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: 2016 volume:13 issue:4

Article
Establishing A New Anatomical Indicator For Antero-Posterior Jaw Discrepancy

Authors: Kasem Ahmed Abeas
Pages: 734 -740
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Abstract

To overcome the deficiencies, at least geometric drawbacks, associated with the most commonly available sagittal indicators (ANB, Wits), efforts were done to develop another an accurate and valuable mean for skeletal prediction.To establish the mean value of a new sagittal approach (µ angle) for the assessment of skeletal relationship in its different patterns and whether or not there is a correlation with the other cephalometric indexes.Depending on a predetermined criteria, the total study sample consist of ninety-four pretreatment lateral cephalometric radiograph of Iraqi subjects with a mean age (13.5± 2). Again it have been subdivided into three skeletal relations (I, II, III) according to the combined criteria of both (ANB and Wits appraisal) for each relevant class. µangle measured from A-B line and a perpendicular on Mandibular plane from point A.The mean values of µ angle were (22.16 ± 3.04; 13.56 ± 3.04; 28.84 ± 3.52) for class I; II; III, respectively and no significant gender differences were detected.Regardless sample subgroups, a strong negative significant correlation (P<0.001) was found between µangle and both ANB and Wits indexes. It was concluded that the new µ angle can accurately be utilized in clinical assessment of sagittal jaw relationship where the other skeletal measures such as ANB angle and Wits appraisal fail to accurately assess some of jaw relations due to anatomical and occlusal factors.


Article
Morphometric Analysis of Infra Orbital Foramen by A Cone Beam Computed Tomography

Authors: Rebaz Samir Ismail --- Ali Sultan Al-Refai
Pages: 741 -794
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Infraorbital foramen conveys infraorbital nerve and vessel, and knowledge about is mandatory. The present study was designed to assess the infraorbital foramen location in Kurdistan population in relation to side and gender. Fortycone beams computed tomographies of adult Kurdistan patients were selected. Axial, sagittal, coronal views and three dimensional reconstruction models were analyzed to achive all informations.The distances of infraorbital foramen from facial midline, infraorbital rim, and piriform aperture were assessed. The locational relationship to upper teeth and supraorbital foramen was also recorded. The mean distance of medial margin of infra orbital foramen from facial midline was 24.09±2.62mm, and the mean distance of its superior margin from infraorbital rim was 7.53 ±1.46mm.Non-significant difference present between the sides and between gender son right side, but it was significant on left side.The mean distance between its medial border and the piriform aperture of the nose was 17.83 ±2.28mm.No significant difference present between sides, but it was significant between genders on both sides.The most common position of the infraorbital foramen was found in position between the upper first and second premolars(40%), and the most common position in relation to the supraorbital foramen/notch was lateral to its lateral margin(55%). No statistically significant difference was noted between sides and genders.The results of the present study may assist dentists and surgeons to localize infraorbital foramen to facilitatelocal anesthetic and surgical procedure.


Article
Correlation of Fetuin A level with ECG types of Acute Myocardial Infarction

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Acute myocardial infarction is one of the commonest disease with serious complications and increasing morbidity and mortality. Coronary atherosclerosis plays a crucial role in the underlying pathophysiology. Fetuin-A is a protein which is closely linked with increased risk of cardiovascular disease, and secreted mainly by the liver, produces subclinical inflammation and insulin resistance. This study was aimed to evaluate the association of serum fetuin A level with ECG types of acute myocardial infarction. This is a case–control study included 88 subjects divided into two groups; 44 patients with acute myocardial infarction,36 of them with STEMI and 7 with NSTEMI. The other 44 were apparently healthy individuals taken as a control. Serum fetuin-A levels were measured by using ELISA technique. There was significant differences in serum fetuin-A levels between patients and control, (p value ≤ 0.05).The mean differences between serum fetuin-A levels and both type of AMI (STEMI and NSTEMI),were also significant(p value ≤ 0.05) where higher values observed in STEMI.This study concluded thatfetuin-A level was significantly correlated with type of AMI and higher values of fetuin-A were observed in STEMI .

Keywords

Fetuin-A --- AMI --- ELISA technique --- STEMI --- NSTEMI --- ECG


Article
Extracorporeal Shockwave Lithotripsy Vs Urerteroscopy in The Treatment of Upper Ureteric Stones

Authors: Salam Abd Elameer Yahya
Pages: 755 -761
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There are two main options for the intervention which are usually used for the treatment of calculi in the upper ureters and these are: extra corporeal shock wave lithotripsy (ESWL) and the lithotripsy by ureteroscope. Till now,there is controversy regarding which method is the most optimum in the treatment of calculi in the upper ureters. In this study we try to compare both modalities of treatment and which option consider the first-line treatment for upper ureteric calculi.From Jan. 2013 to Jan. 2014,one handered patients (54 males and 46 females) with single, unilateral upper ureteric stone size from (6-18 mm) treated in Al hilla teaching hospital are included in this randomized prospective study. The choice certain method for treatment was based on the clinical state of the patients and patients’ choice. Fifty (31 males and 19 females) patients are treated by ESWL, while the other fifty (23 males and 27 females) patients treated by ureteroscopy. Patients treated with ESWL achieved a 80% overall SFR with a 30 % auxiliary procedure rate. While Complications occur in 8% of cases who are treated by ESWL. Regarding group of patients treated with URS had a 92% SFR with an additional procedure rate of 28% While Complications occur in 18% of patients treated with ureteroscopy. (For ESWL group, the need of auxiliary procedures and complication rate are more common where stone size <1cm. Where as in ureteroscope group, the need of auxiliary procedures are higher for those with stone size>1cm. but the complication rate is still higher in patients with stone size <1cm. So in the urological centers in which both modalities of treatment are present, ESWL is the preferable option for treatment of patients with single upper stone in the upper ureterof ≤1 cm while ureteroscopy used for patients had stones of >1 cm.


Article
Evaluation The Protective Effect of Catharanthusroseus Extract on Induced Peptic Ulcer in Male Rabbits

Authors: Rusul Ali kadhem
Pages: 762 -771
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The goal of this study is to evaluate the role of Catharanthusroseus alcoholic extraction for treatment of induced peptic ulcer in male rabbits in which there was thirty male , the animals was divided in five groups normal control given only distal water, active control given 500 mg/kg acetyl salsylic acid orally, standard group received single dose 20mg/kg IP of omeprazole follow by 500mg/kg acetyl salsylic acid, the fourth and fifth group received 20, 30mg/kg subsequently ofC. roseusextract orally by stomach tube one hour before acetyl salsylic acid 500mg/kg orally, macroscopically significant protective effect of C.roseus extract show in dose of 30mg/kg about 61.97%, microscopically in both 20,30mg/kg the sign of healing process were detected which was approximately same as that appear in the standard group, measuring serum level of pro-inflammatory cytokines (IL-4and IL-8),showed there was significant reduction in there level at same level in both doses ,so as conclusion the alcoholic extraction of C.roseus had an antiulcerognic effect with significant reduction in the both IL-4 and IL-8.


Article
Modified Minimal Invasive Stone Treatment: Tubeless Mini PCNL in Supine Position

Authors: S. Tietze --- Amir Hamza
Pages: 772 -777
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The objective of the study was to show the feasibility and efficiency of a mini PCNL in a modified supine (Valdivia) position, as well as sealing the nephrostomy channel using a haemostyptic (gelatine matrix with thrombin) in a random comparative study. Between 6/2014 and 10/2015, 57 prospective randomised patients were analysed. All patients presenting with stones up to 4 cm were included in the analysis. The procedures were performed in the Valdivia position, using a mini nephroscope with 18 Charr Amplatz shaft. At the end of surgery the nephrostomy channel was sealed and secured using a haemostyptic (tubeless group, n=30). In the control group (n=27), the mini PCNL was performed using the abdominal approach and nephrostomy closing procedure. The surgery time, duration of the ureter stents, post-operative analgesic requirements, haemoglobin clearance, stone free rates and complications were recorded according tq the Clavien-Dindo classification tables. The surgery time (78 vs 90 min), duration of ureter stent retention (3,2 vs 4,0 d), duration of hospital stay (4,8 vs 6,2 d), haemoglobin clearance (0,61 vs 0,63 mmol/l), macro-haematuria (1,6 vs 2,3 d), analgesic requirements (2,1 vs 2,6 times post-operative Novalgin), stone free (90 vs 81,5%) and complications (3 vs 7) were reduced in the tubeless group. The initial data relating to the tubeless mini PCNL in a Valdivia position shows that this modification may be implemented without an increase in complications. The total treatment process is, from all patient perspectives, easier and faster. However, the results shown must be verified in a larger cohort to confirm reliability.


Article
The Significance of TP53 Gene Polymorphisms as A Risk Factor For Non-Hodgkin’s Lymphoma in Iraqi Patients

Authors: Maysoon Abdul-Ameer --- Ahmed Al-Salman
Pages: 778 -785
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Genetic factors including single nucleotide polymorphisms have been implicated as predisposing factors for large numbers of malignancies. When genetic disorders occur in a tumor suppressor gene, like TP53 gene, the results are expected to have devastating effects. The current study aimed to assess the effect of certain polymorphisms in TP53 genein the individual’s susceptibility to non- Hodgkin’s lymphomas among Iraqi patients. A total of 62 patients with these malignancies and 34 apparently healthy individuals were enrolled for this study. DNA was extracted from blood samples and fragment in TP53 corresponding for TP53 p.Arg72Pro, TP53 p.Pro47Ser and r.13494 G>A polymorphisms were amplified using specific primers. Genotyping was performed with restriction fragment length polymorphisms. The results revealed significant association of TP53 p.Arg72Pro polymorphism in both heterozygous and mutant homozygous genotypes with incidence of NHLs, while both TP53 p.Pro47Ser and r.13494 G>A polymorphisms had no such association. These results strongly indicate the importance of proline allele of TP53 p.Arg72Pro as a predisposing factor for NHLs.


Article
Effect of Exam Stress on Salivary Interleukin-6 level in Healthy Students

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Cytokines are important small protein molecules one of them is Interleukin-6 (IL-6) .Many tissues secretes IL6 like activated leukocytes .In immune system , IL6 plays main role in production of acute-phase proteins like C- reactive protein . Human labial salivary glands, contain Messenger RNA for IL-6 . Aim of study was to demonstrate the effect of exam stress onsalivary concentrations of interleukin- 6 (IL-6) in healthy secondary school students . Salivary specimens were collected from thirteen male students before and after final academic exam. Cytokine levels were measured by commercial enzyme linked immunoassay. Salivary IL-6 was insignificantly higher after final exam when compared with its level before exam. (P >0.05). students after exam have increased level of inflammatory cytokine (IL-6) in their saliva. TheIL6 level may be used for monitoring the stress.


Article
Incidence of Post-Tonsillectomy Bleeding in Al Hilla General Teaching Hospital

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This is a prospective study of 606 tonsillectomies patients, which were performed in the theatre of ENT department of Al-Hilla General Teaching Hospital, in the period between July 2012 to July 2014 , to estimate the age– specific incidences of post-tonsillectomy bleedings. We collected a number of patients less than 15 years old (1-14) (pediatric group) and another number of 15 years and more patients (adult group) who did tonsillectomy Our study demonstrates: the incidence of post tonsillectomy bleedings ,bleeding rates according to time, age, sex, and indications and fatality. We found he following : *post – tonsillectomy bleeding occurred more often in adult group than in pediatric group (3.8% vs. 1.5%) . *reactionary bleeding (24hours postoperatively) was more common in adult than pediatric group (81.8% vs. 60%). *post – tonsillectomy reactionary bleedings more common in males than females (2-1) while secondary is equal (1-1). post – tonsillectomy bleedings are more common in patients who have a history of chronic and recurrent infections . *fatality nil.

Keywords

ENT --- Ear --- Nose --- Throat --- Post-Tonsillectomy.


Article
Incidence of Recurrent Nasal Polyposis After Endoscopic Polypectomy

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This a prospective study done to provide reference information about the incidence of recurrent nasal polyposis and associated risk factors among 30 patients operated on by means of Endoscopic Sinus Surgery between Jan. 2012 –Jan 2014. These patients presented in otorhinolaryngology dept. in Hilla General Teaching Hospital presented with symptoms and signs of sinonasal polyposis not responding to medical treatment, the diagnosis confirmed by history taken, clinical examination which involved: anterior and posterior rhinoscopy, flexible and rigid nasoendoscopy, with radiological examinations as plain X-ray films and CT- scan of nose ¶nasal sinuses (mainly coronal view) taken to all patients to see middle meatal complex. Then the patients underwent polypectomy by means of Endoscopic Sinus Surgery, after that follow-up done during mean period of 12 months (range 3 months – 24 months) included: regular flexible & rigid nasoendoscopy. In our study we estimated the incidence of recurrent nasal polyposis after Endoscopic Sinus Surgery which was 30% and highlighted the risk factors affected this incidence as: age (mostly affected patients at 4th& 5th decade 66.67%), gender (males more than females 3.5:1), presence of some conditions (allergic rhinitis in 33.33%,allergic fungal sinusitis in 22.22%,childhood asthma in 22.22%, eczema in 11.11%, aspirin intolerance in 11.11%, and Samter's triad in 11.11%), previous nasal surgery(simple polypectomy) in 44.44%, and polyp extension as extensive polyposis in 77.78% .


Article
Evaluation The Effects of Fixed Orthodontic Appliances and Gender on Dental Plaque Accumulation and Gingival Inflammation

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Fixed orthodontic appliances consider as a host for dental plaque accumulations which lead to subsequent gingivitis. O’Leary plaque index and gingival index by Löe and Silness of 60 repeated observations (before and after first stage of orthodontic treatment) which taken from 30 patients (13 male & 17 female) with age range (17-30) years old. According to ANOVA, there was highly significant difference in plaque index before and after treatment in both males (p value=0.00) and females (p value=0.00), but there was no gender difference in plaque index before and after treatment. The present study showed that there was highly significance difference in the gingival index before and after treatment in both males (p value=0.00) and females (p value=0.00). Plaque accumulation and gingival inflammation obviously increased in orthodontic patients, so good oral hygiene program must be followed during orthodontic treatment in order to overcome these side effects.


Article
The Role of Omega-3 EPA/DHA Oral Soft gel in The Treatment of Stable Bronchiectasis

Authors: Ali Salih Baay
Pages: 818 -825
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The omega 3 has a known anti-inflammatory effect which can be beneficial in many human diseases in the respiratory & other systems. In respiratory system its role is not mature yet as in asthma, COPD & bronchiectasis & most are still under study. The safety issues also need to be addressed in the treatment with a relatively need medication. To evaluate the use of omega-3 EPA/DHA oral softgel in the treatment of stable (not in exacerbation) bronchiectasis regarding safety/efficacy effect. 44 Patients with stable bronchiectasis are randomly assigned to the active group (participants receive omega-3 EPA/DHA oral softgel (EPA 180mg &DHA 120mg ) once daily for 6 months in addition to their usual treatment) or the control group (participants receive the usual treatment only for 4 months) from January 2013 to march 2016. Interventional randomized parallel assignment study concern in the safety /efficacy of a suggested treatment. Omega 3 can used in patients with stable bronchiectasis with the expected benefits: 1- reduce exacerbation rate 2- improve FEV1 3- may improve CAT score The treatment does not cause serious side effects regarding the safety aspect apart from the fishy odor sensed by the patients .


Article
Effect of Female Body Weight Indices in Assisted Reproductive Technique Outcome

Authors: Ban Jabir Edan --- Hind Abdlkadhim --- Huda Jabir Edan
Pages: 826 -833
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Many factors effect on reproduction , one of them is weight . Increase body weight may affect negatively on reproduction. It may effect on ovulation by alteration of hormones level, sex hormone binding globulin and interaction between hormones and affecter receptors like insulin resistant. Increase body weight may be linked with decreased likelihood of achieving pregnancy in women undergo assisted reproductive technique(ART).The aim of this study isexamining the association of pregnancy outcome with body weight indices in subfertile women undergo intracytoplasmic sperm injection. A total of 60 subfertile women was participated in this study. The study carried out between, March 2013 and September 2013 Fertility Center, at AL-Sadder teaching hospital. All patients underwent full history and physical examination (including BMI , waist , hip , waist/hip ratio) on day 2 of menstrual cycle and the treatment doses (FSH and LH analogue) were calculated till time of oocyte pickup.Then embryos were classified according to their morphology and percentage of fragmentation. Of the studied women, 28.3% were overweight, 33.3% were obese and 38.4% were normal weight. The positive pregnancy rate among the whole studied women was 20% (12 of 60). According to BMI, the pregnancy rate is 26%, 23%, and 25% in normal, overweight, and obese women, respectively.There were insignificant differences among BMI groups concerning age of patients, duration of subfertility and subfertility cause. While there was significant differences among different BMIgroups regarding waist and waist-hip ratio (p<0.05). The odds ratio of positive pregnancy is found to be negatively but insignificantly related with increase weight. Regarding complication ,all patients with OHSS are overweight and obese (P<0.05). Increase weight may affect negatively on pregnancy outcome in women undergoing ART, including complication with ovarian hyperstimulation syndrome.


Article
Preoperative Passive Ureteral Dilatation Using J Stent in Patients with Ureteric Stone (Benefits and Drawbacks)

Authors: Wadhah Adnan Al-Marzooq
Pages: 834 -838
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More than 95% 0f ureteric stone are now managed by ureteroscopy or extracorporeal shockwave lithotripsy. Although preoperative double J stent insertion is frequently used, little is known about its indications and results. During the period from November 2013 to October 2014, 38 patients with mid and lower ureteric stone were included in our study. All patients underwent ureteroscopy and laser lithotripsy using semi rigid 9 French ureteroscopy and holmium YAG LASER. The patients divided in to 2 groups the first group (1)includes 18 patients who underwent single session ureteroscopy this group compared to group (2) which included 20 patients who underwent 2 sessions procedure (ureteroscopy 2 to 4 week after ipsilateral double J stent insertion). The tow group compared with regard to operative time, stone free rate, stone migration and ureteric injury. The operative time was significantly shorter in group 2 (p value 0.001), ureteric mucosal injury was lower in group 2 (p value <0.05), while stone migration was higher in group 2 (p value <0.05), other results were comparable between both group. The study concludes that preoperative passive ureteral dilatation has many benefits and drawbacks and is recommended in cases of: any difficulty in accessing the ureter; patients cannot tolerate long operative time and patients with single kidney to avoid ureteral trauma and possible stricture.


Article
Surgical Outcomes of Ascending Aortic Aneurysm

Authors: Walla Luay Al-Falluji
Pages: 839 -850
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This is a retrospective study which highlights the surgical outcome of 20 patients who were referred to the cardiac surgical department at Iben Al- Bittar Hospital from 2007 to 2015 as cases of ascended aortic aneurysm. The aims of this research is to focus on Diagnostic tools used in the referred patient and Treatment regimes, its outcome, and comparing it with results from other centers. The age of the patients ranged from 16-58, the commonest: age was 41- 50, blood group was A +ve, male / female ratio was 4:1. 5% of patients were smokers, and another 5% were alcoholics, no history of trauma was detected. 90% of patients were diagnosed as annuloaortic ectasia, while the other 10% were diagnosed as mid, and distal ascending aortic aneurysm. 35% of patients were diagnosed as cases of Marfan syndrome, 10% were having renal cysts, and 10% were having gall stones as non-cardiac diseases. As cardiac associated diseases; 90% of patients were having sever aortic valve regurgitation, 5% bicuspid aortic valve, 5% mild-moderate aortic valve regurgitation. 90% of patients were having left ventricular dysfunction, 5% fair left ventricular function, and 5% good left ventricular function, and 15% were having mild-moderate mitral regurgitation. All of the patients were treated surgically, 75% of them were submitted to modified Bentall operation, 10% were treated with aneurysmoraphy and aortic valve replacement, 5% with aneurysmictomy, and direct end to end anastomosis with aortic valve replacement, 5% with aortic graft and coronary reimplantation, and the last 5% were treated with only aortic valve replacement. Coronary reimplantation was done for 75% of patients. 15% of patient died on table because of bleeding from anastomosing sites, and as non lethal complications; 10% were re-explored in the first post operative day. The life expectancy of patients with ascending aortic aneurysm undergoing surgical repair has improved and is consistent with increased survival.


Article
Physiological Standard Curves of Predicted Pulmonary Function Parameters Impacted by Body Surface Area

Authors: Moaayed Jassim Al-Hayani
Pages: 851 -861
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The objective of the present study was undertaking to estimate the physiological standard curves of predicted PFT parameters (VC, FVC, FEV1, FEV1/FVC, FEF25-75, and PEF) impacted by body surface area in Student College. The study was conducted on 160 healthy non-smoking healthy college students who the aged group 18-25 yrs. Measured the height and weight to calculate the BSA by Mosteller formula and measured PFTs by spirometry. The statistical analysis that used to get the best physiological standard curves of impact BSA on studied pulmonary parameters showed the effectiveness of BSA by linear- shape regression model on FEF25-75 estimated the highly significant(P<0.01) highly significant negative correlation coefficients, and on VC that observed significant (P<0.05) with significant negative correlation, while on FEV1/FVC that showed non-significant(P>0.05) with non- significant correlation coefficient. The compound–shape regression model recorded strong highly significant(P<0.01) with positive and negative highly significant correlation coefficient on the FVC and FEV1 respectively, while by the inverse–shape regression model recorded highly significant (P<0.01) with highly significant negative correlation coefficients on PEF. Firstly we got the best physiological standard curves of predicted PFT parameters impacted by BSA after used linear and non-linear regression various models and various simple linear regression models and their estimates were selected from common bioassay fields. Secondly increases of BSA has impact on PFT values that lead to trouble of airflow rate due to resistance to flowing air in and out of the lung or gaseous exchanges of body demand or chest muscles can't expand enough.


Article
The Most Detective Protozoal Infections in Correlation with Radiological Findings in Wasit Governorate Hospitals During 2015

Authors: Amal Hasan Atiyah
Pages: 862 -873
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Results of current study indicate that parasitic protozoa still a real threat to public health in Iraq. The current study spotlight the diagnosis of infection in hospitalization Wasit governorate by using routine parasitic laboratory testsandradiological examinations. Out of 3350, 1780 (98.18%) and 33 (1.82%) were infected with Entamoeba histolytica and Leishmaina donovani, with overall prevalence was 65.33% for both pathogenic protozoa. The CT scan and ultrasonography in Amoebiasis revealed hepato-splenomegaly 96.66%, Amebic liver abscess2.35%, pleural effusion and Peri-hepatic fluid collection 0.54% and 0.45% respectively. Whereas in Leshmaniasis included Hepatosplenomegaly 48.5%, Ascites 24.2%, Lymphadenopathy15.2%, multiple nodular lesions in the liver and spleen 6.1% and shrinkage liver3.0%. A high number of cases in a region of present study were closely associated with an unusually distribution of a reservoir for human parasitic disease, in addition attributed to lower socioeconomic status and lack ofhealth education. But a ray of hope in the time as the health education is the key changing the attitude of the public is a particular and important for disabling these. In conclusion, we recommended widely using simultaneously radiological test with other criteria for more accuracy diagnosis.


Article
Role of Pulmonary Artery Acceleration Time in Detecting Pulmonary Hypertension and It’s Severity

Authors: Rafid Bashir Hashim Al-Taweel
Pages: 874 -884
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Transthoracic echocardiography with Doppler study is recommended as the initial noninvasive test in the screening, evaluation & monitoring of pulmonary hypertension by estimating pulmonary artery systolic pressure by measuring PA acceleration time which can estimate pressure severity. The aim of this study is to estimate the validity of pulmonary artery acceleration time as an parameter for evaluation and measuring pulmonary artery systolic pressure . This study: A cross sectional study has been carried out from December 2015 to May 2016 in El-Imamein Al-Kadhimain teaching hospital at echocardiography 61 patients (both normal &abnormal pulmonary pressure). Patients at first were assessed for presence of TR to include in the study& both estimated systolic & mean pulmonary pressure were assessed by both TR derived Doppler assessment & then measuring PAAT & PAAT derived pulmonary pressure with comparison between them .It was shownIn this studythat61patients were involved regardless of pulmonary pressure,with mean age of 55.1±17.6 (range 18-85 yr), 18 were male (29.5%) & 43 were females (70.5%). The mean of estimated peak systolic pulmonary artery pressure(EPSPAP) & mean pulmonary arterial pressure (MPAP) derived from tricuspid regurgitation done was 44.9±20.2 mmHg& 32.1±14.2 respectively. The mean value of pulmonary artery acceleration time (PAAT)was 106.89± 27.5ms& mean of PAAT derived MPAP was 30.9 ± 12.35 mmHg .The correlation of pulmonary artery acceleration time (PAAT) to pulmonary systolic pressure shows a significant association (r= - 0.693)(p=0.001) & the correlation of PAAT derived MPAP to TR derived MPAP showed significant correlation P<0.001.The sensitivity and specificity of pulmonary acceleration time in detection of pulmonary hypertension (using the value of 100ms as a cut off value) found sensitivity of 100% and specificity of 63.1%. PAAT was more useful in detecting moderate & severe pulmonary hypertension P<0.001.conclusion:Pulmonary artery acceleration time is a noninvasive obtainable echocardiographic parameter well correlated with measures of pulmonary artery systolic &mean pressure derived by tricuspid regurgitation .


Article
Irregularity Index With Gender Differences Using (Exocad) System

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This study was conducted to detect the greater amount of anterior crowding whether in the upper or lower dental arch in either male or female in different malocclusion using exocad system on digital model. Sample of 30 subjects (15 male, 15 female) with age range (14-18) years old, study model for each subject for upper and lower arch scanned by using MeditIdentica Blue Scanners after Exocad software used to measure intermolar (IMD), intercanine (ICD) and little's irregularity index (LII) in present study. Shows wide range of variation in IMD, ICD and LII, female sample shows wider arch in molar and canine region in cl III malocclusion at both upper and lower dental arches (49.45mm and 45.63mm respectively), whereas male data showed greater IMD found in CLI malocclusion (56.54mm) in the upper arch. Results indicating LII in female group with CLI malocclusion severe anterior crowding was found in the lower arch (13.13mm), whereas the least amount of anterior crowding was found in the upper arch of CLII malocclusion (3.59 mm), while in the lower arch well aligned anterior teeth with minimal crowding was found in CLIII malocclusion (3.14mm), with highly significant differences between groups for both dental arches (P> 0.01). In male group, the results of LII were different as the most anterior crowding was found in CLII malocclusion in both upper and lower dental arches (11.7mm and 9.36mm respectively), whereas the minimal anterior crowding was found in CLIII in the lower and upper dental arches (3.74mm and 8.57mm respectively), with significant differences (P> 0.01). Finding establish that the crooking of incisors its dominant character in female male group in the mandibular arch with the CL I malocclusion, while In male group severe crowding exist in the maxillary arch of CL II malocclusion patients.


Article
Redo Surgery in Mitral Valve Diseases

Authors: Walla Luay Al-Falluji --- Wisam Al-Obaidy --- Ammar Naif
Pages: 896 -903
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This is a retrospective study of a total 70 patients underwent redo mitral valve surgery from 2010 to 2015 in Ibn Al-Bitar Cardiac Center at Baghdad. The objectives of this research are to discuss the outcome of redo surgery in mitral valve, assesses the causes of death for surgery in patients underwent a mitral valve redo surgery, and evaluation of the late outcomes after mitral valve surgery especially after open and closed valvotomy. The gender of our patients is 64% females and 36% males; the middle old age of the suffers at the redo surgery time was 39.6 years (ranged from 13-65 years). Previous mitral surgery was closed mitral commissurotomy (CMC) in 30 patients (42%), mitral valve replacement (MVR) in 20 patients (29%), opened commissurotomy of miral valve in 12 suffers (19%) while repair of mitral valve in 8 suffers (10%). Re-operative surgery included mitral valve replacement with mechanical valves St. Jude type in all suffers . The mean time to redo surgery was 15 years run between 6 months – 35 years. Surgical indication were valve restenosis after open type of commisurotomy & closed type of commisurotomy in 40 patients were restenosis of valve surface area of prosthesis in 10 patients, mitral regurgitation in 8 patients, infected endocarditis in 6 suffers and paravalvular leak in 6 suffers. An operative mortality was 14% (10 patients). We now have proven in this be trained that mitral valve reoperations can be done with a suitable death rate at surgery that compares nicely with results in other studies.


Article
Detection of blaNDM -Metallo-β-Lactamase Genes in Klebsiella pneumonia Strains Isolated From Burn Patients in Baghdad Hospitals

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From the period from March to August 2016, 210 swabs were collected from the burn patients hospitalized in different hospitals in Baghdad City: Al-Karama Teaching Hospital, Special Burn Hospital, Central Teaching Laboratories, Child protection Teaching Hospital, Imam Ali Hospital. Out of 210 clinical isolates, 42 (37.5 %) had been shown a single isolated of pathogenic bacteria K. pneumoniae and the others were belonged to other bacteria and mixed growth isolates. Identification of all isolates were carried out depending on macroscopic, microscopic characterizations, conventional biochemical tests and Api 20E system.Metallo-β lactamase (MBL) enzymes were screen by two phenotypic methods(Meropenem-EDTA double disks method and Modified Hodg test). Susceptibility testing were used with The following antibiotic disks:Imipenem,Meropenem,Ceftazidime,Cefotaxime,Pipracillin,Gentamicin,Amikacin andCiprofloxacin.The percentage of resistance isolates were as followed:Imipenem (21.42%),Meropenem (19.04%),Ceftazidime(69.04%), Cefotaxime (85.71%), Pipracillin(85.71%), Gentamicin (26.19%), Amikacin (19.04 %) andCiprofloxacin(59.52%).The percentage of the prevalence of blaNDM-1 and blaNDM-2 genes in K. pneumoniae isolates from burn patients in Baghdad hospitals were as followed:20(100 %) forblaNDM-1 genes and 6 (30 %) for blaNDM-2 genes.


Article
Phytocomponents Analysis and Biological Activity For The Ethanolic Extract of Punica granatum Rind

Authors: Ahmed Ghazi Sabbar --- Saba Hadi --- Zinah Abdulmunem
Pages: 914 -919
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Abstract

The present work was pointed the recognizable proof of the presence of phytocomponents in ethanolic concentrate of nearby Punica garanatumrind by utilizing gas chromatography/mass spectroscopy; an in vitro investigation of the impact of ethanolic unrefined concentrates of Punica granatumrind on cervical tumor human cell lines (Hela) after 24hour of exposure. The ethanolic concentrate was set up from dried skin of Punica granatum. Yield of concentrate was 12.3%.The ethanolic extract exhibit dose-dependent, cell specific inhibitory effects on human cervical cancer cell line (Hela), was exponentially inhibited with increasing concentration of each extract. Ethanolic extract was produced a clear significant inhibition on Hela cell line, with IC50 values equal to 143.5µg/dl.

Table of content: volume:13 issue:4