Volume 5, Issue 2, Autumn 2009, Page 1-174

Using The PCR Technque In Comparison With Other Tests In The Diagnosis Of Pulmonary TB Associated With Mycotic Infections In AL-Qadisiya Province

Orass M.Al-Taee; Jaafar k. AL-Mousawi; Adnan H. AL-Hamadani

Al-Qadisiah Medical Journal, Volume 5, Issue 2, Pages 56-69

Background: Tuberculosis (TB) remains an important public health problem world wide. It is one of the leading infectious diseases in the world and is responsible for more than 3 million deaths and 8 million new cases annually.The report of World Health Organization (WHO) estimated, for the year 2002 a global incidence of 8.8 million new cases, including 3.9 million smear-positive subjects. Aim of the study: We aimed to evaluate the effectiveness of available rapid diagnostic tests to identify TB infection. The main goal of this study was to use the PCR technique for the rapid detection of tuberculosis using sputum sampling and body fluid specimens other than respiratory secretions. Methods: During the period from December 2006 to May 2007, A total of 50 samples (sputum) were selected from 250 outpatients.The study regard's the culture of sputum as the gold standard test to other methods.Results:All of the examined patients with TB, the cause was M. tuberculosis.Clinical and laboratory diagnosis of the suspected patients revealed that 30 patients were suffering from PMIs , 15 of them had mixed infection.Twenty patients appeared to have pulmonary tuberculosis without mycotic infection. The sensitivity, specificity, PPV, NPV and Accuracy rate of PCR test were (94.2 %, 100%, 100%, 88.2% and 96 %), respectively. Conclusions: The AFB stain was easy but not sufficient to diagnosis the pulmonary TB alone, whereas the use of Lضwenstein-Jensen medium sensitive enough for diagnosis of pulmonary TB, but need along time to get the results. The polymerase chain reaction (PCR) test gave a high sensitivity and specificity in comparison with other done test, with its advantages of greater speed and effectiveness than conventional detection methods. It was successfully to identify the M. tuberculosis, particularly when the staining for acid- fast bacilli is negative and there was a lack of growth on culture or when fresh material has not been collected for culture.

Psychoneurotic Profiles Of Thalassemia

Sami Kh. Suhaim; Ali Al-Hamzawi

Al-Qadisiah Medical Journal, Volume 5, Issue 2, Pages 23-38

Background:Thalassemia is chronic disabling disease which have both physical and psychological consequences. Thalassemic patients are receiving medical care that is the focus of major attention with lesser focus on the psychiatric aspect of the illness. Early diagnosis and appropriate management of psychiatric disorders among thalassemic patients may improve the outcome , prognosis and overall quality of patients life. Objectives :To determine psychoneurotic profiles in thalassemic patients and to find out rates of anxiety, phobia, obsession, somatization, depression &hysteria.Method:The sample of the study was consisted of case group and control group. Each of the two groups include 80 thalassemic patients and 80 normal people respectively. The self-rating inventory Crown Crisp Experiential Index( CCEI) has been used to study their psychoneurotic profiles.Results :The study revealed that the frequency of psychiatric morbidity was significantly high among thalassemic patients.The rate of psychiatric symptoms was 87.5% vs.21.25% among thalassemic free people.The rate of somatization(92.5%), phobia(88.8%), anxiety(85%), obsession(83.8), hysteria(81.3%) and depression(76.3).The most common psychiatric symptom was dizziness and shortness of breath and the least common one was feeling loss of sympathy with others. Conclusions :The psychiatric morbidity of thalassemic patients is remarkable and suggest that all patients with thalassemia should undergo psychiatric assessment and Psychosocial aspects need to be addressed in the overall treatment of children with thalassemia.

Competitive Inhibition Relationship Between Erythropoietin And Interferon-Gamma In Renal Failure Anemia

Kareem T. Mashkour; Baqur A. Sultan; Ali M. Jasim

Al-Qadisiah Medical Journal, Volume 5, Issue 2, Pages 1-7

This is an in vitro laboratory study. It was done in order to prove the competitive inhibition between interferon-gamma (IFN-gamma) and erythropoietin (EPO) in chronic renal failure (CRF) by fixing an inhibition elicited by EPO on IFN-gamma expression by mononuclear cells. These cells were already separated from fresh anticoaggulated blood specimens from nine CRF-patients and nine healthy persons.Then, were co incubated separately with mitogen, phytohemaggluttinin with and without EPO under standard incubation conditions. Thereafter, IFN-gamma level was measured by ELISA. Results have shown that EPO significantly inhibits IFN-gamma expression by mononuclear cells in healthy persons, p value < 0.05, while this inhibition is not significant in CRF-patients.

Staphylococcus Aureus Nasal Carriage Among Medical Staff In AL-Nasiriyah Teaching Hospital ,Thi-Qar,Iraq

Hameed N.Al-Yassiri; Dheaa K. AL-Omer

Al-Qadisiah Medical Journal, Volume 5, Issue 2, Pages 49-55

Conclusion: Staphylococcus aureus nasal carriage is a common health problem all over the world and methicillin resistant Staphylococcus aureus is an emerging subject even in our community ,which requires further attention and support.Key words: Staphylococcus aureus, nasal carrier, penicillin resistance, methicillin resistance. Background : nasal carrier of Staphylococcus aureus is a common health problem world wide. Objective: The present study was conducted to assess the epidemiology of Staphylococcus aureus nasal carriers among hospital staff in AN- Nasiriyah teaching Hospital ,Thi-Qar ,Iraq. Patients and methods: Nasal swabs were taken from each of 140 personnel. After culturing on blood agar for overnight, probable staphylococcal isolates were identified and subjected to tube Coagulase test. After a two-week interval, second nasal swabs were taken from the subjects whose first cultures were positive for S. aureus. Results: Nasal carriage was defined in 31 (22.14%) personnel with positive culture for both sampling time. 74.19% are penicillin resistant, most of them are methicillin sensitive but 2 cases (1.43%) are methicillin resistant.

Determination The Levels Of C-Reactive Protein In Rheumatoid Arthritis Patients In Babylon Province/Iraq

Zaitoon A.Ekheiwsh Al-khafaji

Al-Qadisiah Medical Journal, Volume 5, Issue 2, Pages 17-22

Immunological and Inflammatory reaction play a pivotal role in the initiation and perpetuation of rheumatoid arthritis .The present study is an attempt to measures the level of the rheumatoid factor antibody and to estimate the level of c-reactive protein in blood as a marker for inflammation in patients with rheumatoid arthritis in Babylon government . A total of (89) cases presenting rheumatoid arthritis with age range (9-68)years old of both sex and (25)person healthy controls were included in this study . Serum RF was detected using(Humatex RF kit) and c - reactive protein was detected using(Humatex CRP kit) which is a rapid agglutination test .CRP test was found to be positive in 84/89 cases of RA .

Echocardiography Findings Among Patients Referred For Such Test In Missan Governorate

Yaseen O.Yaseen

Al-Qadisiah Medical Journal, Volume 5, Issue 2, Pages 70-79

In this study ,out of 2215 patients referred for echocardiography unit in Al-sadder general hospital in Al-Ammara from jul.2003-jul.2005. 847 (38.2%) patients were found to have abnormal echocardiograms with more males were been examined than females. Echocardiography findings, were not matching the clinical impression that warranted such test in considerable number of patients. In this study, results regarding the incidence or sex distribution of some cardiac abnormalities were comparable to that recognized in some other studies, while different results were recognized, regarding some other cardiac lesions.

Ceftriaxone Therapy Vs. Ciprofloxacin In Treatment Of Typhoid Fever In Adult Patients

Radhi F.Alshaibani

Al-Qadisiah Medical Journal, Volume 5, Issue 2, Pages 44-48

Patients & method: 200 patients attending to the fever consultation unit from January 2008 to March 2009 in Al-dewania teaching hospital diagnosed on the base of clinical and rising widal O titer as typhoid fever patient were randomly equally divided into two groups G1 received ceftriaxone 1gm TID and G2 received ciprofloxacin 500 mg BID, every patient was closely followed by temperature chart for 7 days.Result: 100% of G1 patients were afebrile (5) days after commencement of treatment while only 50% of G2 patients became afebrile (7) days after treatment.Conclusion: this probably warning that resistant for ciprofloxacin is an evolving problem in our community and ceftriaxone is the drug of choice in treatment of typhoid fever.

Detection Of Secondary Infection In Cutaneous Leishmaniasis

Karrar M. Abdul-sada; Ebtihal Ch.Abass; Sundus AL-Hucheimi

Al-Qadisiah Medical Journal, Volume 5, Issue 2, Pages 8-16

In order to study the prevalence of secondary infection in cutaneous Leishmaniasis and its relationship to the healing process , 76 Leishmaniotic patients were evaluated by three methods . The percentage of positive cases by injection with normal saline, part of skin biopsy and blood drops from lesion was 39 (68.4 %), 48 (84.2%) and 37 (65%) respectively while the percentage of nagative cases was 18 (31.6%), 9 (15.8%) and 20 (36%) respectevely . Secondary infection only were present in 57 (75%) patients, secondary bacterial infection were found in 52/ 57 (91%) patients , Secondary Fungal infection was found in 5/57 (9%) patients , gram positive bacteria only were present in 48/52 (92%) , gram negetive bacteria were present in 4 /52 (8%) patients. The secondary infection gram positive bacteria which appear Staphylococcus aureus 45/48 (93.7%) ,Streptococcus pyogenes 2/48 (4.2%) ,Staphylococcus epidermidis 1/48 (2.1%) , While gram negative bacteria appear Escherichia coli 2/4 (50%) ,Pseudomonas aeruginosa 1/4 (25%), klebsiella spp. 1/4 (25%) .

The Effect Of Fenugreek Extract In The Growth Inhibition Of Some Bacteria In Vitro

Atheer K.ibadi

Al-Qadisiah Medical Journal, Volume 5, Issue 2, Pages 39-43

The seed of trigonella Feneum - graecum was extracted with 70% ethanol, the antibacterial activity of different concentration of the extract were tested to inhibition of some Gram positive pathogenicc bacteria such as Staphylococcus aureus. Diplcoccus pneumonia, Staphylococcus epidermidis, Streptococcus facials and Gram negative such as Escherichia coli, Klebsiella spp & Pseudomonas aeroginousa.The high concentration ،2mg/ml showed antibacterial activity against gram-positive bacteria, while pseudomonas auregenosa was resistant to all concentration of extract.The results indicated that the extract of fenugreek plant seeds is important in treatment of bacterial infection & drugs industries.

Evaluation The Immunological State Of Women’s Sera Infected With Toxoplasmosis

Mahab A. Janna; Fawzia A. Al-Shanawee; Nabil E. Waheeda; Nahla G.Al-Anny

Al-Qadisiah Medical Journal, Volume 5, Issue 2, Pages 80-98

Background: The ubiquitous protozoan parasite Toxoplasma gondii is a major cause of morbidity and mortality in neonates and immunocompromised hosts. Both acute invasion and reactivation of latent infection result in an inflammatory reaction with lymphocytes, macrophages, and neutrophils.
Better understanding of the mechanisms of resistance of the host against this protozoan is
important for development of safe, effective alternative treatment regimens for toxoplasmosis in the future.
Aim of study:This study aimed to investigate some immunological parameters of woman’s sera infected with Toxoplasmosis in Baghdad city, through investigation the potential role of some interleukins mediating the inflammatory response after T. gondii infection.
Methods: Detection of parasite antibodies was achieved by MELA by testing 185 women which referred to central health laboratory during the period from March to July 2004; ELISA technique was used to detect serum concentration of IL-1α, IL-8, and IL-10 , also SRID used to calculate total IgG,IgM, C3, and C4 concentrations in both group understudy.
Results:According to the study, there was significant increasing in mean concentration of IgG whereas IgM concentration do not affected in both patients and control groups, also there were no significant differences in the mean concentration of C3 and C4 component of complement between two groups of study. There were no significant differences in mean concentration of serum IL-1α (0.68 pg/ml) and IL-8 (20.14 pg/ml) in infected women when compared with healthy one (0.187 pg/ml) and (17.0 pg/ml) respectively. However, the mean serum concentration of IL-10 was highly and significantly elevated during T. gondii infection (21.125 pg/ml) in comparison to that of healthy control (9.525 pg/ml). The study did not record any significant change in the mean total WBCs count between patients and control groups, also there were no differences in mean percentage of neutrophils in both groups, the mean percentage of eosinophils and lymphocytes was highly significant in infected women’s samples as compared with control.
Conclusion:Most cases of toxoplasmosis were diagnosed at the chronic stags of disease, hence there were no clear sign and symptoms that draw attention, however, abortion was the only manifestation that refer to infection with toxoplasmosis, since the concentrations of pro inflammatory cytokines (like IL-1α) and chemokines (such as IL-8) decreased against increase the level of anti-inflammatory and regulatory cytokine IL-10 that prevent the host immune response leading to undesirable pathological changes.

A Study Of Lipid Profile On A Group Of Patients With Diabetes Mellitus And Coronary Heart Disease In Najaf

Anwar Madlol AL-Janabi; Salih Mahdi AL-khafaji; Mohammad Saeed Abdul Zahraa

Al-Qadisiah Medical Journal, Volume 5, Issue 2, Pages 99-107

Background: lipid abnormalities are common in patients with diabetes mellitus DM and undoubtly contribute to increase in risk of coronary heart disease (CHD), CHD represent one of the most important health problems and remain the major cause of morbidity and mortality in many countries all over the world.
Objective: The aim of this study is to evaluate the lipid profile parameters level among patients with DM and pateints with CHD.
Methods: A total of 90 patients ( 50 DM; 25 males and 25 females and 40 CHD; 20 males and 20 females ), in comparison with 40 of healthy individuals ( 20 male and 20 female). The patients were randomly selected in Najaf region. The lipid profile parameters were measured for each patients and healthy individuals using Spainreact kits with standard procedure.
Results:The results revealed that DM and CHD patients had higher level of TC and Tg, HDL-cholesterol was significantly lower in DM and CHD patients of both sexes when compared with normal individual, whereas LDL-cholesterol was significantly higher in CHD male and female patients. The atherogenic index was significantly increased in CHD male and female patients according to their age levels.
Conclusion:The present study indicate that lipid profile parameters level were elevated in two types of patients but the atherogenic index was higher in CHD patients more than in DM patients .

The Effects Of Metformin And Pioglitazone Versus Their Low Dose Combination On Progression Of Atherosclerosis

Bassim I. Mohammad; Haidar M. Jawad

Al-Qadisiah Medical Journal, Volume 5, Issue 2, Pages 108-120

Results: Metformin and pioglitazone resulted in significant decrease (p<0.01) in AI. Further they caused significant (p<0.01) reduction in serum MDA, hsCRP and plasma fibrinogen.
Serum GSH level was significantly (p<0.05) elevated by metformin. Combination treatment decreased AI, serum MDA, plasma fibrinogen and hsCRP, increased GSH and possessed more favorable histological findings better than either drug alone.
Conclusion: low doses combination of Met+Pio has more favorable atheroprotective effect than either drug alone possibly due to the combined anti-inflammatory and antioxidant effects.
Background: Atherosclerotic diseases remain the leading cause of death in men and women world wide. In addition to lipid lowering, reduction of atherosclerotic disease will require further pharmacological approaches capable of modifying the disease.
Materials and methods: 35 rabbits were used in this study. Atherosclerosis was carried out by feeding the rabbits an atherogenic diet (AD). The rabbits were randomly assigned into five groups, 7 rabbits each. Group 1 (normal control) received standard chow diet. In addition to AD, the rabbits in group 2 (atherogenic control), group 3 (Met), group 4 (Pio) and group 5 (Met+Pio) received no treatment, metformin, pioglitazone and combination of low doses of metformin and pioglitazone respectively for 10 weeks. At the end of 10th week, all rabbits were sacrificed; serum lipids, MDA, GSH, hsCRP, plasma fibrinogen and aortic histological examination were determined.

The effect of Atracurium on the pulse rate during rapid tracheal intubation

Jaafer Mahbuba; Rana Talib Al-Nafakh

Al-Qadisiah Medical Journal, Volume 5, Issue 2, Pages 121-127

The atracurium dibesilate is intermediate muscle relaxant and has a little effect on heart rate .The aim of this is project is to study the effect of atracurium dibesilate on the pulse rate during rapid tracheal intubation . Materials and method: 25 cases ASA I (American society of anesthesiology .class I) , different surgeries , the same anesthesia technique ,both sexes in AlSader teaching hospital .
Result and discussion: from this study we show reading of pulse rate during three situation (pre-induction – and maintenance of anesthesia) with atracurium dibesilate during rapid tracheal intubation we notice there is not significant changes in pulse rate.Conclusion:from this project we conclude that atracurium associated with little increase in heart rate so it is preferable to be used in patients with heart diseases and elderly patients.

Mucosal Immunology Of Human Infectious Diseases

Ibrahim M.S. Shnawa

Al-Qadisiah Medical Journal, Volume 5, Issue 2, Pages 128-132

Mucosal surfaces play crucial role in immune defenses against human infection diseases. Such mucosal defenses are in a way or other related to systemic defenses mechanisms. A review of ten years works 1999-2009 is being presented. Mucosal infections induces, mucosal and systemic immune response. The systemic response mostly higher than mucosal . The patient herd immunity induces low, moderate and high immune patients, showing normal distribution curves.

Expression of HLA Class 1 In Iraqi Bladder Cancer Patients

Kareem Hamed Ghali

Al-Qadisiah Medical Journal, Volume 5, Issue 2, Pages 133-142

HLA types studied in sixty bladder cancer patients. A control sample of 80 apparently disease free individuals was included for comparisons, matched for ethinical background (Iraqi Arabs), sex and age.
The study demonstrated significant deviations in four antigens,
HLA -A2, -B5, -B51 and -Cw7, when comparisons was made between patients and controls. The frequency of antigen Cw7 was increased in the patients, while antigens A2, B5, and B51 showed decreased frequencies. Other associations were also observed when the tumour staging and grading were considered.

Effect Of Ablaquine Drug On P.Berghei In Vitro(II)

Khalid Majeed Dakhel

Al-Qadisiah Medical Journal, Volume 5, Issue 2, Pages 143-150

The aim of the present study is to establishment of continuous culture of P.berghei using best suitable condition and also the effect of Aablaquine drug on in vitro invasion of P.berghei and the intracellular growth of the parasite .
A short – term culture using different concentrations ( 10 , 100 , 250 , 500 , 1000 , µg/ml ) of Ablaquine drug along with controls was maitained in 24 well culture trays at 37 oC for 21 hr .
The invasion inhibition was found to be directly proportional to the concentration of drug used . 74 % inhibition was recorded with 1000 µg/ml concentration of Ablaquine drug followed by 60 % , 58 % , 47 % , 32 % inhibition caused by 500 µg/ml , 250 µg/ml, 100 µg/ml and 10 µg/ml respectivelly .

Use Of PCR Amplification For The Evaluation Of TB Diagnosis In Children By Classic Methods

Yahia Abedalreda Abbas; Adnan H. Al-Hamdani

Al-Qadisiah Medical Journal, Volume 5, Issue 2, Pages 151-160

All smear positive specimens appeared culture positive, but showed 54.3 %sensitivity and 100 % specificity. PCR amplification results appeared less than culture and more than each of smear and TST with %88.6 sensitivity and 100% specificity .All the thirty one PCR positive samples showed culture positive. It is concluded that although both culture and PCR amplification method are Sensitive and specific for the detection of M. tuberculosis in respiratory specimens of children . Rapid PCR method appeared to be more suitable than other tests especially the routine TST which applied.
There have been few studies evaluating the efficacy of polymerase chain reaction (PCR) testing in Front other routine test for diagnosis of TB in children. The tuberculin skin test (TST) used to detect Mycobacterium tuberculosis infection in children has many drawbacks, and a new diagnostic test for has been introduced. We assessed the diagnostic yield of PCR prospectively in a blinded study of patients referred to Al-Nassyria center for chest diseases and other private laboratories from January to June 2008 and compared the results to the routine TST, smears with Ziehl-Neelsen staining and culture on Lo¨wenstein-Jensen medium which used as the “gold standard.”. Sputum specimens were collected from 108 TB suspects patients and analyzed for the presence of Mycobacterium tuberculosis..TST yielded 23 (21.3%) were positive for TB with 65.7 % sensitivity and 87% specificity in comparing with 35(32.4%) by culture which improved the presence of 3cases as false-positive and 15 cases as false-negative by TST .

Measles Epidemic In Adults In Diwaniah Governorate

Aqeel Reheem H. AL-Barqawi

Al-Qadisiah Medical Journal, Volume 5, Issue 2, Pages 161-167

Background: Measles is a highly infectious viral disease for which humans are the only reservoir and is highly preventable through vaccination.It is rare disease of Adults, large number of cases were observed during the late 2008 in adult patient.
Objectives: to study the abnormal and large epidemic of measles cases in adults in al-diwania city.
Results: 368 of measles cases was admitted to infectious unit in al-diwania teaching hospital most of cases were male(58%) of cases, most of cases between the age of 16-25 yrs. (50%).vaccinated patient comprise just(34%) of cases, pneumonia was the most common complication.
Aim of the study:To address the abnormal and unexpected epidemic of measles cases in adult patients after the age of 16 years old in AL–Diwaniya city .

Computerized Determination Of Velocity Time Integral In Normal Subjects

Noori Y. Kattami

Al-Qadisiah Medical Journal, Volume 5, Issue 2, Pages 168-174

Background:Velocity time integral (VTI) of the blood flow wave is derived from the analysis of the image of the Doppler wave. VTI can be utilized to determine hemodynamic information in certain cardiac disorders.
Objective:To establish visual basic form for analysis of Doppler wave to determine velocity time integral (VTI) in normal subjects.
Method:Doppler waves in twenty normal subjects were analyzed to determine VTI utilizing suitable computer program and visual basic form.
Results:The parameters obtained from the analysis of Doppler wave (Ejection time (ET) and Mean blood velocity across aortic valve (Vm)) were utilized to determine VTI of the normal subjects studied as Mean, ±SD, ±SDE.
Conclusion:The (VTI) was determined in normal subjects from their Doppler waves using a computer program of visual basic form that can be useful in diagnosing and following certain cardiac disorders.