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: 2017 volume:14 issue:1

Article
Patients’ and Clinicians’ Perception of Facial Esthetic Improvement as Determinant of Successful Orthosurgical Treatment

Authors: Wisam Wahab Al-Hamadi --- Fayez Saleh
Pages: 1-7
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Abstract

The purpose of this study was to compare patients’ and clinicians’ perception of facial esthetic improvement after orthognathic surgery. 22 adult females who underwent orthosurgical correction of certain dentofacial deformity were randomly selected with an average age of 24 years. Pretreatment and post-treatment set of good quality and standardized colored photographs (7 photographs for each patient) were collected and displayed in separate folders for evaluation. Structured open-ended questions were answered by evaluators and rated their perception on a percentage scale. Linear multiple regression analysis showed significant differences between patients’ and clinicians’ satisfaction with the orthosurgical outcome. There was a lower correlation between the patients’ self-ratings and that of the same patients by the orthodontist and the maxillofacial surgeon. The results indicated that the patients were not significantly impressed despite the esthetic improvement and due to relatively high cost of the orthosurgical procedures. Overall patients’ satisfaction rating was significantly lower than orthodontists (r = -0.07, p = 0.77) and maxillofacial surgeon (r = 0.07, p = 0.76). On the other hand, both orthodontist and maxillofacial surgeon had moderate significant association (r = 0.54, p = 0.009). Maxillofacial surgeons rated significantly higher than the orthodontist on the scale and much higher than the patients’ ratings.


Article
Anesthetic For Cesarean Section: The Current Practice in Kurdistan Region-Iraq

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A national survey designed to find out the preferred drugs choices for the induction and maintenance of general anesthesia as well as post-delivery analgesia for cesarean section. All members of Kurdistan Anesthesiologist Association were invited to respond this survey.58% (n = 94) response rate is achieved. Propofol is the induction agent of choice being used by 79% (n = 74) of respondents. The main reasons for this agreement about propofol use are its faster recovery effects (33%) and antiemetic properties (26.9%). The most commonly used agent for maintenance is Isoflurane 56% (n = 53) to be followed by halothane (36%, n = 34). However, sevoflurane will be the preferred agent for induction and maintenance if financial constraints withheld. Fentanyl (37%, n = 55) and meperidine (35%, n = 51) are the routinely used analgesic opioids post-delivery with general anesthesia for Cesarean section. 79% of respondents (n = 74) prefers to perform Transversus Abdominis Plane (TAP) block as postoperative analgesia in obstetric anesthesia if possible. The drug of choice for induction of obstetric anesthesia according to current national practice is propofol according to this survey. Anesthesiologists do not support the change to another agent, and they are fairly satisfied with their choice.


Article
Some Physiological and Hormonal Effect of Green tea on Female Rats Treated with Lead nitrate

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Increased exposure to lead from environmental and industrial pollution have negative impact on health. Green tea has become object of study because of its subservient effects on human health. Thirty-two female rats Sprague Dawley, share out with four groups ,8 rats in every group. Group 1 was given distilled water (control), group 2 was given green tea, group 3 was given lead and group 4 was given Lead and green tea, the dose were given orally to the rats for 8 weeks, hormonal levels was estimated after collecting blood samples . The study found that estradiol, Tri-iodothyronine T3 and cortisol decrease significantly (p ≤ 0.05) in rats administered green tea alone and rats administered lead nitrate alone. While; level of estradiol and tri-iodo thyronineT3 increase significantly (p≤0.05) when the rats treated with both lead and green tea. We conclude that there was a significant decrease in the level of estradiol, Tri-iodothyronine and cortisol hormones in the female rats treated with lead nitrate. While the study showed a significant increase in the level of both estradiol and triiodothyronine after the treatment of animals with green tea, while there was no significant difference in the level of cortisol after treatment when compared with control group.


Article
Molecular Study of Two Virulence Genes of Pseudomonas aeruginosa, The Oxa 10 and Tox a with The Comparisons of The Relevant Sequences

Authors: Amir Hani Raziq
Pages: 28-38
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Pseudomonas aeruginosa is one of the leading nosocomial pathogens worldwide. Fifty pre-identified local isolates of P. aeruginosa were collected from major hospitals in Duhok and Erbil during the period from April 2015 to September 2015. The isolates were identified by classical biochemical methods and antibiotic sensitivity profiles were also obtained. Molecular investigation started with DNA extraction, confirmatory identification by the detection of 16S rRNA; PCR amplifications were applied to detect the presence of oxa 10 and toxA genes and then sequencing of the resulted PCR products was also performed. The results showed that all the fifty isolates had biochemical profiles characteristic of P. aeruginosa as it was also confirmed by the amplification band of 956 bp relevant to 16S rRNA; and that 50 % of the isolates revealed resistance to imipenem while 98 % of the isolates were resistant to cefepime. Furthermore, oxa10 gene was successfully detected by PCR in 92 % of the isolates with products bands of 760 bp while toxA gene was detected in 84 % of the isolates with an amplification bands of 396 bp. Then the PCR products of randomly selected ten samples (five for oxa 10 gene (designated A1through A5) and another five for tox A gene (designated B1 through B5) were purified by using a commercial PCR product purification kit and sequenced. The results of sequencing were analyzed in the University of Duhok/Scientific Research Center using DNASTAR/Laser Gene software. Regarding oxa10 gene, the results revealed that strains A4 and A5 are much more related when compared with the other strains. While the result of sequencing tox A gene indicated that isolates B2 and B5 are much more related in comparison with the other three isolates and isolate B1 was much more related to the positive control when all the isolates were compared.


Article
Factors Related to Smoking in a Sample of Pregnant Women in Baghdad City

Authors: Muna Abdul Kadhum Zeidan
Pages: 39-47
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Smoking during pregnancy is significant health problems. Smoking is related to different adverse health effects consist of chronic respiratory diseases in children sudden infant death syndrome. To determine the rate of smoking in a sample of Pregnant women. To identify factors associated with the smoking habits (Maternal age, maternal education ,maternal occupation, gestational age, parity, socio economic status, health problems, and stress). A cross-sectional study conducted in Baghdad in Al- Karkh teaching hospital and Bab-Almoadham primary health center. Sampling was (non-probability convenient) & sample size was 276. The study started from 1st of June 2015 to 1st of October 2015. Data was collected by questionnaire to obtain socio- demographic information. The result shows that mean age of the subjects was 29.02± 6.7 years, and the 49.6% were housewives; about (343.4%) of pregnant women in the sample were smokers. About (43.5%) of the pregnant women with smoker were mainly at 2nd trimester of their pregnancy, 'the frequency of women who had more than one baby was higher among smokers than among non-smokers', about (62.8%) of the subjects were low socio economic status. Analysis of results by (chi-square test) show that (maternal occupation, parity, socio economic status, health problems, and stress) were significant factors associated with anemia. This study shows the rate of smoking during pregnancy was 34.4%, factors that were associated with higher rate of smoking were unemployment, parity, smoking was more related with low socio economic status, health problems and stress.

Keywords

Smoking --- Factors --- Pregnant women


Article
The Validity of Diffusion–Weight MRI in Differentiation Cystic Brain Tumors From Brain Abscess

Authors: Kassim AH. Taj-Aldean
Pages: 48-56
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To determine the ability of diffusion–weight MRI images and ADC (apparent diffusion coefficient) to differentiation brain tumors from brain abscess which are difficult to distinguish on conventional MRI technique. From May 2015 to march 2017, prospectively studied 50 patients (age range 20 to 85years, mean age 55 years) with diagnosis clinically brain tumor or abscess. A conventional MRI was done on Philips MRI a 1.5T using T2, T1 and fat-suppressed technique and echo-planar spin-echo sequence diffusion weight and ADC is carried for all patients. All MR imaging features were categorized brain lesion as brain tumor or abscess , according to the features of imaging which were compared the result with histopathological findings. Fifty patients, 29 male and 21 female the diagnosis was confirmed with pathological findings which included Primary malignant cystic brain tumors 10(20%) Primary benign cystic brain tumor 13 (26%), Metastatic tumor16 (32%) and abscess11 (22%).the sensitivity for diagnosis abscess in DWI are 100%, for diagnosis primary malignant cystic tumor 60%, Primary benign cystic brain tumor 100% and the sensitivity of DWI foe diagnosis metastasis tumor 81%. Diffusion –weight MRI and ADC is good modality for differentiation cystic necrotic tumor from brain abscess.


Article
Management of Biliary Injuries after Open and Laparoscopic Cholecystectomies

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Bile duct injuries during laparoscopic and open cholecystectomy are still serious problems which may cause secondary biliary cirrhosis resulting in chronic liver failure. Injuries occur as a result of technical errors or misidentification of biliary ducts. BDIs are major cause of patient morbidity and litigation. This study aimed to evaluate the management of bile duct injuries (radiological, endoscopic or surgical management) following open and laparoscopic cholecystectomy in a tertiary referral hospital. A prospective clinical study was conducted 50 patients (9 males and 41 females) who sustained bile duct injuries during open and laparoscopic cholecystectomy. Patients were thoroughly investigated to decide the final management, and they were followed up to two years post operation to find out short- and long-term complications. The most common presentations of those patients were biliary fistula, 18 (36%) and jaundice, 14 (28%). After resuscitation, the definite managements were percutaneous drain under ultrasound guide for one patient (2%), Endoscopic retrograde cholangio pancreatographystenting or sphinectrotomy for 5 patients (10%) andhepaticojejunostomy for complete common hepatic duct transection for 43 patients (86%), most of which were done 8weeks after the primary operation. One patient succumbs before any intervention. According to the results of this study, patients with bile duct injuries are preferably treated in hepato-biliary department, where all radiological, endoscopic and experience surgeon available. Roux-en-hepaticojejunostomy is the procedure of choice for the management of patients sustaining complete transaction injury of common hepatic duct, while percutaneous drain is an excellent option for the drainage of intraperitoneal bile collection, without need for open drainage.


Article
Evidence For Complex Physiological Processes In The Enamel Organ Of The Rodent Mandibular Incisor Throughout Amelogenesis

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The process of tooth formation and development is complex involving many signalling pathways and molecules. The enamel formation is a process controlled entirely by the enamel organ with many cell-cell interaction and signalling. Although this process was studied extensively, the full understanding is still to be achieved. Twenty dental pulps from rat mandibular incisor were dissected, fixed, frozen, sectioned, stained with specific antibodies then carefully examined using fluorescence microscope. The basic findings were cellular heterogeneity, presence of spherical vacuoles which may be blood vessels, and striking differential expression of some very important signalling molecules antigen throughout the enamel organ at different stages of development. This paper revealed some of the complexity associated with enamelogenesis and proved that the previous description of enamel organ is very simplistic.

Keywords

enamel organ --- amelogenesis --- NaK-ATPase --- NOS --- Actin


Article
Evaluation of Imaging Study Results in Limping Patients Related to Hip

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Limping is a common chief complaint among children while presenting to the orthopaedic clinics need medical attention and essential consultation from orthopaedic surgeon. To evaluate the imaging study findings of limping patients and their associated risk factors and causes related to hip joint. 80 patients with limping who referred from orthopaedic clinics to radiological clinic in Al-Hilla Teaching Hospital for imaging study of hip joints, between December 2010 and December 2015 were included in this study. Report information of the patient regarding name, age, sex, address, medical and family history and short examination of gait, hip joints and lower limbs. Then imaging study for hip joints done. Clinically (26.3%) of patients had pain, meanwhile, (22.8%) of patients had unilateral pain. (78.8%) of patients had equal leg length and (75.0%) of patients had normal daily activity. (81.3%) had normal range of motion. (81.3%) of limping patients had positive findings by CT scan and MRI. (35.4%) of limping patients with positive finding had perthes disease. Majority of limping patients related to hips appear positive finding by imaging studies, which lead to definitive diagnosis. In addition, the most common cause of limping related to hip joints in this study was perthes disease. Imaging studies (C-T scan, MRI) are good tools for diagnosis of limping patients related to hip causes


Article
Physiological and Biochemical Changes in Acute Heart Failure as A Sequent to Acute Myocardial Infarction

Authors: Ghafil Saihood Hassan
Pages: 91-98
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Acute heart failures (AHF) can develop after acute myocardial infarction (AMI) early or later. It is a major cause of mortality especially in old age. The aim of current study was to detect the site of infarction in AHF patients, evaluation of parameter of AHF and comparison with control group. The present study was done in Marjan Medical City, Hilla, at cardiac center unit. Thirty (30) random patients of AHF sequent to AMI. They include (19male, 11female). The random control subjects include 30 healthy persons (20 male, 10 female) with matching age. The ages of both groups were 50 – 80 years. All patients were diagnosed by a specialist doctor. Medical history, physical examination, echocardiography, electrocardiography blood pressure measurement, body mass and laboratory tests (Serum troponin T and I, serum potassium, serum calcium and serum sodium) are performed to all subjects. The incidence of DM, HT, and smoking in AHF were 56.7%,60%, and 73% respectively. The serum troponin T, serum troponin I, serum calcium, were increased significantly while serum potassium, serum sodium and EF were decreased significantly in AHF compared to control group. The most common site of infarction in AMI with AHF was anterior infarction. Parameters of AHF were increased significantly (HR, serum troponin T, serum troponin I, and serum calcium)while other parameters were decreased significantly (serum potassium, serum sodium, and ejection fraction) were decreased significantly compared with control group.


Article
Clinical Predictors of Malignancy in Solitary Thyroid Nodule, A Study of 146 Cases

Authors: Ibrahim Falih Noori
Pages: 99 -112
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Although most of thyroid nodules are benign, 5-10% are malignant. It is important to predict the risk factors and malignant potential of STN to avoid unnecessary surgery with its complications. A prospective study was conducted to assess the rate and malignant potential of STN in 146 patients. They submitted to thorough investigations including a detailed history and clinical examination, thyroid function test, ultrasound examination and FNAC. There were 126 females and 20 males with female to male ratio about 6:1.The rate of malignancy in STNs was 8.9% with males affected more than female (15% Vs7.9%), and more with age above 40 in both sexes. History and clinical exam suspect malignancy in 6% of cases. All patients were euthyroid. Ultrasonic features such as Ill-defined margin, microclcifications, marked hypoechogenecity, and cervical lymphadenopathy are helpful features for prediction of malignancy, but none of these features are specific or pathognomonic. The results of FNAC in this study were:76 benign colloid goiter, 24 follicular tumor, 18 suspicious aspirate ,6 papillary carcinoma and 22 indeterminate cytology. The sensitivity , specificity and accuracy rate of FNAC in this study were 86.4%,96.3 and 92.3% respectively. History and examination are poor predictors of malignancy in STN. Male and increasing age are proved to be risk factors for malignancy in STN. Certain ultrasonic features are helpful in predicting malignancy but neither specific nor characteristics. These include ill-defined and irregular margin, microcalcification, marked hypoechogenecity, hyper-vascularity and cervical LAP. FNAC is highly sensitive in predicting malignant nodule. FNAC must be the first and could be the only test required to evaluate STN.


Article
A Study Effects of Licorice Plant and Prednisolone on Some Physiological and Immunological Parameters in Experimental Model

Authors: Zaid Al-Nuaimi --- Nasser Almukhtar --- Safaa Alturaihy
Pages: 113 -125
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The present study conducted thirty of adult male white rabbits to uncover the impact of Licorice in minimize the signs associate degreed symptoms after induction of allergic bronchial asthma in rabbits and elucidate what extent it will show an beneficial effects herbs therapy, in state use corticosteroids medical care. The rabbits haphazardly divided into 5 groups and albumen sensitizer was used to stimulate allergic reaction beside to use sensitization boost challenge dose that emphasize by the presence of the clinical symptoms of innate reflex, wheezing, chest tightness and shortness of breath. As well as, to changes within the level of total white blood corpuscle count, Eosinophils measurements, Interleukin-5 estimation and body temperature measurements. Meanwhile, eight days after induction allergic reaction. Extraction of Licorice was given in a variety dose of (160 and 80) mg/kg orally was administrated for eight days. Blood collected samples were done on the day sixteen and thirty, for investigate the above previous parameters through collected blood serum samples. statically analysis fore results were showed that the albumen action considerably (p≤ 0.05) induce allergic response in those of experimental rabbits associate degreed show an elevation with total white blood corpuscle, Eosinophils and Interleukin-5 levels. Whereas orally treating rabbits with root extract observe a big decrease (p≤ 0.05) within the total white blood corpuscle, Eosinophils and with the degree of Interleukin-5. As these effects of (the plant extract) wherever analyzed in comparison with recorded noticeable effects in those of glucocorticoid treated group and those healthy management teams severally.


Article
His- Ventricle (HV) Interval And Syncope As Predictor For Pacemaker Implantation In Patients With Bifascicular Block (BFB)

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Transient drop in the heart beat or transient heart block (AVB) may be consider the main cause of syncope or presyncope inpatients with bifascicular block and syncope According to the Guidelines for cardiac pacing pacemaker consider part of treatment. Aims of our study were to evaluate whether there is role for EPS in patients BFB and to evaluate the symptoms after pacing. 42 patients were enrolled in this study, with mean age value (63.4± 12.2years), suffer from interventricular conductive defect and syncope; patients underwent EPS on admission time, and pacemaker implantation accordingly and programmed follow up for the device in the last four years. Our patients were 25 (59.5%) male and 17 (40.5%)female, all of them with syncope or presncope and good left ventricular systolic function and the left ventricular ejection fraction (LVEF ≥55%). Left bundle branch block was found in 28 (66.71%) patients, while right bundle branch block were found in,14 (33.3) of them, the result of the EPS was find the cut of HV interval for pacing which represent that that the threshold at level of 75 have a sensitivity of 91% and specificity of 80%. The greater HV intervals gave more successful results for pacing. Pacemaker was implanted in 27 (64.3%) of the patients, with significant relation between pacing and syncope disappeared after pacemaker implantation (p value 000) and in 15 (35.7%) no pacemaker was implanted with persistent symptoms. Pacing were more between patients with coronary artery disease and LBBB with abnormal EPS finding. Permanent pacemaker implantation can implant directly in those old patients with syncope and bifascicular block that associated with LBBB and coronaries artery diseases without or before EP study.


Article
Salivary Iron And Ferritin Levels, Orofacial Complications of Patients With Thalassemia Major In Babylon Teaching Hospital For Maternity and Children

Authors: Mahdi Yakoob Kzar --- Ali Mihsen Hussein
Pages: 135 -139
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Different common known genetic disorders such as β- thalassemia major; cause the oral and dental problems. Elevated levels or overload of ferritin and iron need continuous chelation to eliminate toxic effects on the body tissues. The purpose of this study to detect the salivary ferritin and iron levels and association with oral and maxillofacial abnormalities or complications in β-thalassemia major. This study was done from January to march in 2017, thirty (30) patients with thalassemia type (β) major participated in pediatric and gynecology Babylon teaching hospital/department of hematology- hereditary blood disorders centers-sub branch (thalassemia), the examination procedures including (laboratory), intra and extra-orally views obtained foe each patients. Salivary analysis was highly significant (0.000) in salivary ferritin and iron levels in compared to controls. Different percentages of oral and perioral complications were appeared in those patients due to toxic effect of iron depositions.


Article
Impact Of Hypoxemia In Patient With Chronic Obstructive Pulmonary Disease On Renal Function Tests

Authors: Amjed Hassan Abbas --- Samir Sawadi Hammuod
Pages: 140 -147
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Chronic obstructive pulmonary disease (COPD) is one of the most common chronic diseases and is expected to be progressively increasing. There are many co-morbidities associated with it, but the relation between it and changes in renal function tests is still unclear. The aim of this work was to illustrate the extent of kidney dysfunction in patients who suffer from COPD. This study was performed in Merjan Medical City, the period of study was from November 2013 to June 2014, it included 86 patients with COPD and 70 control healthy subjects who completed medical questionnaires, pulmonary function tests and measurement of blood urea and serum creatinine. The data was statistically analyzed, the level of statistical significance that was depended for this study was P values ≤0.05. The results of this study revealed significant difference in the mean values of blood urea (Bur), serum creatinine (Scr), and creatinine clearance (Ccr) before and after treatment for all patients, Bur increased and Ccr decreased significantly in hypoxic group in comparison with non hypoxic group (P ˂ 0.05); while no significant changes in Scr (P = 0.1). In addition, the study showed a significant correlation between blood urea and creatinine clearance (Ccr) with SPO2 (before treatment) (p < 0.05), while non-significant negative correlation between serum creatinine and SPO2 (before treatment) (r = 0.1, P > 0.05).The results illustrated that the Bur and Scr increased; while Ccr decreased significantly in male group in comparison to female group (P˂0.05). Also there was no significant correlation between blood urea, serum creatinine, and creatinine clearance with forced expiratory volume in first second (FEV1) (before treatment) (P > 0.05). From this study, we conclude that abnormalities of renal function tests are common in patients with COPD at the first days of admission to hospital.


Article
Long-Terms Adverse Effects of Using Permanent Fillers in Facial Soft Tissue Augmentation

Authors: Alaa Hussein Al-Farhan --- Bahir Sabah Allawi
Pages: 148 -155
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Soft tissue augmentation of the face using different types of fillers has been increased tremendously in the last years. Many adverse effects has been reported after the use of the permanent type of fillers. Most of these adverse effects are permanent and can cause medical and psychological impact on the patients. The aim of this study is to evaluate the long term adverse effects and influencing Factors of the permanent fillers injected in the face and the possible ways used to treat them. it is a prospective study of 42 patients who presented with delayed-onset adverse effects after injection of polyacrylamide hydrogel (PAAG) or Boldenone Undecylenate as a permanent fillers in the face. Many adverse effects would appear long after the injection of the permanent fillers in the face. Some of the adverse effects are permanent and can cause severe psychological disturbances. Only little can be done to treat such complications. The adverse effects were grouped into four groups, Four patients presented with severe inflammatory reactions. Twenty seven patients had multiple nodules. Five patients had asymmetry in their faces. other patients were suffering from hard masses in their checks. Aspiration was done for some of the hard masses. Drainage was done for the inflammatory cases. Removal of the nodules was done for two cases and some were injected with triminicilone acetate. Temporary fillers were used to correct the patients with asymmetries, Fat injection was not successful to treat the asymmetries. The use of threads , fillers and PRP act as a trigger to the inflammatory reaction in some of these patients.


Article
Study of Minor Echocardiographic Indices of Cardiac Systolic Function in Subjects with Normal Ejection Fraction and Correlation with Age

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Many echocardiographic parameters should be added to traditional cardiac examination beside the EF (ejection fraction) as some conditions are with subclinical systolic dysfunction in spite of normal EF. To study the minor echocardiographic cardiac systolic function indices in subjects with normal ejection fraction and correlation with age. Sixty five healthy subjects with normal resting ejection fraction were involved in this study. They were divided into two age groups, group1: 40 subjects with age range (20-39) year and group2: 25 subjects with age range (40-60) year. Measurement of stroke volume index, pre ejection period, left ventricular ejection time and pre ejection period / ventricular ejection time ratio were done. There were no significant difference of stroke volume index, pre ejection period, ventricular ejection time , and pre ejection period / ventricular ejection time ratio of the two age groups. Correlation study between stroke volume index and ventricular ejection time show significant positive correlation (r=0.5478, p<0.05) and negative correlation with pre ejection period but statistically nonsignificant (r=-0.0111,p>0.05) . Correlation study between stroke volume index and pre ejection period / ventricular ejection time ratio was negative correlation but statistically nonsignificant (r= -0.2139,p>0.05). Minor echocardiographic indices of cardiac systolic function (systolic time periods) during routine echocardiographic examination are effortless and informative and not affected by aging and should be added to traditional cardiac examination beside the ejection fraction as some conditions are with subclinical systolic dysfunction in spite of normal EF.


Article
Gastric Malignancies and the Trend of Gastric Carcinoma in Duhok City-Iraq

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Gastric cancer is one of the common human malignancies particularly gastric adenocarcinoma. The stomach also represents the commonest gastrointestinal site for extra-nodal non-Hodgkin’s lymphoma. This study aims to find out the major types of gastric malignancies in Duhok city, their age and gender distribution and the trend of the types of gastric adenocarcinoma over a six year period from January 2008 till December 2013. This study included nearly all cases of gastric malignancies diagnosed in Duhok City and enrolled 155 cases. The type of malignancy was diagnosed by histopathological examination and supported in some cases by immunohistochemical staining procedures and investigations. The trend of the two major types of gastric carcinoma was determined over this six year period. The results of this study showed that the carcinoma constitutes the largest proportion of gastric malignancies (87.7%), followed by lymphoma (6.5%), then Gastrointestinal stromal tumor (GIST) (4.5%) and lastly neuroendocrine tumors (1.3%). The mean age of the intestinal type (62.1 years) was higher than that of the diffuse type (50.15 years) and the difference was statistically significant (P: < 0.05). Similarly the diffuse type was more common in women than men and also the difference was statistically significant (P: < 0.05). The results of this study show that the trend of intestinal type over a six year period is on the rise side while the trend of the diffuse type is more or less the same. Gastric carcinoma is the most common gastric malignancy in Duhok City with a male predominance and most patients had some bad prognostic factors and there is no decline in the prevalence of the intestinal type.


Article
Maximum Bite Force And Their Relation’s To Body Properties In Different Facial Type Among Iraqi Adult Female At Al Ramadi City

Authors: Mohammed Khudher Abdulhammed
Pages: 169 -179
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Maximal bite force (MBF) is the utmost force obtainable within the mouth using muscles of mastication .The purpose behind current research was to analyze the link between MBF & body properties (namely age, height, weight, Facial height, Facial Width, and Body Mass Index [BMI]) amongst females. Dental students & patients attending the Dentistry College Al Anbar University & at my private Clinic at AL Ramadi City 49 females fulfilling the inclusion criteria and included in this study. The sample classified according to the facial types into long, normal & short face. For Each participant the name, age, Body height, Body weight, the maximum bite force (M.B.F) were Measured. The Facial type determination was done Directly (Anthropometry). The descriptive statistics for all variable in different facial types had been measured. Short face and then the normal face had the largest bite force value whereas the long face had the smallest MBF value. ANOVA test revealed a very highly significant difference in Facial high, maximum bite force, while the Facial width showed a highly significant. The body mass index showed no significant differences among the three types of face. The Pearson’s Correlation of age showed positive correlation with height, facial width in long face, while in short face the height showed positive correlation with facial height, facial width. The weight appeared in positive correlation with the Body Mass Index in all facial types, and with facial width in short face only. The Facial height demonstrated positive correlation with the Facial width in all facial types. Lastly the MBF displayed Positive correlation with Body Mass Index in all facial type. A mean M.B.F for the total sample ranges from 205 to 657 N. The largest value of bite force were in the short face and the smallest value in long face. There were Positive correlation of BMI with the Maximum Bite Force & with the weight in all facial types.


Article
Prevalence of Teeth Number Anomalies in Permanent Dentition in a Sample From Erbil City (an Orthopantomographic Study)

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Supernumerary teeth are those teeth developed along with normal complement as a result of excess dental lamina in the jaws. Developmentally missing teeth include hypodontia, oligodontia and anodontia. Congenital missing of one or more teeth or a supernumerary tooth requires an urgent treatment as suggested by the Index of Orthodontic Treatment Need. This study tries to evaluate the prevalence and distribution of tooth number anomalies in Erbil patients in relation to the side, jaw, tooth types, and gender. Three thousand orthopantomograms of patients (9-36) years' old who is seeking dental treatments are used to determine the spreading and distribution of the hypodontia, oligodontia, and hyperdontia. Their radiographs are retrieved from Orthodontics and Radiographic Clinics at the College of Dentistry, Hawler Medical University, Erbil/Kurdistan Region of Iraq and private dental radiographic clinic in period from 2013 till 2015. A tooth is diagnosed as congenitally missing in case of no identification or discerned radiographically on the basis of calcification or there is no removal evidence. The chi- square test is to determine the importance of the upper and lower numerical teeth abnormality differences and the differences between genders. Five percent was set as the level of significance. Hypodontia was prevalent by 7.76%, it was more often found in females in right side of maxilla. The most missed tooth was maxillary lateral incisor. The permanent congenital missing teeth were frequently in the maxilla. Mesiodens was the most common supernumerary tooth, and its prevalence was 1.13%.


Article
Role of Topoisomerase II Alpha Gene Status on Selection of Anthracycline Therapy in Triple Negative Breast Cancer

Authors: Mohammed Fawzi Abdulmehdi Alqanbar
Pages: 189 -197
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Triple negative breast carcinoma [TNC], is peculiar to have hormone receptors negative [ER and PR] and lose HER2 receptor reactivity by immunostaining. Generally, TNC tumors carry a bad prognosis. Little is to be perceived about TOP2A gene amplification in triple negative breast cancer. This information may be of importance for the expectation of the influence of therapy. Thus the objective of this study is to evaluate topoisomerase II alpha gene status in triple negative breast cancer. A cross sectional study was done, from July 2014 to February 2015 in Oncology hospital of Baghdad Medical Complex. Only 28 patients with triple negative breast cancer were included [ER-, PR-, her2/neu-] other molecular types of breast cancer were excluded. All 28 cases were successfully hybridized using dual-color chromogenic in situ hybridization [DC-CISH][Zyto- Vision] probe kit for determination of topoisomerase II alpha gene status Patients mean age was [47.7 ± 8.8 SD]. Tumor stage was intermediate [stage II] in [57%] while 36% of cases were in stage III. Tumor grade was 46% for grade II and 54% for grade III. Regarding Ki-67, 54% of cases express Ki-67 more than 14% in comparison to 46% of them the expression was less than 14%.Regarding topoisomerase II alpha gene amplification, gene amplification was noticed in single case only as [3.6%] and it was low amplification. So TNBC is always associated with insignificant alterations of topoisomerase 2 alpha gene and thus may predicts poor response to anthracycline therapy in this molecular group of breast cancer.


Article
Regional Differences of Drinking Water Iodine and Its Association with Thyroid Disorder and Serum Iodine

Authors: Jwan Ibrahim Jawzali
Pages: 198 -208
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Abstract

The study aims to evaluate relationship between drinking water iodine and serum iodine with thyroid disorders in patients with symptomatic thyroid disease in Erbil province, Iraq. Outpatients attending Rizgariy and Hawler teaching hospital, Erbil province, were participated in this cross sectional study and samples of drinking water were collected randomly from different geographical region of Erbil province. Biochemical analyses included; serum thyroid hormones, serum iodine and drinking water iodine. Level of water and serum iodine were deficient 24.1± 6.8 μg/l (SD)μg/l and 24.4 ± 21.4 (SD) μg/l respectively. Highest level of the water iodine was in south west of Erbil city and the lowest one was in the east districts. Water iodine showed significant negative correlation with thyroid stimulating hormone (TSH) in patients with abnormal thyroid function and significant increase risk of hypothyroidism in regions with low water iodine. 20% of patient had hypothyroidism. Serum iodine didn’t correlated with water iodine while there was significant negative correlation of it with TSH hormone. Deficiency of drinking water iodine reflects effect of environmental factors on water quality. It is a potential risk factor for developing thyroid disorder especially hypothyroidism in reproductive age of housewives. Continued monitoring treatment and iodized salt programs could prevent hypo and hyperthyroidism.


Article
Concentration of Selenium, Copper, and Zinc in Nephrolithiasis Patients

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Abstract

One of the most popular disease worldwide is nephrolithiasis (kidney stone). Its distributed in many countries specially in the middle east. It may occurred due to changes in electrolytes and minerals. Trace elements are the most important cofactors that contribute in many enzymatic reactions in the body. The most common and important elements are selenium, copper and zinc. The aim of this study is estimate the concentration of the selenium, copper and zinc and compare them between healthy subjects and patients with kidney stones. The flame atomic absorption spectroscopy is the most accurate method to detect the trace elements. The study was conducted on 40 patients and 40 healthy subjects in Hilla city. The results of this study showed that the selenium and zinc levels decreased and copper increased in patients group when compared with the healthy subjects. Selenium and zinc has an inhibitory role to renal stones prevent nucleation of the stones in kidneys.

Keywords

Renal stones --- copper --- zinc --- selenium.


Article
Study of The Fasting of Ramadan on Asthmatic Patients and The Outcome with Treatment Modification

Authors: Ali Salih Baay
Pages: 216 -224
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Abstract

Ramadan, the 9th month of Islamic calendar ranging for 29-30 days in duration, during which Muslims are fasting . It was demonstrated that most of the asthmatics Muslim in our regions did not consider asthma to be a problem to Ramadan, and they pass in fasting by arranging their treatment as use the controller inhaler on Iftar and Sohoor time & stop taking the reliever inhaler in the day time. the Aim is to study the effect of Ramadan fasting on the clinical, spirometric figures of patients with stable asthma with treatment modification . Methods: A prospective cohort study was performed before, during and after Ramadan fasting on well-controlled asthmatic patients as they were classified according to the treatment types as: group 1: on inhaled budesonide + formoterol fixed single device (symbicort, Astra Zeneca, sewed) + on need short acting B adrenergic agonist. group 2 : short acting B adrenergic agonist on needed alone group 3: interleukins antagonists tablets Once daily (10 mg montelukast Na tablet) + short acting B adrenergic agonist on needed. Results found that fasting seen to have detrimental effects on fasting in hot weather as FEV1, FEF in 50% and asthma control test score show statistically significant differences before & after fasting but patient on inhaled symbicort with treatment modification show better outcome.


Article
Detection of Macrolides Resistance Gene in Proteus mirabilis Strains Isolated from Different Clinical Specimens by Using PCR Based on mef(A) gene

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Abstract

Different species of Proteus mirabilis may vary in type of infections in both the community and hospital environments. Proteus mirabilis can cause a variety illnesses including urinary tract (uncommon in normal hosts), uncomplicated cystitis or pyelonephritis, wound, and blood stream infections (BSI). This study aimed to determine the macrolides resistance gene mef(A) in P. mirabilis strains isolated from different clinical samples by using PCR. This a prospective study involving the analyses of different clinical samples (i. e. sputum, wound swabs, urine and ear swabs) were collected from 86 patients suspected of bacterial infections from Al-Sader Medical City and Al-Zahraa hospital for maternity and children were cultivated to isolate P. mirabilis. Bacterial isolates diagnosed according to Baily and Scott’s Diagnostic Microbiology then further identified by Vitek® 2- system, the sequence of the primer used for detection of mef(A) gene was amplified by using Thermal Cycler. Statistical analysis was performed by using SPSS v.20. Eighty-six patients were randomly recruited; they were (65.12%) males and (34.88%) females. P. mirabilis occupies the lowest percentage 3.5 % among other microorganisms in this study. Other bacterial genera occupied different percentages there were 33.7%, 31.4%, 22.1% and 5.8 % for Pseudomonas aeruginosa, E. coli, Proteus vulgaris and Klebsiella pneumoniae. The antimicrobial activity patterns were detected using Kirby- Bauer method. Augmentin (AUG) occupied the highest value of effectiveness (93%) against the bacterial strains in comparison with other antimicrobial agent while the lowest value was (41.9%) for Ceftazidime (CAZ) (P<000). Only one strain carry the 402 mef(A) gene among the three Proteus mirabilis strains previously reported as macrolides resistant (phenotypically).

Table of content: volume:14 issue:1