Table of content

Diyala Journal of Medicine

مجلة ديالى الطبية

ISSN: 97642219
Publisher: Diyala University
Faculty: Medicine
Language: English

This journal is Open Access

About

A scientific, medical journal published by medical college , diyala university at 2010
No. of issues per year(2)
No. of papers per issue(15-20)
No. of issue published (3) issue

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Contact info

djm.diyala@yahoo.com

Table of content: 2014 volume:6 issue:1

Article
Breast Cancer in Kirkuk City, Hormone Receptors Status (Estrogen and Progesterone) and Her-2/Neu and Their Correlation with Other Pathologic Prognostic Variables

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Abstract

Background: Breast cancer shows different clinic- pathological features according to geographic and ethnic groups variation. The ER, PR and Her-2/neu positive status is an indication that the patient is good candidate for hormonal and immunological therapy. Aim of the study: To measure the frequency of estrogen receptor (ER), progesterone receptor (PR), and Her 2/neu positivity and to study their association with other variables in a breast cancer in Kirkuk city. Material and method: A prospective study of 138 female breast cancers in Kirkuk city from October 2012 to December 2013. Results: The age of the patients ranged from16 to 75 years, with a mean of 47 years, most common age group involved was 41-50 years, majority of our patients were less than 50 years, tumor grade III, tumor size between 2-5cm. ER, PR and Her-2/neu expression was seen in 50.7, 47.8 and 41.3% respectively, a characteristic association also found between hormone receptor and Her-2/neu expression and various clinic-pathological parameters. Conclusion: The hormonal receptor expression appear to be lower and Her-2/neu expression appear to be higher in our population compared to the West and a significant reverse association was found between hormone receptor and Her-2/neu.


Article
Angiogenesis and MMP-2expression in Oral Squamous Cell Carcinoma&Verrucous Carcinoma and its Correlation with Clinicopathological Parameters

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Abstract

Background: An important step of tumor progression in which Matrix metalloproteinase have been implicated is angiogenesis, because these enzymes degrade the extracellular matrix and provide a permissive microenvironment for the growth of new blood vessels. The present study conducted to evaluate the immunohistochemical expression ofMatrixmetalloproteinase -2(MMP-2) andangiogenic marker (CD34) in Oralsquamous cell carcinoma(SCC)versus verrucous carcinoma(VC) and to correlate their expressions with the clinicopathological parameters. Material & Methods: MMP-2 and CD34 expression was examined immunohistochemically in twenty four paraffin tissue blocks of squamous cell carcinoma and verrucous carcinoma (twelve cases of each). Results: All cases of Oral SCC exhibited positive immunostaining for MMP-2, while only one case of VC showed –ve expression. Interestingly all cases of VC showed –ve MMP-2 immunostaining of the basal cell layer. Generally lymphatic vessels were more than blood vessels in both VC&SCC cases. The mean MMP-2 immunoexpression was (59.00%) for both stage I &stage II, while the higher CD34 immuno expression was in stage I. The mean expression of MMP-2 was higher in well differentiated OSCCs, while for CD34 it was higher in poorly differentiated OSCCs followed by moderately differentiated, then well differentiated, however no statistically significant difference was found. Non- significant correlation was found concerning the expression of both markers for both lesions. Conclusion: No statistical correlation was found between MMP-2 expression and angiogenesis in OSCC and OVC.

Keywords

SCC --- VC --- MMP-2 --- CD34


Article
Determination of Interleukin-35 in Sera of Male Patients with Chronic Renal Failure on Hemodialysis

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Abstract

Background:- Renal failure may lead to increased inflammatory responses through a number of mechanisms which include decreased clearance of proinflammatory cytokines, decreased levels of antioxidant , that lead to increase of oxidative stress , nephrons are destroyed and kidney function is reduced . Objective:- The aims of this study were to determination the differences in the levels of interleukin-35 (IL-35) in patients with chronic renal failure (CRF) on hemodialysis and compare with control group. Method:- Sixty male individuals (age 40-60) were enrolled in this study which were divided into two groups as follows: Group (C) consisted of 30 healthy individuals as a control subject, (30) patients with (CRF) which were collected of their serum pre and post hemodialysis and control. IL-35, hs-CRP, TAC, MDA, MDA/TAC, urea, creatinine, uric acid, albumin levels were evaluated. Results:- The results in this study revealed that mean of serum IL-35 levels were significantly increased differences in patients with (CRF) pre and post hemodialysis compared with control group and a significant positive correlation between IL-35 and (MDA, MDA/TAC) in patients with pre and post dialysis patients with CRF. Conclusion:- Our findings suggest that a high IL-35 level most possibly reflect that the patients with (CRF) are associated and the positive correlation with oxidant-antioxidant status. Therefore, we suggest that possible antioxidant strategies that can be used therapeutically for better management of (CRF).


Article
Effects of Toluene and Formaldehyde on Oogenesis in Adult Female Mice

Authors: Layla A Kareem --- Hiwa B. Banna --- Kameel M. Naoom
Pages: 33-40
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Abstract

Background: The present study was designed to investigate the effects of toluene and formaldehyde inhalation on the ovaries of adult female mice at room temperature. Material & Methods: Mice were divided into three groups: control group, toluene exposed and formaldehyde exposed groups. The female mice were exposed to (3 ml = 300 ppm toluene) and (2.5 ml=300 ppm formaldehyde) 3 hours daily for 21 days. In this study a haemotoxlyin and eosin stains as well as the periodic acid Schiff (PAS) were used in order to illustrate the histological structures of the ovaries. Results: Female exposed to both solvents showed a significant decrease in their weights. Histological examination of the ovaries of the exposed mice (either to toluene or formaldehyde) revealed an increase in thickness of zona pellucida of ovarian follicles, significant increase in the number of primary, secondary and Graffian follicles with decrease in the number of primordial follicles after inhalation comparisons to the normal groups. Discussions: The results indicate that exposure to these organic solvents may suppress the central nervous system that contains vital centers which leads to reduction of mice weight. Conclusion: Both solvents may cause injuries to the ovaries followed by changes of the histological structure for them. This might be due to disruption of endocrine function which leads to suppression of the releasing of gonadotropins hormones.

Keywords

Toluene --- Formaldehyde --- Oogenesis


Article
Immunohistochemical Analysis of PCNA and P53 Proteins in Oral Lichen Planus, Oral Dysplasia and Normal Oral Mucosa

Authors: Lehadh M. Al – Azzawi
Pages: 41-47
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Abstract

Background: The overexpression of the protein products of genes associated with the cell cycle protein p53 and PCNA is apparently of great significance. Oral lichen planus classified among the potentially malignant lesions of oral mucosa. The aim of this study is to evaluate and compare the tissue expression PCNA and p53 proteins in oral lichen planus, epithelial dysplasia cases and normal oral mucosa. Materials and methods: Formalin-fixed and paraffin- embedded blocks of 21 lichen planus, 21 oral dysplasia and 10 of normal oral mucosa cases were used in immunohistochemical (IHC) analysis for PCNA and p53 monoclonal antibodies. Results: The mean of PCNA expression in OLP (44.14) was less than in the control group (74) and there was an opposite result of p53 (12.19) when compared with the control group (1.05), and in cases of epithelial dysplasia the same result was found and the mean PCNA value in epithelial dysplasia was significantly higher than those found in controls and in oral lichen planus. There was a statistically significant difference between the expression of p53 and PCNA proteins in oral lichen planus cases and non- significant differences of both proteins expression in oral dysplasia cases. Moreover, there was a significant positive correlation between the numbers PCNA and p53 percentage of positive cells in oral lichen planus group. Conclusion: The proportion of cases with positive PCNA and p53 expressions increased from normal oral mucosa to lichen planus to epithelial dysplasia. These results may indicate the presence of high degree of PCNA and p53 proteins in chronic and premalignant lesion like oral lichen planus and epithelial dysplasia can be great helpful in their prognosis and suggested treatment.


Article
Hypertension in the Elderly, Awareness, Control and Complications Cross-Sectional Study

Authors: Sameer AK Muzahim
Pages: 48-54
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Abstract

Background: Essential hypertension is the term applied to the 95% of cases in which no specific underlying cause can be identified. Increases with advancing age, and affects more than half of all people over the age of 60, including isolated systolic hypertension. Nearly three quarters of people with hypertension live in developing countries where awareness of the disease and access to health care are sometimes inadequate. Patients and methods: A total of 275 elderly patients 60%(n=165) females,40%(n=110) males, were seen for ( pre-operative elective surgery) medical check-up, who were found to be hypertensive, included in a cross-sectional study, assessing the disease awareness, control, compliance and complications by clinical assessment and laboratory tests . Their ages ranged from 60-83 years (mean age = 68.5). Results: From the total only 12% (n=33) of patients were found achieving good control Morbidity rate was high. Though hypertension is common in the elderly persons, I noticed the rates of awareness, treatment, and control in these patientswere low, leading to many morbidities especially cardiovascular events and stroke.


Article
Descriptive Study of Hemophilia in Al-Ramadi City

Authors: Ayyed Mohammed Namoos AL- Zubaidy
Pages: 55-59
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Abstract

Background: Hemophilia is hereditary bleeding distorted, and widespread in the world. The Objective: to identify the epidemiological characteristics of sample. Methodology: descriptive of study was conducted in genetic blood disease center in the AL-Ramadi Teaching Hospital for maternity & children during six months period of October to April (2012-2013).The data were collected by reviewing part of registered record in the center. Results: The study included (60) patients with hemophilia registered, (76,7%) was hemophilia A and (23,3%) hemophilia B. Age distribution revealed that the highest affected age group were those from age 6-15 years (33.3%). Gender distribution revealed that (88.3%) were males & (11.7%) were female. Residency distribution revealed that 65% were Rural & 35% were urban. The study showed that (56.7%) of cases were marriages among first cousins, (15%) of cases were marriages among close family or tribe & (28.3%) are marriages unrelated with family. Conclusion: from this study we can conclude that the most common is hemophilia A followed by hemophilia B & the number of newly registered cases is increasing with consanguineous marriages.


Article
Prevalence of Hepatitis C Virus Antigen Among Patients with Lichen Planus in Alkhalis City

Authors: Hayder Mahdi Idan --- Mohammed Ahmed Mahdi
Pages: 60-65
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Abstract

Background: Lichen planus is an idiopathic inflammatory disease with characteristic clinical and pathologic features affecting the skin, mucous membranes, nails, and hair. It is likely that both endogenous (genetic) and exogenous (environmental) factors such as some drugs or some infection(s) may interact to elicit the disease. Objectives: To determine the prevalence of hepatitis C virus antigen among the patients with lichen planus and comparison with healthy control group. Materials and methods: Twenty patients with lichen planus were included in this study (12 males and 8 females) and (40) healthy control (28 males and 12 females), their ages ranged from (15-60) years, obtained from Alkhalis hospital during the period from 1st February to 30th September 2013, using enzyme linked immunosorbent assay (ELISA) technique to detect anti HCV antibody in patients serum and control group. Results: Two (10 %) had positive results for hepatitis C virus antigen (2) out of (20) patients suffering from lichen planus, while none of the within healthy control group had positive result. Statistically significant relationship was observed between both of them. Conclusion: The frequent study showed a difference in prevalence of hepatitis C virus in patients with lichen planus and healthy control.


Article
Leptin, Obesity and IgE in patients with Asthma and Allergic Rhinitis

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Abstract

Background: Asthma is a chronic inflammatory disease of the respiratory airways with a worldwide prevalence. This study was performed to evaluate the role of leptin on asthma and /or allergic rhinitis, and to study asthma-obesity-leptin relationship. Methods: A cross sectional study was performed on asthmatic patients (190), allergic rhinitis patients (110) and healthy control subjects (48). Results: Serum leptin was significantly higher at asthma with overweight, asthma with metabolic syndrome, allergic rhinitis with overweight patients than of control subjects, while it was of no significant statistical difference at asthma with normal weight, allergic rhinitis with normal weight patients than of healthy control individuals. Body mass index was significantly higher in asthma with overweight patients; asthma with metabolic syndrome and allergic rhinitis with overweight. It was of no significant difference in asthmatic with normal weight patients, allergic rhinitis with normal weight than of control subjects. FEV1 was significantly lower in asthma with normal weight patientss; asthma with overweight; asthma with metabolic syndrome; allergic rhinitis with normal weight; allergic rhinitis with over weight than in control subjects. Conclusion: Leptin was significantly higher in patients with asthma and allergic rhinitis as compared to healthy non allergic individuals and it was influenced by BMI and presence of metabolic syndrome in allergic patients. BMI influence FEV 1 in both asthmatic and allergic rhinitis patients.

Keywords

Asthma --- Allergic rhinitis --- Obesity --- Leptin --- IgE --- Metabolic syndrome --- BMI


Article
Non – Exploration of the Recurrent Laryngeal Nerve in Thyroid Surgery

Authors: Hussain AlwanAl-Obaidy
Pages: 77-80
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Abstract

Background: Goiter is a common disease in Iraq and it is more common in the North .The disease is more common in females than in males. For this reason thyroid surgery is a common procedure. Many complications occur during and after surgery such as; bleeding, hypothyroidism, and recurrent laryngeal nerve injury.The later complication, although infrequently encountered can cause a lot of suffering to the patient. Objective: The objective of our study is assessing injury to the recurrent laryngeal nerve without exploration of the nerve routinely during thyroid surgery. exploration of the nerve done for selected cases where there is increase risk to injury. Patients and method: Prospective study of 400 patients whom underwent different thyroid surgery for different thyroid diseases done by one surgeon from July 1992 to July 2012 in Baquba teaching hospital were analyzed for permanent injury to RLN , when non-exploration of the RLN is the rule. Result: from the 400 cases included in the study only 4 cases (1%) had permanent injury to the RLN, 6 cases (1.5%) had transient injury and no injury in 390 cases (97.5%). Conclusion: Exploration of the RLN is not necessarily to be done routinely during thyroid surgery. We recommend exploration of the nerve in selected thyroid diseases.


Article
Fine Needle Aspiration Cytology in Thyroid Lesions: a Personal Experience

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Background: Different invasive and non-invasive investigations are used in the diagnosis and management of thyroid. Fine needle aspiration cytology (FNAC) is a safe test, technically easy to perform and cost effective. This study was conducted to throw a light on practicing FNAC in Baghdad, Iraq. Aim of the study: This study was conducted to throw a light on FNAC from a personal experience with thyroid disorders in Baghdad, Iraq. Methods: A total of 79 patients of clinically diagnosed thyroid swelling was included in the study. FNAC performed and then all patients subjected to surgery. Thyroidectomy specimens were evaluated by histopathological exam. Analysis of variance ANOVA (Is a collection of statistical models used to analyze the differences between group means and their associated procedures such as variation among and between groups) was used to examine the effect of age and duration on FNAC results. Chi square was used to examine the effect of histopathological diagnosis on FNAC readings. Accuracy of the FNAC was assessed using 2X2 table. Results: FNAC results was significantly affected by age of the patients (p=0.005), duration of thyroid swelling (p=0.0001) and histopathological diagnosis (p = 0.0001). Sensitivity, specificity, positive predictive value and negative predictive value were 75%, 57%, 94.7% and 18.2%, respectively. Conclusion: Low negative predictive value for FNAC was reported. the accuracy of FNAC affected by the experience of the histopathologist.


Article
Changes of Proportions of Serum Protein and Iron in Children Infected with Kala-Azar

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This study were performed to determine two biochemical criteria in the serum of Kala- azar patients include measurement of total serum protein & iron concentration and study the differences between each parameters in patient serum according to age, sex & size of sample study which contain (100) infected children's were (63 male &37 female) those admitted to AL-Batool teaching hospital in Diyala Governorate during the period : (1/10/2012 to 25/3/2013 ).The result in study were showed a significant increase in the protein & iron In infected as compared to & healthy children's . The concentrations of iron in the infected children is (105 ±7.0g/100ml) while the iron concentration in healthy children is(75.84±2.6 g/100ml).The concentration of protein in serum of infected children is (7.22±0.22 g/100ml) while in the healthy children is (7.08±0.12 g/100ml) .


Article
Prevalence of Viral Skin Infections among Patients in Diyala Provence - Iraq

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Back ground: Viral skin infections are a common skin problem all over the world especially in childhood and some of which are sexually transmitted with different prevalence rate in relation to age, sex, occupation and social group . Objective: To determine the prevalence of viral skin infections among Iraqi patients, attending Baquba Teaching Hospital. Patients and methods: A cross-sectional study was conducted in a consultant clinic of Baquba Teaching Hospital, in Diyala Provence during the period of 1st October 2008 to 31 March 2012. In which (802) patients with different viral skin diseases were collected and diagnosed clinically by consultant dermatologests, they were (469) males and (333) females, with a mean age of 27.7 ± 8 years. Results: The viral skin wart, was the most prevalent (39.1%) and affecting the young adult males predominantly (mean age 23.54±12.5 years). The plane wart affect predominantly teen age group (mean age 14±11 years), pityriasis rosea and Gianotti Crostti syndrome which were regarded as a viral infections or reactive state to a viral infections, shows a relatively high prevalence rate (9.9% and 9.4% respectively). Molluscum contagiosum was also a common disease (9%) and more prevalent in young adult (mean age 21±14.5 years). Although herpes simplex viral skin infection were relatively a common disease in this study (8.4%), but the genital form was less commonly seen in Iraq (0.5%). Conclusion: This study concluded that viral skin infections were a common problem in Iraq, predominantly in young adult males, with high prevalence of viral wart and low prevalence of xanthematous viral infections.


Article
Effect of Garlic on Dyslipidemic Patients with Diabetes Mellitus (Type 2)

Authors: Zuhair Maroof Hussien
Pages: 100-104
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Back ground: Garlic ( Allium sativum ) has been used in herbal medicine for treatment of cardiovascular diseases risk factors such as serum lipids , blood pressure and plasma viscosity . Aim: The aim of present study is to evaluate the effects of garlic on one of the major cardiovascular risk factors which is dyslipidemia in patients with type 2 diabetes mellitus . Materials and Methods: Type 2 diabetic patients with dyslipidemia were enrolled in this study. It covered 50 patients (35 males and 15 females) whose ages ranged between (40 – 75) years. Twenty clinically healthy individuals were included as a control group at the same above ages. Diabetic patients given garlic for period of 6 weeks and 12 weeks after which their serum lipid profiles where measured after fasting for 12 hours and comparisons was made between the treated and untreated patients . Results: It was found that the patients had a significant reduction in both total cholesterol (TC) and triglycerides (TG) (the main contributing factors to arteriosclerosis) in comparisons to the control group. The administration of garlic ( 1000 mg ) lowers the levels of low density lipoproteins cholesterol ( LDL – C ) and raise the concentrations of high density lipoproteins cholesterol (HDL – C) and so for the very low density lipoproteins cholesterol (VLDL–C) if compared with that of the control group . Conclusion: Garlic may play an important role in the treatment of dyslipidemic patients with type 2 diabetes mellitus.


Article
Single Interrupted Extramucosal Suturing of the Bowel is a Safe Surgical Technique

Authors: Muqdad Fuad Abd.Alkareem
Pages: 105-108
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Background: Leakage from an anastomosis in the gastrointestinal tract is a major complication that is often associated with increased mortality, morbidity and prolonged stay. Different techniques of intestinal anastomosis are present: • Sutured – Single-layer (interrupted or continuous) – Two-layered • Stapled Controversy regarding single versus double layer anastomosis goes as back as 1887 when Halsted proposed interrupted extra mucosal suturing. Aim of the study: To evaluate the safety of the technique single interrupted extramucosal suturing of the bowel. Patients and Method: This is a prospective study of 60 patients undergoing intestinal surgery over a period of one year and 9 months (January 2009-september 2010) in baquba teaching hospital; Both of emergency and elective surgeries are included in the study. The way of bowel suturing (perforation or anastomosis) used was single interrupted extramucosal using two zero vycril (polyglactine). Results: No single patient developed anastomosis dehiscence or fecal fistula and they all tolerated early oral feeding. Conclusion: Single-layer sero-submucosal (extramucosal) technique is safe, easy to perform, simply to taught and with no anastomosis-related morbidity and mortality. It can also be accomplished in shorter time.

Table of content: volume:6 issue:1