic Talipes Equinovarus Effect of Age and Severity on Type of Management

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This study is dealing with the influence of the degree of severity and the age of the patients at the time of referral to the treatment. We report the result of management of forty eight patients with seventy one idiopathic club feet treated during the first six months of their lives. All patients underwent conservative treatment, surgery were planned for severe resistant cases especially with late referral to the treatment and those cases which didn't respond to conservative treatment. 35.6% of forty five feet referred with age less than four weeks ultimately needed some kind of soft tissue release, 73.1% out of 26 cases with age of referral more than four weeks needed surgery. All severe resistant cases finally required surgery, while all mild cases were resolved by conservative treatment. 5.6%out of 21 cases of moderate severity were treated by surgery. By conclusion, early start of treatment (i.e. less than four weeks of age) is essential for better response to the conservative treatment and for reducing the number of cases needed surgery. The method of treatment depends very much on the degree of severity of the deformity.


Article
Surgical or Non Surgical Treatment of Lumbar Spinal Stenosis (LSS) ((Compares Study))

Authors: Isam Ali Al-Sudany --- Salah Mahdi Jaddoa
Pages: 1161 -1167
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This study is to assess the effectiveness of decompressive surgery as compared with non-operative measures in the treatment of patients with lumbar spinal stenosis. prospective study carried out for Forty seven patients with lumber spinal stenosis (LSS) of one level or more categorized into 25patients with surgical group and 22patients with non operative treatment group . The surgical procedure was laminectomy of stenosed segments and undercutting ligamentum flavum while the group of non operative measurements received non steroid anti inflammatory drugs and physiotherapy. Result in both groups showed improvement in leg and back pain and walking ability in first 6 months follow up .At one year follow up the difference was clear in improvement of walking ability and pain in surgical group than non operative group. our conclusion was although the improvements appeared in both group. The outcome of surgery remain favorable in long time follow up. we recommended that more than 2 years follow up needed for evaluation of the surgical results.


Article
Y Risk Factors of Recurrent Lumbar Disk Herniation

Authors: Isam Ali Alsudany
Pages: 1168 -1172
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Recurrent intervertebral disc prolapsed (RDP) is a major cause of poor result after lumbar discectomy surgery. The aim of current study is to assess risk factors of recurrent disc prolapse in Iraqian population in Hilla teaching hospital from 2002-2013. The study reviewed 40 patients with recurrent disc prolapsed and 100 patients without recurrence retrospectively. To evaluate possible risk factors for herniation recurrence A clinically significant recurrent herniation was defined as a disc herniation causing lower limb pain (sciatica) and (MRI) evidence of disc material at the same level of the previous surgery. Other 100 patients without recurrence were used just for compares to identify possible risk factors for recurrent RDP. There was important variation between groups with and without RDP in sex, smoking, height, weight and occupational characteristic. By putting these differences in logistic regression analysis, it showed that gender (male), height, heavy workers and heavy smoker could expected in lumbar disc prolapsed recurrence(RDP). Taking into consideration sex, heavy smoking and heavy workers as predictors of recurrent RPD, surgeons should advice their patients to limit hard work and put away smoking especially in tall and male ones to prevent RDP recurrence.


Article
Evaluation of Some Serum Adipokines and Oxidized Low Density Lipoprotein Before and After Methotrexate Treatment in Patients with Chronic Plaque Psoriasis (A Case-Control Study)

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Psoriasis is a common inflammatory autoimmune skin disease that affects 2–4% of the world population. T-cells infiltration, interleukins and cytokines including adipocytokines like visfatin, high molecular weight- adiponectin (HMW-adiponectin) and retinol binding protein-4 (RBP-4), together with oxidized low density lipoprotein (ox-LDL) have been implicated in psoriasis pathogenesis. A total of 86 subjects (43 with Psoriasis and 43 healthy controls) were enrolled in this study. Their mean age was (41± 14.37) for patients, and (35.81± 18.66) for the control group. The study conducted in dermatology outpatient clinic in Merjan Teaching Hospital in Al –Hilla City and investigations were done in laboratory units of the hospital through the period from June 2013 to September 2014. The sera obtained from blood were used to determine the level of serum visfatin, HMW-adiponectin, RBP-4 and oxidized-LDL by enzyme-linked immunosorbent assay (ELISA). Assessment of psoriasis disease activity and methotrexate efficacy was done by psoriasis area and severity index (PASI) score. Results of this study showed a significant increase (p<0.05) in serum visfatin, HMW- adiponectin, and oxidized-LDL concentrations, and a significant decrease (p<0.05) in retinol binding protein-4 (RBP-4) concentrations in sera of patients with chronic plaque psoriasis when compared with control group. There was a significant correlation between oxidized-LDL and visfatin, HMW-adiponectin and retinol binding protein-4 (r = 0.81, 0.68, -0.77) (p value < 0.001) respectively . Finally, the impact of systemic methotrexate on above adipocytokines and oxidized-LDL was determined by significant reduction in the levels of visfatin, HMW-adiponectin and ox-LDL and a significant increase in levels of RBP – 4 after treatment and by a significant mean difference in PASI score before and after treatment in psoriatic lesions. Results obtained by this study indicate that some adipocytokines including serum visfatin, HMW–adiponectin and RBP-4 levels, in addition to oxidized-LDL measured in patients with chronic plaque psoriasis were closely associated with disease severity and could be used to assess the successful treatment. To the best of our knowledge, this is the first study in Iraq to evaluate serum levels of these adipokines and Ox – LDL in patients with psoriasis and study the effect of methotrexate treatment on these parameters.


Article
Biochemical Changes of Liver Enzymes; ALT, AST, ALP in Patients after Surgical Operation Under General Anesthesia

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The physiologic state induced by general anesthetics typically includes analgesia, amnesia, loss of consciousness, inhibition of sensory and autonomic reflexes, and skeletal muscle relaxation. The liver function is mainly homeostasis. Alanine aminotransferase (ALT), Aspartate aminotransferase (AST) are soluble cytoplasmic and mitochondrial enzymes widely used to assess hepatocellular damage. ALP Alkaline Phosphatase is membrane associated enzyme anchored to cell membrane in particular to the biliary canaliculus. ALP is found in most tissues but is derived predominantly from hepatic cells. Aim of this study was to evaluation of liver enzymes (ALP, ALT, AST ) changes that accompany surgical operation under general anesthetic drugs. A total of (36) patients under go surgical operations under general anesthesia.Blood samples were collected from patients just before and 24 hours after operation. The serum has been stored by deep freezing (-20°C) until used for serological tests to estimate the concentration of serum ALT, AST, ALP enzymes level.The results were significant increase in mean differences of serum ALT, AST, ALP enzymes level. In conclusion this study showed that surgery and general anesthesia elevated serum level of ALT, AST, ALP enzymes.


Article
Influence of Preparation Design and Presence of Class IV Composite Resin Restoration on Fracture Resistance of Ceramic laminate Veneer

Authors: Abdulfatah Altabal --- Hala Ragab --- Essam Osman
Pages: 1198 -1208
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The objective of the study was to evaluate the fracture resistance of ceramic veneer bonded to class IV composite resin restoration using two differentincisal preparation designs. Twenty-eight extracted intact human maxillary incisors free from cracks and of equal dimensions were randomly divided into two main groups; G1 (control): intact teeth without class IV composite restoration, G2: teeth with class IV composite restorations. Each group was further divided according to the preparation design of the laminate veneers (n=7); A: incisal butt joint design and B: incisal overlap design. Class IV was prepared with obliqueincisal margin.Etching and bonding were performed and a nanohybrid composite resin was applied. Two veneer preparation designs were made; butt joint with shoulder finish line and incisal overlap with palatal chamfer. The impression were made usinga 3D-scanner. The veneers were fabricated with a heat pressed all ceramic material (IPS-Emax, IvoclarVivadent) according to manufacturer’s protocol.The internalveneer surface was etched with 5% hydrofluoric acid then silanated.Dual cure resin cement (Variolink N base and catalyst, IvoclarVivadent) wasused for cementation.Fracture resistance measurement was recorded using universal testing machine. The veneer incisal preparation design had a statistically significant effect on mean fracture resistance of PLVs whereas presence of class IV restoration had no statistically significant effect on mean fracture resistance.The incisal overlap design showed statistically significantly higher mean fracture resistance than the incisal butt joint design. The preparation design affected the fracture resistance of PLVs bonded to class IV composite restorations. Yet,the presence of class IV composite restorations did not affectthe fracture resistance of bonded PLVs. The incisal overlap design seemed to protect PLVs bonded to class IV restorations.

Table of content: volume:12 issue:4