Volume 2, Issue 1, Autumn 2007, Page 1-178


APPENDICAL MUCOCELE

Taghreed S. Al.Quizwini; Muayad A. Al.khafaji

Al-Qadisiah Medical Journal, 2007, Volume 2, Issue 1, Pages 65-68

Appendiceal mucocele is cystic dilation of the veriform appendix from accumulation of mucoid substance within the lumen. It is either simple which develops after appendicitis if the lumen became obstructed by fibrosis or one associated with cystadenoma or cystadenocarcinoma.It is a rare condition encountered in only 0.1 - 0.4% of all appendicectomies. We reported a case that presented to agynaecologist with a picture simulating ovarian cyst torsion and we briefly reviewed the literature.

Relationship between ADA level and type of bacterial causative agents of chronic Suppurative Otitis media

Habbeb S.Naher

Al-Qadisiah Medical Journal, 2007, Volume 2, Issue 1, Pages 47-54

A total of 344 ear swabs were obtained from 300 outpatients. ( 152 were female and 148 were male ) .256 of them had unilateral and 44 had bilateral otorrhea , attending to the ENT-Department at general teaching hospital in Najaf governorate for the period from 1st December 1999 to of July 2000 .all patients submitted to ENT-examination by physicians .in addition to that 3ml of venous blood were aspirated from 41 patients with this disease and 45 normal healthy individuals carefully selected as a control for assessment the adenosine deaminase (ADA) enzyme specific activity . Pseudomonas aeruginosa ( the predominant pathogens in this study ) represented in 21.6 % from all isolates followed by other pathogens which include staphylococcus aureus(18%) Proteus species (14.2%) Echerichia coli(10%) Klebsiella pneumoniae(8.4%) anaerobic bacteria which includes bacteriodes species (3.1%) and peptostreptcoccus species. (2.7%) were also of 41 patients. This activity showed a significant decrease in patients (69.± 5.4 U/mg) then in the between three patterns of infection and the level of specific activity of immunoenzyme ADA specific activity were also found between three patterns of infection .in which the Mono – inaction group has a higher activity .there is an association between bacterial infection and the level of specific activity of immunoenzyme ADA.

The Evaluation of serum Zinc, Copper, Sodium and Potassium levels in hemodialysis patients

Yassra A. Mussa; Anwar jasib Th. AL. Mazaal

Al-Qadisiah Medical Journal, 2007, Volume 2, Issue 1, Pages 38-46

The aim of this study was to determine serum zinc(Zn),copper (Cu),sodium (Na) and potassuim (K) levels in patients with chronic renal failure (CRF) undergoning hemodialysis (HD) and to investigate the influnce of HD duration on these trace elements.The study group included (32)HD pateints and a control group of (32) healthy subjects. Blood samples were drown for determination of serum (Zn) and (Cu) levels which measured by atomic absorbtion spectrophotmetry, and serum (Na) and(K) levels measured by electrolyte analyzer. The mean age was (50.5 ±12.7)yr in the (HD) group and (48.1 ± 20.3)yr in the control group .Laboratory findings showed the following mean values: Zn (43.12 ± 12.81)micro.gm/dl in the HD group (vs. 72.59 ± 4.8) micro.gm/dl in the control group, Cu (65.3 ±10.2) micro.gm/dl in the HD group ( vs. 120.1 ± 46.3) micro.gm/dl in the control group, Na (133.9 ± 10.53) mmol/ L in the HD group (vs. 145.8 ±25.35) mmol/ L in the control,K (4.77± 0.68) mmol/ L in the HD group (vs. 3.59± 0.44) mmol/ L in the control group.The serum Zn ,Cu levels of the HD proup was significantly lower than that of the control group( P < 0.01). The serum Na level of HD group was significantly decreased than that control group( P <0.05) ,While serum( K) level in HD significantly increased ( P < 0.05)than that control group.NO significant differences in the serum Zn, Cu ,Na, and K levels between long term and short term dialyzed patients( P > 0.05). Because the levels of trace elements( Zn ,Cu ) of the HD group were significantly low, we recommend that ( Zn,Cu) should be given to patients with ( CRF) undergoing HD.

DISCHARGING OPEN MASTOID CAVITYCONTRIBUTING FACTORS & APPROACH TO MANAGEMNT

RAJAA JABAR KADHIM; YASIR LAFTA HASSOUN; Adel S. AL- Mayaly

Al-Qadisiah Medical Journal, 2007, Volume 2, Issue 1, Pages 1-7

Chronic ear discharge is one of the indications of mastoid surgery, however; this persistent discharge may be the outstanding feature of complicated surgery ““Discharging open mastoid cavity”. Discharging open mastoid cavity is defined as persistently discharging cavity following canal-wall down mastoidectomy for a period more than 3-6 months.The etiology of this discharging cavity is mutifactorial. This study focuses the light on the contributing factors of the persistence of ear discharge after canal-wall down mastoid surgery:surgical , bacteriological & structural ( Eustachian tube function).Fifty patients with discharging cavity & 40 patients with dry cavity were gathered from the outpatient department of Al-Najaf teaching hospital during the period between " October 2002- November 200 . They were evaluated for discharging open mastoid cavity after canal-wall down mastoidectomy & was found that this problem is mutifactorial in etiology both surgical & non-surgical. We concluded that meticulous surgical technique is essential to prevent such a complication, beside prompt follow up to ensure dry cavity postoperatively.

Effect of Valsalva Maneuver on Cardiovascular Reflexes

Ahlam K. Abood; min; Aamir S. Al-Mu; Yesar M.H. Al-Shamma

Al-Qadisiah Medical Journal, 2007, Volume 2, Issue 1, Pages 8-21

Valsalva maneuver (VM) is one of the most important tests used to investigate the integrity of the autonomic nervous system (ANS), it can be used to assess the baroreflex activity since the baroreceptors innervated by both sympathetic and parasympathetic nervous systems. Therefore (VM) used to investigate the changes in the hemodynamic variables in order to assess the integrity of cardiovascular system. The procedure of (VM) involves four phases through these phases the following measurements take place:1. Measurement of stroke volume (SV) which is the volume of blood pumped from the heart by each beat using echocardiographic technique.2. Heart rate (HR) is recorded by ECG in order to count the number of heart beats per each minutes.3. Cardiac output (CO) which is the volume of blood pumped from the heart per each minute can be calculated by the equation CO = HR × SV from the above points (1,2).4. Blood pressure measurement during (VM) by using mercury sphygmomanometer by which measurement of SBP, DBP and MBP.5. Peripheral vascular resistance (PVR) can be calculated from the equation PVR = BP/CO. This study was carried out on seventy normal healthy subjects, their age range (20-40 years) with mean ± SD is (27.31 ± 5.28years). In this study a totally non-invasive techniques were used during all phases of VM. Concerning the responses in different phases of VM we found that there is sudden increase of BP with reflex bradycardia at the onset of straining(phase1). During phase2 (straining phase) there is significant reduction of SV and decreasing of BP to the low point lead to sympathetic stimulation and reflex tachycardia and increment in BP(systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean blood pressure (MBP), so phase 2 can be divided in to phase 2E and phase 2L. At release of strain of VM, there is transient reduction of SV and BP (phase3), phase 2E and phase 3 were not included in this study as BP changes need to be measured by invasive technique. few seconds after release of strain, the SV return to premaneuver level with BP “over shoot” (increased SBP, DBP and MBP) and peripheral vascular resistance (PVR) also increased as it is calculated from this equation (PVR = MBP/CO), and there is reflex bradycardia so cardiac output(CO) is decreased (phase4).

Mental Retardation in Children,Causes &Prevention

Zuhair M. Al-Musawi

Al-Qadisiah Medical Journal, 2007, Volume 2, Issue 1, Pages 30-37

This study was conducted to know the definite & probable causes of mental retardation (M.R.) in children & how can we prevent some of the cases. Three hundred eighty three children with moderate to severe (M.R.) were studied in Kerbala Pediatric Hospital over two years from January 2003 to January 2005. The male to female ratio was 1.51:1. The etiology was known in151 patients (39.4%) & was unknown in 232 patients (60.6%). The probable preventable causes include kernicterus, hypoxic ischaemic encephalopathy, severe malnutrition, prematurity neonatal sepsis, hypothyroidism, encephalitis, meningitis, neural tube defect, galactossaemia, shaken baby syndrome & lead poisoning, constituting (68.8%) of the known probable causes.There was a high rate of consanguinity of parents, (37.8%) were first cousin, (24.8%) were relatives while (37.4%) were not related. Three hundred forty eight patients (90.88%) were diagnosed before their first birthday. It was concluded from the study that we can help to reduce cases of (M.R.) by practicing primary & secondary prevention through health promotion, specific protection; early diagnosis & treatment of treatable disorders by neonatal screening program.

The relation between household exposure to passive smoking and serum concentration of micronutrient

Buthena Abase Frhan

Al-Qadisiah Medical Journal, 2007, Volume 2, Issue 1, Pages 22-29

Twenty female their husband are heavy smokers were involved in this study in addition to another twenty women have no household exposure to cigarette smoking. All women have no serious health problem and they never smoke. The object of our study was to assess the presence of any relation between household exposure to passive smoking and serum concentration of retinol, tocopherols and carotenoids. Persons who smoke cigarettes are known to differ from persons who never smoked with respect to several life style behaviors, including eating less healthful diet and drinking more alcohol. The same could be true, to a lesser degree for comparison of non-smokers exposed to passive smoking with non-smoker who is not exposed to passive smoking. Serum samples were taken from the two groups and analyzed to reveal the concentration of retinol, tocopherols and carotenoids. Comparison between the two groups shows that those non-smokers who were exposed to passive smoking at home had serum concentration of carotenoids lower than in females not exposed to passive smoking at home (P<0.05). For serum retinol concentration.it was significantly higher in female with no household exposure than in female with household exposure (P<0.05), the same for serum tocopherols concentration. The results suggest that passive smoke exposure lowered circulating micronutrient concentration by directly depleting antioxidant micronutrient.

The clinical significance of reproductive hormones concentration in follicular maturation in patient with Luteal phase defect

Buthena Abbas Frhan

Al-Qadisiah Medical Journal, 2007, Volume 2, Issue 1, Pages 55-64

Forty infertile female patients were involved in this study. Twenty infertile female were with luteal phase defect and the rest twenty female were with out luteal phase defect they represent control group .All patient were stimulated with clomiphene citrate (clomid) and human menopausal gonadotropin (Humegon).hormones in follicular fluid of mature, intermediet and immature oocytes. 2-To compare the in vitro fertilization rate of the three groups of the oocytes. The luteal phase is characterized by the production of progesterone from the corpus luteum with in the ovary .The corpus luteum is derived both from the granulosa cells that remain after ovulation, and from some of the theca cells which differentiate to become theca lute in cells. Progesterone produced by the corpus luteum is the dominant hormone of the luteal phase. Serum progesterone level less than 10 ng/ml in cycle day twenty-one indicate the presence of luteal phase defect. Follicular fluid sample following aspiration of oocytes were classified into three group (mature, intermediate and immature oocytes) depending on the morphological structure of the oocytes and the surrounding cells. The concentrations of follicular fluid hormones were measured by enzymes immuno assay method using the minividas. Patients with luteal phase defect have significant higher levels of follicle stimulating hormone, Luteinizing hormone and prolactine hormone than patients with out luteal phase defect (control group). The control group has significant higher level of progesterone and estrogen hormones than luteal phase defect patients. The luteal phase defect patients have the lowest maturation rate and the lowest fertilization rate than control groups. The mature oocytes gave significant higher concentration of progesterone and estrogen hormones than intermediate or immature oocytes with better in vitro fertilization rate and cleavage rate than the immature oocytes. The results of the present study indicate that increased levels of gonadotropin in patients suffering from luteal phase defect have a significant clinical importance in the maturation it could lead to inhiption of the growth of oocytes and result in decrement of the maturation rate and this support the threshold theory of gonadotropin. Those hormones could be considered as potential markers of human oocytes quality and in vitro fertilization.

Seroprevalence of HBsAg among Healthy Blood Donors In Babylon Governorate

Amil M. Hassan; Mohammed A; Habbeb S. Naher

Al-Qadisiah Medical Journal, 2007, Volume 2, Issue 1, Pages 69-79

HBsAg prevalence among healthy blood donors was3% (75:2500). It was increased with age. HBsAg antigenmia was significantly associated with male sex; urban communities; low economic status; low educational level; history of contact with cases of acute hepatitis; but it was not associated with blood group; Rh-type; and a history of blood transfusion.

EPIDEMIOLOGICAL ASPECTS OF HIV/AIDS IN IRAQ

Usama Abdel Jaleel; Atheer Kadhim Al-Ibadi

Al-Qadisiah Medical Journal, 2007, Volume 2, Issue 1, Pages 80-90

This work was carried out at the AIDS Researches and Studies Center and Medico Consulting Center (Ibn Zoher Hospital) in Baghdad from 1st June 2004 to 1st June 2005, by retrospective study of patients records, aiming to describe the epidemiological features of AIDS cases in Iraq and its prevalence.
The total number of patients was (247) which only represented the registered cases from (1986 up to 2005), The prevalence of disease was (0.00095 per 100.000) with evident preponderance of males (86.2%) and age group < 20 years was ( 34.8%) .
Most of the patients were single (74.5%) ; married (23.5%), Patients' occupation were as follows : most of the cases are child (44.9%) followed by earner (29.1%), officers (14.2%) and lastly sex workers (0.4%), The patients were more in urban (95.1%) than in rural area (4.9%), The most common route of transmission was the parentral route (84.6%), then sexual route (11.3%) , The highest percentage of cases were diagnosed in phase (4):(84.6%). As declared that the number of cases were 247, only 64 patients are alive and the rest were dead.
The study recommended : on-going surveillance of all risk groups, health education campaign using different mass media particularly targeting high-risk groups and highly prevalent areas, ensuring safety of donated blood and blood products by proper screening for HIV/AIDS provision of effective antenatal care for early detection and active management of pregnant women and their babies, provision of diagnostic facilities and active antiretroviral drugs in addition to increasing staff efficiency by regular training courses.

Study of snake Bite clinical signs , Complication and Management

Hazem K. Abdul-Kareem

Al-Qadisiah Medical Journal, 2007, Volume 2, Issue 1, Pages 98-106

Background: venomous snake bite represent an environmental health risk in Al- diwanyiah districts.
Objectives: to find out the epidemiology, complications ,mortality due to venomous snakebites & the effectiveness of tranexamic acid in the treatment of coagulopathy caused by snakebites in the absence of specific antivenin.
Patients & methods: the study involved 65 victims of snakebite admitted to the medical ward in Al-diwanyia teaching hospital. Information were collected regarding age,sex,geographical origin areas affected, severity & complications including death .The effectiveness of tranexamic acid in the treatment of coagulopathy analyzed by Chi-square.
Results: 95.5% of victims lived in remote rural areas of Al-Diwaniah districts.66.1% had bleeding at time of admission. The annual mortality rate was 24.4%. Early fasciotomy seemed to worsen the prognosis.Tranexamic acid not reduced the mortality significantly in the group were used. No thrombotic events reported in both groups ( with & without tranexamic acid ).

Cryotherpy treatment of haemorrhoids

Nahidh R.AL-Ammar

Al-Qadisiah Medical Journal, 2007, Volume 2, Issue 1, Pages 91-97

A prospective study of one hundred and thirty two patient with first. Second and third degree haemorrheids (prolapsed haemorhoid were excluded from the study) were treated by cryotherapy in Al-Dewaniya military hospital. For the period from March1996-through March 2003. Analysis was done for all relevant data such as degree haemorrhiod. Freezing time. Pre and postoperative symptoms and any complications.
Good results were obtained in 109 patients out of 132. 6 patients developed anal fissure and treated by anal dilatation. 2 patients developed anal stenos is. Recurrence occurred in 15 patient and treated by formal haemorrhiodectomy.
The method has the following advantages:
Simple. Easy to perform. Painless. Done at the out patient department and cost effective.
To minimize complications such as pain and haemorrhge. The ice-ball should be limited to the mucosal part of the haemorrhiod.
The method will produce good results and low recurrence rate when careful selection of the patients is done. The ideal patient is the one with second and third degree haemrrhiod without any external or skin component.

Effect of captopril and enalapril on selected coagulation markers in hyperlipidemia

Sinaa A.AL-Zubidy; Bassim Irheim Al Sheibani

Al-Qadisiah Medical Journal, 2007, Volume 2, Issue 1, Pages 107-116

Background: In addition to their primary indications, hypertension and congestive heart failure, angiotensin converting enzyme inhibitors, ACE-Is, have pleiotropic effects, which are under active investigations. There is growing evidence of data stating the significant role of ACE-Is in the regulation of hemostasis.
Objectives: The present study aimed to evaluate the effect of ACE-Is on coagulation in hyperlipidemia.
Materials and Methods: Twenty-eight male Sprague-Dawely rats aged 17-19 weeks were enrolled in this study. The animals were randomized into four groups each containg seven rats: group1, 2,3 and 4. Group 1 was fed a
standard chow diet and serve as normal diet control while group 2,3 and 4 received atherogenic diet (4% cholesterol-enriched diet) for eight weeks. Animals in group 2, 3 and 4 were treated with distilled water (lipidemic control), captopril and enalapril for the next four weeks respectively. Captopril was used in a dose of 2x25 mg/kg/day P.O. Enalapril was given in a dose of 15 mg /kg/day P.O. At the end of the experiment, the animals were
sacrified and blood sample was obtained from the heart for determination of prothrombin time (PT), activated partial thromboplastin time (aPTT), plasma fibrinogen, platelets count and total serum cholesterol (TSC).
Results: Hyperlipidemia is associated with significant rise in plasma fibrinogen level (p<0.05). Captopril and enalapril treatment showed significant fall in elevated plasma fibrinogen levels (p<0.05). Hyperlipidemic rats treated with captopril and enalapril for 4 weeks showed significant prolongation of PT and aPTT ( p<0.05) while the platelets counts were statistically unaffected ( p>0.05).
Conclusion: We conclude that captopril and enalapril possess favorable effect on coagulation in hyperlipidemia.

Femoral shaft fractures in all ages. An epidemiological study in Al- Najaf

Mohammed H. Al-Obaidi

Al-Qadisiah Medical Journal, 2007, Volume 2, Issue 1, Pages 117-123

The aim of this paper is to discuss an important fracture, its incidence and causes and to find the effective measures to decrease its occurrence. Material and method: between Jan.1999 and Jan.2002 all patient with fracture shaft of femur who were admitted to alsader teaching hospital in AL-Najaf were investigated for age, sex, cause of the fracture, and period of hospitalisation. Results: The number of the patients was 494.There were 351 male and 143 female. Male to female ratio was 2.4:1.The age was ranging from 2 days to 81 years with mean of 18 years. The mean . hospitalisation period was 9 days. The main three causes of the fractures were road accident (44%), fall from height (25%), and fall (23%). There was no seasonal variation. The incidence of the fracture in children aged 0-15 years was 26.5 per 100.000 child per year. Patients with multiple fractures and other associated injuries represent 13% and most of them were children and the main cause was road accidents. Conclusions: Children were the main victims and road accidents were important cause especially in the most serious injuries. Further
preventive measures are needed to decrease the incidence of the fracture especially among children.

Relationship between postprandial hyperglycaemia and Progression of Diabetic Nephropathy

Hazem K. Abdul-Kareem; Ali S.Abdul-Razzaq Al-hilli

Al-Qadisiah Medical Journal, 2007, Volume 2, Issue 1, Pages 124-132

BACKGROUND:
With the recent development of new methods to measure postprandial hyperglycemia and new treatments to modulate it, investigators have questioned whether postprandial hyperglycemia causes diabetic complications such as nephropathy.
OBJECTIVES:
the aim of our study was to assess the influence of postprandial hyperglycaemia on the incidence of nephropathy in patients with type 2 diabetes.)
Patients&METHODS:
112 patients attending diabetic clinic in Al-diwanyia teaching hospital fulfilled the criteria of the study. The patients investigated for macroalbuminuria. The patient divided into two groups according to the result of 2 successive measurements of post-challenge plasma glucose level (following 75 gm glucose solution )2 weeks apart .
RESULTS:
Of total 112 patients with mild-moderate type 2 diabetes for last 5-7 years, about84 patients(75%) had postprandial plasma glucose values>200 mg/dl, 69(82.1%) patients of them had macroalbuminuria,whereas macroalbuminuria observed in 6 patients only ( 25 % of total ) in those with postprandial plasma glucose < 200 mg / dl total ). Macroalbuminuria reported in 7 patients (of the total 112) had normal FPG.

THE RISK OF INFERTILITY IN THE CHLAMYDIAL VAGINAL INFECTION

MANAL MOHAMMED KADHIM

Al-Qadisiah Medical Journal, 2007, Volume 2, Issue 1, Pages 133-138

Across-section study carried on 100 women attended the Maternity and Child Teaching Hospital and certain public clinics in Diwanyia city from the first of march 2005 to the end of August 2005 ,and complete medical history was taken from each one ,then a serological test was done by using Chlamydial Kit (Biorapid Chlamydia antigen)to identify the rate of infection with Chlamydia and its correlation with risk of infertility in women .The study was revealed that the prevalence rate of chlamydial infection was 26% among women ,and there is an risk factor or Odds ratio (OR) =6 to produce infertility among women.

THE USE OF ALPHA BLOCKERS IN TREATMENTOF LOWER URETERIC STONE

Ali Hamdan alkinany

Al-Qadisiah Medical Journal, 2007, Volume 2, Issue 1, Pages 139-147

Depending on the fact that alpha adrenergic receptors are present in the ureter, the alpha blocker (terazosin) has been added to the conventional treatment of ureteric colic due to lower ureteric stone in hundred patients, to asses its advantage in hasting the passage of lower ureteric stone. The patients were selected on the bases of having a stone of one cm or less in the lower ureter discovered by sonography. The patients followed after ten days by sonography if the stone not pass before that.Eight patients developed intolerable side effects (dizziness and postural hypotension) so that terazosin was stopped and twenty patients not come back for follow up. Those patients were excluded from the study. Sixty-six patients, from the remaining 72 patients, (91.6%) pass the stone within ten days. Fifteen (22.7%) of them pass the stone after three days, nineteen (28.8%) of them did so after five days and eighteen (27.3%) patients after one week, in fourteen(21.2%) patients the stone disappear in the sonography taken after ten days. Six patients (8.3%) need urological interventions as the stone failed to pass even after two course of therapy. In conclusion, the use of alpha blocker (terazosin) seemed beneficial in hasting the passage of lower ureteral stone.

Adenosine deaminase, AMP deaminase, 5`-Nucleotidase, Xanthine oxidase and Xanthine dehydrogenase Activities in Prostate Cancer Patients

Moaed O. Al-Gazally

Al-Qadisiah Medical Journal, 2007, Volume 2, Issue 1, Pages 148-159

The specific activities of some purine metabolism enzymes [Adenosine deaminase (ADA), AMP-deaminase, 5`-nucleotidase (5`-NT) and xanthine oxidase (the two forms: xanthine oxidase (XO) and xanthine dehydrogenase (XDH)], were measured in sera of control (n=45) and patients with prostate cancer (n=47).Sera ADA and AMP-deaminase specific activities in prostate cancer were significantly decreased (p<0.001) when compared with control group. By contrast there was significant increase (p<0.001) in 5`-NT specific activity observed in sera of prostate cancer. The activities of xanthine oxidase (XO) (the oxidase and the dehydrogenase activities) were the results revealed no detectable oxidase activities of XO in sera of prostate cancer. Where as, the dehydrogenase activity of this enzyme show significant decrease (p<0.001) in comparism to control group. Two forms and three forms of ADA were found in sera of control and
prostate cancer patients respectively as judged by polyacrylamide gel electrophoresis .Three forms of 5`-NT were found in sera of prostate cancer patients and control. One forms of AMP-deaminase was detected in the sera of control and prostate cancer patients. ADA, AMP-deaminase, 5`-NT and (XO, XDH) enzymes may be used as a biochemical markers in prostate cancer patients to help the early diagnosis.

Curing of plasmid contents of Proteus spp. isolated from urinary tract infections in AL- Diwaniyah city

Ali A. AL-Nashaa; Azhar N. Hussein; Adnan H. AL-.Hamadan

Al-Qadisiah Medical Journal, 2007, Volume 2, Issue 1, Pages 160-169

This study included isolation and identification of Proteus spp . from urinary tract infections of Gynecology and padiatrics Hospital teaching in Diwaniyah cityand investigated the virulence factors connected with pathogenicity of this bacteria. It aims also at curing of plasmid contact by means of using some chemical materials. The bacteria Proteus spp. Isolates formed 16% which belong
P. mirabilis and P. vulgaris from bacterial causes of urinary tract infection in children. The isolates of this bacteria has some physiological characteristics which represent virulence factors related to the ability of bacteria to make infection .
It seems that 80% from these isolates were capable to Haemagglutination of RBCs . These isolates produce also Haemolysine enzyme. It was found that percentage of production was 60% . As for B- lactamase enzyme production 40% of these bacteria isolates showed ability to produce his enzyme. Moreover, only 20% from Proteus isolates showed ability to produce bacteriocin production. All these isolates were not able to produce capsule production.
When testing the resistance of Proteus isolates toward 8 different commonly used antibiotics in treatment of urinary tract infection, results showed that the isolates have different resistance depending on the type of antibiotic and the strain of the isolates. All these isolates were completely resistance Nitrofurantion in 100% while the least resistance toward Nalidixic acid and Gentamicin reached 20% for both.
The results showed that there were DNA plasmid in 3 bacteria isolates but there was no relationship between the plasmid bands and resistance toward antibiotics. The P. mirabilis isolate which contained 4 plasmid bands was treated with SDS and Ethidiun bromide in an attempt to curing plasmid bands. The result showed that this isolate lost the ability to produce the majority of virulence factors that caused this disease and lost its resistance for som antibiotics especially Nalidix acid , Ampicillin and Choramphenicol. The ethidium bromide was the most effective in curing process since the resultant strain aest all plasmid bands.

Pentalogy of Cantrell

Mohammed J. Aboud

Al-Qadisiah Medical Journal, 2007, Volume 2, Issue 1, Pages 170-178

Pentalogy of Cantrell is a rare syndrome that consists of defects involving the diaphragm, abdominal wall, pericardium, heart and lower sternum. A 2 –day- old male neonate presented to the pediatric surgical unit in the Maternity and Child Teaching hospitalAL-diwaniya with abdominal wall defect,precious baby deliverd by CS to the mother with history of primary infertility for more than 13 year, The first clinical evaluation revealed epigastric omphalocele ( liver ,spleen and transverse colon were exposed with rupture sac , sternal defect , and ectopia cordis. US ,echocardogram and radiological studies were done to exclude others associated anomalies , Staged closure decided because the primary closure will significantly compromise ventilation or abdominal viscera .The first surgery was closure of both abdominal and thoracic defect ,bilateral flank and lateral chest wall release incisions and skin flap done for this closure. The patient had an uncomplicated post-operative course. A chest CT was performed at 2 weeks of life and demonstrated a very hypoplastic appearing anterior chest wall and a stenosis of the left mainstem bronchus as the cause of the patient's left lung hyperinflation. Monthly evaluation were done till he became at age
of two years and every thinks were normal a part from abdominal distention (herniated viscera) which affected and limited the physical activity so the second stage was done, reinforced Dacron mesh placed to the anterior abdominal wall to protects the herniated bowel and redirects the pressure in the abdomen and to promotes enlargement of abdominal cavity.