Volume 6, Issue 2, Autumn 2010, Page 1-196


Efficacy of Diluted Betadine Solution Irrigation in the Prevention of Postoperative Infection of Spinal Surgery

Osama Majeed; Zuhair Abbas Obaidi; Anwer Noori Hafdh

Al-Qadisiah Medical Journal, Volume 6, Issue 2, Pages 180-187

AbstractBackground: Deep wound infection is a serious complication of spinal surgery that can jeopardize patient outcomes and increase costs. Povidone iodine is a widely used antiseptic with bactericidal activity against a wide spectrum of pathogens, including methicillin-resistant Staphylococcus aureus.Objectives: To evaluate the efficacy of diluted betadine irrigation of spinal surgical wounds in prevention of postoperative wound infection.Patients and Methods: One hundred patients of both sex aged 25-65 years old were enrolled in this prospective study. The patients were randomized in to two equal groups. In group 1 (50 patients), surgical wounds were irrigated with diluted betadine solution (3.5% betadine) before wound closure. In group 2(50 patients), the wounds were not irrigated and serve as a control. Otherwise, perioperative management was the same for both groups.Results: Mean length of follow-up was 24 months in both groups (range, 12–24 months). No wound infection occurred in group 1. One superficial infection (2%) and six deep infections (12%) occurred in group 2. Conclusions: Diluted Betadine effectively prevents spinal surgery wound infection therefore it is recommended to use this simple and inexpensive antiseptic substance following spinal surgery.

HER-2/neu overexpression in correlation to Vascular Endothelial Growth Factor ,grade and stage of Non other wised specified Invasive ductal carcinoma

Ali Jabir Neima Al-khafaji; Liwaa H. Al-Kelabi; Esraa A. AL-Dujaily

Al-Qadisiah Medical Journal, Volume 6, Issue 2, Pages 27-37

Abstract This study aimed to assess the significance of human epidermal growth factor (HER-2/neu) protein overexpression and its possible correlation with vascular endothelial growth factor (VEGF),grade and stage in human non otherwise specified breast cancer. The present investigation was performed over a period starting from November 2008 to January 2009 .Formalin fixed, paraffin-embedded blocks from 30 patients with breast cancer were included in this study. A group of 15 patients with benign breast lesions (fibroadenoma) was included as a comparative group and 15 normal breast tissue sections were included as control group. Labeled Streptavidin-Biotin Complex (LSAB) method was employed for immunohistochemical detection of HER-2/neu. Avidin-Biotin Complex (ABC) method was employed for immunohistochemical detection of VEGF . A total of 30 malignant cases were included.HER2/neu was considered as positive in(18 cases)60% of non otherwise specified invasive ductal carcinoma and VEGF was considered as positive in (21cases)70% with concomitant positivity of both markers in more than half (16 cases)53.3% out of 30 malignant cases . No overexpression of both markers have been noticed in normal or benign (fibroadenoma) breast tissue sections with significant difference from that of malignant cases(P<0.05).We did not find any significant difference between overexpression of both(HER-2/neu and VEGF) in relation to age ,tumor size ,tumor stage and positive or negative lymph node breast cancer cases (P>0.05). However there was positive relation between HER-2/neu overexpression and the grade of tumor (P<0.05) ,while there was no significant difference between VEGF overexpression and the tumor grade(P>0.05).HER-2/neu overexpression was positively correlated with VEGF immunostaining in relation to grade and stage (P<0.05). Based upon the findings of this study, it can be concluded that both HER-2/neu and VEGF play an important role in the pathogenesis of non other wised specified breast cancer and supports the evidence of its role in evolution ,angiogenesis and cell survival of this aggressive tumor . This study recommended that the blocking of both HER-2/neu and VEGF may be a target for blocking the evolution and angiogenesis and hence improving the efficacy of anti-cancer therapy against this aggressive type of breast cancer. Breast cancer is the commonest malignant tumor with more than one million new cases occurring worldwide annually(1). In Iraq, where the population was exposed to high levels of depleted uranium following the first and second Gulf Wars, breast cancer is the most common malignant tumor in females(2). Over the last ten years, there has been a three-fold increase in the incidence of breast cancer, with most of this increase being attributed to a particularly aggressive type of the cancer(3) . This may suggest that breast cancer in Iraqi women may have some biological features that need to be explored.Her-2/neu proto-oncogene amplification and or over expression is one of the most important alterations encountered in breast cancer. HER2/neu proto-oncogene is amplified and or over expressed in approximately 20-25% of invasive primary breast cancers (4-6). An association have been found to exist between amplification and or over expression of HER-2/neu and advanced stage , early relapse, and reduced overall survival (7,8). vascular endothelial growth factor, is believed to be a key mediator of angiogenesis which plays a central role both in local tumor growth and distant metastasis in numerous solid tumors, including breast cancer(9). Activation or overexpression of HER-2/neu is associated with up-regulation of vascular endothelial growth factor (VEGF) in human breast cancer cells in vitro. Preclinical experiments indicate that increased expression of VEGF may in part mediate the biologically aggressive phenotype of HER-2/neu overexpressing human breast cancer(10,11) . Therefore we plan to study the possibility of finding a relation between HER-2/neu and VEGF in one of the most aggressive histological types of breast cancer termed the invasive ductal carcinoma of non other wised specified as a possible explanation for the aggressive behavior of this tumor and hence whether such relation could be used as an objective tool for the early management of these patients with this aggressive type of breast cancer patients.

Macroscopical and microscopical study of placenta in normal and in pregnancy induced hypertension

Rafah Hady Lateef Al-Mamori

Al-Qadisiah Medical Journal, Volume 6, Issue 2, Pages 18-26

Abstract Placenta was an indicator of maternal and foetal disorders. Many of the disorders of pregnancy which are associated with high prenatal morbidity and mortality are accompanied by changes in placental histology. The current works was an analysis of gross and histological changes of placenta in hypertensive disorders of pregnancy. A total of 50 placentas are studied 25 placenta from hypertensive pregnant mothers and 25 from non hypertensive pregnant mothers. The morph metric parameters in hypertensive group revealed that there is an increase in the mean placental weights, mean placental diameter and mean birth weights in comparison with normal group. The analysis of macroscopic placental changes showed decrease in the mean number of cotyledons and increase in mean number of calcified areas as well as an increase in the number of marginal insertion of umbilical cord.The histological appearance of placenta in hypertensive pregnant mothers revealed increase in hyalinized spots and areas of calcification also a medial coat proliferation of medium sized blood vessels are observed . In conclusion the hypertensive disorder of pregnancy well reflected on mother placenta.

Is Th-1/Th-2 paradigm a prognostic indicator on childhood Non-Hodgkin lymphoma

Abdul-Razak H. Ahmed

Al-Qadisiah Medical Journal, Volume 6, Issue 2, Pages 1-17

Abstract Non-Hodgkin lymphomas (NHLs) characterized by variable biologic behavior. The levels of some plasma protein may correlate with disease activity, so they could behave as prognostic factors. This study was conducted to evaluate the possible prognostic value of the (IL-10, IL-4 and IFN-gamma) and to assess their usefulness in the prediction of the outcome in childhood NHL patients. Sixty-six patients with NHL and 33, age and sex matched, apparently healthy children, were included. Blood sample were taken from each subject, and sera were used in measurement of IL-10, IL-4, and IFN-γ. The sera of all patients showed higher levels of IL-10, IL-4, and IFN-g than did the control group. The serum level of IL-10 revealed positive correlation with bad prognostic factors (male sex, less than 10 years old, high grad, high stage, non-responding to chemotherapy, and non-surviving). Whereas, IFN- γ showed a negative correlation with bad prognostic factors (male sex, high grade and stage) and a positive with good prognostic factors (age, response to chemotherapy and the survival). IL-4 revealed no clear cut correlation, neither with good nor with bad prognostic factors. We conclude the existence of IL-10/IFN-g as serum marker for disease severity and predictor of response to chemotherapy in NHL, independent of and additive to the other prognostic factors.

CRANIAL CT SCAN FINDINGS IN PATIENTS WITH HEADACHE

KHALIL KAREEM AL-UMERI

Al-Qadisiah Medical Journal, Volume 6, Issue 2, Pages 139-146

Abstract Objectives : 140 patients with non specific headache referred from neurology and medical outpatient clinics were studied to review the cranial computerized tomography findings and check if there were any significant lesion detected by CT scan.Methods : The patients were assessed using CT apparatus Siemens Somatom Emotion soft ware version A40A at Al-diwanyia teaching hospital during the period from July 2008 to September 2009 . CT images were taken with 5 mm slices , intravenous contrast enhancement were done to confirm the diagnosis in patients with cerebral tumors .Results : The patients divided into two main groups on the basis of imaging findings:Group 1: No abnormality detected in cranial CT scan examination of 107 patients ( 76.4 %) .Group 2 : 33 patients ( 23.6 %) with abnormal cranial CT scan examination . Abnormal CT findings divided into : 12 patients with sinusitis or sclerotic mastoid air cells, 10 patients with intracranial space occupying lesion ( SOLs) , 8 patients with cerebral atrophy , 3 patients with cerebral infarction .Conclusion : patients with intracranial SOLs in our study confirms that significant lesions can be detected by CT scan in patients with non specific headache not completely fulfilling international headache society criteria.

VEGF in situ mRNA expression along with different histopathological parameters of colorectal adenocarcinoma

Luay E. AL-Khurri; Ibrahim Abdul-Majeed Mustafa

Al-Qadisiah Medical Journal, Volume 6, Issue 2, Pages 38-51

AbstractCancer progression is a complex multi-step process. Two critical steps in tumor growth and invasion: are the proteolytic processing of the extracellular matrix environment and the angiogenic switch enabling blood supply into the tumor.VEGF is a major regulator of both physiological and pathological neovascularization thus, considered as an important factor for the initiation of angiogenesis. The aims of the current study were to determine whether VEGF mRNA in-situ expression, has any significant correlation with various histopathological parameters during colorectal adenocarcinoma progression and its correlation with metastatic potency. Accordingly, 35 colorectal adenocarcinoma paraffin embedded sections prepared from Iraqi patients, in addition to their respective resection margins were retrospectively collected from (liver and gastrointestinal hospital ) /Baghdad. Based on in –situ hybridization staining, mRNA expression of VEGF demonstrated a significant increase when its level at the tumor sites versus resection margins were analyzed (p<0.001). moreover, when these 35 paraffin embedded sections were broken down according to their various histopathplogical variables, the current study reveals a significant up regulation of VEGF m RNA in situ expression with respect to tumor stage (rs = 0.585, p<0.01), as well as VEGF mRNA in situ expression showed a significant positive correlation with respect to lymph node involvements (rs = 0.474, p<0.01). In conclusion, over expression of VEGF was seem to be associated with increased invasive and metastatic potential of colorectal adenocarcinoma because it was seem to increase angiogenic potential of colon carcinoma . Thus it could be used as target for therapeutic management of patients with primary colorectal adenocarcinoma.

Prevalence of hypothyroidism in patients with gallstone disease

Kussay M. Zwain; Hassan H. Zaini

Al-Qadisiah Medical Journal, Volume 6, Issue 2, Pages 108-117

Abstract Back ground: Earlier, the studies had been shown an increased prevalence of previously diagnosed hypothyroidism in gallstone patient and a delayed emptying of the biliary tract in hypothyroidism, explained partly by the missing prorelaxing effect of thyroxine on the sphincter of oddi contractility . Other explanations include the known link between thyroid failure and disturbances of lipid metabolism that may consecutively lead to change of the composition of the bile and motility of biliary tract. Aim: To show the prevalence of previously undiagnosed hypothyroidism in patients with gallstones . Patient and method: A cross sectional study was done in Al-Sader Teaching Hospital in Al-Najaf city between 15th of February 2008 and 1st of November 2009 of 225 cases were taken to show relation between gallstone and hypothyroidism. For every patient with diagnosed gallstone, full history and clinical examination was taken and sent for ultrasound of neck for goitre detection and laboratory blood test for T3, T4 and TSH. Results: Out of 225 patients with gallstone 198 (88%) were females and 27 (12%) males. Thyroid disorder in form of hypothyroidism was found in 24 (10.6%), (from this percentage 22 (9.7%) were females and from this 18 (8.0%) were subclinical and 4 (1.7%) were clinical hypothyroidism and males were 2 (0.9%) with subclinical cases. From 225 cases with gallstones, 22(9.7%) cases complaining from goitre. Peak age between 51-60 years. Conclusion and recommendation: There is no significant association between hypothyroidism and gallstones in both genders. Gallstone patients between 51-60 years should be checked for serum TSH, T3 and T4 because of high incidence of hypothyroidism among this age group.

HAEMATOLOGICAL AND EPIDEMIOLOGICAL STUDY OF VISCERAL LEISHMANIASIS IN PEDIATRIC PATIENTS In MID-EUPHRATE AREA

HASHIM RAHEEM TARISH

Al-Qadisiah Medical Journal, Volume 6, Issue 2, Pages 118-130

Abstract This study was conducted in the Mid-Euphrate region (Al-Qadisya,Najaf and Karbala provinces) during the period from 1/June 2004 to 1/ May 2006. Two types of laboratory tests were used in this study for the diagnosis of visceral leishmaniasis in suspected patients who attending to the pediatric hospitals in these provinces. The study included 150 child suspected of having visceral leishmaniasis depending on the clinical features, haematological changes and 2 tests (Dipstick and ELISA) were used for the diagnosis the disease. It was found that all children were susceptible for the disease but those who were 13-24 month old are the most susceptible age for all applied tests and the percentage of the positive cases according to the tests were used. . The study was showed that all patients entered to the hospitals were suffered from increase of the fever. All patients were admitted to hospitals have had mild splenomegally (1-5 cm) below the costal margin .It was found that both sexes were infected, but the males were more susceptible and the disease was more prevalent in rural areas.

Common causes of neonatal sepsis in AL-kadhimiyia Teaching Hospital

Areege Abdul abass; Abdul karem jasem albahadle

Al-Qadisiah Medical Journal, Volume 6, Issue 2, Pages 52-59

Abstract Sepsis is common in the neonatal period which may be acquired in utero through the placental or trans-cervical routes and during or after birth and because the immunological system of neonates is not well developed make this infection series and fatal if did not treated in optimal manner . To identify the most common causes of sepsis in AL-Kadhthimyia Teaching Hospital and its mortality rate. Cross-sectional study was conducted during the period between 14th of February 2009 to 25th of February 2010 on 127 neonates with sepsis diagnosed clinically and they were admitted in AL-Kadhthimyia Teaching Hospital ,they ere divided into two groups according to the time of appearance of the disease which were early onset sepsis and late onset sepsis. blood was taken from them and send for culture. The most common clinical presentation in early onset sepsis [EOS] were , poor feeding, lethargy and fever( 94.12% ,91.76 % ,and 52.94 % respectively )which is similar to late onset sepsis[LOS] (95.24%,92.86% and 57.14 % respectively). the most common organisms responsible for[EOS] were Staph.aureus, Enterobacteria,and staph.epidermidis (25.89 % ,21.18 % and21.18 % respectively ) while in[LOS] Staph.aureus Enterobacteria and E.coli ( 21.43 % ,16.67 % and 11.90 % ). The over all mortality was 29.92 % which was slightly more in [LOS] 30.95 % than in [EOS] 29.41% also it was more common in male than female in both groups. Staph.aureus,Enterobacteria were the leading cause of sepsis in both groups while staph.epidermidis wase more common in [EOS]and E.coli was more common in [LOS] .

Obstetrical and Gynecological conditions requiring intensive admission from Basra maternity and child hospital A five year survey

Sajdai Al-Rubaei

Al-Qadisiah Medical Journal, Volume 6, Issue 2, Pages 188-196

Abstract Objective:- To assess the obstetrical and gynecological cases admitted to ICU, causes of admission, intervention required, and their morbidity and mortality. Methods :- During the five years period from 1st of Jan 2004 till 1st of Jan 2009, 119 patients were admitted to ICU. Cases were reviewed in detail including age, parity, reason for ICU admission, clinical features, response to intervention and maternal outcome.Result :- mean maternal age was (29.8±6) years the main causes for admission massive bleeding, complications of anesthesia followed by hypertensive disorders of pregnancy (42.8%) (21.8%) (18.4%) respectively, coagulopathy (36.1%) and respiratory failure (26.8%) were the main organ failure, most the admitted patients needed transfusion (50.4%) and ventilatory support (26.50%) specialized intervention like dialysis and surgical intervention were also required (20.1%) .Conclusion:- Invasive hemodynamic monitoring and ventilatory support were the two main interventions, improving quality of care before and after admission to ICU may reduce maternal mortality.

Carotid tree changes of Maxillofacial Missile injuries by Doppler sonographay - an Iraqi study

Raja Kummoona; Suha Mohammad Sami; Header Dakhel AL- Muala

Al-Qadisiah Medical Journal, Volume 6, Issue 2, Pages 94-107

AbstractBackground: Injuries of the carotid artery caused by penetrating wounds of the neck are nearly 10 times as common as those caused by non penetrating trauma (1), over 10% of all penetrating neck wounds result in significant carotid artery(2) ,and more than 90% of such injuries are secondary to gunshot wounds (3).Injuries to the extra cranial carotid arteries from penetrating trauma is more likely to cause a dissection through intimae disruption and subsequent formation of a false channel and thrombus (4).Patients: Patients were selected from Maxillofacial department in the Specialized Surgeries Hospital in Baghdad . thirty patients were examined , twenty nine were male ( mean 96,66% ) ,only one female was examined ( 3,34% ) .We prepared a specially designed case sheet including , life saving procedures , type of missile , clinical examination include site of missile injuries according to Saletta JD et al 1976 (5) who classified the neck Into three zones , investigation X- ray ,C T scan. .The ultrasonographic scanning of the carotid arteries was performed, the Doppler machine was -SIEMENS – sonoline ELEGRA . Using a high- frequency linear array imaging probe or transducer 7,5- 9 ( MHz) with a Hewlett-packard scanner .Methods : The ultrasonographic scanning of the carotid arteries was performed with the patient in the supine position , the examination takes 30 to 60 minutes (6,7) . Using a high- frequency linear array imaging probe (7.5- 9 MHz) .Results : Patients age ranging from 15 – 57 years and the mean was 36 years ,most cases were from age range 20-29 years ( 40%) .Eighteen patients ( 60%) were injured with bullets , twelve were injured with shell fragments ( 40 % ) , twelve ( 40%) were hand gun bullets and six ( 20%) were rifle bullets. Intimae media thicknesses of common carotid arteries were measured .Mean of IMT right was 0.7 mm and left side was 0.71 mm . While IMT of right external carotid artery was 0.71 mm , IMT of left external carotid artery was 0.75 mm . IMT of right internal carotid artery was 0.8 mm ,IMT of left internal carotid artery was 0.78 mm .Results reveled that mean of IMT of Ext. carotid artery at injured side was more thicker ( 0.79 mm) than non injured side and the mean of IMT of common carotid artery was also thicker at injured side 0.8 mm .Conclusion: Ultrasound scanning is noninvasive, and usually painless . , there are no known harmful effects on humans , carotid Ultrasound has to be a risk free procedure . Further Ultrasound scanning gives a clear picture of soft tissues that do not show up well on X- ray images . Mean of IMT of Ext. carotid artery at injured side was more thicker ( 0.79 mm) than non injured side and the mean of IMT of common carotid artery was also thicker at injured side 0.8 mm .

Evaluation of Some Immunological Tests for Early Diagnosis of Bacterial Neonatal Sepsis

Manal Mohammed Kadhim; Jaafar Kadhim AlMousawi

Al-Qadisiah Medical Journal, Volume 6, Issue 2, Pages 67-80

Abstract: Neonatal sepsis is a major cause of death in newborns despite sophisticated neonatal intensive care. This cross-section study was done on 69 neonates with suspected sepsis who were admitted in Neonatal Intensive Care Unit (NICU) of Maternity and Child Teaching Hospital at AL-Diwaniya city, and 20 healthy neonates as a (control group) in the period from March to October 2009.This study was conducted to evaluate the diagnostic value of some immunological marker such as (CRP,IL-6, IL-8,TNF-α, in the early diagnosis of neonatal sepsis prior to the blood culture ( the golden standard test). The culture positivity rate 20 (28.9%) among suspected sepsis neonates, the male more affected than female among proven sepsis. it was found that the median concentration of CRP, TNF-α, IL-8, IL-6 decreased in order of definitive infection, clinical sepsis and healthy subjects respectively (P<0.001), and found that the TNF-α (≥65.4pg/l) followed by IL-8 (≥60.9pg/l) were better than IL-6 and CRP with sensitivity of (80%) and (75%) respectively and negative predictive value of (97%) and (94.1%) respectively when used as a tests to predict culture positive sepsis cases differentiating them from culture negative sepsis cases .

Effect of physical exercise on fasting blood glucose level and vital capacity in type 2 diabetic patients

Shrooq Majeed Mohammed saeed AL-Saleh; Samir Hassan Hadi AL-Nesrawy; Ghafil Saihood Hassan AL-Shujairi

Al-Qadisiah Medical Journal, Volume 6, Issue 2, Pages 131-138

Abstract: This study was conducted at twenty five male subjects (13 diabetic patients, and 12 normal persons). Their ages ranged from 40 – 60 years old. The patients were diagnosed by specialist physicians. All subjects were recruited to medical Physics' laboratory in the College of Medicine, Babylon University, in Iraq. The study conducted during the period from March 2009 to September 2009. Fasting blood glucose (FBS), heart rate (HR) and vital capacity were measured before and after exercise. The body weight and height were measured for all subjects at rest. The results of the present study revealed that all type 2 diabetic patients had decrease level of fasting blood sugar significantly (P < 0.001) in comparison to control after 15 minutes of moderate exercise, with non significant increase of HR (P > 0.05). The controls group showed non significant (P > 0.05) decrease in level of sugar, but they showed significant increase in vital capacity of lungs (P < 0.001).

Effect of Health Education on Depression of patients with Cariadic Catherization

Rahim S. Shweikh

Al-Qadisiah Medical Journal, Volume 6, Issue 2, Pages 60-66

Abstract To evaluate the effectiveness of health education on depression of patient with cardiac catherization.A quesi experimental.In Medical word at Iraqi center for heart disease.Beck Depression inventory (BDI).After coping style assessment, received the patients educational teaching booklet for the cardiac catherization to decrease level of depression before, during and after the cardiac cauterization.There would be a statistically significant decrease mean scores of depression from the cardiac catherization to the post cardiac as a result of teaching manual.The nurse observer behavioral response system data revealed that patient who received educational teaching booklet less in pre cardiac catherization than in post cardiac catherization.

CLINCO-BIOCHEMICAL PROFILE OF NEONATAL SEIZURES

JASIM M.AL.MARZOKI

Al-Qadisiah Medical Journal, Volume 6, Issue 2, Pages 161-174

Abstract:Background: Neonatal seizures are the most prominent feature of neurological dysfunction during neonatal period. Neonatal seizures occur within the first 4 weeks of life in a full-term infant and up to 44 weeks from conception for premature infant. Neonatal seizures are occurring in approximately 1.8 – 3.5 / 1000 live birth.Objectives: To study clinical types, time of onset and to determine the etiology of neonatal seizures.Methods: Out of eighty eight full term and preterm neonates with seizure at neonatal care unit and general wards of Babylon Gynecology and Pediatrics teaching hospital were studied prospectively in regard to clinco-biochemical profile of neonatal seizures from period 1st of May 2009 to 1st of December 2009.Results: Eighty eight full term and preterm neonates, (95.4%) of them were term and (4.6%) were preterm. The most common cause of neonatal convulsion was metabolic disturbances collectively constitute (47.7%).The other causes were asphyxia (15.4%),meningitis (6.6%),structural abnormalities (4.4%) and unknown cause (27.2%). Tonic type occurred in (100%) of preterm patients while in term patients, (31.8℅) of them were subtle type ,followed by tonic type (24.3℅) , focal clonic (16.2℅),generalized tonic clonic (11.3℅) and multi focal clonic type(11.3℅).80℅ of hypoglycemia occurred in male patients.Conclusions: The commonest cause of seizure was metabolic abnormalities. Subtle seizures were the commonest type of seizure observed in term babies and tonic seizures were the most commonest type in preterm babies in this studyRecommendations: Metabolic abnormalities should be excluded in every case of neonatal seizure. Improving of the laboratory services and the availability of other investigations must be available. Proper fetal monitoring during labor is recommended to avoid birth asphyxia .

Natural History of isolated Ventricular Septal Defects in the first two years of life

AdnanK. Janabi; Shaker K. Gatea

Al-Qadisiah Medical Journal, Volume 6, Issue 2, Pages 147-160

ABSTRACTObjective: To evaluate the natural history of isolated ventricular septal defects in the first two years of life.Patients and Methods: We prospectively studied a total of 50 infants diagnosed as isolated ventricular septal defect between january2008 -january 2009. Infants aged less than three months, with isolated ventricular septal defects were followed for two years. Infants with Down syndrome, other types of ventricular septal defect and those who had an additional hemodynamic significant heart defects were excluded.Results: A total of 50 infants 30 males vs. 20 females (60% vs. 40%) were followed up for 24 months. The mean age at the time of diagnosis was forty days ±5 days (Range: 1 day-3.0 months). 34 patients (68.0%) had membranous , 10 patients (20.0%). had muscular,4 patients (8.0%) had inlet and 2 patients (4.0%) had outlet ventricular septal defects. There were 16(32.0%) small ,28(56.0%) moderate, and 6(12.0%) large size defects .7 of muscular defects closed spontaneously, 2 were closed surgically and 1 remained open but decrease in size (70.0%, 20.0%, and 10.0% respectively). On the other hand 25 of membranous defects closed spontaneously and 9 defects remained open by the end of the study ((74.0%),(26.%) respectively). Regardless of type all small 16(32.0%) not required medical treatment, 34(68.0%) of moderate and large size defects needed medical and/or surgical treatment in the first two yeas of life but by the end of fallow up 16(32.0%) defect closed spontaneously and 10(20.0%) defects had their size decreased ,all of them of moderate size.Conclusion: Infants with muscular ventricular septal defects have better prognosis in the 1st year but spontanous closure with membranous is more in the 1st 2 years and infants with moderate and large ventricular septal defects usually need medical and/or surgical treatment.

Primary Hydatidosis of Vastus Lateralis

Jasim Hasan

Al-Qadisiah Medical Journal, Volume 6, Issue 2, Pages 175-179

Abstract Hydatid cyst disease is common in some regions of the world and is usually located in liver and lung, but it can be seen any where in the body. this report presents a case of primary hydatid disease located partially Subcutaneosuly and partially intramuscular in the vastus lateralis.Case presentation :A 38-year-old male laborer Presented to our hospital with a slow growing swelling in the lateral aspect of his thigh for the last 6 months. Ultrasound and MRI revealed a lesion resembling hydatid cyst. The patient did not have a history of hydatid cyst disease and hydatid cysts were not detected in other organs. Total excision of cyst was done and the pathological examination confirmed the diagnosis. Conclusion :Muscular hydatidosis should be considered in the differential diagnosis of soft tissue lesions in endemic areas. Total excision of the cyst with an intact wall is the best treatment.

Assessment of Citicoline protection against seizure induced in the rabbits

Hussein Abdul Khadim; Ammar Rasoul; Ekhlas Sabah Hassan

Al-Qadisiah Medical Journal, Volume 6, Issue 2, Pages 81-93

Seizure is a big neurological health problem affect about 1% of the general population causing significant social, health, and economic burdens that necessities further evaluations of more effective treatment for this disorder. In a trial of assessing the phospholipid derived citicoline protection against neurological and metabolic sequalaes of seizure, a rabbit model was prepared by intraperitoneal (i.p.) injection of xylocaine in comparison with xylocaine given together with citicoline in another group of rabbits. Clinical monitoring of convulsions together with physiographic electroencephalogram ( EEG ) recording and serum lactate dehydrogenase (LDH) and creatine phosphokinase ( CPK ) parameters were evaluated. There was a significant protection against development of convulsion obtained in citicoline given group. Moreover citicoline significantly protected against EEG synchronization in that just 30 +/- 7 microV at upper alpha band(10-11.5 Hz) has been obtained which was within normal limits in comparison with xylocaine alone : 60 +/- 11 microV at theta 4-7.5 Hz band and 55 +/- 8 microV at gamma 20-45Hz ; P<0.05. Significant reductions in serum CPK and serum LDH were also attributed to administration of citicoline, P<0.05 .In conclusion : citicoline has beneficial protective effects against seizures and convulsion in a lower therapeutic dose.