Volume 9, Issue 1, Spring 2013, Page 1-264


Total antioxidant in term ferric reducing ability of plasma in pregnant with gestational diabetes mellitus

Ajile A.Al-Zamily; Ferdous A.Jaber; Tagreed Al-Ksweny; Shaima Abdul Aziz

Al-Qadisiah Medical Journal, Volume 9, Issue 1, Pages 1-12

Increased free radical activity in gestational diabetes (GDM) can lead to a host of damaging and degenerative maternal and fetal complications.
Hence antioxidant levels in the term ferric reducing ability of plasma (FRAP) of GDM could be given.
30 pregnant women in second trimester were evaluated in this study. They were divided in to three groups 10 pregnant having normal glucose tolerance (NGT group), 10 pregnant having impaired gestational diabetes mellitus (IGDM group ), and 10 pregnant having newly diagnosis gestational diabetes mellitus(GDM group) . Ferric reducing ability of plasma (FRAP) were estimated, in addition to BMI. The changes in FRAP in GDM was significantly different from controls. Hence, elevated glucose levels can induce oxidative stress in GDM. The average concentrations of total antioxidant in term FRAP were ( 414.7, 452.73, 858.4)µmole/L for NGT, IGDM, and GDM respectively.
In this study there was a significant correlation( R2 =0.4685) between BMI (KG/M2) and serum glucose (mg/dl) after 2-hour oral glucose tolerance test (2-OGTT).
The influence of plasma glucose level in the second trimester pregnant women with GDM or IGDM on the level of plasma antioxidant status (TAS) was also conducted in addition to the correlation between plasma glucose level and total antioxidant status in pregnant women with IGDM or GDM.
The research was conducted at AL-Diwaniya Governorate, Al-Qadisiya university, College of medicine, department of clinical chemistry.
The aim of this study was assessment of total antioxidant status(TAS) in the second trimester pregnant women with gestational diabetes (GDM); impaired gestational diabetes mellitus (IGDM) and normal glucose tolerance (NGT).

Study of BRCA1 gene expression in breast cancer in relation to some clinicopathological parameters in Al-Diwanyia city by immunohistochemistry

Maather Baqer Hussein Al-Harmooshy

Al-Qadisiah Medical Journal, Volume 9, Issue 1, Pages 13-26

Background: Breast cancer causes major part of cancer deaths in women and is increasing in incidence. The tumor suppressor gene, BRCA1 has been conferred to increase the susceptibility to breast cancer. We aimed to determine the significance of BRCA1 gene expression in relation to other prognostic factors.
Materials and methods: 45 patients with positive family history of breast cancer were selected from Al-Diwaniya Teaching Hospital / department of pathology for the study. A control group of 10 healthy subjects were also included. BRCA1 expression was assessed and correlated with age, family history , histological type and grade of breast cancer.
Results: BRCA1 was found in 9 patients 'samples (20% of the breast cancer tissues) while remaining patients (80%) were negative as well as the control group. A positive significant relationship was demonstrated between BRCA1 expression and high histological grade, age of the patient and family history and A significant negative correlation was found between BRCA1 expression and type of the tumor.
Conclusion: The study demonstrated the lack of BRCA1 gene expression in the majority of breast cancer cases and confirmed the relationship between BRCA1 expression and parameters that determine the poor prognosis in breast cancer .

Oxidant /Antioxidant Status in Newly Diagnosed Patients with Parkinsonism :Effects of Therapy

Imad A-J Thanoon; Fadel A.Al-Hamamy; Mohammed M.Al-Sheikh

Al-Qadisiah Medical Journal, Volume 9, Issue 1, Pages 27-35

To assess effects of a fixed therapy on the oxidant (malondialdehyde ''MDA'' levels)/ antioxidant status (Total antioxidant status "TAS")in newly diagnosed patients with Parkinson disease in comparison to healthy controls.
Thirty eight newly diagnosed patients with Parkinson disease were included in this study. they were referred cases from neurologist Clinic from October 2009 to February 2011. included also in the study 40 apparently healthy age and sex matched subjects as a control groups. A blood samples were taken initially from the patients before starting therapy and the controls and assay of serum MDA and TAS were done. Body mass index (BMI) were calculated according to a certain equation. Patients then were put on fixed therapy for 3 months after which another blood samples were taken and assay of the same parameters were done.
There was a significantly elevated serum MDA and a significantly lowered serum TAS levels in newly diagnosed patients with Parkinson disease in comparison to healthy controls. After therapy patients still having a highly significant difference in the levels of serum MDA and TAS in comparison to controls.
There was insignificant difference in the serum levels of MDA and TAS between patients in the pre-therapy and post-therapy stages.
Newly diagnosed patients with Parkinson disease having signs of oxidation stress, and that the specific anti-parkinsonian therapy used in this study have no significant effect on the shifted oxidant/ antioxidant status.

Effect of intravenous fluid supplementation on serum bilirubin level during conventional phototherapy of term infants with severe hyperbilirubinemia

Zuhair Omran Easa

Al-Qadisiah Medical Journal, Volume 9, Issue 1, Pages 36-45

Background: Adequate hydration (hence good urine output ) improve the efficacy of phototherapy. The aim of this study was to evaluate the effect of intravenous fluid supplementation on decrease of serum bilirubin levels in jaundiced healthy term infants during conventional phototherapy.
Patients and Methods: this study conducted in Karbala teaching hospital for children during the period from January 2, 2010 through December 31, 2010. Sixty four healthy breast-fed neonates with non-hemolytic hyperbilirubinemia (total serum bilirubin > 18 mg/dL [308 μmol/L] to < 22 mg/dL [375 μmol/L ] ) were assigned randomly to receive either breast milk or bottle formula exclusively (non-supplemented group; n=32) or intravenous fluid in addition to breast milk or formula (supplemented group; n=32) during conventional phototherapy.
Results: The mean total serum bilirubin (TSB) levels at the time of enrollment and within 84 hours after phototherapy were not statistically different between two groups. Similarly, the duration of phototherapy required in both supplemented and non supplemented groups was 48hr.
Conclusion: These data show that administration of extra intravenous fluid in jaundiced healthy, term, breastfed neonates have no beneficial effect on the rate of serum bilirubin reduction during conventional phototherapy.

Otomycosis associated with active chronic otitis media

Kassim R. Dekhil; Anwar S. Sayhoud; Saja Mahdi

Al-Qadisiah Medical Journal, Volume 9, Issue 1, Pages 46-51

Seventy samples from out patients seeking medical care in Al-Diwanyia teaching hospital were screened for identification of fungi associated with active chronic otitis media during June to December 2011
There were 45 (64.28%) had positive culture for fungal growth while 25 (35.71%) patients had negative culture for fungal growth. The patients from 61-70 and 71-80 years were more susceptible to fungal otitis externa than other age groups .the most common causal fungal isolates were Aspergillus niger (26.92%) followed by Candia albicans (19.24%) ,A.flavus (15.38%),A.fumigatus (11.53%),Penicillum digitatum and Cephalosporium sp (7.69%) for each one while Alternaria alternata and Rhizopus sp (5.7%) for each one .

Patterns of use of benzodiazepines in psychiatric patients

Kareem Nasir Hussain

Al-Qadisiah Medical Journal, Volume 9, Issue 1, Pages 52-63

Background: The benzodiazepine has been one of the most commonly used drugs in psychiatry and general medicine because benzodiazepine have multifaceted actions like pain killing, antiepileptic and others therefore increasing the abuse of these drugs.
Objectives (Aims): The aim of the study is to show the indications for benzodiazepine as in psychiatric patients, and to clarify some of the risks and hazards of their use in general.
Methods: This is a cross sectional study that enrolled 300 patients who had been admitted in three centres including Ibn-Rushid Teaching Hospital For Mental Illness, Al-Rashad Mental Hospital and Al-Diwaniyah Teaching Hospital, Psychiatric Unit, during period between 1st of May 2011-20st of March 2012 because of different psychiatric illness.
Result: This study revealed that 66% patients are male and the majority of patients for whom benzodiazepines were prescribed during their stay in hospital are depression (38%). Also this study revealed majority of patients whom benzodiazepines were prescribed for first admission to psychiatric hospitals or psychiatric unit in general hospital.
Conclusion: This study proved that the effect of drug benzodiazepine up on an individual is complex interacting. There are many variables involved such as their pharmacological actions, unwanted effects and interactions with other drugs. We should not prescribe drugs in divided daily dose in those instances where once-daily dose offers advantages.

A descriptive study of toenail and fingernail Onychomycosis in Al-Diwanyia city

Heiam k. Mohammed

Al-Qadisiah Medical Journal, Volume 9, Issue 1, Pages 64-72

A total of 44 clinical cases which clinically diagnosed as onychomycosis of those patients whom admitted the consult of dermatology and venereal diseases in AL-Diwanyia Teaching Hospital at the period from August- 2010 to June-2011.Nial clipping samples were taken from both gender and different ages to examine directly by KOH smear preparation and /or culturing on sabourauds Dextrose agar to isolate and identify the etiological agent .The results revealed that moulds ( Aspergillus spp.) constitute( 95.46%) and yeast ( Candida albicans ) (4.64%) as etiological agent of onychomycosis.According to age, the isolation percent was high (79.54%) in ages (30-40)years old and lowest(6.82%) in ages (50-60) years old,while in females,th percent of isolation was (45.46%) and males (54.54%).
The MIC values of ketoconazole,griseofluvin and nystatin were determined for fungal isolates and ranged(1.2-4.12mg/ml) for ketoconazole,(2.6-62.5mg/ml) for griseofluvin and (1.2-15.75mg/ml) for nystatin.In addition to that , the toenails was the most infected (79%) than the fingr nails (21%).

Prevalence of hepatitis c infection among multitransfused thalassemia major patients in ibn-albalady center of thalassemia

Abdul karem jasem Albahadle; Areege Abdul Abass; Ali Hussein Ali

Al-Qadisiah Medical Journal, Volume 9, Issue 1, Pages 73-84

Back ground : Beta thalassemia major occurs in the Mediterranean littoral ,characterized by chronic heterolysis and frequent blood transfusion which carry a lot of complication like viral hepatitis
Objective: To evaluate the prevalence of Hepatitis C infection among multitransfused thalassemia major patients.
Methods: A retrospective study was conducted on 206 thalassemia major patients referred to the IBN-ALBALADY Center of Thalassemia and Hemoglobinopathy from May to September 2011,data about age,sex,number of blood transfusion ,history of splenectomy and result of serological viral markers for anti HCV antibody, HBsAg and anti HIV antibody were obtained from the patient files at the hospital. The result were analyzed using Chi-squared distribute to obtain the p-value.
Results: Out of 206 patients, 99 (48.1%) were male and 107 (51.9%) were female.Forty one(19.9%) were seroposative for hepatitis C infection.Forty six patients were < 5 years tow(4.3%) of them were positive , 77 between 5-10 years,16 (20.8% )of them were infected and 83 above 10 years of age23(27.7%) of them were infected . Thirty three (16%) were received < 30 times blood transfusion only one(3%) of them get the infection, while 173 (84%) received ≥ 30 times40 (23.1%)of them get infecton . Fifty seven patients (27.7%) had already undergone splenectomy 11(19.3%) of them get the infection, while30(20.1%) of 149 patients without splenectomy get the infection.
Conclusion: multi transfused thalassemic patients are at a risk for HCV infection. Thus routine screening using more accurate technique is necessary in order to prevent viral infection.

Left handed simple, recognition and choice reaction times

Khalid Ibrahim Riah

Al-Qadisiah Medical Journal, Volume 9, Issue 1, Pages 85-96

In this study, 27 left handed healthy volunteers (12 male and 15 female) aged between 18 and 23 yrs were included in reaction time (RT) test that include simple reaction time (SRT), Recognition reaction time (RRT) and Choice reaction time (CRT).
It’s appeared from the results that, SRT for the central target colors was less than for the peripheral on white and black background. The individual ability in recognizing the colored targets depends on the contrast of these colors with the background, when the contrast increased the individual ability to response increase. Two back targets RRT for individuals were longer than one back targets. Using the two hands together for individuals produces a faster CRT than using one hand only.

Minimally Invasive Splenectomy for splenomegaly by traditional technique:A comparative study with conventional laparoscopic Splenectomy

Fadhil A. MuhiAldeen; Kalandar H. Kasnazan

Al-Qadisiah Medical Journal, Volume 9, Issue 1, Pages 97-107

Minimally invasive surgery is a well known advantageous technique to all health systems, it is still possible to do minimal invasive technique, without using expensive equipments and its burden regarding; cost, maintenance and other disadvantages. This study was performed to compare minimally invasive surgery with classical traditional surgical technique in the aspects of reduced post-operative pain, shorter hospital stay and shorter convalescence period. In this study our cases underwent splenectomy through small incisions, which are almost equal to laparoscopic procedures and compared to equal number of cases underwent splenectomy through classical traditional technique. Decisions for splenectomy were made by physicians for a variety of well known disease status that complete cure or improvement will be gained by splenectomy. In this study, eighteen cases were studied, from which nine were males (mean age34.3±20.45) and nine were females (mean age=21.6±15.99). Nine of them were underwent splenectomy through minimally invasive incisions, the other group splenectomized through classical traditional incisions. The first group was discharged earlier; need much lesser narcotic medication and shorter convalescence period. In summary, compared to conventional classical method approach, Minimally Invasive Splenectomy is significantly facilitates the surgical procedure, reduces the risk and difficulty in the cases of splenomegaly. So this technique is more feasible and more effective than conventional clasical method for the removing of the splenomegaly.

A Study of Human Leukocyte Antigens-G (HLA-G), cANCA and pANCA in Inflammatory Bowel Diseases Patients

Hummady A. Al-Hilaly; Osama T. Al-Obaidi; Abdul razaq Abdullah Tahir

Al-Qadisiah Medical Journal, Volume 9, Issue 1, Pages 108-118

Inflammatory bowel disease (IBD) is a chronic relapsing inflammatory disorder of the bowel, consisting mainly of Crohn’s disease (CD) and ulcerative colitis (UC). The incidence of IBD has been rising not only in Western countries, but also in Asia, the exact causes of both diseases are still a mystery.
A total of forty two Iraqi patients from Al-Diwanyia province (15 females and 27 males) who have been diagnosed by specialist physicians in Al-Diwaniya Teaching Hospital for Gastrointestinal Tract and Hepatic diseases unit, compared with twenty one unrelated, healthy controls (10 females and 11 males). All patients was diagnosed by endoscopy and biopsy from the sites of inflammation (hitopathological method). The patients group was composed of two sub-groups; 38(90.5%) patients with Ulcerative Colitis and 4(9.5%) patients with Crohn's disease. The highest age incidence was above 40 years old (55.3% and 25% of UC and CD patients, respectively), followed by age of 30-39 years. The majority of UC (81.5 %) have shown positive results for p.ANCA, compared with (25 %) of CD patients, while all controls have given negative results for this test. Both of UC(47.4%) and CD(100%) patients shown positive results for HLA-G, while all healthy controls were given negative results for this test.

Study of lipid profile alteration in the patients infected with Giardia lamblia and compare the results with healthy individuals

ani N. Al-Shamari; Dhuha M. Jabir

Al-Qadisiah Medical Journal, Volume 9, Issue 1, Pages 119-129

This study was include collection of 40 stool samples from people were suffer from steatorrhea and the genral stool examination for these stool samples showed the presence of the intestinal parasite Giardia lamblia the etiologic agent of giardiasis .
Blood samples were collected from 60 individual 40 of them were the infected with Giardia lamblia patients and the other 20 were healthy and used as control ,then the serum was obtained from all blood samples in the field of the study and the estimation of total (Cholesterol ,Triglyceride ,High density lipoproteins, Low density lipoproteins and Very low density lipoproteins )was done .
the result showed that the cholesterol levels were decreased in giardiasis patients while the other types of lipids were normal in the same patients because Giardia lamblia consumed the cholesterol of the host in the bio synthesis of the cell . because the parasite is unable to synthesize cholesterol by itself .

Nonalcoholic Steatohepatitis;N.A.S.H In Babil Governorate

Thamir M. Kadhim

Al-Qadisiah Medical Journal, Volume 9, Issue 1, Pages 130-133

Fatty liver is a well known cause of sudden death. It could affect any one with different etiologies, alcohol ,metabolic, drugs, poisons, pregnancy, obesity…etc
Objective:To demonstrate the extent of such defect among general population in order to correct it by elimination the cause and the promising treatment.
Patients and materials: A hundred cadavers referred to the Forensic pathology department in the Babil Health Directorate were examined from the 1st of April 2007 to the 1st of April 2008, 65 males, 35 females fall in the category of the violent death .Alcoholics, diabetics, obese, pregnant, and those who were in the both extremities of age were excluded.
Result: A mild type of fatty changes was found in eight cadavers (5 males, 3 females) not associated with hepato or spleenomegaly.

Morphological and Molecular Identification of Hospital Pseudomonas spp.

Adnan hamad Al-Hamdani; Mohammad Mojer Al-Shamsi; Mohammad Noah Sheet

Al-Qadisiah Medical Journal, Volume 9, Issue 1, Pages 134-143

The study was designed for isolation and identification of Pseudomonas spp. from neonatal nosocomial infections, from Three Teaching Hospitals of Maternity and Pediatrics in Al-Mosul city. The total collected samples were 288,which included clinical(134samples collected from preterm and full-term neonates who less one year of age ) and environmental samples(154)from January 2011 till end July 2011, in order to evaluate the classical laboratory diagnostic
procedures for diagnosis of Pseudomonas isolates and compared them with molecular technique on the basis Polymerase Chain Reaction (PCR).
Pseudomonas spp. has been isolated and identified by using cultural method, biochemical tests and Mini API 20NE system as confirmative test. On the other hand, PCR technique was utilized to detected 16SrRNA gene as a house keeping gene, specific for diagnosis of Pseudomonas spp.
The present study showed that the isolation percent of Pseudomonas spp. from clinical samples was 17/30 (18.8%)and 30/111(27%) from environmental samples, whereas the PCR results showed that there were high specificity (100%) in detection of Pseudomonas spp. versus each of cultural, biochemical and Mini API 20NE system .

Direct detection of Mycoplasma species from male with sterile Pyuria by Polymerase Chain Reaction

Ibtisam H. S. Al-Azawi

Al-Qadisiah Medical Journal, Volume 9, Issue 1, Pages 144-153

To determine the percent of occurrence of Mycoplasma spp. in sterile pyuria and the evaluation of e-Myco PCR as rapid and sensitive technique for identification. Sterile pyuria urine samples collected from 55 patients attending to Al-Diwania Teaching Hospital and different private laboratories in Al-Diwania province were tested by polymerase chain reaction (PCR) for the presence of Mycoplasma spp. by a new kit called e-Myco in addition to 20 healthy individual as control group.
In the present study the ages of patients with sterile pyuria were )20-57) year old and the age group (20-30 years) recorded the highest incidence of sterile pyuria 31/55 (56.37%). From total 55 sterile pyuria patients 21 (38%) patients were positive for Mycoplasma spp. by direct detection by PCR with significant difference (P<0.05). On the other hand 7/21( 12.7% ) patients were with recurrent urinary tract infection, 4/11 (7.2%) patients with primary and secondary infertility, in 3/3 (5.5%) patients with urinary bladder cancer, in 3/6 (5.5%) patients with chronic prostitis and 4/14 (7.2%) in non complications patients were positive for Mycoplasma spp.
PCR assay provide a rapid and effective measure to detect Mycoplasma spp. in sterile pyuria. The incidence of sterile pyuria decrease with progress in age.

Reciprocal Intermolecular antigenic competition between E. coli and P. aeruginosa

Ibrahim Mohamed-Saeed Abdulwahid; Raad Abdulabass Hamza AL-Harmoosh

Al-Qadisiah Medical Journal, Volume 9, Issue 1, Pages 154-164

It has been observed that in a dimicrobic mucosal urinary tract infection . The specific antibody titre of E. coli was higher than that of P. aeruginosa. The interpretation was based on antigenic competition . Hence a case of UTI with combined gram negative infection were chosen and diagnosed as E. coli and P. aeruginosa (Identified by classical tests and API 20E system) .
Balanced and unbalanced heat killed E. coli and P. aeruginosa antigens in different combination proportions were made and used for specific immune priming of rabbits. Monotypic heat killed antigens were made and used for priming rabbits separately standard tube agglutination and ELISA IL-4 were used to match humoral and cellular arms respectively in the state of secondary immune responses. The specific antibody mean titres in combinations was reduced as compared to mean titres of monotypic sera which is an indication for antigenic competition . It was reciprocal intermolecular type (T cell dependent) . IL-4 determinations were increased as compared monotypic and control in the sera react against unbalanced combinations. Such increase indicate its role in antigenic competition .
Thus , the E. coli-P. aeruginosa antigenic competition is a reciprocal , humoral and cellular and intermolecular type. The role of IL-4 in antigenic competition is being reported for the first time .

Measurement of serum lipids and lipoproteins in children as a risk index for cardio vascular diseases in adulthood

Akeel A. AL-Kafagi

Al-Qadisiah Medical Journal, Volume 9, Issue 1, Pages 165-172

Many diseases and metabolic abnormalities are take place as result of increase lipids and lipoprotein in the blood. Cardiovascular events are the most common disease in this regard.
The aim of this study is to determine the level of cholesterol, triglycerides, high density lipoprotein cholesterol and low density lipoprotein cholesterol in children as a risk index for cardiovascular diseases in adulthood. To achieve this aim , the study was evaluate the effect of weight, family history and health status for children on the level of the lipids and lipoproteins.
The result revealed significant increase in the level of lipids and lipoproteins (cholesterol and triglycerides) in the over weight children when compared with normal kids.
While no clear effects were observed in the scale of lipids and lipoprotein values with regard to the family history and the health status issues.
The outcome indicate that increase in the concentration of cholesterol and triglycerides in the over weight children are the main directing consideration for the cardio vascular diseases in the adult. Further more the follow up ,the screening for the intensity of lipids and lipoproteins and the early therapy for hyperlipidemia will certainly decrease the incidence of future cardiovascular disease.

Epidemiological variation in acute appendicitis regarding incidences and causes

Hussein Taher Abbas AL-Baaj

Al-Qadisiah Medical Journal, Volume 9, Issue 1, Pages 173-179

Discussion
Our study show difference in incidence of disease in that it is common in males above 25 year and below 12 years about more than 70% of cases are males while equal incidence between males and females between 12 -25 years paradoxical to international study. Also show the fibrosis of previous attacks is the commonest causes of obstructed type in age above 30 years and fecolith is second to it which is the commonest cause of obstructive appendicitis in the international study. Recurrent appendicitis form about 27% of causes so it is good practice to operate in all cases of acute appendicitis whatever it is mild to prevent more sever attack of recurrence due to obstruction induce by fibrosis.

Conclusion
27% of cases are recurrent and the commonest cause of obstruction is old fibrosis and the disease is more common in males in age after 30 years and before 12 years.
10% of cases complicated by perforation mainly in children.
This study in epidemiology and causes of acute appendicitis in our city ( aldywania) to show the difference in the incidence and causes and complications of the disease in comparison with international study.
Material and methodies: prospective study collect 140 cases of approved appendicitis randomly during two years .
Results:
64 cases are between 13- 25 years and half of them are males while the incidence of males in above 25 years 38 of total 55 cases.
36 cases of obstruction are cause by fibrosis while 32 cases are cause by fecolith.
14 cases are perforated.

Paraumbilical hernial repair by mesh plug under local anesthesia

Fadel Habeeb Taher

Al-Qadisiah Medical Journal, Volume 9, Issue 1, Pages 180-188

Back ground and objectives : The standard method of repair of paraumbilical hernia is by the mayo's technique,using a double-breasted flap of the rectus sheath.
The present study describes and evaluates the application of a prolen mesh plug in the paraumbilical repair.The use of a mesh plug in hernial repair is not a new concept with previous investigators yielding consistently excellent results in the repair of femoral and inguinal hernia.
Patients and Methods: The study is prospective analysis of 36 patients having undergone PUH repair using the mesh plug technique in the period April 2004-April 2007. The study was conducted in Al-yarmouk teaching hospital .There were 16 males and 20 females with a median age of 50 years.
( range 30-80 years). Seventy percentage of the patient sample was obese (median BMI 30). whenever possible local anesthesia was used. Principal outcome measures were post –operative complications, recurrences,length of stay in hospital, analgesia, drain, return to normal activities and patient satisfaction.
Results: post operative complications encountered included one case of seroma and a single case of wound infection.
Ninety eight persent [35 ] of patients were satisfied with procedure.
Conclusion : Mesh plug repair can be performed with minimal post operative pain , minimal postoperative complications ,low recurrence rate and achieving excellent patient satisfaction.
Prosthetic mesh plug repair under local anesthesia could become the standard treatment for PUH in adults.

TIMP1, and TIMP2 Immunohistochemical staining along with different histopathological parameters of colorectal adenocarcinoma

Ibrahim Abdul Majeed Mustafa; Khalid Tariq Al-Naib; Luay E. Al-Khuri

Al-Qadisiah Medical Journal, Volume 9, Issue 1, Pages 189-201

Cancer 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. Matrix metalloproteases (MMPs) are a group of proteolytic enzymes that degrade components of the extracellular matrix and are implicated in tissue remodeling and tumor infiltration, while Tissue inhibitor of metalloproteinases (TIMPs) inhibit activity of the MMP family and preserve stromal integrity, as a consequence, inhibiting tumor migration. More importantly, the recently documented paradoxical functions of TIMPs have not been characterized in these neoplasms.
The aims of the current study were to determine whether TIMP-1 and TIMP-2 has any histopathological significance during colorectal adenocarcinoma progression.
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 immunohistochemical staining, it was found that there were a significant increase in the cellular expression of TIMP-1, and TIMP-2 in all of the 35 tumor samples compared to their respective resection margins (p<0.001, and p<0.001 respectively). Keeping in mind this up regulation of TIMP-1, and TIMP-2, was transient and reflect a host responses to the remodeling stimuli to balance the local tissue degradation process. moreover, when these 35 paraffin embedded sections were broken down according to their various histopathplogical variables, both TIMP-1, and TIMP-2, appear to negatively correlated with tumor histopathplogical variables, still only TIMP-2 revealed a significant negative correlation with both tumor stage and lymph node involvement (rs = -0.463, p<0.01; and rs = -0.482, p<0.01, respectively).
In conclusion, TIMP-2 are seem to be more interesting clinical tool compared to (TIMP-1) in CRC, since, it was found to have the play maker role during Duke’s stage progression, and L.N involvement, thus they could be used as targets for therapeutic management of patients with primary colorectal adenocarcinoma.

Pattern of congenital heart disease in newborn in Al-Diwaniyah maternity and children teaching hospital

Abbas Muhammed Hussain; Adel Jabbar Hussain; Qahtan Kayon Hmood

Al-Qadisiah Medical Journal, Volume 9, Issue 1, Pages 202-211

Background:CHD in the newborn is a problematic disease that need thorough investigation and may need urgent intervention.
Objective:To review the pattern of CHD in newborns in Al-Diwaniyah city and to establish the relationship between CHD and certain parameters like sex,and consanguinity
Patients and Methods: The study started at 1st of June 2008 till the 1st of January 2010 ,all newborn babies with suspected CHD were included in this study and undergo thorough history with specific attention on prenatal ,natal and postnatal history also questionnaire including sex ,full term or preterm delivery ,any previously affected sibling with CHD, the degree of consanguinity between the parents ,order of the patient in his family , then perfect general and cardiovascular system examination were performed to detect any other congenital or evidence of chromosomal abnormalities .Sixty seven neonates were enrolled in this study (7 of them were excluded because of prematurity)and 60 neonate were evaluated by chest X-ray, electrocardiograph, and echocardiography which done by expert pediatric cardiologist.
Results :In this study we found that acyanotic CHD is more common than cyanotic type with VSD is accounting about 35% of cases followed by PDA 26.6% and then ASD 8.3% and TOF 8.3% ,also the study show that asymptomatic murmur is the commonest presentations of CHD in the newborn and consanguinity may be a risk factor.
Conclusion: Early detection of CHD is very important for proper management so proper clinical examination and expert echocardiography is considered a gold standard for the diagnosis of CHD .Two dimensions echocardiography is also essential for the diagnosis special cardiac center should be established in our region (AL-Diwaniah)in order to manage the patient effectively without delay that may affect the out- come of the disease

The effect of some factors (age group of mother, new borne gender year months) on the congenital malformation percent of new borns in Al-Zahra Hospital for obstatric and pediatric / Najaf goverement

Noor Ismeal Nasser; Rokaya Ali Salman; Mohammed abdl Razaq; Abdul hadi Sallal Mohammed

Al-Qadisiah Medical Journal, Volume 9, Issue 1, Pages 212-224

The study was conducted on specimen (402) of new born congital malformations during years (2009,2010,2011) in al-Zahra hospital of obstatric / Al-Najaf , for determine the relation-ship among (age group of mother ,new borne gender, and year months ) with malformation percent.
The present study was revealed that the age group (22-26) year which more percentage of malformation , was (%38) in year 2009.
(%31.6) in year 2010 , and (%29.4) in year 2011.
The total of congenital malformations of new borns for three )years 2009, 2010, 2011) were (105 ,117, 180) case at respectively.
The high percent (%19)of malformations appeared during year 2009 was congenital hydrocephalus, in the period year 2010, the high percent of malformation (%27) was Microcephallus, while the cardiovascular malformation were high percent in year 2011, that reached to (%40.5).
The effect of new borne gender on the malformations percent was biostatical significant for year 2011 in the males (%59.5) when compared with female (%40.5), while in year 2010 the percent in female (%57.5).
The high malformation percent (%10.2, %13.8) were appeared in the March and April in year 2010 and 2011. while the high percent of malformation (%14.2) was in year 2009 during December period.

Risk of splenic injuryassociated with fracture of 9th, 10thand 11thribsin blunt trauma

Fadhil Ghadhban Alsaaedi; Ali Nayyef Assi; AlaaJamel Hassan

Al-Qadisiah Medical Journal, Volume 9, Issue 1, Pages 225-231

Spleen is the intra abdominal organ most frequently injured in blunt trauma ,suspension of splenic injury should be raised in any patient with blunt trauma to the abdomen and lower left side of chest(blow,fall,or sport related injury.{3}This study was done in the emergency department (ED)in ALHussein teaching hospital (AL-Nassiria)during 2 years( between 15thmarch2007 to 14thfeberory 2009) 96patients [ 62malesand34females].Patients present as a trauma to the abdomen and/or lower chest. 74 of those patients have rupture spleen with fracture of left lower ribs proved by chest x-ray,abdominal US and C.T scan.
To evaluate percentage of splenic injury associated with fracture of left lower ribs we did such study.
About 54%of those patient get splenic injury associated with fracture of 3 lower ribs and 24% of patient get splenic injury associated with fracture of 9th&10thribs and about 11% associated with single rib fracture especially10th rib and about 11% have no splenicinjury although they have fracture ribs.Patient with fracture of lower 3 ribs have high risk of splenic injury about double risk from those who have 2lower rib fracture .and triple to those who have single rib fractureespecially 10th rib which regarded most effective rib in splenic injury ,and about 11% 0f patients have no association splenic injury even some of them with 3 ribs fracture.

Fetal congenital abnormalities, types & their relationshipwith age, prtity and recurrent abortions

Basima Shamkhi Al- Ghazali

Al-Qadisiah Medical Journal, Volume 9, Issue 1, Pages 232-239

Objective : To study fetal congenital abnormalities, types and their relationship with age , parity and number of abortions .
Design : Prospective study .
Setting :Alzahraa maternity teaching hospital in Al-Najaf city .
Patient : 100mothers delivered normal babies &100 mothers delivered congenitally abnormal babies .
Result : No significant relationship between fetal congenital abnormalities with age
and parity but there is a significant relationship between fetal congenital abnormalities and abortion especiallyrecurrent abortions. Conclusion : We find that there a significant relationship between fetal
congenital abnormalities and abortion especially recurrent abortion and for that we
adviseevery women with history of abortion for early prenatal screening and
diagnostictests.

Genotyping and antifungal susceptibility profile of Candida albicans isolated from neonatal thrush infections in Iraq

Haydar Mahmood Ali Samaka; Adnan Hamad Al-Hamadani; Ali Muhsen Al-Muhana

Al-Qadisiah Medical Journal, Volume 9, Issue 1, Pages 240-249

Thrush was an important problem in Neonatal Intensive Care Units (NICUs) in all the world and also in our hospitals. So, this study come to focused on genotyping and antifungal susceptibility to the 22 isolates of Candida albicans obtained from thrush babies in (NICU) in Al-Zahra educational Hospital, an-Najaf governorate, Iraq.
From February to August 2010, 33 cases of thrush were tested. A total of 25(75.75%) Candida isolates were obtained, only 22(66.6%) isolates were identified as Candida albicans and the others 3(9%) isolates were identified as Candida other than albicans.
The genotyping of the transposable intron region of C. albicans strains showed that 21(95.45%) isolates belonged to the genotype A and 1 (4.54%) isolates belonged to the genotype B. Antifungal sensitivity test show no resistant to Amphotericin-B, while 3(13.63%) isolates showed cross resistant to fluconazole, itraconazole and ketoconazole, while one(4.54%) isolates showed cross resistant to fluconazole and ketoconazole.

Determination of Hepatitis C Viral Load and Genotypes by Real-Time and RT-PCR at Thi_Qar Province

Yahya A. Abbas; Adnan H. Aubaid; Bushra J. Hamad

Al-Qadisiah Medical Journal, Volume 9, Issue 1, Pages 250-264

The present study was carried out from Sept. 2010 to Jul. 2011 to detect the viral load and genotypes of HCV infections among asymptomatic peoples and patients referred to the central blood bank, center of thalassemia /AL-Haboby Hospital, renal dialysis unit/Al-Hussein Teaching Hospital and public health laboratory at Thi-Qar province.
Real-Time Polymerase Chain Reaction Technique (RT-qPCR) was implemented on 90 individuals of anti-HCV seropositive by ELISA III assay. The results revealed that 51(56.66%) were gave positive results for HCV. The RT-qPCR analyses of the positive samples were showed that the viral loads were ranged from 1.19 × 103 to 4.3 × 106 IU/ml of blood .The mean of viral load was 5.9 × 105 IU/ml of blood, whilst, the median was 2.6 × 105 IU/ml. Three genotypes of HCV were detected in patients serum by RT-PCR technique. Genotype 1a (33.33%), genotype 1b (37.25%) and genotype 4 (86.27%) with significant differences (p>0.05). Genotype 4 was the predominant and found in 44 of 51 cases, of those 21(41.18%) as single infections. Mixed infections with genotype 4 and each of 1a and 1b was found in 21.57% and 11.76% respectively. Mixed infections with genotype 4 and both 1a and 1b was found in 11.76%. Single infections with genotype 1b only was found in 13.73%, while genotype 1a was detected only in mixed infections. This study was the first at Thi-Qar province which involved the searching for HCV viral load and genotypes by using of Real-Time and RT-PCR technique.