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: 2018 volume:15 issue:2

Article
Model of Protein Isoforms Analysis by Aqueous Two‑phase Systems: Methodology Importance in Clinical Biochemistry and Biopharmaceutical Production

Authors: Rana M. Hameed
Pages: 107-117
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Abstract

Aqueous phase partitioning has a long history of applications to the analytical characterization of biomolecules. However, process applications have attracted the most interest in biotechnology where it has become widely recognized as a cost‑effective technique. The application of aqueous two‑phase systems (ATPSs) has been demonstrated in many cases including a number of industrial applications with excellent levels of purity and yield. This type of separation and purification system has also been successfully used for the separation of virus and virus‑like particles. The advantage of this technique is that it may be used to monitor the aforementioned changes for purified proteins as well as for proteins in biological fluids, and that it is readily adaptable to automated high‑throughput screening. However, the wide use of this technology has been diminished by the lack of a clear understanding of the factors and mechanisms that govern the behavior of proteins in these systems. It has prevented the development of analytical models that assist the rational design of these systems. This work has revised the development of ATPSs (preparation and sampling techniques), and also highlighted the knowledge gap in the ATPS.


Article
Dental Health of Osteopenia Diabetes Mellitus Male Patients

Authors: Anass Muez AL‑Yasiry
Pages: 118-123
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Abstract

Objective: The aim of the study was to examine the oral health of osteopenia diabetes mellitus (DM) male, which includes condition of the teeth, the periodontal tissue, and the temporomandibular joint (TMJ). Materials and Methods: The basis of the absolute value and t-score, only 42 diabetic osteopenia male patients were included in this study. The examination used only male patients with DM osteopenia, aged between 30 and 70 years; they were divided into two groups according to the type of DM. The following clinical parameters used in this study determined the conditions of periodontal tissues involved: Carious of the teeth, gingivitis, periodontitis bleeding on probing, mobility of the teeth, and number of the teeth and the TMJ included TMJ tenderness, TMJ clicking, limitation in opening, drifting to one side, and statement of teeth like the presence of attrition. Results: The results of this study for the osteopenia DM patients found that the carious teeth and gingivitis occurred in all ages in both groups of DM. TMJ tender, clicking, limiting of mouth opening percentage increased with increasing the age in both groups of DM, the older age more suspected to, periodontitis, bleeding on probing, number of the teeth, and mobility of the teeth also attrition increased with increasing the age in both groups of DM. Conclusion: The oral health for the diabetic osteopenia male patients more effected, the percentage of carious teeth, gingivitis, attrition mobility of the teeth, bleeding on probing periodontitis, and number of the teeth were increased with increasing the age in both the groups of DM.


Article
Levels of Cytokines Profile in Polycystic Ovary Syndrome

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Abstract

Background: Polycystic ovary syndrome (PCOS) is one of the commonest endocrine disorder of female at reproductive age and it's prevalence in general population as 20%–33%. Objective: The aim of this study was to measure the level of interleukin (IL) 18, IL 6, and tumor necrosis factor (TNF) in polycystic ovary women and compare their levels with apparently healthy control group. Materials and Methods: A case‑control study was carried out in Basra. In this study, blood samples from 73 women with PCOS and 73 healthy control women were collected from outpatients and private gynecological clinics and primary health care centers from different area of Basra during August 2016–March 2017 for estimation of their serum levels of IL6, IL18, and TNF alpha by using enzyme‑linked immunosorbent assay technique. Results: It is found that serum levels of IL6, IL18, and TNF alpha were elevated in PCOS women, and we conclude that serum levels of IL6, IL18, and TNF alpha are highly statistically significance in PCOS women than in healthy control group. Conclusion: Levels of IL6, IL18, and TNF alpha were highly statistically significant in PCOS comparing to normal women, and these high levels were related to PCOS independent on the presence of obesity or hyperandrogenism.


Article
Early Outcome of Surgical Intervention of Esophageal Atresia and Tracheo‑esophageal Fistula in Erbil Pediatric Surgical Center

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Background: Esophageal atresia (EA) and treacheo-esophageal fistula occur in 1 out of every 3500 live births. Children born with EA have a higher incidence of prematurity than the general population EA. The treatment of EA and tracheo-esophageal fistula, although still a challenge, represents one of the true successes of newborn surgery. Objective: The aim of this study cases with EA and/or tracheo-esophageal fistula in Rapareen pediatric surgery center, Erbil, Iraq, regarding management, and early outcome. Materials and Methods: Fifty-three neonates were enrolled in this study from October 2011 to September 2015. Preoperative investigations included chest X-ray, ultrasound of the abdomen, and echocardiography. All patients were resuscitated before surgical intervention. Statistical Package for the Social Sciences version 20 was used for data analysis. Results: Out of 53 cases, 21 survived and 32 died. Thirty patients were male and 23 were female (male-to-female ratio 1.3:1). Twelve were premature and 41 term babies. The most common type was EA and distal fistula in 47 cases, pure atresia in 5 cases, and EA with both distal and proximal fistula in one case. Presenting features were excessive salivation in all cases, failure to pass nasogastric tube in 98.1%, cyanosis in 69.8%, and chocking in 37.7%. Prenatal history of polyhydramnios was present in 67.9%. Eighteen cases had associated anomalies, most of them were cardiac. Conclusion: EA with distal tracheo-esophageal fistula is the most common type of anomaly. Early diagnosis, weight, maturity, and associated anomalies are the most important factors that affect the outcome. Postoperative respiratory care is necessary, especially for those who have a preoperative chest infection.


Article
Association of sFas and sFas Ligand with Progression of Type 2 Diabetes Mellitus in Basrah Province

Authors: Saja Majid Hamid, Wafaa Sadoon Shani
Pages: 135-138
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Abstract

Objective: This study aimed to assess the role of Fas/Fas ligand (FasL) system in the progression of type 2 diabetes mellitus (T2DM). Materials and Methods: This study included 100 participants – 30 persons as a control group and 70 patients with T2DM (35 males and 35 females) and their ages were ranged from 40 to 70 years. The patients were distributed into two groups according to gender and duration of the disease: newly diagnosed group for short duration ≤5 years and chronic diagnosed group for long duration >5 years. Serum sFas and sFasL levels were measured by enzyme‑linked immunosorbent assay technique, and also, lipid and glucose profile were measured by COBAS analyzer. Results: The results revealed a significant (P ≤ 0.05) decrement in the levels of FasL in T2DM than controls while the levels of Fas were increasing significantly (P ≤ 0.05) in T2DM than controls. Hemoglobin A1c (HbA1c) and fasting blood glucose were negatively correlated with FasL, while high‑density lipoprotein was positively correlated with it, and whereas HbA1c positively correlated with Fas, the gender and duration of disease did not show any correlation with the disease. Conclusion: Our findings suggest that hyperglycemia causes increase in Fas levels which lead to dysfunction of pancreatic β‑cell in T2DM.


Article
Assessment of Psychosocial Status and Spiritual Beliefs of a Sample of Infertile Men in Baghdad City/Iraq

Authors: Mohammad Abdulbaqi Abdulmohsin
Pages: 139-144
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Abstract

Background: Infertility is considered one of the most important marital problems which may lead to separation between spouses, especially in male societies either by the request of the wife or negatively effect on the man’s psyche, and in this case, the man initiates to terminate the married life, away from the painful situation he suffers. Objective: This cross‑sectional descriptive study aims to identify the infertile men’s personal‑demographic characteristics, in addition to determine the psychosocial status and spiritual beliefs. Materials and Methods: The study consists of 150 patients selected randomly from the fertility center and infertility treatment/Kamal Al‑Samurai hospital in Baghdad city, the data were collected by direct interview with those patients by using a questionnaire. Results: Most of the infertile men were at age group (20–30) years, duration of marriage (1–5 years), had primary infertility. As overall assessment, the study stated that the majority of the sample was in fair psychological condition, good social condition, and spiritual beliefs in good condition. In addition, the results show that no significant difference between some personal‑demographical characteristics (age husband, duration of marriage, type of infertility, husband occupation, residential area, degree of relationship, smoking habit, take of medicines, chronic diseases, and erectile dysfunction) with psychological and social status. Conclusions: The problem of infertility is one of the most difficult problems facing newly married couples that cause negative psychological and social effects.


Article
Increased Transforming Growth Factor‑β and Interleukin‑17 Transcripts in Peripheral Blood of Breast Cancer Patients with Different Clinical Stages

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Background: Currently, cancer as major problem around the world threatens human health and has a high incidence in developing countries. Many reports have showed that there is a dysfunction in the immune system of cancer patients. Interleukin‑17 (IL‑17) and transforming growth factor‑β (TGF‑β) are increased in the generated through cancers, and IL‑17 is considered as a pro‑inflammatory cytokine; IL‑17 is an angiogenic factor and promotes tumor growth. Materials and Methods: In this study TGF‑β and IL‑17, mRNA gene expression has been measured in peripheral blood of 35 breast cancer patients and 35 normal age‑matched women using quantitative real‑time polymerase chain reaction method with master mix reaction containing SYBER Green. β‑actin gene was used as housekeeping gene. Results: Our data demonstrated a significant upregulation of TGF‑β and IL‑17 gene expression (P ˂ 0.05) in patient’s peripheral blood compared to normal healthy control. Levels of genes expression were higher in the breast cancer group compared to the control group. Conclusion: TGF‑β and IL‑17 expression could be used as a diagnostic marker for detecting breast cancer.


Article
Associated Clinical Manifestations and Self‑management Approaches of Primary Dysmenorrhea among Adolescent Students in Erbil City, Iraq

Authors: Awaz Aziz Saeed
Pages: 150-154
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Background: Primary dysmenorrhea is one of the most common gynecological problems among adolescent females which interferes with daily activities and affects their physical and emotional aspects and has a negative impact on quality of life. Self‑medication for primary dysmenorrhea is a very common practice. Objective: This study aimed to find the associated clinical manifestations and self‑management approaches of primary dysmenorrhea and its relations with some demographical and menstrual characteristics. Materials and Methods: A descriptive cross‑sectional study was conducted on 300 dysmenorrheic adolescent students in secondary schools in Erbil city, during the period from March to June 2016. A purposive (nonprobability) sampling was used. A questionnaire format was prepared by researcher which included following parts: sociodemographic data, menstrual data, clinical manifestation, and self‑management approaches to minimize this problem. Results: Majority of the study samples aged between 14 and 17 years, their school class was 11, the education of their mothers was illiterate, and mothers’ occupation was housewife. Regarding the menstrual characteristics, age of menarche among majority of the study samples was between 12 and 14 years, frequency of menstrual cycle was between 29 and 31 days, and level of pain during menstruation was severe. There was a high significant association between headache, breast tenderness, and age of adolescents. Significant association was also found between reduced ability of concentration and age of menarche. There was a significant relationship between self‑management approach used by adolescents with school class and regularity of blood flow. Conclusion: Primary dysmenorrhea considerably affected physical activity and concentration of students. Self‑management approaches practiced by adolescent participated in this study were poor.


Article
Obsessive‑Compulsive Symptoms among Clients Attending Psychiatric Outpatients’ Clinic in Duhok

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Background: Obsessive‑compulsive disorder (OCD) is a neuropsychiatric illness, develops in childhood, and can result in considerable impairment to an individual’s lifespan. The persons suffer from OCD do not seek treatment in medical settings and remain undiagnosed or misdiagnosed, and consequently, the person faces persistent untreated symptoms over time leading to considerable disturbance in familial, academic, or social functioning. Therefore, careful assessment of OCD symptoms is seminal to clinical practice. OCD among clients attending the outpatient clinic of Azadi Teaching Hospital in Iraq was assessed in the current study. Methods: This cross‑sectional study that consisted of 465 consecutive clients who visited an outpatient psychiatric clinic of Azadi Teaching Hospital in Iraq was designed, and face‑to‑face interview was performed using a translated Arabic version of Padua Inventory‑Washington State University Revision in order to assess the OCD symptoms. Results: The study confirmed previously unrecognized symptoms of obsessions and compulsions in those who visited the psychiatric outpatients’ clinic. In addition, it was shown that among total obsessions and compulsions, obsessions included contamination, thoughts of harm to self/others, impulses to harm self/others and compulsions included checking and dressing/grooming and washing which were more prevalent in males, those completed primary school education, completed higher education, and divorced/married clients. The study did not show any significant difference among different age group and employment aspects. Conclusion: The study confirmed that some individuals are unaware of their obsessions and compulsions and clinical screening would give us a golden opportunity to their issue recognition and immediate treatment commencement.

Keywords

Assessment --- compulsion --- obsession --- symptoms


Article
Evaluation of 80 Cases of Anterior Cruciate Ligament Arthroscopic Reconstruction done in Al‑Wasity Teaching Hospital, Baghdad

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Background: The objectives of anatomic anterior cruciate ligament (ACL) reconstruction is to reproduce the native anatomy of the ACL by restoring native insertion site, the tension pattern of the (ACL), the two functional bundles, and individualizing the surgery for each patient. This can be achieved using either the single‑bundle or double‑bundle technique depending on the patient condition. Objective: The goal of anatomic reconstruction in short term is to benefit clinical outcome and in long term is to reduce the prevalence of osteoarthritis. To review the results of patients who underwent arthroscopic reconstruction of the (ACL) using the semitendinosus and gracilis tendon double or triple stranded graft. Materials and Methods: Eighty cases (72 males, 8 females) who met the inclusion criteria of study that underwent arthroscopical reconstruction for (ACL) injury and followed up for 6 months in Al‑Wasti Hospital between September 2012 and October 2014 were included in this study. Results: Excellent clinical outcome was reported with 92.5% of the patients, 2(2.5%) cases had delay flexion and extension, failure of surgery was reported with only one case and deep venous thrombosis, and infection were reported with two cases only. No significant difference regarding complications was reported according to the method of fixation or sex difference. Conclusion: Excellent functional outcome was obtained with all methods of fixation which confirm the reliability and safety of these techniques.


Article
Knowledge, Attitude, and Practice Regarding Diabetic Mellitus among a Sample of Students at Technical Institute of Karbala

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Background: Diabetes mellitus (DM) is a life‑threatening disease whose complications can cause heart attack or stroke, blindness, and kidney failure. Objective: The main objective of this study was to determine knowledge, attitude, and practices regarding DM among a sample of students at the Technical Institute of Karbala. Materials and Methods: This cross‑sectional study was conducted in Al‑Furat A‑Awsat Technical University, Technical Institute of Karbala, Iraq. A total of 856 students were included in this study. Data were collected by direct interview with students using a questionnaire form. Results: Total sample in this study was 856 students (52.3% male and 47.7% female), 58 DM (Type II) patients were included in this study. The mean age of the study population was 20.86 ± 1.58 years (range of 17–25 years). The majority of students (48.8%) were in the age group of (≤20 years). The most of the respondents were single and lived in urban areas as represent 87.4% and 75.9%, respectively. Nearly 60% of cases had good and acceptable knowledge scores, while 50% had good and acceptable scores for attitude and practice regarding DM. Conclusion: The overall scores were good and acceptable regarding knowledge, attitude, and practice. A better educational program on diabetes should be conducted to improve awareness, attitude, and practice toward DM using mass media and health education in all Ministries.


Article
Correlation between Non-high-density Lipoprotein‑Cholesterol and the Degree of Glycemic Control in Type 2 Diabetes Mellitus

Authors: Abdulazeez Sulaiman Safo
Pages: 169-173
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Backgrounds: Diabetic dyslipidemia is regarded as a modifiable risk factor for cardiovascular diseases (CVDs). Non-high-density lipoprotein‑cholesterol (non‑HDL‑C) is a better measure of CVDs’ prediction in contrast with glycosylated hemoglobin (HbA1c) in type 2 diabetic patients. Objectives: In the present study, the prevalence of dyslipidemia and correlation of non‑HDL‑C with HbA1c were examined and evaluated in patients with type 2 diabetes mellitus. Patients and Methods: In this cross‑sectional study, 210 patients aged 18 years and older of both gender previously diagnosed regardless of their sociodemographic characteristics were invited for the assessment of dyslipidemia indicators and HbA1c in Duhok Diabetes Center, Duhok, Iraq, in 2017. Results: The mean age of the study patients was 55.56 (10.48) years and had diabetes for about 7.99 (4.50) years. The study showed a high level of dyslipidemia, including triglyceride, low‑density lipoprotein‑cholesterol, and non‑HDL‑C, and low level of HDL‑C with a high level of uncontrollable HbA1c. The study revealed a significant positive correlation between HbA1c and non‑HDL‑C (r = 0.30, P < 0.001). Non‑HDL‑C was found to be only independent risk factor for higher HbA1c in type 2 diabetic patients (P = 0.002). Conclusions: The present study showed that non-HDL-C can be used as a predictor of HbA1c in type-2 diabetic patients, and its level directly correlated with glycemic control as measured by HbA1c. It is recommended that non‑HDL‑C to be used by clinicians for routine clinical purposes.


Article
Correlation of Elevated Cardiac Troponin T Level with Severity and In‑Hospital Outcomes in Patients with Acute Ischemic Stroke

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Background: Although elevated cardiac troponin T (cTnT) is a specific marker of acute coronary syndrome, its increment in patients with acute ischemic stroke is not clear. The aim of this study is to identify the relationship between high cTnT levels and stroke severity as well as in‑hospital outcomes. Materials and Methods: This observational, cross‑sectional study was conducted on 100 patients with acute ischemic stroke in Rizgary teaching hospital from January 2016 to January 2017. Patients were divided into two groups: Group 1 patients (n = 61) with normal cTnT level and Group 2 patients (n = 39) with elevated cTnT level. The relationships between cTnT levels and stroke severity as well as in‑hospital outcomes were assessed and compared between the two groups. Results: In this study, cTnT was raised in 39 patients (39%). Patients with elevated cTnT levels were mainly males, had a significantly higher prevalence of hypertension and diabetes mellitus than the normal cTnT group (P < 0.001, for all). Systolic blood pressure and total cholesterol were significantly higher (P < 0.008 and < 0.001, respectively) in Group II patients than in Group I. In addition, Group II patients had more severe stroke and longer length of stay in hospital than in Group I patients, and the differences were statistically significant (P < 0.001, for all). The incidence of aspiration pneumonia, seizures, hemorrhagic transformation of ischemic stroke, and death was significantly higher (P < 0.001, for all) in Group II patients than in Group I patients. Conclusion: Elevated serum cTnT level at hospital admission is highly correlated with severity and poor in‑hospital outcomes in patients with acute ischemic stroke.


Article
Prolactin Serum Levels and Breast Cancer: Relationships with Hematological Factors among Cases in Karbala Province, Iraq

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Background: About one million of women are diagnosed with breast cancer globally and nearly half of whom will die from cancer. Breast cancer is the most common cancer and the leading of mortality among women. The present study aimed to find out the relationship breast cancer and levels of PRL and influence on some hematological parameters. Materials and Methods: A total of 71 specimens were collected from females with breast cancer. Blood specimens were collected, and a blood group, packed cell volume (PCV), hemoglobin (Hb), erythrocyte sedimentation rate (ESR), and prolactin (PRL) level was evaluated. Results: The results show that most breast cancer cases were age group 40–50 years and less common among other age groups. The married women were 97% and the unmarried was 3% only. Most studied cases (43%) were O+ and (26%) were A+ blood group, in compare to other blood groups. In addition, many women show a slight decrease in Hb and PCV level (<11.0 g/dl, <36% respectively), on the other hand, the mean value of ESR was increased nonsignificantly (P > 0.05). The PRL levels were increased (31.5 ng/ml) in compare to the range of normal value (14.5 ng/ml) in women at all age groups. Conclusions: The study concludes that there was a relationship between PRL level and breast cancer with a highly significant value.


Article
Arabic Websites Relevant to Patient Information about Spinal Cord Injury: Characteristics and Quality Assessment Using the DISCERN Tool

Authors: Mohamed H. Elshahidi
Pages: 182-185
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Background: Spinal cord injury (SCI) requires special healthcare and rehabilitation. Objective: The article describes and qualitatively assesses Arabic websites relevant to patient information about SCI. Materials and Methods: In March 2018, Google was searched using the Arabic translation of SCI. The first 100 results were assessed against inclusion and exclusion criteria. The following data were collected: Website name, URL, its category, SCI topic, and whether Health on the Net (HON) code was included in this study. In addition, the quality of them was assessed using the DISCERN tool. Results: A total of 13 websites were included in this study. Only two websites included HON code. Majority of them (>10) included information about the definition of SCI, its causes and its complications. Eight of them mentioned available treatment options. Most of them were blogs. Two of them were from hospital that is advertising for their SCI healthcare. According to the quality level assessment, 30.8% were of poor quality, 23.7% were of fair quality, 23.7% were of good quality, and 23.7% were of excellent quality. Conclusion: This study shows that the current available Arabic websites with SCI are insufficient. Moreover, their quality needs to be improved. In addition, there is no available governmental or institutional website with patient information about the topic. Governments, universities, and associations are encouraged to fill this gap to prevent probable patient risks that may arise from it. Some recommendations regarding quality improvement are provided.

Keywords

Arabic --- quality --- spinal cord injury --- websites


Article
Effect of Scaling and Root Planing on Salivary Alkaline Phosphatase and Acid Phosphatase in Patients with Chronic Periodontitis

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Background: Chronic periodontitis affects the supporting structures of the dentition, namely, the gingiva, periodontal ligament, cementum, and alveolar bone; it arises from interactions between the host and around 700 bacterial taxa in the subgingival microbiota, and the host responses include production of different enzymes that released by stromal, epithelial, inflammatory, or bacterial cells. Objective: This study aimed to evaluate the effect of scaling and root planing on the activity level of salivary alkaline and acid phosphatase (ACP) in patients with chronic periodontitis. Materials and Methods: The study was conducted on 60 patients, 40 were with chronic periodontitis and 20 were controlled with healthy periodontium. Scaling and root planing were conducted for periodontitis patients, and saliva samples were collected at baseline before treatment and after 2, 4, and 6 weeks of periodontal therapy and from control patients to estimate the activity levels of alkaline and ACP. Results: Scaling and root planing resulted in significant reduction of plaque index, gingival index, bleeding on probing, pocket depth, and clinical attachment level after 4 weeks of treatment (P < 0.01) and also reduction of activity levels of alkaline and ACP after 2 weeks of treatment and continued into 4 weeks as compared to baseline before treatment (P < 0.01, P < 0.05). Conclusion: The activity levels of both enzymes were reduced gradually after scaling and root planing due to the reduction of inflammatory reaction and healing of periodontal tissue, so both enzymes can be used as a biomarker for periodontitis diagnosis, treatment responses, and follow‑up.


Article
Doppler Ultrasound Hemodynamic Assessment in Preeclampsia

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Background: Preeclampsia (PE) is the main factor in maternal mortality across the world, affecting 5%–8% of pregnant women. The impairment in placental perfusion due to vascular abnormalities leads to clinical presentations and is detectable by Doppler ultrasound. Objective: The aim of the study is to assess the hemodynamic changes in pregnant women with and without PE, using Doppler ultrasound of the uterine, the umbilical, and the middle cerebral arteries. Materials and Methods: Forty pregnant women aged 19–40 years old, diagnosed with PE, were recruited from the outpatient gynecology clinic into a case–control study. Their Doppler ultrasound hemodynamic assessment of the uterine artery and its early diastolic notching, the middle cerebral artery, and the umbilical artery was compared to that of 60 matched control non‑preeclampsia (non‑PE) pregnant women aged 19–40 years old. Results: The proportions of patients with uterine artery, umbilical artery, and middle cerebral artery Doppler ultrasound abnormalities were 77.5%, 62.5%, and 37.5% in the PE group, compared to nil, 8.3%, and 11.7% in the non‑PE women, respectively. Similarly, mean resistance index of each artery and proportions of notch parameters of the uterine artery showed significant differences between PE and non‑PE patients (P < 0.001). Conclusions: Doppler ultrasound assessment in pregnant women of the uterine, the umbilical, and the middle cerebral arteries can be used to determine hemodynamic dysfunction associated with PE.


Article
Pattern of Cancer: Comparison of Risk in Basrah with National Pattern

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Cancer is receiving a significant attention in Iraq as a major health problem both in terms of incidence and mortality.[1‑3] Evidence from reports of the Iraqi Cancer Board over many years suggests an increasing risk of cancer incidence in Iraq.[4] However, the apparent rise is difficult to explain on one basis. It could reflect a package of factors including improvement in case detection as a result of better diagnostic opportunity and rising awareness of the population, better registration of detected cases, as well as the recent introduction of early detection programs for selected cancers

Keywords

Table of content: volume:15 issue:2